Friday, September 24, 2010

Major Public Heath Achievements of the 20th Century

In this blog post, I will be summarizing and commenting on the course reading "Ten Great Public Health Achievements in U.S. 1900-1999."

After reading this article, I am astounded by the broad impact of public health.  All ten of these public health achievements have greatly contributed to the overall health of the United States population.  Thus, as stated in the article, these public health innovations helped achieve a 25 year increase in overall life expectancy over the past century.  Although all ten of the achievements are very important, I believe that the most important public health innovation of the 20th century is the series of vaccination that has virtually eradicated smallpox and polio, and has controlled other infectious diseases such as measles, mumps, and rubella.  Nowadays, all babies that are born receive some sort of vaccination of MMR (measles, mumps, rubella), influenza b, and tetanus.  Most of these vaccinations need to be administered again every ten years due to the fact that these infectious diseases can mutate and become immune to previous vaccinations.  By being able to control the outbreak of these infectious diseases, millions of lives have been saved.  Therefore, these vaccinations, in my opinion, is the most important public health achievement of the 20th century.

A public health achievement that I can particularly resonate with is motor-vehicle safety.  Like most teenagers, I am new to driving and have only had my license for two years.  Therefore, there is a higher chance that I might get into an accident than someone who is an experienced driver would.  With the advent of safer cars and seat belts/air bags, this could not only reduce my personal injury should I get into an accident but also reduce the injury of the person I get into an accident with.  Being a teenager, I am well aware of the problem of drinking and driving.  Teenagers have high adrenaline in their blood and mix that with alcohol and there will most likely be accidents on the road.  However, motor safety laws have been very strict about drinking and driving and permit only the slightest amount of alcohol level if you are driving.  The police has also been very effective in enforcing these laws.  The problem of drinking and driving affects me because back in high school, if I am driving home from a friend's house, I do not want to be on the road with drunk drivers or speeding drivers.  Although I may drive perfectly and obey all the laws, I cannot control the other person's driving and should I get into an accident, we will both get injured even though I may have done nothing wrong on my part.  Therefore, this sometimes makes me think twice about driving at night.

I believe that the improvement of mental health should be included in this list.  According to The US Department of Health and Human Services, about 1 in 4 US adults suffer from some type of mental disorder with major depression as the leading cause of disability in the US.  However, research over the past decades have made great strides in understanding the biological causes of mental disorder and developing mental treatment/interventions.  Nowadays, there are numerous programs and drugs that patients suffering from mental problems can look to for help.  This is a very important achievement because there are now services out there to help this particular segment of the population.

Friday, September 17, 2010

New Study Sheds Hope For Those With Aggressive Thyroid Cancer Tumors

In this post, I will be discussing a recent study of a newly developed drug that could possibly treat the most aggressive form of thyroid cancer. 

Thyroid cancer refers to malignant tumors on the thyroid gland.  The thyroid gland is an organ in the throat that helps control body temperature, heat rate, and blood pressure.  Thyroid cancer is a public health issue because according to the National Cancer Institute (NCI), there are about 37,000 new cases of thyroid cancer each year in the US alone.  Although thyroid cancer may affect people of all age groups, it is most prevalent amongst women and the elderly.  The study I am about to talk about focuses on the most aggressive form of thyroid cancer, which according to the article, affects about five percent of all thyroid cancer patients.  This form of thyroid cancer cannot be successfully treated by conventional means and patients must turn to chemotherapy, which is pretty unpopular and also not very effective. 

In the study performed by Dr. Julian Molina at the Mayo Clinic, 37 patients with the most aggressive form of thyroid cancer took a new drug called pazopanib everyday.  After a period of time (not specified by the article), results showed that tumor size decreased by at least 30 percent in almost half of the patients.  Dr. Molina emphasized that pazopanib is not a cure for the most aggressive form of thyroid cancer, but rather a way to decrease the symptoms and growth of the tumor.

This study was a clinical trial in which there was only the intervention group and no control group.  Due to the fact that there were only 37 patients in the study, there are clearly many weaknesses of this specific study.  Even Dr. Molina said, "future research needs to be done on larger populations in order to confirm the findings."  Also, the fact that there was no control group present in the study meant that there is no comparability.  However, the reason for this small number of patients is that pazopanib is a new drug so people are wary of what side effects the drug may cause.  In fact, 16 patients in the study had to reduce their pazopanib dosage because they were experiencing negative side effects.  Also, the fact that many ethical issues arises when dealing with clinical trials discourages many patients from participating. 

This study could be strengthened in many ways.  There are many advantages of clinical trials such as randomizing patients into two groups, a treatment group and a control group.  The purpose of randomizing patients into these two groups is to avoid bias and to increase comparablity of the groups to determine if intervention is associated with a better outcome.  Therefore, increasing the number of patients being studied and randomizing them into a treatment group and control group would definitely better support the results.  However, the disadvantage of clinical trials is the many ethical issues involved when conducting experiments on actual human beings.  In the past, these ethical dilemmas have even sometimes made it to the Supreme Court.

Link: http://www.msnbc.msn.com/id/39239797/ns/health-cancer/     

Friday, September 10, 2010

My Background and Initial Impressions

My name is Yunpeng Gao and this is my blog.  In this blog, I will be introducing myself, describing what public health is, and my initial impressions on this subject.

I grew up in a family devoted to science and medicine.  Both my parents were doctors in China and my grandmother was a nurse.  When we came to the US, my parents started pursuing medical research.  As a result, scientific discussions were unavoidable at the dinner table throughout my childhood.  Therefore, even as a child, I have dreamed of becoming a doctor saving lives or a medical researcher driving science forward by finding new cures for diseases.  However, as I became older and more mature, I realized that public health was also a viable career option.  Throughout my childhood, I have witnessed on television numerous public health disasters such as 9/11, the mad cow crisis, Hurricane Katrina, and the SARS epidemic, to name a few.  Through these events and more, I have realized that if I wanted to help as many people as I can, I should pursue a career in public health.  However, in contrast to medicine/research, public health is a very new subject to me because I don't have prior background or mentors that I can look up to.  That is why I am taking this course so I can gain a deeper understanding of public health.  As for my long term interests, I plan to major in public health and obtain a Masters in Public Health.  Although I have developed a new interest in public health, my passion for medicine and research have not waned.  Therefore, I am not quite sure whether my professional goals will be in medicine and research or public health.

This comes to the question "What is Public Health?"  From what I've learned in the first couple of classes, public health is the general well-being of people's health and the measures the people and government are taking to improve their health.  Unlike medicine, public health centers around everyone's health and strives to improve the health of the general public.  As a result, public health administrators and implementers often do not get the respect that doctors get from directly attending to a patient's needs.  I also learned about the three core functions of public health: Assessment, Policy development, and Assurance.  Public health administrators gather information about the health of a population, then  develop policies on how to improve the health of the community, and finally, make sure the services are available and accessible to everyone in the community.  This is the essence of public health.  

My initial impressions on the first couple of classes were that this class is going to be very interesting since there will be numerous discussions and debates.  Discussion and debate makes the class interesting and more engaging because it lets people share their unique views on certain public health policies or events.  By getting input from people of all backgrounds and cultures, we can see what public health means in another person's perspective.  Therefore, I am looking forward to learning more about public health and gaining insight into all perspectives of it.