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Cropped view of teenage driver taking car keys from father. Focus on key.

This week’s topics include international obesity, a lack of benefit to self-monitoring glucose, driving and ADHD, and antibiotic use in the hospital and adverse events.

Program notes:
0:50 Lack of benefit relative to glucose self-monitoring
1:55 No difference in hemoglobin A1c
2:52 Glucose test strips expense
3:34 ADHD and driving
4:35 Over 2400 with ADHD
5:35 On medication?
6:30 Antibiotic use while in the hospital
7:30 20% of antibiotics not indicated
8:08 Obesity worldwide
9:08 Childhood obesity often increasing faster
10:37 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/06/23/adhd-and-driving/
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Anchor lead: Children comprise a disturbing percentage of gun-related deaths, Elizabeth Tracey reports

Children younger than 18 years of age account for thousands of gun-related injuries and deaths yearly, the CDC has reported. Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, reviews the findings.

Klag: This is very disturbing data, so this is data from the CDC looking at data in the US from 2012 to 2014, indicating that on average, 5790 children received medical treatment in an emergency room for a gun-related injury. And about 21% are unintentional. If you look at the number of children dying an incredibly sad statistic. That from 2012 to 2014 1297 children died annually from a gun-related injury.  :30

Klag says empowering primary care physicians to ask about guns in the home is an important part of stemming the tide of this tragedy, as well as public health education efforts regarding gun and ammunition storage to keep firearms away from children at all times. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Fewer teenagers are smoking and vaping, Elizabeth Tracey reports

There’s been a big decline in the number of US teenagers smoking cigarettes and vaping, the latest CDC data show. Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, applauds public health workers who’ve helped.

Klag: It’s a great public health success story. US teens are smoking less, they’re vaping less. So this was data from the CDC 2016. What they found is that e-cigarette use among middle and high school students fell from 3 million students in 2015 to just under 2.2 in 2016. About 11% of high school students used e-cigarettes in the last 30 days in 2016, down from 16% in 2015.  :26

Klag says one factor that has discouraged teens from picking up the habit of smoking or vaping is cost, with the average national annual cost of smoking traditional cigarettes at about $2600, and of vaping about $1500. Other strategies known to be effective include prohibitions on smoking or vaping on or around school grounds and other public places. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: For people who have trouble speaking, an electrical current delivered through the skull may help, Elizabeth Tracey reports

Primary progressive aphasia, or PPA, is medicalese for a condition where people have trouble speaking or naming things, but don’t have Alzheimer’s disease or another common cause. Kyrana Tsapkini, a PPA researcher at Johns Hopkins, is using an ancient technique to try to help.

Tsapkini: Transcranium direct current stimulation. We now have the biggest cohort of patients in the country who are being treated with TDCS. Mostly 50% of this current goes through the skull to the brain area underneath.   :15

Tsapkini says it’s not really known exactly why external electrical stimulation through the skull may help.

Tsapkini: What is new is it started with stroke rehabilitation. If electricity helps, what does it do? We want to make the neurons to fire faster. :10

The technique may also help brain cells communicate better with each other. Tsapkini says most people describe the intervention as a kind of buzzing on their scalp and do not report it as painful, but she says those who may be tempted to try using such a strategy themselves to improve memory really shouldn’t, since the consequences of stimulation aren’t known. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: People who have trouble communicating may have a condition called primary progressive aphasia, or PPA, and there is a therapy that may help, Elizabeth Tracey reports

When someone has trouble talking, it may have a number of causes, one of which is called primary progressive aphasia, or PPA. Kyrana Tsapkini, an PPA researcher at Johns Hopkins, says brain scans show specific findings.

Kyrana Tsapkini: The areas of brain atrophy go together with the manifestation of it, and the deficit they have. For example, those who have more posterior atrophy, parietal lobe, they cannot put the syllables together.  :15

Tsapkini is using an approach combining electrical stimulation and training to see if such an intervention can help.

Tsapkini: There are two things you are looking at in rehab programs. One is how long results are sustained, so we start with before after, then two weeks, then at two months. And the second is how much do they generalize?   :13

Tsapkini says the electrical stimulation, known as transcranial direct current stimulation, has been is use for decades in an attempt to improve things like memory, so she is optimistic about using it in people with primary progressive aphasia. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can prescribing food help people with diabetes? Elizabeth Tracey reports

If you were prescribed healthy foods and brought to a pharmacy that provided them along with recipes and preparation methods, would that help you follow doctor’s orders? Yes, a study of people with type 2 diabetes found, concluding that such a strategy also improves blood markers for the disease. Rita Kalyani, a diabetes expert at Johns Hopkins, comments.

Kalyani: The fundamental idea that prescribing fresh food that otherwise can be prohibitively costly , fresh foods are often more expensive than the processed foods, that if we can make these more accessible to patients they would actually enjoy eating them, they’d reap the benefits from a health perspective, and it could improve the economic cost incurred by diabetes.  :22

Kalyani: If you can prevent the complications from diabetes and do it in a way that is healthy for the patient with behaviors that are sustainable, we know that one of the greatest economic costs from diabetes are from the complications.  :14

The study found that each 1 point reduction in hemoglobin A1c, the standard way of monitoring long term blood sugar in diabetes, saved the healthcare system thousands of dollars. At Johns Hopkins, I’m Elizabeth Tracey.

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Program notes:

0:17 I have noticed that people are overwhelmed

1:12 54% of physicians feel a sign of burnout

2:12 They feel isolated from colleagues

3:10 Technology will help solve some but not all

4:04 All task forces have members from all hospitals

5:01 Give them support and tools

5:36 End

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