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This week's topics include treating adolescent depression, self management of hypertension, transmissibility of MERS, and cardiovascular events around the world.
Program notes:
0:31 Self management of high blood pressure
1:30 Increase or decrease medications themselves
2:30 Estimated 20% of people eligible
3:07 Cardiovascular events around the world
4:07 High income countries more meds and interventions
5:08 MERS transmission
6:08 Looked for virus or antibodies
7:08 Low transmission rate but contact screening needed
7:26 Treating depression in adolescents
8:26 Offered CBT, medications, or both
9:26 Subsequent depression may be worse
10:40 End
Related blog:http://podblog.blogs.hopkinsmedicine.org/2014/08/29/teenagers-and-depression/
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Anchor lead:  A surprisingly large number of people are killed or injured while walking, Elizabeth Tracey reports

How many people are killed or injured in the United States each year as a result of an accident with a vehicle while they are pedestrians?  Keisha Pollack, an injury prevention expert at the Johns Hopkins Bloomberg School of Public Health,  who’s spearheading a pedestrian safety initiative, says the number, and the problem, are much bigger than most people realize.

Pollack:  It’s a huge problem so in 2010 there were about 4300 pedestrians who were killed in traffic crashes and about 70,000 were injured.  And when we think about what those numbers really mean we’re talking about a crash-related pedestrian death one every two hours, and a pedestrian injury about one every eight minutes, so we know this is a huge problem, and even for people who might get hit and don’t die there’s oftentimes long term disability or other consequences.   :27

Pollack says now that school is back in session in most of the country, everyone, whether walking, riding, or driving, needs to increase their vigilance by keeping music volume low, paying attention, and slowing down. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Now that school is in session, everyone needs to think about pedestrian safety, Elizabeth Tracey reports

Who’s at risk of being struck by a vehicle while walking?  Everyone, including people you might not think would be.  That’s according to Keisha Pollack, an injury prevention expert at the Johns Hopkins Bloomberg School of Public Health.

Pollack: Issues of pedestrian safety are huge for college students, we don’t think about that. Many schools don’t even allow first year students to have cars, so students have so much more exposure to walking.  We also have the issue of being distracted on both sides, both drivers and pedestrians.  There’s been a lot of literature about people just not paying attention, crossing the street on their smartphones, having iPods, listening to music, though all of this is a problem we know how to prevent it.  Here at the injury center we are promoting strategies around the three e’s, which is education, engineering changes, and enforcement.   :30

Pollack says the public needs to be made aware of the risks and public works folks need to change signage and create barriers. Finally, those who flout the law, whether on foot or in a vehicle, should be fined.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Getting health professionals involved on the ground floor of municipal projects can benefit all, Elizabeth Tracey reports

How can we maximize the health benefits of municipal projects while keeping an eye out for pitfalls and taking steps to avoid them?  That’s the intention of the Health Impact Project, a collaboration between the Robert Wood Johnson Foundation and Pew Charitable Trust. Keisha Pollack, an injury prevention expert at the Johns Hopkins Bloomberg School of Public Health, describes one initiative.

Pollack: We get to work with transportation for example and say, as you’re thinking of implementing a new bike share program, let’s think about all the ways you can really maximize the positive health benefits from this and minimize the negative ones, so let’s think about helmet use, let’s think about road design, let’s not just give people bikes but let’s think about ways to really make it safe for people to use bike share.  They’ve been doing this sort of work outside the US for a long time. It’s exciting to be part of the group here in the US really thinking about these issues.   :29

Pollack says getting everyone to collaborate on such projects makes tax dollars go further and work better for the benefit of everyone.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead:  Chikungunya virus has now been transmitted in the US, but a vaccine is under development, Elizabeth Tracey reports

The first cases of direct transmission of Chikungunya virus infection in the US have been reported, and that means our mosquitos are becoming infected.  The virus, originally from Africa, has been causing high fevers and muscle and joint pain, for several months in the Caribbean, which some describe as excruciating or disabling.  Michael Klag, dean of the Bloomberg School of Public Health at Johns Hopkins, describes what‘s known so far.

Klag: It’s now adapted to be transmitted by a second species of mosquito, it’s here in the US, and there’s a phase one study that’s just been reported in the Lancet, very small, 25 healthy volunteers, and they received this new vaccine which is small nanoparticles, which consist of proteins that are in the coat of the Chikungunga virus.  In the majority of people who were treated neutralizing antibodies were detected and they were longlasting.   :25

Klag says for now, avoiding mosquito bites is the best strategy.  At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: States with medical marijuana laws see fewer deaths related to opiate use, Elizabeth Tracey reports

When medical marijuana use laws are on the books, fewer people die as a result of prescription opioid overdose, a study by Colleen Barry, a health policy expert in the Johns Hopkins Bloomberg School of Public Health, and colleagues, has found.

Barry: We found that rates of prescription opioid overdose deaths had increased in all states over our study period, which was 1999 to 2010, however the yearly rate of opioid deaths in states with medical marijuana laws was about 25% lower on average than in states without these laws.  States with medical marijuana law had about 1700 fewer opiate painkiller overdose deaths in 2010 than we would have expected.   :31

Barry says this study provides an association only, and urges prospective study to understand the phenomenon better.  The study is published in JAMA Internal Medicine.  At Johns Hopkins, I’m Elizabeth Tracey.

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This week’s topics include a new drug for MDR TB, concussion in adolescent girls, cancer screening in the elderly, and smoking cessation after hospital discharge.

Program notes:

0:35 Cancer screening in the elderly
1:35 31 to 55% of high mortality risk still screened
2:35 Patient education time consumption
3:04 Smoking cessation after hospitalization
4:04 Six months of phone calls after discharge
5:02 In motivated patients
5:15 Concussion in adolescent girls
6:15 Symptoms could last seven to 15 days
7:15 Helmet use?
8:06 MDR TB and a new drug
9:07 Both clearing and cure improved
10:27 End

Related blog: http://podblog.blogs.hopkinsmedicine.org/2014/08/23/hey-girls-how-about-a-concussion/

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