tag:blogger.com,1999:blog-60448176111652688392024-03-12T23:04:28.574-04:00Jane on HealthScience and research driven commentary on timely topics.Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comBlogger95125tag:blogger.com,1999:blog-6044817611165268839.post-36555287223836786802024-03-08T12:51:00.003-05:002024-03-08T12:51:29.064-05:00What women want...information and no commercials<p>By listening to women and working with a fabulous group of experts we found that Latinas and their health care providers want information on how to be as healthy as possible that <b>(1) does <u>not</u> have any commercial interest driving the message and (2) inspires and reinforces healthy behaviors.</b> As a result we developed a three day seminar that includes the different systems in our bodies and how they interact, risk factors you can control, seeking well-being, importance of reading food and product labels, and much more. Over <b>640</b> <b>community health workers and community leaders</b> have completed the three day seminar. </p><p>We also recognize the limited time many of us have so we distilled the information to a <b>two hour webinar that is self-paced</b>. We released it today to celebrate International Women's Day. It is available in <b>English</b> <a href="https://www.healthyamericasfund.org/mi-hermana">Link</a> and <b>Spanish</b> <a href="https://www.buenasaludparatodos.org/mi-hermana">Link</a>.</p><p>Let me know what you think.<br /></p><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-37363422306384406282024-02-03T22:02:00.007-05:002024-02-03T22:10:49.788-05:00Harmful Health Outcomes (HHO)— Are All About You<p><span style="font-family: arial;"><span style="caret-color: rgb(33, 33, 33);">To have world class science and the best health outcomes means moving forward in bold ways that will improve the lives of scientists, health care providers, and people. </span></span></p><p><span style="font-family: arial;"><span style="caret-color: rgb(33, 33, 33);">For more details read "To advance science we need to address 'otherness' " in Nature Human Behaviour published on 2/2/24. You</span><span style="caret-color: rgb(33, 33, 33); color: #212121;"> can access the free online version <a href="https://rdcu.be/dxCUc" target="_blank">here</a> </span>or for <span style="caret-color: rgb(33, 33, 33); color: #212121;">a free ePrint please click on this <a href="https://eorder.sheridan.com/3_0/app/orders/14216/article.php" target="_blank">link</a>.</span></span></p>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-34583252861843740012024-01-18T17:06:00.000-05:002024-01-18T17:06:44.431-05:00Dear Patient---I Only Have Some of Your Health Record.<p><span style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial, sans-serif; font-size: 11pt; line-height: 1.2;">Most patients believe that once they grant permission that a health care provider has access to their full health history. In fact, what is shared is limited in many ways. Jack Lewin and I had our Commentary on Interoperability and the need for the full patient record published in <a href="https://www.statnews.com/2024/01/18/health-care-data-interoperability-hhs-rule-cures-act" target="_blank">StatNews.</a></span><span style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Calibri, sans-serif; font-size: 11pt; line-height: 1.2;"> </span></p><p><span style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Calibri, sans-serif; font-size: 11pt; line-height: 1.2;">Some medical records are very lengthy and go back decades. Is all that information really necessary? It depends on the situation. </span><span style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Calibri, sans-serif; font-size: 11pt;">One reader from Norway shared their story.</span></p><p><span style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial, sans-serif; font-size: 11pt; line-height: 1.2;"></span></p><p><span style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Calibri, sans-serif; font-size: 11pt; line-height: 1.2;"><span style="font-family: Arial; font-size: 16px;"><i>"This is interesting, since I recently witnessed how lack of available medical records may change a planned surgical procedure just minutes before an operation.</i></span></span></p><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;"><i>Norway has less inhabitants than Manhattan, but the principle of making medical records available to all medical health providers, is universal. Over here, Southern Norway has a system whereby all MDs and all hospitals may access any patient medical record, - if (note!) the patient has been treated in southern Norway. If a patient has had an operation in Northern Norway, a health provider in Southern Norway will not learn about this, unless the patient mentions it. And the same goes the other way around, - south vs. north. To my surprise this system has remained for the last 10 years, without health authorities doing anything about it.</i></div><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;"><i><br /></i></div><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;"><i>On December 4 I was going to have a hernia operation in Bergen, - on the southwest coast of Norway. The hospital has a section specializing in hernia repair with 3 surgeons performing only this kind of operation. They have extensive experience with laparoscopy (lap), and as I met my surgeon on the morning of the operation, she told me that the lap method was their standard procedure, unless the patients' condition dictated otherwise. I then told her that I had been operated for intestinal loop (blockage) back in 1970 in Bodø (Northern Norway), and she was surprised. She had not read anything about that in my medical record, and I showed her the remaining sutures. That made her change her mind regarding her planned way of repairing my hernia just minutes before the operation as the 1970 operation had actually accessed both the stomach lining and cut a muscle. So she decided to make an open repair."</i></div><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;"><i><br /></i></div><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;">What do you think about the need for access to the full patient record? If AI is seen as the solution how can we expect AI to guide clinical decision making if the data on the patient are at best incomplete. </div><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;"><br /></div><div style="caret-color: rgb(33, 33, 33); color: #212121; font-family: Arial; font-size: 16px;">We have a long way to go...and we need to get there soon.</div>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-9592416484797238942023-10-30T17:04:00.000-04:002023-10-30T17:05:33.796-04:00View "Real or Synthetic" and Share the Wait2Click Challenge <p><span style="font-family: arial;">Over the past year The Healthy Americas Foundation worked with The Carter Center and the creators of the comic strip "Baldo" to develop "Real or Synthetic?" These materials explain how information people receive is meant to engage them quickly. These resources are available in <a href="https://www.healthyamericasfund.org/wait2click" target="_blank">English</a> and <a href="https://www.buenasaludparatodos.org/wait2click" target="_blank">Spanish</a>. </span></p><p><span style="font-family: arial;">The challenge is </span><u style="font-family: arial;">not</u><span style="font-family: arial;"> to click, especially when something quickly grabs your attention. Here are specific cues to look for. </span></p><div><span style="font-family: arial;"><b>1. When you have a strong and immediate emotional response to the content or an image.</b> False information often relies on strong emotional appeals, to get people to believe it and share it. A story or claiming vista is often specifically designed to make you angry, scared, or overly excited. Moreover, it is increasingly easy to create images that are not real and increasingly <u>difficult</u> to detect when they are not real. </span></div><div><span style="font-family: arial;"><b>2. The sender asks for personal information or money. </b>They may not ask the first time they contact you, but do so after a series of interactions when they have earned your confidence. </span></div><div><span style="font-family: arial;"><b>3. The sender claims to have been referred by someone you know. </b>Contact the person, preferably by phone, and check.</span></div><div><span style="font-family: arial;"><b>4. Promises a quick solution to a problem.</b></span></div><div><span style="font-family: arial;"><b>5. If it sounds too good to be true, it usually is not true. </b>There are many fact-checking websites and organizations that verify the accuracy of claims and news stories. Websites like <a href="https://Snopes.com" target="_blank">Snopes.com</a>, <a href="https://FactCheck.org" target="_blank">FactCheck.org</a>, and <a href="https://Politifact.com" target="_blank">Politifact.com</a> can help you determine if a piece of information is true. For Spanish go to <a href="https://factchequeado.com" target="_blank">https://factchequeado.com</a></span></div><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;">Most important of all invest 30 minutes of time and watch the <u>free</u> webinar <a href="http://wait2click.org" target="_blank">wait2click.org</a><br /></span><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><br /></div><br /></div><br /><br /><br /></div><br /><p></p></div>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-39018137605313346592022-02-05T14:56:00.003-05:002022-02-07T15:08:20.741-05:00New England Journal of Medicine and my article, "Beyond Diversity— Time for New Models of Health." It is all about leadership.<p></p><div class="separator" style="clear: both; text-align: left;"><br /></div>Although I had collected data for my dissertation in the US, Colombia, and Brazil, my committee told me not to use the word culture as culture was not a relevant variable. That was over 40 years ago. Fast forward to the summer of 2021 when I submitted an article to JAMA. One of the comments in the rejection was, "The section on cultural themes does not make sense."<div><br /></div><div>It was not the first time I heard that comment so I submitted my article to New England Journal of Medicine (NEJM). The thoughtful editors had specific questions and very helpful, insightful suggestions. They accepted my article for publication and here is the link to the online version, <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2115149?query=WB&cid=NEJM+Weekend+Briefing%2C+February+5%2C+2022+DM690600_NEJM_Non_Subscriber&bid=807758671" target="_blank">"Beyond Diversity— Time for New Models of Health."</a> The print version is in the New England Journal of Medicine, Volume 386:6, February 10, 2022, Pgs 503-505.</div><div><br /></div><div>But this is not about my article, it is about how an institution and its leadership leads. NEJM is an example of leading through words and actions. The closing sentence of NEJM's October 7, 2021 editorial <a href="https://www.nejm.org/doi/full/10.1056/NEJMe2114651">"Striving for Diversity in Research Studies" </a>clearly stated, "From this perspective, diversity in research isn't simply a matter of social justice. It's a critical part of learning how to improve the health of every person." NEJM's actions were to outline new requirements for future submissions for publication that included a supplementary table on the representativeness of study participants. Words and actions. </div><div><br /></div><div>I am hopeful that my article will be widely read and stimulate healthy discussions. Consultant driven solutions, e.g., an organizational theory of change, setting up DEI committees, or appointing a Chief Diversity Officer, may create activities but are rarely the solution for meaningful outcomes.</div><div><br /></div><div>Change happens through leadership and that starts with each one of us.</div><div><br /></div><div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><br /><p></p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><br /></div><br /><div style="text-align: left;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><br /><p></p></div>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-55027845438873421102020-12-16T17:08:00.001-05:002020-12-16T17:08:55.815-05:00More on Sadness, Depression, and COVID<p><span style="font-family: arial;"> Just want to share my two recent articles on depression that were published in The Hill.</span></p><p><a href="https://thehill.com/changing-america/opinion/528613-how-to-understand-depression-during-the-covid-19-pandemic-and-what" target="_blank"><span style="font-family: arial;">Sadness is not Depression</span></a></p><p><span style="font-family: arial;"><a href="https://thehill.com/changing-america/opinion/530550-covid-19-and-holidays-how-to-overcome-stress-during-an-already" target="_blank">Holidays and Stress</a></span></p><p><br /></p>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-18857690870887838872020-08-01T00:53:00.004-04:002020-08-01T00:53:48.490-04:00COVID-19 Vaccine Trials Need to Be Based on Good ScienceIt is 2020 and we still have to remind the health care decision makers that data need to be collected, analyzed, and reported by race, ethnicity, and gender. The reason behind this push to have meaningful inclusion of diverse population is that it is good science; and, to <u>not</u> do so may have dangerous consequences. This is especially true for clinical trials as they are meant to provide information that is useful about <u>anyone</u> who will use it or take it. Here is our OpEd piece on COVID-19 vaccine clinical trials that appeared in <a href="https://thehill.com/opinion/healthcare/510052-how-to-prevent-racial-and-ethnic-disparities-with-a-covid-19-vaccine" target="_blank">The Hill</a>.Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-57842883816558503392020-08-01T00:31:00.007-04:002020-08-01T00:33:27.576-04:00Buena Salud® Guide on Understanding Depression and Enjoying Life<div><div>As COVID-19 began to change our way of life I knew that this would be a hard time for most people and that many people would need support. I wrote the first edition in 2011 and because of how the science has advanced and how our expectations have changed what started as an update ended up being 90% new plus 92 endnotes. </div><div><br /></div><div>Life has changed and what is needed is a combination of science, clinical insights, and the lessons learned from many others. There is much that we can do on our own to make our lives better and when we cannot do it alone...there are many options for treatment.</div><div><br /></div><div>The book is available at Amazon and at your local bookstores. </div><div>Here is the link for <a href="https://smile.amazon.com/Buena-Salud%C2%AE-Understanding-Depression-Enjoying/dp/0997995424/ref=sr_1_5?dchild=1&keywords=delgado+depression&qid=1596255793&s=books&sr=1-5" target="_blank">English </a>edition and for the <a href="https://smile.amazon.com/Salud%C2%AE-Entender-Depresi%C3%B3n-Disfrutar-Spanish/dp/0997995440/ref=sr_1_3?dchild=1&keywords=delgado+depression&qid=1596255719&sr=8-3" target="_blank">Spanish</a> edition</div></div>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-26383140163848260632020-07-08T16:45:00.001-04:002020-07-08T17:40:30.570-04:00COVID-19 Requires Hospital to Rethink The Patient Experience<div class="MsoNormal" style="font-family: Calibri, sans-serif; font-size: 12pt; margin: 0in 0in 0.0001pt;">
<span style="font-family: "arial" , sans-serif; font-size: 12pt;">Keeping patients and health care workers safe is more than cleaning surfaces and having people tested for COVID-19 four days before they come from a procedure. It also means thinking about exposure, viral load, and ventilation. The time a patient spends in a hospital or health care facilities must be minimized for the health of the patient and all those who work in a health care setting. Procedures need to be recalibrated in real time to take into account the changing realities of COVID-19. </span><span style="font-family: "arial" , sans-serif; font-size: 12pt;">It is <u>not</u> about having to wait; it is about the extra time spent possibly being exposed or exposing others.</span></div>
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<span style="font-family: "arial" , sans-serif;">For example, it is unconscionable that Georgetown University Hospital asks patients to check-in 2 hours <u>before</u> they are taken in to start the prep-op for a procedure. Good management practices would find it unacceptable that the process should take 2 hours. In the case that I witnessed the process actually took less than 20 minutes but the patient had to be there 2 hours before and then ended up waiting an additional hour because the other procedures were delayed. Of course there is paperwork that needs to be done, but much of that can be, and is often accomplished by phone or online.<o:p></o:p></span></div>
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<span style="font-family: "arial" , sans-serif;">I contacted the hospital by email about my concerns. The “Patient Advocate” responded in a way that made clear that they were an advocate for the hospital. I eventually called Dr. Michael Sachtleben, President, </span><span style="background: white; font-family: "arial" , sans-serif;">MedStar Georgetown University Hospital and Dr. Lisa Boyle, Vice President of Medical Affairs kindly returned the call. I emphasized that especially now, u</span><span style="font-family: "arial" , sans-serif;">nder the current circumstances, 2 hours should be unacceptable to all. </span><span style="background: white; font-family: "arial" , sans-serif;">For certain</span><span style="font-family: "arial" , sans-serif;"> what is required is timely action and not the process of a committee to agree that 2 hours is too long. The goal must be to reduce time spent in the hospital as much as possible. </span><span style="font-family: "arial" , sans-serif; font-size: 12pt;">No excuses. </span><span style="font-family: "arial" , sans-serif;">Following pre-COVID-19 standard operating procedures is dangerous to some and fatal to others.</span></div>
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<span style="background: white; font-family: "arial" , sans-serif;">I will see if there is any change as I will be taking my patient back for a repeat procedure. </span></div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-29350289042445655262020-02-06T10:28:00.002-05:002020-02-06T14:35:30.313-05:00The Evidence on Vitamin D is Clear<div style="font-family: "Times New Roman", serif; margin-left: 0in; margin-right: 0in;">
<span style="background-color: white; font-family: "arial" , sans-serif;">In August 2018 I wrote my first blog on Vitamin D and wondered how long it would take for clinical practice to change. Much more has been documented since then to move prescribers to rethink and change what they recommend.<o:p></o:p></span></div>
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<span style="background-color: white; font-family: "arial" , sans-serif;">On August 27, 2019 JAMA published an original investigation, <a href="https://jamanetwork.com/journals/jama/fullarticle/2748796">“</a><a href="https://jamanetwork.com/journals/jama/fullarticle/2748796">Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial.” </a>The September 3, 2019 NEJM Journal Watch comments on the study were succinct, <a href="https://www.jwatch.org/na49798/2019/09/03/vitamin-d-supplementation-more-better?query=topic_bone&jwd=000101483533&jspc=">“</a><a href="https://www.jwatch.org/na49798/2019/09/03/vitamin-d-supplementation-more-better?query=topic_bone&jwd=000101483533&jspc=">In any case, the findings point to no benefit for bone integrity — and even potential harm — with high-dose vitamin D supplementation in patients whose vitamin D levels are adequate.” </a><o:p></o:p></span></div>
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<span style="background-color: white;"><span style="font-family: "arial" , sans-serif;">Even with critically ill patients the benefits were not evident. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1911124">The December 26, 2019 NEJM original article “</a></span><span style="font-family: "arial" , sans-serif;"><a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1911124">Early High-Dose Vitamin D<span style="position: relative; top: 6pt;">3 </span>for Critically Ill, Vitamin D–Deficient Patients” from The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network</a> concluded “Early administration of high-dose enteral vitamin D<span style="position: relative; top: 3pt;">3 </span>did not provide an advantage over placebo with respect to 90-day mortality or other, nonfatal outcomes among critically ill, vitamin D–deficient patients."</span></span></div>
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<span style="background-color: white; font-family: "arial" , sans-serif;">When it comes to recommending Vitamin D the willingness to change current prescribing behavior is still missing</span><span style="background-color: white; font-family: "otnejmscalasanslf" , serif; font-size: 10pt;">. </span><span style="background-color: white;"><span style="font-family: "arial" , sans-serif;">The lag between the bench and clinical practice is not just a matter of communication; prescribers also have to be willing to change.</span><span style="font-family: "otnejmscalasanslf" , serif; font-size: 10pt;"> </span></span><o:p></o:p></div>
Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-91461476680424648542019-03-27T14:34:00.001-04:002019-03-27T14:37:17.076-04:00High-fructose Corn Syrup (HFCS) and YouWhile the March 22, 2019 report in<a href="http://science.sciencemag.org/content/363/6433/1345"> Science, "High-fructose corn syrup enhances intestinal tumor growth in mice,"</a> may need to be confirmed with humans, it is reasonable to expect that a similar effect will be found with people. At the very least each one of us who shops for food or beverages for ourselves and others should carefully read the ingredients that are listed on the label. And then what? When the product has HFCS...be proactive with your health and and the health of those you love and get something else.Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-61063400872387211992019-01-17T12:51:00.002-05:002019-01-17T12:57:00.174-05:00Saving Money in Health Care A good way to redirect the discussion on health care costs and savings is by reading our piece on<a href="https://www.statnews.com/2019/01/17/diversity-clinical-trials-good-science-better-medicine/"> clinical trials</a>. We need to make sure that each person gets the medicines that we know will work for them. This is how to save lives and save money in our health care system.Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-52314038540665642002018-08-21T18:07:00.000-04:002018-08-22T07:43:17.749-04:00Redo Recommendations Now: Vitamin D, Fake Data, and Hype<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">We all need Vitamin D, a hormone, but the challenge is in how to measure levels of Vitamin D, how to determine how much a person needs, and when necessary how to supplement it. Over the years it was difficult for me to reconcile how practically everyone I knew had a Vitamin D deficiency. Since we are not all part of one cohort and we are certainly a group that is diverse in many ways it seemed very odd that we all had the same deficiency.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">An answer came in two recent articles. First and most concerning was the August 17, 2018 issue of <a href="http://science.sciencemag.org/content/361/6403/636"><i>Science</i> article,"Tide of Lies— The researcher at the center of an epic scientific fraud remains an enigma to the scientists who exposed him."</a></span><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="http://science.sciencemag.org/content/361/6403/636">(DOI: 10.1126/science.361.6403.636).</a> This analysis detailed that much of what we know about Vitamin D was based on Dr. Sato's fabricated studies. According to the article his work was "referenced more than 1,000 times, and 23 systematic reviews or meta-analyses have included one or more of the 12 trials." Second, on August 18, 2018 <span style="background-color: white; color: #333333;">A Kaiser Health News investigation for The New York Times, </span><a href="https://www.nytimes.com/2018/08/18/business/vitamin-d-michael-holick.html">"Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It,"</a> revealed the effect of one person on an entire field of practice.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">Both are disturbing commentary on the state of our knowledge...and our sense of responsibility to one another. How fast will clinical practice change to take this fake data and hype into account? How long will it take to change the Recommendations for Vitamin D Supplementation, the Algorithms in medical decision making and AI, and all the other information that we give and have been giving. Given this evidence how do we answer the question, "Do I stop taking my Vitamin D?"</span>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-13026059989427696532018-08-03T17:37:00.002-04:002018-08-05T12:25:25.824-04:00How Can We Do Better...<span style="font-family: "arial" , sans-serif;">This has been a year of field research that evidenced that too often efforts to create a better situation ends up compromising a person's health and well-being. Here are three cases to consider.</span><br />
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<span style="font-family: "arial" , sans-serif;"><i>Frank entered the hospital with pneumonia but upon returning home it seemed that while in the hospital he had contracted an infection of his foot. Several weeks later the infection was much worse and Frank was taken back to the hospital to determine how much of his leg would have to be amputated. There were no plans for rehab. </i></span></div>
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<span style="font-family: "arial" , sans-serif;">In 2011 75,000 patients with HAIs died during their <a href="https://www.cdc.gov/hai/surveillance/index.html">hospitalizations.</a></span></div>
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<span style="font-family: "arial" , sans-serif;"><i>After Rosa’s stroke she was told that in order to prevent another stroke she needed to have the blockage in her artery cleared, i.e., carotid endarterectomy (CEA). Rosa knew the risks of the procedure but went through with it. Much to her disappointment, a few months later the blockage had reappeared. One year later she still has the blockage but no stroke.</i></span><span style="font-family: , serif;"><o:p></o:p></span></div>
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<span style="font-family: "arial" , sans-serif;">Translational research is a step in the right direction but the continued lag from the bench <a href="https://www.sciencedaily.com/releases/2017/03/170324144541.htm">(research)</a> to the bedside (clinical practice) is unacceptable. At the same time evidence based medicine (EBM) continues to be undermined by the lack of inclusion and analysis by individual characteristics as well as the tendency of clinicians and insurers to apply a rigid set of procedures that are not nuanced to the person in front of you.</span></div>
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<span style="font-family: "arial" , sans-serif;"><i>Agnes was having difficulty breathing and was taken to the hospital. Her initial diagnosis was pneumonia and a UTI; then, suddenly while at the hospital she had two heart attacks. Her family was told that (1) her heart had stopped working and was severely damaged, (2) there were no treatments available, and (3) diagnostic procedures that were invasive were not possible given her age and fragility. Agnes' family was also told that she would die that night in the ICU. Agnes's family decided that given the damage to her heart that "palliative or comfort" care was the best option for her. Somehow Agnes got through the night and after two more nights in the ICU Agnes was moved to a private room. The family was told she could not go home because the levels of oxygen given were higher than allowed in a home setting.</i></span></div>
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<span style="font-family: "arial" , sans-serif;"><a href="https://www.nhpco.org/press-room/press-releases/what-comfort-care">Comfort care</a> what does that mean? How do we know?</span></div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-32631538623417972082017-06-27T11:54:00.000-04:002017-06-27T11:54:18.513-04:00<div>
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<strong><span style="font-family: Arial; font-size: 10pt;">Statement on CBO Estimates of Better Care Reconciliation Act</span></strong><span style="font-family: Arial; font-size: 10pt;"><o:p></o:p></span></div>
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<em><span style="font-family: Arial; font-size: 10pt;">22 million people losing health insurance is unconscionable</span></em><span style="font-family: Arial; font-size: 10pt;"><o:p></o:p></span></div>
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<span style="font-family: Arial; font-size: 10pt;">“The CBO estimate of 22 million people losing health insurance should be a bill stopper. This bill was supposed to increase the number of people who have health insurance. As it stands the legislation is unconscionable,” said Jane L. Delgado, PhD, MS, President and CEO of the National Alliance for Hispanic Health, the nation’s leading Hispanic health advocacy group.<o:p></o:p></span></div>
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<span style="font-family: Arial; font-size: 10pt;">“It’s time for legislators to go back to the drafting table. The American people deserve bipartisan legislation that will deliver on the promise of insurance for everybody. Congress must (1) ensure access for people with pre-existing conditions instead of enacting barriers to access that may be a death sentence; (2) roll back Medicaid cuts and allow for rates of growth that reflect the reality of an aging population; (3) ensure an orderly transition that does not disrupt care and ensures states can respond to changes in a way that reduces cost growth without compromising quality and access; and, (4) strengthen and expand the network of community health centers that have a proven capacity to deliver quality services,” emphasized Dr. Delgado.<o:p></o:p></span></div>
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<span style="font-family: Arial; font-size: 10pt;">“The one thing that everybody agrees on is that our system is not perfect, so it is time to start working in a bipartisan fashion and serve the interests of the nation. The American people deserve better,” concluded Dr. Delgado.<o:p></o:p></span></div>
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<strong><span style="font-family: Arial; font-size: 10pt;">About the National Alliance for Hispanic Health (The Alliance) </span></strong><span style="font-family: Arial; font-size: 10pt;"><br />The Alliance is the nation's foremost science-based source of information and trusted advocate for the best health outcomes for all. For more information, visit: <a href="http://healthyamericas.org/" style="color: purple;">http://www.healthyamericas.org</a> or call the Alliance's Su Familia National Hispanic Family Health Helpline at 1-866-783-2645.</span></div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-73646952412837185862017-06-22T10:14:00.000-04:002017-06-22T10:21:44.263-04:00<div class="MsoNormal" style="margin: 0in 0in 0.0001pt;">
<span style="font-family: "calibri" , sans-serif;"><b><span style="font-size: 11pt;">The New No Gimmick Diet— </span></b></span><br />
<span style="font-family: "calibri" , sans-serif;"><b><span style="font-size: 11pt;">The </span><span style="font-size: 14.666666984558105px;"><i>Buena</i></span><span style="font-size: 11pt;"><i> Salud</i>® Guide to Losing </span><span style="font-size: 14.666666984558105px;">Weight</span><span style="font-size: 11pt;"> and Keeping It Off</span></b></span></div>
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<span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;">I am thrilled by the review and recommendation by Redbook for the latest book in the <span style="font-size: 14.666666984558105px;"><i>Buena</i></span><span style="font-size: 11pt;"><i> Salud</i>®</span> Series. You can </span><span style="font-size: 14.666666984558105px;">order</span><span style="font-size: 11pt;"> the book from Amazon in </span></span><span style="font-family: "calibri" , sans-serif; font-size: small;"><o:p></o:p></span><b style="font-family: Calibri, sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><a href="https://www.amazon.com/dp/0997995416/ref=sr_1_4?ie=UTF8&qid=1498011789&sr=8-4&keywords=Jane+Delgado" target="_blank">English</a> or</span></b><span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><a href="https://www.amazon.com/dp/0997995408/ref=sr_1_5?ie=UTF8&qid=1498011789&sr=8-5&keywords=Jane+Delgado" style="font-weight: bold;" target="_blank"> Spanish</a> or through your local bookstore<b>. </b>Let me know what you think. The process of writing and living the book has been quite a journey.</span></span><br />
<span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><br /></span></span><span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;">The other books in the </span></span><i style="font-size: 11pt;">Buena Salud</i><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;"> series include:</span></span></span></span><br />
<span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;"><b><span style="font-size: 11pt;">The </span><span style="font-size: 14.666666984558105px;"><i>Buena</i></span><span style="font-size: 11pt;"><i> Salud</i>® Guide for a Healthy Heart</span></b></span></span></span></span><br />
<span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;"><b><span style="font-size: 11pt;">The </span><span style="font-size: 14.666666984558105px;"><i>Buena</i></span><span style="font-size: 11pt;"><i> Salud</i>® Guide to Diabetes and Your Life</span></b></span></span></span></span><br />
<span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;"><b><span style="font-size: 11pt;">The </span><span style="font-size: 14.666666984558105px;"><i>Buena</i></span><span style="font-size: 11pt;"><i> Salud</i>® Guide to Arthritis & Your Life</span></b></span></span></span></span><br />
<span style="font-family: "calibri" , sans-serif; font-size: 16px;"><span style="font-size: 11pt;"><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 11pt;"><b><span style="font-size: 11pt;">The </span><span style="font-size: 14.666666984558105px;"><i>Buena</i></span><span style="font-size: 11pt;"><i> Salud</i>® Guide to Overcoming Depression and Enjoying </span></b></span></span></span></span><span style="font-family: "calibri" , sans-serif;"><span style="font-size: 14.666666984558105px;"><b>Life</b></span></span></div>
Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-28401952877617117722017-05-13T08:13:00.000-04:002017-05-13T08:13:35.829-04:00<span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;"><b>Considering Arthroscopic Surgery for Your Degenerative Knee Disease?</b></span><br />
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<span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;">According to the most recent </span><a href="https://doi.org/10.1136/bmj.j1982" style="font-family: interfaceregular, 'Helvetica Neue', Helvetica, Arial, sans-serif;" target="_blank">recommendations</a><span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;"> published in BMJ i</span><span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;">t seems that your answer should be,"No."</span><span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;"> The exceptions are </span><span style="background-color: white; font-family: Arial, Helvetica, sans-serif;">young patients with sports-related injuries, patients with major trauma, and those with a true locked knee. </span><span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;">This is a huge concern as according to the article 25% of people</span><span style="color: #333333; font-family: interfaceregular, 'Helvetica Neue', Helvetica, Arial, sans-serif;"> 50+ years old have degenerative knee disease. </span><br />
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<span style="color: #333333; font-family: interfaceregular, 'Helvetica Neue', Helvetica, Arial, sans-serif;">While a health care provider may be an expert on this </span><span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;">procedure and may have been doing it for years...the time has come to rethink when to do it or have it done. The evidence is that in most cases a</span><span style="color: #333333; font-family: interfaceregular, 'Helvetica Neue', Helvetica, Arial, sans-serif;">rthroscopic surgery for degenerative knee disease</span><span style="color: #333333; font-family: interfaceregular, Helvetica Neue, Helvetica, Arial, sans-serif;"> does not produce the desired outcome.</span><br />
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<span style="color: #333333; font-family: interfaceregular, 'Helvetica Neue', Helvetica, Arial, sans-serif;">There will be more research to come...in the meantime the challenge is to develop new interventions which are truly helpful. </span>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-5376964773417713562017-02-17T13:48:00.000-05:002017-02-17T13:48:45.862-05:00<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><b>Back Pain</b><o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The data indicate that most people with back pain that lasts less than 12 weeks get better regardless of the treatment. Some people get better even without treatment. Taking all this into consideration as well as all the available evidence, the American College of Physicians recently published new guidelines for the treatment of
back pain. This was the first revision since 2007 and what is recommended is a
departure from past practice. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">There are surprises in the new guidelines, e.g., for acute back pain the recommendations include superficial heat, massage, and acupuncture. There are also very specific guidelines as to the medicines a person should take. Take a look at the </span><a href="http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice" style="font-family: Arial, Helvetica, sans-serif;" target="_blank">recommendations</a><span style="font-family: Arial, Helvetica, sans-serif;"> and share them with a friend. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The science behind wellness is growing. T</span><span style="font-family: Arial, Helvetica, sans-serif;">o make the best decisions for our health and the health of those we care for, w</span><span style="font-family: Arial, Helvetica, sans-serif;">e each need to know the
latest science based information. </span></div>
Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-77986813936288174412016-08-15T15:35:00.000-04:002016-08-15T15:36:00.521-04:00Another Limit of the Electronic Health Record<div class="MsoNormal">
<span style="font-family: "arial"; font-size: 14.0pt;">Do most
people take the time to review their medical record? Of course not. In my case,
what was supposed to be a tool to improve care missed the mark. <o:p></o:p></span></div>
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<span style="font-family: "arial"; font-size: 14.0pt;">For 35
years I had the same internist. As he changed practices I went with him. Whether
he was a preferred provider or not it was reassuring to know that he had my
whole health history at his fingertips. He could flip through the decades of my
health history and see the changes in my life. It was wonderful to feel the
security inherent in the vision of continuity of care. <o:p></o:p></span></div>
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<span style="font-family: "arial"; font-size: 14.0pt;">All that
came to an abrupt stop when this past year my internist retired. I was all
prepared to find a new internist when I realized it would be helpful to have a
copy of my medical record. Imagine my surprise when I discovered that 31 years
of my medical history were gone.<span style="mso-spacerun: yes;"> </span>What
had happened? <o:p></o:p></span></div>
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<span style="font-family: "arial"; font-size: 14.0pt;">It seems that
when my internist changed his practice to being part of MedStar my paper
records did not go with him. MedStar was on an electronic system and the health
record they had was only for the last four years he had been with them.<span style="mso-spacerun: yes;"> </span>All previous paper records were not with
MedStar. When I asked what happened to 31 years of my health record the MedStar
person referred me to my internist’s former practice. <o:p></o:p></span></div>
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<span style="font-family: "arial"; font-size: 14.0pt;">It seemed
that while Medstar was willing to take the patients that came with the
physician the paper health records of the patient were not welcome. <o:p></o:p></span></div>
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<span style="font-family: "arial"; font-size: 14.0pt;">The
situation became more problematic as I reviewed my electronic record. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>There
were diagnoses for conditions I never had and prescriptions that were never
given. <o:p></o:p></span></div>
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<span style="font-family: "arial"; font-size: 14.0pt;">My
suggestion to everyone?<span style="mso-spacerun: yes;"> </span>Carefully review
your medical record and keep a copy of it for yourself. The life you end up
saving may be your own. <o:p></o:p></span></div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-91862727493639696202016-04-18T12:01:00.000-04:002016-04-18T12:01:50.428-04:00Rethinking Clinical Trials <div style="font-family: Arial, sans-serif; font-size: 13px;">
Here is the link to my article that appeared today in <i>El Mundo's </i>(translation below) supplement on innovation and technology (Innovadores). El Mundo is one of the most prestigious newspapers in Spain. </div>
<div style="font-family: Arial, sans-serif; font-size: 13px;">
<a href="http://www.elmundo.es/economia/2016/04/15/5710e1aa468aebbb748b4624.html" target="_blank">http://www.elmundo.es/economia/2016/04/15/5710e1aa468aebbb748b4624.html</a> </div>
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Much has been said about the major discoveries that will change our lives. These range from treatments for cancer to those that change the course of the increasing number of rare and new diseases. Developing cures or treatments aligns with the business goal of developing a product or intervention that will improve lives and generate revenue for the innovator company. </div>
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<br />Given all the products that are in the discovery pipeline it is clear that companies want to develop new products that improve or enhance lives. And of course the product must be priced so that it is affordable; without sales there are no revenues. Unfortunately, too often in the discussion of the need to develop new treatments the arguments about price are at best myopic. One way to manage prices is to decrease the cost of drug development that according to industry estimates is about $1.2 to $1.3 billion. Advances in different fields like engineering, information technology, and telecommunications need to be applied to drug development.<br /><br />Other opportunities lie in building new methodologies for clinical trials so that we know more precisely the characteristics of people who will benefit from the treatments that are in development. What we know is that the bulk of trials are based on models of drug and treatment development that ignore that health is very individualized.<br /><br />There is much upbeat talk about the promise of precision medicine or personalized medicine but it will remain just talk as long as the clinical trials that underlie the development process continue to be structured in a way that is neither precise nor personalized. The innovator working with regulatory agencies has to rethink these critical aspects of development.<br /><br />The use of animal studies has long been an essential part of basic research. Yet even in these often seminal efforts there have been huge omissions that effect everything from validity to reliability. Reardon [1]pointed out that, “In 2014, the NIH [United States National Institutes of Health] began requiring researchers to include female animals in studies, and giving out supplementary grants to those who complained about the cost." The omission of female animals was not good science.<br /><br />Likewise factors that also effect outcomes in animal studies are what the animal has been fed and its living conditions. Research indicates that variations in these conditions change the health and longevity of the animals, which impacts on the outcomes and the ability to replicate the research. Although leading experts indicate that animal studies are becoming less relevant we still often extrapolate from animals to humans.<br /><br />When it comes to studies of people our failures to develop targeted treatments and interventions are compromised even further. To develop precision or personalized medicine clinical trials must at a minimum include and analyze information using race, ethnicity, and gender. These are characteristics that are essential to understanding the success or failure of treatments. The process will be enhanced as information about the individual’s genetic and microbiome become more available.<br /><br />The solution is not to spend more money on larger clinical trials but to use the advances in all of the sciences and design trials that are better defined, that are inclusive, and carefully monitored. This will make it possible to develop medicines and treatments that meet the health needs of the individual, the revenue goals of the innovators, and most importantly, continue to support future discoveries to benefit us all.<br /><br />[1] Reardon, S. "A mouse's house may ruin studies— Environmental factors lie behind many irreproducible rodent experiments." Nature. February 18, 2016 vol. 530 Pg. 254</div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-13318312074126565602016-01-07T17:05:00.004-05:002016-01-07T17:05:55.080-05:00Sugar and the 2015-2020 Dietary Guidelines<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none;">
<span style="color: #262626; font-family: Arial; font-size: 14.0pt;">We are all too
familiar with sugar as a driver for diabetes and excess weight. Yang et al<a href="https://www.blogger.com/blogger.g?blogID=6044817611165268839#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: #262626; font-family: Arial; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Cambria; mso-fareast-language: EN-US;">[1]</span></span><!--[endif]--></span></span></a>
</span><span style="font-family: Arial; font-size: 14pt;"><span style="font-weight: bold;"> </span>piled on even more
data to raise our concerns about sugar when their research found that people
who had more sugar in their diet were more likely to die sooner from
cardiovascular disease.</span><span style="font-family: Arial; font-size: 14.0pt;"> <o:p></o:p></span></div>
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<span style="font-family: Arial; font-size: 14.0pt;">So today when I listened to the </span><span style="font-family: Arial; font-size: 14.0pt; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">Dietary Guidelines Stakeholders Briefing convened
by USDA and DHHS I was very interested in the recommendations on sugar. I knew that
in March 2015 the World Health Organization released a<span style="color: #262626;"> new <a href="http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/" target="_blank">guideline</a> that recommended
adults and children reduce their daily intake of free sugars to less than 10%
of their total energy intake and that a further reduction to below 5% or
roughly 25 grams (6 teaspoons) per day would provide additional health
benefits. <span style="mso-spacerun: yes;"> </span></span></span><span style="color: #262626; font-family: Arial; font-size: 14pt;">I wanted
to understand the rationale on deciding on the U.S. guideline of 10% instead of 5%. </span></div>
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<span style="font-family: Arial; font-size: 14pt;">I was glad to be part of this briefing and
liked the transparency of of being </span><span style="color: #262626; font-family: Arial; font-size: 14pt;">encouraged to type in our questions. As I typed
in my question I could see the questions that others had asked and was looking
forward to the answers about soy, caffeine, etc. When the moment for Q & A’s
came up I was shocked that none of the questions that were posted were asked. I
typed my question in again just in case someone had missed it…and still no
response. I sent an email to <a href="mailto:ASHMedia@hhs.gov">ASHMedia@hhs.gov</a>
and am still waiting for a response. A simple answer would be informative. But I guess it is all related to why the 2015-2020 Dietary
Guidelines were not released until 2016.</span></div>
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<a href="https://www.blogger.com/blogger.g?blogID=6044817611165268839#_ftnref1" name="_ftn1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: Cambria; font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: Cambria; mso-fareast-language: EN-US;">[1]</span></span><!--[endif]--></span></span></a> <span style="font-family: Arial; font-size: 14.0pt; mso-bidi-font-weight: bold;">Yang, Q.,
Zhang, Z., Gregg, E.W., Flanders, W., Merritt, R., Hu, F.B. “Added Sugar Intake
and Cardiovascular Diseases Mortality Among US Adults,” <i>JAMA Internal
Medicine. </i>2014;174(4) </span><span style="font-family: Arial; font-size: 14.0pt;">Pgs. <span style="mso-bidi-font-weight: bold;">516-524.
doi:10.1001/jamainternmed.2013.13563.</span></span><o:p></o:p></div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-75800037206506226332015-12-29T16:20:00.002-05:002015-12-29T16:20:28.345-05:00Myths We Love<div class="MsoNormal">
Megan Scudellari’s, “Myths that will not die,” (Nature, Dec.
17, 2015 Vol. 528 pages 322-325) <a href="http://www.nature.com/news/the-science-myths-that-will-not-die-1.19022" target="_blank">http://www.nature.com/news/the-science-myths-that-will-not-die-1.19022</a> focused on five myths: (1) s<span style="text-indent: -0.25in;">creening saves lives for all types of cancer; (2) a</span><span style="text-indent: -0.25in;">ntioxidants are good and free radicals are bad; (3) h</span><span style="text-indent: -0.25in;">umans have exceptionally large brains; (4) i</span><span style="text-indent: -0.25in;">ndividuals learn best when taught in their preferred
learning style; and, (5) t</span><span style="text-indent: -0.25in;">he human population is growing exponentially.</span></div>
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Each statement had some initial evidence to support it but
over time more research challenged the initial outcomes. What was compelling as
I read the article was realizing that there were factors that seem to
perpetuate if not strengthen a myth. These factors include a vocal community of
supporters; the development of products, industries, and research lines to address or remedy the
situation; and, attempts to discredit new research. As a result, myths
like lies that are repeated, become accepted as truth. In the end the damage is
done to all of us because rather than moving forward with science we are in a
chokehold because of what others want us to believe.<o:p></o:p></div>
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As I look forward to 2016 and beyond, my hope is that as our knowledge grows we
will use information wisely and change what we know and espouse. "Trust, but verify," should apply to much of what we do in
health so that we can achieve the healthier
and longer lives we all want.</div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-14479933761803631872015-08-26T10:39:00.001-04:002015-08-26T10:41:35.538-04:00Me and Burgers <span style="font-family: Arial, Helvetica, sans-serif;">I love hamburgers but lately I only eat them at home. I do not want to seem like a wuss but it seemed to me that when I ate burgers outside my home my microbiome let me know that they were displeased with my selection. Some of the people I know thought that I was just being picky when I said that I preferred meat that did not have added antibiotics or hormones. Today's Washington Post made clear that my microbiome led me to a <a href="http://www.washingtonpost.com/you-just-cant-kill-the-bacteria-in-some-hamburger/2015/08/25/65ed433b-57d1-4833-b4c2-c090499b884d_story.html" target="_blank">healthier choice.</a></span>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-15602667844116396662015-08-09T22:05:00.002-04:002015-08-09T22:09:18.344-04:00Coca-Cola Funds Global Energy Balance Network<span style="font-family: Arial, Helvetica, sans-serif;">WHO is recommending limits in sugar intake because of the worldwide increase in people who have excess weight. Drinking one typical can of sugar sweetened beverage exceeds the limit. Nevertheless, it seems that Coca-Cola is interested in research that documents that excess weight is not due to bad diets but to not enough exercise <a href="http://nyti.ms/1KZUZ4e" target="_blank">http://nyti.ms/1KZUZ4e</a> They just funded the <span style="background-color: white;"><span style="line-height: 23px;">Global Energy Balance Network to lead this work. </span></span></span>Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.comtag:blogger.com,1999:blog-6044817611165268839.post-41707716640127968882015-05-07T13:28:00.001-04:002015-05-07T13:28:17.879-04:00How to Reach the Hispanic Community...<span style="font-family: Arial, Helvetica, sans-serif;">Here is the link to my article that appeared on May 6, 2015 in </span><span style="font-family: Arial, Helvetica, sans-serif;"><i>El Mundo</i>, Section on Business and Innovation, </span><span style="font-family: Arial, Helvetica, sans-serif;">Madrid, Spain. </span><span style="font-family: Arial, Helvetica, sans-serif;"><a href="http://www.elmundo.es/economia/2015/05/06/5549dfc8e2704ee34b8b4574.html" target="_blank">http://www.elmundo.es/economia/2015/05/06/5549dfc8e2704ee34b8b4574.html</a> . The</span><span style="font-family: Arial, Helvetica, sans-serif;"> translation is below.</span><span style="font-family: Arial, Helvetica, sans-serif;"> </span><div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><b>Reaching Everybody</b></span><div class="MsoNormal">
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<span style="font-family: Arial, Helvetica, sans-serif;">I was
having a conversation with the CEO of a major company about how to reach 57
million peple in the United States. When I mentioned that I was talking about reaching
the Hispanic consumer there was a pause and a palpable change in the
conversation. The enthusiastic CEO went into automatic mode accentuated by polite
comments that indicated interest and understanding. Then the entire project was
handed off to the person responsible for Diversity — a death knell for
meaningful work. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">The Chief
Diversity Officer is a C suite position without budget responsibilities that
lacks the clout that is necessary to execute. These positions are meant to
deflect challenges to the status quo rather than define the possibilities and
the opportunities in a growing market. With neither a place in the chain of
command nor the portfolio that could make the necessary investments it is a place
where ideas go to die. The Diversity person is there to make the company appear
like they are doing something to serve their diverse consumer base. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Just like EEO
Offices of decades past or the more recent renaming of similar offices as Minority,
Disparities, Equity, or some other politically palatable name of the moment these
offices do little more than develop plans and do training. Most companies take
a 20<sup>th</sup> century approach and establish an employee group that is made
up of the targeted community to advise them; hire outside expertise on the
targeted group; create an advisory group of stakeholders; create a diversity,
health equity, multicultural, or alliance development office; translate
existing documents, webpages, etc. to the target language; add pictures of the
target group; add food selections at corporate cafeterias that cover a variety
of countries; and, sponsor “Month of…” events. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">While these
may be well-intentioned the totality of activities make it obvious that what
has been accomplished is mostly veneer. Even worse they can be seen as a
defensive response devoid of the tools to create the type of meaningful inclusion
that produces financial results. This is bad for business and for our economy.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Reaching
Hispanics or any target group means reaching individuals with an image, work,
and product that resonates with who they are and what they want. It takes more
than a diversity office to do that…it takes leadership and the commitment by
every person in a company.<span style="mso-spacerun: yes;"> </span>That
leadership is hard to come by when Hispanics are one in six persons in the U.S.
but at Fortune 500 companies are less than 2% of the CEOs and less than 4% of
the Boards of Directors.<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">Trust and brand loyalty go
hand-on-hand and today each individual wants to know that a company knows who
they are and what they want. Too often I hear that Hispanics are too diverse
and because of that it is hard/incorrect/disrespectful to get a single message
that resonates with everyone. That type of strategy reveals a lack of
understanding of the American marketplace. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">With the rare exception of being in a
building that is on fire and yelling ”Fire,” it is unlikely that a single word can
reach everyone. The era of the single message went the way of having only a
handful of major networks. Each person wants and expects to be reached with a
message that is tailored to them; that is why Google has been so successful.
Google knows each of their users and craft messages for them. <o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">So when I am asked how do you reach
Hispanics? It’s the same strategy that you use for everybody—use language and
images that are meaningful to the individual, make clear that you understand
what they want and desire, and as a result earn trust and respect. You do
different things at different times. Reaching everybody is no longer a one shot
deal.</span><span style="font-family: Arial; font-size: 14pt;"><o:p></o:p></span></div>
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Jane L. Delgadohttp://www.blogger.com/profile/08011965176198794770noreply@blogger.com