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May 28, 2004 - It has come to this - a blog page... Blog is short for Web Log. Now that the Internet has become an almost indispensable part of our lives, many have started using it to keep an online journal of sorts. I started adding "Newsworthy Stuff" tidbits back near towards the end of 2000 on my What's New Page. I thought these tidbits would be more useful if they were compiled on one page. Therefore, all these tidbits will be compiled on this page after they've had their Net time on the most recent What's New Page, with the most recent entries at the beginning (so you don't have to scroll so much). Added links along the way will continue to be compiled on annual "What Was New" pages that you can access by clicking on year graphic. Thanks. Betty
Suggested Citation: Jung, B.C. (2007 - 2023). Betty C. Jung's 2007 Public Health Blog.
Web document: https://www.bettycjung.net/Blog2007.htm

December 29, 2007 Home Page Revamped Over the years, I have made some cosmetic changes to the home page, nothing drastic. I learned that sometimes change is not always a good thing. Early on, while I was teaching myself how to create Webpages, I read about developing a flashpage as the home page. Very spartan, nothing much, but just a few links. I tried that and traffic dropped tremendously because content rules. So, I went back to the 3-page maximum (you only need 2 clicks to reach what you want), and added a Site Index, along with a site search engine, and links to major sections of the Web site. This has worked pretty well. After some thought (and some free time), I decided to revamp the home page so that it will be shorter. I think I have accomplished that without compromising my basic intent or the content. Just in time for the new year! Enjoy...

December 27, 2007 An epidemiologist's dream comes true... One of the most exciting things epidemiologists do is to conduct trend analyses. Of course, this cannot be done without continuous reliable sources of data that allow for the possibility of comparisons over time. Compilations of such data make up the bulk of what epidemiologists do, aside from agreeing on standard definitions of a disease case.
Despite advances in computer technology (i.e., desktop statistical analysis and GIS mapping, etc.) population-based statistics still require years to compile, especially if they are for numerous diseases and large geographic locations. For example, national morbidity and mortality statistics still take two to three years to compile, although the Internet has reduced the time it takes to get these compilations to you via Internet postings, a smart strategy the CDC has adopted in recent years. The only problem is the cost of publishing has been transferred over to the end user. Even though we all want a paperless existence, this is not going to happen any time soon. I still find it virtually impossible to look at statistical tables on a computer screen, and I am sure many epidemiologists would agree.
For the first time, I believe that the divide between data compilation and dissemination may be eliminated with the advent of technologies the Internet can make the most of. Poodwaddle.com, a one-man operation, has managed to develop a series of clocks that can track a variety of data. I like his World Clock so much that it has become part of my home page. Check it out and view the statistics for a number of the most common noncommunicable and infectious diseases in the world, for the year, the month, the week or even the day. Frightening and fascinating at the same time, you will develop an appreciation of why Public Health is still the most important issue in our lives.

December 23, 2007 Cybersquatting continues... The domain name of bettycjung.com, which has no affiliation with my Web site, has been bought in October by still another cybersquatter. Here is the information:
Administrative Contact [344946]: hostmaster hostmaster hostmaster@domainparkltd.com Domain Park Limited Vaea Street Level 2, Lotemau Centre Apia Samoa 0815 WS Phone: +1.2676535381 Source: http://www.networksolutions.com/whois/results.jsp?domain=bettycjung.com Administrative Contact [749612]: hostmaster hostmaster hostmaster@domainparkltd.com Domain Park Limited Markgrafenstr. 56 Suite 131 Berlin n/a 10117 DE Phone: +1.2676535381 Domain servers in listed order: PNS1.TRELLIAN.COM 216.188.26.233 PNS2.TRELLIAN.COM 209.132.99.10 Record created on: 2007-10-09 08:00:23.0 Database last updated on: 2007-10-09 08:00:22.18 Domain Expires on: 2008-10-09 08:00:23.0 Registrant Search: "Domain Park Limited" owns about 71,746 other domains Email Search: is associated with about 74,396 domains Registrar History: 2 registrars with 1 drop. IP History: 14 changes on 9 unique name servers over 3 years. Whois History: 94 records have been archived since 2007-01-11. Reverse IP: 241,712 other sites hosted on this server. Source: http://whois.domaintools.com/roxylogo.com

Apparently, these companies still think they can make money from erroneous URL entries. Obviously, there is a lot of money to be made with these transactions. Avoid using them and put them out of business. Then again, it's good to see there is legal recourse in such matters:
Citizens Financial Group, Inc. v. Domain Park Limited Claim Number: FA0705000975307

December 21, 2007 Bioterrorism Readiness . Healthyamericans.org releases its 2007 edition of Ready or Not? Protecting the Public's Health From Diseases, Disasters and Bioterrorism . Well, is the U.S. ready? Depends. More states are showing that they are meeting an increased number of indicators, but those states that were ahead last year are not this year. What would that say? Not enough vigilance. Readiness is not a one-time thing. Being ready means being forever ready, which is a challenge. However, public reporting is probably spurring states to improve their preparedness for disaster, which is a good thing. You can find links to this year and last year's reports on my Evaluation/Report Cards Page .

December 12, 2007 Meat causes cancer . A recently released study implicates meat as the cause of certain types of cancers. Reuters reported
The work is the first big study to show a link between meat and lung cancer. It also shows that people who eat a lot of meat have a higher risk of liver and esophageal cancer and that men raise their risk of pancreatic cancer by eating red meat.
A decrease in the consumption of red and processed meat could reduce the incidence of cancer at multiple sites," Dr. Amanda Cross and colleagues at the U.S. National Cancer Institute wrote in their report, published in the Public Library of Science journal PLoS Medicine.
Red meat was defined as all types of beef, pork and lamb. Processed meat included bacon, red meat sausage, poultry sausage, luncheon meats, cold cuts, ham and most types of hot dogs including turkey dogs.
Meats can cause cancer by several routes, the researchers noted. "For example, they are both sources of saturated fat and iron, which have independently been associated with carcinogenesis," the researchers wrote.
Meat is also a source of several chemicals known to cause DNA mutations, including N-nitroso compounds (NOCs), heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs).
Source: http://health.yahoo.com/news/reuters/cancer_meat_dc.html
Original research article: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040325
You can also find a link to this article on my Nutrition Page , the section "Food and Chronic Diseases."

December 7, 2007 So many charities.... Yes, 'tis the season for being inundated by numerous charities to get generous. However, being a good steward does not mean just giving to silence the guilt-driven badgering that reaches a stratospheric pitch about now. They all do good deeds, but are you getting your money's worth of good deeds? To find out more about charities, check out Charity Navigator, a terrific site that helps you to decide which are the charities worthy of your hard earned money. You can find a link to this site on my Cool Sites , under the section: Money - Giving.

December 7, 2007 2008 is almost here Since I have a little time today, I decided to get this "What's New Page" ready for the new year! The 2007 Blog is ready. And, two new pages have been created: 2007 Family Christmas Newsletter , and Fitness Resources on the Net , which is a spinoff from the Consumer Health Information Page . Cheers!

December 5, 2007 Glycemic Index and Diabetes Two recent studies, "Prospective Study of Dietary Carbohydrates, Glycemic Index, Glycemic Load, and Incidence of Type 2 Diabetes Mellitus in Middle-aged Chinese Women" and "Glycemic Index, Glycemic Load, and Cereal Fiber Intake and Risk of Type 2 Diabetes in US Black Women" published in the Archives of Internal Medicine's November 26, 2007 issue provide evidence that my hunch about the usefulness of the glycemic index was on the mark. When I first looked into the glycemic index a couple of years ago, there was scientific evidence that carbohydrates were not all the same. Intake of foods that are carbohydrates differ in the way they affect blood sugar levels.
In a nutshell, the glycemic index assigns a value to carbohydrates (a source of energy; the other two are proteins and fats) on the basis of that food's ability to cause a rapid sugar dump, the higher the value, the more rapid the sugar dump (well, this is in layman's terms). The rapid rise in blood sugar caused by some carbohydrates (aka carbs) places a major burden on the pancreas to release insulin rapidly to metabolize the sugar. Those carbs that cause this rapid rise have a higher value on the glycemic index.
The constant demand of these rapid sugar dumps will eventually burn out the pancreas, which means Type 2 diabetes, when the pancreas can no longer secrete the insulin, thus, necessitating the need to receive insulin from an outside source to meet the demand to metabolize blood sugar. People who take oral drugs for diabetes basically have a failing pancreas. Once the pancreas goes, then they must take insulin.
I should mention that not everyone sees the value of the glycemic index for managing diabetes (avoiding those carbs that are high on the glycemic index scale). But with the release of these two studies, I am hoping that more people will seriously look at carbs a different way. We do need to eat carbs (that's the only source of energy the brain uses), but not all carbs are the same, some are just better for you than others.
Diabetes educators I have spoken to are pretty much split 50/50 on using the glycemic index for nutrition counseling, from total rave to total nay. I like it because there is a scientific basis to this useful tool. A very simple way to remember what's good and not good (glycemic index-wise) - eat very colorful fruits and vegetables (low on the glycemic index, except for carrots), and avoid white foods - rice, bread, potato, pasta (high on the glycemic index, in which white rice is the #1 offender).
If you want to eat these starches, go for the more colorful, whole grain versions. Check out the "Glycemic Index" section on my Diabetes Page for links to sites dealing with the glycemic index, one of which is a spreadsheet you can use to track your carb intake on the basis of how various foods add to the glycemic load that body must deal with. Salud!

November 29, 2007 Medicare Preventive Care Services Preventive care services are essential to living a healthy life. This is especially true for those who are 50 and older, and the benefits from receiving these services continue to increase as one gets older. The Centers for Medicare and Medicaid Services have provided a couple of really useful charts that shows what to expect with the Initial Preventive Physical Examination, once you start receiving Medicare benefits (at age 65), and the types of preventive services that older people should be getting, how frequently, etc. Of course, being a great advocate of preventive services, it would make more sense that those 65 and older get annual physicals than just one at the start of Medicare coverage. You can find links to these helpful charts on my Health Care Information on the Net Page , under the Medicare section.
A guide to Medicare Preventive Services for health professionals is also available from CMS. You can find a link to this guide on my Resources for Health Professionals Page .

November 28, 2007 Senior Health Literacy Do you know an older person who is having a hard time getting along with the Internet? Of course you do. It is a known fact that many seniors today do not have the wherewithal to deal with the Internet, which has evolved within the last 10-15 years into what is fast becoming THE medium for all forms of communication, from keeping in touch to doing business.
The Internet is insidiously replacing your local library as the source for information and resources, your local retailers for goods and services, your banker for banking, etc., etc. Using the Internet has become THE most important skill to navigate in the world today. Just look at what current job seekers must deal with in finding a job. Notice how the newpaper want ads have dwindled into nothing, especially when employers, watching the bottom line, are using the Internet to recruit new workers, as well as check out their references and profiles online.
Okay, back to seniors today. NIH has come out with a toolkit for trainers to help seniors find health information online. Finding health information, especially credible health information, is an important skill to have, not only for seniors, of which health is an important issue, but for everyone. I think it is so crucial that I have made finding credible health information a vital part of the university Wellness course I am currently teaching. My students must develop a fact sheet on a Wellness topic solely from researching Internet sources.
Health illiteracy is not just a problem with seniors, but with young people as well. Not everything on the Internet is credible, and there's nothing worse than making health decisions based on poor quality information, or disinformation. Knowing what's credible health information is a critical thinking skill that is not intuitive, but requires some direction, instruction and practice to truly be able to separate the chaff from the wheat. (See my August 1, 2007 Blog entry about credible health information. This is one of my favorite recurrent topic of interest on my blog).
While the toolkit is geared towards trainers, it is simple enough for anyone to use for instruction or self-instruction. It would make for a great refresher course for anyone who want to get the most out of their Internet experience. We all can learn to use the Internet more proficiently. People can use materials provided for spending quality time with their parents and older relatives. School age kids can do a shared activity with their grandparents, as they explore together what health information is available online. Lesson plans include:
For beginning students with little computer experience:
Module 1: Internet Basics
For beginning students with some Internet experience:
Module 2: Introduction to NIHSeniorHealth
Module 3: NIHSeniorHealth Quizzes and Videos
Module 4: NIHSeniorHealth FAQs and Site Index
For beginning and intermediate students:
Module 5: NIHSeniorHealth and Exercise for Older Adults
For intermediate students:
Module 6: Introduction to MedlinePlus
Module 7: MedlinePlus: Drugs and Supplements, Medical Encyclopedia
Module 8: MedlinePlus: News and Directories
For all students:
Module 9: Evaluating Health Websites
Glossary of Computer and Internet Terms for Older Adults
You can find a link to NIHSeniorHealth Toolkit for Trainers on my Senior Health Page .

November 26, 2007 Happy 6th Birthday, Public Health Jobs E-list! Yes, this newsletter has reached a milestone today. It has turned 6. Yes, 6 years, with 1,552 issues disseminated, to a listserv of 991 subscribers, on an almost daily basis. The free Yahoo!groups listserv has allowed me to get out this popular newsletter expeditiously, while saving me the hassles of managing a listserv.
Over the years, I have received positive comments from users, so it is a satisfying endeavor for me that jobseekers are finding it a useful source for jobs. I developed the newsletter because in the early days of PHENOM , most of my mentoring contacts were people looking for jobs. As I developed my Internet skills, I was able to find an efficient way to get job postings out to those interested, thus, a newsletter. If you are a jobseeker, you can subscribe for free on my Web site. For more information about about the listserv, check out http://health.groups.yahoo.com/group/Phjobs/

November 11, 2007 Trans-Siberian Orchestra at Mohegan Sun, Uncasville, CT A definite holiday concert for those who enjoy an energized rock-flavored twist to traditional Christmas music. The light show and pyrotechnics were out of this world. While everything they played was super, I still found "Wizards in Winter" to be one of my favorites. Don't miss them!

November 9, 2007 Fight hunger and get smart at the same time Freerice.com offers a novel way to feed the hungry on our planet. By getting the definition right for each word you see on their site, they will donate 10 grains of rice. Not only do you get to increase your vocabulary, you are actually helping to address hunger! I donated 2,000 grains rice! You can find a link to this page on my Everything You Ever Wanted to Know About... . Thanks, Rose!

November 1, 2007 Recommendations to Live By Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective is the name of the actual report from which the press has been talking about in recent days regarding obesity and cancer. Not a moment too soon for a wake-up call. The healthcare system is already overwhelmed so we really have to start taking care of ourselves better. In brief:
RECOMMENDATIONS

BODY FATNESS - Be as lean as possible within the normal range of body weight

PHYSICAL ACTIVITY - Be physically active as part of everyday life

FOODS AND DRINKS THAT PROMOTE WEIGHT GAIN - Limit consumption of energy-dense foods. Avoid sugary drinks

PLANT FOODS - Eat mostly foods of plant origin

ANIMAL FOODS - Limit intake of red meat and avoid processed meat

ALCOHOLIC DRINKS - Limit alcoholic drinks

PRESERVATION, PROCESSING, PREPARATION - Limit consumption of salt. Avoid mouldy cereals (grains) or pulses (legumes)

DIETARY SUPPLEMENTS - Aim to meet nutritional needs through diet alone

BREASTFEEDING - Mothers to breastfeed; children to be breastfed

CANCER SURVIVORS - Follow the recommendations for cancer prevention

Source: http://www.dietandcancerreport.org/downloads/BARRELFOLD2_WCRF.pdf
All the recommendations are common sense, and should not be a shock to anybody. The only recommendation I would probably add is about smoking - don't start, and if you are smoking, stop. You can find a link to the original report on my Nutrition Page . I must warn you it's 537 pages long!

October 28, 2007 PRAY that you never see this take over your wallpaper, because if you do, you are in big trouble. Most likely, you would not even be able to read this message. The trojan virus responsible for this forced me to take my computer in to have the hard drive wiped. Of course, I didn't know this happened until I read Kim Kommando's 10/15 column - 3 days after the fact:
"Attacked by Safewebnavigate
Q. We are being bombarded by pop-ups. The pop-ups indicate an alleged threat. We got thousands of these yesterday, and many more today. Initially, there was also a blood red (dripping) screen with Oriental style writing. I eliminated the red screen. The pop-ups refer to Safewebnavigate. They are getting past our antivirus protection. My wife and kids swear they haven't been on anything that would cause this. Please help.
A. This is a heavy-duty adware infection. References to it began cropping up on the Web in August. Your antivirus program probably would not find or remove it. You need to use anti-spyware programs."
Source: Kim Kommando's October 15th Tip of the Day.

October 27-28, 2007 Google Gadgets It is amazing how easy one can add interactivity to one's Web site with the use of Google Gadgets! There are over 22,000 of such gadgets available. After perusing 2,300 of these, I have added 31 of them across 17 pages. They are listed as links for those pages, followed by (GG). Most of what I have added are useful online tools, while others were added for a day-to-day change for returning visitors (like Masterpiece of the Day, National Geographic Picture of the Day, etc.).
For example, here is one in which you can find out the current value of your U.S. savings bonds that I have added to my Cool & Use Sites - Money Matters section :

And, here is my favorite that I have on my Cool & Useful Sites Index Page ,

I can look at this all day, and the best part is I don't have to feed them! I hope you enjoy finding these on the various Web pages of this site!

October 19, 2007 The Strangers at Toad's Place, New Haven, CT. Just got back from a most enjoyable evening with The Strangers, a Billy Joel tribute band. Two hours and 15 minutes of pure Billy Joel. They did a nice job covering all the hits, but missed two of my favorites, Uptown Girl and All for Leyna. Other than that, this band is worth catching!

October 18, 2007 Bone Hormones, Immune System, the Brain and Gut and Diabetes. The human body never ceases to amaze! A couple of days ago, the New York Times reported new findings about diabetes that I think will change the way we think of the disease. Here are some highlights:
"New research suggests that a hormone from the skeleton, of all places, may influence how the body handles sugar. Mounting evidence also demonstrates that signals from the immune system, the brain and the gut play critical roles in controlling glucose and lipid metabolism. .... For the first time, ... we see that the skeleton is actually an endocrine organ, producing hormones that act outside of bone....Working with mice, he found that a previously known substance called osteocalcin, which is produced by bone, acted by signaling fat cells as well as the pancreas.
A deficiency in osteocalcin could also turn out to be a cause of Type 2 diabetes, Dr. Karsenty said. Another recent suspect in glucose regulation is the immune system. In 2003, researchers from two laboratories found that fat tissue from obese mice contained an abnormally large number of macrophages, immune cells that contribute to inflammation.
Many researchers agree that obesity is accompanied by a state of chronic, low-grade inflammation in which some immune cells are activated, and that that may be a primary cause of insulin resistance. They also agree that the main type of cell responsible for the inflammation is the macrophage, Dr. Saltiel said. New research also suggests that not all macrophages are created equal, added Dr. Saltiel. There appear to be good ones and bad ones competing in fat tissue, with potentially large consequences for inflammation anddiabetes.... Hormones from the small intestine called incretins turn out to talk directly with the brain and pancreas in ways that help reduce blood sugar and cause animals and people to eat less and lose weight, Dr. Rizza said." Source: http://www.nytimes.com/2007/10/16/health/16diab.html?ei=5087&en=ea71c481d25b57a6&ex=1208145600&adxnnl=1&mkt=healthphoto&adxnnlx=1192709153-oZmfD2WDOdSFYcG03X3PMA (Thanks, Sue Hewes)
While researchers are learning how complex Type 2 diabetes is, and are excited about the possibilities of new types of therapies to treat diabetes, I am seeing public health implications of what we can do to prevent the development of diabetes.
Hormones have always played an essential role in our bodies. I think Osteocalcin may actually be "THE" explanation for the increase in fractures among those who take glitazones, which was found to be a class effect (Source: http://www.prescriber.org.uk/?p=336). When I first heard about the increased risk for fractures, I was puzzled as to the mechanism for this, and no one had an answer. Now, it looks like we do.
Low-grade inflammation has been known to be a cause of endothelial dysfunction, the fundamental pathology of cardiovascular disease (http://circ.ahajournals.org/cgi/reprint/01.CIR.0000017863.52347.6Cv1.pdf) [thus,why aspirin is recommended], as well as other diseases. Knowing that "good and bad" macrophages (what's responsible for low-grade inflammation) exist in fat tissue may be contributing to the development of insulin resistance is a good reason for eliminating or decreasing the fat we carry (especially around our waist) with better diet and exercise.
Finally, I think that conceptualizing bone as an endocrine organ may be a good explanation for why brisk walking is good for those with diabetes in helping them control their blood sugar. Walking, an aerobic activity, has always been seen as protecting the cardiovascular system against heart disease by building up the heart muscle. But, now we may begin to view walking as also a good way of stimulating the bone to release osteocalcin, thus, preventing the development of diabetes. Another good reason to take a brisk walk every day.

October 14, 2007 Breast Cancer - the real statistics For women, the fear of breast cancer is great, and partially fueled by how statistics is used. Here are the true numbers.
According to the CDC:
Aside from non-melanoma skin cancer, breast cancer is the most common form of cancer in women. Breast cancer is the number one cause of cancer death in Hispanic women. It is the second most common cause of cancer death in white, black, Asian/Pacific Islander, and American Indian/Alaska Native women.
In 2004 (the most recent year numbers are available),

186,772 women and 1,815 men were diagnosed with breast cancer*
40,954 women and 362 men died from breast cancer*

Source: http://www.cdc.gov/cancer/breast/statistics/
"Incidence rate" means how many women out of a given number get the disease each year. (In 2004), white women had the highest incidence rate for breast cancer. Black women had the second highest incidence of getting breast cancer, followed by Asian/Pacific Islander, Hispanic, and American Indian/Alaska Native women.
From 1969-2004, the rate of women dying from breast cancer has varied, depending on women's race and ethnicity. ....black women were more likely to die of breast cancer than any other group. White women had the second highest rate of deaths from breast cancer, followed by women who are Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander.
Source: http://www.cdc.gov/cancer/breast/statistics/race.htm
The risk of getting breast cancer increases with age. For example, 3.5% of women who are now 60 years old will get breast cancer sometime during the next 10 years. That is, 3 to 4 out of every 100 women who are 60 years old today will get breast cancer by the age of 70.
The risk of dying from breast cancer increases with age. For example, 0.7% of women who are now 60 years old will die from breast cancer during the next 10 years. That is, about 1 woman out of 100 women who are 60 years old today will die from breast cancer by the age of 70.
Source: http://www.cdc.gov/cancer/breast/statistics/age.htm
As reported in a 10/1 New York Times article:
"More than 80 percent of those surveyed believed that one in eight women will be diagnosed with breast cancer this year. This common breast cancer statistic is often misapplied. The truth is that a woman's lifetime risk for developing breast cancer is about one in eight, or 12 percent. About 178,000 women will be diagnosed this year, which amounts to 0.2 percent of adult women, based on United States census data. The odds that breast cancer will kill a particular woman is one in 35, according to the American Cancer Society."
Source: http://well.blogs.nytimes.com/2007/10/01/despite-awareness-campaigns-breast-cancer-myths-linger/
For more information of what is currently known about breast cancer, check my Breast Cancer Page

October 6, 2007 TouchGraph Google Browser - a new way to look at the Web The Internet gets more interesting day to day. A new visualization tool has been released called "TouchGraph Google Browser" which does a magnificent job of visualizing the interconnectivity of the World Wide Web. I remember there was this capability in the early years of this century (sounds so old), and in the late 1990s, that is, before GIS (Geographic Information Systems) became popular and accessible on the desktop.
Apparently, many of these projects were academic in nature, and sustainability was not a strategy to preserving this type of work, so they died when these academics moved on to other things. However, some did archive their projects online (good thing), so you really can see the primordial stages of this kind of mapping, which look really primitive against Touch Graph. If geographers can map our physical world, then why not map the virtual world that makes up the World Wide Web???
I tried it out on my Web site url: http://www.bettycjung.net/, and this is what I got

Then I tried my name: Betty C. Jung, and this is what I got:

Isn't this absolutely the coolest thing you have ever seen? You can watch TouchGraph dynamically graph the relationships it finds. It's color-coded, showing which sites are related in content to specific popular pages on my Web site.
I have tried to do this with my Web site, by using a common background and navigational bar for pages with related content. Unfortunately, some Web site raters do not understand this concept of interconnectivity and consider this as a sign of inconsistency. I suppose they have a lot to learn about what the Web is really all about...
This brings to mind a matter of semantics. The word "mapping" is used to describe the act of showing spatial distance - a picture of where a particular place is located, in relation to other places. This is why we use a map to find a place, or to provide us guidance with how to get to some particular place. Then the term "mapping" was used to describe ideas in terms of distance and location (e.g., concept mapping), though such renditions are not always easy to grasp, even though intuitively you can sort of see what the mapper was driving at. In essence, mapping is just a term we are so familiar with that we can easily understand when people say, "Let's map it out."
However, technically speaking, can we really map the World Wide Web?? Where exactly does the World Wide Web exist? It resides in the memory of computers, which can be located at a variety of places we can physically visit (but may not have the security clearance to gain access). So, when you use your browser to retrieve a Web site, the location of that Web site (which can be one or many pages) is where you retrieved it, wherever that may be in the physical world we live in (then again, you could be on a plane and do this).
Actually, a Web site can virtually exist at a number of different places at the same time, and it can instantaneously show up on your computer in a matter of seconds (with a fast connection, that is). So, where exactly does a Web site exist? Is it on the server where the physical pages (but this is nothing like what we call hardcopies) actually reside, or, on the computer in front of you (in virtual residence???), where you can download the page to your C drive, or print it out and actually have it physically in your hands? I can go on, but if this gets you to think about what cyberspace is all about, that's good enough for me.
So, in summary, I see "Web mapping" as more conceptual in nature, and more akin to what graphing does, and that is to show relationships (which are more than just spatial when it comes to the Web). So, the proper terminology should probably be "Web graphing" for these visual renderings of the Web (a term which captures the strength of what it does, in every sense of the word), and what TouchGraph esthetically does so well. The Internet has truly forced us to transcend our physical world in ways that were inconceivable some 10 years ago!
You can find a link to TouchGraph on my Graphing Page , which is fast becoming the most popular content page on my Web site. Can you see why?

October 5, 2007 CDC's Chronic Disease Indicators Page Many years in the making, the Chronic Disease Indicators Page offers chronic disease epidemiologists the opportunity to interactively retrieve data for 90 different chronic disease indicators that can compare the US to any state. You can find a link to this awesome page and other resources for chronic disease on my Cardiovascular Disease Index & Chronic Disease Information Page .

October 3, 2007 It has taken me 5 hours, but I think you will find the Connecticut Public Health Resources Page a site to behold (at least I hope). Let me know what else you would like to see on this page

October 3, 2007 The Economic Burden of Chronic Disease The management of long-term conditions, such as chronic disease is extremely expensive, but it isn't until now that there are statistics to quantify the cost. The Milken Institute's An Unhealthy America: The Economic Burden of Chronic Disease provides statistics for the most common chronic diseases (Cancer, Diabetes, Heart Disease, Pulmonary Conditions, Hypertension, Stroke and Emotional Diseases), risk factors (Air quality, Alcohol, Cholesterol, Illicit Drug Use, Obesity, Overweight, Physical Activity, Smoking), and intergenerational impacts, by State. Once you view these stats, you will understand why the cost of health care will continue to rise, and how chronic diseases will have a continuing impact on the U.S. economy. You can find links to the stats on my Cardiovascular Disease Index & Chronic Disease Information Page that is devoted to chronic disease. There is also a link on the Evaluation Page as well.

September 28, 2007 Do you have a Type D personality? More studies are beginning to show the impact Personality has on our health. Though some studies have not shown a connection between Type A personality and heart disease, the Type A to C typology remains popular, and researchers (e.g., Professor Johan Denollet of Tilburg University) have added a Type D personality, for those who are prone to emotional distress. More importantly, medical research is being done and published about the effect this personality type has on heart disease and the impact it has on recovery and death from heart disease. In general, studies have found: Type D personality has been linked with

early death
increased risk for developing cardiovascular problems after a heart attack
poorer response to proven treatments for heart disease
increased chances of sudden cardiac arrest.

Instead of focusing on individual elements such as depression, anxiety, hostility, and social isolation, using broad personality traits may be a faster or more efficient way to identify people at higher-than-average risk of heart disease.
The problem with this approach is that it's easier to change a particular trait, such as hostility, or a mood, such as depression, than it is to change a personality type. But as Dr. Denollet says, this is just the beginning of the research process, not the end. (Source: http://www.health.harvard.edu/newsweek/Type_D_for_distressed.htm)
For more info and links to Type D personality, check my Temperament Page , Under "Birth Order, Emotion, Temperament - Impact on Creativity and Health", Type D Personality.

September 27, 2007 SAMHSA's National Registry of Evidence-based Programs and Practices Public Health practitioners are continuously challenged to promote health in a variety of venues. Even though we think "population", population is not always as homogeneous as we think it is. There are actually many subpopulations that are defined by a variety of sociodemographic variables, as well as by need, to mention two.
Some of what Public Health covers in its interventions overlap with what Social Work covers, such as substance abuse and mental health issues. The main difference, of course, is Public Health targets populations, while Social Work targets individuals for intervention.
SAMHSA has put together a registry of substance abuse and mental health interventions that may be useful to Public Health practitioners working in these areas. Types of interventions covered by the registry include: Mental health promotion, Mental health treatment, Substance abuse prevention, Substance abuse treatment, Co-occurring disorders. You can search for what has been done by picking type, design, population, setting, etc. You can find a link to this registry at Health Education Resources on the Net Page
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September 26, 2007 If research won't change a doctor's mind, what will? This is what I would like to know. In a 9/21/2007 MedPage report on a survey they conducted:
"So we asked visitors to MedPage Today whether they felt prepared to interpret conflicting research on a drug's safety.

More than half (55%) of 339 respondents answered Yes, but only 28% said they'd change their practice if their interpretation of the research warranted doing so.
A nearly equal percentage (27%) said they wouldn't change their practice patterns without a published guideline from a reputable authority.
Although the poll wasn't structured to determine whether clinicians were as ill-prepared as the residents to understand biostatistics, 45% of respondents said that sometimes the research is so arcane that it's not readily apparent which, if any, of the studies ought to be translated into practice."

Source: http://www.medpagetoday.com/Surveys/Surveys/tb2/6753
So, there you have it. Only about a quarter would change their practice in the face of conflicting research findings. Though one survey does not a study make, researchers may need to think about the way they present their findings to physicians who may be too busy to try and figure out what to believe. Frankly, there have been many times I have read abstracts that were so poorly written that I question the quality of the research itself enough to not even bother reading the article. All comes down to communication, doesn't it?

September 24, 2007 Yes! After being on the Web for 8 years, AND after 85 awards, finally - a gold award! Never hurts to keep trying, and trying, and trying....

September 18, 2007 . Let us never forget those who innocently died at the hands of terrorists on 9/11/2001.

September 14, 2007 Fourth Quarter, 2007 . Not quite yet, but I always feel better about being a little bit ahead of the curve.... By the time I move these little gems to the 2007 blog page , it will be another year!
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September 4, 2007 September is National Preparedness Month . This is the best thing I have seen in the "USA.gov News, from USA.gov, the U.S. government's official web portal (Vol. 6, No. 10 September 4, 2007)" ;
September is National Preparedness Month. If you've been putting emergency planning on hold, let the procrastination come to an end! Visit Ready.gov for help getting prepared. You'll find:
A checklist of supplies for a basic emergency kit
Guidance on developing a plan for emergency situations
Information about different kinds of disasters and emergencies
Separate preparedness sections for kids and businesses

August 30, 2007 , I have just added this graphic to all my public health sites pages that will enable you to get back to the index page so you can easily access the other public health sites pages. I have decided to spruce up these pages because I have removed all the wellness pages that showcased the research of students from earlier semesters. Most of the links on those pages started dying (as expected). So, rather than spend hours removing the dead links I have decided to provide wellness information on the public health sites pages. Just click on the graphic to get to the Public Health Sites Index Page and see what topics are covered, either on the Public Health Sites Pages, or on individual pages for the more popular topics. This goes to show that there is no end to finding ways to enhance the site....

August 29, 2007 "F as in Fat" (How Obesity Policies are Failing in America , 2007) is the title of Healthyamericans.org's recent report on how obesity is killing Americans. Mississippi ranks 1st for obesity (when it usually ranks last for everything else), with physical inactivity at 36.1%.
I think that Mississippi should be viewed as the "canary in the coal mine" of where the country is heading, and that this state deserves some serious attention for testing out interventions for stemming the tide of obesity. I have constantly heard at conferences, lectures, etc. about how obesity is spreading across all states over time. I think the most telling is the map for 2001:

Yet, not one speaker has ever pointed out the blatant fact that Mississippi stands out above all other states and the first state to belong in a higher percentage category for obesity each time a new category is created. In 2006, Mississippi, now along with West Virginia, have an obesity prevalence of over 30%. Both of these states have the highest rates of Type 2 diabetes in the nation (over 10%), hypertension (over 32%), and both are in the top ten states for the highest rates of poverty. I can go on, but you should read what else they have to say in this eye-opening report. You can find a link to this on my Evaluation Page, under "State Report Cards [Health Behaviors] (Non-government)"

August 27, 2007 North American Plan for Avian and Pandemic Influenza . Well, at least there is a plan to address the potential for an influenza pandemic for the western hemisphere. It is really important to think through what can (and should) be done when something like this can affect so many people in a short span of time - an essential Public Health task. At least we won't be caught unaware and unprepared.

August 25, 2007
I am so pleased that this Web site has reached another birthday! Thanks to all the many visitors from around the world who have come by, whether they have stumbled upon, surfed by, etc. to this Web site. It has been a growing experience for me as a Webmaster, who started off with only the idea of posting my annotated bibliographies (to share my passion for reading).
Along the way, I found that I could share just about anything (my passion for movies), get to help others who wanted some career guidance (PHENOM, an online mentoring program) and even help those who we think are pretty smart already (Graphing and Biostatistics). I have the chance to provide kids a safe place online to share in the joy of learning, and as well as provide the opportunity for people to learn more about themselves (Personality Page). But, above all else, and most of all, I am able to share my true passion - Public Health!
To all visitors, new and returning, please continue to drop by 24/7. I welcome all your comments, suggestions and appreciate your accolades . A millions heart-felt thanks for making what I view as my hobby into a worthwhile endeavor!

August 20, 2007 - President's Cancer Panel "According to the President's Cancer Panel, in 2007 more than half a million Americans will lose their battle with cancer, and tragically, nearly two-thirds of these deaths could have been prevented through lifestyle changes."
Source: Cancer Panel Attacks Tobacco Industry and Government http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/tb2/6444 (8/17/2007)

August 12, 2007 - Death is a fact of life Though this may very well be true, death is not a subject most people are comfortable with. This is why the funeral industry makes loads of money on those who must deal with the actuality of someone who just died and grieving the loss at the same time - not a good time to make decisions that are usually quite expensive.
If you want to get a sense of what it is like to deal with unbearable loss, I recommend Joan Didion's "Year of Magical Thinking." No writing is more poignant than what a gifted writer can portray about the almost automatic adoption of irrational thinking caught in a web of seething emotion. It's that unbelievable feeling at a wake when you expect the deceased to just get up out of the coffin and comfort everyone with the physical presence that is impossible to occur. After the burial, the emptiness is palpable.
Finally, it is great to see that the NIH's National Institute of Aging has come out with a great Webpage called "Mourning the Death of a Spouse" that is practical and helpful for those who have lost a spouse. But don't wait until then to read the page, do it now in preparation for the inevitable loss of a loved one. Share it with your parents. It will help everyone to plan ahead. You can find a link to this resource on my Senior Health Resources Page
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August 10, 2007 - Five preventive services that would save 100,000 lives each year A recent report from Robert Wood Johnson Foundation reports:

*45,000 additional lives would be saved each year if we increased to 90 percent the portion of adults who take aspirin daily to prevent heart disease. Today, fewer than half of American adults take aspirin preventively.

*42,000 additional lives would be saved each year if we increased to 90 percent the portion of smokers who are advised by a health professional to quit and are offered medication or other assistance. Today, only 28 percent of smokers receive such services.

*14,000 additional lives would be saved each year if we increased to 90 percent the portion of adults age 50 and older who are up to date with any recommended screening for colorectal cancer. Today, fewer than 50 percent of adults are up to date with screening.

*2,000 additional lives would be saved each year if we increased to 90 percent the portion of adults age 50 and older immunized against influenza annually. Today, 37 percent of adults have had an annual flu vaccination.

*Nearly 4,000 additional lives would be saved each year if we increased to 90 percent the portion of women age 40 and older who have been screened for breast cancer in the past two years. Today, 67 percent of women have been screened in the past 2 years.

*30,000 cases of pelvic inflammatory disease would be prevented annually if we increased to 90 percent the portion of sexually active young women who have been screened in the past year for chlamydia infection. Today, 40 percent of young women are being screened annually.

Source:http://www.rwjf.org/newsroom/newsreleasesdetail.jsp?id=10506&c=EMC -CA141 (Thanks to Barbara Dingfelder).

August 9, 2007 - A warning from our neighbors to the South According to an 8/3/07 Reuters news release, Mexico's health care system is in danger of going bankrupt trying to address the number one killer for the country, diabetes. Thirty-four percent of the country's social services budget goes towards diabetes care. Mexico has one of the highest rates of obesity in the world, and the Health Secretary Jose Cordova states,"The concept of healthy eating is almost nonexistent." Is this where the U.S. is heading??? (Source: http://www.diabetes.org/diabetesnewsarticle.jsp?storyId=15658220&filename=20070803/reuters20070803health00000013reutershealthewEDIT.xml)

August 8, 2007 - Battle At Kruger After spending hours watching Planet Earth a few months ago, I thought that I learned all the things about nature that I needed to know but didn't learn in college natural science courses: predators and prey were meant to play those roles in the general scheme of things. Crocodiles never let go of their prey, the young are sacrificed for the survival of the herd, etc.
So, it was really interesting (and has been for the some 8 million views noted) to watch an amateur cinematographer capture the most exciting 8:23 minutes of what will most likely call for a rewriting of books on animal behavior. He was a lucky observer, at the right place at the right time, and was astute enough to capture something quite out of the ordinary - that prey do not sacrifice their young, that they do come back and can fight back, and that crocodiles do let go of their prey.
However, what's really important to remember was it took only one cape buffalo to break away from centuries of conditioning to do something animal prey as a herd does not usually do, and that's to fight back. A baby buffalo is saved from the jaws of a pride of lions and two crocodiles to live another day. The lions will live to hunt again because hunger will demand them to do so. But I am sure that the cape buffalo that stood against the lions knows it never need to fear again because it can fight back.

August 8, 2007 - Health insurance impacting the Public's Health Aside from the horrors shown by Michael Moore in his must-see film, "Sicko," it is time to really do something about the U.S. healthcare system, when I read that children are not getting the required immunizations because they are underinsured -
"The children are not eligible for state or federally supported vaccination programs because they are in health plans, even though those plans don't cover vaccinations...
In contrast, children who are covered by Medicaid or are uninsured are eligible for full coverage through the federal Vaccines for Children program.
We estimate that 2.3 million children are unable to receive state-purchased meningococcal conjugate vaccine in the private sector, and 1.2 million children are unable to receive this vaccine even if they are referred to the public sector.
The problem is caused by both holes in the public health safety net from inadequate government support, and from a fragmented and disjointed health-care system..."
(Source: Underinsured Children Shut Out from Recommended Vaccines, http://www.medpagetoday.com/Pediatrics/Vaccines/tb2/6359).
Since when did immunization become no longer a necessity? There is something fundamentally wrong when children cannot get the health care they need to live a healthy life. They must be healthy to thrive and learn so they can meet the demands of tomorrow. Any health care system must be able to provide the preventive health services necessary to live in a healthy way. This is so basic that it really bothers me that those who can do something about this have not. What are they waiting for - a pandemic to get moving?

August 7, 2007 - Advancing the Nation's Health: A Guide for Public Health Research Needs, 2006-2015 (Research Guide) is a new document from the CDC that outlines research priorities in a number of Public Health areas.
"The Research Guide provides a comprehensive, long-range vision of national and global public health needs that CDC and its partners can address through research. The Research Guide helps identify critical knowledge needed to achieve CDC's new Health Protection Goals which are designed to maximize the health impact of programs, services, and emergency responses." (CDC Announcement)
I view it as a companion document to Healthy People 2010, in which problems are fleshed out as research priorities. Actually, what would be great is to actually integrate these two documents into one. By doing so, it would be possible for agencies and organizations to streamline their program planning to meet the goals and objectives of Healthy People 2010.
Because Public Health is so broad, it's really important to have one Vision for which everyone working in Public Health can strive towards. It would certainly make research more useful in the practice-oriented atmosphere of Public Health. After all, we know that much of the research conducted is not practice-friendly so that application of research findings is hard to come by. Many times, it is only after meta-analyses do the pearls emerge.
The Research Guide actually makes for interesting reading by laying out a comprehensive background of what has already been accomplished, what needs to be addressed for the problems identified, and suggested research priorities for several broad areas. The backgrounders are really what's happening in Public Health today, accompanied by a wishlist from those who visualize solutions that can be made possible through research. Public health research should be an integral part of Public Health Practice, and it can be when it's conceptualized as Healthy People 2010 strategies. You can find a link to this guide on my Healthy People 2020 page and my Public Health Practice page .

August 5, 2007 - Watch your typing! Unfortunately, cybersquatting continues. Here is another illegitimate site.
WHOIS Search Results for: betycjung.net Domain ID: Domain Name: betycjung.net Created On: 02-Aug-2007 00:00:00 Expiration Date: 02-Aug-2008 00:00:00 Sponsoring Registrar: 'Check Whois' (DOMAINDOORMAN, LLC) Status: ok Name Server: ns-1.domainspace4you.com Name Server: ns-2.domainspace4you.com Registrant ID: Unknown Registrant Name: Unknown Registrant Organization: Unknown Registrant Street1: Unknown Registrant Street2: Unknown Registrant Street3: Unknown Registrant City: Unknown Registrant State/Province: Unknown Registrant Postal Code: Unknown Registrant Country: Unknown Registrant Phone: Unknown Registrant Fax: Unknown Registrant Email: Unknown Admin ID: Unknown Admin Name: Unknown Admin Organization: Unknown Admin Street1: Unknown Admin Street2: Unknown Admin Street3: Unknown Admin City: Unknown Admin State: Unknown Admin Postal Code: Unknown Admin Country: Unknown Admin Phone: Unknown Admin Fax: Unknown Admin Email: Unknown

August 5, 2007 - Good Eyesight and People Skills are the key requirements reported by older workers for performing their jobs (Who would ever think that eyesight was so important??). Generally speaking, the skills needed these days are computer and people skills, and those with computer skills get to stay longer in the workforce than those who don't have the computer skills. Health was found to be a factor in retiring for 35% of people in their late 50s.
Looking at those 55 to 59 who are working, 88% "really enjoy going to work", and the percentages are higher with those older. Maybe employers who have low job satisfaction scores should consider hiring older people who want to work and enjoy it. These and other interesting findings can be found in the new National Institute on Aging's report, "The Health and Retirement Study." You can find a link to this report on my Senior Health Resources on the Net Page.

August 5, 2007 - Can You Hear Me Now? Hearing loss is something I always think about AFTER I attend a rock concert. That is because even wearing earplugs I can still hear the music during The Police concert I attended a few days ago. What I found scary was the vibrations I felt through the concrete floor and the very expensive bleacher seats as well. Now that's loud! (Of course, there was that episode with the screaming banshee at the Cheap Trick concert that probably did some damage to my left ear....)
The constant audio assault is nothing new, especially for those who live in urban settings. So it was very public health for New York City to revamp its 1972 Noise Code in July to address this environmental problem. Many people address this by turning up their iPods to drown out the noise. This is not necessarily the best solution to the problem, and there are recommendations about this: Use sound-isolating or noise-canceling headphones (Wired.com). You can find more information about Hearing Loss , a new section on my Public Health H - L Sites page.

August 1, 2007 - Are You a Cyberchrondriac? Well, that is what the Harris Poll calls people who get health information from the Net before they see their doctors. (Source: http://www.computerworld.com/action/article.do?command=viewArticleBasic&articleId=9028555). Though the term is not derogatory (cyber anything should clue you in that it has something to do with the Internet), I don't think it's a bad thing people are using the Net to find health information. The Harris Poll estimates that 71% of Americans have gone online to look for health information.
The problem with looking for information on the Net is that there is just so much that is out there that it becomes almost impossible to digest everything without becoming confused. For example, if you wanted to find information about a particular disease with a search engine, the plethora of sites that turn up on the search results can be overwhelming.
There are, of course, the personal Web sites of those who suffer from the disease and want to share their experiences with diagnosis, treatment, etc. These can offer some support to those with the disease, or those caring for those with the disease. But, the health information may not be as comprehensive or as current as what's really available. Then, there are the chat rooms, blogs, forums that include just about everything you can think of. These I found are the most confusing and unreliable for health information. The next worse are the sites that sell you products that supposedly will cure you of whatever ails you. Totally promotional, they will have a page or two devoted to the "facts." You should just skip these entirely, if you are looking for good health information.
The most reliable sources for health information are government sites (xxx.gov), education sites (xxx.edu), and nonprofit and research sites (xxx.org) devoted to addressing the disease because of the internal information quality oversight in place. Most of the information released have been extensively peer reviewed, so you will most likely not find too much discrepancy among these sites, if you really compare the information.
Health news related sites, such as Medscape and Medpage Today are good, but because they are partially sponsored by pharmaceutical companies, you just have to be aware of some bias when it comes to reporting on diseases that you can take medications for. In those instances, you really should check who is sponsoring the study. For example, can you ever see a tobacco company sponsoring research studies that show that tobacco is bad for you??? For more information about information quality, check out my Information Quality , Health Care Resources on the Net, Health Care Quality Standards , and Healthcare Quality Issues Pages.

July 31, 2007 - The Police Live in Concert at Rentscheler Field, CT And, indeed they were. A concert for all diehard Police fans, for sure. A minor annoyance was the frat bro who wanted to dance with all the ladies in my section, including me. He was really asking for a chorus of "Don't stand so close to me" from everyone around me. Sting and Andy were great. Sting can still belt it out. Stewart Copeland on percussion was just phenomenal. He is the one who makes The Police sound like a much bigger band than one of three. Yes, you got your money's worth of all their greatest hits, along with a geat light show! Getting out of the stadium, however, was a major pain.

July 19, 2007 - International Health Regulations (IHR) were developed by the World Health Organization (WHO) in 1969, and revised in 2005 and came into force June 15, 2007. It includes all diseases and health events that may constitute a public health emergency of international concern. The United States has accepted these regulations with the understanding that:
Under the IHR, incidents that involve the natural, accidental or deliberate release of chemical, biological, or radiological materials must be reported.
Countries that accept the IHR are obligated to report, to the extent possible, potential public health emergencies that occur outside their borders.
The IHR do not create any separate private right to legal action against the Federal government.
The 2005 revision reflects the reality of today's world as it combats new infectious diseases:
Always Notifiable
Smallpox
Poliomyelitis, wild type
Human influenza, new subtype
SARS

Other Events Potentially Notifiable:
Examples: cholera, pneumonic plague, yellow fever, viral hemorrhagic fever, and West Nile fever
Other biological, radiological, or chemical events may fit the decision algorithm and be reportable

For more detailed information about the International Health Regulations, check Public Health Sites under "International Health". The International Health Regulations presentation is a very easy-to-understand summary of IHR.

July 12, 2007 - The Skinny on Fat Though most of us view fat as being unsightly (cellulite!), fat does play an important role in many metabolic processes in the body (we need fat to use Vitamins A,D,E and K). The problem comes when there is too much fat. This happens when we don't use up what we eat and it gets stored as adipose tissue. It gets stored beneath the skin (subcutaneous) and around our organs (intra-abdominal or visceral fat). What researchers are finding is that it's the visceral fat that is the more deadlier kind. This shows up with the expanding waist-line (apple-shaped people), or Belly Fat.
And though we have always thought that fat just sits around taking up space (inert), making us look awful in barely-there swimsuits, new research is showing that adipose tissue is living tissue that is now considered an endocrine organ, secreting hormones and other substances that are not necessarily good for our health, from causing endothelial dysfunction to increasing cardiovascular risk. A connection has been made to increased insulin resistance, and for some, type 2 diabetes.
So, how does one get rid of visceral fat? There's only one way - exercise. A brisk 30-minute walk a day, six times a week will prevent the buildup, and more than that will help get rid of it (17 miles a week of jogging (or any exercise equivalent to that) does the trick [Science Daily http://www.sciencedaily.com/releases/2005/09/050914090337.htm]).
Sometimes people lose motivation when they are not dropping the pounds, so they just stop. Don't stop, because if you do, all you do is re-building the visceral fat storage (that's 4 pounds a year). The body responds to exercise by getting rid of the visceral fat. So, go out there and pound some pavement so you can pound out that visceral fat! And, eat healthy, too. For more information about visceral fat and exercise, check out the Consumer Health Page , under the new section, Visceral Fat.

June 29, 2007 - How's Your Hospital Doing? All hospitals strive to do better than the next because they want your business. Unfortunately, health care has really come to that (maybe it has always been that way, but now there's more publicity about it). The U.S. Department of Health & Human Services maintains the Hospital Compare Web site at which you can compare hospitals, by geography, death rates and process of care measures.
For example, pick a state, then all the hospitals you want to compare. Then pick a condition (e.g., Heart Attack, Heart Failure, Pneumonia, or Surgical Care Improvement/Surgical Infection Prevention), and then a process of care measure (e.g., for Heart Attack, Percent of Heart Attack Patients Given ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD)). You will then get a bar chart comparing all the hospitals against the other hospitals you have chosen, against the average for the nation and for all hospitals within the chosen state for the particular process measures you have chosen.
The site does provide an explanation of how to interpret the bar charts, but it may not have the data you are looking for for some measures because there are not enough data to report for a particular time period. Perhaps, with ongoing reporting, data will be available for comparison. Nevertheless, this is a great way to choose a hospital based on how well it performs against a criteria. You can find a link to "Hospital Compare" on my Health Care Resources on the Net under "Health Services Information.

June 16, 2007 - Another quarter already? Well, not yet, but it's hard to believe that almost half of 2007 is over....

June 8, 2007 - Heart Disease - Good News & Bad News Between 1980 and 2000, coronary heart disease deaths have been halved, holding true for both men and women. Rises in evidence-based treatments [such as secondary preventive therapies after myocardial infarction or revascularization](47%) and reductions in risk factors (44%) have been responsible for this favorable trend. This basically means that 91% of the reason for this trend has been explained, which is good news. Statisticians love this because the more that can be explained, the less there is unknown, thus, less uncontrolled variation...
More good news is that improvements in known risk behaviors (lowering total cholesterol, lowering systolic blood pressure, quitting smoking, more physical activity) do make a difference when it comes to whether or not a person will die from heart disease. This supports my original contention that a multi-prong approach is a necessary strategy for such chronic diseases as heart disease (See May 4th entry).
The bad news is that all this progress may eventually be overturned by the increase in obesity and diabetes. Though this sounds like two problems, it's really one, if we can reduce obesity, then diabetes won't be the problem it can be if the population continues to expand its waistline. Though we now know that Type 2 diabetes has a genetic component to it, it is preventable, and a realistic strategy would be to delay the onset of the disease. Good eating habits are important, but exercise may prove, in the long run, to be a very necessary component to mobilizing all those fatty acids out of the adipose tissue that is settling around the waistline. Half an hour a day for physical activity is good and an hour a day is even better. A nice brisk walk is so much better for your mind AND body than 30 to 60 minutes a day sitting in front of the TV....
(Source: Cardiac Mortality Drop Attributed to Therapies and Risk Factor Reductions; http://www.medpagetoday.com/Cardiology/CoronaryArteryDisease/tb/5880)

May 31, 2007 - PubMed Knowledge-based Search Engine The U.S. National Library of Medicine's PubMed is a wealth of research information, but may be a bit intimidating for the average user. The GoPubMed search engine will be a delight for everyone, developed by Transinsight & Technical University Dresden. I found it really easy to use. You can find links to this search engine on my Web site Medical Search Engines and my Health Sciences Search Engines Pages.

May 28, 2007 - Fonda & Christie Rule and are still the best in the business, despite the fact that these actresses would be considered geriatric. Jane Fonda made "Georgia Rule" work because her character was who kept the family together, despite its dysfunctional relationships. It's too bad it took this long to see her in a film that made use of her talent. Julie Christie was absolutely great in "Away From Her," a realistic look at what Alzheimer's can do to a decades-old marriage. The screen still belongs to her in every scene she is in. I would like to see these two nominated for best actress, and the starlets can learn something from them - talent doesn't always belong to Youth, but to those who have a life off on-screen and aged ever so gracefully.

May 22, 2007 - No Period Pill The menstrual cycle has become reconceptualized as an inconvenience (Imagine...No More Periods, http://women.webmd.com/features/no-more-periods?ecd=wnl_day_051107) that can be easily remedied by a new pharmaceutical concoction that eliminates periods. This is not a good idea. When birth control pills first became available, women who used this form of contraception lauded its benefits, that is until they tried to conceive but couldn't because manipulating the menstrual cycle resulted in shutting down the system. Over the years, other side effects became evident for those susceptible - greater chance of blood clots, stroke and heart attack, along with other side effects as worsening of migraine headaches, gall bladder disease, increase in blood pressure and an extremely rare liver tumor (The Pill: Side Effects & Current Issues:http://www.unm.edu/~shc1/pill-side-effects.html).
More recently, the Women's Health Initiative Study was stopped early because hormone replacement therapy did not help women to stay heart-healthy longer (http://www.ohsuwomenshealth.com/news/whi.html). The underlying message is to not mess with the hormonal cycles of the human body. These cycles were meant to naturally fluctuate and change over time, and most of the hormonal therapies have muted these fluctuations, which then eventually go on to affect other bodily functions. The new no period pill is disturbing not just because it continues this trend of artificially manipulating normal body functions, but view a natural body function as an inconvenience. Perhaps, we really need to rethink our lifestyles and philosophy of Life when what's natural is considered an inconvenience.

May 18, 2007 - The Messy Health Care System Because of the rising costs of health care, healthcare providers, from individual practitioners to healthcare systems, have been forced to economize (my word, but you will probably hear the phrase "become more efficient"). Cutting costs is usually seen as a negative strategy. To make it palatable, cost cutting strategies are re-framed as quality improvement initiatives (doesn't it sound better already?). Thus, healthcare processes and outcomes are constantly being measured and analyzed, with newer measures being developed every day, more complex analyses being performed, and more report cards released annually. Yet, why is the health care system still a mess? (Associated Press (5/15), "Ethicist: Health care system is a 'a mess').
One should probably ask, what is driving the health care system? Is it the patient in need of healthcare services, or health insurance companies that benefit from not paying out for these services? Is quality of care ensured with access to multiple providers who do not communicate with each other on a particular patient they all care for, and is it compromised by forcing physicians to spend the bulk of their time trying to get their treatment strategies pre-approved by various health insurance companies that have different protocols? And, with all the money that is supposedly saved from using generic instead of brand drugs (and I'm not condoning the pharmaceutical industry's insidious tactics either), to being allowed to use alternative therapies for chronic conditions, has health outcomes really been improved? And, where is all that money saved, and who is being held accountable for the ethical management of this surplus money supply that has been salvaged from being wasted on ineffective treatment strategies?
Associated with quality of care is the whole issue of expectations. What exactly do we expect the health care system to do for us? It most likely cannot save us from ourselves, despite the technological advances in diagnostics and treatment. However, I don't think it's too much to ask that we should be able to access the care we need, and to do so in a timely fashion. I don't mind taking a less expensive pill or undergoing a less expensive procedure, if I knew that in doing so my health is not being compromised and the savings from my actions would help others to get the care they need.
I don't mind paying the high cost of health insurance as long as health insurance companies have our best interests at heart (rather than their bottom line), and that whatever money they save from their strategies to limit the choices of providers and patients are put back into the health care system to reduce the burden of disease for those who cannot afford health coverage.
Similarly, I understand that it cost money to run a hospital, but I don't think it's too much to ask that when I am hospitalized that I will be getting decent care from the best professionals trained to make good decisions in the interest of helping me to get well. And, I don't think it's too much to ask that there is a Registered Nurse to coordinate my inpatient care, to ensure that the services I am receiving are integrated, because everyone knows a nurse will get it done.
And, I don't think it's too much to ask that the infrastructure for all services needed by the average citizen (medical and otherwise) be one that enhances our ability to get the services we need, regardless of where we live. I think this is all possible when service systems are patient- or need-driven, rather than customer-driven, which implies the customer with the most money gets the best service. The health care system is a mess because its heart is in the wrong place and it is in danger of losing its soul.

May 12, 2007 - Cheap Trick at Mashantucket's Foxwoods As I slowly recover from the audio assault of the 6-foot screaming banshee that sat next to me, I was pleasantly surprised by the 80-minute set from Cheap Trick, a rock legend that can still bring down the house, although you can tell they needed a smidgeon more time between songs. I am so glad I had the chance to see them live, given they started in 1968 (which means they've been around for almost 40 years), and most of the band members are in their 50s. Robin Zander still has one of the best Rock voices and is the distinctive voice of Cheap Trick. Rick Nielsen managed to show off his guitar collection by playing a different one with each song, Tom Petersson did a great solo, and Bun E. Carlos did great with the drums (I'm glad to see he didn't have a cigarette hanging off his lips like he did in their early music videos). While they did include the more familiar "I Want You to Want Me," "The Flame," "Surrender," "Voices," "If You Want My Love," and quite a few from their new "Rockford" CD (which is vintage Cheap Trick), good thing they snuck in "Dream Police" during the encore. I would have loved to have heard "Heaven Tonight," "Clock Strikes Ten," "Southern Girls," "Takin' Me Back," "Tonight It's You," and "Younger Girls". Oh well, it's hard to fit in so many good songs in under 90 minutes....

May 11, 2007 - The Tenth Dad Commandment I just came across Best Life's pearls of wisdom called "The Dad Commandments - 10 fundamental laws for fathers." What a wonderfully simple set of rules to live by for men who would be fathers! The best one was the 10th one (given that Sunday is Mother's Day):
10. Love their mother
Hug Mom. Often. In front of the kids. Sure, sometimes marriages end, but the obligation to a woman doesn't. Be grateful to her. Speak to her with respect. Try to make her laugh. Listen. Even if you're not married to her, figure out how to love her.
You can find a link to these pearls at Men's Health .

May 8, 2007 - Projected exhaustion of Medicare Hospital Insurance (MHI reserves) - 2019; Social Security reserves - 2041 Alrighty, the Social Security and Medicare Boards of Trustees has issued its 2007 annual report, "Status of the Social Security and Medicare Programs A SUMMARY OF THE 2007 ANNUAL REPORTS" and it's not good news. In its message to the Public, they are actually projecting the demise (and this is not too strong a word) of Medicare hospital insurance in 12 years, and Social Security to go defunct in 34 years.
Here is their conclusion: The financial difficulties facing Social Security and Medicare pose enormous, but not insurmountable, challenges. The sooner these challenges are addressed, the more varied and less disruptive their solutions can be. We urge the public to engage in informed discussion and policymakers to think creatively about the changing needs and preferences of working and retired Americans. Such a national conversation and timely political action are essential to ensure that Social Security and Medicare continue to play a critical role in the lives of all Americans.
I was so concerned about the Social Security System's sustainability that I had a letter published about this in 1994, or 13 years ago (Baby Boomers' Impact on Future Social Services. [Letter]. Chance. 7(3):3). It's not like we have not been warned. Don't you think it is time for Congress to act???? You can find a link to this report on my Health Care Information on the Internet Page under "Medicare".

May 7, 2007 - Patient safety in the hospital setting How can we ensure patients are safe when they are hospitalized? In a recent issued report, "Hospital Survey on Patient Safety Culture: 2007 Comparative Database Report," teamwork is the secret:
"Teamwork Within Units the extent to which staff support one another, treat each other with respect, and work together as a team was the patient safety culture composite with the highest average percent positive response (78 percent), indicating this is an area of strength for most hospitals. The survey item with the highest average percent positive response (85 percent) was: "When a lot of work needs to be done quickly, we work together as a team to get the work done."
Another important ingredient to patient safety is:
"Nonpunitive Response to Error the extent to which staff feel that their mistakes and event reports are not held against them, and that mistakes are not kept in their personnel file was the patient safety culture composite with the lowest average percent positive response (43 percent), indicating this is an area with potential for improvement for most hospitals."
You can find a link to this report on my Healthcare Quality Issues Page, under "Medical Safety"

May 4, 2007 - 02:03:04 05/06/07 Coming in the early hours of May 6th... This will never happen again (at least in our lifetime; thanks, Rose)

May 4, 2007 - Trends in State Public Health Legislation 2006 - State Public Health Legislation Report Policy and environmental changes are the latest strategies in addressing major public health problems. Chronic diseases, which are multi-factorial, cannot be addressed by one entity, nor can a single change in one's behaviors be effective in stemming the problem.
For example, addressing heart disease is not just treating those who have the disease and getting people to change their health behaviors (e.g., stop smoking AND reduce cholesterol intake AND monitor blood pressure, etc.). These activities need to be reinforced with policy and environmental changes, such as limiting the public's exposure to second-hand smoke through smoking bans; working with school systems to offer healthy alternatives to what is being sold in vending machines; developing wellness programs in the workplace to keep employees healthy; getting food manufacturers and restaurants to eliminate trans fatty acids from their products, etc. Multi-prong approaches are necessary to address multi-factorial diseases.
Many of these broader changes can be enhanced through passing legislation that mandates changes that impact the population. Many times, it is difficult to track what's going on with legislation because it takes forever to get an idea into something concrete that all parties can agree on, and then put it into a legally binding package that then needs to go through numerous levels of approval. Of course, once something does get approved, there is then the hope that funding will be available to implement the policy.
The Council of State Governments and Thomson West have released a useful document (467 pages) that seeks to summarize what is going on throughout the U.S., in a state-by-state look at the status of bills in progress that were meant to address public health issues. Find out how your state is doing. You can find a link to this document on my Evaluation Resources on the Net Page , under "State Report Cards [Health] (Non-government)"

May 3, 2007 - Criminal and Epidemiological Investigation Handbook The CDC, the Federal Bureau of Investigation, the U.S. Department of Justice, and the U.S. Army Soldier Biological Chemical Command have jointly issued a useful resource that provides guidance on how the justice and public health agencies and insititutions can work together in addressing emergency situations. What I found to be really great is its coverage on how important epidemiology and surveillance are in such situations. Actually, I think if law enforcement people were to apply the principles of epidemiology in their work, they may be more successful in solving crime! You can find a link to this handbook on my Epidemiology Sites A - L Page , under "Epidemiology Sites."

May 2, 2007 - What is a mother's job worth? According to ABC News, in dollars and cents - for a 91-hour workweek (overtime included), it comes to $138,000. And, you can't even pay anyone for a mother's dedication. Basically, you can never pay your mother for what she has done for you, but a show of appreciation on more than one day a year would be nice....

May 2, 2007 - National Preparedness Day, Part IV Here is an item in the most recent issue of CDC Public Health Law News:
*** Canadian Emergency Preparedness Week (5/6-5/12). Emergency Preparedness (EP) Week is an annual Canadian event that takes place during the first full week of May. The main objective is to increase awareness about individual preparedness. All EP Week activities reinforce the idea that risks can be reduced and the consequences of a disaster can be lessened by being better prepared. To learn more, visit http://www.epweek.ca/index_e.asp"
I love this idea! Maybe we can learn something important from our neighbors from the North, and don't forget, they never had to deal with a "9/11" to see the benefits of emergency preparedness.

April 30, 2007 - 582,304 is the number of unique visitors who have visited since 2/2005 (when my tracking program started collecting such data). Mind boggling. Of course, the nicer stat is that 21.8% of visits are return visits. Thank you.

April 28, 2007 - Public Health Practice Competencies What exactly do public health professionals do? A lot, and it depends on a variety of factors, such as area of expertise, setting and era (like Epidemiology's person, place and time), among other things. Definitions of Public Health Practice may change over time, but there are still core Public Health functions that must be maintained regardless of whether it's 1850, 1950 or 2050.
In recent years, a number of professional organizations have tried to define the competencies of those who work in public health, such as in a particular area of expertise. Others have defined core competencies that public health professionals should have regardless of what setting they may work in, or area of expertise. Understanding these standards will help you develop an appreciation of what public health practitioners really do, and the expectations they must meet to consider themselves proficient. You can find a total of 37 links (19 new) to these practice standards on my Public Health Practice Page, that I have revamped by creating a new section called, "Public Health Practice Competencies."

April 27, 2007 - Meeting Whoopi. If you were to meet someone famous, and you only had like 30 seconds to say something, what would you say? Well, tonight I had the opportunity to talk with Whoopi Goldberg for 30 seconds, and all I could say was I loved her movies, and that I assigned one of her movies for my students to watch. She asked, "Which one?" I said, "The Color Purple." We then smiled for a picture, shook hands, and exchanged thumbs up. What a cool woman! Her stand-up tonight was great. Perhaps, one of her best lines, "I would like to die curious about something." I suppose, you can say, she is a thinking woman's woman.

April 19, 2007 - Excessive and unconscionable behavior. The excessive showing of the killer's video manifesto is irresponsible, given that there are still so many grieving the loss of life at Virginia Tech. The media just can't seem to get beyond the sensationalism it generates.
I was truly disgusted when I read:
Speculators have registered Web domains related to the Virginia Tech killings, including URLs such as vatechshooting.com and vtmurders.com. Some are for sale for as much as $1 million.
The domains were registered Monday, the day of the shootings; several were registered via an anonymous registrant service that masks the name, phone number and mailing address of the person who purchased the URL.
Domain registration spikes are not unusual in the aftermath of major news events, with those registering either expecting a windfall on the sale of notable URLs or, in some cases, using them as lures for spam or phishing attacks.... "It is extremely disturbing that criminals have so quickly jumped to exploiting this horrible tragedy," said Ron O'Brien, a Sophos senior security analyst. (Source: http://www.computerworld.com/action/article.do?command=viewArticleBasic&articleId=9017118 - Speculators snap up Virginia Tech-related domains, Spammers and malware purveyors feed on tragedy)
More than at any time, compassion is what's needed and not the venal and avaricious side of slimy predators preying on the curiosity of those who have lost the ability to understand and feel during times of random senselessness.

April 18, 2007 - The 4/16 tragedy at Virginia Tech. My condolences to the families and classmates of the 32 students and professors who were gunned down in their classrooms, and in a dorm. This horrific massacre serves to remind us that personal and public safety can be compromised in a matter of moments. The American Academy of Pediatrics has a wonderful Webpage of resources to help everyone affected by this event to cope. You can find a link to this page on my Educational and Health Sites for Kids, under "Health Issue - Kids & Violence."

April 13, 2007 - Virtual Identity Theft - The horrors of Typosquatting/URL hijacking is the unfortunate fallout of having a "popular" Web site. I discovered this when I inadvertently typed my Web site address as bettyjung.net. Who would have ever guessed that my Web site would be monitored so closely by miscreants? Ordinarily, if a Web surfer were to do this in Google, or with any of the major search engines, they would return with the question: "Did you mean: bettycjung.net?" which is a good thing. At least, those algorithms are working right! And, of course, spelling counts.
Here are the definitions of terms you should know, and which I, unfortunately, have to deal with:
URL hijacking
Also called "typosquatting," it refers to taking advantage of common typos users make when entering a Web address into their browser. A domain name with a misspelled version of a popular URL is legally registered and used as a legitimate site. For example, www.micrsoft.com may be a domain name for a Web site offering software. See cybersquatting and page hijacking.
Source: http://www.pcmag.com/encyclopedia_term/0,2542,t=URL+hijacking&i=53517,00.asp
typosquatting
(tipo-skwotting) slang. Purchasing a domain name that is a variation on a popular domain name with the expectation that the site will get traffic off of the original sight because of a user's misspelling of the name. For example, registering the domain names webapedia.com or yahooo.com in the hopes that someone making a typo will get to that site unexpectedly.
Source: http://www.webopedia.com/TERM/T/typosquatting.html
The following two Web addresses are bogus sites and have nothing to do with my Web site. I have spent many years developing this Web site to provide good content on the Net, only to have to spend time fending off the vultures in cyberspace. Basically, it's what I would call "virtual identity theft." (I think this deserves to be in a glossary of Internet terms, which I just coined, and no, no one else has used this term, I just did a search....)
These sites were put up so they can make money off the unfortunate visitors who happen to stumble onto those sites (and a number of my visitors have told me that is how they found my site!!!) thinking they were coming to this site. My Web site address is http://www.bettycjung.net . Bookmark it so you can return to this site and not to these bogus sites, which have NOTHING to do with this Web site. Here are the domain information for these bogus sites. Unfortunately, I cannot do anything about their existence, but you can, by making sure you do not go to these sites by accident, or clicking on any links on those sites, which generates money for these miscreants. Put them out of business by not supporting their parasitic existence on the Net. Thank you.
WHOIS information for: bettycjung.com: [whois.crsnic.net] Whois Server Version 2.0 Domain names in the .com and .net domains can now be registered with many different competing registrars. Go to http://www.internic.net for detailed information. Domain Name: BETTYCJUNG.COM Registrar: DOMAINDOORMAN, LLC Whois Server: whois.domaindoorman.com Referral URL: http://www.domaindoorman.com Name Server: DNS1.AKNAMES.COM Name Server: DNS2.AKNAMES.COM Name Server: DNS3.AKNAMES.COM Status: clientTransferProhibited Updated Date: 09-oct-2006 Creation Date: 28-may-2006 Expiration Date: 28-may-2007 WHOIS information for: bettyjung.net: [whois.crsnic.net] Whois Server Version 2.0 Domain names in the .com and .net domains can now be registered with many different competing registrars. Go to http://www.internic.net for detailed information. Domain Name: BETTYJUNG.NET Registrar: COMPANA, LLC Whois Server: whois.budgetnames.com Referral URL: http://www.budgetnames.com Name Server: NS1.COOLLINK1.COM Name Server: NS2.COOLLINK1.COM Status: clientTransferProhibited Updated Date: 01-feb-2007 Creation Date: 31-jan-2006 Expiration Date: 31-jan-2008

April 11, 2007 - National Preparedness Day, Part III Here is a serendipitous support for my suggestion for a National Preparedness Day that I talked about in my December 1 and 13, 2006 blog entries. At that time I mentioned the "Ready or Not? Protecting the Public's Health From Diseases, Disasters and Bioterrorism" report that shows how unprepared states are for any public health crisis. Just recently, the American Public Health Association issued, "National Opinion Survey to Determine Levels of Preparedness for a Public Health Crisis" (2/2007) that looks at just how prepared Americans are for a public health crisis, and the answer is hardly. I think the time has come for a National Preparedness Day. You can find links to these two reports on my Evaluation Resources Page , under "State Report Cards, Non-government."

April 6, 2007 - Personal DNA Here is a great personality test that will really help you to get to know yourself better. It took me about 20 minutes because you really have to think about your answers. Most responses are on a sliding scale, or fun things like pinpointing your choice on a grid or emptying a bucket. Keep in mind that once you start you can't go backwards, or you will have to start all over. But the reward for finishing the test is a comprehensive report that interprets your choices to create a personality profile of who you are, along with a bar chart of your ratings (I love this stuff). I thought the report was reflective of me, a "cautious analyst." Why does this not surprise me??? You can find a link to this test on my Temperament Page , under "Personality Tests - Some Fun Stuff." Have fun while you learn more about yourself! If you like, E-mail me your thoughts about the test. Did you think it was accurate? (Just curious).

April 2, 2007 - Data Demand and Information Use (DDIU) in the Health Sector - Conceptual Framework The University of North Carolina's Population Center has developed a wonderful conceptual framework for the medical field that integrates the use of data for quality improvement, evidence-based practice and decision-making.
This is not unlike the many evaluation models currently out there, offering guidance for evaluating public health programs. Evaluation is important because we do not have limitless resources, so we must work efficiently with what there is, and to remember there is no room for ineffective programs. This is why it is so important to document what we are doing throughout the life of a program. If the program doesn't work, we need to move on to strategies that do, and if it does, we will have the proof we need to continue and build on the program's success. And, the best way to hold a program accountable is through evaluation. Check out this resource, along with other tools on my Evaluation Resources on the Net .

March 25, 2007 - Make a list for the doctor Do you ever get nervous when you see the doctor? You are not alone. All the questions you wanted to ask your doctor somehow get forgotten until you are out the door. Well, AHRQ has developed a Webpage with which you can build a questions list to bring to your doctor next time. It lists a set of questions, and then you pick and choose the questions you want to ask and then print out the list. What's nice about this page is that it will prompt you to think about questions you didn't even think to ask, but probably should just so you will have the information necessary to can make a good decision. You can find a link to this webpage on my Healthcare Resources Page and my Healthcare Quality Issues Page , entitled "What to Ask Your Doctor at Your Next Visit"

March 24, 2007 - Catch the 1985 movie, Brazil!!! I just recently had a chance to watch Terry Gilliam's Brazil . While it was released 22 years ago, I found it to be amazingly prescient of the world today. It may have seem more like a fantasy when it came out, but it's too "2007" for comfort. Kudos to Terry Gilliam, Charles McKeown and Tom Stoppard for the amazing screenplay!

March 23, 2007 - Mental Health, United States, 2004 SAMHSA just came out with this tome about mental health services. I know 2004 already sounds ancient, but this is an unfortunate outcome for comprehensive reports, which does take 2-3 years to compile. It does go into some detail but will be useful for those working in the area of mental health services. You can find a link to this document on my Public Health Documents Page

March 23, 2007 - Hello to a new quarter Well, not for another week, but it never hurts to be a little ahead of the wave....

March 22, 2007 - Wikipedia is not for academic research Wikipedia gets a black eye in a recent news article ( The word on Wikipedia: Trust but verify - Popular online encyclopedia, plagued by errors, troubles educators [http://www.msnbc.msn.com/id/17740041/]), which got me thinking that I needed to express my opinion on this.
I have always found Wikipedia an interesting phenomenon, believing that a democratic approach to knowledge sharing is possible. We all know that a hobbyist is really an unacknowledged expert in the field of his hobby because a hobbyist will go through extraordinary effort and means to understand the inspiration of his passion. In a way, when we learn, we should really adopt the attitude of a hobbyist to truly get the most out of the learning experience.
I have found Wikipedia to be great for looking up a quick biosketch of someone in the news, or, a quick overview of some everyday topic, but I would not rely on it for serious research work. I do not allow my students to use it simply because there is no way to hold anyone accountable for the material written up in Wikipedia. For example, who would you ask to verify a statement made, or to clarify a concept presented? Anonymity may help with honesty in offering opinions, but does not necessarily guarantee the accuracy of the entries.
Of course, just like the easy out for many of my classmates in elementary school, getting everything from an encyclopedia, Wikipedia plays into a modern-day easy out of not having to do the necessary research to truly understand the subject. I expect my students to at least research a minimum of 3 different sources because any differences in perspective will show up. And, if there are differences, then it's only right to continue to look at more sources to determine where the truth really lies (oh, this sounds strange, but true).
It is unfortunate that students today think that being critical is critical thinking, and being exposed to different points of view is seen as confusing rather than a challenge to think through a subject, to then develop a comprehensive understanding of the subject being researched. Certainly, Education remains an important aspect to becoming all that we can be because it is meant to help us develop the discipline necessary to focus on what is really important, and that's getting the facts and ideas right, and then applying them to our lives.

March 8, 2007 - Finland's strategy for preventing Type 2 Diabetes In a March 1st Reuters release - "The World Health Organization has predicted a 39 percent rise in the worldwide prevalence of diabetes between 2000 and 2030, but (the study) indicates that this figure might be a gross underestimation... Type-2 diabetes is associated with obesity, poor diet and a lack of exercise. It has reached epidemic proportions in many developed countries as people eat a richer diet and exercise less." In the same release, Canada reported a "69 percent increase in the rate of diabetes in Ontario between 1995 and 2005 -- far beyond the 60 percent global predicted increase for 2030 and above rates projected for Canada by then."
Type 2 diabetes, a multifactorial chronic disease, when not managed properly results in poor health outcomes. The country of Finland has developed a wonderful comprehensive document outlining its program for preventing Type 2 diabetes in its country. "Programme for the Prevention of Type 2 Diabetes in Finland 2003-2010" will be useful for anyone working on the problem of diabetes. You can find a link to this on my Diabetes Resources on the Net Page , under Public Health Information.

March 5, 2007 - The Downward Spiral of American Health A March 5th NIH bulletin reports, "Americans in their early to mid-50s today report poorer health, more pain and more trouble doing everyday physical tasks than their older peers reported at the same age in years past,..." "researchers compared the overall, self-reported health of people in three birth-year groups -- those born in 1936-41 (now ages 66 to 71), 1942-47 (now ages 60 to 65) and 1948-53 (now ages 54 to 59).
-- The two younger groups were less likely than the oldest group to have said their health was "excellent or very good" at 51 to 56 years of age.
-- The youngest group reported having more pain, chronic health conditions, and drinking and psychiatric problems than people who were the same age 12 years earlier.
-- Compared with the oldest group, the youngest group was more likely to have reported difficulty in walking, climbing steps, getting up from a chair, kneeling or crouching, and doing other normal daily physical tasks.
This new analysis provides some initial data raising the question of whether today's pre-retirees could reach retirement age in worse shape than their predecessors, with individuals potentially in poorer health than current retirees and possibly increasing health care costs for society.
Researchers and policymakers are vitally interested in whether this trend will continue, accelerate or decelerate with the retirement of the baby boom, a critically important question in planning for health, housing and other needs of this wave of retirees, who begin to turn 65 in 2011." (Source: http://www.nih.gov/news/pr/mar2007/nia-05.htm)
Well, given that the current younger generation is no better off than those in their 50s, I can see that this unfortunate trend, or downward spiral will continue if Americans don't stop what they're doing and start concentrating on their health. As it is, the health care system cannot handle the current load of ill health, and it will only get worse, but much more rapidly than most people anticipated. Stop smoking, eat better, get some serious exercise, and on a more broader level, it's time to fix the health care system.

February 26, 2007 - Post-Oscars Blues Well, another year over, and I feel badly for the also-rans, but more for those who didn't even get nominated, but should have. I am glad that Helen Mirren won, and it's nice to see a woman who's not in her 20s win; at least, for one year, experience counts. The probably-should-have-at-least-got-nominated include Annette Bening (seriously under-rated) for her hilarious turn in "Running with Scissors". She always gives a fine over-the-top performance in all the films I've seen her in, from "American Beauty" to "Being Julia," and let's not forget "The Grifters", "Bugsy" and "Mars Attack!" Catherine O'Hara was truly great in "For Your Consideration", and it would have been fun to see her live out a "Stranger Than Fiction" scenario on Oscar night, which reminds me that Emma Thompson should have gotten a nod for her role in the aforementioned film.
Yes, Jack Nicholson has gotten nominated plenty, but it would have been nice to recognize his fine work in "The Departed," it's been awhile since Jack has done this much acting since he can always get by just being Jack. Despite Mel Gibson's troubles off-screen, Apocalypto was a great film that got overlooked, as did Clint Eastwood's "Letters from Iwo Jima," which I thought was more a "Best Picture" film than "The Departed" (although I really disliked "Flags of Our Fathers", and I don't want to count the ways).
Maybe the Academy was trying to make up for all the years they passed over Scorsese, so they gave him both picture and director honors (which the Academy hasn't done in years). Finally, a brief plug for a couple a cool films, "Flyboys", a film I found educational and entertaining, that did poorly in the theaters, but worth seeing, and "The Curse of the Golden Flower," which somehow got lost in the last-minute year-end releases. Talk about a Chinese "Greek Tragedy"! By the way, Ellen DeGeneres did a great job. They should bring her back.

February 5, 2007 - Public Health Mapping Ever since John Snow mapped the cholera deaths of London in the 1850s, public health practitioners have developed a deep appreciation of cartography. Within the past 15 years or so, desktop mapping software have made it possible to develop beautiful maps to characterize not only disease epidemics, but to visualize the geographic spread of a health problem. Instead of numerous tables of numbers, a series of maps can tell the story with greater impact, as the spread of obesity across the country during the recent decades. If you really want to see what cartographers are up to these days, check out Worldmapper.org, which brings to the forefront the concept of equal area cartograms. This group is on a quest to map every possible social and demographic topic they can think of, many of which are useful to public health practitioners. I was somewhat disappointed to see that in the area of Health Service Quality (yes, they have a map of that too), the U.S. ranks 15th in the world. And, who's #1? Japan, followed by Switzerland. You can find links to this Web site on my Public Health Software Page , under Public Health Mapping.

February 4, 2007 - Oscar Time Typically, my list of "must-see" movies is dictated by Entertainment Weekly's "25 must-see movies before the Oscars", which is EW's educated guesses for possible Oscar nominations. For 2006, I actually did pretty well, seeing 21 out of the 25 listed. I will try and see the rest, but some are already out of the theaters. My amateur Oscar guesses for 2/25:
I think Martin Scorcese will finally get the golden guy this year for "The Departed" - it's time. Best Picture is a little unpredictable for me. In recent years, the Academy seems to like spreading out the awards. Babel seemed a favorite early on (winning the Golden Globe), but then Little Miss Sunshine has gotten a few awards from the critics. If last year was any indication, Golden Globe did not predict the Academy's big picture for Crash (Golden Globe gave it to Brokeback Mountain). I actually liked The Queen, and that's worth seeing for Helen Mirren, who should get Best Actress. The Departed is good, but not sure if gangster movies appeal to the Academy's esthetics. I would not be surprised if Letters from Iwo Jima gets best picture (even though it's really a foreign film [and did win the Golden Globe in that category]. The fact that it got nominated on such short notice and late release makes me think it could be an upset, and simply because Clint Eastwood has done this twice already in recent years...). Babel just seemed too much like Crash, and I don't think the Academy picks the same types of pictures in a row. Of course, the movies I enjoyed the most never make it to the Oscars, but that's okay, it's all entertainment.

January 13, 2007 - Information Pollution We have now reached the point of diminishing returns in our quest to be informed. We are basically swamped by data of questionable value, weighted down by senseless commentaries that do not add any value to the equation, and takes away time from the need to reflect upon what we have read. This is most clearly seen on the Internet, a place where literally anybody can set up a site and blog to oblivion. David Nelson's "Reducing Information Pollution in the Internet Age" makes for thoughtful reading for those who seek to provide quality content on the Web for those who seek information they can use. You can find a link to this article on my Health Care Quality Issues Page, under "Health Literacy."

January 12, 2007 - Pay for Performance Strategies are constantly being developed to improve health care quality. Many times, it seems like these efforts are accompanied by the further deterioration of the health care system as a whole. Most likely, a revamping of the entire health care system would be needed to improve the quality of health care, despite the efforts of dedicated health professionals, and the quality improvement mavens measuring what's going on.
The latest strategy to gain momentum is "Pay for Performance" or, now conveniently referred to as P4P. If you are confused by the growing glossary of the terminology being used, you are not alone. I recently came across North American Spine Society's "The Quick and Dirty Guide to Performance Measurement and Pay for Performance (P4P)", which provides an outline summary of all the key concepts and terms you will ever need to know (at least for now) about health care quality improvement in 3 pages. You can find a link to this primer on my Health Care Quality Issues, under "Pay for Performance."

January 1, 2007 - Happy New Year!!

Don't forget, there was a time "2001" seemed futuristic....

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Published on the Web: January 30, 2007; Renamed December 24, 2009, Blog links added 12/31/11
Updated: 11/20/2022 R299
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