CDC Study Reveals Adults May Not Get Enough Rest or Sleep

About 10 percent of adults report not getting enough rest or sleep every day in the past month, according to a new four-state study released by the Centers for Disease Control and Prevention′s (CDC) Morbidity and Mortality Weekly Report.
The data from the four states–Delaware, Hawaii, New York, and Rhode Island–may not reflect national trends. But an additional study conducted by CDC utilizing data from the National Health Interview Study indicated that across all age groups the percentage of adults who, on average, report sleeping six hours or less has increased from 1985 to 2006.
Nationwide, an estimated 50 to 70 million people suffer from chronic sleep loss and sleep disorders. Sleep loss is associated with health problems, including obesity, depression, and certain risk behaviors, including cigarette smoking, physical inactivity, and heavy drinking.
“It′s important to better understand how sleep impacts people′s overall health and the need to take steps to improve the sufficiency of their sleep,” said Lela R. McKnight-Eily, Ph.D., the study′s lead author and a behavioral scientist in CDC′s Division of Adult and Community Health. “There are very few studies to assess and address sleep insufficiencies; therefore, more needs to done to better understand the problem and to develop effective sleep interventions.”
The study, “Perceived Insufficient Rest or Sleep--Four States, 2006,” analyzed data from CDC′s Behavioral Risk Factor Surveillance System (BRFSS) survey. Among the four states, the percentage of adults who reported not getting enough rest or sleep every day in the past 30 days ranged from 14 percent in Delaware to 8 percent in Hawaii.
People concerned about chronic sleep loss should consult a physician for an assessment and possible treatment, such as behavioral or medical interventions, McKnight-Eily said. They can also try setting a regular sleep schedule and avoiding caffeine or other stimulants before bed, she said.
Variation for insufficient rest and sleep may be due to occupational or lifestyle factors. The causes of sleep loss could include busy schedules or shift work; irregular sleep schedules; or lifestyle factors such as heavy family demands, late–night television watching and Internet use, or the use of caffeine and alcohol, according to a 2006 Institute of Medicine report. The National Sleep Foundation reports that most adults need 7-9 hours of sleep each night to feel fully rested while school children aged 5-12 years require 9-11 hours, and adolescents aged 11-17 years require 8.5–9.5 hours each night.
The study also found that the prevalence of insufficient sleep decreased with age. An estimated 13.3 percent of adults aged 18-34 reported insufficient rest or sleep everyday in the past month compared to only 7.3 percent of adults ages 55 and older. While some studies have found sleep disturbance more prevalent among older adults, results from this study are consistent with other research that supports the idea that older adults (who are more likely to be retired) make fewer complaints regarding impaired sleep and adapt their perception of what encompasses sufficient sleep.
In addition, the study showed that only one out of three (29.6 percent) adults said they did get enough rest or sleep every day in the past month.
The MMWR report said the definitions of “enough” (sufficient) sleep and “rest,” and responses to the survey question were subjective and were not measured or equated to reports of hours of sleep per night. The report said the analysis cannot be compared directly with studies measuring hours of sleep. The survey question also did not define or distinguish between “rest” and “sleep.”

Few docs to care for kids with diabetes

More kids with diabetes, few specialized pediatricians to care for them U-M study finds for every 290 children with diabetes, there is only one board-certified pediatric endocrinologist available to care for them
Ann Arbor, Mich. - The rate of childhood obesity in the United States has more than doubled in the past 20 years, bringing with it more children at risk for developing type 1 and even type 2 diabetes.
Despite this growing trend, the number of board-certified pediatric endocrinologists - those physicians who specialize in caring for children with diabetes and obese children at risk for the disease - is not keeping pace with demand for their specialized care, say researchers at the University of Michigan C.S. Mott Children's Hospital.
Results from a new study published in the March issue of The Journal of Pediatrics show that at the national level, for every 290 children with diabetes, there is only one board-certified pediatric endocrinologist available to care for them. It also finds that the ratio of obese children to board-certified pediatric endocrinologists is about 17,000 to one.
"Although the American Diabetes Association recommends that all children with diabetes be cared for by a pediatric endocrinologist as part of a diabetes team, there is a current shortage of pediatric endocrinologists in this country," says study lead author Joyce Lee, M.D., MPH, a pediatric endocrinologist and member of the Child Health Evaluation and Research (CHEAR) Unit in the U-M Division of General Pediatrics. "This problem will likely only worsen due to the recent epidemic of childhood obesity."
Currently, 16.5 percent of American children ages 6 to 19 are obese. These children are at an increased risk for developing diseases previously thought to be limited to adults, including type 2 diabetes, high blood pressure and high cholesterol. As a result, more children than ever before are being referred to pediatric specialists, such as pediatric endocrinologists who can screen, evaluate and manage children at risk for developing diabetes.
"Even if just a small fraction of obese children are referred to a pediatric endocrinologist for evaluation, the overall ratio of one pediatric endocrinologist to 17,000 obese children makes providing the necessary care extremely challenging," says Lee, assistant professor in the Department of Pediatrics and Communicable Diseases at the U-M Medical School.
The bottom line: pediatric endocrinologists currently do not have the capabilities to see even a fraction of the large number of children with diabetes or at risk for diabetes. "The epidemic of childhood obesity has undoubtedly created new challenges for our health care, and we need to reassess the current system to ensure children with diabetes or at risk for diabetes receive appropriate care," Lee notes.
Using data from the American Board of Pediatrics and the National Survey of Children's Health, Lee and her colleagues compared the number of board certified pediatric endocrinologists by region to obese children and children with diabetes in those same areas.
Their research revealed that there are an estimated 229,249 children with diabetes, and only 790 board-certified pediatric endocrinologists in the country. And, in two states - Montana and Wyoming - there are no board-certified pediatric endocrinologists.
Further complicating matters, Lee and her colleagues found that the geographic distribution of children with diabetes and obesity does not match the geographic distribution of board-certified pediatric endocrinologists.
According to study results, the area with the greatest supply of pediatric endocrinologists was in the Northeast. In comparison, the Midwest fared the worst with regard to the supply of pediatric endocrinologists. The geographic disparity was even greater for ratios of children with obesity to board-certified pediatric endocrinologists by state, ranging from about 5,000 to one in Massachusetts to about 99,000 to one in Mississippi.
While the American Board of Pediatrics reports that the number of medical fellows entering the field of pediatric endocrinology since 1997 has increased annually by 12 percent - with about 76 pediatricians entering the field from 2005 to 2006 - Lee cautions that it is still not enough of an increase to meet growing demand for care.
"The increases in the endocrinology workforce are incremental. Ultimately, the pediatric endocrine workforce shortage raises the question of how health care delivery for U.S. children with diabetes and children at risk for diabetes should ideally be organized," says Lee.
She notes that a critical reassessment of the current system of health care delivery for obese children is needed, along with the creation of sustainable models of care to effectively improve health outcomes for obese children who are at risk for developing chronic diseases in childhood.

MMR and Autism: US court says there’s a link, and awards compensation

The MMR (measles, mumps, rubella) vaccine can cause autism, a US court has concluded.
In a secret ruling that has only just come to light, the US Court of Federal Claims has conceded that the mercury-based preservative thimerosal, which was in vaccines until 2002, caused autism in the case of one child.
The ruling is one of 4,900 cases currently being considered for compensation payments, and it is feared by health officials that it could open the floodgates for even more claims. It also appears to support the controversial findings of Dr Andrew Wakefield, who, in 1998, suggested a link between the vaccine and autism.
The ruling, made by US Assistant Attorney General Peter Keisler, was made last November, and was one of three test cases into the MMR-autism link that was being considered by a three-member panel, which Keisler chaired.
In his conclusion, Keisler said that “compensation is appropriate”.
The case involved a child who, when she was 18 months old, received nine vaccinations in July 2000, two of which included thimerosal. Within days, the girl, who had previously been healthy, suddenly exhibited no response to verbal direction, loss of language skills, no eye contact, insomnia, incessant screaming, and arching.
A diagnosis of autism was confirmed seven months later.
In its defense, the US government said the girl had a pre-existing mitochondrial disorder that was aggravated by the vaccine.

Tamiflu: Flu drug can kill, FDA warns
[LEFT]
Tamiflu, one of the front-line drugs against flu, can kill, a new warning from America’s drug regulator, the Food and Drug Administration (FDA), has revealed this week. [/LEFT]
[LEFT]The drug can cause hallucinations, delirium or abnormal behaviour which sometimes “results in fatal outcomes,” the FDA has said. [LEFT]These new reactions have been discovered by doctors who suspected the drug of being the cause, and so there’s no way of knowing how widespread the problem is. [LEFT]Tamiflu’s manufacturer, Roche, has this week written to every practitioner in the USA about the new reactions, and it has been instructed to change the warnings on the drug’s patient information sheet. [LEFT]The drug is also being used as a defense against avian flu, and governments around the world have bought billions of dollars worth of supplies to be used to protect key workers. [/LEFT]

HRT: Cancer risk continues three years after stopping drug

Women who take HRT (hormone replacement therapy) are more likely to develop breast cancer even three years after they have stopped treatment. Their risk is 27 per cent higher than it would be for a woman who hadn’t taken the drug, while overall cancer risk is 24 per cent greater.
These latest findings come from the Women’s Health Initiative study, which was stopped early after it discovered a cancer risk for women who were still taking the drug.

Pacemakers: Manufacturers sell devices they know are faulty
[LEFT]
Pacemakers are being fitted to patients even when the manufacturer knows they are faulty, and may even be fatal. [/LEFT]
[LEFT]A leading expert says manufacturers “repeatedly and knowingly” sell devices that are defective. Dr William Maisel, director of the Medical Device Safety Institute in Boston, USA, says that the three major manufacturers of pacemakers have all at some time continued to sell their products after they have discovered they were defective, and sometimes lethally so. [LEFT]His comments are made in the wake of the controversy surrounding the withdrawal of Medtronic’s Sprint Fidelis pacemaker, which had been approved in 2004 without a single human trial having taken place. [LEFT]Since then, 268,000 devices have been fitted, but it was withdrawn last autumn after the manufacturer announced that it could fracture. After finally carrying out an in-depth study, the manufacturer discovered the fracture had caused five deaths, and had fractured in 665 cases. [/LEFT]

[/FONT]
[FONT=Comic Sans MS]
Stroke: Outcome depends on nutrition – so stay out of hospital

[/FONT]
[FONT=Comic Sans MS]A stroke can be catastrophic or it can have minimal impact – and its severity has much to do with your own nutritional status. People who have a good diet are less likely to suffer badly from a stroke – which is why no stroke victim should spend too much time in his or her local hospital afterwards.
The food dished up at most hospitals is so dire that it can worsen the outcome, researchers have discovered.
They checked the nutritional status of 131 stroke victims on arrival at one hospital, and then again a week later, and discovered that 26 were under-nourished by the end of the week. As a result, the patients were nearly five times more likely to suffer complications following the stroke.

Pain in fibromyalgia is linked to changes in brain molecule
[LEFT]
Decreases in the amount of the neurotransmitter glutamate are linked to reductions in pain self-report in fibromyalgia patients [/LEFT]
[LEFT]ANN ARBOR, Mich. - Researchers at the University of Michigan Health System have found a key linkage between pain and a specific brain molecule, a discovery that lends new insight into fibromyalgia, an often-baffling chronic pain condition. [LEFT]In patients with fibromyalgia, researchers found, pain decreased when levels of the brain molecule called glutamate went down. The results of this study, which appears in the journal Arthritis and Rheumatism, could be useful to researchers looking for new drugs that treat fibromyalgia, the authors say. [LEFT]"If these findings are replicated, investigators performing clinical treatment trials in fibromyalgia could potentially use glutamate as a 'surrogate' marker of disease response," says lead author Richard E. Harris, Ph.D., research assistant professor in the Division of Rheumatology at the U-M Medical School's Department of Internal Medicine and a researcher at the U-M Chronic Pain and Fatigue Research Center. [LEFT]The molecule glutamate is a neurotransmitter, which means it conveys information between neurons in the nervous system. When glutamate is released from one neuron, it diffuses across the space between cells, and then binds to receptors on the next neuron in line and causes the cell to become excited, or to be more active. [LEFT]This molecule was suspected to play a role in fibromyalgia because previous studies had shown that some brain regions in fibromyalgia patients appear to be highly excited. One such region is the insula. [LEFT]In functional magnetic resonance imaging (fMRI) studies, researchers at U-M had previously shown that the insula displays augmented activity in fibromyalgia, which means neurons in these patients are more active in this part of the brain. The U-M team hypothesized, Harris notes, that more activity among these neurons might be related to the level of glutamate in this region. [LEFT]To gauge the linkage between pain and glutamate, the researchers used a non-invasive brain imaging techinique called proton magnetic resonance spectroscopy (H-MRS). H-MRS was performed once before and once following a four-week course of acupuncture or "sham" acupuncture. [LEFT]Researchers used either acupuncture or sham acupuncture to reduce pain symptoms. The sham procedure involved using a sharp device to prick the skin in order to mimic real acupuncture sensations. [LEFT]Following the four weeks of treatment, both clinical and experimental pain reported were reduced significantly. More importantly the reduction in both pain outcomes was linked with reductions in glutamate levels in the insula: patients with greater reductions in pain showed greater reductions in glutamate. This suggests that glutamate may play a role in this disease and that it could potentially be used as a biomarker of disease severity. [/LEFT]