Shows like 24 get advice from CDC
Sun, 22 Apr 2007 18:36:06 GMTBy MIKE STOBBE, AP Medical Writer
UNIVERSAL CITY, Calif. - Two AIDS doctors made a house call last month to the set of TV's "Law & Order: Special Victims Unit." The plot line was the suggestion that HIV doesn't cause AIDS — a fringe theory promoted on the Internet and by certain African leaders. But the two physicians weren't there to doctor the script.
They just wanted to make sure the TV show followed some standard doctor advice: First, do no harm.
Surveys show that most people believe the medical information they see on television dramas and soap operas. With fictional TV shows playing such a powerful role in public health education, the government is dedicated to keeping an eye on what Hollywood says. That's why the CDC is one of four government health agencies that fund the "Hollywood, Health & Society" program at the University of Southern California. The program has an annual budget of nearly $564,000.
It's run by a former CDC employee, Vicki Beck, but the real "talent" are government health officials and other medical experts the program sets up with writers of daytime soap operas, nighttime dramas and other shows.
To be sure, many TV shows consult with doctors, lawyers and others professionals on plot details. Some even hire physicians to be writers. The executive producer of "Law & Order: SVU" is an MD.
Still, some TV and movie scripts skirt — or outright ignore — the practical limitations of the real world. Some low points:
_"Medical Investigation," an NBC series in 2004-05, made health officials cringe. The show didn't even get the names right: The series' heroes did the out-in-the-field epidemic detective work of the CDC, but were identified as employees of the National Institutes of Health, a federal agency that's more focused on lab science. Worse, the heroes wore leather jackets instead of protective gear when checking for a deadly pathogen.
_"Fatal Contact," an ABC movie last spring about bird flu reaching the United States, was denounced as unrealistic by some prominent flu experts for, among other things, showing an Angolan village strewn with bloody bodies that looked more like a mass suicide than an area hit by flu.
_"Outbreak," a 1995 motion picture starring Dustin Hoffman, involves a government plan to bomb a California town to stop the spread of an Ebola-like contagion. But CDC officials insist that they would not deal with such an outbreak by bombing towns.
Beck's program tries to head off such errors.
The CBS show "Numbers" is one example. "Numbers" writer David Harden called, saying he was pursuing a plotline about black market profiteering in human organs. TV writers like the topic because of it's dramatic potential and persistent hold on the public imagination: Who hasn't heard the urban myth about the man who meets a hot woman in a bar and wakes up in a bathtub full of ice?
Health officials, however, hate it. They say there is no black market in organs in the United States, and dramatizing the idea may dissuade Americans from becoming organ donors.
But the program took Harden's call and convinced some experts to talk to him. One in particular was skeptical of the plot idea at first, Harden recalled, but answered every question.
The resulting show, which aired in January 2006, was about an international black market that provided detailed information on how the national organ matching program works. Health officials deemed it a success: In a subsequent online survey of about 160 people who said they were not organ donors, 10 percent said they had decided to become donors after watching the episode.
Another success occurred a few years ago with the Fox show "24."
The show was interested in this scenario: Terrorists release a biological agent in a hotel air conditioning system, making people sick in a matter of minutes and killing roughly 2,000 people within a few hours. They concocted a genetically engineered "Cordella virus" to do it, and wanted government officials to be able to wave an electronic device that could instantly detect the virus in the air.
They consulted CDC officials, who said there are no such devices. The CDC also suggested that health officials might try to deal with such a situation by isolating the ill from the well, perhaps reducing the contagion's impact, said Dr. Mitchell Cohen, director of CDC's Coordinating Center for Infectious Diseases.
The writers took the tip, and the final death toll fell to under 800. "We saved 1,200 virtual people," said Cohen, who consulted with the "24" writers and did an on-camera interview for the DVD boxed set of the series.
CDC officials make time for Hollywood meetings, because they know what's on screen can be influential. In a 2000 CDC-sponsored survey, more than half of TV viewers said they trust health information on prime-time shows to be accurate, and about one-quarter said prime-time television is one of their top three sources of health information.
Health-focused plots, and sympathetic characters dealing with disease, do seem to stir public reaction. Just one example: A CDC study that chronicled the impact of a 2001 story line on a soap opera, "The Bold and The Beautiful," in which a heterosexual male Hispanic character was diagnosed with HIV. The phone number to a CDC hotline for AIDS and sexually transmitted diseases was televised immediately after the episodes, and calls to the hotline spiked from about 100 calls a day to more than 1,400.
Program officials present themselves as resources, not advocates, so there's been little push to get smoking characters to drop the habit push or eat more fruits and vegetables.
They also do relatively little with the movies. The CDC placed a smoking prevention employee in Hollywood in 2002 as a liaison with the motion picture industry, but stopped funding the effort in 2004. Beck hasn't tried to fill that void.
"Film is too difficult to track and influence because of the many years, writers and stages of change that a film undergoes before it is released," she said.
Health officials acknowledge that it can be tough to work in Hollywood, a town that's driven by relationships. They acknowledge to being cautious about taking steps that might be seen as challenging or critical of entertainment leaders.
That's a failing, said Stanton Glantz, a University of California-San Francisco researcher who leads a campaign to remove smoking from the movies. He's critical of how little success the CDC and others have had in diminishing episodes of cinematic smoking, which he said declined only slightly from 1999 to 2006.
Glantz alluded to recent statistics that show, in the last three years, a leveling off in the decline in both teen and adult smoking.
The CDC's approach "does raise consciousness. It does educate people. But it just hasn't had any effect," he said.
"They should follow the lead of several state and local health departments and start pushing for policy changes — most notably an R rating for smoking," he said.
Beck's work includes not only arranging consultations but also holding the "Sentinel for Health" awards, which recognizes TV shows that do fact-based story lines with positive public health impact.
A Sentinel for Health may lack the cache an Emmy, but writers said the award is noted and appreciated.
"It reflects that hard work that we put in to accurately portray health issues that affect Americans," said Paul Grellong, a writer for "Law & Order: SVU."
Grellong and four of the show's other writers sat in on the recent meeting at Universal Studios with the two HIV experts, Dr. Joseph Cadden and Dr. Jocelyn Suzette Dee of L.A.'s Rand Schrader Clinic.
The meeting was run by Josh Kotcheff, the writer penning the episode, who sat with the doctors at a conference table. The other writers sat on a nearby couch with notebooks, listening for future-episode fodder.
Kotcheff peppered the two with questions about disease theories and the intricacies of HIV testing. He listened intently to their replies. Later, he said he wanted not only to master the realism-ensuring details, but also to be responsible in how he presents characters that deny HIV causes AIDS.
"There are people who do believe these kinds of myths, and it can have an impact on their lives. If they don't take meds, they're going to die," he said.
Despite hardships Cubans live longer
Sun, 22 Apr 2007 20:56:10 GMTBy WILL WEISSERT, Associated Press Writer
HAVANA - "Fidel: 80 More Years," proclaim the good wishes still hanging on storefront and balcony banners months after Cubans celebrated their leader's 80th birthday. Fidel Castro may be ailing, but he's a living example of something Cubans take pride in — an average life expectancy roughly similar to that of the United States.
They ascribe it to free medical care, mild climate, and a low-stress Caribbean lifestyle, which they believe make up for the hardships and shortages they suffer.
"Sometimes you have all you want to eat and sometimes you don't," said Raquel Naring, a 70-year-old retired gas station attendant. "But there aren't elderly people sleeping on the street like other places."
Cuba's average life expectancy is 77.08 years — second in Latin America after Puerto Rico and more than 11 years above the world average, according to the 2007 CIA World Fact Book.
It says Cuban life expectancy averages 74.85 years for men and 79.43 years for women, compared with 75.15 and 80.97 respectively for Americans.
Most Cubans live rent-free, and food, electricity and transportation are heavily subsidized. But the island can still be a tough place to grow old.
Homes that were luxurious before Castro's 1959 revolution are now falling apart and many cramped apartments contain three generations of family members. Food, water and medicine shortages are chronic.
But most prescription drugs and visits to the doctor are free and physicians encourage preventive care.
"There's a family doctor on almost every block," said Luis Tache, 90 and blind from glaucoma but still chatty and up on the news.
Tache lived in New York for six straight summers starting in 1945, paying $8 a month for a furnished apartment at 116th Street and Broadway. An English teacher, he retired 30 years ago.
Sitting in a rocking chair in his breezy living room in Havana's Playa district, Tache said Cuban communism "is both good and bad," while the high cost of living in capitalist societies "must be very stressful."
A relaxed lifestyle, which prizes time spent with family over careers, helps keep Cubans healthy, Tache said.
"It's bad for production, bad for the nation," he said. "But it's good for the people."
The government runs residence halls for seniors with no family to care for them, though space is severely limited. Community groups make sure older people look after one another.
"It's a very happy society. There aren't so many worries and problems and that helps," said Alida Gil, 57, leader of a community group in Old Havana known as "Circle of Grandmothers 2000."
Shortly after 8 a.m. every weekday, Gil leads two dozen elderly women through 40 minutes of calisthenics on the windowless, water-damaged ground floor of a state-owned building adorned with photos of Castro and his brother, Raul.
Raul Castro, 75, took over in July after the president underwent intestinal surgery. Officials offer increasingly upbeat reports about his progress, but his condition and ailment remain state secrets.
One of Fidel Castro's personal physicians, Dr. Eugenio Selman, in 2003 helped launch the "120 Years Club," an organization of more than 5,000 seniors — many 100 or older — from several countries including the United States. They hope to reach the 120-year mark through healthy diet, exercise and a positive outlook.
Selman has not spoken publicly since Castro fell ill, but had previously suggested the president could live to 120. Whether Castro is a member of the club is unclear.
Gerardo de la Llera, who still practices medicine at 77, is the club's vice president. He said the oldest member was a 122-year-old woman who lives in the eastern Cuban province of Granma, but he did not know her name or exact birthrate. Cuba has a history of claiming very old citizens whose ages have not been authenticated.
The government says it wants Cuba to become the world leader in life expectancy, vying with the 82-year average for Japan and Singapore.
Merged sciences may aid cancer treatment
Sun, 22 Apr 2007 08:51:53 GMTBy TANALEE SMITH, Associated Press Writer
SINGAPORE - Western science and traditional Eastern medicine could be combined to enhance treatment of cancer and other diseases, an oncology professor told a medical forum Sunday.
But comprehensive clinical studies must be carried out and patients must be educated to accept the combination of methods, Tony Mok Shu Kam, a professor at the Chinese University of Hong Kong, told participants at a two-day medical forum in Singapore sponsored by the Lancet medical journal.
"Traditional medicine was previously the standard medicine, and a large portion of cancer patients still use it," Mok said referring to China. "We cannot discredit traditional medicines, because they are so old and they are still here, so there must be some virtue. But we must do something in a scientific fashion to prove it better."
While a number of Chinese studies have been published on the efficacy of some common herbal medicines, Mok said their trials were too small or the methods too inconsistent to be approved in the West.
"We have to move forward and invest in high-quality studies," Mok said.
Some traditional Eastern medicines have been proven effective through research and clinical trials. For example, Artemisin, used for more than 2,000 years in Chinese herbal medicine, is emerging as a drug of choice for treating drug-resistant malaria, an advance supported by the World Health Organization.
Mok referred to ongoing studies in the United States and Russia that are examining the use of kanglaite, commonly used as a supplement in Chinese diets and one of the top-selling anti-cancer traditional herbs. Another Western-led study is looking at the herb astragalus, used in China to boost the immune system during chemotherapy.
Another researcher worried that too many people in developing countries are being taken advantage of by untrained traditional healers.
"There are many people who are not trained. These people are out to make money," Monika Bardhan of Malaysia's NCI Cancer Hospital told The Associated Press.
She said too many people first go to traditional healers and pay exorbitant prices for concoctions with unproven ingredients. By the time they come to the hospital, it is often too late to treat them.
Bardhan said she is not against traditional medicine as long as patients are educated about what they are receiving and the doctors or healers are legitimate.
Mok said some hospitals in China were using both traditional and Western medicines — herbs and chemotherapy, or acupuncture and modern diagnostic imaging, for example — but more needed to be done to integrate the methods.
A key factor in the integration would be convincing users of traditional medicine that modern science is as good as or better than their centuries-old methods.
A 2004 study in China showed that 49 percent of women who were being treated for breast cancer with traditional Chinese medicine believed it to be an effective treatment for their disease.
Mok also referred to a Chinese trial he was involved in this year in which some prospective patients declined to be part of a placebo control study to test the effectiveness of a traditional medicine when they learned their chances of getting the medicine were only 50-50. They preferred to go to a traditional doctor who would definitely prescribe the treatment they sought.
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Associated Press writer Margie Mason contributed to this report.
Corzine faces tough therapy
Sun, 22 Apr 2007 00:31:25 GMTBy TOM HESTER Jr., Associated Press Writer
TRENTON, N.J. - It will be agonizing, emotional and draining. Most of all, it will be painful.
New Jersey Gov. Jon S. Corzine faces months of intensive therapy to recover from serious injuries suffered in an April 12 crash on the Garden State Parkway.
"It is a grueling course that he's going to go through," said Kathleen O'Donnell, an inpatient rehabilitation manager at Atlantic Health, which operates several northern New Jersey health facilities. "My heart goes out to him."
Corzine has been in intensive care since breaking 11 ribs, his sternum, a leg, his collarbone and a vertebra in the crash.
Dr. Steven Ross at Cooper University Hospital said Saturday the governor has started talking with family members and doctors and is drinking some clear liquids.
Corzine showed signs of bronchitis and was being treated with antibiotics, Ross said. Doctors removed a breathing tube on Friday.
Physical therapists said Corzine may face his toughest tests after he leaves the hospital. The 60-year-old man faces excruciating daily exercises designed to rebuild his strength, but they'll also make it difficult for him to initially devote much time to being governor.
"He's got to really work on getting himself stable and up to par," O'Donnell said.
Elton Strauss, senior faculty member at Mount Sinai Medical School, said patients who suffered injuries as severe as Corzine's often need to first receive psychological support.
"Most of these patients undergo stress, anxiety, sometimes anger towards what took place," Strauss said.
O'Donnell said Corzine will likely be sent to a rehabilitation center where he will have access to a psychologist and anti-anxiety medication.
His physical therapy, however, will likely start out being basic.
"Helping him to learn to bathe and dress again independently, getting in and out of the shower, donning and doffing clothes and shoes — things that we take for granted but are extremely difficult when you have these types of injuries," O'Donnell said.
With his chest and shoulder injuries making it difficult to use crutches, therapists said Corzine will likely use a walker and wheelchair at first.
Vincent Perez, a director at Columbia University Medical Center Eastside in New York, said Corzine's early therapy will be comparable to "learning to walk again."
"If he is immobilized for a prolonged period, recovering the motion in his knee will be time-consuming and somewhat painful," Perez said. "He will probably utilize a stationary bicycle, weight lifting, weight bearing exercises, gait training under the watchful eye of a skilled physical therapist."
Tom Kiger, clinical director for Dynamic Physical Therapy & Aquatic Rehabilitation, a rehabilitation facility with 12 locations in Delaware and Pennsylvania, said Corzine will also need work on injuries associated with the broken collarbone.
"They're going to have to get in there and start to do passive motions with him," Kiger said. "Your muscles will atrophy very dramatically being laid up in the hospital, so he's going to lose a lot of muscle bulk in general."
Corzine will spend up to four hours per day in therapy, therapists said.
"He's deconditioning right now," said Kevin Gard, an associate physical therapy and rehabilitation director at Drexel University. "Physically, his cardiovascular endurance is decreasing and that sort of thing, so it's going to take a period of time to build that back up again for him to be able to tolerate a couple of hours of therapy every day."
Kiger said complete rehabilitation could take until spring 2009.
"I'm not saying he's not going to be able to work in the capacity of the governor or anything like that, but for him to be up and running and jogging and things like that he could basically be probably be looking up to a year," he said.
Also Saturday, The Star-Ledger of Newark reported that state police were investigating whether the trooper who was driving Corzine was communicating with his girlfriend's estranged husband at the time of the crash.
Davy Jones, president of the State Troopers Fraternal Association, told the newspaper that investigators want to know if trooper Robert Rasinski was communicating with the man, either by phone or mobile e-mail, while he was driving Corzine or immediately before.
State Police Superintendent Rick Fuentes confirmed in a statement to The Star-Ledger that the department was "in receipt of an allegation made against Trooper Robert Rasinski and will look further into the matter."
Telephone messages left for Jones and Rasinski by The Associated Press were not immediately returned Saturday. Lt. Gerald Lewis, a state police spokesman, declined comment.
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Associated Press Writer Chris Newmarker contributed to this report.
Five million children obese in EU
Sun, 22 Apr 2007 22:31:25 GMTBUDAPEST - Around 22 million of the European Union's 75 million children are overweight and 5.1 million are obese, delegates told a conference that started here on Sunday.
&;It's an extraordinary figure and there are 300,000 more obese children each year,&; Tim Lobstein of the London-based International Association for the Study of Obesity told a press briefing at the start of the four-day meeting.
He said the scientific community knows little about preventing child obesity but added: &;we may have focused too much on the child and not enough on the environment.&;
One study to be presented at the conference, which will bring together some 2,500 European obesity specialists, found that a programme developed by Paul Sacher of the University College London led to significant improvements in overweight and obese children over a period of one year.
Sacher developed the nine-week multi-disciplinary programme, combining exercise, nutrition and empowerment, to fight excess weight and obesity, which affects one in three children in the United Kingdom.
Scientists also said that a lack of specialisation among doctors made it more difficult to treat obese children in Europe.
