John 3:16 played during Broncos playoff game riff off of Tim Rebow

BBC News - Clock change 'stops outdoor play' Point is : free play is really healthy.

Amount of 'play light' may have a huge public health role against childhood obesity. Point is : free play is really healthy. 

Clock change 'stops outdoor play'

                               by Helen Briggs, bbc.co.uk
November 9th 2011

Not putting the clocks back would help in the fight against child obesity, a study suggests.

According to research, children are more influenced by daylight than the weather when deciding whether or not to play outside.

UK researchers report that not changing the clocks would give more opportunities for active play.

It strengthens the public health arguments for proposed changes to daylight saving, they say.

The research, published in the Journal of Physical Activity and Health, studied the activity levels of 325 children in south-east England aged between eight and 11.

The children wore accelerometers to record the amount of exercise they did, and kept a record of their activities in a diary.

A team from the London School of Hygiene and Tropical Medicine and University College London found the children did more exercise outside on longer days, particularly at the end of the day during summer.

“Start Quote

This provides the most direct evidence yet that changing the clocks so that there is more daylight in the afternoon could increase children's physical activity”

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This happened regardless of the likes of rain, cloud or wind.

Outdoor play was a bigger factor in overall physical activity than other factors such as structured sport sessions and cycling or walking to school, the team says.

Co-researcher Dr Anna Goodman, of the London School of Hygiene and Tropical Medicine, told the BBC: "This provides the most direct evidence yet that changing the clocks so that there is more daylight in the afternoon could increase children's physical activity."

She added: "The fact that kids spend more time playing outdoors and are more physically active overall on these longer days could be important at a population level for promoting their fitness and in preventing child obesity.

"This strengthens the public health argument for the Daylight Saving Bill currently under consideration by the House of Commons, which proposes putting the clocks forward by an extra hour all year round."

The clocks were moved forward by an hour during World War II to increase productivity at munitions factories and help people get home safely before the blackout.

But some health experts argue that a change to this tradition would give children more opportunities for outdoor play, as well as making it safer for them to travel home from school.

'Safe space'

Tam Fry, a spokesperson for the National Obesity Forum, said: "The longer the daylight hours, the longer kids will play. They really don't seem to care much about the weather but they do care about the dark.

"They need clearly to see the environment in which they can roam unfettered, and it should be no surprise that longer summer evenings provide that environment.

"They will be healthier and fitter from their outdoor play. Pack them all off to a safe space until bedtime."

Ministers are writing to counterparts in Scotland, Wales and Northern Ireland to seek a UK-wide consensus on a trial.

It would see the UK adopt Central European Time, with BST plus one hour in summer and GMT plus one in winter.

Original Page: http://www.bbc.co.uk/news/health-15646812

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RISk of obesity starts young. Infant growth charts can predict later obesity - latimes.com

  CAVEAT! It's only a risk, not a determination. If both parents are fit, and have healthy lifestyles, I don't this data applies, or at least not as robustly.  

Infant growth can predict later obesity, a study indicates

by Shari Ro, latimes.com
November 7th 2011 Infant weight and height are faithfully charted at each pediatrician's visit to make sure the child is growing properly. But nowadays doctors are more likely to see babies who are growing too fast rather than ones lagging behind. A new study shows that rapid growth on these charts foretells obesity in childhood.

Researchers looked at the weight-for-length charts that show how a baby's weight compares to that of other babies of the same length. For example, babies on the 5th percentile growth line have a weight that puts them among the smallest 5% of all babies their length. Doctors mostly want to see that a child is following his or her growth curve over time and not falling off or jumping up. The major percentile lines are the 5th, 10th, 25th, 50th, 75th, 90th and 95th.

The study, which tracked more than 44,000 babies, found that those who rose two or more major percentiles -- for example, going from 50% to 90% at some point -- before age 2 were twice as likely to be obese at age 5 and 75% more likely to be obese at age 10.

Babies who jumped two or more percentiles before six months of age had the highest risk of obesity at age 10 as well as babies who were already in a high percentile at their first visit. For example a 6-month-old baby who started at the 75th percentile who jumped two or more percentiles in the next six months had an obesity prevalence of almost 30% at age 5. Babies who started at less than the 25th percentile and jumped two or more percentiles had an obesity prevalence at age 5 of about 7%.

"We shouldn't neglect these early gains and think that it's just baby fat, and that these children are going to grow out of it," said Dr. Elsie Taveras, the lead author of the study at Children's Hospital Boston.

Of all the babies in the study, 11.6% were obese at age 5 and 16% at age 10. Jumping two or more percentiles was common, the researchers found, with 43% rising two or more percentiles in their first six months of life and 64% at some point in their first two years.

The study was published Monday in the Archives of Pediatrics and Adolescent Medicine. The journal also carries an interesting commentary on child obesity by Dr. Robert C. Whitaker of the Center for Obesity Research and Education at Temple University.

Whitaker discusses the widespread social change that will be required to reverse the obesity epidemic. "The childhood obesity epidemic was an unexpected consequence of numerous well-intentioned decisions made by adults about how to improve our way of living. These decisions were often made without considering children or all aspects of their well-being," he writes.

Return to Booster Shots blog. Follow me: twitter.com/LATShariRoan

Original Page: http://www.latimes.com/health/boostershots/la-heb-infant-growth-20111107,0,2456006.story

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Fat babies may mean something more than cuteness JK

Infant growth can predict later obesity, a study indicates

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Babies who grow too fast have a much higher risk of becoming obese, a study indicates. (Los Angeles Times)

• ALSO
• Parents to pediatricians: Don't tell me my kid's 'fat'
• Childhood obesity risk studies: Key factors
• Companies marketing food to kids need stronger guidelines, health advocates say
• Increase in breast-feeding could save lives and billions of dollars
• Healthful vending machines are increasing, but do they help?

By Shari Roan, Los Angeles Times / For the Booster Shots blog

November 7, 2011, 12:21 p.m.

Infant weight and height are faithfully charted at each pediatrician's visit to make sure the child is growing properly. But nowadays doctors are more likely to see babies who are growing too fast rather than ones lagging behind. A new study shows that rapid growth on these charts foretells obesity in childhood.

Researchers looked at the weight-for-length charts that show how a baby's weight compares to that of other babies of the same length. For example, babies on the 5th percentile growth line have a weight that puts them among the smallest 5% of all babies their length. Doctors mostly want to see that a child is following his or her growth curve over time and not falling off or jumping up. The major percentile lines are the 5th, 10th, 25th, 50th, 75th, 90th and 95th.

The study, which tracked more than 44,000 babies, found that those who rose two or more major percentiles -- for example, going from 50% to 90% at some point -- before age 2 were twice as likely to be obese at age 5 and 75% more likely to be obese at age 10.

Babies who jumped two or more percentiles before six months of age had the highest risk of obesity at age 10 as well as babies who were already in a high percentile at their first visit. For example a 6-month-old baby who started at the 75th percentile who jumped two or more percentiles in the next six months had an obesity prevalence of almost 30% at age 5. Babies who started at less than the 25th percentile and jumped two or more percentiles had an obesity prevalence at age 5 of about 7%.

"We shouldn't neglect these early gains and think that it's just baby fat, and that these children are going to grow out of it," said Dr. Elsie Taveras, the lead author of the study at Children's Hospital Boston.

Of all the babies in the study, 11.6% were obese at age 5 and 16% at age 10. Jumping two or more percentiles was common, the researchers found, with 43% rising two or more percentiles in their first six months of life and 64% at some point in their first two years.

The study was published Monday in the Archives of Pediatrics and Adolescent Medicine. The journal also carries an interesting commentary on child obesity by Dr. Robert C. Whitaker of the Center for Obesity Research and Education at Temple University.

Whitaker discusses the widespread social change that will be required to reverse the obesity epidemic. "The childhood obesity epidemic was an unexpected consequence of numerous well-intentioned decisions made by adults about how to improve our way of living. These decisions were often made without considering children or all aspects of their well-being," he writes.

Return to Booster Shots blog.

Follow me: twitter.com/LATShariRoan 

Didn't even realize she just received a flu shot

Reminder to get a flu vaccine.

The danger of overuse of technology. Translates to over diagnosis, and a waste of worry? THe case of the MRI.

M.R.I.'s, Often Overused, Ofte

by GINA KOLATA, mobile.nytimes.com

October 29th 2011 

Dr. James Andrews, a widely known sports medicine orthopedist in Gulf Breeze, Fla., wanted to test his suspicion that M.R.I.'s, the scans given to almost every injured athlete or casual exerciser, might be a bit misleading. So he scanned the shoulders of 31 perfectly healthy professional baseball pitchers.

The pitchers were not injured and had no pain. But the M.R.I.'s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. "If you want an excuse to operate on a pitcher's throwing shoulder, just get an M.R.I.," Dr. Andrews says.

He and other eminent sports medicine specialists are taking a stand against what they see as the vast overuse of magnetic resonance imaging in their specialty.

M.R.I.'s can be invaluable in certain situations - finding serious problems like tumors or helping distinguish between competing diagnoses that fit a patient's history and symptoms. They also can make money for doctors who own their own machines. And they can please sports medicine patients, who often expect a scan.

But scans are easily misinterpreted and can result in misdiagnoses leading to unnecessary or even harmful treatments.

For example, said Dr. Bruce Sangeorzan, professor and vice chairman of the department of orthopedics and sports medicine at the University of Washington, if a healthy, uninjured person goes out for a run, a scan afterward will show fluid in the knee bone. It is inconsequential. But in an injured person, fluid can be a sign of a bone that is stressed or even has a crack and is trying to heal.

"An M.R.I. is unlike any other imaging tool we use," Dr. Sangeorzan said. "It is a very sensitive tool, but it is not very specific. That's the problem." And scans almost always find something abnormal, although most abnormalities are of no consequence.

"It is very rare for an M.R.I. to come back with the words 'normal study,' " said Dr. Christopher DiGiovanni, a professor of orthopedics and a sports medicine specialist at Brown University. "I can't tell you the last time I've seen it."

In sports medicine, where injuries are typically torn muscles or tendons or narrow cracks in bones, specialists like Dr. Andrews and Dr. DiGiovanni say M.R.I.'s often are not needed - they usually can figure out what is wrong with just a careful medical history, a physical exam and, sometimes, a simple X-ray.

M.R.I.'s are not the only scans that are overused in medicine but, in sports medicine, where many injuries involve soft tissues like muscles and tendons, they rise to the fore.

In fact, one prominent orthopedist, Dr. Sigvard T. Hansen, Jr., a professor of orthopedics and sports medicine at the University of Washington, says he pretty much spurns such scans altogether because they so rarely provide useful information about the patients he sees - those with injuries to the foot and ankle.

"I see 300 or 400 new patients a year," Dr. Hansen says. "Out of them, there might be one that has something confusing and might need a scan."

The price, which medical facilities are reluctant to reveal, depends on where the scan is done and what is being scanned. One academic medical center charges $1,721 for an M.R.I. of the knee to look for a torn ligament. The doctor who interprets the scan gets $244. Doctors who own their own M.R.I. machines - and many do - can pocket both fees. Insurers pay less than the charges - an average of $150 to the doctor and $960 to the facility.

Steve Ganobcik is something of a poster child for what can go wrong with the scans. A salesman who turns 44 on Saturday, Mr. Ganobcik twisted his knee skiing in Colorado in February. He continued skiing anyway and skied again the next two days as well, not wanting to cut his vacation short.

When he got home to Cleveland, his knee still bothered him, so he saw a sports medicine orthopedist. The doctor immediately ordered an M.R.I. and said it showed a torn anterior cruciate ligament, or A.C.L. It is one of the most common - and most devastating - sports injuries. The standard treatment is surgery, with a difficult recuperation lasting six months to a year.

Mr. Ganobcik looked into surgical techniques and decided he wanted a different one than the one his doctor offered. So he saw another sports medicine orthopedist who, agreeing that Mr. Ganobcik's ligament was torn, scheduled the operation.

Meanwhile, Mr. Ganobcik heard that Dr. Freddie H. Fu, chairman of the division of sports medicine at the University of Pittsburgh, had what might be an even better technique, so he went to see him.

To Mr. Ganobcik's surprise, Dr. Fu told him his ligament was not torn after all. His pain was from a fracture in a long bone in the lower leg that the other doctors had also noticed was broken. An M.R.I. at the University of Pittsburgh confirmed it, showing a perfectly normal A.C.L. (Dr. Fu adds that Mr. Ganobcik's original scans had an image that was ambiguous. He wanted a better one, to see if Mr. Ganobcik's ligament had been partly torn and was healing or had never been torn at all. He would not need surgery with a partial tear, but he would need more careful recuperation.)

Dr. Fu's suspicions were raised by Mr. Ganobcik's story. He could never have continued skiing with a torn A.C.L. The diagnosis "made no sense," Dr. Fu said.

And that, Dr. Fu says, illustrates a common problem: relying on an M.R.I. instead of a history and an exam. Dr. Fu's diagnosis "was a shock," Mr. Ganobcik said. "I thought he was going to talk about options for surgery."

M.R.I.'s can be extremely useful in sports medicine, said Dr. Andrew Green, the chief of shoulder and elbow surgery at Brown University. But, he says, there is a fine line between appropriate use and overuse.

That, at least, is what he found in one of the few studies to address the issue. The ideal study would randomly assign patients to have scans or not and then assess their outcomes. Such a study has not been done. Instead, a few researchers asked if scans made a difference for people who happened to have them. They found they did not - at least in two common situations.

Dr. Green and his colleagues reviewed the records of 101 patients who had shoulder pain lasting at least six weeks and that had not resulted from trauma, like a fall. Forty-three arrived bearing M.R.I.'s from a doctor who had seen them previously. The others did not have scans. In all cases, Dr. Green made a diagnosis on the basis of a physical exam, a history, and regular X-rays.

A year later, Dr. Green re-assessed the patients. There was no difference in the outcome of the treatment of the two groups of patients despite his knowledge of the findings on the scans. M.R.I.'s, he said, are not needed for the initial evaluation and treatment of many whose shoulder pain does not result from an actual injury to the shoulder.

Dr. DiGiovanni did a similar study with foot and ankle patients, looking back at 221 consecutive patients over a three-month period, 201 of whom did not have fractures. More than 15 percent arrived with M.R.I.'s obtained by doctors they had seen before coming to Dr. DiGiovanni. Nearly 90 percent of those scans were unnecessary and half had interpretations that either made no difference to the patient's diagnosis or were at odds with the diagnosis.

"Patients often feel like they are getting better care if people are ordering fancy tests, and there are some patients who come in demanding an M.R.I. - that's part of the problem," he said.

Some doctors might also feel they are providing better care if they order the scans, Dr. DiGiovanni said, and doctors often feel that they risk malpractice charges if they fail to scan a patient and then miss a diagnosis.

Dr. Hansen teaches his fellows - doctors in training - to be careful with scans and explains the risks of making the wrong diagnosis if they order them unnecessarily. He also knows it is not easy to refrain from ordering an M.R.I.

It's different for him, Dr. Hansen says. He is so eminent that patients tend not to question him.

"When I say 'You don't need a scan,' then it's over," Dr. Hansen said. His fellows get a different response. Patients, he says, "look at them like, 'You don't know what you're doing.' "

Original Page: http://mobile.nytimes.com/article?a=860324&f=26

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Re anti vaccine movement.

PERSPECTIVE

The Age-Old Struggle against the Antivaccinationists

Gregory A. Poland, M.D., Robert M. Jacobson, M.D.

N Engl J Med 364:97-99 | January 13, 2011

Since the introduction of the first vaccine, there has been opposition to vaccination. In the 19th century, despite clear evidence of benefit, routine inoculation with cowpox to protect people against smallpox was hindered by a burgeoning antivaccination movement. The result was ongoing smallpox outbreaks and needless deaths. In 1910, Sir William Osler publicly expressed his frustration with the irrationality of the antivaccinationists by offering to take 10 vaccinated and 10 unvaccinated people with him into the next severe smallpox epidemic, to care for the latter when they inevitably succumbed to the disease, and ultimately to arrange for the funerals of those among them who would die (see the Medical Notes section of the Dec. 22, 1910, issue of the Journal). A century later, smallpox has been eradicated through vaccination, but we are still contending with antivaccinationists.

The Cow Pock — or — the Wonderful Effects of the New Inoculation.

Since the 18th century, fear and mistrust have arisen every time a new vaccine has been introduced. Antivaccine thinking receded in importance between the 1940s and the early 1980s because of three trends: a boom in vaccine science, discovery, and manufacture; public awareness of widespread outbreaks of infectious diseases (measles, mumps, rubella, pertussis, polio, and others) and the desire to protect children from these highly prevalent ills; and a baby boom, accompanied by increasing levels of education and wealth. These events led to public acceptance of vaccines and their use, which resulted in significant decreases in disease outbreaks, illnesses, and deaths. This golden age was relatively short-lived, however. With fewer highly visible outbreaks of infectious disease threatening the public, more vaccines being developed and added to the vaccine schedule, and the media permitting widespread dissemination of poor science and anecdotal claims of harm from vaccines, antivaccine thinking began flourishing once again in the 1970s.¹

Little has changed since that time, although now the antivaccinationists' media of choice are typically television and the Internet, including its social media outlets, which are used to sway public opinion and distract attention from scientific evidence. A 1982 television program on diphtheria–pertussis–tetanus (DPT) vaccination entitled "DPT: Vaccine Roulette" led to a national debate on the use of the vaccine, focused on a litany of unproven claims against it. Many countries dropped their programs of universal DPT vaccination in the face of public protests after a period in which pertussis had been well controlled through vaccination² — the public had become complacent about the risks of the disease and focused on adverse events purportedly associated with vaccination. Countries that dropped routine pertussis vaccination in the 1970s and 1980s then suffered 10 to 100 times the pertussis incidence of countries that maintained high immunization rates; ultimately, the countries that had eliminated their pertussis vaccination programs reinstated them.² In the United States, vaccine manufacturers faced an onslaught of lawsuits, which led the majority of them to cease vaccine production. These losses prompted the development of new programs, such as the Vaccine Injury Compensation Program (VICP), in an attempt to keep manufacturers in the U.S. market.

The 1998 publication of an article, recently retracted by the Lancet, by Wakefield et al.³ created a worldwide controversy over the measles–mumps–rubella (MMR) vaccine by claiming that it played a causative role in autism. This claim led to decreased use of MMR vaccine in Britain, Ireland, the United States, and other countries. Ireland, in particular, experienced measles outbreaks in which there were more than 300 cases, 100 hospitalizations, and 3 deaths.⁴

Today, the spectrum of antivaccinationists ranges from people who are simply ignorant about science (or "innumerate" — unable to understand and incorporate concepts of risk and probability into science-grounded decision making) to a radical fringe element who use deliberate mistruths, intimidation, falsified data, and threats of violence in efforts to prevent the use of vaccines and to silence critics. Antivaccinationists tend toward complete mistrust of government and manufacturers, conspiratorial thinking, denialism, low cognitive complexity in thinking patterns, reasoning flaws, and a habit of substituting emotional anecdotes for data.⁵ Their efforts have had disruptive and costly effects, including damage to individual and community well-being from outbreaks of previously controlled diseases, withdrawal of vaccine manufacturers from the market, compromising of national security (in the case of anthrax and smallpox vaccines), and lost productivity.²

The H1N1 influenza pandemic of 2009 and 2010 revealed a strong public fear of vaccination, stoked by antivaccinationists. In the United States, 70 million doses of vaccine were wasted, although there was no evidence of harm from vaccination. Meanwhile, even though more than a dozen studies have demonstrated an absence of harm from MMR vaccination, Wakefield and his supporters continue to steer the public away from the vaccine. As a result, a generation of parents and their children have grown up afraid of vaccines, and the resulting outbreaks of measles and mumps have damaged and destroyed young lives. The reemergence of other previously controlled diseases has led to hospitalizations, missed days of school and work, medical complications, societal disruptions, and deaths. The worst pertussis outbreaks in the past 50 years are now occurring in California, where 10 deaths have already been reported among infants and young children.

In the face of such a legacy, what can we do to hasten the funeral of antivaccination campaigns? First, we must continue to fund and publish high-quality studies to investigate concerns about vaccine safety. Second, we must maintain, if not improve, monitoring programs, such as the Vaccine Adverse Events Reporting System (VAERS) and the Clinical Immunization Safety Assessment Network, to ensure coverage of real but rare adverse events that may be related to vaccination, and we should expand the VAERS to make compensation available to anyone, regardless of age, who is legitimately injured by a vaccine. Third, we must teach health care professionals, parents, and patients how to counter antivaccinationists' false and injurious claims. The scientific method must inform evidence-based decision making and a numerate society if good public policy decisions are to be made and the public health held safe. Syncretism between the scientific method and unorthodox medicine can be dangerous.

Fourth, we must enhance public education and public persuasion. Patients and parents are seeking to balance risks and benefits. This process must start with increasing scientific literacy at all levels of education. In addition, public–private partnerships of scientists and physicians could be developed to make accurate vaccine information accessible to the public in multiple languages, on a range of reading levels, and through various media. We must counter misinformation where it is transmitted and consider using legal remedies when appropriate.

The diseases that we now seek to prevent with vaccination pose far less risk to antivaccinationists than smallpox did through the early 1900s. Unfortunately, this means that they can continue to disseminate false science without much personal risk, while putting children, the elderly, and the frail in harm's way. We can propose no Oslerian challenge to demonstrate our point but have instead a story of science and contrasting worldviews: on the one hand, a long history of stunning triumphs, such as the eradication of smallpox and control of many epidemic diseases that had previously maimed and killed millions of people; on the other hand, the reality that none of the antivaccinationists' claims of widespread injury from vaccines have withstood the tests of time and science. We believe that antivaccinationists have done significant harm to the public health. Ultimately, society must recognize that science is not a democracy in which the side with the most votes or the loudest voices gets to decide what is right.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

References

1. RM Wolfe, LK SharpAnti-vaccinationists past and present.BMJ2002;325:430-432
2. EJ Gangarosa, AM Galazka, CR Wolfe, Impact of anti-vaccine movements on pertussis control: the untold story.Lancet1998;351:356-361
3. Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998;351:637-41. [Retraction, Lancet 2010;375:445.]
4. J McBrien, J Murphy, D Gill, M Cronin, C O'Donovan, MT CafferkeyMeasles outbreak in Dublin, 2000.Pediatr Infect Dis J2003;22:580-584
5. RM Jacobson, PV Targonski, GA PolandA taxonomy of reasoning flaws in the anti-vaccine movement.Vaccine2007;25:3146-3152

Source Information

From the Mayo Clinic Vaccine Research Group (G.A.P., R.M.J.), the Department of Medicine (G.A.P.), and the Department of Pediatric and Adolescent Medicine (G.A.P., R.M.J.), Mayo Clinic, Rochester, MN.

Study Linking Childhood Vaccine And Autism Was Fraudulent

  Even so, it may take years of dissipation for the skepticism re vaccines to fade. 

http://www.npr.org/blogs/health/2011/01/06/132703314/study-linking-childhood-vaccine-and-autism-was-fraudulent?sc=17&f=1001

Study Linking Childhood Vaccine And Autism Was Fraudulent
by Scott Hensley

- January 6, 2011

Just when you think there's nothing left to say about a 13-year-old paper that purported to link childhood vaccination and autism, it turns out you're wrong.

In the latest issue of BMJ, the British Medical Journal, investigative reporter Brian Deer makes the case that the infamous Lancet study, withdrawn last year, wasn't just wrong -- it was fraudulent because key facts were altered to support the autism link.

The original paper reported on a dozen kids, eight of whom supposedly developed gastrointestinal trouble and "regressive autism," a form of the disorder that strikes later in childhood, after getting a combination vaccine against measles mumps and rubella. The work was led by Andrew Wakefield, an English doctor whose license was revoked last May for "serious professional misconduct" related to the work.

Where did the paper go wrong? Deer counts the ways after scouring health records and interviewing the patients families and various doctors. A few of the lowlights:

Only 1 of 9 kids said to have regressive autism clearly had it. Three had no form of autism.

Contrary to the paper's assertion that all the kids were normal before vaccination, five had some sort of preexisting developmental problems.

Behavioral problems the paper said popped up days after vaccination didn't actually appear for months in some kids, a fact that undercuts the causality of vaccination.

Wakefield's hypothesized link between vaccination and autism was flimsy from the start, and has since been repeatedly repudiated. But the provocative Lancet paper fueled a vigorous backlash against vaccination.

An accompanying editorial in BMJ argues that "clear evidence of falsification of data should now close the door on this damaging vaccine scare" for good.

CNN's Anderson Cooper interviewed Wakefield, who called Deer, "a hitman" hired to "take me down." Wakefield defended the paper and his methods. See the video below for the full discussion.

UPDATE 4:30 p.m.

As NPR's Jon Hamilton reports on today's All Things Considered, more revelations about Wakefield aren't likely to make the fear of vaccines go away. But David Ropeik, is an instructor at Harvard, says something else eventually will. "As more and more people get measles and kids die, which is happening around the world. Eventually the threat of the disease will come back and surmount our fear of the vaccine." [Copyright 2011 National Public Radio]

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

Article: Parents Embrace ‘Race to Nowhere,’ on Pressures of School - NYTimes.com

On the debate of defining childhood. 

Parents Embrace 'Race to Nowhere,' on Pressures of School - NYTimes.com
http://www.nytimes.com/2010/12/09/education/09nowhere.html?ref=homepage&src=me&pagewanted=all

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Advertise on NYTimes.com

Parents Embrace Documentary on Pressures of School

By TRIP GABRIEL

Published: December 8, 2010

It isn't often that a third of a movie audience sticks around to discuss its message, but that is the effect of "Race to Nowhere," a look at the downside of childhoods spent on résumé-building.

"How do you help your children balance when the whole education system is pushing, pushing, pushing, and you want your kids to be successful?" Alethea Lewis, a mother of two, asked a roomful of concerned parents who had just seen the film, a documentary, last week in Bronxville, N.Y., at a screening co-sponsored by the private Chapel School.

With no advertising and little news media attention, "Race to Nowhere" has become a must-see movie in communities where the kindergarten-to-Harvard steeplechase is most competitive.

More than 1,100 attended a screening last week at New Trier High School in Winnetka, Ill. About 500 saw it at the 92nd Street Y in Manhattan in November. It has been shown to a roomful of fathers at Pixar during lunch hour and twice to employees at the Silicon Valley headquarters of Google.

All 325 seats in the auditorium of New Canaan Country School in Connecticut were filled during a screening for parents last Thursday night. Francie Irvine, the assistant head of school, said, "Our parents' association president called me and said, 'My sister just saw this in California and we have to, have to, have to have it here.' "

The film portrays the pressures when schools pile on hours of homework and coaches turn sports into year-round obligations. Left somewhat unexamined is the role of parents whose high expectations contribute the most pressure of all.

"Everyone expects us to be superheroes," one high school senior in the film says.

Another tells of borrowing her friends' prescription for Adderall to juggle her many commitments. "It's hard to be the vice president of your class, play on the soccer team and do homework," she says.

The movie introduces boys who drop out of high school from the pressure, girls who suffer stress-induced insomnia and worse, and students for whom "cheating has become another course," as one puts it.

"When success is defined by high grades, test scores, trophies,"' a child psychologist says in the film, "we know that we end up with unprepared, disengaged, exhausted and ultimately unhealthy kids."

Vicki Abeles, the middle-aged mother and first-time filmmaker who made "Race to Nowhere," picked up a camera when a doctor said that her then-12-year-old daughter's stomachaches were being caused by stress from school.

"I was determined to find out how we had gotten to a place where our family had so little time together," she explains in the film, which has an unslick, home-video quality, "where our kids were physically sick because of the pressures they were under."

In many ways, the movie is the alter ego to the better-known "Waiting for Superman," another education documentary playing around the country this fall.

That film has earned $6.3 million at the box office since its release and ranks 20th among the most successful documentaries ever, according to Box Office Mojo, in no small part because of a blast of publicity. The director appeared on "The Oprah Winfrey Show," and President Obama greeted its stars at the White House.

"Race to Nowhere" had a one-week run in two theaters, in New York and Los Angeles, but it has primarily been screened by community groups in school auditoriums, churches and temples. Local sponsors like parent-teacher associations sell tickets and split the take with the filmmakers.

Ms. Abeles, a corporate lawyer who briefly traded on the gold desk at Goldman Sachs before moving to Northern California with her family, said the film cost her and other backers in the "mid-six figures." It will have been shown at some 700 locations through February.

With her movie's grass-roots success, Ms. Abeles has been approached by major distributors offering to place it in commercial theaters. But she is not convinced that the movie would reach as wide an audience or inspire viewers to stay for the discussions, which are moderated by principals, child psychologists and sometimes Ms. Abeles herself. The film's Web site encourages viewers to follow up with local activism (and also links to research and studies supporting the film, which pretty much avoids citing any data).

"My passion is around the change this film has the potential to create," Ms. Abeles said.

While "Waiting for Superman" lionizes urban reformers who embrace standardized testing as a necessary yardstick to hold schools and teachers accountable, Ms. Abeles believes that the testing movement is what has caused education to go off the tracks.

She talks to students, teachers and experts who say that teaching to tests, including the Advanced Placement tests, narrows education and diminishes creativity and independent thinking. Employers complain that college graduates these days lack initiative. An educator, Denise Pope, a lecturer at Stanford, says that the University of California requires remedial courses of half its students, even though their high school grades were stellar.

"They're spitting back but not retaining the information," Dr. Pope said.

Most of the families in "Race to Nowhere" are suburban and privileged, and the film has found its audience in those communities where parents often move for excellent schools. In addition to New Canaan and Winnetka, there were screenings last week in Los Altos, Calif., Bethesda, Md., and Chappaqua, N.Y. — towns where an Ivy League sticker on the back of a Range Rover is a given.

"You would not believe what reactions you get from other parents when you mention what colleges your children are looking at — you're so judged," Tara Vessels, a mother at New Canaan Country School, told about 40 other parents and staff members who discussed the movie last Friday in the school cafeteria.

The school espouses a "whole child" philosophy, and its mission statement, inscribed on the cafeteria walls, includes the sentence: "We value the imagination and curiosity of children and respect childhood as an integral part of life."

But parents said the larger community imposed its own values, and their children clamored to join an ice hockey league that practices until 10 p.m.

"Imagine if a sign out front of school says 'Mistakes Are Made Here Often,' " mused one teacher, echoing a theme in the movie that schools should accept failure as part of learning. "No one would come here! But why not?"

A mother complained that her 13-year-old "had a chapter test, and that night had to study for a quiz" in the same class. "What is the point of all the testing?" she said. "It's so stressful."

Tim Bazemore, the head of school, acknowledged ruefully that "the whole child in high school is a full résumé," telling the parents that this reflected "a failure of education leadership."

Nonetheless, he wondered how parents would feel if teachers assigned less homework and did not penalize students who did not do it. Would families think the school was failing to prepare their children for high school and beyond?

The school "needs an honest dialogue with you," Mr. Bazemore said.

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 Lot of different angles on Vitamin D and The IOM report. 

Another take on the IOM report

From Evernote:

Triple That Vitamin D Intake, Panel Prescribes - WSJ.com Clipped from: http://online.wsj.com/article/SB10001424052748704584804575645023841631864.html

Triple That Vitamin D Intake, Panel Prescribes

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By MELINDA BECK

A long-awaited report from the Institute of Medicine to be released Tuesday triples the recommended amount of vitamin D most Americans should take every day to 600 international units from 200 IUs set in 1997.

That's far lower than many doctors and major medical groups have been advocating—and it could dampen some of the enthusiasm that's been building for the sunshine vitamin in recent years.

Many doctors have added blood tests of vitamin D levels to annual physicals, and sales of vitamin D supplements have soared to $425 million last year from $40 million in 2001, according to the Nutrition Business Journal.

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The IOM panel also issued new recommendations for daily calcium intake, up to 1,200 milligrams for women 51 and older.

Who Needs Extra D

Some people are at high risk for vitamin D deficiency, and experts believe they may benefit from more vitamin D than the new recommendations:

• People age 50 and older: This group is at increased risk for Vitamin D insufficiency. As people age, their skin is less efficient in synthesizing the vitamin and the kidney is less able to convert it to its active hormone form.
• People with osteoporosis: Vitamin D is crucial for building and maintaining strong bones.
• People with limited sun exposure: This population includes the homebound, those living in northern latitudes and individuals who wear long robes and head coverings.
• People with dark skin: Greater amounts of the pigment melanin result in darker skin and reduce the skin's ability to produce vitamin D from sunlight. People who have immigrated from sunnier climates may find their levels dropping sharply in latitudes where the sun's rays aren't as strong much of the year.
• People with fat malabsorption: Vitamin D requires some dietary fat in the gut for absorption. Individuals who have a reduced ability to absorb dietary fat might require supplements. Fat malabsorption is associated with conditions including pancreatic enzyme deficiency, Crohn's disease, cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines and some forms of liver disease.
• People taking certain medications:Prednisone and anti-seizure drugs can cause vitamin D to be absorbed and metabolized more quickly, reducing available blood levels.
• People who are obese: Individuals with a body mass index equal to or greater than 30 typically have a low concentration of the vitamin in the blood.

Source: National Institutes of Health Office of Dietary Supplements

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It's long been known that vitamin D is essential to maintaining strong bones. But hundreds of new studies have also linked low vitamin D levels to a higher risk of a slew of chronic health problems—heart disease, stroke, diabetes, prostate, breast and colon cancers, auto-immune diseases, infections, depression and cognitive decline. Studies have also suggested that many Americans are vitamin D deficient due to working and playing indoors and slathering on sunscreen.

The Institute of Medicine, an arm of the National Academy of Sciences that sets governmental nutrient levels, said there wasn't enough evidence to prove that low vitamin D causes such chronic diseases; it based its new recommendations on the levels needed to maintain strong bones alone.

"The evidence for bone health is compelling, consistent and gives strong evidence of cause and effect," said Patsy Brannon, a professor of nutritional sciences at Cornell University and member of the IOM panel. For the other health problems, she said, "there are relatively few randomized controlled trials, and even in the observational studies, the effects are inconsistent."

The new recommendations, which cover the U.S. and Canada, call for 600 IUs daily for infants through adults age 70 and 800 IUs after age 71. The IOM assumed that most people are getting minimal sun exposure, given rising concern over skin cancer and latitudes where the sun is too weak to create vitamin D on the skin much of the year. The panel also raised the acceptable upper limit of daily intake to 4,000 IUs for adults, from 2,000 previously.

Those levels do take into account vitamin D from food sources—but only a few, such as salmon and mackerel, contain much naturally. Milk fortified with vitamin D contains about 40 IUs per cup. Most Americans and Canadians need to get much of their vitamin D from supplements.

The IOM panel also issued new recommendations for daily calcium intake— ranging from 700 milligrams for children aged 1 to 3 up to 1,200 milligrams for women 51 and older. The main change from the 1997 recommendations was to lower the recommended level for men 50 to 70 to 1,000 from 1,200. The panel noted that teenage girls may not get enough calcium, and that postmenopausal women may get too much, running the risk of kidney stones.

The changes will impact the percentages of recommended daily allowances of vitamin D and calcium listed on food packages, as well as the composition of school-lunch menus and other federal nutrition programs

The panel dismissed concerns that many Americans and Canadians are vitamin D deficient, noting that there is no scientifically validated level that's considered optimum. Even so, the panel concluded that for 97% of the population, a blood level of 20 nanograms of vitamin D per milliliter is sufficient.

Some vitamin D advocates took particular issue with that assumption. Several major medical groups, including the Endocrine Society and the International Osteoporsis Foundation, have concluded that a level of 30 ng/ml is necessary for optimal bone health.

"Randomized clinical trials have shown that in men and women 60 and older, you see fewer falls and fractures at the 30 ng/ml level," said Bess Dawson-Hughes, endocrinologist and director of the Bone Metabolism Laboratory at Tufts University. She also noted that while healthy people may reach that level taking 800 IUs per day, those who don't go outside, who use sunscreen religiously, have very dark skin or are taking some medications will need more.

Studies have also shown that at levels below 30 ng/ml, the body seeks calcium for everyday needs by leaching it from bones.

Dr. Brannon said the panel found such a wide range of blood levels considered optimal in various studies that it could not settle on a single threshold level. "I think the confusion is understandable. The committee is very concerned about the lack of evidence-based consensus guidelines for interpreting blood levels for vitamin D," said Dr. Brannon. "We strongly recommend that these be developed."

The panel was also concerned about what she called "emerging evidence of concern" about possible ill effects of too much vitamin D. Besides a risk of kidney and heart damage noted with vitamin D levels of 10,000 IUs per day, Dr. Brannon said the panel had seen higher death rates from pancreatic cancer, prostate cancer and other causes in men whose blood levels were above 50 ng/ml. The link is still tentative and may never be proven, she noted: "The difficulty is, you can't design a trial to look at adverse effects."

Other vitamin D advocates had guarded praise for the recommendations. "At least they recognized that there was a need to raise the daily intake level. That's a very important message," said Michael Holick, a professor of medicine at Boston University School of Medicine who testified before the committee in April.

He said that despite the paucity of randomized-controlled trials, the long list of chronic diseases associated with vitamin D does make sense, given that it is actually a hormone that affects virtually every organ in the human body and regulates as many as 2,000 genes.

For his part, Dr. Holick recommends that adults take 2,000 to 3,000 IUs per day—and notes that he had done studies giving subjects 50,000 IUs twice a month for six years and seen no harmful effects. "There is no downside to increasing your vitamin D intake, and there are more studies coming out almost on a weekly basis," he said.

One in particular may help settle whether vitamin D has long-term benefits beyond bone health: The National Institutes of Health has begun recruiting 20,000 men and women over age 60 for a nationwide clinical trial to study whether taking 2,000 IUs of vitamin D, or omega-3 fatty acids from fish oil, is any better than a placebo at lowering the risk of heart disease, cancer than other diseases.

In the meantime, some doctors say the IOM recommendations will not change their belief in testing patients' vitamin D levels and supplementing them as needed.

"I supplement patients who are deficient and they feel better. They come in and say, 'I've been much less achy and stiff or my mood's been better since I've been taking the vitamin D,' said Alan Pocinki, an internist in Washington D.C. Most of his patients are office workers, and 75% of them are below the 30 ng/ml level he considers necessary.

"Do we have the data to prove this conclusively? No. We don't have evidence for much of what we do in medicine, but if you wait for the evidence, you may be depriving your patients of beneficial treatments," Dr. Pocinki said.

Write to Melinda Beck at HealthJournal@wsj.com

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