JAMA Report Videos

The following are JAMA Report videos made publicly available once the related article in JAMA has published.

  • December 20, 2016

    Early Physical Activity After Concussion in Kids and Teens

    Early Physical Activity After Concussion in Kids and Teens

    INTRO: After a concussion, many doctors recommend an initial period of rest to help children and teens recover fully. But can early physical activity help decrease persistent post concussive symptoms? A new study in JAMA found that light exercise may be key to better recovery. Laura Berger has more in this week’s JAMA Report.

     

     

    AUDIO:

    VO:

     

    THOUSANDS OF CHILDREN IN THE U.S. VISIT EMERGENCY DEPARTMENTS AFTER SUFFERING CONCUSSIONS AND ABOUT 1/3 DEVELOP POST CONCUSSIVE SYMPTOMS THAT LAST MORE THAN A MONTH.  FOR YEARS, DOCTORS HAVE ADVISED STRICT REST RIGHT AFTER THE INJURY TO HELP AVOID THESE PROLONGED SIDE EFFECTS.

     

    (B-roll: Doctor doing concussion exam on patient)

     

     

    AUDIO:

    SOT/FULL

    Roger Zemek, M.D.-Children’s Hospital of Eastern Ontario

    Super@:15

    Runs:12

     

    “Children can present in a whole variety of symptoms following a concussion.  Some children may have early physical symptoms such as headache, or feeling like they want to vomit or being dizzy.”

     

     

     

    AUDIO:

    VO:

     

    1. ROGER ZEMEK FROM THE CHILDREN’S HOSPITAL OF EASTERN ONTARIO AND CO-AUTHORS STUDIED MORE THAN 3 THOUSAND CANADIAN CHILDREN AND TEENS WHO HAD CONCUSSIONS TO SEE IF ADDING PHYSICAL ACTIVITY WITHIN ONE WEEK OF INJURY CAN HELP PREVENT POST-CONCUSSIVE SYMPTOMS.

     

    USING A STANDARD QUESTIONNIARE, RESEARCHERS MONITORED THE CHILDREN AND TEENS FROM THE EMERGENCY DEPARTMENT UNTIL 28 DAYS AFTER THEIR INJURY TO SEE HOW WELL THEY RECOVERED AND ALSO TO TRACK THEIR PHYSICAL ACTIVITY.

     

    THE RESEARCHERS FOUND THAT THE CHILDREN WHO PARTICIPATED IN LIGHT PHYSICAL ACTIVITY AFTER THEIR CONCUSSION HAD A REDUCED RISK OF HAVING PROLONGED POST-CONCUSSIVE SYMPTOMS.

     

    (B-ROLL:Dr. Zemek walking down the hall, working at his desk, on the phone, patient walking in the snow)

     

    AUDIO:

    SOT/FULL

    Roger Zemek, M.D.-Children’s Hospital of Eastern Ontario

    Super@:1:00

    Runs:16

     

     “We really don’t want children to be having another concussion while they’re recovering, but there is likely a strong benefit for having some sort of movement, and early physical activity following concussion such as walking, jogging or stationary bicycle.”

     

     

    AUDIO:

    VO:

    DR. ZEMEK SAYS MORE RESEARCH NEEDS TO BE DONE TO DETERMINE THE IDEAL TYPE, INTENSITY, AND DURATION OF PHYSICAL ACTIVITY FOLLOWING CONCUSSION. (Broll:patient walking on trail)

    LAURA BERGER, THE JAMA REPORT

    (BROLL: patient walking outside)

     

         TAG: THE STUDY WAS CONDUCTED FROM AUGUST 2013 TO JUNE 2015.

     

     

     

  • December 13, 2016

    Large Differences Seen in Mortality Rates Among US Counties

    Large Differences Seen in Mortality Rates Among US Counties

    INTRO: How do mortality rates for major causes of death vary by county in the U.S.? A new study looked at mortality data from 1980 to 2014 to see what kinds of geographic patterns exist. Authors of the new study hope that the results can help provide insight into disease-specific trends and life expectancy. Laura Berger has more in this week’s JAMA Report.

     

     

    AUDIO:

    VO:

     

    RESEARCH SHOWS THAT INEQUALITIES IN LIFE EXPECTANCY ACROSS DIFFERENT COUNTIES IN THE UNITED STATES ARE INCREASING, BUT LESS IS KNOWN ABOUT SPECIFIC GEOGRAPHIC PATTERNS AND THE UNDERLYING CAUSES OF DEATH.

     

     

    (B-ROLL:graphic map of United States)

     

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:11

    Runs:15

     

    Well, there’s probably two key drivers of death rates changing, changes in risks that people have, like tobacco, or obesity, getting better or worse. And then access to treatment, whether prevention or cure.”

     

     

    AUDIO:

    VO:

     

    1. CHRIS MURRAY AND CO-AUTHORS REVIEWED DEATH CERTIFICATES FROM MORE THAN 3 THOUSAND U.S. COUNTIES FROM 1980 TO 2014. THEY WANTED TO KNOW WHAT THE LEADING CAUSES OF DEATH WERE IN EACH AREA AND TO DETERMINE TRENDS OVER TIME BY REGION. THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

     

     

     

     

    (B-ROLL: Dr. walking, working in office looking at map, close up map, doctor reading papers)

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:47

    Runs:27

     

     

     “We found that differences or disparities across counties are actually getting larger over time. So we’re not narrowing the gap, the gap is widening. And we found that different causes matter more in different parts of the country. So out West for example in the U.S., violent death is more common, whereas heart disease is more common in the Southeast. And deaths from drugs are much more common in West Virginia or Kentucky as examples.”

     

     

    AUDIO:

    VO:

     

    DR. MURRAY SAYS IN THE FUTURE HE WANTS TO LOOK AT MORE DETAILED CAUSES OF DEATH IN EACH AREA IN ORDER TO HELP IMPROVE THE HEALTH OF EACH COMMUNITY.  (B-roll doctor writing at white board, showing map)

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:1:23

    Runs:18

    (B-roll at end woman walking with daughter)

     

    “The biggest takeaway is that one size doesn’t fit all in the U.S.  We really need to understand why there’s such variation in how long people live, and what causes children, adults and older people to die at such different levels in different communities.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:woman walking with daughter)

     

         TAG: IN A SMALL NUMBER OF CASES, COUNTY BOUNDARIES SHIFTED      BETWEEN 1980 AND THE PRESENT.  SEVERAL COUNTIES WERE MERGED DUE TO THE CHANGE.

     

  • November 21, 2016

    Changes in the Prevalence of Dementia in the United States

    Changes in the Prevalence of Dementia in the United States

    INTRO: As the elderly population in the United States continues to grow, the number of older adults who will suffer from dementia will also increase, but by how much? A new study in JAMA Internal Medicine looked at whether the prevalence of dementia has changed from 2000 to 2012.  Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

    DEMENTIA AFFECTS 4 TO 5 MILLION OLDER ADULTS IN THE UNITED STATES, AS WELL AS THEIR FAMILIES, AND GOVERNMENT PROGRAMS. A NEW STUDY IN JAMA INTERNAL MEDICINE LOOKS AT HOW THE PREVALENCE OF DEMENTIA HAS CHANGED FROM 2000 TO 2012.

     

    ( B-ROLL: Graphic of 4 to 5 million over blur of people walking on street

    Woman working with elderly man, woman looking at microscope, scientist looking at brain slices)

     

    SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:13

    Runs:22

    “Dementia is characterized by declines in memory and other cognitive functions, things like speech, and the ability to plan and to organize one’s day.// We found that the prevalence of dementia declined significantly between 2000 and 2012, from about 11.5% down to about 9%.”

    (b-roll of people in wheelchairs)

     

    AUDIO:

    1. KENNETH LANGA AND CO-AUTHORS STUDIED MORE THAN 21 THOUSAND U.S. ADULTS OVER THE AGE OF 65 USING DATA FROM THE HEALTH AND RETIREMENT STUDY FROM 2000 AND 2012. LANGA SAYS HE ATTRIBUTES THE DECLINE IN DEMENTIA PREVALENCE TO TWO FACTORS: INCREASES IN THE EDUCATION LEVEL AMONG THIS GROUP AND BETTER TREATMENTS FOR CARDIOVASCULAR RISK FACTORS LIKE DIABETES, OBESITY, AND HYPERTENSION.

     

    (B-ROLL: Dr. Langa working at desk and looking at brain scans

    GRAPHIC OF DECLINE IN DEMENTIA REASONS )

     

    Runs SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:58

    Runs:19

     “This suggests that a 75 year old today has a lower risk of having dementia today than a 75 year old 10 or 20 years ago. Both increases in education and better control of cardiovascular risk factors may be important in explaining some of this decline.”

    (B-roll of woman getting blood pressure taken, woman walking on track)

     

    1. LANGA SAYS MORE WORK NEEDS TO BE DONE BOTH IN THE U.S. AND ABROAD TO KEEP DEMENTIA TRENDS ON THE DECLINE.

    (Broll: Woman doing cognitive tests with nurse)

     

     

    SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:1:23

    Runs:14

     

    “…even without a big breakthrough in medication or  other kind of intervention that might decrease Alzheimer’s risk or change the course of Alzheimer’s, that it appears that there’s things we can do decrease risk.”

    (Broll: (b-roll people working out)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:woman walking with walker)

     

    TAG: THE NUMBER OF OLDER ADULTS WITH DEMENTIA IN THE UNITED STATES AND AROUND THE WORLD IS EXPECTED TO GROW UP TO 3-FOLD BY 2050.

     

     

     

     

  • November 13, 2016

    Statin Use for the Prevention of Cardiovascular Disease

    Statin Use for the Prevention of Cardiovascular Disease

    INTRO: Cardiovascular disease is one of the leading causes of death in the United States.  Statins are a prescription medication that can help decrease the risk for cardiovascular disease. But just who is at risk? The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services, including for cardiovascular disease. The Task Force has just issued a new recommendation statement on statin use for adults who are at risk for cardiovascular disease. Laura Berger has more in this week’s JAMA Report.

    AUDIO:

    VO:

     

    STROKE IS THE 5TH LEADING CAUSE OF DEATH IN THE U.S. AND THE 2ND LEADING CAUSE OF DEATH WORLDWIDE. EACH YEAR MORE THAN 750,000 AMERICANS EXPERIENCES A STROKE.

     

    (B-ROLL: Graphic 1 in 3 adults will die from cardiovascular disease, bottles of statins, Dr. Owens and patient)

     

     

    AUDIO:

    SOT/FULL

    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force

    Super@:11

    Runs:8

     

    “The risk factors for cardiovascular disease include high cholesterol, high blood pressure, smoking, diabetes, and your age.”

     

     

    AUDIO:

    VO:

     

    1. DOUGLAS OWENS, AN AUTHOR OF THE U-S PREVENTIVE SERVICES TASK FORCE RECOMMENDATION, SAYS THE GROUP RECOMMENDS THAT SOME PEOPLE AGE 40-75 WHO HAVE ONE OR MORE OF THOSE RISK FACTORS: HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, SMOKING, OR DIABETES, AND DO NOT HAVE A HISTORY OF CARDIOVASCULAR DISEASE, AND WHOSE CHANCE OF HAVING A HEART ATTACK OR STROKE OVER THE NEXT TEN YEARS IS 7.5% OR HIGHER, USE A STATIN. THOSE WHOSE RISK IS 10% OR HIGHER WILL BENEFIT MOST.

    ALTHOUGH THERE ARE RISKS, DR. OWENS SAYS THE USE OF A STATIN ALONG WITH A HEALTHY DIET AND EXERCISE, CAN BE A USEFUL TOOL IN THE FIGHT AGAINST CARDIOVASCULAR DISEASE.

     

    THE TASK FORCE RECOMMENDATIONS APPEAR IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

     

     

     

    (B-ROLL: Dr. Owens sitting at desk looking at the computer, man on street shots, Graphic of risk factors, man on street, smokers, statin bottle, counting pills, cardiovascular procedure b roll.)

     

     

    AUDIO

    SOT/FULL

    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force

    Super@: 1:04

    Runs:17

     

    “The benefits of statins are a reduction in heart attack, strokes and death. The harms of statins we judge based on our very comprehensive review of the literature to be small. And in patients who are at elevated risk for cardiovascular disease, the benefits outweigh the harms.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL: Statin pill bottles)

     

    TAG: THE TASK FORCE FOUND THE EVIDENCE FOR INITIATING STATINS FOR PEOPLE OVER 75 TO BE INSUFFICIENT.

     

  • November 10, 2016

    iPad Game Helps Treat Common Eye Condition in Children

    iPad Game Helps Treat Common Eye Condition in Children

    INTRO: Amblyopia or lazy eye is a leading cause of visual impairment in children.  The standard treatment for lazy eye involves patching the opposite eye to force the lazy eye to work harder. But could a special iPad game also be effective?  A new study in JAMA Ophthalmology compared the treatment of amblyopia using a binocular iPad game vs. two hours of daily patching. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    AMBLYOPIA OR LAZY EYE IS ONE OF THE MOST COMMON CAUSES OF VISUAL IMPAIRMENT IN CHILDREN, AFFECTING 3 TO 5 PERCENT OF KIDS IN THE UNITED STATES.

     

     

    (B-ROLL: Child getting patch on her eye, looking at eye chart with doctor, Doctor controlling chart on her phone)

     

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 9

    Runs:14

     

    “Amblyopia is a reduction of vision in one eye because of abnormal visual experience early in life. Amblyopia not only has deficits in vision, but it causes deficits in 3D depth perception, reading and fine motor skills.”

     

     

     

    AUDIO:

    1. KRISTA KELLY AND CO-AUTHORS STUDIED 28 CHILDREN AGES 4 TO 10 WHO HAD AMBLYOPIA. IN THIS RANDOMIZED TRIAL, CHILDREN WERE ASSIGNED TO TWO GROUPS, ONE THAT USED AN IPAD GAME FOR TREATMENT AND THE OTHER WHO USED PATCHING. AFTER TWO WEEKS THE GROUP THAT PATCHED ALSO TOOK HOME THE GAME.

     

    THE CHILDREN PUT ON A PAIR OF GLASSES AND HIGH CONTRAST IMAGES ARE SENT TO THE WEAKER EYE AND LOW CONTRAST IMAGES ARE SENT TO THE STRONGER EYE. THE CHILD HAS TO WORK THE WEAKER EYE IN ORDER TO PLAY THE GAME AS WELL AS WORK BOTH EYES TOGETHER.

     

     

    THE STUDY APPEARS IN JAMA OPHTHALMOLOGY.

     

    (B-ROLL: Dr. Kelly and co-author walking down hall, Dr. Kelly looking at eye scan, child playing, game and glasses close up, Dr. Kelly and child with patch, child playing game with glasses)

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 59

    Runs:14

     

    “We found that at the 2 week visit children who had the iPad game improved much more than children who patched…Both groups improved about  2 lines of vision on the letter chart…and about 40% of the children recovered normal vision.

    (B-roll in middle, girl playing the game)

     

     

    AUDIO:

    VO:

    1. KELLY SAYS THIS NEW GAME IS A PROMISING ADDITION TO EXISTING TREATMENTS FOR LAZY EYE. SHE HOPES MORE GAMES, TV SHOWS, AND MOVIES CAN BE USED AS TREATMENT IN THE FUTURE.

    (B-ROLL: Dr. Kelly and co-author looking at charts)

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 1:23

    Runs:10

     

     

    “So we want to be able to treat amblyopia early in life to be able to circumvent these deficits and hopefully allow the child to be able to develop and thrive academically and socially.”

     (b-roll at end of girl playing game)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:girl playing game)

     

    TAG: THE STUDY WAS CONDUCTED FROM FEBRUARY 2015 TO JANUARY 2016.

  • October 31, 2016

    Opioid Poisonings Among Children and Teenagers

    Opioid Poisonings Among Children and Teenagers

    INTRO: Although there is a lot of discussion on how the prescription opioid epidemic has affected the U.S. adult population, how has it affected children and teens? A new study looked at how often kids and teenagers are hospitalized for opioid poisonings.  The study in JAMA Pediatrics examined these trends over a 16-year period from 1997 to 2012. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    FROM 1999 TO 2010 RETAIL SALES OF PRESCRIPTION OPIOIDS QUADRUPLED. AND AS MORE ADULTS BECOME ADDICTED TO THESE MEDICATIONS, MORE CHILDREN AND TEENAGERS ARE ALSO AT A HIGHER RISK FOR OPIOID POISONING AND MISUSE.

     

    (B-ROLL: Morphine bottle/fentanyl bottle/pharmacist)

     

    AUDIO:

    SOT/FULL

    Julie Gaither, PhD- Department of Epidemiology, Yale School of Medicine

    Super@: 14

    Runs:19

     

    “In the past 2 decades the opioid epidemic has grown exponentially. It really began in the mid-1990s when physicians were encouraged to do a better job of treating chronic pain…. in particular in 2014 there were approximately 19,000 deaths that were attributed to opioid medications.”

    (B-roll of pills to cover the cut)

     

     AUDIO:

    VO:

    1. JULIE GAITHER AND DR. DEEPA CAM-en-GAY AND CO-AUTHORS REVIEWED THE U.S. PEDIATRIC HOSPITAL DISCHARGE RECORDS OF CHILDREN AND TEENS AGES 1 TO 19, FROM 1997 TO 2012. THEY IDENTIFIED MORE THAN 13,000 CHILDREN AND TEENS WHO WERE HOSPITALIZED FOR OPIOID POISONINGS WITHIN THAT TIME FRAME.

     

    THEY ALSO LOOKED AT 15 TO 19 YEAR OLDS WHO WERE HOSPITALIZED FOR HEROIN POISONINGS.

    THE STUDY APPEARS IN JAMA PEDIATRICS.

     

    (B-ROLL: Two doctors walking/working at computer/ambulance/gurney wheeling into hospital/doctors looking at monitor)

     

    AUDIO

    SOT/FULL

    Deepa Camenga, MD-Department of Pediatrics, Yale School of Medicine

    Super@: 56

    Runs: 22

    “We found that the rates of hospitalizations for opioid poisonings doubled during … 1997 to 2012. We also found… that the highest number of hospitalizations were among teenagers, ages 15 thru 19 …the highest rates of increase in hospitalizations were among our youngest population, which was 1 to 4-year-old children.”

     

    (B-roll in middle, pill warning/girl on gurney/nurse in room)


    Julie Gaither, PhD- Department of Epidemiology, Yale School of Medicine

    Super@: 1:19

    Runs:14

     

    “Heroin poisonings increased by 150% during this time point and then very importantly, poisonings from methadone increased by approximately 950%, so almost tenfold in less than two decades.”

     

    AUDIO:

    VO:

    1. GAITHER AND DR. CAM-en-GAY SAY CHANGES IN HOW WE PRESCRIBE, DISPOSE, AND PACKAGE THESE DRUGS ARE NEEDED TO KEEP CHILDREN AND TEENS SAFE.

     (B-ROLL: Pharmacist with syringes/pills/hospital machine)

     

    SOT/FULL

    Deepa Camenga, MD-Department of Pediatrics, Yale School of Medicine

    Super@: 1:41

    Runs: 13

     

    “ Our national conversation is focused on how to improve the treatment and prevention of opioid misuse and abuse, but we also hope that this conversation focuses on how to safeguard children from this epidemic.”

    (b-roll in middle pharmacist crushing pills)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL: morphine bottle)

     

    TAG: THE PEDIATRIC COMMUNITY MAKES UP ¼ OF THE U.S. POPULATION.

  • October 19, 2016

    Bariatric Surgery in Women of Childbearing Age

    Bariatric Surgery in Women of Childbearing Age

    INTRO: As the U.S. deals with an obesity epidemic many younger women are having bariatric surgery for weight loss. But is there a risk for the infants of women who have had bariatric surgery? Is there a way to decrease perinatal complications and is there an optimal time to wait to have children after surgery?   A new study in JAMA Surgery examined these risks. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO

    VO:

    IN THE UNITED STATES 1 IN 5 WOMEN ARE OBESE AT THE TIME OF CONCEPTION. OBESITY DURING PREGNANCY CAN INCREASE THE RISK OF COMPLICATIONS FOR BOTH MOTHERS AND INFANTS. THAT IS ONE OF THE REASONS WHY YOUNGER WOMEN MIGHT TURN TO BARIATRIC OR WEIGHT LOSS SURGERY.

    (B-ROLL: pregnant woman at doctor/ultrasound/close up belly)

     

     

    AUDIO:

    SOT/FULL

     Brodie Parent, MD- Department of Surgery, UW

    Super@ 14

    Runs:   13

    “Bariatric surgery is becoming a very common operation in the United States in particular. // And just in the past about 5 years the rates of bariatric surgery have doubled from about 4 per hundred patients to about 8 per hundred patients.”

    (B-roll of surgery video in middle of sot)

     

     

    VO: DR. BRODIE PARENT OF THE UNIVERSITY OF WASHINGTON MEDICAL CENTER AND CO-AUTHORS STUDIED THE BIRTH CERTIFICATES AND HOSPITAL DISCHARGE DATA OF MORE THAN 10,000 MOTHERS AND INFANTS IN WASHINGTON STATE FROM 1980 TO 2013.

     

    THEY STUDIED TWO GROUPS, ONE OF WOMEN THAT HAD BARIATRIC SURGERY PRIOR TO PREGNANCY AND THE OTHER THAT DID NOT HAVE WEIGHT LOSS SURGERY.

     

    THEY WANTED TO SEE IF THE INFANTS OF THE WOMEN WHO HAD BARIATRIC SURGERY WERE AT HIGHER RISK FOR PREMATURITY, LOW BIRTH WEIGHT, AND INTENSIVE CARE ADMISSION.

     

    THE STUDY APPEARS IN JAMA SURGERY.

     

    (B-ROLL Dr. Parent walking through the hall and looking at papers/bariatric surgery b-roll/babies in ICU)

     

     

    AUDIO

    SOT/FULL

    Brodie Parent, MD- Department of Surgery, UW

    Super@: 58

    Runs: 15

    “The way to reduce that risk is perhaps by waiting 2 to 3 years after they’ve had the operation. If they give birth before that 2 to 3 year interval, there’s a higher risk of their infant requiring an ICU admission, or their infant being low weight, or premature.”

    (B-ROLL: babies in hospital in middle of sot)

     

     

     

    AUDIO

    VO:

    1. PARENT SAYS BARIATRIC OR WEIGHT LOSS SURGERY HAS MANY POTENTIAL BENEFITS BUT RECOMMENDS WAITING AS LONG AS POSSIBLE BEFORE CONCEPTION IN ORDER TO DECREASE RISKS FOR THE MOTHERS AND THEIR INFANTS.

    (B-ROLL: bariatric surgery/pregnant woman/baby in hospital)

     

     

    LAURA BERGER THE JAMA REPORT

    (B-ROLL: babies in hospital)

     

    TAG: DURING THE PAST THREE YEARS IN WASHINGTON STATE, ABOUT 200 WOMEN A YEAR HAVE HAD A BARIATRIC OPERATION PRIOR TO GIVING BIRTH.

  • October 11, 2016

    Trends in Dietary Supplement Use

    Trends in Dietary Supplement Use

    INTRO: Over the past two decades, numerous studies of diet supplements use have found little evidence of benefit. But the industry continues to grow. Does this abundance of new information affect supplement use among U.S. adults? A new study in JAMA looked at the trends in dietary supplement use from 1999-2012. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:  IN RECENT YEARS, DIETARY SUPPLEMENTS HAVE GROWN INTO A 32 BILLION DOLLAR A YEAR BUSINESS. AND AS THE INDUSTRY HAS EXPANDED, SO HAS RESEARCH INTO THE POSSIBLE BENEFITS AND RISKS OF TAKING SUPPLEMENTS.

     

     

    (B-ROLL: Supplements in bottles on table/powder supplement with graphic $32 billion/bottle close up/person taking pills)

     

     

    AUDIO:

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

    Super@: 12

    Runs: 14

    (b-roll in middle of doctor w bottles)

     

    “Supplements are tremendously popular.  In the late 1980s, more than a third of Americans were using these sort of products. And today a little more than half of all American adults use dietary supplements.”

     

     

    AUDIO:

    VO: IN THE CURRENT ISSUE OF JAMA, DR.  PIETER COHEN DISCUSSES THE RESULTS OF A NEW STUDY EXAMINING TRENDS IN DIETARY SUPPLEMENT USE AMONG U.S. ADULTS BETWEEN 1999-2012.

     

    A TOTAL OF 38,000 PEOPLE WERE ASKED ABOUT WHAT VITAMINS, MINERALS, AND SUPPLEMENTS THEY USED.  THE RESULTS WERE COMPARED OVER THE 13 YEAR PERIOD TO IDENTIFY TRENDS AND CHANGES OVER TIME.

     

    THIS TIME PERIOD WAS ALSO AN ERA OF INTENSE INVESTIGATION INTO THE HEALTH EFFECTS OF SUPPLEMENTS. THE NATIONAL INSTITUTES OF HEALTH INVESTED SEVERAL HUNDRED MILLION DOLLARS INTO RESEARCH ON SUPPLEMENTS ONLY TO FIND MOST HAVE NO SIGNIFICANT BENEFIT.

    (B-ROLL: Doctor working/person taking pills/doctor at desk/pill bottles/ pills)

     

     

    AUDIO

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

     

    Super@: 1:04

    Runs: 15

     

    “… there was very high use of supplements going into, at the start of the study in 1999, 52%. What’s interesting is that did not budge at all over the next 13 years and it was exactly the same, 52% at the end of the 13 years.”

     

    AUDIO:

    VO:

    (B-ROLL Doctor walking/doctor with pills)

    1. COHEN SAYS HE IS SURPRISED THAT SUPPLEMENT USAGE HAS STAYED THE SAME EVEN THOUGH STUDIES HAVE SHOWN THAT MANY SUPPLEMENTS HAVE LITTLE TO NO BENEFIT.

     

     

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

    Super@: 1:28

    Runs: 14

    “And how will a consumer know if a supplement has certain side effects or risks? These are things that are not well presented given today’s regulatory environment. And I think those are some major questions for the near future.”

     

    (BROLL: pill bottles/labels/pills)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: MULTIVITAMIN OR MULTIMINERAL USE DECREASED FROM 37% IN 1999-2000 TO 31% IN 2011-2012.

  • October 06, 2016

    Estrogen Blocking  Drugs Can Decrease Risk of Breast Cancer in Opposite Breast

    Estrogen Blocking  Drugs Can Decrease Risk of Breast Cancer in Opposite Breast

    INTRO: Can certain drugs help women with breast cancer decrease the risk of developing cancer in the opposite breast? A new study in JAMA Oncology found that estrogen blocking drugs can decrease the risk of contralateral breast cancer, especially among women whose breast cancer was estrogen receptor positive. The study found the women who took the drugs longer had a lower risk of developing cancer in their opposite breast.  Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

    DURING THE 10 YEARS AFTER BREAST CANCER DIAGNOSIS, 5% OF WOMEN DEVELOP CANCER IN THEIR OPPOSITE BREAST KNOWN AS CONTRALATERAL BREAST CANCER.

     

    (B-ROLL Doctor and patient looking at scans, mammogram exam, doctor looking at monitor)

     

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 9 Runs: 22

     

     “We know from clinical trials that there are medications that can be used to reduce risk of contralateral breast cancer.  Particularly for women who are diagnosed with estrogen receptor positive breast cancer, tamoxifen and aromatase inhibitors may be used. We wanted to evaluate these medications in a general community health care setting to see how well they work in the real world.”

     

    AUDIO:

    VO:

    1. GRETCHEN GIERACH FROM THE NATIONAL CANCER INSTITUTE AND CO-AUTHORS REVIEWED THE RECORDS OF MORE THAN 7500 WOMEN DIAGNOSED WITH INVASIVE BREAST CANCER FROM 1990 TO 2008.

     

    THEY FOLLOWED THE WOMEN THROUGH 2011 TO SEE WHICH ONES DEVELOPED BREAST CANCER IN THE OPPOSITE BREAST.  THE RESEARCHERS ALSO RECORDED WHO TOOK TAMOXIFEN OR AROMATASE INHIBITORS, TWO TYPES OF MEDICATIONS THAT BLOCK ESTROGEN. 

     

    DR GIERACH’S TEAM FOUND THAT WOMEN TAKING THESE MEDICATIONS FOR A LONGER PERIOD HAD A LOWER RISK OF CONTRALATERAL BREAST CANCER. 

     

    THE STUDY APPEARS IN JAMA ONCOLOGY.

     

    (B-ROLL: Dr. Gierach at her desk/talking to co-worker looking at scans/ Doctor looking at scan/ mammogram/prescription bottles/ pharmacist working)

     

     

    AUDIO

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 1:06 Runs: 10

     

    “So for women who took the drug for 4 years or longer, we observed reduced risk of contralateral breast cancer for up to 5 years after they stopped taking the medication.”

     

    AUDIO:

    VO:

    WOMEN GOING THROUGH BREAST CANCER TREATMENT HAVE MANY TOUGH DECISIONS TO MAKE IN CHOOSING A THERAPY PLAN.  DR. GIERACH SAYS IF THEY DECIDE TO USE THESE DRUGS AND CAN STICK WITH THEM, THERE ARE LONG TERM BENEFITS.

    (B-ROLL :Doctor talking to patient/scan close up/pills on shelf/girl walking up to pharmacy counter )

     

     

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 1:28 Runs: 14 B roll middle to end of bite of pill bottles

     

    “These medications are known to have side effects which might impact or challenge women in being able to complete her full treatment course… The longer they took the drug the greater the risk reduction, so we know that therapy duration really does make a difference.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: IN THE STUDY, THE AVERAGE AGE FOR WOMEN AT TIME OF CANCER DIAGNOSIS WAS 61.

     

     

  • September 27, 2016

    Early Stroke Treatment Improves Patient Outcomes

    Early Stroke Treatment Improves Patient Outcomes

    INTRO: After a large vessel stroke, how long does a patient have to get treatment in order to prevent long lasting effects? A new study in JAMA found that a shorter time to treatment after a stroke is critical to having the best recovery. But just how long does a patient have to restore blood flow to the brain? Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    STROKE IS THE 5TH LEADING CAUSE OF DEATH IN THE U.S. AND THE 2ND LEADING CAUSE OF DEATH WORLDWIDE. EACH YEAR MORE THAN 750,000 AMERICANS EXPERIENCES A STROKE.

     

    (B-ROLL ambulance arriving at hospital with a patient)

    (Graphic of 750,000 Americans each year)

     

     

    AUDIO:

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@: 11

    Runs: 13

     

    “So it’s critically important for patients to recognize the warning signs of stroke, get to the hospital as soon as possible and for doctors, nurses and health systems to then rapidly treat patients when they arrive.”

     

    AUDIO:

    VO:

    1. JEFFREY SAVER FROM UCLA AND CO-AUTHORS REVIEWED THE OUTCOMES OF OVER 1200 PATIENTS EXPERIENCING ACUTE ISCHEMIC STROKE IN 5 LARGE RANDOMIZED CLINICAL TRIALS. SOME PATIENTS RECEIVED STANDARD MEDICAL THERAPY, OTHERS RECEIVED STANDARD THERAPY PLUS TREATMENT WITH A THROMBECTOMY DEVICE.

     

    THE AUTHORS FOUND THAT THE SOONER THE DEVICE, WHICH PULLS CLOTS OUT OF THE AFFECTED ARTERY AND HELPS RESTORE BLOOD TO THE BRAIN, IS USED, THE BETTER THE PATIENT’S OVERALL RECOVERY.

     

    THE STUDY APPEARS IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. 

     

    (B-ROLL: Saver and other dr. looking at brain scans//Saver and dr. looking at thrombectomy device and holding it up.)

     

     

    AUDIO

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@:57

    Runs: 25

     

    “There was some benefit of therapy up to 7 1/3 hours after onset that’s an important new aspect…If you get the artery open at 3 hours then 65% of patients will be able to live independently 3 months later.  If it takes 8 hours to get it open, then only 45% will be able to live independently, it makes a major difference in outcome.”

     

    AUDIO:

    VO:

    IT IS CRITICAL FOR THE PUBLIC TO BE AWARE OF THE SIGNS OF STROKE.  DOCTOR SAVER SAYS USE THE ACRONYM FAST—IF YOU SEE FACIAL DROOPING, ARM WEAKNESS, AND SPEECH DIFFICULTY, IT’S TIME TO CALL 911.

    (B-ROLL patient wheeling into hospital//GRAPHIC WITH FAST ACRONYM)

     

     

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@: 1:34

    Runs: 15

     

    “Often the patient can’t make the call themselves because the stroke is affecting their speaking or their ability to recognize they are having a stroke. So it’s very important for family, friends, witnesses, if you see someone having stroke symptoms, call 911.  Every minute matters.”

     

    (BROLL: 2 doctors looking at brain scans, close up of the scans)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: DR. SAVER SAYS HOSPITALS SHOULD USE THIS PROCEDURE WITHIN 75 MINUTES OF A PATIENT’S ARRIVAL.

  • September 20, 2016

    Wearable Technology’s Effect on Weight Loss

    Wearable Technology’s Effect on Weight Loss

    INTRO: Does adding wearable technology to a program of diet and exercise help with weight loss?  A new study in JAMA reports that adding physical activity tracking gadgets to a lifestyle modification program did not result in more weight loss among a group of obese and overweight young adults. Laura Berger has more in this week’s JAMA Report.

    AUDIO

    VO:

    IN THE FIGHT AGAINST OBESITY MANY AMERICANS ARE TURNING TO WEARABLE DEVICES TO HELP MEET THEIR FITNESS GOALS.  BUT ARE THESE GADGETS EFFECTIVE?

    (B-ROLL group exercising, treadmill running, elliptical, woman with wearable arm band)

    AUDIO:

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@ 8

    Runs:  14

    “… when we gave people these strong behavioral weight loss programs that are kind of group based…we actually that thought adding wearable technologies to that program would help them lose more weight over 24 months and to our surprise, that isn’t what we found.” (B-roll in middle w devices and person working out)

    VO:

    1. JOHN JAKICIC (JA-KEY-SICK) FROM THE UNIVERSITY OF PITTSBURGH AND CO-AUTHORS STUDIED 471 OVERWEIGHT OR OBESE YOUNG ADULTS FROM 2010 TO 2012. ALL STUDY PARTICIPANTS RECEIVED COUNSELING ON DIET AND EXERCISE. 6 MONTHS INTO THE STUDY, HALF WERE RANDOMLY ASSIGNED TO GET A WEARABLE DEVICE TO HELP TRACK PHYSICAL ACTIVITY AND DIET. 

    THE AUTHORS FOUND THAT THE GROUP THAT DID NOT USE THE WEARABLE DEVICE, LOST MORE WEIGHT THAN THE GROUP WHO DID.  AN AVERAGE OF 5.3 POUNDS MORE.

    THE STUDY APPEARS IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. 

     (B-ROLL: Dr. walking through hall//B-roll overweight people//people working out// wearables//more working out)

    AUDIO

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@: 53

    Runs: 15

    “ …they may give people a false sense of security that they don’t pay attention to some of the key behaviors that they need to pay attention to. They are relying on the device too much and that’s why we saw less weight loss in that group. “

    AUDIO

    VO:

    ALTHOUGH WEARABLE TECHNOLOGY HAS CHANGED AND IMPROVED SINCE THE STUDY STARTED, THERE IS STILL NO ONE SIZE FITS ALL FITNESS TRACKING DEVICE.  (B ROLL: of newer wearable technology)

    AUDIO

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@:

    Runs:

    “…maybe we shouldn’t just think broadly about using these devices across everyone. I think we need to understand more about how to use them and for whom.”

    Laura Berger, the JAMA Report.

    (B-ROLL: people lifting weights and working out

    Tag: THE YOUNG ADULTS IN THIS STUDY ARE DEFINED AS AGES 18-35.

  • September 14, 2016

    JAMA Report: Using Hospital Records to Predict Death by Suicide

    JAMA Report: Using Hospital Records to Predict Death by Suicide

    “Using Hospital Records to Predict Death by Suicide”

     

     

    INTRO: Although suicide is the 10th leading cause of death in the United States, predicting just who is at increased risk of suicide can be challenging. Is there a better way to determine an individual’s risk for suicide? The authors of a new study in JAMA Psychiatry examined hospital discharge reports using natural language processing, and found several key predictors that can highlight potential suicide risk. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO

    VO:

    ON AVERAGE THERE ARE 117 SUICIDES PER DAY IN THE UNITED STATES. AND EACH YEAR, MORE THAN 40,000 AMERICANS DIE BY SUICIDE. ALTHOUGH IT’S THE 10TH LEADING CAUSE OF DEATH IN THE UNITED STATES, EXACTLY WHO IS AT RISK OF SUICIDE IS STILL HARD TO PREDICT.

     

    (B-ROLL WITH GRAPHIC people walking down the street with a graphic over it with text of statistics)

     

     

    AUDIO:

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@16

    Runs:  9

    “…what we hope to do is understand if you are in the hospital for any reason and then you are discharged can we say something about your risk of death from suicide.”

     

    SOT/FULL

    Thomas H. McCoy, Jr., M.D., – Director of Research, Center for Quantitative Health, MGH

    Super@31

    Runs:  17

    “To try and better understand who would go on to die by suicide… we drew on…typical risk factors…But we also added a newer risk predictor and that was the words that the doctors had written about the patient at the time of discharge.“

     

    VO:

    1. THOMAS MCCOY JR. AND DR. ROY PERLIS AND CO-AUTHORS FROM MASSACHUSETTS GENERAL HOSPITAL EXAMINED THE HOSPITAL DISCHARGE NOTES OF MORE THAN 450,000 PATIENTS FROM 2005 TO 2013.

    RESEARCHERS ANALYZED THESE NOTES BY A COMPUTER PROGRAM USING SENTIMENT ANALYSIS—WHICH LOOKS FOR POSITIVE OR NEGATIVE WORDS LIKE LOVELY, DELIGHTFUL, PLEASANT– OR DREADFUL, UNFORTUNATE OR POORLY. THEY FOUND THAT CERTAIN WORDS CAN PREDICT A HIGHER RISK FOR SUICIDE.

     

    THE STUDY APPEARS IN JAMA PSYCHIATRY. 

    (B-ROLL of the two doctors walking, doctors at desk, computer screen, medium shoot of doctors, wide shot doctors, Graphic of computer with words highlighted, JAMA logo)

     

     

    AUDIO

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@: 1:12

    Runs:  14

    “The value of using natural language processing is it’s a tool that lets us pull things out we would otherwise miss if we just looked at diagnostic codes and medicines, and peoples age and gender and so forth.”

     

    AUDIO

    VO:

    DOCTORS MCCOY AND PERLIS HOPE OTHER HOSPITALS ACROSS THE COUNTRY CAN EVENTUALLY ADOPT THIS NEW APPROACH AND HELP BRING MORE INSIGHT INTO PREVENTING SUICIDE.

    (B ROLL: doctors in office talking)

     

    AUDIO

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@: 1:35

    Runs:  8

    “…And if we can make predictions about who’s at high risk, we can better target resources, we can better target interventions to reduce this risk.”

    (BROLL: some sot covered with 2 doctors in office)

     

    Laura Berger, the JAMA Report.

    (B-ROLL: doctors at computer looking at graphs)

     

     

    Tag: IN THE STUDY ONLY 1.3% OF THE PATIENTS IN THE STUDY HAD A PRIMARY PSYCHIATRIC DIAGNOSIS.

  • September 06, 2016

    MRI Exposure During Early Pregnancy Not Associated with Increased Fetal Harm

    MRI Exposure During Early Pregnancy Not Associated with Increased Fetal Harm

     

    VNR Script

    68 seconds

    Audio: Video:
    VO:Should women take a pregnancy test before having an MRI? A new study published in The Journal of the American Medical Association looked at the safety of magnetic resonance imaging during pregnancy, especially during the first trimester.13 secs Female patient in doctor officeDoctor/Patient interactionMRI Scan
    SOT:“We already have a fair amount of data on CAT scan safety in pregnancy, but MRI was lacking.”TC 5:53 – 6:007 secs Dr. Joel Ray on camera
    VO:Dr. Joel Ray and his colleagues at Saint Michael’s Hospital in Toronto analyzed data collected over 12 years and concluded that MRI in the first trimester was not harmful to the developing fetus.11 secs Exterior of hospital, B-roll of Dr. Ray looking at data, etc.
    SOT:“An MRI in the first trimester is unlikely to be harmful, so special pregnancy testing or measures are unlikely to be required.”TC 2:34 – 2:439 secs Dr. Joel Ray on camera
    VO:Women undergoing an MRI with the contrast agent gadolinium at any point during pregnancy were also included in the study. These MRIs with contrast were associated with a higher risk of fetal death and a variety of inflammatory and skin conditions in the newborn.13 secs Female patient undergoing MRI
    SOT:“It reinforces a to date evidence-free notion that gadolinium might harm the fetus.TC 4:53 – 5:01<CUT> 

    “Gadolinium contrast would be best avoided in pregnancy.”

    TC 2:52 – 2:56

     

    12 secs

    Dr. Joel Ray on cameraB-roll of MRI scans or procedure as necessary to cover cut
     VO: This is Laura Kelly for the JAMA Report.

     

     

  • August 23, 2016

    Reducing the High Cost of Prescription Drugs in the U.S.

    Reducing the High Cost of Prescription Drugs in the U.S.

    INTRO:Prescription drug costs in the United States continue to rise well above inflation rates and make up an increasingly large share of total health care spending. A new report examines the reasons for these higher prices and also suggests policy changes that could help contain drug costs. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People walking on street, pharmacy sign, doctor holding drug bottles, shelves of prescription drugs

    AUDIO
    VO
    For many Americans, a trip to the pharmacy can result in sticker shock. People in the United States pay more for their prescription drugs than anywhere else in the world.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:08
    Runs:06
    “There’s a lot of frustration about high drug costs and how they impact the delivery of patient care.”

    VIDEO
    B-ROLL
    Dr. Kesselheim walking in clinic, various shots of him sitting at computer

    AUDIO
    VO
    Dr. Aaron Kesselheim and his colleagues at Brigham and Women’s Hospital reviewed the medical and health policy literature on prescription drug prices in the U.S. The researchers say high drug costs stem from several factors.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:25
    Runs:15
    “The provision of market exclusivity that allows drug companies to charge whatever the market will bear and then limitations on payers and their ability to negotiate drug prices and the limitations on competition, that might drive drug prices down.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:49
    Runs:08
    “Another factor; a lot of physicians don’t know what the price of the drugs are to patients and so will prescribe drugs without thinking about the price of the product.”

    (Video covering 1st part of bite: pills being counted)

    AUDIO
    VO
    This contributes to patients sometimes not filling prescriptions and spreading out doses or splitting pills to reduce costs.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:00
    Runs:07
    “We need more education for physicians and patients about the implications of high drug prices on the delivery of care.”

    VIDEO
    B-ROLL
    Pan of prescription drugs on shelf, doctor looking at drug bottle

    AUDIO
    VO
    Also, more information on identifying high and low value drugs, so resources aren’t wasted.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:15
    Runs:09
    “And insuring that there is both reasonable periods of market exclusivity as well as adequate competition when those market exclusivity periods end.”

    VIDEO
    B-ROLL
    Push in to pile of drugs, pan of drugs

    AUDIO
    VO
    And timely availability of high quality and safe generic drugs.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:26
    Runs:13
    “There have been a number of studies showing, when generic drugs enter the market that drug prices fall substantially. Money that is spent unnecessarily on expensive drugs cannot be spent in other areas of health care delivery.”

    (Video covering 2nd half of bite: pills being poured out of bottle and counted)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Another justification for higher drug prices is that it will help encourage innovation.  However, according to the authors, most innovation comes from publically funded science in government labs and academic research settings.

  • August 16, 2016

    New Medication for High Cholesterol Not Cost-Effective

    New Medication for High Cholesterol Not Cost-Effective

    INTRO: Statins are a common medication used to lower L-D-L or “bad” cholesterol levels. However, for some patients, statins alone aren’t enough. Last year, a new type of medication known as P-C-S-K-9 inhibitors became available for use along with statins.  Although effective, these drugs are very expensive. A new study evaluated the cost-effectiveness of this therapy and how increased use might affect the U.S. health care system. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Video of people walking, Graphic

    AUDIO
    VO
    Millions of people struggle to lower their L-D-L or “bad” cholesterol. A new type of therapy called a P-C-S-K-9 inhibitor can help reduce L-D-L or “bad” cholesterol by nearly 50 percent.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@:11
    Runs:12
    “They block a specific enzyme in the cholesterol pathway. In doing so, they increase the removal of LDL cholesterol from the blood into the liver and lower LDL cholesterol levels.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@:23
    Runs:20
    “They were approved to be used for individuals who are at higher risk for heart disease, who have had a heart attack, a stroke or who have a family history of very high cholesterol. These drugs were approved to be used in addition to the statin medications in these particular individuals.”

    (Video covering  middle of bite: dye being injected into artery)

    VIDEO
    B-ROLL
    Dr. Bibbins-Domingo and Dr. Kazi walking down hall, looking at blocked artery on computer screen, Graphic

    AUDIO
    VO
    Doctors Kirsten Bbibbins-Domingo and Dhruv (drewz) Kazi from the University of California San Francisco and their co-authors examined the cost-effectiveness of P-C-S-K-9 inhibitors and their potential effect on U-S health care spending. Using a simulation model that included all U-S adults 35 and older, they evaluated outcomes like expected numbers of deaths due to cardiovascular disease, heart attacks and strokes and balanced this with the cost and potential benefits of these drugs. The authors estimated that about 9 million people would be eligible for this therapy.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of Californ ia San Francisco
    Super@1:13
    Runs:06
    “This innovation comes at a price. They were launched at a little over 14 thousand dollars per patient per year.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@1:19
    Runs:07
    “It would increase our total expenditure on prescription drugs by almost 40 percent.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@1:30
    Runs:09
    “All health care expenses would go up 4 percent. That’s a large increase in our total U.S. health care expense based on one set of drugs alone.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@1:39
    Runs:08
    “Our analysis suggests that price tag should be closer to just over 4 thousand dollars a year for them to be cost-effective.”

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@1:47
    Runs:07
    “Should that not happen we would expect to see an unprecedented strain on health system budgets across the country.”

    VIDEO
    Dr. Kazi on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The P-C-S-K-9 inhibitors would also help a small portion of patients who are unable to take statins to lower their bad cholesterol.

  • August 09, 2016

    Device Reduces Risk of Brain Injury After Heart Valve Replacement

    Device Reduces Risk of Brain Injury After Heart Valve Replacement

    INTRO: Patients who need a heart valve replacement but are too ill for major surgery sometimes undergo a less invasive procedure that uses a catheter to replace their damaged valve. As a complication of the procedure, up to 10 percent of these patients experience a stroke. A new study looked at whether or not a filter device inserted into the blood vessels can help protect the brain from stroke by removing debris that is dislodged during the procedure. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of TAVI procedure

    AUDIO
    VO
    A procedure is underway to replace this patient’s diseased heart valve. It’s called trans-catheter aortic valve implantation or “TAVI.” Instead of open heart surgery, doctors use a catheter to implant a new valve inside the old one. During this process, tissue and plaque in the blood vessels can become loose, traveling through the bloodstream to the brain.

    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@:19
    Runs:08
    “Because of the material you have neurologic injuries, like little strokes or little cerebral infarcts.”

    VIDEO
    B-ROLL
    Preparing catheter with filters in solution

    AUDIO
    VO
    A cerebral protection device is a type of filter that is placed by catheter, directly into the vessels that supply the brain.

    AUDIO
    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@:34
    Runs:17
    “By using the filter we are trying to capture this material and protect the brain. The device is designed to save brain tissue that would otherwise be killed by particles that occlude little vessels that supply the brain with blood and oxygen.”

    (Video covering 2nd part of bite: catheters inside heart on screen)

    VIDEO
    B-ROLL
    Dr. Linke sitting at his desk, procedure, heart monitor, filter being prepared, patient undergoing MRI, procedure

    AUDIO
    VO
    Dr. Axel Linke (Lin-keh) from the University of Leipzig Heart Center, In Germany and co-authors studied 100 patients with an average age of 80 who underwent the “TAVI” procedure. Half the patients received the filter device. The other half did not. They also underwent an M-R-I of the brain before and again at two and seven days after the procedure.

    AUDIO
    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@1:09
    Runs:11
    “By using the filter device, the number of lesions in the brain was reduced by 50 percent and the volume was reduced by 50 percent as well.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@1:24
    Runs:22
    “You’re reducing the number of lesions, which means the number of holes in the brain, and you’re reducing the amount of dead tissue in the brain. You have more functional neurons and more alive brain tissue present as compared to somebody without the embolic protection.”

    (Video covering last part bite: pan of procedure)

    VIDEO
    B-ROLL
    Patient undergoing procedure

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Larger studies are needed to prove whether this device can also result in better neurological and cognitive outcomes in patients.

  • August 01, 2016

    Eating More Plant Protein Associated with Lower Risk of Death

    Eating More Plant Protein Associated with Lower Risk of Death

    INTRO Understanding what kinds of food provide the best health outcomes is an important area of research. In particular, the types of protein we eat, both animal and plant-based, can have long-term effects on overall health. A new study examined how diets heavy in either animal or plant-based protein sources can influence mortality. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Various shots of different foods AUDIO
    VO
    Figuring out the components of a balanced diet can often mean endless choices. Both animal and plant based proteins are part of those choices.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:07 Runs:05
    “Someone’s protein intake is potentially associated with long-term health outcomes and mortality.”

    AUDIO SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@:13 Runs:11
    “People should not only care about how much protein they consume, but also pay attention to what kind of food they consume to gather the protein.”

    VIDEO
    B-ROLL Dr. Song and Dr. Chan walking down hallway, sitting at desk talking, shot of fish, olives, people walking outside, various other shots of food, including sandwiche

    AUDIO
    VO
    Doctors Mingyang Song and Andrew Chan from Massachusetts General Hospital and co-authors examined how animal and plant based protein sources influence long-term health. They looked at more than 131 thousand adults participating in two long-running, national health studies. Participants provided 25 to 30 years of detailed information on diet, lifestyle, and medical conditions. Researchers reviewed detailed food questionnaires that were sent to the participants every four years.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:49 Runs:10
    “Individuals that consumed the highest amounts of animal based proteins had a somewhat higher risk of mortality, in particular, cardiovascular mortality.” AUDIO SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@1:00 Runs:07
    “And this association is stronger among people with unhealthy lifestyle factors.”
    VIDEO
    B-ROLL Man with cigarette, beer and wine, overweight people

    AUDIO
    VO
    Those with a healthier lifestyle did not see an increase in their risk of dying.

    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    VO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@1:29 Runs:11
    “When we look at animal protein versus plant protein, we found that replacement of animal protein with plant protein is associated with substantial reduction of mortality.”

    AUDIO SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@1:46 Runs:11 “Clearly over the long-term a diet which is comprised of primarily plant-based proteins tends to be more favorable for longevity than someone who consumes most of their protein from animal sources.” (Video covering 2nd half of bite: various foods)

    VIDEO
    B-ROLL Dr. Chan on camera
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say previous studies have only looked at the amount of protein intake, not the type of protein sources consumed.

  • July 25, 2016

    Unintentional Marijuana Exposure Increases among Colorado Children

    Unintentional Marijuana Exposure Increases among Colorado Children

    INTRO: As of 2015, four U-S states, including Colorado, have legalized recreational marijuana. The drug is available in various forms, including cigarettes and edibles like candy and baked goods. These products are sometimes unintentionally ingested by children. A new study evaluated these unintentional marijuana exposures among young children in Colorado. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Pics of sour gummies, chocolate chip cookie, brownie, marijuana AUDIO
    VO
    Sour gummies, this chocolate chip cookie and this brownie may look like regular candy and baked goods, but they aren’t. They are made with marijuana.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:08 Runs:08
    “And so they would look highly attractive and taste just like any other food that a child would like to get into.”

    VIDEO
    B-ROLL Dr. Wang walking in the emergency department, looking at papers in nurses station, walking into exam bay, park, various children in park
    AUDIO
    VO
    Dr. G. Sam Wang (Wong) from Children’s Hospital Colorado and co-authors evaluated the number of children seen for unintentional exposure to marijuana from 2009 thru 20-15, before and after recreational use became legal in the state. They identified children from zero to nine years old coming to the Children’s Hospital and also reviewed calls to the regional poison center.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:37 Runs:18
    “Between 2009 through 20-15, we saw a pretty big jump in kids annually coming here for marijuana exposures. There was one in 2009 and there was 16 in 2015. Calls to the poison center for marijuana exposures in the same age group increased from nine to 47.”

    GXF FULL
    JAMA PEDIATRICS LOGO

    AUDIO
    VO
    The study appears in JAMA, Pediatric.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:57 Runs:09
    “The majority of these kids got into marijuana by route of ingestion, meaning they ate a marijuana product, and a large percentage of them were actually edible products.”
    VIDEO
    B-ROLL Little girl walking in the park

    AUDIO
    VO
    Their average age: just over 2 years old.
    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@1:09 Runs:12
    “Most kids who became symptomatic had some sort of degree of sleepiness. We’ve had children who’ve become comatose had such difficulty breathing that they actually needed a breathing tube to help them breathe.”

    (Video covering middle of bite: Emergency room sign on building, insides exam room)

    VIDEO
    B-ROLL Dr. Wang talking with hospital colleague, various shots of edible marijuana products

    AUDIO
    VO Dr. Wang (Wong) says it’s important to keep marijuana edibles in their original child-resistant packaging and store them safely and out of reach.

    AUDIO
    G. Sam Wang, M.D., – Children’s Hospital Colorado Super@1:28 Runs:14
    “As more states decide to legalize marijuana we have to make sure the public health impact gets evaluated and we have to continue surveillance on how legalization of marijuana does impact the pediatric population.”

    (Video covering middle of bite: pan of marijuana canisters. Video covering end of bite: children in park) VIDEO
    B-ROLL Children in park AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say in the overwhelming majority of cases, the marijuana was found in the child’s home.

  • July 18, 2016

    Bariatric Surgery Can Improve Mobility and Pain for Obese Teens

    Bariatric Surgery Can Improve Mobility and Pain for Obese Teens

    INTRO: Many adults who undergo bariatric surgery not only lose weight, but they also see improvements in muscle and joint pain and the ability to walk around. What about teenagers that undergo these procedures? A new study followed a group of teens that had bariatric surgery to see whether the procedure also helped decrease pain and improve mobility. Catherine Dolf explains in this week’s JAMA Report.
    VIDEO
    B-ROLL Girl looking over a fence, young girl walking in the park, elevator door closing, going up flight of stairs
    AUDIO
    For most teenagers, worrying about things is a normal part of growing up. But teens who are severely obese may worry about being able to walk around and keep up with their friends, or even whether a building has an elevator so they don’t have to climb several flights of stairs.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@:15 Runs:04
    “And what this can do is really decrease the quality of life for these individuals.”

    AUDIO
    SOT/FULL Justin R. Ryder, Ph.D., – University of Minnesota Medical School Super@:19 Runs:12
    “Bariatric surgery is a viable treatment option for youth with severe obesity. But with that comes risks but also comes substantial benefits.”

    VIDEO
    B-ROLL Dr. Ryder and Dr. Kelly walking down hallway, various shots of bariatric surgery, teens walking down the street

    AUDIO
    Doctors Justin Ryder and Aaron Kelly from the University of Minnesota School of Medicine and co-authors are tracking long-term outcomes for 242 teens that underwent bariatric surgery at 5 centers around the U-S. Surgery like this one, performed by Dr. Thomas Inge at the Cincinnati Children’s Hospital. The current study includes 206 of these teenagers and focuses on improvements in mobility and joint pain. All patients participated in a quarter mile walk test before and after surgery.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@:57 Ends:14
    “We figured from the outset that bariatric surgery, because of the magnitude of weight-loss that accompanies it, that these teenagers would be able to walk further and have less pain but we were surprised about just how much that improved.”
    AUDIO
    GXF FULL
    JAMA PEDIATRICS LOGO

    AUDIO
    VO
    The study appears in JAMA, Pediatric.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@1:14 Ends:07
    “They were able to walk this distance faster and with a lower heart rate, indicating that their fitness levels improved.”
    AUDIO
    SOT/FULL Justin R. Ryder, Ph.D., – University of Minnesota School of Medicine Super@1:21 Runs:08
    “They were about 30 seconds faster at six months and those benefits were sustained up to two years post-surgery.”

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota School of Medicine Super@1:29 Runs:13
    “In addition, they were able to do it relatively pain free compared to before they had the surgery. Many of them will be more likely to engage in physical activity and exercise over time, which we think will give them a better shot of keeping the weight off in the long-term.” (Video covering end of bite: girl walking)
    VIDEO
    B-ROLL Girl walking AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Teenagers participating in the study were at least 13 but less than 19 years old.

  • July 11, 2016

    Increased Risk for Chronic Opioid Use After Surgery

    Increased Risk for Chronic Opioid Use After Surgery

    “Increased Risk for Chronic Opioid Use After Surgery”

    INTRO: Chronic use of prescription pain medications known as opioids is increasing in the United States. Many patients who have not previously taken this type of medication are prescribed these drugs to help manage pain after surgery. A new study examined whether these patients are also at an increased risk for using opioids long-term. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Wide shot of surgery
    AUDIO
    VO
    Each day, thousands of surgeries are performed across the United States.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:04 Runs:06
    “It’s pretty normal to get a pain killer after you, after you go home from your surgery and during your surgery.”

    VIDEO
    B-ROLL Various shots of medication, Dr. Sun walking down steps, various shots of Dr. Sun sitting at desk looking at computer, surgery shots

    AUDIO
    VO What’s not normal is to still be taking those pain medications many months after surgery. Dr. Eric Sun and his colleagues at the Stanford University School of Medicine reviewed the records of more than 641 thousand patients who were not taking pain medication during the year prior to surgery. they had one of 11 common operations, including joint replacements, gall bladder removal, and C-sections, during a 12-year-period.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:32 Runs:15 “We wanted to see at the year out after their surgery, were they at increased risk of using opioids chronically compared to patients who didn’t get surgery. Some opioid use is to be expected shortly after surgery, so we did exclude the first 90 days following their surgery.”

    VIDEO
    B-ROLL Various shots of pharmacy and medication

    AUDIO
    Chronic use was defined as filling at least 10 prescriptions, or more than 120 days worth of opioids, during the first year after surgery.

    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    VO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:57 Runs:15
    “Patients who didn’t use opioid prior to surgery were at an increased risk for chronic opioid use following their surgery. The risks range from about one and a half to five times depending on the surgery. Overall, the risk is pretty low, it was about less than one percent for most of the surgeries we looked at.”
    VIDEO
    B-ROLL Various shots of opioid medications

    AUDIO
    VO
    Men and older patients were at an increased risk of chronic opioid use along with patients with a history of certain medical conditions.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@ 1:19 Runs:10
    “Patients who use benzodiazepines, that’s a fairly common drug people use for anxieties and also patients with a history of drug abuse and alcohol abuse are at high risk for chronic opioid use following their surgery.” VIDEO
    B-ROLL Various shots of surgery

    AUDIO
    VO
    Dr. Sun says physicians should be aware of this risk even though the overall risk is small.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@ 1:38 Runs:10
    “Physicians should closely monitor their surgical patients to see how much opioid they are or aren’t taking, and just be aware that they may be at high risk for using opioids chronically.”
    (Video covering end of bite: Medication on counter)

    VIDEO
    B-ROLL Medication on counter AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say more research is needed to better manage the pain patients experience after surgery.

  • July 05, 2016

    Availability of Euthanasia and Physician-Assisted Suicide Around the World

    Availability of Euthanasia and Physician-Assisted Suicide Around the World

    INTRO:Worldwide, euthanasia and physician-assisted suicide are increasingly being legalized but remain controversial. A new study examined how the public’s attitude toward the practices has changed, as well as what types of patients that are using the procedures and why. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@:02
    Runs:05
    “There’s been an increase in legalization of euthanasia and assisted suicide in developed countries.”

    VIDEO
    B-ROLL
    Graphic-Maps, Dr. Emanuel walking and in his office

    AUDIO
    VO
    Both are legal in the Netherlands, Belgium, Luxembourg, Columbia, and Canada. Switzerland, along with 5 U-S states: Oregon, Washington, Montana, Vermont, and California offer physician-assisted suicide.  Dr. Ezekiel Emanuel and his colleagues from the University of Pennsylvania reviewed all available data on these interventions from the late 1940s through 20-16.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@:26
    Runs:16
    “Public support for euthanasia and assisted suicide is quite interesting. It’s more supportive of euthanasia. It increased from 1947 to about 1990 and then plateaued and over the last few years there’s been about a five or ten percent decline in support.”

    GXF FULL
    JAMA LOGO

    VIDEO
    B-ROLL
    Graphic-Map

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association. The interventions are rare.  In the Netherlands and Belguim, less than 5 percent of all deaths are by assisted suicide or euthanasia.  In Washington and Oregon, only 3 in a thousand deaths are by assisted suicide.  However, not every case is reported so it’s impossible to tell if these are true rates.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@1:02
    Runs:14
    “70 to 75 percent of the patients who get assisted suicide or euthanasia, no matter what the country, tend to be patients with cancer. It’s people who have really sort of given up on life…or they fear the loss of autonomy and dignity.”

    VIDEO
    B-ROLL
    Graphic

    AUDIO
    VO
    They tend to be older, white, well- educated, and well insured.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@1:20
    Runs:20
    “We know these aren’t flawless procedures, we know that they have mistakes and complications, we just don’t know the exact rate and the full nature of them. Worries about widespread abuse of these practices, that people who don’t have insurance or poor people might be predominantly targeted, do not seem to be borne out by the data.”

    VIDEO
    B-ROLL
    Dr. Emanuel at his desk

    AUDIO
    VO
    Dr. Emanuel also says these practices occur whether they are legal or not.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:44
    Runs:10
    “It behooves us to actually look at the practices and try to understand how they work, how well they work, what the problems are before we rush to legalize it in a lot of other countries.”

    VIDEO
    B-ROLL
    Dr. Emanuel on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say public support for these interventions is about 65 percent but the support is much less among physicians.

  • June 28, 2016

    Rethinking Blood Pressure Control in Older Adults

    Rethinking Blood Pressure Control in Older Adults

    INTRO: Three-quarters of people who are 75 and older have high blood pressure. Having high blood pressure increases the risk of heart attack, heart failure and stroke. A new study examined what would be the best target blood pressure to reduce the risks of these complications in older adults. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Mary walking from her car into hospital

    AUDIO
    VO
    Living independently is important to Mary Powers and her husband of 63 years.

    AUDIO
    SOT/FULL
    Mary Powers – Study Participant
    Super@:04
    Runs:06
    “We’re still in our home and we have a garden, we travel a little and enjoy life.”

    VIDEO
    B-ROLL
    Mary walking into hospital, getting blood pressure checked, cu of blood pressure machine, cu of Mary

    AUDIO
    VO
    Like a lot of people in their 80s, Mary has high blood pressure.  She works with her doctor to manage the blood pressure so she can be as healthy as possible for as long as possible.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@:19
    Runs:07
    “The most common reasons that people end up losing their independence are often complications of hypertension.”

    VIDEO
    B-ROLL
    Dr. Williamson walking down hall, talking with colleague, older people walking and shopping in the community

    AUDIO
    VO
    Dr. Jeff Williamson from Wake Forest School of Medicine and co-authors released the latest results from the systolic blood pressure intervention trial also known as the “sprint” trial.  They enrolled more than 26 hundred people, 75 and older.  All participants were living in their own home and could get back and forth to the doctor. they were randomly assigned to two groups.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@:43
    Runs:18
    “We wanted to test and see whether a systolic blood pressure target of less than 120 millimeters of mercury, that’s the top number measured in the doctor’s office, was more effective than 140 at reducing the risk of stroke, heart attack, heart failure
    and death.”

    VIDEO
    B-ROLL
    Mary’s blood pressure being monitored, taking a memory test and a walking test

    AUDIO
    VO
    In addition to recording those outcomes, researchers monitored blood pressure along with memory skills, and the ability to walk a little more than 13 feet, every three to four months. The trial was scheduled to run five years.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@1:12
    Runs:15
    “After just over two years, the study was stopped by the National Institutes of Health because we found a strongly favorable result in those individuals assigned to a blood pressure treatment target of less than 120.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@1:31
    Runs:09
    “The blood pressure target of 120 systolic is much more effective than a target of 140 in reducing the complications of high blood pressure.”

    VIDEO
    B-ROLL
    Various shots of people walking in the community

    AUDIO
    VO
    Even those individuals who were somewhat frail appeared to benefit from the lower blood pressure target.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@ 1:45
    Runs:09
    “This should remove a great deal of confusion for patients and their physicians about what the blood pressure target should be for older people.”

    VIDEO
    B-ROLL
    Cu of blood pressure monitor, wide shot of Mary getting blood pressure checkeD

    AUDIO
    Mary’s blood pressure has been well controlled and she has just one word for how she feels these days.

    AUDIO
    SOT/FULL
    Mary Powers – Study Participant
    Super@1:59
    Runs:01
    “Great.”

    VIDEO
    B-ROLL
    Mary smiling on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: To achieve the lower blood pressure goal, participants required, on average, one additional medication per day.  90 percent of the medications used were generic.

  • June 15, 2016

    Updated Recommendations for Colorectal Cancer Screening in Adults

    Updated Recommendations for Colorectal Cancer Screening in Adults

    INTRO: Colorectal cancer is the second leading cause of cancer death in the United States. Screening can accurately detect early stage colorectal cancer and precancerous polyps. The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services, including cancer screening. The Task Force has just issued updated recommendations on colorectal cancer screening for adults. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    VO
    In the United States this year, an estimated 134 thousand people will be diagnosed with colorectal cancer and about 49 thousand will die from the disease.

    VIDEO
    B-ROLL
    Various shots of people down the street

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:09
    Runs:05
    “Most colorectal cancer occurs after people are 50 and the rates go up as you get older.”

    VIDEO
    B-ROLL
    Dr. Owens walking outside, sitting at desk looking at graphs on a computer, colonoscopy screening

    AUDIO
    VO
    Dr. Douglas Owens, an author of the recommendation and a former member of the U-S Preventive Services Task Force, says the group strongly recommends screening average risk adults age 50 to 75 for colorectal cancer, and then making individual screening decisions for adults age 76 to 85, taking into account the patient’s overall health and screening history.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:32
    Runs:06
    “There are a number of ways to be screened for colorectal cancer and the good news is, is that they are effective.”

    VIDEO
    B-ROLL
    Patient undergoing colonoscopy, technician working in lab

    AUDIO
    VO
    Those include direct visualization tests like a colonoscopy and also stool based tests.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:44
    Runs:04
    “The important thing is that you choose one and be screened.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The new Task Force recommendations appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:51
    Ends:18
    “For people 76 to 85, the benefits of screening are smaller but some people may still benefit. People who’ve never been screened before and who are healthy enough to undergo treatment for colorectal cancer, should it be diagnosed, and who don’t have other conditions that would limit their life expectancy.”

    VIDEO
    B-ROLL
    People walking on the street

    AUDIO
    VO
    The decision to screen for colorectal cancer in this older age group should be individualized and take that patient’s overall health into account.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@1:16
    Ends:09
    “About a third of people in the United States who should be getting screening for colorectal cancer are not being screened currently, and that’s an important missed opportunity.”

    VIDEO
    B-ROLL
    Dr. Owens on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The Task Force does not have a recommendation for screening after age 85.

  • June 07, 2016

    U-S Obesity Rates Increase In Women, Stay Stable In Men

    U-S Obesity Rates Increase In Women, Stay Stable In Men

    INTRO: Obesity rates in the United States have increased, especially during the 1980s and 90s.  In the decade after, those rates appeared to have stabilized but what about now? A new study examined the latest trends in obesity rates among men and women in the U-S. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:01
    Runs:07
    “It’s really important to monitor trends in obesity and extreme obesity in the United States because obesity has an impact on our health.”

    VIDEO
    B-ROLL
    Overweight men and women walking on the street, Dr. Ogden walking outside, Dr. Ogden walking with colleague, various shots of Dr. Ogden at working at her desk

    AUDIO
    VO
    Obesity is closely linked to several health problems including diabetes, hypertension and heart disease. Dr. Cynthia Ogden and her colleagues from the National Center for Health Statistics examined trends in obesity among U-S adults from 2005 to 2014. They used data provided by the long-running National Health and Nutrition Examination Survey or N-HANES.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:26
    Runs:13
    “We were able to measure weight and height which are used to calculate BMI. Obesity is actually a BMI at or about 30. Class 3 obesity is a BMI above 40 and that’s sometimes also called extreme obesity.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    VIDEO
    B-ROLL
    Various shots of overweight people walking

    AUDIO
    VO
    To examine trends over the decade, the researchers looked at a nationally representative sample of more than 13 thousand men and 13 thousand women.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:51
    Runs:19
    “We saw that there had been no change in men in either obesity or extreme obesity but there had been an increase in women in both obesity and extreme obesity and when we adjusted for potential contributors of obesity by age, race, Hispanic origin, education and smoking status that didn’t change the results.”

    (Video covering end of bite: man walking into building)

    VIDEO
    B-ROLL
    Various shots of overweight men and women walking on the street

    AUDIO
    VO
    They also examined data from 26 hundred men and 28 hundred women in the most recent survey period, two thousand 13 thru two thousand 14.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@ 1:18
    Runs:12
    “The prevalence of obesity among men was about 35 percent and among women was about 40 percent and the prevalence of extreme obesity was 5 and a half percent in men and almost 10 percent in women.”

    VIDEO
    B-ROLL
    Graphic:
    Obesity Rates
    Asian Men
    Age 20 to 39

    AUDIO
    VO
    They also saw obesity rates increase among Asian men, age 20 to 39.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@1:35
    Runs:08
    “The prevalence was about 23 percent and that compares to about 6 percent in middle aged Asian men and 4 percent in older Asian men.”

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Black and Hispanic women continue to have a higher prevalence of obesity compared to non-Hispanic white women.

  • May 24, 2016

    Rates of Obesity and Diabetes Lower In More Walkable Neighborhoods

    Rates of Obesity and Diabetes Lower In More Walkable Neighborhoods

    INTRO: Despite public health efforts to reduce obesity through diet and exercise, the rates of overweight, obesity and diabetes continue to rise. A new study from Ontario, Canada examined whether living in more walkable neighborhoods is associated with a slower increase in rates of obesity-related diseases compared to less walkable neighborhoods. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of people walking in the city

    AUDIO
    VO
    Neighborhoods that are more walkable tend to be more densely populated.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:03
    Runs:07
    “And they tend to be zoned so that there’s retail and other services within the neighborhood. So there’s more places people can reach on foot.”

    VIDEO
    B-ROLL
    Various shots of cars driving

    AUDIO
    VO
    In less walkable suburban neighborhoods, stores and services are harder to reach on foot.  People usually have to drive to get places.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:17
    Runs:10
    “It seems that neighborhoods that are more walkable and are designed to make it easier to walk may actually help people to be more physically active.”

    VIDEO
    B-ROLL
    Dr. Booth walking down hospital hallway, sitting and working at her desk, people walking down the street, driving shots of neighborhood from car, people walking

    AUDIO
    VO
    Dr. Gillian Booth from St. Michael’s Hospital and co-authors studied almost 9000 neighborhoods in southern Ontario looking at walkability scores, along with government health data and survey results during a 12-year period.  They examined whether rates of overweight, obesity, and new cases of diabetes were rising more slowly in neighborhoods that were easier to walk in.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:46
    Runs:16
    “Rates of overweight and obesity were much lower in the most walkable neighborhoods compared to less walkable ones and were actually stable over time in the most walkable neighborhoods, whereas they were continuing to increase in less walkable areas.”

    (Video covering middle of bite: people walking on the street)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@1:05
    Runs:11
    “Rates of diabetes were actually going down, and then least in terms of the number of new cases in the most walkable areas, whereas rates were not falling in less walkable areas.”

    VIDEO
    B-ROLL
    Various shots of people walking, riding bikes and buses going down street

    AUDIO
    VO
    Neighborhoods with lower rates of obesity and diabetes also had higher rates of walking, biking and mass transit use.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@ 1:23
    Runs:16
    “It doesn’t mean that if we build neighborhoods differently that rates of overweight and obesity will fall, but it’s certainly hopeful and it gives us more information and some potential solutions that we can test in the future.”

    VIDEO
    B-ROLL
    People walking on the street

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say that the number of car trips per capita was also lower in more walkable neighborhoods.

  • May 17, 2016

    Surrogate Decision Makers for Critically Ill Patients Often Have Overly Optimistic Expectations

    Surrogate Decision Makers for Critically Ill Patients Often Have Overly Optimistic Expectations

    INTRO:When critically ill patients are unable to speak for themselves, a family member or close friend is often asked to serve as a surrogate decision maker.  Sometimes these surrogates and physicians have different expectations about a patient’s prognosis. A new study examined how often this happens and why it happens. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Graphic: Pictures of Mary Ann

    AUDIO
    VO
    Mary Ann Flati was a loving mother and grandmother.

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@:05
    Runs:10
    “My mom was, the kind of mom the whole world needs. She was very loving and she did everything she could for us and for her friends.”

    VIDEO
    B-ROLL
    Graphic: Pictures of Mary Ann

    AUDIO
    VO
    Before she died, Mary Ann spent 15 days in the I-C-U after a serious autoimmune disease affected her lungs.

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@:19
    Runs:08
    “The actions were a little of hope, of trying things, but it seemed contradictory with seeing her on a ventilator.”

    VIDEO
    B-ROLL
    Cara walking down hallway

    AUDIO
    VO
    Mary Ann’s daughter was one of her surrogate decision makers.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@:31
    Runs:07
    “We set out to understand how often physicians and surrogates in ICUs have different expectations about the patient’s prognosis.”

    VIDEO
    B-ROLL
    Dr. White walking with colleague, standing with colleagues talking, various shots of patient in the ICU

    AUDIO
    VO
    Dr. Douglas White from the University of Pittsburgh Medical Center and co-authors enrolled 99 physicians and 229 surrogates who made decisions for 174 critically ill patients in 4 I-C-U’s at a major medical center. They were interested in discordance, defined as at least a 20 percent difference between the physician’s and surrogate’s expectations about a patient’s prognosis.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super:59
    Runs:12
    “In roughly half the cases surrogates had substantially more optimistic expectations about prognosis compared to the physicians and that the physician’s estimates were much more accurate than the surrogate’s.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@1:15
    Runs:13
    “In almost all cases, surrogates misunderstood physician’s prognostic expectations. In about half of cases, surrogates held systematically different beliefs about the prognosis compared to what they heard from the physicians.”

    (Video covering middle of bite: patient in ICU)

    VIDEO
    B-ROLL
    Graphic over video of ICU patient
    COMMON SURROGATE BELIEFS
    -MAINTAINING HOPE
    -RELIGIOUS BELIEFS
    -UNIQUE STRENGTHS

    AUDIO
    VO
    Those beliefs most commonly included the need to maintain hope in order to improve the patient’s outcome, religious beliefs and a belief that the patient had unique strengths, unknown to the physician that would make the prognosis better.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@1:40
    Runs:16
    “Sometimes clinicians think that all they need to do is to communicate clearly about the patient’s prognosis. They may need to explore family members’ and surrogates’ beliefs about prognosis rather than merely conceptualizing their role as conveying the information clearly.”

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@ 2:01
    Runs:11
    “Knowing what I know now, I think I would have asked to just have an honest conversation. This is what I am feeling and how does that square with what your understanding is as a medical team.”

    (Video covering 1st part of bite: Cara looking out window)

    VIDEO
    B-ROLL
    Picture of Mary Ann with her grandchildren

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say that when surrogates have overly optimistic expectations about a prognosis, they tend to choose more aggressive, invasive treatment than they would if they had more accurate expectations.

  • May 09, 2016

    Lowering Prescription Drug Costs Using Similar, Cheaper Alternatives

    Lowering Prescription Drug Costs Using Similar, Cheaper Alternatives

    INTRO:The United States spends more per capita on health care and prescription drugs than any other country. Using generic instead of brand name medications is one way to decrease costs. A new study examined whether therapeutic substitution, another way to lower drugs costs, could also save money on prescription medications. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL Various shots of a pharmacy
    AUDIO
    VO
    This pharmacy is filled with thousands of different medications. some are brand name, some are generic and some can be used in a process known as therapeutic substitution.
    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@:08 Runs:15
    “This is theoretically different than generic drugs. Generic drug substitution is substitution of the exact same drug. Therapeutic substitution is the use of a similar but not the same drug within a drug class.” (Video covering middle of bite: pharmacist counting pills)
    VIDEO
    B-ROLL Dr. Johansen walking down hallway, various shots of Dr. Johansen talking with person in pharmacy and holding pill bottles
    AUDIO
    VO
    Dr. Michael Johansen from The Ohio State University along with his colleague reviewed the records of more than 107 thousand patients between 2010 and 2012. They looked at prescription drug use and estimated how much money could be saved using therapeutic substitution.
    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@:39 Runs:18 “There were 26 included drug classes that spanned cardiovascular health, mental health, allergies, urology and many other aspects of medicine. 62 percent of people in the United States used prescription drugs. Around one third of people took a drug from the included classes.”
    (Video covering middle part of bite: Dr. Johansen looking at medications, pan of pharmacy)
    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    The study appears in JAMA Internal Medicine.

    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super1:00 Runs:19
    “In total 73 billion dollars over three years or nearly one out of every 10 dollars spent on prescription drugs could have been saved with therapeutic substitution. Importantly, the consumer paid just over one third or 24.6 billion dollars of the total 73 billion that could have been saved.”

    (Video covering middle of bite: pharmacist preparing prescription)
    VIDEO
    B-ROLL Various shots of Dr. Johansen handling and pouring out medications

    AUDIO
    VO
    Dr. Johansen says that therapeutic substitution is somewhat controversial because it could impede decisions about medications that are made between doctors and patients.

    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@1:29 Runs:17
    “There is tremendous potential savings from undertaking of therapeutic substitution on a large scale. However, therapeutic substitution is controversial, it needs to be done in a respectful manner of patients health because that’s really what we’re here for is to try to make patients healthier.”

    (Video covering middle of bite: Dr. Johansen looking at medications) VIDEO
    B-ROLL Pharmacists working
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the number of drug classes that could be included in therapeutic substitution is wide ranging.

  • May 04, 2016

    Better Telephone C-P-R Instruction Improves Outcomes after Cardiac Arrest

    Better Telephone C-P-R Instruction Improves Outcomes after Cardiac Arrest

    INTRO:When a cardiac arrest occurs outside the hospital, it’s important for bystanders to perform effective C-P-R as soon as possible, but that doesn’t always happen. A new study examined whether providing C-P-R instruction over the phone with help from trained 9-1-1 dispatchers would improve survival rates for people who experience cardiac arrest. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pics of Dr. Gailey and his dental staff
    AUDIO
    VO
    Dentist Tim Gailey began his day like any other…seeing patients.

    AUDIO
    SOT/FULL
    Tim Gailey, D.M.D., – Cardiac Arrest Survivor
    Super@:03
    Runs:04
    “I sat down, that was the last thing I remembered, I just collapsed.”

    VIDEO
    B-ROLL
    Dr. Gailey and Valerie talking outside, various shots of 911 dispatcher

    AUDIO
    VO
    Dr. Gailey experienced a cardiac arrest. With the 9-1-1 dispatcher on the phone, his staff began C-P-R.

    AUDIO
    SOT/FULL
    Valerie Ruiz – Performed CPR
    Super@:10
    Runs:04
    “I’m so grateful that you know I had 911 and someone helping direct me.”

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super:18
    Runs:10
    “People don’t always think about 911 dispatchers as the first medical responders, but they really are. It turns out that they really have this enormous, life-saving potential.”

    AUDIO
    NATSO/FULL
    Runs:01
    “…are the paramedics there…”

    B-ROLL
    911 dispatcher on the phone, cu of Dr. Bobrow talking to dispatcher, another dispatcher on the phone, cu of keyboard, people performing CPR on dummies, cu of hands doing CPR

    AUDIO
    VO
    Many 9-1-1 dispatchers already offer C-P-R instruction over the phone. But Dr. Ben Bobrow (Bob-roe) from the Arizona Department of Health Services and co-authors provided additional training to 9-1-1 disptachers in two regional centers in the Phoenix metropolitan area. The dispatchers were trained to be more confident and assertive with rescuers on the phone. They measured outcomes from more than 23-hundred out of hospital cardiac arrests during a three-year period.

    AUDIO
    VOICE OF:
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super@:52
    Runs:12
    “Training them to say you need to do chest compressions, I’m going to help you, let’s start. We’ve actually found that subtle thing is very important in motivating lay rescuers.”

    AUDIO
    SOT/FULL
    Hannah Roether – 911 Dispatcher
    Super@1:09
    Runs:07
    “We have to use a very strict tone of voice to kind of get them to listen to us and pull all that chaoticness away from them.”

    (Video covering 1st part of bite: Hannah talking on phone)

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super@1:14
    Runs:11
    “Our dispatchers did well. They gave telephone CPR instructions significantly more often. They got first chest compressions started much sooner.”

    (Video covering 1st part of bite: Dr. Bobrow talking to dispatchers)

    GXF FULL
    JAMA CARDIOLOGY LOGO

    AUDIO
    VO
    The study appears in JAMA Cardiology.

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., Arizona Department of Health Services
    Super@:1:24
    Runs:21
    “We found a 32 percent relative increase in the proportion of patients that survived to hospital discharge, so they went home from the hospital and remarkably a 43 percent relative increase in functional outcome, which means patients that actually went back home in good shape.”

    VIDEO
    B-ROLL
    Dr. Gailey and Valerie walking

    AUDIO
    VO
    That’s exactly what happened to Dr. Gailey, a husband and father of 13. Thanks to everyone working together, he survived.

    AUDIO
    SOT/FULL
    Valerie Ruiz – Performed CPR
    Super@1:52
    Runs:07
    “I was just praying that he would be okay, thinking about his children and I would do the right things that he needed.”

    (Video covering 2nd part of bite: picture of his children)

    AUDIO
    SOT/FULL
    Tim Gailey, D.M.D., – Cardiac Arrest Survivor
    Super@2:00
    Runs:08
    “I just remember giving them hugs and crying and telling them how grateful I was that they saved my life and how grateful my family was to them for saving me.”

    (Video covering 2nd half of bite: Picture of Dr. Gailey and his family)

    VIDEO
    B-ROLL
    Pic of Dr. Gailey and his family

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Bystander C-P-R has been shown to double or even triple survival from out of hospital cardiac arrest.

  • April 26, 2016

    Rotating Night Shift Work and the Risk of Heart Disease in Women

    Rotating Night Shift Work and the Risk of Heart Disease in Women

    INTRO: An estimated 15 million Americans do some kind of rotating shift work, including overnights, evenings and early morning shifts. But can this type of shift work increase the risk of coronary heart disease? A new study examined the link between rotating night shift work and heart disease in a group of female nurses. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various night time outside shots, hospital workers walking at night

    AUDIO
    VO
    At night, when most of us are heading to bed, many health care workers, including nurses, are just beginning their work day. But does working these rotating shifts take a toll on their health?

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super:09
    Runs:07
    “The link between shift work and coronary heart disease has been an open question for several decades now.”

    VIDEO
    B-ROLL
    Dr. Vetter and colleague walking down hall, Dr. Vetter looking at computer, nurse working, gurney rolling by, outside of hospital

    AUDIO
    VO
    Dr. Céline Vetter from Brigham and Women’s Hospital and co-authors examined that link. Tthey used data from the long running Nurses Health Study ONE and TWO, which has followed 240 thousand female nurses over a 24 year period. The researchers specifically looked at 189 thousand women who reported their lifetime exposure to rotating night shift work.

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@:36
    Runs:09
    “Over the course of the study period a little more than 10 thousand cases of newly developed coronary heart disease occurred.”

    GXF FULL
    JAMA LOGO

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@:48
    Runs:24
    “Rotating night shift work is associated with modest risk of coronary heart disease even after taking into account known risk factors such as elevated BMI, smoking, poor diet quality and low levels of physical activity. Once you stop working shifts, the time since quitting shift work is associated with a decreased risk.”

    (Video covering middle of bite: nurse walking into exam room, various shots of heart monitors, nurse pushing hospital bed)

    VIDEO
    B-ROLL
    Nurses walking in hospital hallways

    AUDIO
    VO
    Rotating shift work was defined as working at least three night shifts per month in addition to morning and evening shifts.

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@1:19
    Runs:22
    “Even though the absolute risks we observed were small and the contribution of shift work to coronary heart disease is modest, there is an opportunity to help and prevent coronary heart disease by trying to find out which are the characteristics of shift schedules that may carry the highest risk.”

    (Video covering middle of bite: heart monitor)

    VIDEO
    B-ROLL
    Nurse walking outside

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:the Study authors call for further studies to determine those characteristics.

  • April 19, 2016

    New Treatment for Melanoma Targets the Immune System

    New Treatment for Melanoma Targets the Immune System

    INTRO:Melanoma is a type of cancer that develops from pigment-containing cells, most commonly from the skin. If diagnosed early, many patients can be cured with surgery.  However if melanoma spreads through the body, the prognosis for long-term survival is poor.  A new way of treating advanced melanoma allows a patient’s immune system to fight the tumor without the need for chemotherapy or radiation. In a new study researchers examined the response to this type of therapy. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Tom walking into office

    AUDIO
    VO
    When Tom Stutz was diagnosed with melanoma about 5 years ago, it had spread to several of his organs.

    AUDIO
    SOT/FULL
    Tom Stutz – Melanoma Patient
    Super:05
    Runs:09
    “I was whipped to be honest with you and I thought that was pretty much the end of the line for me.”

    VIDEO
    B-ROLL
    Tom checking in for treatment, Graphic

    AUDIO
    VO
    Tom enrolled in a clinical trial, receiving a new type of immunotherapy called pem-bro-liz-u-mab, an antibody that blocks a protein called P-D-1. These proteins prevent the body’s immune system from attacking the cancer.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super:25
    Runs:11
    “With pembrolizumab what we’re trying to do is to redirect that immune response to fight the cancer. Pembrolizumab binds to PD-1 and then the immune system cells attack the cancer.”

    VIDEO
    Dr. Ribas and colleague walking, Tom receiving his treatment, cu of Tom’s arm, various shots of medication

    AUDIO
    VO
    Dr. Antoni Ribas from the University of California-Los Angeles and co-authors tested this drug on more than 650 patients. The trial was conducted at U-C-L-A and other sites in North America, Europe and Australia. Early in the study, several patients showed a clinical response to pembrolizumab, which later received “break through” therapy status from the Food and Drug Administration.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@:55
    Runs:10
    “When we compared the baseline tumors to the tumors after dosing, the metastases or the lesions around the body were smaller in one third of the patients.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@1:10
    Runs:10
    “The patients who responded, the great majority, continued to respond at one or two years, 75 percent of them maintained the response.”

    VIDEO
    B-ROLL
    Tom receiving treatment

    AUDIO
    VO
    The drug was well tolerated in the majority of patients.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@1:22
    Runs:22
    “The median survival of the 655 patients was 23 months, which by all practical means is much better than we would have expected in a group of patients like these. With this new generation of immunotherapies we’re now having a sizable number of patients who have a response to the therapy and are going on to live normal lives, three or four years later.”

    (Video covering middle of bite: Dr. Ribas looking at scans)

    VIDEO
    B-ROLL
    Tom walking outside

    AUDIO
    That’s exactly what happened for tom, who continues to receive the therapy.

    AUDIO
    SOT/FULL
    Tom Stutz – Melanoma Patient
    Super1:48
    Runs:10
    “I’ve been to family events, I’ve gone on vacations with my kids, I’m feeling great, so what can I say, no complaints.” (Hold for laugh)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:4 PERCENT OF PATIENTS HAD TO STOP THE THERAPY BECAUSE OF SIDE EFFECTS.

  • April 12, 2016

    Better Air Quality Decreases Respiratory Symptoms in Children

    Better Air Quality Decreases Respiratory Symptoms in Children

    INTRO: Air pollution is associated with chronic health problems in children, like bronchitis and asthma. In southern California, air pollution levels have been decreasing over the past 20 years. A new study examined whether those reductions have helped to improve respiratory symptoms in the state’s children. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Plane flying, trains on track, cars on freeway, skyline of Los Angeles

    AUDIO
    VO
    Planes, trains, and automobiles are ever present in southern California. They all contribute to what’s called ambient air pollution.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@:10
    Runs:14
    “Ambient air pollution is particulate matter, which are microscopic particles, some of them especially the fine ones, actually deposit deep into the lung and are known to cause a lot of respiratory problems in children and humans in general.”

    VIDEO
    B-ROLL
    Dr. Berhane walking in office, various shots of children playing in park, cars on freeway, young girl with inhaler, nurse examining younger girl

    AUDIO
    VO
    Dr. Kiros Berhane (bur-rah-nee) from the University of Southern California and co-authors followed just over 46-hundred children in 8 southern California communities across 3 different time periods from 19-93 t0 2012. In addition to monitoring air quality, the researchers looked at children with and without asthma and whether they reported respiratory symptoms like bronchitis, congestion, phlegm production, or a daily cough for 3 months in a row during the previous year.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@:47
    Runs:13
    “In the children with asthma, we found at the beginning of the study, in the first cohort, almost 48 percent of them had bronchitic symptoms in the last year. Now in the children without asthma, this number was only about 11 percent.”

    AUDIO
    VO
    Air pollution levels dropped significantly during the observation period. Bronchitic symptoms were compared in three groups of children from 19-93 to 2012.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@1:08
    Runs:11
    “The prevalence of bronchitic symptoms went down by about 32 percent in those children with asthma. We also found that it went down by about 21 percent in those children without asthma.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@1:23
    Runs:16
    “These reductions were significant and important in both children with asthma and children without asthma. So all children benefitted from this reductions in air pollution. Protecting our environment really leads to better respiratory health in children.”

    (Video covering 2nd part of bite: wide shot of city)

    B-ROLL
    Wide shot of playground

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Berhane says the findings from southern California can help guide air quality efforts in other locations in the U-S and around the world.

  • April 10, 2016

    Summary Video

    Summary Video

    Income inequality is the topic of heated discussion in the United States, and now researchers have used deidentified federal income tax returns and death records to better understand if differences in income are associated with differences in life expectancy at age 40.

     

    They report that men in the top percentile of household income lived almost 15 years longer than those in the lowest, and women in the top percentile of household incomes lived about 10 years longer than those in the lowest.

     

    Women lived longer than men at any income percentile, with a 6-year advantage among the poorest 1% diminishing to a 1.5-year advantage for thee wealthiest.

     

    Despite differences at the highest and lowest percentiles, gains in life expectancy leveled off above a median household income of about $200,000.

     

    Life expectancy increased over the 14-year study period, an average of about 3 years for men and women in the top income quartile compared to an average of about 1 year for those in the bottom quartile.

     

    In an accompanying editorial, Nobel laureate Angus Deaton writes, ‘The infamous one percent is not only richer, but much healthier. Individuals in the top 100% of income have 10 to 15 more years to enjoy their richly funded lives and to spend time with their children and grandchildren, and they are pulling away from everyone else.”

     

    Where people live makes a difference.

     

    Life expectancy was 6.4 years less for the poorest men in Detroit compared to New York City, and about 5 years less for the poorest women in Detroit compared to New York City, between-city differences that largely disappeared at the highest incomes.

     

    Nevada, Indiana, and Oklahoma had the lowest life expectancies; California, New York, and Vermont had the highest.

     

    People in the top income quartile were expected to live longest in of Salt Lake City and die younger in Las Vegas, while those in the bottom income quartile were expected to live longest in New York City and die youngest in Gary Indiana.

     

    People in the top income quartile gained the most life expectancy over the study period in El Paso Tx and lost the most in Lakeland Florida, while those in the bottom quartile gained the most in Toms River NJ and lost the most in Tampa Florida.

     

    ‘It is as if the top income percentiles belong to one world, the world of the elite, wealthy US adults, whereas the bottom income percentiles each belong to separate worlds of poverty, each unhappy and unhealthy in its own way,” writes Deaton.

     

    Behavior-related variables, such as smoking, exercise, and obesity, were highly correlated with difference in life expectancy by geographic area, the researchers write,  and they suggest that lower income individuals do better in more affluent cities with highly educated populations and high levels of government expenditures, such as New York City and San Francisco.

     

    Other explanations for the observations include reverse causality,  meaning, poor health causes reduced income rather than the other way around; parental rather than personal income; and education.

     

    “The next step is to extend the analysis by including education [to] advance the understanding of factors underlying the relationship between income and life expectancy.”

  • April 05, 2016

    Pain and Physical Function Improve After Weight-Loss Surgery

    Pain and Physical Function Improve After Weight-Loss Surgery

    INTRO: Severe obesity can lead to joint pain and interfere with a person’s ability to bend, lift, carry, and even walk. Undergoing bariatric surgery helps with weight-loss, but can it also help alleviate joint pain and improve a person’s overall physical function? A new study examined whether pain levels and physical function improved for patients after weight-loss surgery. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Earl riding stationary bike

    AUDIO
    VO
    Earl McConnell had gastric bypass surgery three years ago after being diagnosed with diabetes.

    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@:05
    Runs:03
    “I did have back problems. They told me I had to lose weight.”

    VIDEO
    B-ROLL
    Earl riding stationary bike

    AUDIO
    VO
    Now, his diabetes is controlled and so is his back pain.

    AUDIO
    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@:12
    Runs:09
    “It was definitely easier to get around, easier to get up and down off the floors, playing with my grandkids, and goin’ running around, chasing them.”

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@:19
    Runs:08
    “Patients come to bariatric surgery for all sorts of reasons, some of them it may be their diabetes but for many of them it’s major health issues.”

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@:27
    Runs:11
    “Most commonly knee and hip pain that prevents people from doing walking activities and other activities. Primarily in clinical practice, what I hear are concerns with joint function.”

    VIDEO
    B-ROLL
    Dr. Courcoulas and Dr. King sitting at desk and talking, bariatric surgery, various shots of patient questionnaire, Earl doing a walking test

    AUDIO
    Doctors Anita Courcoulas and Wendy King from the University of Pittsburgh and co-authors studied more than 22 hundred bariatric surgery patients from 10 U-S hospitals over a 4-year period. Patients filled out questionnaires about their pain and physical function before surgery and each year, for three years, after surgery. patients also participated in a 400 meter walking test.

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@:58
    Runs:09    “There was 50 to 70 percent improvement in pain and physical function at the one year time point and then some continued improvements up to three years as well.”

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@1:08
    Runs:07
    “And although there is deterioration of improvement in some patients from one to three years, the majority still by three years, are much better off than they were before surgery.”

    (Video covering 1st part of bite: Earl walking)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@1:23
    Runs:19
    “With our objective walking test we also saw that about a quarter of patients still had mobility deficits post-surgery. We looked at patients who had severe pain and disability in their hips and knees, indicative of osteoarthritis and three fourths of them had improvements in their hip and knee pain and function through three years of follow-up.”

    (Video covering middle of bite: Earl walking in PT Room)

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@1:35
    Runs:09
    “This sends the message that bariatric surgical procedures may have a big impact on people’s ability to improve their physical function over time.”

    VIDEO
    B-ROLL
    Earl and physical therapist working on steps

    AUDIO
    Earl maintains his weight-loss and recently received praise from his cardiologist.

    AUDIO
    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@1:47
    Runs:08
    “It’s the first time I’ve ever seen him smile too, when I went in there after I had the gastric bypass done. I’m looking for a long and happy life and see the grandkids get married.”

    VIDEO
    Earl and therapist working on steps

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Younger patients, those with fewer depressive symptoms and a higher income pre-surgery had a greater likelihood of improvements in their pain and function levels after surgery.

  • March 22, 2016

    Alternative Mind-Body Therapies Help Improve Chronic Back Pain

    Alternative Mind-Body Therapies Help Improve Chronic Back Pain

    INTRO:Low back pain, millions of Americans live with it every day. A variety of treatments are used to treat back pain including medication, massage, manipulation and physical therapy. There are also therapies that include a mind-body component.  A new study examined whether two approaches that focus on the mind rather than directly on the body, could help improve longstanding back pain. Catherine Dolf explains in this week’s JAMA Report.

    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super:01
    Runs:09
    “One of the most important new understandings of chronic pain and chronic low back pain is that the mind plays a very important part.”

    VIDEO
    B-ROLL
    Various shots of Dr. Cherkin walking and looking at his computer, Dr. Balderson conducting a cognitive behavioral therapy class

    AUDIO
    VO
    Dr. Daniel Cherkin from Group Health Research Institute in Seattle and his co-authors studied two mind-body therapies. One is already shown to be effective for treating depression and other chronic conditions.

    AUDIO
    SOT/FULL
    Benjamin H. Balderson, Ph.D., -Group Health Research Institute
    Super@:24
    Runs:13
    “Cognitive behavioral therapy or CBT is a therapy that tries to address what are the behaviors that we do because of pain and what are the behaviors that might actually help to alleviate pain versus help to actually create or keep pain going.”

    (Video covering first part of bite: Dr. Balderson talking to group)
    VIDEO

    AUDIO
    NATSO/FULL
    Runs:04
    “…how do I gradually get back to those activities I’ve given up because of pain…”

    VIDEO
    B-ROLL
    Carolyn leading mindfulness meditation

    AUDIO
    VO
    The other, mindfulness-based stress reduction, has not been well studied.

    AUDIO
    NATSO/FULL
    Runs:08
    “…so you’re bringing an atmosphere of friendliness and kindness observing your experience just as it is…”

    AUDIO
    SOT/FULL
    Carolyn McManus, P.T., M.S., M.A., – Mindfulness and Meditation Leader
    Super@:50
    Runs:18
    “One of the things that I think mindfulness empowers people to recognize is that everything’s always in a state of change. Breathing in, I’m aware, I’m feeling this sensation, it’s uncomfortable, breathing out, I meet myself with compassion, a friendliness, an openness.”

    VIDEO
    B-ROLL
    Man rubbing his back, various shots of people participating in mindfulness meditation

    AUDIO
    342 patients between 20 and 70 years old with back pain that had lasted for at least three months, participated in 8 weekly, 2-hour sessions of either mindfulness or cognitive therapy. A third group received usual care. Outcomes were assessed at 6 months and one year.

    AUDIO
    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super@1:25
    Runs:13
    “Cognitive behavioral therapy and mindfulness based stress reduction led to an increased likelihood of having clinically meaningful improvement in back pain than those who were only receiving usual care.”

    (Video covering 2nd part of bite: Dr. Balderson talking to group)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    VO
    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super@1:42
    Runs:10
    “Benefits in decreased pain and improved function lasted for a full year, which is not common amongst treatment for chronic pain.”

    AUDIO
    SOT/FULL
    Benjamin H. Balderson, Ph.D., -Group Health Research Institute
    Super@1:51
    Runs:04
    “It’s something they can add to their tool box for things that they do in different various times.”

    AUDIO
    SOT/FULL
    Carolyn McManus, P.T., M.S., M.A., – Mindfulness and Meditation Leader
    Super@1:57
    Runs:12
    “It empowers people with the skills to make choices and changes that enhance their well-being, reduce their pain and increase their function.”

    (Video covering 2nd part of bite: people mediating)

    VIDEO
    B-ROLL
    People meditating

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:These mind-body interventions can also be used in addition to traditional therapies.

  • March 15, 2016

    The Role of Vaccine Refusal in Recent Outbreaks of Measles and Whooping Cough

    The Role of Vaccine Refusal in Recent Outbreaks of Measles and Whooping Cough

    INTRO:Measles and pertussis, or whooping cough, have been effectively controlled in the United States with the use of vaccines. However, recent outbreaks of these vaccine-preventable diseases have prompted many to examine why this is happening. A review of recent research looks at whether the reluctance of some parents to have their children vaccinated plays a role in these outbreaks.  Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:01
    “…hello, how are you…?”

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:05
    Runs:13
    “Most parents do the right thing and get their children vaccinated. Even if you go out and do the right thing your child’s risk depends on other people as well.”

    (Video covering beginning of bite: nurse in exam room with mother and child)

    VIDEO
    B-ROLL
    Children playing swings, going down a slide, three children and parent walking on to playground

    AUDIO
    VO
    Like whom they interact with on the playground, in school, and even within their own family.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:19
    Runs:09
    “If there is a group of people which are unprotected, they can increase the risks of even those who are vaccinated.”

    VIDEO
    B-ROLL
    Dr. Omer walking down the hall, sitting at a table talking with his team, graph on computer screen, same graph on big screen, MMR vaccine vial, MMR vaccine in boxes

    AUDIO
    VO
    Dr. Saad Omer, from Emory University, and his colleagues reviewed published reports for both measles and pertussis. They specifically looked at the role vaccine refusal plays in outbreaks of both diseases.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:38
    Runs:16
    “In the post-elimination era for measles, vaccine refusal has played a role in these recent outbreaks. A majority of those cases occurred in those who did not get vaccines for philosophical or religious reasons.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:58
    Runs:18
    “The contribution of vaccine refusal is higher in early part of epidemics compared to later parts, indicating that vaccine refusers provide those pockets of susceptibility, that tinder, that can start the fire of an epidemic.”

    VIDEO
    B-ROLL
    Syringe being filled with vaccine, little child getting vaccinated

    AUDIO
    VO
    For whooping cough, outbreaks are harder to control because the vaccine’s protective immunity can wane over time.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@1:22
    Runs:13
    “Waning immunity is a problem but even in the context of waning immunity you have vaccine refusal which is playing a role. It is in everyone’s benefit that everyone stays protected.”

    (Video covering 2nd part of bite: People in park)

    VIDEO
    B-ROLL
    People in park

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:One of the more important public health achievements in the last 10 to 20 years has been the elimination of measles from the U-S.

  • March 08, 2016

    Identifying Children at Risk for Persistent Symptoms After Concussion

    Identifying Children at Risk for Persistent Symptoms After Concussion

    INTRO:Each year, emergency departments across the United States treat about 750 thousand children with concussions. For many patients, concussion-related symptoms resolve within 2 weeks of injury but some go on to experience persistent symptoms. Researchers have developed a new clinical score that may help predict which patients are at higher risk for prolonged symptoms. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of Johnny and teammate playing hockey

    AUDIO
    VO
    Johnny Coburn is back on the ice after being sidelined with a concussion.

    AUDIO
    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@:04
    Runs:03
    “It was a really bad headache. Just really bad.”

    VIDEO
    B-ROLL
    Various hockey shots

    AUDIO
    VO
    His parents watched him carefully. While his symptoms initially improved, after about a week, the headaches returned.

    AUDIO
    SOT/FULL
    Mike Coburn – Johnny’s Father
    Super@:13
    Runs:07
    “I knew that the severity of the concussion was much greater than 5 days or 7 days of rest would fix.”

    VIDEO
    B-ROLL
    Various hockey shots

    AUDIO
    More than half of these children treated at emergency departments end up with headaches after concussion.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@:26
    Runs:19    “Parents usually ask about, well how long is my son or daughter going to have symptoms and what’s going to go on after that and what do I have to do? But there’s no good way at this moment in time to actually predict those that are going to go on to have persistent symptoms following the emergency department visit.”

    VIDEO
    B-ROLL
    Dr. Babcock and Dr. Kurowski talking and looking at computer screen, various shots of Dr. Kurowski doing different tests with young boy

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    In an editorial, Doctors Lynn Babcock and Brad Kurowski from Cincinnati Children’s Hospital discuss new research designed to help predict which children are at higher risk for developing persistent symptoms after concussion.   Canadian researchers evaluated just over three thousand patients, age 5 to 18. about 30 percent ended up with persistent post concussion symptoms at 28 days.

    Both the study and editorial appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@1:13
    Runs:10
    “They actually had 46 predictors that they were looking at. After they evaluated those 46 variables they came up with 9 variables that were fairly predictive of post-concussive symptoms.”

    (Video covering middle of bite: Dr. Kurowski examining young boy)

    AUDIO
    NASOT/FULL
    Runs:03
    “I want you to just follow my finger with your eyes, ok?”

    VIDEO
    B-ROLL
    Young boy being examined by Dr. Kurowski, Graphic lower third,right over video: Age, Sex, Migraines, Depression, Prior Concussion, Balance

    AUDIO
    VO
    The clinical variables were used in a 12-point risk score. They included things like age, sex, history of migraines or depression, prior history of concussion, and problems with balance.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@1:34
    Runs:11
    “Some of these things have been shown before in smaller studies but nothing together as a collective summary of symptoms. It’s variables that we would normally capture in the emergency department but now it’s compiled into one decision rule.”

    VIDEO
    B-ROLL
    Johnny on skating on the ice with teammate

    AUDIO
    VO
    Johnny says he is feeling much better. He doesn’t have any more headaches and is back, playing hockey.

    AUDIO
    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@1:55
    Runs:09
    (Video covering 1st half of bite: Johnny and teammate skating)

    “I’m looking forward to playing with my team for a few years, playing really good hockey in college and hoping that I get to the NHL.”

    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@1:55
    Runs:09
    “I’m looking forward to playing with my team for a few years, playing really good hockey in college and hoping that I get to the NHL.”

    (Video covering 1st half of bite: Johnny and teammate skating)

    VIDEO
    Johnny on the ice

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Before this new scoring system is adopted for use in clinical practice, further research is needed to validate and confirm the study outcomes.

  • March 03, 2016

    Long-Term Aspirin Use Associated With Decreased Cancer Risk

    Long-Term Aspirin Use Associated With Decreased Cancer Risk

    INTRO:Taking a daily low dose aspirin is recommended to prevent heart disease and more recently, colorectal cancer. But does daily aspirin, over the long-term, also help prevent other types of cancers? A new study examined the potential cancer prevention benefits among people who have been taking aspirin regularly for years. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL Person taking an aspirin
    AUDIO
    VO
    Aspirin—you can buy it without a prescription and it’s relatively easy to take.

    AUDIO SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:05 Runs:09
    “There’s very strong evidence that aspirin can prevent colorectal cancer but the association of aspirin with other cancer types isn’t really as well established.” VIDEO
    B-ROLL Dr. Chan walking down hallway into exam room, looking at papers, graphic: 135,965 Health Professionals, pan up from papers to Dr. Chan AUDIO
    VO
    Dr. Andrew Chan from Massachusetts General Hospital and co-authors examined data from two large national studies that include almost 136 thousand health- professionals, both men and women, who have been providing detailed information about their overall health for decades.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:29 Runs:08
    “We were able to actually look at aspirin data they had provided us over the years and link that up with their diagnosis of various diseases, including cancer.”

    VIDEO
    B-ROLL Aspirin being poured out, aspirin bottle, aspirin outside of bottle AUDIO
    VO
    Individuals who took various doses of aspirin on a regular basis did have a lower overall risk of developing any type of cancer.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:44 Runs:10
    “It was about a 3 percent lower incidence of cancer. Much of those cancers however, were cancers of the gastrointestinal tract. So cancers that affect the esophagus, the stomach.” GXF FULL JAMA ONCOLOGY LOGO AUDIO
    The study appears in JAMA, Oncology.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:58 Runs:15
    “There was about a 15 to 20 percent reduction in the risk of developing colon cancer if you were using an aspirin on a regular basis. We also found that it did take about six years of use for a benefit to emerge but you know, once there was this benefit, it was sustained over time.”

    VIDEO B-ROLL Aspirin pills, patient undergoing colonoscopy, cu over doctor’s shoulder looking at screen AUDIO
    VO
    Dr. Chan also says daily aspirin may have an added benefit on top of routine colorectal cancer screening.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@1:19 Runs:16
    “And in addition, for folks that do not undergo screening for whatever reason, the effect of aspirin also is quite pronounced, and because we know that cancer and heart disease are really the two leading causes of death in the U-S population, the public health impact of these findings might be substantial.”
    (Video covering middle of bite: slide of polyp in colon)

    VIDEO
    B-ROLL Dr. Chan on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Aspirin use was not associated with the risk for breast, prostate, or lung cancer.

  • February 22, 2016

    Updated Definitions And Clinical Criteria For Recognizing Life-Threatening Sepsis And Septic Shock

    Updated Definitions And Clinical Criteria For Recognizing Life-Threatening Sepsis And Septic Shock

    INTRO:Sepsis is a common and potentially life-threatening manifestation of infection, affecting millions of patients worldwide. Sepsis can also be difficult to diagnose. A new study summarized the findings of an international group of experts who set out to update the previous definitions of sepsis. They also describe a more streamlined way to recognize patients with sepsis, so that treatment can be started more quickly.  Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@:01
    Runs:04
    “As soon as you get an infection, the body starts responding to infection.”

    AUDIO
    SOT/FULL
    Christopher W. Seymour, M.D., M.Sc., – University of Pittsburgh School of Medicine
    Super@:05
    Runs:06
    “Sepsis is when the body’s response to infection injures its own tissue and organs.”

    VIDEO
    B-ROLL
    Dr. Seymour and Dr. Angus walking into lab, Dr. Seymour and Dr. Angus looking at slides of infections, graphic

    AUDIO
    VO
    Doctors Christopher Seymour and Derek Angus from the University of Pittsburgh School of Medicine and co-authors summarized the findings of an international task force who updated the definitions of sepsis.  In a related study, they reviewed the electronic health records of more than 1 million patients to assess the usefulness of a clinical score known as “SOFA”, used to identify patients with sepsis.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@:31
    Runs:11
    “SOFA behaved very well especially in ICU patients. But a lot of time outside the ICU, you haven’t done all the measurements for a full SOFA score.

    (Video covering middle of bite: out of focus shoot of ICU)

    AUDIO
    SOT/FULL
    Christopher W. Seymour, M.D.,  M.Sc., – University of Pittsburgh School of Medicine
    Super@:41
    Runs:20

    “The Task Force also identified something new called the Q-SOFA or quick SOFA, which can be used as a clinical prompt at the bedside for doctors and nurses. This uses only vital signs such as altered mental status, low blood pressure, as well as difficulty breathing. Two of those will identify a patient most likely to be septic.

    (Video covering middle of bite: Dr. Seymour and others talking with patient, monitor, pan from machines to Dr. Seymour)

    GXF FULL
    JAMA LOGO

    AUDIO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@1:05
    Runs:14
    “If you have an infected patient that scores two points or more on Q-SOFA, you should be worried about that patient. In more austere settings, where you can’t get the blood tests this may actually be a very practical tool.”

    SOT/FULL
    Christopher W. Seymour, M.D., M.Sc., – University of Pittsburgh School of Medicine
    Super@1:19
    Runs:11
    “Sepsis is difficult to recognize. The Task Force provides us with these criteria so this helps doctors and nurses recognize sepsis quicker and get treatment started right away.”

    (Video covering middle of bite: ICU patient’s hand, nurse checking medication bags)

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@1:30
    Runs:28
    “We expect and look forward to this being improved. We want to see this change over time and we hope that using data to validate the definitions is ushering in a new era. We’ve been trying to help people come up with simpler rules that will help promote early, simple, easy identification of patients to then prompt early and appropriate intervention and management.”

    (Video covering 2nd half of bite: doctors and nurse walking into an ICU room)

    VIDEO
    B-ROLL
    (Doctors and nurse walking into an ICU room)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Sepsis carries an enormous public health burden, accounting for more than 5 percent of total U-S hospital costs.

  • February 15, 2016

    Caregivers Likely to Experience Emotional, Physical, and Financial Difficulties

    Caregivers Likely to Experience Emotional, Physical, and Financial Difficulties

    INTRO:When an older adult becomes ill, most often it’s a spouse or adult child who becomes the primary caregiver, usually without compensation. A new study examined just how many of these family or unpaid caregivers are out there and also the physical, emotional and financial difficulties they experience. Catherine Dolf explains in this week’s JAMA Report. VIDEO B-ROLL Judith walking down the hall, sitting at table reading AUDIO
    VO
    Judith Vick is back in medical school after taking a year off to help care for her mother, who experienced a devastating stroke.

    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super:10 Runs:07
    “My mom’s husband, my mom and I are really part of a team and we help each other in big and small ways every day.”
    (Video covering 1st part of bite: Pic of Judith, her mom and mom’s husband)
    VIDEO
    B-ROLL Looking at medication list on computer
    AUDIO
    VO
    Judith had a lot to learn including how to manage the 14 different medications her mother was taking.

    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super@:21 Runs:12
    “I spent hours translating that vague list to a very specific schedule of what she was supposed to take, when. It was like a puzzle to figure out that schedule.”

    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@:33 Runs:07
    “Although the caregiving role is highly varied it often involves considerable time and may affect caregivers own health and well-being.” VIDEO
    B-ROLL Dr. Wolff walking down hallway into her office, sitting and working at computer, couple walking on street, houses in neighborhood, graphic

    AUDIO
    VO Dr. Jennifer Wolff from the Johns Hopkins Bloomberg School of Public Health and co-authors used data from two nationally representative samples that provided insight into older adults and the caregivers who help them, living in communities like this around the U-S. The researchers estimate that nearly 15 million of these caregivers are helping almost 8 million older adults with health related disabilities.
    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@1:01 Runs:16
    “About 6 and a half million or 45 percent provided substantial health care help, on the order of 28 hours of care per week, were about twice as likely to experience physical, financial or emotional difficulty than caregivers who did not provide this help.” GXF FULL JAMA LOGO AUDIO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@1:20 Runs:07
    “About 1 in 4 reported their own health to be fair or poor and about half were helping an older adult with dementia. VIDEO
    B-ROLL Caregiver walking with patient, Graphic, man with a walking cane, Pic of Judith’s mom and her husband
    AUDIO
    VO
    These caregivers also participated in fewer social or leisure activities and if they worked outside the home, they were more than three times as likely to experience a loss in job-related productivity compared to individuals who didn’t provide this type of help. Judith says her mom is continuing to improve and this whole experience has brought them closer.
    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super@1:46 Runs:11
    “There are difficult parts of caregiving but it really is such a privilege to be so involved in her care. It has definitely been an enriching and meaningful experience.”

    (Video covering 2nd half of bite: Pic of Judith and her mom)

    VIDEO
    B-ROLL Pic of Judith and her mom

    AUDIO
    “There are difficult parts of caregiving but it really is such a privilege to be so involved in her care. It has definitely been an enriching and meaningful experience.”

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Researchers add that only one in four of these caregivers used supportive services, got education or training about how to provide care or participated in support groups.

  • February 11, 2016

    BRCA Testing Increasing Among Younger Women Diagnosed with Breast Cancer

    BRCA Testing Increasing Among Younger Women Diagnosed with Breast Cancer

    INTRO:For younger women diagnosed with breast cancer, genetic counseling along with testing for B-R-C-A 1 and 2 is a standard recommendation. But how many young women are undergoing testing and do the results have an effect on treatment decisions? A new study looked at these questions. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO B-ROLL Breast image showing tumor AUDIO
    VO
    A breast cancer diagnosis in a young woman leaves her with a choice of whether or not to undergo genetic testing.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:07 Runs:04
    “So, what I always say to my patients is knowledge is power.”
    VIDEO
    B-ROLL Dr. Partridge walking with patient, sitting at table and talking with patient, slide being loaded and looked at through microscope

    AUDIO
    VO
    Dr. Ann Partridge from the Dana Farber Cancer Institute says current guidelines recommend every young woman diagnosed with breast cancer should be counseled about and receive testing for B-R-C-A 1 and 2.
    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:21 Runs:09
    “We’re making strides and improving over time how we get the message to young women that they should consider testing.”
    VIDEO
    B-ROLL Women walking outside, graphic: shot freezes: 897 Women -Genetic Testing Rates -Barriers to Testing -Treatment Decisions AUDIO
    VO
    Since 2006, she and her co-authors began following women, 40 and younger, diagnosed with breast cancer. For this study they focused on nearly 900 of these women, looking at genetic testing rates, barriers to testing, and how the test results affected treatment decisions.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:45 Runs:10
    “In 2006 the rates of testing were in the 70 percent range and they went all the way up to about 95 percent by 20-12 and 20-13.”

    GXF FULL JAMA LOGO AUDIO
    The study appears in the journal, JAMA Oncology.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:58 Runs:16
    “While the majority of women are being tested many are not and a small minority, but an important minority, report that nobody even talked to them about the possibility of harboring a genetic predisposition for breast cancer and they should get tested.”

    VIDEO
    Dr. Partridge walking down hallway, woman getting mammogram, cu of breast image

    AUDIO
    VO
    Dr. Partridge also says not every woman will choose to be tested. However, it appeared genetic testing or the concern about genetic predisposition did affect treatment decisions.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@1:24 Runs:11
    “The majority of these women said that it affected whether or not they underwent a unilateral mastectomy or lumpectomy followed by radiation or a bilateral mastectomy.”
    (Video covering middle of bite: breast cancer surgery)

    VIDEO
    B-ROLL Technician preparing chemotherapy medication AUDIO
    VO
    And fewer women reported that concerns about genetic risk affected whether or not they received chemotherapy or hormonal therapy.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@1:42 Runs:19 “It’s imperative that we not only help women to get this information but that we also counsel them, help to support them as they make these treatment decisions especially in the context of a newly diagnosed patient who is stressed and anxious and needs to have good communication with her providers and good support.” VIDEO B-ROLL Dr. Partridge on camera
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The study says concerns about genetic risk also affected a woman’s treatment decisions even if she tested negative.

     

  • February 02, 2016

    Eating Seafood May Help Lower The Risk Of Dementia

    Eating Seafood May Help Lower The Risk Of Dementia

    INTRO:Many people eat seafood because of its health benefits. However, seafood also contains mercury and at very high levels, mercury has been linked to problems with cognitive function and brain changes associated with dementia. A new study examined mercury levels in the brains of deceased older people, to see if there was a relationship between seafood consumption and the type of brain changes commonly seen with dementia. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of seafood

    AUDIO
    VO
    These days many people are eating more seafood because of its health benefits. But seafood also contains mercury.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@:06
    Runs:09
    “There’s concerns about if people eat seafood are they also consuming more mercury and that is impairing their health.”

    VIDEO
    Dr. Morris sitting in her office, graphic showing retirement communities, still pic of group of older people, technician looking at slices of brains

    AUDIO
    VO
    Dr. Martha Clare Morris from Rush University Medical Center in Chicago, and co-authors enrolled older people living in public housing and retirement communities in an ongoing study of memory and aging. Participants had normal memory function when they entered the study. They were asked to keep track of their diet, using a detailed questionnaire. participants also agreed to brain donation after they died. In total, 286 brains were examined.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@:39
    Runs:17
    “So we have a very comprehensive assessment of people’s seafood consumption during their older age years and then we can relate seafood consumption to brain changes associated with dementia when they die.”

    (Video covering second part of bite: technician examining brain slices)

    VIDEO
    B-ROLL
    Graphic: slide of brain tissue with plaques and tangles circled

    AUDIO
    VO
    These changes include plaques and tangles seen in the brain, hallmark features of Alzheimer dementia.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@1:01
    Runs:23
    “Seafood consumption of at least one meal per week decreased the occurrence of the amyloid plaques and tangles associated with Alzheimer’s dementia. We observed this however, only in people who had the apolipoprotein e4 allele. This is a genotype that puts one at increased risk of dementia.”

    (Video covering middle of bite: technician looking at brain slides under microscope)

    GXF FULL
    JAMA LOGO

    AUDIO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@1:28
    Runs:11
    “The increased level of seafood consumption did increase brain levels of mercury, but that the mercury didn’t appear to have an impact on brain health.”

    VIDEO
    B-ROLL
    Various kinds of seafood, Dr. Morris sitting at microscope looking at slides

    AUDIO
    VO
    Dr. Morris also says seafood consumption was only associated with less brain changes specific to Alzheimer dementia, not vascular or Lewy Body dementia. Catherine Dolf, the JAMA Report.

    Tag:Study participants who ate seafood had between one and 6 seafood containing meals per week.

  • January 26, 2016

    Updated Recommendations for Depression Screening in Adults

    Updated Recommendations for Depression Screening in Adults

    INTRO:Depression is an important clinical problem worldwide. The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services. The Task Force has just issued updated recommendations on depression screening for adults in the primary care setting. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@:01
    Runs:13
    “Depression is a really important health topic in the United States and worldwide. It’s one of the leading causes of disability in adults and is often times under recognized and under treated.”

    VIDEO
    B-ROLL
    Patient filling out depression screening questionnaire

    AUDIO
    VO
    Adults visiting their primary care provider should, at some point, be screened for depression.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@:17
    Runs:15
    “The primary care doctor has an important initial role in identifying people with depression and directing them towards treatment and appropriate follow up.
    Preventive Services Task Force always evaluates both the potential benefits and the potential downsides of any clinical preventive
    service.”

    (Video covering middle of bite: doctor talking with patient)

    VIDEO
    B-ROLL
    Dr. Pignone walking down clinic hallway, people walking down the street

    AUDIO
    VO
    Dr. Michael Pignone (pin-yoh-nee), one of several members of the U-S Preventive Services Task Force, says the group continues to recommend that adults, 18 and older, be screened for depression.

    GXF FULL
    JAMA LOGO

    AUDIO
    The new Task Force recommendations appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:04
    Runs:15
    “We have additional evidence about the effectiveness of screening and treatment in pregnant women and peripartum women. There’s much more information available in that population to make us confident screening that was effective.”

    (Video covering middle of bite: pregnant women getting blood drawn, mother walking with child on the street, mother pushing stroller)

    VIDEO
    B-ROLL
    New mom walking with her child down hospital hallway, pregnant woman getting an ultrasound

    AUDIO
    VO
    While several treatments are available for pregnant and peri-partum women, the Task Force recommends that clinicians and patients work together to determine the best approach to treatment.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:27
    Runs:09
    “Because there is some suggestion that some medications that are used for treating depression may have adverse effects on the fetus.”

    VIDEO
    B-ROLL
    Older man walking, older people sitting in wheel chairs

    AUDIO
    The Task Force also continues to recommend depression screening in older adults.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:49
    Ends:18
    “We still need more evidence in older adults about the effectiveness of screening and treating depression on outcomes. We really need to be a little bit more active in finding patients with depression and treating them effectively and this recommendation reinforces that.”

    (Video covering 1st half of bite: older people outside)

    VIDEO
    B-ROLL
    Patient and doctor talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The Task Force recommends depression screening be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow up for patients.

  • January 19, 2016

    Fewer U.S. Cancer Patients Dying in the Hospital but I-C-U Care Remains Common

    Fewer U.S. Cancer Patients Dying in the Hospital but I-C-U Care Remains Common

    INTRO:There’s a common perception that the United States spends a lot more on health care because it spends so much more on end of life care than other developed countries. So, how does the U-S compare to other nations? A new study examined several health care measures at the end of life for cancer patients in five European countries, Canada and the United States. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:01
    Runs:11
    “We know that end of life care is intensive, we know it’s expensive, we know that still too many people are dying in the hospital, even today.”

    (Video covering 2nd half of bite: nurse in hospital room)

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@:12
    Runs:06
    “The United States is not the worst in end of life care, at least when it comes to cancer patients, nor is it the best.”

    VIDEO
    B-ROLL
    Dr. Emanuel and Dr. Bekelman walking, nurse walking into hospital room with patient, nurse talking to patient, Graphic: Map with 7 different countries shown

    AUDIO
    VO
    Doctors Ezekiel Emanuel and Justin Bekelman from the University of Pennsylvania Perelman School of Medicine and co-authors compared the health care experience for cancer patients, older than 65, in six countries and the U-S in 20-10. Those countries included, Canada, Belgium, Germany, England, the Netherlands and Norway. They examined several clinical measures six and one month before death.

    AUDIO
    SOT FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:39
    Runs:05
    “The United States and the Netherlands had the lowest proportion of patients dying in the hospital.”

    VIDEO
    B-ROLL
    Graphic: Empty Hospital room, percentages wipe in over video

    AUDIO
    VO
    About 22 percent of U-S cancer patients died in hospitals. Almost 30 percent in the Netherlands; and Belgium and Canada had just over 50 percent of patients die in the hospital.

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@ :53
    Runs:05
    “We have the fewest hospitalizations and we have the shortest number of hospital days of all patients.”

    (Video covering end of bite: hospital bed being pushed down the hall)

    AUDIO
    SOT/FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:59
    Runs:04
    “The U-S wasn’t as expensive as we might have thought or might have predicted.”

    VIDEO
    B-ROLL
    Graphic: Map with hospital costs of each country

    GXF FULL
    JAMA LOGO

    B-ROLL
    Dr. Bekelman and Dr. Emanuel looking over study information

    AUDIO
    VO
    During the last six months of life, patients in Norway and Canada had higher hospital costs than patients in the U-S. There was less spending in Germany and Belgium but the lowest expenditures were in the Netherlands and England.

    The study appears in JAMA, Journal of the American Medical Association.  Both researchers note that there are areas where care can be improved for U-S patients.

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@1:23
    Runs:19
    “The United States has far and away the most patients who end up in the intensive care unit in the last six months of life. About 40 percent of patients actually end up in the intensive care unit.  They spend the longest time of any country in the world. We also give a lot of chemotherapy to patients in the last six months of life.”

    (Video covering end of bite: lab worker preparing chemotherapy treatment)

    AUDIO
    SOT/FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@1:44
    Runs:13
    “A question is for our patients, if they wrote the chapter about their last six months or about their last month, would it resemble the findings that we’re reporting? And I’ll bet the answer is no and that means we have more work to do.”

    (Video covering end of bite: Various shots of patients and staff in ICU)

    VIDEO
    B-ROLL
    Dr. Bekelman on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study helps set a baseline about how the United States and other countries can learn from each other in order to improve end of life care.

  • January 12, 2016

    New Procedure Helps Patients with Severe Emphysema

    New Procedure Helps Patients with Severe Emphysema

    INTRO:Emphysema is a lung disease that makes breathing very difficult.  Patients with severe emphysema experience shortness of breath and often have poor quality of life. There is no cure and current therapies, including lung reduction surgery, can be risky. A new study examined a minimally invasive procedure to see if it could improve breathing and also be a safe and cost effective way to treat emphysema. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    -ROLL
    Patient walking down hallway and breathing heavily

    AUDIO
    VO
    This patient has severe emphysema.

    AUDIO
    NATSO/FULL
    Runs:03
    “…haaa…haaa…”

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:05
    Runs:05
    “Emphysema is characterized by destruction of the lung.”

    VIDEO
    B-ROLL
    X-ray showing destruction of lung tissue

    AUDIO
    VO
    Air becomes trapped in the spaces created by the damaged lung tissue.

    AUDIO
    SOT/FULL
    Voice of:
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:14
    Runs:06
    “Too much air in fact, in the lung, it’s very difficult for the patient to breathe.”

    (Video covering bite: x-ray of lung, patient on breathing machine)

    VIDEO
    B-ROLL
    Dr. Deslée walking down hospital hallway, looking at x-ray of lungs, cu of coil

    AUDIO
    VO
    Dr. Gaëtan (gay-taun) Deslée (des-lay) from the University of Reims, in France, and co-authors investigated a new procedure, permanently placing several coils like this into the lung.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:30
    Runs:14
    “They help to induce the recoil of the lung which is impaired in severe emphysema and it improves the elasticity of the lung.”

    (Video covering middle of bite: showing coils in lung, showing the coil expanding in his hand)

    VIDEO
    B-ROLL
    Man taking breathing test, graphic showing coils inside lungs, patient taking walking test

    AUDIO
    VO
    The study included 100 patients from 10 centers across France. 50 patients had an average of 10 coils placed in their lungs and the other 50 received standard medical treatment. Both groups were followed closely and assessed at 6 and 12 months. They participated in a six-minute walk test to see if their breathing had improved, allowing them to walk farther.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@1:09
    Runs:27
    “Coil treatment improved exercise test after 6 months. 36 percent of the patients treated by coil treatment had an improvement of at least 54 meters or 177 feet in the 6 minute walk test compared to only 18 percent in the control group.”

    (Video covering 1st part of the bite: patient taking the walking test)

    (Video covering middle of 2nd part of bite: patient walking with nurse)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Jurnal of the American Medical Association.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@ 1:33
    Runs:11
    “There was a significant improvement of quality of life at 6 and 12 months in the group treated by coil treatment.”

    VIDEO
    B-ROLL
    Dr. Deslée holding the coil in his hand

    AUDIO
    VO
    Coil placement was safe but quite expensive in the short-term.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@ 1:47
    Runs:13
    “We need the data after three and five years of follow up to get the final information about the cost and cost effectiveness of this new technology.”

    (Video covering 2nd part of bite: x-ray with coils in lungs)

    VIDEO
    B-ROLL
    Coils in lungs

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the patients who did not receive the coil treatment in this study will be offered the coil treatment going forward.

  • January 05, 2016

    Combination of Weight Loss and Exercise Offers Benefits in Patients with a Common Type of Heart Failure

    Combination of Weight Loss and Exercise Offers Benefits in Patients with a Common Type of Heart Failure

    INTRO:An increasingly common type of heart failure occurs when the heart is pumping normally but doesn’t fill with enough blood. As a result, patients experience shortness of breath and fatigue with physical exertion. So far, medications have been unsuccessful in treating this disorder. A new study examined whether weight loss, exercise, or a combination of the two would result in improvement for patients with this type of heart failure. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Lynora walking on track

    AUDIO
    VO
    These days you can hardly keep up with Lynora Essic. But it wasn’t always that way.

    AUDIO
    SOT/FULL
    Lynora Essic – Program Participant
    Super@:04
    Runs:07
    “When I first started the study and I found out I was going to have to walk, I about had a panic attack. I was like ‘this is really not going to work for me.’”

    (Video covering 2nd half of bite: Lynora walking on track)

    VIDEO
    B-ROLL
    Lynora walking on track

    AUDIO
    VO
    She could barely do four laps without struggling for breath, but not now.

    AUDIO
    SOT/FULL
    Voice of:
    Lynora Essic – Program Participant
    Super@:17
    Runs:03
    “My last time around I was up to 32 laps.”

    VIDEO
    B-ROLL
    Lynora getting blood pressure checked

    AUDIO
    VO
    Lynora has an increasingly common type of heart failure.  Although her heart pumps normally, it doesn’t fill with enough blood because the lower chamber of the heart is too stiff.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ :26
    Runs:16
    “This form of heart failure is the most common one in America, it’s the fastest growing. However, despite all of our efforts we’ve not found any medication treatments that improve the outcomes in patients with this disorder.”

    VIDEO
    B-ROLL
    People riding exercise bike and walking

    AUDIO
    VO
    More than 80 percent of these patients are also overweight or obese.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ :46
    Ends:16
    “About 5 years ago we tested exercise for these patients and found that it improved their main symptom which is exercise intolerance, or shortness of breath and fatigue with physical exertion.”

    (Video covering middle of bite: Lynora exercising)

    VIDEO
    B-ROLL
    Dr. Kitzman walking down hallway, Lynora talking with staff member, going over her numbers

    AUDIO
    VO
    Dr. Dalane Kitzman from the Wake Forest School of Medicine and co-authors studied whether weight loss and exercise might help symptoms in a group of 100 patients with this form of heart failure. Patients were randomly assigned to a calorie restricted diet, exercise training, or both.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ 1:16
    Ends:14
    “With exercise, participants lost about six and a half pounds of body weight. With diet, they lost more than twice as much. When we put diet and exercise together they lost 22 pounds.”

    GXF FULL
    JAMA LOGO

    VIDEO
    B-ROLL
    Lynora and Dr. Kitzman greeting each other and talking

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association. Dr. Kitzman says patients who were in the combination group also saw the most improvement in physical symptoms.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ 1:41
    Ends:13
    “With a significant improvement in exercise tolerance with diet alone and with exercise alone but when you added them together you had a large improvement in exercise tolerance.”

    VIDEO
    B-ROLL
    Lynora in study kitchen picking up her meals, being weighed

    AUDIO
    VO
    After 12 weeks of diet and exercise, Lynora is down 15 and a half pounds.

    AUDIO
    SOT/FULL
    Lynora Essic – Program Participant
    Super@ 2:00
    Runs:12
    “I feel good all the time and to me that’s really important. My family is really, really active and I don’t want to be the one on the sidelines anymore, I’ll be right there with them.”

    (Video covering 1st part of bite: Lynora on scale)

    VIDEO
    B-ROLL
    Lynora on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors also found that diet alone appeared to show a larger improvement in quality of life for the participants than exercise alone.

  • December 20, 2016

    Early Physical Activity After Concussion in Kids and Teens

    Early Physical Activity After Concussion in Kids and Teens

    INTRO: After a concussion, many doctors recommend an initial period of rest to help children and teens recover fully. But can early physical activity help decrease persistent post concussive symptoms? A new study in JAMA found that light exercise may be key to better recovery. Laura Berger has more in this week’s JAMA Report.

     

     

    AUDIO:

    VO:

     

    THOUSANDS OF CHILDREN IN THE U.S. VISIT EMERGENCY DEPARTMENTS AFTER SUFFERING CONCUSSIONS AND ABOUT 1/3 DEVELOP POST CONCUSSIVE SYMPTOMS THAT LAST MORE THAN A MONTH.  FOR YEARS, DOCTORS HAVE ADVISED STRICT REST RIGHT AFTER THE INJURY TO HELP AVOID THESE PROLONGED SIDE EFFECTS.

     

    (B-roll: Doctor doing concussion exam on patient)

     

     

    AUDIO:

    SOT/FULL

    Roger Zemek, M.D.-Children’s Hospital of Eastern Ontario

    Super@:15

    Runs:12

     

    “Children can present in a whole variety of symptoms following a concussion.  Some children may have early physical symptoms such as headache, or feeling like they want to vomit or being dizzy.”

     

     

     

    AUDIO:

    VO:

     

    1. ROGER ZEMEK FROM THE CHILDREN’S HOSPITAL OF EASTERN ONTARIO AND CO-AUTHORS STUDIED MORE THAN 3 THOUSAND CANADIAN CHILDREN AND TEENS WHO HAD CONCUSSIONS TO SEE IF ADDING PHYSICAL ACTIVITY WITHIN ONE WEEK OF INJURY CAN HELP PREVENT POST-CONCUSSIVE SYMPTOMS.

     

    USING A STANDARD QUESTIONNIARE, RESEARCHERS MONITORED THE CHILDREN AND TEENS FROM THE EMERGENCY DEPARTMENT UNTIL 28 DAYS AFTER THEIR INJURY TO SEE HOW WELL THEY RECOVERED AND ALSO TO TRACK THEIR PHYSICAL ACTIVITY.

     

    THE RESEARCHERS FOUND THAT THE CHILDREN WHO PARTICIPATED IN LIGHT PHYSICAL ACTIVITY AFTER THEIR CONCUSSION HAD A REDUCED RISK OF HAVING PROLONGED POST-CONCUSSIVE SYMPTOMS.

     

    (B-ROLL:Dr. Zemek walking down the hall, working at his desk, on the phone, patient walking in the snow)

     

    AUDIO:

    SOT/FULL

    Roger Zemek, M.D.-Children’s Hospital of Eastern Ontario

    Super@:1:00

    Runs:16

     

     “We really don’t want children to be having another concussion while they’re recovering, but there is likely a strong benefit for having some sort of movement, and early physical activity following concussion such as walking, jogging or stationary bicycle.”

     

     

    AUDIO:

    VO:

    DR. ZEMEK SAYS MORE RESEARCH NEEDS TO BE DONE TO DETERMINE THE IDEAL TYPE, INTENSITY, AND DURATION OF PHYSICAL ACTIVITY FOLLOWING CONCUSSION. (Broll:patient walking on trail)

    LAURA BERGER, THE JAMA REPORT

    (BROLL: patient walking outside)

     

         TAG: THE STUDY WAS CONDUCTED FROM AUGUST 2013 TO JUNE 2015.

     

     

     

  • December 13, 2016

    Large Differences Seen in Mortality Rates Among US Counties

    Large Differences Seen in Mortality Rates Among US Counties

    INTRO: How do mortality rates for major causes of death vary by county in the U.S.? A new study looked at mortality data from 1980 to 2014 to see what kinds of geographic patterns exist. Authors of the new study hope that the results can help provide insight into disease-specific trends and life expectancy. Laura Berger has more in this week’s JAMA Report.

     

     

    AUDIO:

    VO:

     

    RESEARCH SHOWS THAT INEQUALITIES IN LIFE EXPECTANCY ACROSS DIFFERENT COUNTIES IN THE UNITED STATES ARE INCREASING, BUT LESS IS KNOWN ABOUT SPECIFIC GEOGRAPHIC PATTERNS AND THE UNDERLYING CAUSES OF DEATH.

     

     

    (B-ROLL:graphic map of United States)

     

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:11

    Runs:15

     

    Well, there’s probably two key drivers of death rates changing, changes in risks that people have, like tobacco, or obesity, getting better or worse. And then access to treatment, whether prevention or cure.”

     

     

    AUDIO:

    VO:

     

    1. CHRIS MURRAY AND CO-AUTHORS REVIEWED DEATH CERTIFICATES FROM MORE THAN 3 THOUSAND U.S. COUNTIES FROM 1980 TO 2014. THEY WANTED TO KNOW WHAT THE LEADING CAUSES OF DEATH WERE IN EACH AREA AND TO DETERMINE TRENDS OVER TIME BY REGION. THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

     

     

     

     

    (B-ROLL: Dr. walking, working in office looking at map, close up map, doctor reading papers)

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:47

    Runs:27

     

     

     “We found that differences or disparities across counties are actually getting larger over time. So we’re not narrowing the gap, the gap is widening. And we found that different causes matter more in different parts of the country. So out West for example in the U.S., violent death is more common, whereas heart disease is more common in the Southeast. And deaths from drugs are much more common in West Virginia or Kentucky as examples.”

     

     

    AUDIO:

    VO:

     

    DR. MURRAY SAYS IN THE FUTURE HE WANTS TO LOOK AT MORE DETAILED CAUSES OF DEATH IN EACH AREA IN ORDER TO HELP IMPROVE THE HEALTH OF EACH COMMUNITY.  (B-roll doctor writing at white board, showing map)

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:1:23

    Runs:18

    (B-roll at end woman walking with daughter)

     

    “The biggest takeaway is that one size doesn’t fit all in the U.S.  We really need to understand why there’s such variation in how long people live, and what causes children, adults and older people to die at such different levels in different communities.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:woman walking with daughter)

     

         TAG: IN A SMALL NUMBER OF CASES, COUNTY BOUNDARIES SHIFTED      BETWEEN 1980 AND THE PRESENT.  SEVERAL COUNTIES WERE MERGED DUE TO THE CHANGE.

     

  • November 21, 2016

    Changes in the Prevalence of Dementia in the United States

    Changes in the Prevalence of Dementia in the United States

    INTRO: As the elderly population in the United States continues to grow, the number of older adults who will suffer from dementia will also increase, but by how much? A new study in JAMA Internal Medicine looked at whether the prevalence of dementia has changed from 2000 to 2012.  Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

    DEMENTIA AFFECTS 4 TO 5 MILLION OLDER ADULTS IN THE UNITED STATES, AS WELL AS THEIR FAMILIES, AND GOVERNMENT PROGRAMS. A NEW STUDY IN JAMA INTERNAL MEDICINE LOOKS AT HOW THE PREVALENCE OF DEMENTIA HAS CHANGED FROM 2000 TO 2012.

     

    ( B-ROLL: Graphic of 4 to 5 million over blur of people walking on street

    Woman working with elderly man, woman looking at microscope, scientist looking at brain slices)

     

    SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:13

    Runs:22

    “Dementia is characterized by declines in memory and other cognitive functions, things like speech, and the ability to plan and to organize one’s day.// We found that the prevalence of dementia declined significantly between 2000 and 2012, from about 11.5% down to about 9%.”

    (b-roll of people in wheelchairs)

     

    AUDIO:

    1. KENNETH LANGA AND CO-AUTHORS STUDIED MORE THAN 21 THOUSAND U.S. ADULTS OVER THE AGE OF 65 USING DATA FROM THE HEALTH AND RETIREMENT STUDY FROM 2000 AND 2012. LANGA SAYS HE ATTRIBUTES THE DECLINE IN DEMENTIA PREVALENCE TO TWO FACTORS: INCREASES IN THE EDUCATION LEVEL AMONG THIS GROUP AND BETTER TREATMENTS FOR CARDIOVASCULAR RISK FACTORS LIKE DIABETES, OBESITY, AND HYPERTENSION.

     

    (B-ROLL: Dr. Langa working at desk and looking at brain scans

    GRAPHIC OF DECLINE IN DEMENTIA REASONS )

     

    Runs SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:58

    Runs:19

     “This suggests that a 75 year old today has a lower risk of having dementia today than a 75 year old 10 or 20 years ago. Both increases in education and better control of cardiovascular risk factors may be important in explaining some of this decline.”

    (B-roll of woman getting blood pressure taken, woman walking on track)

     

    1. LANGA SAYS MORE WORK NEEDS TO BE DONE BOTH IN THE U.S. AND ABROAD TO KEEP DEMENTIA TRENDS ON THE DECLINE.

    (Broll: Woman doing cognitive tests with nurse)

     

     

    SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:1:23

    Runs:14

     

    “…even without a big breakthrough in medication or  other kind of intervention that might decrease Alzheimer’s risk or change the course of Alzheimer’s, that it appears that there’s things we can do decrease risk.”

    (Broll: (b-roll people working out)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:woman walking with walker)

     

    TAG: THE NUMBER OF OLDER ADULTS WITH DEMENTIA IN THE UNITED STATES AND AROUND THE WORLD IS EXPECTED TO GROW UP TO 3-FOLD BY 2050.

     

     

     

     

  • November 13, 2016

    Statin Use for the Prevention of Cardiovascular Disease

    Statin Use for the Prevention of Cardiovascular Disease

    INTRO: Cardiovascular disease is one of the leading causes of death in the United States.  Statins are a prescription medication that can help decrease the risk for cardiovascular disease. But just who is at risk? The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services, including for cardiovascular disease. The Task Force has just issued a new recommendation statement on statin use for adults who are at risk for cardiovascular disease. Laura Berger has more in this week’s JAMA Report.

    AUDIO:

    VO:

     

    STROKE IS THE 5TH LEADING CAUSE OF DEATH IN THE U.S. AND THE 2ND LEADING CAUSE OF DEATH WORLDWIDE. EACH YEAR MORE THAN 750,000 AMERICANS EXPERIENCES A STROKE.

     

    (B-ROLL: Graphic 1 in 3 adults will die from cardiovascular disease, bottles of statins, Dr. Owens and patient)

     

     

    AUDIO:

    SOT/FULL

    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force

    Super@:11

    Runs:8

     

    “The risk factors for cardiovascular disease include high cholesterol, high blood pressure, smoking, diabetes, and your age.”

     

     

    AUDIO:

    VO:

     

    1. DOUGLAS OWENS, AN AUTHOR OF THE U-S PREVENTIVE SERVICES TASK FORCE RECOMMENDATION, SAYS THE GROUP RECOMMENDS THAT SOME PEOPLE AGE 40-75 WHO HAVE ONE OR MORE OF THOSE RISK FACTORS: HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, SMOKING, OR DIABETES, AND DO NOT HAVE A HISTORY OF CARDIOVASCULAR DISEASE, AND WHOSE CHANCE OF HAVING A HEART ATTACK OR STROKE OVER THE NEXT TEN YEARS IS 7.5% OR HIGHER, USE A STATIN. THOSE WHOSE RISK IS 10% OR HIGHER WILL BENEFIT MOST.

    ALTHOUGH THERE ARE RISKS, DR. OWENS SAYS THE USE OF A STATIN ALONG WITH A HEALTHY DIET AND EXERCISE, CAN BE A USEFUL TOOL IN THE FIGHT AGAINST CARDIOVASCULAR DISEASE.

     

    THE TASK FORCE RECOMMENDATIONS APPEAR IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

     

     

     

    (B-ROLL: Dr. Owens sitting at desk looking at the computer, man on street shots, Graphic of risk factors, man on street, smokers, statin bottle, counting pills, cardiovascular procedure b roll.)

     

     

    AUDIO

    SOT/FULL

    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force

    Super@: 1:04

    Runs:17

     

    “The benefits of statins are a reduction in heart attack, strokes and death. The harms of statins we judge based on our very comprehensive review of the literature to be small. And in patients who are at elevated risk for cardiovascular disease, the benefits outweigh the harms.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL: Statin pill bottles)

     

    TAG: THE TASK FORCE FOUND THE EVIDENCE FOR INITIATING STATINS FOR PEOPLE OVER 75 TO BE INSUFFICIENT.

     

  • November 10, 2016

    iPad Game Helps Treat Common Eye Condition in Children

    iPad Game Helps Treat Common Eye Condition in Children

    INTRO: Amblyopia or lazy eye is a leading cause of visual impairment in children.  The standard treatment for lazy eye involves patching the opposite eye to force the lazy eye to work harder. But could a special iPad game also be effective?  A new study in JAMA Ophthalmology compared the treatment of amblyopia using a binocular iPad game vs. two hours of daily patching. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    AMBLYOPIA OR LAZY EYE IS ONE OF THE MOST COMMON CAUSES OF VISUAL IMPAIRMENT IN CHILDREN, AFFECTING 3 TO 5 PERCENT OF KIDS IN THE UNITED STATES.

     

     

    (B-ROLL: Child getting patch on her eye, looking at eye chart with doctor, Doctor controlling chart on her phone)

     

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 9

    Runs:14

     

    “Amblyopia is a reduction of vision in one eye because of abnormal visual experience early in life. Amblyopia not only has deficits in vision, but it causes deficits in 3D depth perception, reading and fine motor skills.”

     

     

     

    AUDIO:

    1. KRISTA KELLY AND CO-AUTHORS STUDIED 28 CHILDREN AGES 4 TO 10 WHO HAD AMBLYOPIA. IN THIS RANDOMIZED TRIAL, CHILDREN WERE ASSIGNED TO TWO GROUPS, ONE THAT USED AN IPAD GAME FOR TREATMENT AND THE OTHER WHO USED PATCHING. AFTER TWO WEEKS THE GROUP THAT PATCHED ALSO TOOK HOME THE GAME.

     

    THE CHILDREN PUT ON A PAIR OF GLASSES AND HIGH CONTRAST IMAGES ARE SENT TO THE WEAKER EYE AND LOW CONTRAST IMAGES ARE SENT TO THE STRONGER EYE. THE CHILD HAS TO WORK THE WEAKER EYE IN ORDER TO PLAY THE GAME AS WELL AS WORK BOTH EYES TOGETHER.

     

     

    THE STUDY APPEARS IN JAMA OPHTHALMOLOGY.

     

    (B-ROLL: Dr. Kelly and co-author walking down hall, Dr. Kelly looking at eye scan, child playing, game and glasses close up, Dr. Kelly and child with patch, child playing game with glasses)

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 59

    Runs:14

     

    “We found that at the 2 week visit children who had the iPad game improved much more than children who patched…Both groups improved about  2 lines of vision on the letter chart…and about 40% of the children recovered normal vision.

    (B-roll in middle, girl playing the game)

     

     

    AUDIO:

    VO:

    1. KELLY SAYS THIS NEW GAME IS A PROMISING ADDITION TO EXISTING TREATMENTS FOR LAZY EYE. SHE HOPES MORE GAMES, TV SHOWS, AND MOVIES CAN BE USED AS TREATMENT IN THE FUTURE.

    (B-ROLL: Dr. Kelly and co-author looking at charts)

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 1:23

    Runs:10

     

     

    “So we want to be able to treat amblyopia early in life to be able to circumvent these deficits and hopefully allow the child to be able to develop and thrive academically and socially.”

     (b-roll at end of girl playing game)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:girl playing game)

     

    TAG: THE STUDY WAS CONDUCTED FROM FEBRUARY 2015 TO JANUARY 2016.

  • October 31, 2016

    Opioid Poisonings Among Children and Teenagers

    Opioid Poisonings Among Children and Teenagers

    INTRO: Although there is a lot of discussion on how the prescription opioid epidemic has affected the U.S. adult population, how has it affected children and teens? A new study looked at how often kids and teenagers are hospitalized for opioid poisonings.  The study in JAMA Pediatrics examined these trends over a 16-year period from 1997 to 2012. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    FROM 1999 TO 2010 RETAIL SALES OF PRESCRIPTION OPIOIDS QUADRUPLED. AND AS MORE ADULTS BECOME ADDICTED TO THESE MEDICATIONS, MORE CHILDREN AND TEENAGERS ARE ALSO AT A HIGHER RISK FOR OPIOID POISONING AND MISUSE.

     

    (B-ROLL: Morphine bottle/fentanyl bottle/pharmacist)

     

    AUDIO:

    SOT/FULL

    Julie Gaither, PhD- Department of Epidemiology, Yale School of Medicine

    Super@: 14

    Runs:19

     

    “In the past 2 decades the opioid epidemic has grown exponentially. It really began in the mid-1990s when physicians were encouraged to do a better job of treating chronic pain…. in particular in 2014 there were approximately 19,000 deaths that were attributed to opioid medications.”

    (B-roll of pills to cover the cut)

     

     AUDIO:

    VO:

    1. JULIE GAITHER AND DR. DEEPA CAM-en-GAY AND CO-AUTHORS REVIEWED THE U.S. PEDIATRIC HOSPITAL DISCHARGE RECORDS OF CHILDREN AND TEENS AGES 1 TO 19, FROM 1997 TO 2012. THEY IDENTIFIED MORE THAN 13,000 CHILDREN AND TEENS WHO WERE HOSPITALIZED FOR OPIOID POISONINGS WITHIN THAT TIME FRAME.

     

    THEY ALSO LOOKED AT 15 TO 19 YEAR OLDS WHO WERE HOSPITALIZED FOR HEROIN POISONINGS.

    THE STUDY APPEARS IN JAMA PEDIATRICS.

     

    (B-ROLL: Two doctors walking/working at computer/ambulance/gurney wheeling into hospital/doctors looking at monitor)

     

    AUDIO

    SOT/FULL

    Deepa Camenga, MD-Department of Pediatrics, Yale School of Medicine

    Super@: 56

    Runs: 22

    “We found that the rates of hospitalizations for opioid poisonings doubled during … 1997 to 2012. We also found… that the highest number of hospitalizations were among teenagers, ages 15 thru 19 …the highest rates of increase in hospitalizations were among our youngest population, which was 1 to 4-year-old children.”

     

    (B-roll in middle, pill warning/girl on gurney/nurse in room)


    Julie Gaither, PhD- Department of Epidemiology, Yale School of Medicine

    Super@: 1:19

    Runs:14

     

    “Heroin poisonings increased by 150% during this time point and then very importantly, poisonings from methadone increased by approximately 950%, so almost tenfold in less than two decades.”

     

    AUDIO:

    VO:

    1. GAITHER AND DR. CAM-en-GAY SAY CHANGES IN HOW WE PRESCRIBE, DISPOSE, AND PACKAGE THESE DRUGS ARE NEEDED TO KEEP CHILDREN AND TEENS SAFE.

     (B-ROLL: Pharmacist with syringes/pills/hospital machine)

     

    SOT/FULL

    Deepa Camenga, MD-Department of Pediatrics, Yale School of Medicine

    Super@: 1:41

    Runs: 13

     

    “ Our national conversation is focused on how to improve the treatment and prevention of opioid misuse and abuse, but we also hope that this conversation focuses on how to safeguard children from this epidemic.”

    (b-roll in middle pharmacist crushing pills)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL: morphine bottle)

     

    TAG: THE PEDIATRIC COMMUNITY MAKES UP ¼ OF THE U.S. POPULATION.

  • October 19, 2016

    Bariatric Surgery in Women of Childbearing Age

    Bariatric Surgery in Women of Childbearing Age

    INTRO: As the U.S. deals with an obesity epidemic many younger women are having bariatric surgery for weight loss. But is there a risk for the infants of women who have had bariatric surgery? Is there a way to decrease perinatal complications and is there an optimal time to wait to have children after surgery?   A new study in JAMA Surgery examined these risks. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO

    VO:

    IN THE UNITED STATES 1 IN 5 WOMEN ARE OBESE AT THE TIME OF CONCEPTION. OBESITY DURING PREGNANCY CAN INCREASE THE RISK OF COMPLICATIONS FOR BOTH MOTHERS AND INFANTS. THAT IS ONE OF THE REASONS WHY YOUNGER WOMEN MIGHT TURN TO BARIATRIC OR WEIGHT LOSS SURGERY.

    (B-ROLL: pregnant woman at doctor/ultrasound/close up belly)

     

     

    AUDIO:

    SOT/FULL

     Brodie Parent, MD- Department of Surgery, UW

    Super@ 14

    Runs:   13

    “Bariatric surgery is becoming a very common operation in the United States in particular. // And just in the past about 5 years the rates of bariatric surgery have doubled from about 4 per hundred patients to about 8 per hundred patients.”

    (B-roll of surgery video in middle of sot)

     

     

    VO: DR. BRODIE PARENT OF THE UNIVERSITY OF WASHINGTON MEDICAL CENTER AND CO-AUTHORS STUDIED THE BIRTH CERTIFICATES AND HOSPITAL DISCHARGE DATA OF MORE THAN 10,000 MOTHERS AND INFANTS IN WASHINGTON STATE FROM 1980 TO 2013.

     

    THEY STUDIED TWO GROUPS, ONE OF WOMEN THAT HAD BARIATRIC SURGERY PRIOR TO PREGNANCY AND THE OTHER THAT DID NOT HAVE WEIGHT LOSS SURGERY.

     

    THEY WANTED TO SEE IF THE INFANTS OF THE WOMEN WHO HAD BARIATRIC SURGERY WERE AT HIGHER RISK FOR PREMATURITY, LOW BIRTH WEIGHT, AND INTENSIVE CARE ADMISSION.

     

    THE STUDY APPEARS IN JAMA SURGERY.

     

    (B-ROLL Dr. Parent walking through the hall and looking at papers/bariatric surgery b-roll/babies in ICU)

     

     

    AUDIO

    SOT/FULL

    Brodie Parent, MD- Department of Surgery, UW

    Super@: 58

    Runs: 15

    “The way to reduce that risk is perhaps by waiting 2 to 3 years after they’ve had the operation. If they give birth before that 2 to 3 year interval, there’s a higher risk of their infant requiring an ICU admission, or their infant being low weight, or premature.”

    (B-ROLL: babies in hospital in middle of sot)

     

     

     

    AUDIO

    VO:

    1. PARENT SAYS BARIATRIC OR WEIGHT LOSS SURGERY HAS MANY POTENTIAL BENEFITS BUT RECOMMENDS WAITING AS LONG AS POSSIBLE BEFORE CONCEPTION IN ORDER TO DECREASE RISKS FOR THE MOTHERS AND THEIR INFANTS.

    (B-ROLL: bariatric surgery/pregnant woman/baby in hospital)

     

     

    LAURA BERGER THE JAMA REPORT

    (B-ROLL: babies in hospital)

     

    TAG: DURING THE PAST THREE YEARS IN WASHINGTON STATE, ABOUT 200 WOMEN A YEAR HAVE HAD A BARIATRIC OPERATION PRIOR TO GIVING BIRTH.

  • October 11, 2016

    Trends in Dietary Supplement Use

    Trends in Dietary Supplement Use

    INTRO: Over the past two decades, numerous studies of diet supplements use have found little evidence of benefit. But the industry continues to grow. Does this abundance of new information affect supplement use among U.S. adults? A new study in JAMA looked at the trends in dietary supplement use from 1999-2012. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:  IN RECENT YEARS, DIETARY SUPPLEMENTS HAVE GROWN INTO A 32 BILLION DOLLAR A YEAR BUSINESS. AND AS THE INDUSTRY HAS EXPANDED, SO HAS RESEARCH INTO THE POSSIBLE BENEFITS AND RISKS OF TAKING SUPPLEMENTS.

     

     

    (B-ROLL: Supplements in bottles on table/powder supplement with graphic $32 billion/bottle close up/person taking pills)

     

     

    AUDIO:

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

    Super@: 12

    Runs: 14

    (b-roll in middle of doctor w bottles)

     

    “Supplements are tremendously popular.  In the late 1980s, more than a third of Americans were using these sort of products. And today a little more than half of all American adults use dietary supplements.”

     

     

    AUDIO:

    VO: IN THE CURRENT ISSUE OF JAMA, DR.  PIETER COHEN DISCUSSES THE RESULTS OF A NEW STUDY EXAMINING TRENDS IN DIETARY SUPPLEMENT USE AMONG U.S. ADULTS BETWEEN 1999-2012.

     

    A TOTAL OF 38,000 PEOPLE WERE ASKED ABOUT WHAT VITAMINS, MINERALS, AND SUPPLEMENTS THEY USED.  THE RESULTS WERE COMPARED OVER THE 13 YEAR PERIOD TO IDENTIFY TRENDS AND CHANGES OVER TIME.

     

    THIS TIME PERIOD WAS ALSO AN ERA OF INTENSE INVESTIGATION INTO THE HEALTH EFFECTS OF SUPPLEMENTS. THE NATIONAL INSTITUTES OF HEALTH INVESTED SEVERAL HUNDRED MILLION DOLLARS INTO RESEARCH ON SUPPLEMENTS ONLY TO FIND MOST HAVE NO SIGNIFICANT BENEFIT.

    (B-ROLL: Doctor working/person taking pills/doctor at desk/pill bottles/ pills)

     

     

    AUDIO

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

     

    Super@: 1:04

    Runs: 15

     

    “… there was very high use of supplements going into, at the start of the study in 1999, 52%. What’s interesting is that did not budge at all over the next 13 years and it was exactly the same, 52% at the end of the 13 years.”

     

    AUDIO:

    VO:

    (B-ROLL Doctor walking/doctor with pills)

    1. COHEN SAYS HE IS SURPRISED THAT SUPPLEMENT USAGE HAS STAYED THE SAME EVEN THOUGH STUDIES HAVE SHOWN THAT MANY SUPPLEMENTS HAVE LITTLE TO NO BENEFIT.

     

     

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

    Super@: 1:28

    Runs: 14

    “And how will a consumer know if a supplement has certain side effects or risks? These are things that are not well presented given today’s regulatory environment. And I think those are some major questions for the near future.”

     

    (BROLL: pill bottles/labels/pills)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: MULTIVITAMIN OR MULTIMINERAL USE DECREASED FROM 37% IN 1999-2000 TO 31% IN 2011-2012.

  • October 06, 2016

    Estrogen Blocking  Drugs Can Decrease Risk of Breast Cancer in Opposite Breast

    Estrogen Blocking  Drugs Can Decrease Risk of Breast Cancer in Opposite Breast

    INTRO: Can certain drugs help women with breast cancer decrease the risk of developing cancer in the opposite breast? A new study in JAMA Oncology found that estrogen blocking drugs can decrease the risk of contralateral breast cancer, especially among women whose breast cancer was estrogen receptor positive. The study found the women who took the drugs longer had a lower risk of developing cancer in their opposite breast.  Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

    DURING THE 10 YEARS AFTER BREAST CANCER DIAGNOSIS, 5% OF WOMEN DEVELOP CANCER IN THEIR OPPOSITE BREAST KNOWN AS CONTRALATERAL BREAST CANCER.

     

    (B-ROLL Doctor and patient looking at scans, mammogram exam, doctor looking at monitor)

     

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 9 Runs: 22

     

     “We know from clinical trials that there are medications that can be used to reduce risk of contralateral breast cancer.  Particularly for women who are diagnosed with estrogen receptor positive breast cancer, tamoxifen and aromatase inhibitors may be used. We wanted to evaluate these medications in a general community health care setting to see how well they work in the real world.”

     

    AUDIO:

    VO:

    1. GRETCHEN GIERACH FROM THE NATIONAL CANCER INSTITUTE AND CO-AUTHORS REVIEWED THE RECORDS OF MORE THAN 7500 WOMEN DIAGNOSED WITH INVASIVE BREAST CANCER FROM 1990 TO 2008.

     

    THEY FOLLOWED THE WOMEN THROUGH 2011 TO SEE WHICH ONES DEVELOPED BREAST CANCER IN THE OPPOSITE BREAST.  THE RESEARCHERS ALSO RECORDED WHO TOOK TAMOXIFEN OR AROMATASE INHIBITORS, TWO TYPES OF MEDICATIONS THAT BLOCK ESTROGEN. 

     

    DR GIERACH’S TEAM FOUND THAT WOMEN TAKING THESE MEDICATIONS FOR A LONGER PERIOD HAD A LOWER RISK OF CONTRALATERAL BREAST CANCER. 

     

    THE STUDY APPEARS IN JAMA ONCOLOGY.

     

    (B-ROLL: Dr. Gierach at her desk/talking to co-worker looking at scans/ Doctor looking at scan/ mammogram/prescription bottles/ pharmacist working)

     

     

    AUDIO

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 1:06 Runs: 10

     

    “So for women who took the drug for 4 years or longer, we observed reduced risk of contralateral breast cancer for up to 5 years after they stopped taking the medication.”

     

    AUDIO:

    VO:

    WOMEN GOING THROUGH BREAST CANCER TREATMENT HAVE MANY TOUGH DECISIONS TO MAKE IN CHOOSING A THERAPY PLAN.  DR. GIERACH SAYS IF THEY DECIDE TO USE THESE DRUGS AND CAN STICK WITH THEM, THERE ARE LONG TERM BENEFITS.

    (B-ROLL :Doctor talking to patient/scan close up/pills on shelf/girl walking up to pharmacy counter )

     

     

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 1:28 Runs: 14 B roll middle to end of bite of pill bottles

     

    “These medications are known to have side effects which might impact or challenge women in being able to complete her full treatment course… The longer they took the drug the greater the risk reduction, so we know that therapy duration really does make a difference.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: IN THE STUDY, THE AVERAGE AGE FOR WOMEN AT TIME OF CANCER DIAGNOSIS WAS 61.

     

     

  • September 27, 2016

    Early Stroke Treatment Improves Patient Outcomes

    Early Stroke Treatment Improves Patient Outcomes

    INTRO: After a large vessel stroke, how long does a patient have to get treatment in order to prevent long lasting effects? A new study in JAMA found that a shorter time to treatment after a stroke is critical to having the best recovery. But just how long does a patient have to restore blood flow to the brain? Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    STROKE IS THE 5TH LEADING CAUSE OF DEATH IN THE U.S. AND THE 2ND LEADING CAUSE OF DEATH WORLDWIDE. EACH YEAR MORE THAN 750,000 AMERICANS EXPERIENCES A STROKE.

     

    (B-ROLL ambulance arriving at hospital with a patient)

    (Graphic of 750,000 Americans each year)

     

     

    AUDIO:

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@: 11

    Runs: 13

     

    “So it’s critically important for patients to recognize the warning signs of stroke, get to the hospital as soon as possible and for doctors, nurses and health systems to then rapidly treat patients when they arrive.”

     

    AUDIO:

    VO:

    1. JEFFREY SAVER FROM UCLA AND CO-AUTHORS REVIEWED THE OUTCOMES OF OVER 1200 PATIENTS EXPERIENCING ACUTE ISCHEMIC STROKE IN 5 LARGE RANDOMIZED CLINICAL TRIALS. SOME PATIENTS RECEIVED STANDARD MEDICAL THERAPY, OTHERS RECEIVED STANDARD THERAPY PLUS TREATMENT WITH A THROMBECTOMY DEVICE.

     

    THE AUTHORS FOUND THAT THE SOONER THE DEVICE, WHICH PULLS CLOTS OUT OF THE AFFECTED ARTERY AND HELPS RESTORE BLOOD TO THE BRAIN, IS USED, THE BETTER THE PATIENT’S OVERALL RECOVERY.

     

    THE STUDY APPEARS IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. 

     

    (B-ROLL: Saver and other dr. looking at brain scans//Saver and dr. looking at thrombectomy device and holding it up.)

     

     

    AUDIO

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@:57

    Runs: 25

     

    “There was some benefit of therapy up to 7 1/3 hours after onset that’s an important new aspect…If you get the artery open at 3 hours then 65% of patients will be able to live independently 3 months later.  If it takes 8 hours to get it open, then only 45% will be able to live independently, it makes a major difference in outcome.”

     

    AUDIO:

    VO:

    IT IS CRITICAL FOR THE PUBLIC TO BE AWARE OF THE SIGNS OF STROKE.  DOCTOR SAVER SAYS USE THE ACRONYM FAST—IF YOU SEE FACIAL DROOPING, ARM WEAKNESS, AND SPEECH DIFFICULTY, IT’S TIME TO CALL 911.

    (B-ROLL patient wheeling into hospital//GRAPHIC WITH FAST ACRONYM)

     

     

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@: 1:34

    Runs: 15

     

    “Often the patient can’t make the call themselves because the stroke is affecting their speaking or their ability to recognize they are having a stroke. So it’s very important for family, friends, witnesses, if you see someone having stroke symptoms, call 911.  Every minute matters.”

     

    (BROLL: 2 doctors looking at brain scans, close up of the scans)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: DR. SAVER SAYS HOSPITALS SHOULD USE THIS PROCEDURE WITHIN 75 MINUTES OF A PATIENT’S ARRIVAL.

  • September 20, 2016

    Wearable Technology’s Effect on Weight Loss

    Wearable Technology’s Effect on Weight Loss

    INTRO: Does adding wearable technology to a program of diet and exercise help with weight loss?  A new study in JAMA reports that adding physical activity tracking gadgets to a lifestyle modification program did not result in more weight loss among a group of obese and overweight young adults. Laura Berger has more in this week’s JAMA Report.

    AUDIO

    VO:

    IN THE FIGHT AGAINST OBESITY MANY AMERICANS ARE TURNING TO WEARABLE DEVICES TO HELP MEET THEIR FITNESS GOALS.  BUT ARE THESE GADGETS EFFECTIVE?

    (B-ROLL group exercising, treadmill running, elliptical, woman with wearable arm band)

    AUDIO:

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@ 8

    Runs:  14

    “… when we gave people these strong behavioral weight loss programs that are kind of group based…we actually that thought adding wearable technologies to that program would help them lose more weight over 24 months and to our surprise, that isn’t what we found.” (B-roll in middle w devices and person working out)

    VO:

    1. JOHN JAKICIC (JA-KEY-SICK) FROM THE UNIVERSITY OF PITTSBURGH AND CO-AUTHORS STUDIED 471 OVERWEIGHT OR OBESE YOUNG ADULTS FROM 2010 TO 2012. ALL STUDY PARTICIPANTS RECEIVED COUNSELING ON DIET AND EXERCISE. 6 MONTHS INTO THE STUDY, HALF WERE RANDOMLY ASSIGNED TO GET A WEARABLE DEVICE TO HELP TRACK PHYSICAL ACTIVITY AND DIET. 

    THE AUTHORS FOUND THAT THE GROUP THAT DID NOT USE THE WEARABLE DEVICE, LOST MORE WEIGHT THAN THE GROUP WHO DID.  AN AVERAGE OF 5.3 POUNDS MORE.

    THE STUDY APPEARS IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. 

     (B-ROLL: Dr. walking through hall//B-roll overweight people//people working out// wearables//more working out)

    AUDIO

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@: 53

    Runs: 15

    “ …they may give people a false sense of security that they don’t pay attention to some of the key behaviors that they need to pay attention to. They are relying on the device too much and that’s why we saw less weight loss in that group. “

    AUDIO

    VO:

    ALTHOUGH WEARABLE TECHNOLOGY HAS CHANGED AND IMPROVED SINCE THE STUDY STARTED, THERE IS STILL NO ONE SIZE FITS ALL FITNESS TRACKING DEVICE.  (B ROLL: of newer wearable technology)

    AUDIO

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@:

    Runs:

    “…maybe we shouldn’t just think broadly about using these devices across everyone. I think we need to understand more about how to use them and for whom.”

    Laura Berger, the JAMA Report.

    (B-ROLL: people lifting weights and working out

    Tag: THE YOUNG ADULTS IN THIS STUDY ARE DEFINED AS AGES 18-35.

  • September 14, 2016

    JAMA Report: Using Hospital Records to Predict Death by Suicide

    JAMA Report: Using Hospital Records to Predict Death by Suicide

    “Using Hospital Records to Predict Death by Suicide”

     

     

    INTRO: Although suicide is the 10th leading cause of death in the United States, predicting just who is at increased risk of suicide can be challenging. Is there a better way to determine an individual’s risk for suicide? The authors of a new study in JAMA Psychiatry examined hospital discharge reports using natural language processing, and found several key predictors that can highlight potential suicide risk. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO

    VO:

    ON AVERAGE THERE ARE 117 SUICIDES PER DAY IN THE UNITED STATES. AND EACH YEAR, MORE THAN 40,000 AMERICANS DIE BY SUICIDE. ALTHOUGH IT’S THE 10TH LEADING CAUSE OF DEATH IN THE UNITED STATES, EXACTLY WHO IS AT RISK OF SUICIDE IS STILL HARD TO PREDICT.

     

    (B-ROLL WITH GRAPHIC people walking down the street with a graphic over it with text of statistics)

     

     

    AUDIO:

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@16

    Runs:  9

    “…what we hope to do is understand if you are in the hospital for any reason and then you are discharged can we say something about your risk of death from suicide.”

     

    SOT/FULL

    Thomas H. McCoy, Jr., M.D., – Director of Research, Center for Quantitative Health, MGH

    Super@31

    Runs:  17

    “To try and better understand who would go on to die by suicide… we drew on…typical risk factors…But we also added a newer risk predictor and that was the words that the doctors had written about the patient at the time of discharge.“

     

    VO:

    1. THOMAS MCCOY JR. AND DR. ROY PERLIS AND CO-AUTHORS FROM MASSACHUSETTS GENERAL HOSPITAL EXAMINED THE HOSPITAL DISCHARGE NOTES OF MORE THAN 450,000 PATIENTS FROM 2005 TO 2013.

    RESEARCHERS ANALYZED THESE NOTES BY A COMPUTER PROGRAM USING SENTIMENT ANALYSIS—WHICH LOOKS FOR POSITIVE OR NEGATIVE WORDS LIKE LOVELY, DELIGHTFUL, PLEASANT– OR DREADFUL, UNFORTUNATE OR POORLY. THEY FOUND THAT CERTAIN WORDS CAN PREDICT A HIGHER RISK FOR SUICIDE.

     

    THE STUDY APPEARS IN JAMA PSYCHIATRY. 

    (B-ROLL of the two doctors walking, doctors at desk, computer screen, medium shoot of doctors, wide shot doctors, Graphic of computer with words highlighted, JAMA logo)

     

     

    AUDIO

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@: 1:12

    Runs:  14

    “The value of using natural language processing is it’s a tool that lets us pull things out we would otherwise miss if we just looked at diagnostic codes and medicines, and peoples age and gender and so forth.”

     

    AUDIO

    VO:

    DOCTORS MCCOY AND PERLIS HOPE OTHER HOSPITALS ACROSS THE COUNTRY CAN EVENTUALLY ADOPT THIS NEW APPROACH AND HELP BRING MORE INSIGHT INTO PREVENTING SUICIDE.

    (B ROLL: doctors in office talking)

     

    AUDIO

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@: 1:35

    Runs:  8

    “…And if we can make predictions about who’s at high risk, we can better target resources, we can better target interventions to reduce this risk.”

    (BROLL: some sot covered with 2 doctors in office)

     

    Laura Berger, the JAMA Report.

    (B-ROLL: doctors at computer looking at graphs)

     

     

    Tag: IN THE STUDY ONLY 1.3% OF THE PATIENTS IN THE STUDY HAD A PRIMARY PSYCHIATRIC DIAGNOSIS.

  • September 06, 2016

    MRI Exposure During Early Pregnancy Not Associated with Increased Fetal Harm

    MRI Exposure During Early Pregnancy Not Associated with Increased Fetal Harm

     

    VNR Script

    68 seconds

    Audio: Video:
    VO:Should women take a pregnancy test before having an MRI? A new study published in The Journal of the American Medical Association looked at the safety of magnetic resonance imaging during pregnancy, especially during the first trimester.13 secs Female patient in doctor officeDoctor/Patient interactionMRI Scan
    SOT:“We already have a fair amount of data on CAT scan safety in pregnancy, but MRI was lacking.”TC 5:53 – 6:007 secs Dr. Joel Ray on camera
    VO:Dr. Joel Ray and his colleagues at Saint Michael’s Hospital in Toronto analyzed data collected over 12 years and concluded that MRI in the first trimester was not harmful to the developing fetus.11 secs Exterior of hospital, B-roll of Dr. Ray looking at data, etc.
    SOT:“An MRI in the first trimester is unlikely to be harmful, so special pregnancy testing or measures are unlikely to be required.”TC 2:34 – 2:439 secs Dr. Joel Ray on camera
    VO:Women undergoing an MRI with the contrast agent gadolinium at any point during pregnancy were also included in the study. These MRIs with contrast were associated with a higher risk of fetal death and a variety of inflammatory and skin conditions in the newborn.13 secs Female patient undergoing MRI
    SOT:“It reinforces a to date evidence-free notion that gadolinium might harm the fetus.TC 4:53 – 5:01<CUT> 

    “Gadolinium contrast would be best avoided in pregnancy.”

    TC 2:52 – 2:56

     

    12 secs

    Dr. Joel Ray on cameraB-roll of MRI scans or procedure as necessary to cover cut
     VO: This is Laura Kelly for the JAMA Report.

     

     

  • August 23, 2016

    Reducing the High Cost of Prescription Drugs in the U.S.

    Reducing the High Cost of Prescription Drugs in the U.S.

    INTRO:Prescription drug costs in the United States continue to rise well above inflation rates and make up an increasingly large share of total health care spending. A new report examines the reasons for these higher prices and also suggests policy changes that could help contain drug costs. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People walking on street, pharmacy sign, doctor holding drug bottles, shelves of prescription drugs

    AUDIO
    VO
    For many Americans, a trip to the pharmacy can result in sticker shock. People in the United States pay more for their prescription drugs than anywhere else in the world.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:08
    Runs:06
    “There’s a lot of frustration about high drug costs and how they impact the delivery of patient care.”

    VIDEO
    B-ROLL
    Dr. Kesselheim walking in clinic, various shots of him sitting at computer

    AUDIO
    VO
    Dr. Aaron Kesselheim and his colleagues at Brigham and Women’s Hospital reviewed the medical and health policy literature on prescription drug prices in the U.S. The researchers say high drug costs stem from several factors.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:25
    Runs:15
    “The provision of market exclusivity that allows drug companies to charge whatever the market will bear and then limitations on payers and their ability to negotiate drug prices and the limitations on competition, that might drive drug prices down.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:49
    Runs:08
    “Another factor; a lot of physicians don’t know what the price of the drugs are to patients and so will prescribe drugs without thinking about the price of the product.”

    (Video covering 1st part of bite: pills being counted)

    AUDIO
    VO
    This contributes to patients sometimes not filling prescriptions and spreading out doses or splitting pills to reduce costs.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:00
    Runs:07
    “We need more education for physicians and patients about the implications of high drug prices on the delivery of care.”

    VIDEO
    B-ROLL
    Pan of prescription drugs on shelf, doctor looking at drug bottle

    AUDIO
    VO
    Also, more information on identifying high and low value drugs, so resources aren’t wasted.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:15
    Runs:09
    “And insuring that there is both reasonable periods of market exclusivity as well as adequate competition when those market exclusivity periods end.”

    VIDEO
    B-ROLL
    Push in to pile of drugs, pan of drugs

    AUDIO
    VO
    And timely availability of high quality and safe generic drugs.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:26
    Runs:13
    “There have been a number of studies showing, when generic drugs enter the market that drug prices fall substantially. Money that is spent unnecessarily on expensive drugs cannot be spent in other areas of health care delivery.”

    (Video covering 2nd half of bite: pills being poured out of bottle and counted)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Another justification for higher drug prices is that it will help encourage innovation.  However, according to the authors, most innovation comes from publically funded science in government labs and academic research settings.

  • August 16, 2016

    New Medication for High Cholesterol Not Cost-Effective

    New Medication for High Cholesterol Not Cost-Effective

    INTRO: Statins are a common medication used to lower L-D-L or “bad” cholesterol levels. However, for some patients, statins alone aren’t enough. Last year, a new type of medication known as P-C-S-K-9 inhibitors became available for use along with statins.  Although effective, these drugs are very expensive. A new study evaluated the cost-effectiveness of this therapy and how increased use might affect the U.S. health care system. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Video of people walking, Graphic

    AUDIO
    VO
    Millions of people struggle to lower their L-D-L or “bad” cholesterol. A new type of therapy called a P-C-S-K-9 inhibitor can help reduce L-D-L or “bad” cholesterol by nearly 50 percent.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@:11
    Runs:12
    “They block a specific enzyme in the cholesterol pathway. In doing so, they increase the removal of LDL cholesterol from the blood into the liver and lower LDL cholesterol levels.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@:23
    Runs:20
    “They were approved to be used for individuals who are at higher risk for heart disease, who have had a heart attack, a stroke or who have a family history of very high cholesterol. These drugs were approved to be used in addition to the statin medications in these particular individuals.”

    (Video covering  middle of bite: dye being injected into artery)

    VIDEO
    B-ROLL
    Dr. Bibbins-Domingo and Dr. Kazi walking down hall, looking at blocked artery on computer screen, Graphic

    AUDIO
    VO
    Doctors Kirsten Bbibbins-Domingo and Dhruv (drewz) Kazi from the University of California San Francisco and their co-authors examined the cost-effectiveness of P-C-S-K-9 inhibitors and their potential effect on U-S health care spending. Using a simulation model that included all U-S adults 35 and older, they evaluated outcomes like expected numbers of deaths due to cardiovascular disease, heart attacks and strokes and balanced this with the cost and potential benefits of these drugs. The authors estimated that about 9 million people would be eligible for this therapy.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of Californ ia San Francisco
    Super@1:13
    Runs:06
    “This innovation comes at a price. They were launched at a little over 14 thousand dollars per patient per year.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@1:19
    Runs:07
    “It would increase our total expenditure on prescription drugs by almost 40 percent.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@1:30
    Runs:09
    “All health care expenses would go up 4 percent. That’s a large increase in our total U.S. health care expense based on one set of drugs alone.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@1:39
    Runs:08
    “Our analysis suggests that price tag should be closer to just over 4 thousand dollars a year for them to be cost-effective.”

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@1:47
    Runs:07
    “Should that not happen we would expect to see an unprecedented strain on health system budgets across the country.”

    VIDEO
    Dr. Kazi on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The P-C-S-K-9 inhibitors would also help a small portion of patients who are unable to take statins to lower their bad cholesterol.

  • August 09, 2016

    Device Reduces Risk of Brain Injury After Heart Valve Replacement

    Device Reduces Risk of Brain Injury After Heart Valve Replacement

    INTRO: Patients who need a heart valve replacement but are too ill for major surgery sometimes undergo a less invasive procedure that uses a catheter to replace their damaged valve. As a complication of the procedure, up to 10 percent of these patients experience a stroke. A new study looked at whether or not a filter device inserted into the blood vessels can help protect the brain from stroke by removing debris that is dislodged during the procedure. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of TAVI procedure

    AUDIO
    VO
    A procedure is underway to replace this patient’s diseased heart valve. It’s called trans-catheter aortic valve implantation or “TAVI.” Instead of open heart surgery, doctors use a catheter to implant a new valve inside the old one. During this process, tissue and plaque in the blood vessels can become loose, traveling through the bloodstream to the brain.

    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@:19
    Runs:08
    “Because of the material you have neurologic injuries, like little strokes or little cerebral infarcts.”

    VIDEO
    B-ROLL
    Preparing catheter with filters in solution

    AUDIO
    VO
    A cerebral protection device is a type of filter that is placed by catheter, directly into the vessels that supply the brain.

    AUDIO
    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@:34
    Runs:17
    “By using the filter we are trying to capture this material and protect the brain. The device is designed to save brain tissue that would otherwise be killed by particles that occlude little vessels that supply the brain with blood and oxygen.”

    (Video covering 2nd part of bite: catheters inside heart on screen)

    VIDEO
    B-ROLL
    Dr. Linke sitting at his desk, procedure, heart monitor, filter being prepared, patient undergoing MRI, procedure

    AUDIO
    VO
    Dr. Axel Linke (Lin-keh) from the University of Leipzig Heart Center, In Germany and co-authors studied 100 patients with an average age of 80 who underwent the “TAVI” procedure. Half the patients received the filter device. The other half did not. They also underwent an M-R-I of the brain before and again at two and seven days after the procedure.

    AUDIO
    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@1:09
    Runs:11
    “By using the filter device, the number of lesions in the brain was reduced by 50 percent and the volume was reduced by 50 percent as well.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@1:24
    Runs:22
    “You’re reducing the number of lesions, which means the number of holes in the brain, and you’re reducing the amount of dead tissue in the brain. You have more functional neurons and more alive brain tissue present as compared to somebody without the embolic protection.”

    (Video covering last part bite: pan of procedure)

    VIDEO
    B-ROLL
    Patient undergoing procedure

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Larger studies are needed to prove whether this device can also result in better neurological and cognitive outcomes in patients.

  • August 01, 2016

    Eating More Plant Protein Associated with Lower Risk of Death

    Eating More Plant Protein Associated with Lower Risk of Death

    INTRO Understanding what kinds of food provide the best health outcomes is an important area of research. In particular, the types of protein we eat, both animal and plant-based, can have long-term effects on overall health. A new study examined how diets heavy in either animal or plant-based protein sources can influence mortality. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Various shots of different foods AUDIO
    VO
    Figuring out the components of a balanced diet can often mean endless choices. Both animal and plant based proteins are part of those choices.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:07 Runs:05
    “Someone’s protein intake is potentially associated with long-term health outcomes and mortality.”

    AUDIO SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@:13 Runs:11
    “People should not only care about how much protein they consume, but also pay attention to what kind of food they consume to gather the protein.”

    VIDEO
    B-ROLL Dr. Song and Dr. Chan walking down hallway, sitting at desk talking, shot of fish, olives, people walking outside, various other shots of food, including sandwiche

    AUDIO
    VO
    Doctors Mingyang Song and Andrew Chan from Massachusetts General Hospital and co-authors examined how animal and plant based protein sources influence long-term health. They looked at more than 131 thousand adults participating in two long-running, national health studies. Participants provided 25 to 30 years of detailed information on diet, lifestyle, and medical conditions. Researchers reviewed detailed food questionnaires that were sent to the participants every four years.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:49 Runs:10
    “Individuals that consumed the highest amounts of animal based proteins had a somewhat higher risk of mortality, in particular, cardiovascular mortality.” AUDIO SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@1:00 Runs:07
    “And this association is stronger among people with unhealthy lifestyle factors.”
    VIDEO
    B-ROLL Man with cigarette, beer and wine, overweight people

    AUDIO
    VO
    Those with a healthier lifestyle did not see an increase in their risk of dying.

    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    VO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@1:29 Runs:11
    “When we look at animal protein versus plant protein, we found that replacement of animal protein with plant protein is associated with substantial reduction of mortality.”

    AUDIO SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@1:46 Runs:11 “Clearly over the long-term a diet which is comprised of primarily plant-based proteins tends to be more favorable for longevity than someone who consumes most of their protein from animal sources.” (Video covering 2nd half of bite: various foods)

    VIDEO
    B-ROLL Dr. Chan on camera
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say previous studies have only looked at the amount of protein intake, not the type of protein sources consumed.

  • July 25, 2016

    Unintentional Marijuana Exposure Increases among Colorado Children

    Unintentional Marijuana Exposure Increases among Colorado Children

    INTRO: As of 2015, four U-S states, including Colorado, have legalized recreational marijuana. The drug is available in various forms, including cigarettes and edibles like candy and baked goods. These products are sometimes unintentionally ingested by children. A new study evaluated these unintentional marijuana exposures among young children in Colorado. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Pics of sour gummies, chocolate chip cookie, brownie, marijuana AUDIO
    VO
    Sour gummies, this chocolate chip cookie and this brownie may look like regular candy and baked goods, but they aren’t. They are made with marijuana.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:08 Runs:08
    “And so they would look highly attractive and taste just like any other food that a child would like to get into.”

    VIDEO
    B-ROLL Dr. Wang walking in the emergency department, looking at papers in nurses station, walking into exam bay, park, various children in park
    AUDIO
    VO
    Dr. G. Sam Wang (Wong) from Children’s Hospital Colorado and co-authors evaluated the number of children seen for unintentional exposure to marijuana from 2009 thru 20-15, before and after recreational use became legal in the state. They identified children from zero to nine years old coming to the Children’s Hospital and also reviewed calls to the regional poison center.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:37 Runs:18
    “Between 2009 through 20-15, we saw a pretty big jump in kids annually coming here for marijuana exposures. There was one in 2009 and there was 16 in 2015. Calls to the poison center for marijuana exposures in the same age group increased from nine to 47.”

    GXF FULL
    JAMA PEDIATRICS LOGO

    AUDIO
    VO
    The study appears in JAMA, Pediatric.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:57 Runs:09
    “The majority of these kids got into marijuana by route of ingestion, meaning they ate a marijuana product, and a large percentage of them were actually edible products.”
    VIDEO
    B-ROLL Little girl walking in the park

    AUDIO
    VO
    Their average age: just over 2 years old.
    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@1:09 Runs:12
    “Most kids who became symptomatic had some sort of degree of sleepiness. We’ve had children who’ve become comatose had such difficulty breathing that they actually needed a breathing tube to help them breathe.”

    (Video covering middle of bite: Emergency room sign on building, insides exam room)

    VIDEO
    B-ROLL Dr. Wang talking with hospital colleague, various shots of edible marijuana products

    AUDIO
    VO Dr. Wang (Wong) says it’s important to keep marijuana edibles in their original child-resistant packaging and store them safely and out of reach.

    AUDIO
    G. Sam Wang, M.D., – Children’s Hospital Colorado Super@1:28 Runs:14
    “As more states decide to legalize marijuana we have to make sure the public health impact gets evaluated and we have to continue surveillance on how legalization of marijuana does impact the pediatric population.”

    (Video covering middle of bite: pan of marijuana canisters. Video covering end of bite: children in park) VIDEO
    B-ROLL Children in park AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say in the overwhelming majority of cases, the marijuana was found in the child’s home.

  • July 18, 2016

    Bariatric Surgery Can Improve Mobility and Pain for Obese Teens

    Bariatric Surgery Can Improve Mobility and Pain for Obese Teens

    INTRO: Many adults who undergo bariatric surgery not only lose weight, but they also see improvements in muscle and joint pain and the ability to walk around. What about teenagers that undergo these procedures? A new study followed a group of teens that had bariatric surgery to see whether the procedure also helped decrease pain and improve mobility. Catherine Dolf explains in this week’s JAMA Report.
    VIDEO
    B-ROLL Girl looking over a fence, young girl walking in the park, elevator door closing, going up flight of stairs
    AUDIO
    For most teenagers, worrying about things is a normal part of growing up. But teens who are severely obese may worry about being able to walk around and keep up with their friends, or even whether a building has an elevator so they don’t have to climb several flights of stairs.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@:15 Runs:04
    “And what this can do is really decrease the quality of life for these individuals.”

    AUDIO
    SOT/FULL Justin R. Ryder, Ph.D., – University of Minnesota Medical School Super@:19 Runs:12
    “Bariatric surgery is a viable treatment option for youth with severe obesity. But with that comes risks but also comes substantial benefits.”

    VIDEO
    B-ROLL Dr. Ryder and Dr. Kelly walking down hallway, various shots of bariatric surgery, teens walking down the street

    AUDIO
    Doctors Justin Ryder and Aaron Kelly from the University of Minnesota School of Medicine and co-authors are tracking long-term outcomes for 242 teens that underwent bariatric surgery at 5 centers around the U-S. Surgery like this one, performed by Dr. Thomas Inge at the Cincinnati Children’s Hospital. The current study includes 206 of these teenagers and focuses on improvements in mobility and joint pain. All patients participated in a quarter mile walk test before and after surgery.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@:57 Ends:14
    “We figured from the outset that bariatric surgery, because of the magnitude of weight-loss that accompanies it, that these teenagers would be able to walk further and have less pain but we were surprised about just how much that improved.”
    AUDIO
    GXF FULL
    JAMA PEDIATRICS LOGO

    AUDIO
    VO
    The study appears in JAMA, Pediatric.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@1:14 Ends:07
    “They were able to walk this distance faster and with a lower heart rate, indicating that their fitness levels improved.”
    AUDIO
    SOT/FULL Justin R. Ryder, Ph.D., – University of Minnesota School of Medicine Super@1:21 Runs:08
    “They were about 30 seconds faster at six months and those benefits were sustained up to two years post-surgery.”

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota School of Medicine Super@1:29 Runs:13
    “In addition, they were able to do it relatively pain free compared to before they had the surgery. Many of them will be more likely to engage in physical activity and exercise over time, which we think will give them a better shot of keeping the weight off in the long-term.” (Video covering end of bite: girl walking)
    VIDEO
    B-ROLL Girl walking AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Teenagers participating in the study were at least 13 but less than 19 years old.

  • July 11, 2016

    Increased Risk for Chronic Opioid Use After Surgery

    Increased Risk for Chronic Opioid Use After Surgery

    “Increased Risk for Chronic Opioid Use After Surgery”

    INTRO: Chronic use of prescription pain medications known as opioids is increasing in the United States. Many patients who have not previously taken this type of medication are prescribed these drugs to help manage pain after surgery. A new study examined whether these patients are also at an increased risk for using opioids long-term. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Wide shot of surgery
    AUDIO
    VO
    Each day, thousands of surgeries are performed across the United States.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:04 Runs:06
    “It’s pretty normal to get a pain killer after you, after you go home from your surgery and during your surgery.”

    VIDEO
    B-ROLL Various shots of medication, Dr. Sun walking down steps, various shots of Dr. Sun sitting at desk looking at computer, surgery shots

    AUDIO
    VO What’s not normal is to still be taking those pain medications many months after surgery. Dr. Eric Sun and his colleagues at the Stanford University School of Medicine reviewed the records of more than 641 thousand patients who were not taking pain medication during the year prior to surgery. they had one of 11 common operations, including joint replacements, gall bladder removal, and C-sections, during a 12-year-period.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:32 Runs:15 “We wanted to see at the year out after their surgery, were they at increased risk of using opioids chronically compared to patients who didn’t get surgery. Some opioid use is to be expected shortly after surgery, so we did exclude the first 90 days following their surgery.”

    VIDEO
    B-ROLL Various shots of pharmacy and medication

    AUDIO
    Chronic use was defined as filling at least 10 prescriptions, or more than 120 days worth of opioids, during the first year after surgery.

    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    VO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:57 Runs:15
    “Patients who didn’t use opioid prior to surgery were at an increased risk for chronic opioid use following their surgery. The risks range from about one and a half to five times depending on the surgery. Overall, the risk is pretty low, it was about less than one percent for most of the surgeries we looked at.”
    VIDEO
    B-ROLL Various shots of opioid medications

    AUDIO
    VO
    Men and older patients were at an increased risk of chronic opioid use along with patients with a history of certain medical conditions.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@ 1:19 Runs:10
    “Patients who use benzodiazepines, that’s a fairly common drug people use for anxieties and also patients with a history of drug abuse and alcohol abuse are at high risk for chronic opioid use following their surgery.” VIDEO
    B-ROLL Various shots of surgery

    AUDIO
    VO
    Dr. Sun says physicians should be aware of this risk even though the overall risk is small.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@ 1:38 Runs:10
    “Physicians should closely monitor their surgical patients to see how much opioid they are or aren’t taking, and just be aware that they may be at high risk for using opioids chronically.”
    (Video covering end of bite: Medication on counter)

    VIDEO
    B-ROLL Medication on counter AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say more research is needed to better manage the pain patients experience after surgery.

  • July 05, 2016

    Availability of Euthanasia and Physician-Assisted Suicide Around the World

    Availability of Euthanasia and Physician-Assisted Suicide Around the World

    INTRO:Worldwide, euthanasia and physician-assisted suicide are increasingly being legalized but remain controversial. A new study examined how the public’s attitude toward the practices has changed, as well as what types of patients that are using the procedures and why. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@:02
    Runs:05
    “There’s been an increase in legalization of euthanasia and assisted suicide in developed countries.”

    VIDEO
    B-ROLL
    Graphic-Maps, Dr. Emanuel walking and in his office

    AUDIO
    VO
    Both are legal in the Netherlands, Belgium, Luxembourg, Columbia, and Canada. Switzerland, along with 5 U-S states: Oregon, Washington, Montana, Vermont, and California offer physician-assisted suicide.  Dr. Ezekiel Emanuel and his colleagues from the University of Pennsylvania reviewed all available data on these interventions from the late 1940s through 20-16.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@:26
    Runs:16
    “Public support for euthanasia and assisted suicide is quite interesting. It’s more supportive of euthanasia. It increased from 1947 to about 1990 and then plateaued and over the last few years there’s been about a five or ten percent decline in support.”

    GXF FULL
    JAMA LOGO

    VIDEO
    B-ROLL
    Graphic-Map

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association. The interventions are rare.  In the Netherlands and Belguim, less than 5 percent of all deaths are by assisted suicide or euthanasia.  In Washington and Oregon, only 3 in a thousand deaths are by assisted suicide.  However, not every case is reported so it’s impossible to tell if these are true rates.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@1:02
    Runs:14
    “70 to 75 percent of the patients who get assisted suicide or euthanasia, no matter what the country, tend to be patients with cancer. It’s people who have really sort of given up on life…or they fear the loss of autonomy and dignity.”

    VIDEO
    B-ROLL
    Graphic

    AUDIO
    VO
    They tend to be older, white, well- educated, and well insured.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@1:20
    Runs:20
    “We know these aren’t flawless procedures, we know that they have mistakes and complications, we just don’t know the exact rate and the full nature of them. Worries about widespread abuse of these practices, that people who don’t have insurance or poor people might be predominantly targeted, do not seem to be borne out by the data.”

    VIDEO
    B-ROLL
    Dr. Emanuel at his desk

    AUDIO
    VO
    Dr. Emanuel also says these practices occur whether they are legal or not.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:44
    Runs:10
    “It behooves us to actually look at the practices and try to understand how they work, how well they work, what the problems are before we rush to legalize it in a lot of other countries.”

    VIDEO
    B-ROLL
    Dr. Emanuel on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say public support for these interventions is about 65 percent but the support is much less among physicians.

  • June 28, 2016

    Rethinking Blood Pressure Control in Older Adults

    Rethinking Blood Pressure Control in Older Adults

    INTRO: Three-quarters of people who are 75 and older have high blood pressure. Having high blood pressure increases the risk of heart attack, heart failure and stroke. A new study examined what would be the best target blood pressure to reduce the risks of these complications in older adults. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Mary walking from her car into hospital

    AUDIO
    VO
    Living independently is important to Mary Powers and her husband of 63 years.

    AUDIO
    SOT/FULL
    Mary Powers – Study Participant
    Super@:04
    Runs:06
    “We’re still in our home and we have a garden, we travel a little and enjoy life.”

    VIDEO
    B-ROLL
    Mary walking into hospital, getting blood pressure checked, cu of blood pressure machine, cu of Mary

    AUDIO
    VO
    Like a lot of people in their 80s, Mary has high blood pressure.  She works with her doctor to manage the blood pressure so she can be as healthy as possible for as long as possible.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@:19
    Runs:07
    “The most common reasons that people end up losing their independence are often complications of hypertension.”

    VIDEO
    B-ROLL
    Dr. Williamson walking down hall, talking with colleague, older people walking and shopping in the community

    AUDIO
    VO
    Dr. Jeff Williamson from Wake Forest School of Medicine and co-authors released the latest results from the systolic blood pressure intervention trial also known as the “sprint” trial.  They enrolled more than 26 hundred people, 75 and older.  All participants were living in their own home and could get back and forth to the doctor. they were randomly assigned to two groups.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@:43
    Runs:18
    “We wanted to test and see whether a systolic blood pressure target of less than 120 millimeters of mercury, that’s the top number measured in the doctor’s office, was more effective than 140 at reducing the risk of stroke, heart attack, heart failure
    and death.”

    VIDEO
    B-ROLL
    Mary’s blood pressure being monitored, taking a memory test and a walking test

    AUDIO
    VO
    In addition to recording those outcomes, researchers monitored blood pressure along with memory skills, and the ability to walk a little more than 13 feet, every three to four months. The trial was scheduled to run five years.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@1:12
    Runs:15
    “After just over two years, the study was stopped by the National Institutes of Health because we found a strongly favorable result in those individuals assigned to a blood pressure treatment target of less than 120.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@1:31
    Runs:09
    “The blood pressure target of 120 systolic is much more effective than a target of 140 in reducing the complications of high blood pressure.”

    VIDEO
    B-ROLL
    Various shots of people walking in the community

    AUDIO
    VO
    Even those individuals who were somewhat frail appeared to benefit from the lower blood pressure target.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@ 1:45
    Runs:09
    “This should remove a great deal of confusion for patients and their physicians about what the blood pressure target should be for older people.”

    VIDEO
    B-ROLL
    Cu of blood pressure monitor, wide shot of Mary getting blood pressure checkeD

    AUDIO
    Mary’s blood pressure has been well controlled and she has just one word for how she feels these days.

    AUDIO
    SOT/FULL
    Mary Powers – Study Participant
    Super@1:59
    Runs:01
    “Great.”

    VIDEO
    B-ROLL
    Mary smiling on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: To achieve the lower blood pressure goal, participants required, on average, one additional medication per day.  90 percent of the medications used were generic.

  • June 15, 2016

    Updated Recommendations for Colorectal Cancer Screening in Adults

    Updated Recommendations for Colorectal Cancer Screening in Adults

    INTRO: Colorectal cancer is the second leading cause of cancer death in the United States. Screening can accurately detect early stage colorectal cancer and precancerous polyps. The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services, including cancer screening. The Task Force has just issued updated recommendations on colorectal cancer screening for adults. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    VO
    In the United States this year, an estimated 134 thousand people will be diagnosed with colorectal cancer and about 49 thousand will die from the disease.

    VIDEO
    B-ROLL
    Various shots of people down the street

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:09
    Runs:05
    “Most colorectal cancer occurs after people are 50 and the rates go up as you get older.”

    VIDEO
    B-ROLL
    Dr. Owens walking outside, sitting at desk looking at graphs on a computer, colonoscopy screening

    AUDIO
    VO
    Dr. Douglas Owens, an author of the recommendation and a former member of the U-S Preventive Services Task Force, says the group strongly recommends screening average risk adults age 50 to 75 for colorectal cancer, and then making individual screening decisions for adults age 76 to 85, taking into account the patient’s overall health and screening history.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:32
    Runs:06
    “There are a number of ways to be screened for colorectal cancer and the good news is, is that they are effective.”

    VIDEO
    B-ROLL
    Patient undergoing colonoscopy, technician working in lab

    AUDIO
    VO
    Those include direct visualization tests like a colonoscopy and also stool based tests.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:44
    Runs:04
    “The important thing is that you choose one and be screened.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The new Task Force recommendations appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:51
    Ends:18
    “For people 76 to 85, the benefits of screening are smaller but some people may still benefit. People who’ve never been screened before and who are healthy enough to undergo treatment for colorectal cancer, should it be diagnosed, and who don’t have other conditions that would limit their life expectancy.”

    VIDEO
    B-ROLL
    People walking on the street

    AUDIO
    VO
    The decision to screen for colorectal cancer in this older age group should be individualized and take that patient’s overall health into account.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@1:16
    Ends:09
    “About a third of people in the United States who should be getting screening for colorectal cancer are not being screened currently, and that’s an important missed opportunity.”

    VIDEO
    B-ROLL
    Dr. Owens on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The Task Force does not have a recommendation for screening after age 85.

  • June 07, 2016

    U-S Obesity Rates Increase In Women, Stay Stable In Men

    U-S Obesity Rates Increase In Women, Stay Stable In Men

    INTRO: Obesity rates in the United States have increased, especially during the 1980s and 90s.  In the decade after, those rates appeared to have stabilized but what about now? A new study examined the latest trends in obesity rates among men and women in the U-S. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:01
    Runs:07
    “It’s really important to monitor trends in obesity and extreme obesity in the United States because obesity has an impact on our health.”

    VIDEO
    B-ROLL
    Overweight men and women walking on the street, Dr. Ogden walking outside, Dr. Ogden walking with colleague, various shots of Dr. Ogden at working at her desk

    AUDIO
    VO
    Obesity is closely linked to several health problems including diabetes, hypertension and heart disease. Dr. Cynthia Ogden and her colleagues from the National Center for Health Statistics examined trends in obesity among U-S adults from 2005 to 2014. They used data provided by the long-running National Health and Nutrition Examination Survey or N-HANES.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:26
    Runs:13
    “We were able to measure weight and height which are used to calculate BMI. Obesity is actually a BMI at or about 30. Class 3 obesity is a BMI above 40 and that’s sometimes also called extreme obesity.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    VIDEO
    B-ROLL
    Various shots of overweight people walking

    AUDIO
    VO
    To examine trends over the decade, the researchers looked at a nationally representative sample of more than 13 thousand men and 13 thousand women.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:51
    Runs:19
    “We saw that there had been no change in men in either obesity or extreme obesity but there had been an increase in women in both obesity and extreme obesity and when we adjusted for potential contributors of obesity by age, race, Hispanic origin, education and smoking status that didn’t change the results.”

    (Video covering end of bite: man walking into building)

    VIDEO
    B-ROLL
    Various shots of overweight men and women walking on the street

    AUDIO
    VO
    They also examined data from 26 hundred men and 28 hundred women in the most recent survey period, two thousand 13 thru two thousand 14.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@ 1:18
    Runs:12
    “The prevalence of obesity among men was about 35 percent and among women was about 40 percent and the prevalence of extreme obesity was 5 and a half percent in men and almost 10 percent in women.”

    VIDEO
    B-ROLL
    Graphic:
    Obesity Rates
    Asian Men
    Age 20 to 39

    AUDIO
    VO
    They also saw obesity rates increase among Asian men, age 20 to 39.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@1:35
    Runs:08
    “The prevalence was about 23 percent and that compares to about 6 percent in middle aged Asian men and 4 percent in older Asian men.”

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Black and Hispanic women continue to have a higher prevalence of obesity compared to non-Hispanic white women.

  • May 24, 2016

    Rates of Obesity and Diabetes Lower In More Walkable Neighborhoods

    Rates of Obesity and Diabetes Lower In More Walkable Neighborhoods

    INTRO: Despite public health efforts to reduce obesity through diet and exercise, the rates of overweight, obesity and diabetes continue to rise. A new study from Ontario, Canada examined whether living in more walkable neighborhoods is associated with a slower increase in rates of obesity-related diseases compared to less walkable neighborhoods. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of people walking in the city

    AUDIO
    VO
    Neighborhoods that are more walkable tend to be more densely populated.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:03
    Runs:07
    “And they tend to be zoned so that there’s retail and other services within the neighborhood. So there’s more places people can reach on foot.”

    VIDEO
    B-ROLL
    Various shots of cars driving

    AUDIO
    VO
    In less walkable suburban neighborhoods, stores and services are harder to reach on foot.  People usually have to drive to get places.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:17
    Runs:10
    “It seems that neighborhoods that are more walkable and are designed to make it easier to walk may actually help people to be more physically active.”

    VIDEO
    B-ROLL
    Dr. Booth walking down hospital hallway, sitting and working at her desk, people walking down the street, driving shots of neighborhood from car, people walking

    AUDIO
    VO
    Dr. Gillian Booth from St. Michael’s Hospital and co-authors studied almost 9000 neighborhoods in southern Ontario looking at walkability scores, along with government health data and survey results during a 12-year period.  They examined whether rates of overweight, obesity, and new cases of diabetes were rising more slowly in neighborhoods that were easier to walk in.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:46
    Runs:16
    “Rates of overweight and obesity were much lower in the most walkable neighborhoods compared to less walkable ones and were actually stable over time in the most walkable neighborhoods, whereas they were continuing to increase in less walkable areas.”

    (Video covering middle of bite: people walking on the street)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@1:05
    Runs:11
    “Rates of diabetes were actually going down, and then least in terms of the number of new cases in the most walkable areas, whereas rates were not falling in less walkable areas.”

    VIDEO
    B-ROLL
    Various shots of people walking, riding bikes and buses going down street

    AUDIO
    VO
    Neighborhoods with lower rates of obesity and diabetes also had higher rates of walking, biking and mass transit use.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@ 1:23
    Runs:16
    “It doesn’t mean that if we build neighborhoods differently that rates of overweight and obesity will fall, but it’s certainly hopeful and it gives us more information and some potential solutions that we can test in the future.”

    VIDEO
    B-ROLL
    People walking on the street

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say that the number of car trips per capita was also lower in more walkable neighborhoods.

  • May 17, 2016

    Surrogate Decision Makers for Critically Ill Patients Often Have Overly Optimistic Expectations

    Surrogate Decision Makers for Critically Ill Patients Often Have Overly Optimistic Expectations

    INTRO:When critically ill patients are unable to speak for themselves, a family member or close friend is often asked to serve as a surrogate decision maker.  Sometimes these surrogates and physicians have different expectations about a patient’s prognosis. A new study examined how often this happens and why it happens. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Graphic: Pictures of Mary Ann

    AUDIO
    VO
    Mary Ann Flati was a loving mother and grandmother.

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@:05
    Runs:10
    “My mom was, the kind of mom the whole world needs. She was very loving and she did everything she could for us and for her friends.”

    VIDEO
    B-ROLL
    Graphic: Pictures of Mary Ann

    AUDIO
    VO
    Before she died, Mary Ann spent 15 days in the I-C-U after a serious autoimmune disease affected her lungs.

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@:19
    Runs:08
    “The actions were a little of hope, of trying things, but it seemed contradictory with seeing her on a ventilator.”

    VIDEO
    B-ROLL
    Cara walking down hallway

    AUDIO
    VO
    Mary Ann’s daughter was one of her surrogate decision makers.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@:31
    Runs:07
    “We set out to understand how often physicians and surrogates in ICUs have different expectations about the patient’s prognosis.”

    VIDEO
    B-ROLL
    Dr. White walking with colleague, standing with colleagues talking, various shots of patient in the ICU

    AUDIO
    VO
    Dr. Douglas White from the University of Pittsburgh Medical Center and co-authors enrolled 99 physicians and 229 surrogates who made decisions for 174 critically ill patients in 4 I-C-U’s at a major medical center. They were interested in discordance, defined as at least a 20 percent difference between the physician’s and surrogate’s expectations about a patient’s prognosis.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super:59
    Runs:12
    “In roughly half the cases surrogates had substantially more optimistic expectations about prognosis compared to the physicians and that the physician’s estimates were much more accurate than the surrogate’s.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@1:15
    Runs:13
    “In almost all cases, surrogates misunderstood physician’s prognostic expectations. In about half of cases, surrogates held systematically different beliefs about the prognosis compared to what they heard from the physicians.”

    (Video covering middle of bite: patient in ICU)

    VIDEO
    B-ROLL
    Graphic over video of ICU patient
    COMMON SURROGATE BELIEFS
    -MAINTAINING HOPE
    -RELIGIOUS BELIEFS
    -UNIQUE STRENGTHS

    AUDIO
    VO
    Those beliefs most commonly included the need to maintain hope in order to improve the patient’s outcome, religious beliefs and a belief that the patient had unique strengths, unknown to the physician that would make the prognosis better.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@1:40
    Runs:16
    “Sometimes clinicians think that all they need to do is to communicate clearly about the patient’s prognosis. They may need to explore family members’ and surrogates’ beliefs about prognosis rather than merely conceptualizing their role as conveying the information clearly.”

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@ 2:01
    Runs:11
    “Knowing what I know now, I think I would have asked to just have an honest conversation. This is what I am feeling and how does that square with what your understanding is as a medical team.”

    (Video covering 1st part of bite: Cara looking out window)

    VIDEO
    B-ROLL
    Picture of Mary Ann with her grandchildren

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say that when surrogates have overly optimistic expectations about a prognosis, they tend to choose more aggressive, invasive treatment than they would if they had more accurate expectations.

  • May 09, 2016

    Lowering Prescription Drug Costs Using Similar, Cheaper Alternatives

    Lowering Prescription Drug Costs Using Similar, Cheaper Alternatives

    INTRO:The United States spends more per capita on health care and prescription drugs than any other country. Using generic instead of brand name medications is one way to decrease costs. A new study examined whether therapeutic substitution, another way to lower drugs costs, could also save money on prescription medications. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL Various shots of a pharmacy
    AUDIO
    VO
    This pharmacy is filled with thousands of different medications. some are brand name, some are generic and some can be used in a process known as therapeutic substitution.
    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@:08 Runs:15
    “This is theoretically different than generic drugs. Generic drug substitution is substitution of the exact same drug. Therapeutic substitution is the use of a similar but not the same drug within a drug class.” (Video covering middle of bite: pharmacist counting pills)
    VIDEO
    B-ROLL Dr. Johansen walking down hallway, various shots of Dr. Johansen talking with person in pharmacy and holding pill bottles
    AUDIO
    VO
    Dr. Michael Johansen from The Ohio State University along with his colleague reviewed the records of more than 107 thousand patients between 2010 and 2012. They looked at prescription drug use and estimated how much money could be saved using therapeutic substitution.
    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@:39 Runs:18 “There were 26 included drug classes that spanned cardiovascular health, mental health, allergies, urology and many other aspects of medicine. 62 percent of people in the United States used prescription drugs. Around one third of people took a drug from the included classes.”
    (Video covering middle part of bite: Dr. Johansen looking at medications, pan of pharmacy)
    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    The study appears in JAMA Internal Medicine.

    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super1:00 Runs:19
    “In total 73 billion dollars over three years or nearly one out of every 10 dollars spent on prescription drugs could have been saved with therapeutic substitution. Importantly, the consumer paid just over one third or 24.6 billion dollars of the total 73 billion that could have been saved.”

    (Video covering middle of bite: pharmacist preparing prescription)
    VIDEO
    B-ROLL Various shots of Dr. Johansen handling and pouring out medications

    AUDIO
    VO
    Dr. Johansen says that therapeutic substitution is somewhat controversial because it could impede decisions about medications that are made between doctors and patients.

    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@1:29 Runs:17
    “There is tremendous potential savings from undertaking of therapeutic substitution on a large scale. However, therapeutic substitution is controversial, it needs to be done in a respectful manner of patients health because that’s really what we’re here for is to try to make patients healthier.”

    (Video covering middle of bite: Dr. Johansen looking at medications) VIDEO
    B-ROLL Pharmacists working
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the number of drug classes that could be included in therapeutic substitution is wide ranging.

  • May 04, 2016

    Better Telephone C-P-R Instruction Improves Outcomes after Cardiac Arrest

    Better Telephone C-P-R Instruction Improves Outcomes after Cardiac Arrest

    INTRO:When a cardiac arrest occurs outside the hospital, it’s important for bystanders to perform effective C-P-R as soon as possible, but that doesn’t always happen. A new study examined whether providing C-P-R instruction over the phone with help from trained 9-1-1 dispatchers would improve survival rates for people who experience cardiac arrest. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pics of Dr. Gailey and his dental staff
    AUDIO
    VO
    Dentist Tim Gailey began his day like any other…seeing patients.

    AUDIO
    SOT/FULL
    Tim Gailey, D.M.D., – Cardiac Arrest Survivor
    Super@:03
    Runs:04
    “I sat down, that was the last thing I remembered, I just collapsed.”

    VIDEO
    B-ROLL
    Dr. Gailey and Valerie talking outside, various shots of 911 dispatcher

    AUDIO
    VO
    Dr. Gailey experienced a cardiac arrest. With the 9-1-1 dispatcher on the phone, his staff began C-P-R.

    AUDIO
    SOT/FULL
    Valerie Ruiz – Performed CPR
    Super@:10
    Runs:04
    “I’m so grateful that you know I had 911 and someone helping direct me.”

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super:18
    Runs:10
    “People don’t always think about 911 dispatchers as the first medical responders, but they really are. It turns out that they really have this enormous, life-saving potential.”

    AUDIO
    NATSO/FULL
    Runs:01
    “…are the paramedics there…”

    B-ROLL
    911 dispatcher on the phone, cu of Dr. Bobrow talking to dispatcher, another dispatcher on the phone, cu of keyboard, people performing CPR on dummies, cu of hands doing CPR

    AUDIO
    VO
    Many 9-1-1 dispatchers already offer C-P-R instruction over the phone. But Dr. Ben Bobrow (Bob-roe) from the Arizona Department of Health Services and co-authors provided additional training to 9-1-1 disptachers in two regional centers in the Phoenix metropolitan area. The dispatchers were trained to be more confident and assertive with rescuers on the phone. They measured outcomes from more than 23-hundred out of hospital cardiac arrests during a three-year period.

    AUDIO
    VOICE OF:
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super@:52
    Runs:12
    “Training them to say you need to do chest compressions, I’m going to help you, let’s start. We’ve actually found that subtle thing is very important in motivating lay rescuers.”

    AUDIO
    SOT/FULL
    Hannah Roether – 911 Dispatcher
    Super@1:09
    Runs:07
    “We have to use a very strict tone of voice to kind of get them to listen to us and pull all that chaoticness away from them.”

    (Video covering 1st part of bite: Hannah talking on phone)

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super@1:14
    Runs:11
    “Our dispatchers did well. They gave telephone CPR instructions significantly more often. They got first chest compressions started much sooner.”

    (Video covering 1st part of bite: Dr. Bobrow talking to dispatchers)

    GXF FULL
    JAMA CARDIOLOGY LOGO

    AUDIO
    VO
    The study appears in JAMA Cardiology.

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., Arizona Department of Health Services
    Super@:1:24
    Runs:21
    “We found a 32 percent relative increase in the proportion of patients that survived to hospital discharge, so they went home from the hospital and remarkably a 43 percent relative increase in functional outcome, which means patients that actually went back home in good shape.”

    VIDEO
    B-ROLL
    Dr. Gailey and Valerie walking

    AUDIO
    VO
    That’s exactly what happened to Dr. Gailey, a husband and father of 13. Thanks to everyone working together, he survived.

    AUDIO
    SOT/FULL
    Valerie Ruiz – Performed CPR
    Super@1:52
    Runs:07
    “I was just praying that he would be okay, thinking about his children and I would do the right things that he needed.”

    (Video covering 2nd part of bite: picture of his children)

    AUDIO
    SOT/FULL
    Tim Gailey, D.M.D., – Cardiac Arrest Survivor
    Super@2:00
    Runs:08
    “I just remember giving them hugs and crying and telling them how grateful I was that they saved my life and how grateful my family was to them for saving me.”

    (Video covering 2nd half of bite: Picture of Dr. Gailey and his family)

    VIDEO
    B-ROLL
    Pic of Dr. Gailey and his family

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Bystander C-P-R has been shown to double or even triple survival from out of hospital cardiac arrest.

  • April 26, 2016

    Rotating Night Shift Work and the Risk of Heart Disease in Women

    Rotating Night Shift Work and the Risk of Heart Disease in Women

    INTRO: An estimated 15 million Americans do some kind of rotating shift work, including overnights, evenings and early morning shifts. But can this type of shift work increase the risk of coronary heart disease? A new study examined the link between rotating night shift work and heart disease in a group of female nurses. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various night time outside shots, hospital workers walking at night

    AUDIO
    VO
    At night, when most of us are heading to bed, many health care workers, including nurses, are just beginning their work day. But does working these rotating shifts take a toll on their health?

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super:09
    Runs:07
    “The link between shift work and coronary heart disease has been an open question for several decades now.”

    VIDEO
    B-ROLL
    Dr. Vetter and colleague walking down hall, Dr. Vetter looking at computer, nurse working, gurney rolling by, outside of hospital

    AUDIO
    VO
    Dr. Céline Vetter from Brigham and Women’s Hospital and co-authors examined that link. Tthey used data from the long running Nurses Health Study ONE and TWO, which has followed 240 thousand female nurses over a 24 year period. The researchers specifically looked at 189 thousand women who reported their lifetime exposure to rotating night shift work.

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@:36
    Runs:09
    “Over the course of the study period a little more than 10 thousand cases of newly developed coronary heart disease occurred.”

    GXF FULL
    JAMA LOGO

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@:48
    Runs:24
    “Rotating night shift work is associated with modest risk of coronary heart disease even after taking into account known risk factors such as elevated BMI, smoking, poor diet quality and low levels of physical activity. Once you stop working shifts, the time since quitting shift work is associated with a decreased risk.”

    (Video covering middle of bite: nurse walking into exam room, various shots of heart monitors, nurse pushing hospital bed)

    VIDEO
    B-ROLL
    Nurses walking in hospital hallways

    AUDIO
    VO
    Rotating shift work was defined as working at least three night shifts per month in addition to morning and evening shifts.

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@1:19
    Runs:22
    “Even though the absolute risks we observed were small and the contribution of shift work to coronary heart disease is modest, there is an opportunity to help and prevent coronary heart disease by trying to find out which are the characteristics of shift schedules that may carry the highest risk.”

    (Video covering middle of bite: heart monitor)

    VIDEO
    B-ROLL
    Nurse walking outside

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:the Study authors call for further studies to determine those characteristics.

  • April 19, 2016

    New Treatment for Melanoma Targets the Immune System

    New Treatment for Melanoma Targets the Immune System

    INTRO:Melanoma is a type of cancer that develops from pigment-containing cells, most commonly from the skin. If diagnosed early, many patients can be cured with surgery.  However if melanoma spreads through the body, the prognosis for long-term survival is poor.  A new way of treating advanced melanoma allows a patient’s immune system to fight the tumor without the need for chemotherapy or radiation. In a new study researchers examined the response to this type of therapy. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Tom walking into office

    AUDIO
    VO
    When Tom Stutz was diagnosed with melanoma about 5 years ago, it had spread to several of his organs.

    AUDIO
    SOT/FULL
    Tom Stutz – Melanoma Patient
    Super:05
    Runs:09
    “I was whipped to be honest with you and I thought that was pretty much the end of the line for me.”

    VIDEO
    B-ROLL
    Tom checking in for treatment, Graphic

    AUDIO
    VO
    Tom enrolled in a clinical trial, receiving a new type of immunotherapy called pem-bro-liz-u-mab, an antibody that blocks a protein called P-D-1. These proteins prevent the body’s immune system from attacking the cancer.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super:25
    Runs:11
    “With pembrolizumab what we’re trying to do is to redirect that immune response to fight the cancer. Pembrolizumab binds to PD-1 and then the immune system cells attack the cancer.”

    VIDEO
    Dr. Ribas and colleague walking, Tom receiving his treatment, cu of Tom’s arm, various shots of medication

    AUDIO
    VO
    Dr. Antoni Ribas from the University of California-Los Angeles and co-authors tested this drug on more than 650 patients. The trial was conducted at U-C-L-A and other sites in North America, Europe and Australia. Early in the study, several patients showed a clinical response to pembrolizumab, which later received “break through” therapy status from the Food and Drug Administration.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@:55
    Runs:10
    “When we compared the baseline tumors to the tumors after dosing, the metastases or the lesions around the body were smaller in one third of the patients.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@1:10
    Runs:10
    “The patients who responded, the great majority, continued to respond at one or two years, 75 percent of them maintained the response.”

    VIDEO
    B-ROLL
    Tom receiving treatment

    AUDIO
    VO
    The drug was well tolerated in the majority of patients.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@1:22
    Runs:22
    “The median survival of the 655 patients was 23 months, which by all practical means is much better than we would have expected in a group of patients like these. With this new generation of immunotherapies we’re now having a sizable number of patients who have a response to the therapy and are going on to live normal lives, three or four years later.”

    (Video covering middle of bite: Dr. Ribas looking at scans)

    VIDEO
    B-ROLL
    Tom walking outside

    AUDIO
    That’s exactly what happened for tom, who continues to receive the therapy.

    AUDIO
    SOT/FULL
    Tom Stutz – Melanoma Patient
    Super1:48
    Runs:10
    “I’ve been to family events, I’ve gone on vacations with my kids, I’m feeling great, so what can I say, no complaints.” (Hold for laugh)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:4 PERCENT OF PATIENTS HAD TO STOP THE THERAPY BECAUSE OF SIDE EFFECTS.

  • April 12, 2016

    Better Air Quality Decreases Respiratory Symptoms in Children

    Better Air Quality Decreases Respiratory Symptoms in Children

    INTRO: Air pollution is associated with chronic health problems in children, like bronchitis and asthma. In southern California, air pollution levels have been decreasing over the past 20 years. A new study examined whether those reductions have helped to improve respiratory symptoms in the state’s children. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Plane flying, trains on track, cars on freeway, skyline of Los Angeles

    AUDIO
    VO
    Planes, trains, and automobiles are ever present in southern California. They all contribute to what’s called ambient air pollution.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@:10
    Runs:14
    “Ambient air pollution is particulate matter, which are microscopic particles, some of them especially the fine ones, actually deposit deep into the lung and are known to cause a lot of respiratory problems in children and humans in general.”

    VIDEO
    B-ROLL
    Dr. Berhane walking in office, various shots of children playing in park, cars on freeway, young girl with inhaler, nurse examining younger girl

    AUDIO
    VO
    Dr. Kiros Berhane (bur-rah-nee) from the University of Southern California and co-authors followed just over 46-hundred children in 8 southern California communities across 3 different time periods from 19-93 t0 2012. In addition to monitoring air quality, the researchers looked at children with and without asthma and whether they reported respiratory symptoms like bronchitis, congestion, phlegm production, or a daily cough for 3 months in a row during the previous year.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@:47
    Runs:13
    “In the children with asthma, we found at the beginning of the study, in the first cohort, almost 48 percent of them had bronchitic symptoms in the last year. Now in the children without asthma, this number was only about 11 percent.”

    AUDIO
    VO
    Air pollution levels dropped significantly during the observation period. Bronchitic symptoms were compared in three groups of children from 19-93 to 2012.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@1:08
    Runs:11
    “The prevalence of bronchitic symptoms went down by about 32 percent in those children with asthma. We also found that it went down by about 21 percent in those children without asthma.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@1:23
    Runs:16
    “These reductions were significant and important in both children with asthma and children without asthma. So all children benefitted from this reductions in air pollution. Protecting our environment really leads to better respiratory health in children.”

    (Video covering 2nd part of bite: wide shot of city)

    B-ROLL
    Wide shot of playground

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Berhane says the findings from southern California can help guide air quality efforts in other locations in the U-S and around the world.

  • April 10, 2016

    Summary Video

    Summary Video

    Income inequality is the topic of heated discussion in the United States, and now researchers have used deidentified federal income tax returns and death records to better understand if differences in income are associated with differences in life expectancy at age 40.

     

    They report that men in the top percentile of household income lived almost 15 years longer than those in the lowest, and women in the top percentile of household incomes lived about 10 years longer than those in the lowest.

     

    Women lived longer than men at any income percentile, with a 6-year advantage among the poorest 1% diminishing to a 1.5-year advantage for thee wealthiest.

     

    Despite differences at the highest and lowest percentiles, gains in life expectancy leveled off above a median household income of about $200,000.

     

    Life expectancy increased over the 14-year study period, an average of about 3 years for men and women in the top income quartile compared to an average of about 1 year for those in the bottom quartile.

     

    In an accompanying editorial, Nobel laureate Angus Deaton writes, ‘The infamous one percent is not only richer, but much healthier. Individuals in the top 100% of income have 10 to 15 more years to enjoy their richly funded lives and to spend time with their children and grandchildren, and they are pulling away from everyone else.”

     

    Where people live makes a difference.

     

    Life expectancy was 6.4 years less for the poorest men in Detroit compared to New York City, and about 5 years less for the poorest women in Detroit compared to New York City, between-city differences that largely disappeared at the highest incomes.

     

    Nevada, Indiana, and Oklahoma had the lowest life expectancies; California, New York, and Vermont had the highest.

     

    People in the top income quartile were expected to live longest in of Salt Lake City and die younger in Las Vegas, while those in the bottom income quartile were expected to live longest in New York City and die youngest in Gary Indiana.

     

    People in the top income quartile gained the most life expectancy over the study period in El Paso Tx and lost the most in Lakeland Florida, while those in the bottom quartile gained the most in Toms River NJ and lost the most in Tampa Florida.

     

    ‘It is as if the top income percentiles belong to one world, the world of the elite, wealthy US adults, whereas the bottom income percentiles each belong to separate worlds of poverty, each unhappy and unhealthy in its own way,” writes Deaton.

     

    Behavior-related variables, such as smoking, exercise, and obesity, were highly correlated with difference in life expectancy by geographic area, the researchers write,  and they suggest that lower income individuals do better in more affluent cities with highly educated populations and high levels of government expenditures, such as New York City and San Francisco.

     

    Other explanations for the observations include reverse causality,  meaning, poor health causes reduced income rather than the other way around; parental rather than personal income; and education.

     

    “The next step is to extend the analysis by including education [to] advance the understanding of factors underlying the relationship between income and life expectancy.”

  • April 05, 2016

    Pain and Physical Function Improve After Weight-Loss Surgery

    Pain and Physical Function Improve After Weight-Loss Surgery

    INTRO: Severe obesity can lead to joint pain and interfere with a person’s ability to bend, lift, carry, and even walk. Undergoing bariatric surgery helps with weight-loss, but can it also help alleviate joint pain and improve a person’s overall physical function? A new study examined whether pain levels and physical function improved for patients after weight-loss surgery. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Earl riding stationary bike

    AUDIO
    VO
    Earl McConnell had gastric bypass surgery three years ago after being diagnosed with diabetes.

    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@:05
    Runs:03
    “I did have back problems. They told me I had to lose weight.”

    VIDEO
    B-ROLL
    Earl riding stationary bike

    AUDIO
    VO
    Now, his diabetes is controlled and so is his back pain.

    AUDIO
    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@:12
    Runs:09
    “It was definitely easier to get around, easier to get up and down off the floors, playing with my grandkids, and goin’ running around, chasing them.”

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@:19
    Runs:08
    “Patients come to bariatric surgery for all sorts of reasons, some of them it may be their diabetes but for many of them it’s major health issues.”

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@:27
    Runs:11
    “Most commonly knee and hip pain that prevents people from doing walking activities and other activities. Primarily in clinical practice, what I hear are concerns with joint function.”

    VIDEO
    B-ROLL
    Dr. Courcoulas and Dr. King sitting at desk and talking, bariatric surgery, various shots of patient questionnaire, Earl doing a walking test

    AUDIO
    Doctors Anita Courcoulas and Wendy King from the University of Pittsburgh and co-authors studied more than 22 hundred bariatric surgery patients from 10 U-S hospitals over a 4-year period. Patients filled out questionnaires about their pain and physical function before surgery and each year, for three years, after surgery. patients also participated in a 400 meter walking test.

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@:58
    Runs:09    “There was 50 to 70 percent improvement in pain and physical function at the one year time point and then some continued improvements up to three years as well.”

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@1:08
    Runs:07
    “And although there is deterioration of improvement in some patients from one to three years, the majority still by three years, are much better off than they were before surgery.”

    (Video covering 1st part of bite: Earl walking)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@1:23
    Runs:19
    “With our objective walking test we also saw that about a quarter of patients still had mobility deficits post-surgery. We looked at patients who had severe pain and disability in their hips and knees, indicative of osteoarthritis and three fourths of them had improvements in their hip and knee pain and function through three years of follow-up.”

    (Video covering middle of bite: Earl walking in PT Room)

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@1:35
    Runs:09
    “This sends the message that bariatric surgical procedures may have a big impact on people’s ability to improve their physical function over time.”

    VIDEO
    B-ROLL
    Earl and physical therapist working on steps

    AUDIO
    Earl maintains his weight-loss and recently received praise from his cardiologist.

    AUDIO
    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@1:47
    Runs:08
    “It’s the first time I’ve ever seen him smile too, when I went in there after I had the gastric bypass done. I’m looking for a long and happy life and see the grandkids get married.”

    VIDEO
    Earl and therapist working on steps

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Younger patients, those with fewer depressive symptoms and a higher income pre-surgery had a greater likelihood of improvements in their pain and function levels after surgery.

  • March 22, 2016

    Alternative Mind-Body Therapies Help Improve Chronic Back Pain

    Alternative Mind-Body Therapies Help Improve Chronic Back Pain

    INTRO:Low back pain, millions of Americans live with it every day. A variety of treatments are used to treat back pain including medication, massage, manipulation and physical therapy. There are also therapies that include a mind-body component.  A new study examined whether two approaches that focus on the mind rather than directly on the body, could help improve longstanding back pain. Catherine Dolf explains in this week’s JAMA Report.

    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super:01
    Runs:09
    “One of the most important new understandings of chronic pain and chronic low back pain is that the mind plays a very important part.”

    VIDEO
    B-ROLL
    Various shots of Dr. Cherkin walking and looking at his computer, Dr. Balderson conducting a cognitive behavioral therapy class

    AUDIO
    VO
    Dr. Daniel Cherkin from Group Health Research Institute in Seattle and his co-authors studied two mind-body therapies. One is already shown to be effective for treating depression and other chronic conditions.

    AUDIO
    SOT/FULL
    Benjamin H. Balderson, Ph.D., -Group Health Research Institute
    Super@:24
    Runs:13
    “Cognitive behavioral therapy or CBT is a therapy that tries to address what are the behaviors that we do because of pain and what are the behaviors that might actually help to alleviate pain versus help to actually create or keep pain going.”

    (Video covering first part of bite: Dr. Balderson talking to group)
    VIDEO

    AUDIO
    NATSO/FULL
    Runs:04
    “…how do I gradually get back to those activities I’ve given up because of pain…”

    VIDEO
    B-ROLL
    Carolyn leading mindfulness meditation

    AUDIO
    VO
    The other, mindfulness-based stress reduction, has not been well studied.

    AUDIO
    NATSO/FULL
    Runs:08
    “…so you’re bringing an atmosphere of friendliness and kindness observing your experience just as it is…”

    AUDIO
    SOT/FULL
    Carolyn McManus, P.T., M.S., M.A., – Mindfulness and Meditation Leader
    Super@:50
    Runs:18
    “One of the things that I think mindfulness empowers people to recognize is that everything’s always in a state of change. Breathing in, I’m aware, I’m feeling this sensation, it’s uncomfortable, breathing out, I meet myself with compassion, a friendliness, an openness.”

    VIDEO
    B-ROLL
    Man rubbing his back, various shots of people participating in mindfulness meditation

    AUDIO
    342 patients between 20 and 70 years old with back pain that had lasted for at least three months, participated in 8 weekly, 2-hour sessions of either mindfulness or cognitive therapy. A third group received usual care. Outcomes were assessed at 6 months and one year.

    AUDIO
    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super@1:25
    Runs:13
    “Cognitive behavioral therapy and mindfulness based stress reduction led to an increased likelihood of having clinically meaningful improvement in back pain than those who were only receiving usual care.”

    (Video covering 2nd part of bite: Dr. Balderson talking to group)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    VO
    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super@1:42
    Runs:10
    “Benefits in decreased pain and improved function lasted for a full year, which is not common amongst treatment for chronic pain.”

    AUDIO
    SOT/FULL
    Benjamin H. Balderson, Ph.D., -Group Health Research Institute
    Super@1:51
    Runs:04
    “It’s something they can add to their tool box for things that they do in different various times.”

    AUDIO
    SOT/FULL
    Carolyn McManus, P.T., M.S., M.A., – Mindfulness and Meditation Leader
    Super@1:57
    Runs:12
    “It empowers people with the skills to make choices and changes that enhance their well-being, reduce their pain and increase their function.”

    (Video covering 2nd part of bite: people mediating)

    VIDEO
    B-ROLL
    People meditating

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:These mind-body interventions can also be used in addition to traditional therapies.

  • March 15, 2016

    The Role of Vaccine Refusal in Recent Outbreaks of Measles and Whooping Cough

    The Role of Vaccine Refusal in Recent Outbreaks of Measles and Whooping Cough

    INTRO:Measles and pertussis, or whooping cough, have been effectively controlled in the United States with the use of vaccines. However, recent outbreaks of these vaccine-preventable diseases have prompted many to examine why this is happening. A review of recent research looks at whether the reluctance of some parents to have their children vaccinated plays a role in these outbreaks.  Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:01
    “…hello, how are you…?”

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:05
    Runs:13
    “Most parents do the right thing and get their children vaccinated. Even if you go out and do the right thing your child’s risk depends on other people as well.”

    (Video covering beginning of bite: nurse in exam room with mother and child)

    VIDEO
    B-ROLL
    Children playing swings, going down a slide, three children and parent walking on to playground

    AUDIO
    VO
    Like whom they interact with on the playground, in school, and even within their own family.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:19
    Runs:09
    “If there is a group of people which are unprotected, they can increase the risks of even those who are vaccinated.”

    VIDEO
    B-ROLL
    Dr. Omer walking down the hall, sitting at a table talking with his team, graph on computer screen, same graph on big screen, MMR vaccine vial, MMR vaccine in boxes

    AUDIO
    VO
    Dr. Saad Omer, from Emory University, and his colleagues reviewed published reports for both measles and pertussis. They specifically looked at the role vaccine refusal plays in outbreaks of both diseases.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:38
    Runs:16
    “In the post-elimination era for measles, vaccine refusal has played a role in these recent outbreaks. A majority of those cases occurred in those who did not get vaccines for philosophical or religious reasons.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:58
    Runs:18
    “The contribution of vaccine refusal is higher in early part of epidemics compared to later parts, indicating that vaccine refusers provide those pockets of susceptibility, that tinder, that can start the fire of an epidemic.”

    VIDEO
    B-ROLL
    Syringe being filled with vaccine, little child getting vaccinated

    AUDIO
    VO
    For whooping cough, outbreaks are harder to control because the vaccine’s protective immunity can wane over time.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@1:22
    Runs:13
    “Waning immunity is a problem but even in the context of waning immunity you have vaccine refusal which is playing a role. It is in everyone’s benefit that everyone stays protected.”

    (Video covering 2nd part of bite: People in park)

    VIDEO
    B-ROLL
    People in park

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:One of the more important public health achievements in the last 10 to 20 years has been the elimination of measles from the U-S.

  • March 08, 2016

    Identifying Children at Risk for Persistent Symptoms After Concussion

    Identifying Children at Risk for Persistent Symptoms After Concussion

    INTRO:Each year, emergency departments across the United States treat about 750 thousand children with concussions. For many patients, concussion-related symptoms resolve within 2 weeks of injury but some go on to experience persistent symptoms. Researchers have developed a new clinical score that may help predict which patients are at higher risk for prolonged symptoms. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of Johnny and teammate playing hockey

    AUDIO
    VO
    Johnny Coburn is back on the ice after being sidelined with a concussion.

    AUDIO
    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@:04
    Runs:03
    “It was a really bad headache. Just really bad.”

    VIDEO
    B-ROLL
    Various hockey shots

    AUDIO
    VO
    His parents watched him carefully. While his symptoms initially improved, after about a week, the headaches returned.

    AUDIO
    SOT/FULL
    Mike Coburn – Johnny’s Father
    Super@:13
    Runs:07
    “I knew that the severity of the concussion was much greater than 5 days or 7 days of rest would fix.”

    VIDEO
    B-ROLL
    Various hockey shots

    AUDIO
    More than half of these children treated at emergency departments end up with headaches after concussion.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@:26
    Runs:19    “Parents usually ask about, well how long is my son or daughter going to have symptoms and what’s going to go on after that and what do I have to do? But there’s no good way at this moment in time to actually predict those that are going to go on to have persistent symptoms following the emergency department visit.”

    VIDEO
    B-ROLL
    Dr. Babcock and Dr. Kurowski talking and looking at computer screen, various shots of Dr. Kurowski doing different tests with young boy

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    In an editorial, Doctors Lynn Babcock and Brad Kurowski from Cincinnati Children’s Hospital discuss new research designed to help predict which children are at higher risk for developing persistent symptoms after concussion.   Canadian researchers evaluated just over three thousand patients, age 5 to 18. about 30 percent ended up with persistent post concussion symptoms at 28 days.

    Both the study and editorial appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@1:13
    Runs:10
    “They actually had 46 predictors that they were looking at. After they evaluated those 46 variables they came up with 9 variables that were fairly predictive of post-concussive symptoms.”

    (Video covering middle of bite: Dr. Kurowski examining young boy)

    AUDIO
    NASOT/FULL
    Runs:03
    “I want you to just follow my finger with your eyes, ok?”

    VIDEO
    B-ROLL
    Young boy being examined by Dr. Kurowski, Graphic lower third,right over video: Age, Sex, Migraines, Depression, Prior Concussion, Balance

    AUDIO
    VO
    The clinical variables were used in a 12-point risk score. They included things like age, sex, history of migraines or depression, prior history of concussion, and problems with balance.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@1:34
    Runs:11
    “Some of these things have been shown before in smaller studies but nothing together as a collective summary of symptoms. It’s variables that we would normally capture in the emergency department but now it’s compiled into one decision rule.”

    VIDEO
    B-ROLL
    Johnny on skating on the ice with teammate

    AUDIO
    VO
    Johnny says he is feeling much better. He doesn’t have any more headaches and is back, playing hockey.

    AUDIO
    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@1:55
    Runs:09
    (Video covering 1st half of bite: Johnny and teammate skating)

    “I’m looking forward to playing with my team for a few years, playing really good hockey in college and hoping that I get to the NHL.”

    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@1:55
    Runs:09
    “I’m looking forward to playing with my team for a few years, playing really good hockey in college and hoping that I get to the NHL.”

    (Video covering 1st half of bite: Johnny and teammate skating)

    VIDEO
    Johnny on the ice

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Before this new scoring system is adopted for use in clinical practice, further research is needed to validate and confirm the study outcomes.

  • March 03, 2016

    Long-Term Aspirin Use Associated With Decreased Cancer Risk

    Long-Term Aspirin Use Associated With Decreased Cancer Risk

    INTRO:Taking a daily low dose aspirin is recommended to prevent heart disease and more recently, colorectal cancer. But does daily aspirin, over the long-term, also help prevent other types of cancers? A new study examined the potential cancer prevention benefits among people who have been taking aspirin regularly for years. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL Person taking an aspirin
    AUDIO
    VO
    Aspirin—you can buy it without a prescription and it’s relatively easy to take.

    AUDIO SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:05 Runs:09
    “There’s very strong evidence that aspirin can prevent colorectal cancer but the association of aspirin with other cancer types isn’t really as well established.” VIDEO
    B-ROLL Dr. Chan walking down hallway into exam room, looking at papers, graphic: 135,965 Health Professionals, pan up from papers to Dr. Chan AUDIO
    VO
    Dr. Andrew Chan from Massachusetts General Hospital and co-authors examined data from two large national studies that include almost 136 thousand health- professionals, both men and women, who have been providing detailed information about their overall health for decades.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:29 Runs:08
    “We were able to actually look at aspirin data they had provided us over the years and link that up with their diagnosis of various diseases, including cancer.”

    VIDEO
    B-ROLL Aspirin being poured out, aspirin bottle, aspirin outside of bottle AUDIO
    VO
    Individuals who took various doses of aspirin on a regular basis did have a lower overall risk of developing any type of cancer.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:44 Runs:10
    “It was about a 3 percent lower incidence of cancer. Much of those cancers however, were cancers of the gastrointestinal tract. So cancers that affect the esophagus, the stomach.” GXF FULL JAMA ONCOLOGY LOGO AUDIO
    The study appears in JAMA, Oncology.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:58 Runs:15
    “There was about a 15 to 20 percent reduction in the risk of developing colon cancer if you were using an aspirin on a regular basis. We also found that it did take about six years of use for a benefit to emerge but you know, once there was this benefit, it was sustained over time.”

    VIDEO B-ROLL Aspirin pills, patient undergoing colonoscopy, cu over doctor’s shoulder looking at screen AUDIO
    VO
    Dr. Chan also says daily aspirin may have an added benefit on top of routine colorectal cancer screening.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@1:19 Runs:16
    “And in addition, for folks that do not undergo screening for whatever reason, the effect of aspirin also is quite pronounced, and because we know that cancer and heart disease are really the two leading causes of death in the U-S population, the public health impact of these findings might be substantial.”
    (Video covering middle of bite: slide of polyp in colon)

    VIDEO
    B-ROLL Dr. Chan on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Aspirin use was not associated with the risk for breast, prostate, or lung cancer.

  • February 22, 2016

    Updated Definitions And Clinical Criteria For Recognizing Life-Threatening Sepsis And Septic Shock

    Updated Definitions And Clinical Criteria For Recognizing Life-Threatening Sepsis And Septic Shock

    INTRO:Sepsis is a common and potentially life-threatening manifestation of infection, affecting millions of patients worldwide. Sepsis can also be difficult to diagnose. A new study summarized the findings of an international group of experts who set out to update the previous definitions of sepsis. They also describe a more streamlined way to recognize patients with sepsis, so that treatment can be started more quickly.  Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@:01
    Runs:04
    “As soon as you get an infection, the body starts responding to infection.”

    AUDIO
    SOT/FULL
    Christopher W. Seymour, M.D., M.Sc., – University of Pittsburgh School of Medicine
    Super@:05
    Runs:06
    “Sepsis is when the body’s response to infection injures its own tissue and organs.”

    VIDEO
    B-ROLL
    Dr. Seymour and Dr. Angus walking into lab, Dr. Seymour and Dr. Angus looking at slides of infections, graphic

    AUDIO
    VO
    Doctors Christopher Seymour and Derek Angus from the University of Pittsburgh School of Medicine and co-authors summarized the findings of an international task force who updated the definitions of sepsis.  In a related study, they reviewed the electronic health records of more than 1 million patients to assess the usefulness of a clinical score known as “SOFA”, used to identify patients with sepsis.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@:31
    Runs:11
    “SOFA behaved very well especially in ICU patients. But a lot of time outside the ICU, you haven’t done all the measurements for a full SOFA score.

    (Video covering middle of bite: out of focus shoot of ICU)

    AUDIO
    SOT/FULL
    Christopher W. Seymour, M.D.,  M.Sc., – University of Pittsburgh School of Medicine
    Super@:41
    Runs:20

    “The Task Force also identified something new called the Q-SOFA or quick SOFA, which can be used as a clinical prompt at the bedside for doctors and nurses. This uses only vital signs such as altered mental status, low blood pressure, as well as difficulty breathing. Two of those will identify a patient most likely to be septic.

    (Video covering middle of bite: Dr. Seymour and others talking with patient, monitor, pan from machines to Dr. Seymour)

    GXF FULL
    JAMA LOGO

    AUDIO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@1:05
    Runs:14
    “If you have an infected patient that scores two points or more on Q-SOFA, you should be worried about that patient. In more austere settings, where you can’t get the blood tests this may actually be a very practical tool.”

    SOT/FULL
    Christopher W. Seymour, M.D., M.Sc., – University of Pittsburgh School of Medicine
    Super@1:19
    Runs:11
    “Sepsis is difficult to recognize. The Task Force provides us with these criteria so this helps doctors and nurses recognize sepsis quicker and get treatment started right away.”

    (Video covering middle of bite: ICU patient’s hand, nurse checking medication bags)

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@1:30
    Runs:28
    “We expect and look forward to this being improved. We want to see this change over time and we hope that using data to validate the definitions is ushering in a new era. We’ve been trying to help people come up with simpler rules that will help promote early, simple, easy identification of patients to then prompt early and appropriate intervention and management.”

    (Video covering 2nd half of bite: doctors and nurse walking into an ICU room)

    VIDEO
    B-ROLL
    (Doctors and nurse walking into an ICU room)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Sepsis carries an enormous public health burden, accounting for more than 5 percent of total U-S hospital costs.

  • February 15, 2016

    Caregivers Likely to Experience Emotional, Physical, and Financial Difficulties

    Caregivers Likely to Experience Emotional, Physical, and Financial Difficulties

    INTRO:When an older adult becomes ill, most often it’s a spouse or adult child who becomes the primary caregiver, usually without compensation. A new study examined just how many of these family or unpaid caregivers are out there and also the physical, emotional and financial difficulties they experience. Catherine Dolf explains in this week’s JAMA Report. VIDEO B-ROLL Judith walking down the hall, sitting at table reading AUDIO
    VO
    Judith Vick is back in medical school after taking a year off to help care for her mother, who experienced a devastating stroke.

    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super:10 Runs:07
    “My mom’s husband, my mom and I are really part of a team and we help each other in big and small ways every day.”
    (Video covering 1st part of bite: Pic of Judith, her mom and mom’s husband)
    VIDEO
    B-ROLL Looking at medication list on computer
    AUDIO
    VO
    Judith had a lot to learn including how to manage the 14 different medications her mother was taking.

    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super@:21 Runs:12
    “I spent hours translating that vague list to a very specific schedule of what she was supposed to take, when. It was like a puzzle to figure out that schedule.”

    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@:33 Runs:07
    “Although the caregiving role is highly varied it often involves considerable time and may affect caregivers own health and well-being.” VIDEO
    B-ROLL Dr. Wolff walking down hallway into her office, sitting and working at computer, couple walking on street, houses in neighborhood, graphic

    AUDIO
    VO Dr. Jennifer Wolff from the Johns Hopkins Bloomberg School of Public Health and co-authors used data from two nationally representative samples that provided insight into older adults and the caregivers who help them, living in communities like this around the U-S. The researchers estimate that nearly 15 million of these caregivers are helping almost 8 million older adults with health related disabilities.
    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@1:01 Runs:16
    “About 6 and a half million or 45 percent provided substantial health care help, on the order of 28 hours of care per week, were about twice as likely to experience physical, financial or emotional difficulty than caregivers who did not provide this help.” GXF FULL JAMA LOGO AUDIO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@1:20 Runs:07
    “About 1 in 4 reported their own health to be fair or poor and about half were helping an older adult with dementia. VIDEO
    B-ROLL Caregiver walking with patient, Graphic, man with a walking cane, Pic of Judith’s mom and her husband
    AUDIO
    VO
    These caregivers also participated in fewer social or leisure activities and if they worked outside the home, they were more than three times as likely to experience a loss in job-related productivity compared to individuals who didn’t provide this type of help. Judith says her mom is continuing to improve and this whole experience has brought them closer.
    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super@1:46 Runs:11
    “There are difficult parts of caregiving but it really is such a privilege to be so involved in her care. It has definitely been an enriching and meaningful experience.”

    (Video covering 2nd half of bite: Pic of Judith and her mom)

    VIDEO
    B-ROLL Pic of Judith and her mom

    AUDIO
    “There are difficult parts of caregiving but it really is such a privilege to be so involved in her care. It has definitely been an enriching and meaningful experience.”

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Researchers add that only one in four of these caregivers used supportive services, got education or training about how to provide care or participated in support groups.

  • February 11, 2016

    BRCA Testing Increasing Among Younger Women Diagnosed with Breast Cancer

    BRCA Testing Increasing Among Younger Women Diagnosed with Breast Cancer

    INTRO:For younger women diagnosed with breast cancer, genetic counseling along with testing for B-R-C-A 1 and 2 is a standard recommendation. But how many young women are undergoing testing and do the results have an effect on treatment decisions? A new study looked at these questions. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO B-ROLL Breast image showing tumor AUDIO
    VO
    A breast cancer diagnosis in a young woman leaves her with a choice of whether or not to undergo genetic testing.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:07 Runs:04
    “So, what I always say to my patients is knowledge is power.”
    VIDEO
    B-ROLL Dr. Partridge walking with patient, sitting at table and talking with patient, slide being loaded and looked at through microscope

    AUDIO
    VO
    Dr. Ann Partridge from the Dana Farber Cancer Institute says current guidelines recommend every young woman diagnosed with breast cancer should be counseled about and receive testing for B-R-C-A 1 and 2.
    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:21 Runs:09
    “We’re making strides and improving over time how we get the message to young women that they should consider testing.”
    VIDEO
    B-ROLL Women walking outside, graphic: shot freezes: 897 Women -Genetic Testing Rates -Barriers to Testing -Treatment Decisions AUDIO
    VO
    Since 2006, she and her co-authors began following women, 40 and younger, diagnosed with breast cancer. For this study they focused on nearly 900 of these women, looking at genetic testing rates, barriers to testing, and how the test results affected treatment decisions.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:45 Runs:10
    “In 2006 the rates of testing were in the 70 percent range and they went all the way up to about 95 percent by 20-12 and 20-13.”

    GXF FULL JAMA LOGO AUDIO
    The study appears in the journal, JAMA Oncology.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:58 Runs:16
    “While the majority of women are being tested many are not and a small minority, but an important minority, report that nobody even talked to them about the possibility of harboring a genetic predisposition for breast cancer and they should get tested.”

    VIDEO
    Dr. Partridge walking down hallway, woman getting mammogram, cu of breast image

    AUDIO
    VO
    Dr. Partridge also says not every woman will choose to be tested. However, it appeared genetic testing or the concern about genetic predisposition did affect treatment decisions.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@1:24 Runs:11
    “The majority of these women said that it affected whether or not they underwent a unilateral mastectomy or lumpectomy followed by radiation or a bilateral mastectomy.”
    (Video covering middle of bite: breast cancer surgery)

    VIDEO
    B-ROLL Technician preparing chemotherapy medication AUDIO
    VO
    And fewer women reported that concerns about genetic risk affected whether or not they received chemotherapy or hormonal therapy.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@1:42 Runs:19 “It’s imperative that we not only help women to get this information but that we also counsel them, help to support them as they make these treatment decisions especially in the context of a newly diagnosed patient who is stressed and anxious and needs to have good communication with her providers and good support.” VIDEO B-ROLL Dr. Partridge on camera
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The study says concerns about genetic risk also affected a woman’s treatment decisions even if she tested negative.

     

  • February 02, 2016

    Eating Seafood May Help Lower The Risk Of Dementia

    Eating Seafood May Help Lower The Risk Of Dementia

    INTRO:Many people eat seafood because of its health benefits. However, seafood also contains mercury and at very high levels, mercury has been linked to problems with cognitive function and brain changes associated with dementia. A new study examined mercury levels in the brains of deceased older people, to see if there was a relationship between seafood consumption and the type of brain changes commonly seen with dementia. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of seafood

    AUDIO
    VO
    These days many people are eating more seafood because of its health benefits. But seafood also contains mercury.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@:06
    Runs:09
    “There’s concerns about if people eat seafood are they also consuming more mercury and that is impairing their health.”

    VIDEO
    Dr. Morris sitting in her office, graphic showing retirement communities, still pic of group of older people, technician looking at slices of brains

    AUDIO
    VO
    Dr. Martha Clare Morris from Rush University Medical Center in Chicago, and co-authors enrolled older people living in public housing and retirement communities in an ongoing study of memory and aging. Participants had normal memory function when they entered the study. They were asked to keep track of their diet, using a detailed questionnaire. participants also agreed to brain donation after they died. In total, 286 brains were examined.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@:39
    Runs:17
    “So we have a very comprehensive assessment of people’s seafood consumption during their older age years and then we can relate seafood consumption to brain changes associated with dementia when they die.”

    (Video covering second part of bite: technician examining brain slices)

    VIDEO
    B-ROLL
    Graphic: slide of brain tissue with plaques and tangles circled

    AUDIO
    VO
    These changes include plaques and tangles seen in the brain, hallmark features of Alzheimer dementia.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@1:01
    Runs:23
    “Seafood consumption of at least one meal per week decreased the occurrence of the amyloid plaques and tangles associated with Alzheimer’s dementia. We observed this however, only in people who had the apolipoprotein e4 allele. This is a genotype that puts one at increased risk of dementia.”

    (Video covering middle of bite: technician looking at brain slides under microscope)

    GXF FULL
    JAMA LOGO

    AUDIO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@1:28
    Runs:11
    “The increased level of seafood consumption did increase brain levels of mercury, but that the mercury didn’t appear to have an impact on brain health.”

    VIDEO
    B-ROLL
    Various kinds of seafood, Dr. Morris sitting at microscope looking at slides

    AUDIO
    VO
    Dr. Morris also says seafood consumption was only associated with less brain changes specific to Alzheimer dementia, not vascular or Lewy Body dementia. Catherine Dolf, the JAMA Report.

    Tag:Study participants who ate seafood had between one and 6 seafood containing meals per week.

  • January 26, 2016

    Updated Recommendations for Depression Screening in Adults

    Updated Recommendations for Depression Screening in Adults

    INTRO:Depression is an important clinical problem worldwide. The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services. The Task Force has just issued updated recommendations on depression screening for adults in the primary care setting. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@:01
    Runs:13
    “Depression is a really important health topic in the United States and worldwide. It’s one of the leading causes of disability in adults and is often times under recognized and under treated.”

    VIDEO
    B-ROLL
    Patient filling out depression screening questionnaire

    AUDIO
    VO
    Adults visiting their primary care provider should, at some point, be screened for depression.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@:17
    Runs:15
    “The primary care doctor has an important initial role in identifying people with depression and directing them towards treatment and appropriate follow up.
    Preventive Services Task Force always evaluates both the potential benefits and the potential downsides of any clinical preventive
    service.”

    (Video covering middle of bite: doctor talking with patient)

    VIDEO
    B-ROLL
    Dr. Pignone walking down clinic hallway, people walking down the street

    AUDIO
    VO
    Dr. Michael Pignone (pin-yoh-nee), one of several members of the U-S Preventive Services Task Force, says the group continues to recommend that adults, 18 and older, be screened for depression.

    GXF FULL
    JAMA LOGO

    AUDIO
    The new Task Force recommendations appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:04
    Runs:15
    “We have additional evidence about the effectiveness of screening and treatment in pregnant women and peripartum women. There’s much more information available in that population to make us confident screening that was effective.”

    (Video covering middle of bite: pregnant women getting blood drawn, mother walking with child on the street, mother pushing stroller)

    VIDEO
    B-ROLL
    New mom walking with her child down hospital hallway, pregnant woman getting an ultrasound

    AUDIO
    VO
    While several treatments are available for pregnant and peri-partum women, the Task Force recommends that clinicians and patients work together to determine the best approach to treatment.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:27
    Runs:09
    “Because there is some suggestion that some medications that are used for treating depression may have adverse effects on the fetus.”

    VIDEO
    B-ROLL
    Older man walking, older people sitting in wheel chairs

    AUDIO
    The Task Force also continues to recommend depression screening in older adults.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:49
    Ends:18
    “We still need more evidence in older adults about the effectiveness of screening and treating depression on outcomes. We really need to be a little bit more active in finding patients with depression and treating them effectively and this recommendation reinforces that.”

    (Video covering 1st half of bite: older people outside)

    VIDEO
    B-ROLL
    Patient and doctor talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The Task Force recommends depression screening be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow up for patients.

  • January 19, 2016

    Fewer U.S. Cancer Patients Dying in the Hospital but I-C-U Care Remains Common

    Fewer U.S. Cancer Patients Dying in the Hospital but I-C-U Care Remains Common

    INTRO:There’s a common perception that the United States spends a lot more on health care because it spends so much more on end of life care than other developed countries. So, how does the U-S compare to other nations? A new study examined several health care measures at the end of life for cancer patients in five European countries, Canada and the United States. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:01
    Runs:11
    “We know that end of life care is intensive, we know it’s expensive, we know that still too many people are dying in the hospital, even today.”

    (Video covering 2nd half of bite: nurse in hospital room)

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@:12
    Runs:06
    “The United States is not the worst in end of life care, at least when it comes to cancer patients, nor is it the best.”

    VIDEO
    B-ROLL
    Dr. Emanuel and Dr. Bekelman walking, nurse walking into hospital room with patient, nurse talking to patient, Graphic: Map with 7 different countries shown

    AUDIO
    VO
    Doctors Ezekiel Emanuel and Justin Bekelman from the University of Pennsylvania Perelman School of Medicine and co-authors compared the health care experience for cancer patients, older than 65, in six countries and the U-S in 20-10. Those countries included, Canada, Belgium, Germany, England, the Netherlands and Norway. They examined several clinical measures six and one month before death.

    AUDIO
    SOT FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:39
    Runs:05
    “The United States and the Netherlands had the lowest proportion of patients dying in the hospital.”

    VIDEO
    B-ROLL
    Graphic: Empty Hospital room, percentages wipe in over video

    AUDIO
    VO
    About 22 percent of U-S cancer patients died in hospitals. Almost 30 percent in the Netherlands; and Belgium and Canada had just over 50 percent of patients die in the hospital.

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@ :53
    Runs:05
    “We have the fewest hospitalizations and we have the shortest number of hospital days of all patients.”

    (Video covering end of bite: hospital bed being pushed down the hall)

    AUDIO
    SOT/FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:59
    Runs:04
    “The U-S wasn’t as expensive as we might have thought or might have predicted.”

    VIDEO
    B-ROLL
    Graphic: Map with hospital costs of each country

    GXF FULL
    JAMA LOGO

    B-ROLL
    Dr. Bekelman and Dr. Emanuel looking over study information

    AUDIO
    VO
    During the last six months of life, patients in Norway and Canada had higher hospital costs than patients in the U-S. There was less spending in Germany and Belgium but the lowest expenditures were in the Netherlands and England.

    The study appears in JAMA, Journal of the American Medical Association.  Both researchers note that there are areas where care can be improved for U-S patients.

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@1:23
    Runs:19
    “The United States has far and away the most patients who end up in the intensive care unit in the last six months of life. About 40 percent of patients actually end up in the intensive care unit.  They spend the longest time of any country in the world. We also give a lot of chemotherapy to patients in the last six months of life.”

    (Video covering end of bite: lab worker preparing chemotherapy treatment)

    AUDIO
    SOT/FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@1:44
    Runs:13
    “A question is for our patients, if they wrote the chapter about their last six months or about their last month, would it resemble the findings that we’re reporting? And I’ll bet the answer is no and that means we have more work to do.”

    (Video covering end of bite: Various shots of patients and staff in ICU)

    VIDEO
    B-ROLL
    Dr. Bekelman on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study helps set a baseline about how the United States and other countries can learn from each other in order to improve end of life care.

  • January 12, 2016

    New Procedure Helps Patients with Severe Emphysema

    New Procedure Helps Patients with Severe Emphysema

    INTRO:Emphysema is a lung disease that makes breathing very difficult.  Patients with severe emphysema experience shortness of breath and often have poor quality of life. There is no cure and current therapies, including lung reduction surgery, can be risky. A new study examined a minimally invasive procedure to see if it could improve breathing and also be a safe and cost effective way to treat emphysema. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    -ROLL
    Patient walking down hallway and breathing heavily

    AUDIO
    VO
    This patient has severe emphysema.

    AUDIO
    NATSO/FULL
    Runs:03
    “…haaa…haaa…”

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:05
    Runs:05
    “Emphysema is characterized by destruction of the lung.”

    VIDEO
    B-ROLL
    X-ray showing destruction of lung tissue

    AUDIO
    VO
    Air becomes trapped in the spaces created by the damaged lung tissue.

    AUDIO
    SOT/FULL
    Voice of:
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:14
    Runs:06
    “Too much air in fact, in the lung, it’s very difficult for the patient to breathe.”

    (Video covering bite: x-ray of lung, patient on breathing machine)

    VIDEO
    B-ROLL
    Dr. Deslée walking down hospital hallway, looking at x-ray of lungs, cu of coil

    AUDIO
    VO
    Dr. Gaëtan (gay-taun) Deslée (des-lay) from the University of Reims, in France, and co-authors investigated a new procedure, permanently placing several coils like this into the lung.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:30
    Runs:14
    “They help to induce the recoil of the lung which is impaired in severe emphysema and it improves the elasticity of the lung.”

    (Video covering middle of bite: showing coils in lung, showing the coil expanding in his hand)

    VIDEO
    B-ROLL
    Man taking breathing test, graphic showing coils inside lungs, patient taking walking test

    AUDIO
    VO
    The study included 100 patients from 10 centers across France. 50 patients had an average of 10 coils placed in their lungs and the other 50 received standard medical treatment. Both groups were followed closely and assessed at 6 and 12 months. They participated in a six-minute walk test to see if their breathing had improved, allowing them to walk farther.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@1:09
    Runs:27
    “Coil treatment improved exercise test after 6 months. 36 percent of the patients treated by coil treatment had an improvement of at least 54 meters or 177 feet in the 6 minute walk test compared to only 18 percent in the control group.”

    (Video covering 1st part of the bite: patient taking the walking test)

    (Video covering middle of 2nd part of bite: patient walking with nurse)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Jurnal of the American Medical Association.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@ 1:33
    Runs:11
    “There was a significant improvement of quality of life at 6 and 12 months in the group treated by coil treatment.”

    VIDEO
    B-ROLL
    Dr. Deslée holding the coil in his hand

    AUDIO
    VO
    Coil placement was safe but quite expensive in the short-term.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@ 1:47
    Runs:13
    “We need the data after three and five years of follow up to get the final information about the cost and cost effectiveness of this new technology.”

    (Video covering 2nd part of bite: x-ray with coils in lungs)

    VIDEO
    B-ROLL
    Coils in lungs

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the patients who did not receive the coil treatment in this study will be offered the coil treatment going forward.

  • January 05, 2016

    Combination of Weight Loss and Exercise Offers Benefits in Patients with a Common Type of Heart Failure

    Combination of Weight Loss and Exercise Offers Benefits in Patients with a Common Type of Heart Failure

    INTRO:An increasingly common type of heart failure occurs when the heart is pumping normally but doesn’t fill with enough blood. As a result, patients experience shortness of breath and fatigue with physical exertion. So far, medications have been unsuccessful in treating this disorder. A new study examined whether weight loss, exercise, or a combination of the two would result in improvement for patients with this type of heart failure. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Lynora walking on track

    AUDIO
    VO
    These days you can hardly keep up with Lynora Essic. But it wasn’t always that way.

    AUDIO
    SOT/FULL
    Lynora Essic – Program Participant
    Super@:04
    Runs:07
    “When I first started the study and I found out I was going to have to walk, I about had a panic attack. I was like ‘this is really not going to work for me.’”

    (Video covering 2nd half of bite: Lynora walking on track)

    VIDEO
    B-ROLL
    Lynora walking on track

    AUDIO
    VO
    She could barely do four laps without struggling for breath, but not now.

    AUDIO
    SOT/FULL
    Voice of:
    Lynora Essic – Program Participant
    Super@:17
    Runs:03
    “My last time around I was up to 32 laps.”

    VIDEO
    B-ROLL
    Lynora getting blood pressure checked

    AUDIO
    VO
    Lynora has an increasingly common type of heart failure.  Although her heart pumps normally, it doesn’t fill with enough blood because the lower chamber of the heart is too stiff.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ :26
    Runs:16
    “This form of heart failure is the most common one in America, it’s the fastest growing. However, despite all of our efforts we’ve not found any medication treatments that improve the outcomes in patients with this disorder.”

    VIDEO
    B-ROLL
    People riding exercise bike and walking

    AUDIO
    VO
    More than 80 percent of these patients are also overweight or obese.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ :46
    Ends:16
    “About 5 years ago we tested exercise for these patients and found that it improved their main symptom which is exercise intolerance, or shortness of breath and fatigue with physical exertion.”

    (Video covering middle of bite: Lynora exercising)

    VIDEO
    B-ROLL
    Dr. Kitzman walking down hallway, Lynora talking with staff member, going over her numbers

    AUDIO
    VO
    Dr. Dalane Kitzman from the Wake Forest School of Medicine and co-authors studied whether weight loss and exercise might help symptoms in a group of 100 patients with this form of heart failure. Patients were randomly assigned to a calorie restricted diet, exercise training, or both.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ 1:16
    Ends:14
    “With exercise, participants lost about six and a half pounds of body weight. With diet, they lost more than twice as much. When we put diet and exercise together they lost 22 pounds.”

    GXF FULL
    JAMA LOGO

    VIDEO
    B-ROLL
    Lynora and Dr. Kitzman greeting each other and talking

    AUDIO
    VO
    The Study appears in JAMA, Journal of the American Medical Association. Dr. Kitzman says patients who were in the combination group also saw the most improvement in physical symptoms.

    AUDIO
    SOT/FULL
    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
    Super@ 1:41
    Ends:13
    “With a significant improvement in exercise tolerance with diet alone and with exercise alone but when you added them together you had a large improvement in exercise tolerance.”

    VIDEO
    B-ROLL
    Lynora in study kitchen picking up her meals, being weighed

    AUDIO
    VO
    After 12 weeks of diet and exercise, Lynora is down 15 and a half pounds.

    AUDIO
    SOT/FULL
    Lynora Essic – Program Participant
    Super@ 2:00
    Runs:12
    “I feel good all the time and to me that’s really important. My family is really, really active and I don’t want to be the one on the sidelines anymore, I’ll be right there with them.”

    (Video covering 1st part of bite: Lynora on scale)

    VIDEO
    B-ROLL
    Lynora on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors also found that diet alone appeared to show a larger improvement in quality of life for the participants than exercise alone.

  • December 20, 2016

    Early Physical Activity After Concussion in Kids and Teens

    Early Physical Activity After Concussion in Kids and Teens

    INTRO: After a concussion, many doctors recommend an initial period of rest to help children and teens recover fully. But can early physical activity help decrease persistent post concussive symptoms? A new study in JAMA found that light exercise may be key to better recovery. Laura Berger has more in this week’s JAMA Report.

     

     

    AUDIO:

    VO:

     

    THOUSANDS OF CHILDREN IN THE U.S. VISIT EMERGENCY DEPARTMENTS AFTER SUFFERING CONCUSSIONS AND ABOUT 1/3 DEVELOP POST CONCUSSIVE SYMPTOMS THAT LAST MORE THAN A MONTH.  FOR YEARS, DOCTORS HAVE ADVISED STRICT REST RIGHT AFTER THE INJURY TO HELP AVOID THESE PROLONGED SIDE EFFECTS.

     

    (B-roll: Doctor doing concussion exam on patient)

     

     

    AUDIO:

    SOT/FULL

    Roger Zemek, M.D.-Children’s Hospital of Eastern Ontario

    Super@:15

    Runs:12

     

    “Children can present in a whole variety of symptoms following a concussion.  Some children may have early physical symptoms such as headache, or feeling like they want to vomit or being dizzy.”

     

     

     

    AUDIO:

    VO:

     

    1. ROGER ZEMEK FROM THE CHILDREN’S HOSPITAL OF EASTERN ONTARIO AND CO-AUTHORS STUDIED MORE THAN 3 THOUSAND CANADIAN CHILDREN AND TEENS WHO HAD CONCUSSIONS TO SEE IF ADDING PHYSICAL ACTIVITY WITHIN ONE WEEK OF INJURY CAN HELP PREVENT POST-CONCUSSIVE SYMPTOMS.

     

    USING A STANDARD QUESTIONNIARE, RESEARCHERS MONITORED THE CHILDREN AND TEENS FROM THE EMERGENCY DEPARTMENT UNTIL 28 DAYS AFTER THEIR INJURY TO SEE HOW WELL THEY RECOVERED AND ALSO TO TRACK THEIR PHYSICAL ACTIVITY.

     

    THE RESEARCHERS FOUND THAT THE CHILDREN WHO PARTICIPATED IN LIGHT PHYSICAL ACTIVITY AFTER THEIR CONCUSSION HAD A REDUCED RISK OF HAVING PROLONGED POST-CONCUSSIVE SYMPTOMS.

     

    (B-ROLL:Dr. Zemek walking down the hall, working at his desk, on the phone, patient walking in the snow)

     

    AUDIO:

    SOT/FULL

    Roger Zemek, M.D.-Children’s Hospital of Eastern Ontario

    Super@:1:00

    Runs:16

     

     “We really don’t want children to be having another concussion while they’re recovering, but there is likely a strong benefit for having some sort of movement, and early physical activity following concussion such as walking, jogging or stationary bicycle.”

     

     

    AUDIO:

    VO:

    DR. ZEMEK SAYS MORE RESEARCH NEEDS TO BE DONE TO DETERMINE THE IDEAL TYPE, INTENSITY, AND DURATION OF PHYSICAL ACTIVITY FOLLOWING CONCUSSION. (Broll:patient walking on trail)

    LAURA BERGER, THE JAMA REPORT

    (BROLL: patient walking outside)

     

         TAG: THE STUDY WAS CONDUCTED FROM AUGUST 2013 TO JUNE 2015.

     

     

     

  • December 13, 2016

    Large Differences Seen in Mortality Rates Among US Counties

    Large Differences Seen in Mortality Rates Among US Counties

    INTRO: How do mortality rates for major causes of death vary by county in the U.S.? A new study looked at mortality data from 1980 to 2014 to see what kinds of geographic patterns exist. Authors of the new study hope that the results can help provide insight into disease-specific trends and life expectancy. Laura Berger has more in this week’s JAMA Report.

     

     

    AUDIO:

    VO:

     

    RESEARCH SHOWS THAT INEQUALITIES IN LIFE EXPECTANCY ACROSS DIFFERENT COUNTIES IN THE UNITED STATES ARE INCREASING, BUT LESS IS KNOWN ABOUT SPECIFIC GEOGRAPHIC PATTERNS AND THE UNDERLYING CAUSES OF DEATH.

     

     

    (B-ROLL:graphic map of United States)

     

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:11

    Runs:15

     

    Well, there’s probably two key drivers of death rates changing, changes in risks that people have, like tobacco, or obesity, getting better or worse. And then access to treatment, whether prevention or cure.”

     

     

    AUDIO:

    VO:

     

    1. CHRIS MURRAY AND CO-AUTHORS REVIEWED DEATH CERTIFICATES FROM MORE THAN 3 THOUSAND U.S. COUNTIES FROM 1980 TO 2014. THEY WANTED TO KNOW WHAT THE LEADING CAUSES OF DEATH WERE IN EACH AREA AND TO DETERMINE TRENDS OVER TIME BY REGION. THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

     

     

     

     

    (B-ROLL: Dr. walking, working in office looking at map, close up map, doctor reading papers)

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:47

    Runs:27

     

     

     “We found that differences or disparities across counties are actually getting larger over time. So we’re not narrowing the gap, the gap is widening. And we found that different causes matter more in different parts of the country. So out West for example in the U.S., violent death is more common, whereas heart disease is more common in the Southeast. And deaths from drugs are much more common in West Virginia or Kentucky as examples.”

     

     

    AUDIO:

    VO:

     

    DR. MURRAY SAYS IN THE FUTURE HE WANTS TO LOOK AT MORE DETAILED CAUSES OF DEATH IN EACH AREA IN ORDER TO HELP IMPROVE THE HEALTH OF EACH COMMUNITY.  (B-roll doctor writing at white board, showing map)

     

    AUDIO:

    SOT/FULL

    Christopher Murray, M.D., D.Phil. –Professor of Global Health, U of Washington

    Super@:1:23

    Runs:18

    (B-roll at end woman walking with daughter)

     

    “The biggest takeaway is that one size doesn’t fit all in the U.S.  We really need to understand why there’s such variation in how long people live, and what causes children, adults and older people to die at such different levels in different communities.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:woman walking with daughter)

     

         TAG: IN A SMALL NUMBER OF CASES, COUNTY BOUNDARIES SHIFTED      BETWEEN 1980 AND THE PRESENT.  SEVERAL COUNTIES WERE MERGED DUE TO THE CHANGE.

     

  • November 21, 2016

    Changes in the Prevalence of Dementia in the United States

    Changes in the Prevalence of Dementia in the United States

    INTRO: As the elderly population in the United States continues to grow, the number of older adults who will suffer from dementia will also increase, but by how much? A new study in JAMA Internal Medicine looked at whether the prevalence of dementia has changed from 2000 to 2012.  Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

    DEMENTIA AFFECTS 4 TO 5 MILLION OLDER ADULTS IN THE UNITED STATES, AS WELL AS THEIR FAMILIES, AND GOVERNMENT PROGRAMS. A NEW STUDY IN JAMA INTERNAL MEDICINE LOOKS AT HOW THE PREVALENCE OF DEMENTIA HAS CHANGED FROM 2000 TO 2012.

     

    ( B-ROLL: Graphic of 4 to 5 million over blur of people walking on street

    Woman working with elderly man, woman looking at microscope, scientist looking at brain slices)

     

    SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:13

    Runs:22

    “Dementia is characterized by declines in memory and other cognitive functions, things like speech, and the ability to plan and to organize one’s day.// We found that the prevalence of dementia declined significantly between 2000 and 2012, from about 11.5% down to about 9%.”

    (b-roll of people in wheelchairs)

     

    AUDIO:

    1. KENNETH LANGA AND CO-AUTHORS STUDIED MORE THAN 21 THOUSAND U.S. ADULTS OVER THE AGE OF 65 USING DATA FROM THE HEALTH AND RETIREMENT STUDY FROM 2000 AND 2012. LANGA SAYS HE ATTRIBUTES THE DECLINE IN DEMENTIA PREVALENCE TO TWO FACTORS: INCREASES IN THE EDUCATION LEVEL AMONG THIS GROUP AND BETTER TREATMENTS FOR CARDIOVASCULAR RISK FACTORS LIKE DIABETES, OBESITY, AND HYPERTENSION.

     

    (B-ROLL: Dr. Langa working at desk and looking at brain scans

    GRAPHIC OF DECLINE IN DEMENTIA REASONS )

     

    Runs SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:58

    Runs:19

     “This suggests that a 75 year old today has a lower risk of having dementia today than a 75 year old 10 or 20 years ago. Both increases in education and better control of cardiovascular risk factors may be important in explaining some of this decline.”

    (B-roll of woman getting blood pressure taken, woman walking on track)

     

    1. LANGA SAYS MORE WORK NEEDS TO BE DONE BOTH IN THE U.S. AND ABROAD TO KEEP DEMENTIA TRENDS ON THE DECLINE.

    (Broll: Woman doing cognitive tests with nurse)

     

     

    SOT/FULL

    Kenneth Langa, M.D., PhD –Professor of Medicine, University of Michigan

    Super@:1:23

    Runs:14

     

    “…even without a big breakthrough in medication or  other kind of intervention that might decrease Alzheimer’s risk or change the course of Alzheimer’s, that it appears that there’s things we can do decrease risk.”

    (Broll: (b-roll people working out)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:woman walking with walker)

     

    TAG: THE NUMBER OF OLDER ADULTS WITH DEMENTIA IN THE UNITED STATES AND AROUND THE WORLD IS EXPECTED TO GROW UP TO 3-FOLD BY 2050.

     

     

     

     

  • November 13, 2016

    Statin Use for the Prevention of Cardiovascular Disease

    Statin Use for the Prevention of Cardiovascular Disease

    INTRO: Cardiovascular disease is one of the leading causes of death in the United States.  Statins are a prescription medication that can help decrease the risk for cardiovascular disease. But just who is at risk? The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services, including for cardiovascular disease. The Task Force has just issued a new recommendation statement on statin use for adults who are at risk for cardiovascular disease. Laura Berger has more in this week’s JAMA Report.

    AUDIO:

    VO:

     

    STROKE IS THE 5TH LEADING CAUSE OF DEATH IN THE U.S. AND THE 2ND LEADING CAUSE OF DEATH WORLDWIDE. EACH YEAR MORE THAN 750,000 AMERICANS EXPERIENCES A STROKE.

     

    (B-ROLL: Graphic 1 in 3 adults will die from cardiovascular disease, bottles of statins, Dr. Owens and patient)

     

     

    AUDIO:

    SOT/FULL

    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force

    Super@:11

    Runs:8

     

    “The risk factors for cardiovascular disease include high cholesterol, high blood pressure, smoking, diabetes, and your age.”

     

     

    AUDIO:

    VO:

     

    1. DOUGLAS OWENS, AN AUTHOR OF THE U-S PREVENTIVE SERVICES TASK FORCE RECOMMENDATION, SAYS THE GROUP RECOMMENDS THAT SOME PEOPLE AGE 40-75 WHO HAVE ONE OR MORE OF THOSE RISK FACTORS: HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, SMOKING, OR DIABETES, AND DO NOT HAVE A HISTORY OF CARDIOVASCULAR DISEASE, AND WHOSE CHANCE OF HAVING A HEART ATTACK OR STROKE OVER THE NEXT TEN YEARS IS 7.5% OR HIGHER, USE A STATIN. THOSE WHOSE RISK IS 10% OR HIGHER WILL BENEFIT MOST.

    ALTHOUGH THERE ARE RISKS, DR. OWENS SAYS THE USE OF A STATIN ALONG WITH A HEALTHY DIET AND EXERCISE, CAN BE A USEFUL TOOL IN THE FIGHT AGAINST CARDIOVASCULAR DISEASE.

     

    THE TASK FORCE RECOMMENDATIONS APPEAR IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

     

     

     

    (B-ROLL: Dr. Owens sitting at desk looking at the computer, man on street shots, Graphic of risk factors, man on street, smokers, statin bottle, counting pills, cardiovascular procedure b roll.)

     

     

    AUDIO

    SOT/FULL

    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force

    Super@: 1:04

    Runs:17

     

    “The benefits of statins are a reduction in heart attack, strokes and death. The harms of statins we judge based on our very comprehensive review of the literature to be small. And in patients who are at elevated risk for cardiovascular disease, the benefits outweigh the harms.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL: Statin pill bottles)

     

    TAG: THE TASK FORCE FOUND THE EVIDENCE FOR INITIATING STATINS FOR PEOPLE OVER 75 TO BE INSUFFICIENT.

     

  • November 10, 2016

    iPad Game Helps Treat Common Eye Condition in Children

    iPad Game Helps Treat Common Eye Condition in Children

    INTRO: Amblyopia or lazy eye is a leading cause of visual impairment in children.  The standard treatment for lazy eye involves patching the opposite eye to force the lazy eye to work harder. But could a special iPad game also be effective?  A new study in JAMA Ophthalmology compared the treatment of amblyopia using a binocular iPad game vs. two hours of daily patching. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    AMBLYOPIA OR LAZY EYE IS ONE OF THE MOST COMMON CAUSES OF VISUAL IMPAIRMENT IN CHILDREN, AFFECTING 3 TO 5 PERCENT OF KIDS IN THE UNITED STATES.

     

     

    (B-ROLL: Child getting patch on her eye, looking at eye chart with doctor, Doctor controlling chart on her phone)

     

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 9

    Runs:14

     

    “Amblyopia is a reduction of vision in one eye because of abnormal visual experience early in life. Amblyopia not only has deficits in vision, but it causes deficits in 3D depth perception, reading and fine motor skills.”

     

     

     

    AUDIO:

    1. KRISTA KELLY AND CO-AUTHORS STUDIED 28 CHILDREN AGES 4 TO 10 WHO HAD AMBLYOPIA. IN THIS RANDOMIZED TRIAL, CHILDREN WERE ASSIGNED TO TWO GROUPS, ONE THAT USED AN IPAD GAME FOR TREATMENT AND THE OTHER WHO USED PATCHING. AFTER TWO WEEKS THE GROUP THAT PATCHED ALSO TOOK HOME THE GAME.

     

    THE CHILDREN PUT ON A PAIR OF GLASSES AND HIGH CONTRAST IMAGES ARE SENT TO THE WEAKER EYE AND LOW CONTRAST IMAGES ARE SENT TO THE STRONGER EYE. THE CHILD HAS TO WORK THE WEAKER EYE IN ORDER TO PLAY THE GAME AS WELL AS WORK BOTH EYES TOGETHER.

     

     

    THE STUDY APPEARS IN JAMA OPHTHALMOLOGY.

     

    (B-ROLL: Dr. Kelly and co-author walking down hall, Dr. Kelly looking at eye scan, child playing, game and glasses close up, Dr. Kelly and child with patch, child playing game with glasses)

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 59

    Runs:14

     

    “We found that at the 2 week visit children who had the iPad game improved much more than children who patched…Both groups improved about  2 lines of vision on the letter chart…and about 40% of the children recovered normal vision.

    (B-roll in middle, girl playing the game)

     

     

    AUDIO:

    VO:

    1. KELLY SAYS THIS NEW GAME IS A PROMISING ADDITION TO EXISTING TREATMENTS FOR LAZY EYE. SHE HOPES MORE GAMES, TV SHOWS, AND MOVIES CAN BE USED AS TREATMENT IN THE FUTURE.

    (B-ROLL: Dr. Kelly and co-author looking at charts)

     

     

    SOT/FULL

    Krista Kelly, PhD- Retina Foundation of the Southwest

    Super@: 1:23

    Runs:10

     

     

    “So we want to be able to treat amblyopia early in life to be able to circumvent these deficits and hopefully allow the child to be able to develop and thrive academically and socially.”

     (b-roll at end of girl playing game)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL:girl playing game)

     

    TAG: THE STUDY WAS CONDUCTED FROM FEBRUARY 2015 TO JANUARY 2016.

  • October 31, 2016

    Opioid Poisonings Among Children and Teenagers

    Opioid Poisonings Among Children and Teenagers

    INTRO: Although there is a lot of discussion on how the prescription opioid epidemic has affected the U.S. adult population, how has it affected children and teens? A new study looked at how often kids and teenagers are hospitalized for opioid poisonings.  The study in JAMA Pediatrics examined these trends over a 16-year period from 1997 to 2012. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    FROM 1999 TO 2010 RETAIL SALES OF PRESCRIPTION OPIOIDS QUADRUPLED. AND AS MORE ADULTS BECOME ADDICTED TO THESE MEDICATIONS, MORE CHILDREN AND TEENAGERS ARE ALSO AT A HIGHER RISK FOR OPIOID POISONING AND MISUSE.

     

    (B-ROLL: Morphine bottle/fentanyl bottle/pharmacist)

     

    AUDIO:

    SOT/FULL

    Julie Gaither, PhD- Department of Epidemiology, Yale School of Medicine

    Super@: 14

    Runs:19

     

    “In the past 2 decades the opioid epidemic has grown exponentially. It really began in the mid-1990s when physicians were encouraged to do a better job of treating chronic pain…. in particular in 2014 there were approximately 19,000 deaths that were attributed to opioid medications.”

    (B-roll of pills to cover the cut)

     

     AUDIO:

    VO:

    1. JULIE GAITHER AND DR. DEEPA CAM-en-GAY AND CO-AUTHORS REVIEWED THE U.S. PEDIATRIC HOSPITAL DISCHARGE RECORDS OF CHILDREN AND TEENS AGES 1 TO 19, FROM 1997 TO 2012. THEY IDENTIFIED MORE THAN 13,000 CHILDREN AND TEENS WHO WERE HOSPITALIZED FOR OPIOID POISONINGS WITHIN THAT TIME FRAME.

     

    THEY ALSO LOOKED AT 15 TO 19 YEAR OLDS WHO WERE HOSPITALIZED FOR HEROIN POISONINGS.

    THE STUDY APPEARS IN JAMA PEDIATRICS.

     

    (B-ROLL: Two doctors walking/working at computer/ambulance/gurney wheeling into hospital/doctors looking at monitor)

     

    AUDIO

    SOT/FULL

    Deepa Camenga, MD-Department of Pediatrics, Yale School of Medicine

    Super@: 56

    Runs: 22

    “We found that the rates of hospitalizations for opioid poisonings doubled during … 1997 to 2012. We also found… that the highest number of hospitalizations were among teenagers, ages 15 thru 19 …the highest rates of increase in hospitalizations were among our youngest population, which was 1 to 4-year-old children.”

     

    (B-roll in middle, pill warning/girl on gurney/nurse in room)


    Julie Gaither, PhD- Department of Epidemiology, Yale School of Medicine

    Super@: 1:19

    Runs:14

     

    “Heroin poisonings increased by 150% during this time point and then very importantly, poisonings from methadone increased by approximately 950%, so almost tenfold in less than two decades.”

     

    AUDIO:

    VO:

    1. GAITHER AND DR. CAM-en-GAY SAY CHANGES IN HOW WE PRESCRIBE, DISPOSE, AND PACKAGE THESE DRUGS ARE NEEDED TO KEEP CHILDREN AND TEENS SAFE.

     (B-ROLL: Pharmacist with syringes/pills/hospital machine)

     

    SOT/FULL

    Deepa Camenga, MD-Department of Pediatrics, Yale School of Medicine

    Super@: 1:41

    Runs: 13

     

    “ Our national conversation is focused on how to improve the treatment and prevention of opioid misuse and abuse, but we also hope that this conversation focuses on how to safeguard children from this epidemic.”

    (b-roll in middle pharmacist crushing pills)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

    (BROLL: morphine bottle)

     

    TAG: THE PEDIATRIC COMMUNITY MAKES UP ¼ OF THE U.S. POPULATION.

  • October 19, 2016

    Bariatric Surgery in Women of Childbearing Age

    Bariatric Surgery in Women of Childbearing Age

    INTRO: As the U.S. deals with an obesity epidemic many younger women are having bariatric surgery for weight loss. But is there a risk for the infants of women who have had bariatric surgery? Is there a way to decrease perinatal complications and is there an optimal time to wait to have children after surgery?   A new study in JAMA Surgery examined these risks. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO

    VO:

    IN THE UNITED STATES 1 IN 5 WOMEN ARE OBESE AT THE TIME OF CONCEPTION. OBESITY DURING PREGNANCY CAN INCREASE THE RISK OF COMPLICATIONS FOR BOTH MOTHERS AND INFANTS. THAT IS ONE OF THE REASONS WHY YOUNGER WOMEN MIGHT TURN TO BARIATRIC OR WEIGHT LOSS SURGERY.

    (B-ROLL: pregnant woman at doctor/ultrasound/close up belly)

     

     

    AUDIO:

    SOT/FULL

     Brodie Parent, MD- Department of Surgery, UW

    Super@ 14

    Runs:   13

    “Bariatric surgery is becoming a very common operation in the United States in particular. // And just in the past about 5 years the rates of bariatric surgery have doubled from about 4 per hundred patients to about 8 per hundred patients.”

    (B-roll of surgery video in middle of sot)

     

     

    VO: DR. BRODIE PARENT OF THE UNIVERSITY OF WASHINGTON MEDICAL CENTER AND CO-AUTHORS STUDIED THE BIRTH CERTIFICATES AND HOSPITAL DISCHARGE DATA OF MORE THAN 10,000 MOTHERS AND INFANTS IN WASHINGTON STATE FROM 1980 TO 2013.

     

    THEY STUDIED TWO GROUPS, ONE OF WOMEN THAT HAD BARIATRIC SURGERY PRIOR TO PREGNANCY AND THE OTHER THAT DID NOT HAVE WEIGHT LOSS SURGERY.

     

    THEY WANTED TO SEE IF THE INFANTS OF THE WOMEN WHO HAD BARIATRIC SURGERY WERE AT HIGHER RISK FOR PREMATURITY, LOW BIRTH WEIGHT, AND INTENSIVE CARE ADMISSION.

     

    THE STUDY APPEARS IN JAMA SURGERY.

     

    (B-ROLL Dr. Parent walking through the hall and looking at papers/bariatric surgery b-roll/babies in ICU)

     

     

    AUDIO

    SOT/FULL

    Brodie Parent, MD- Department of Surgery, UW

    Super@: 58

    Runs: 15

    “The way to reduce that risk is perhaps by waiting 2 to 3 years after they’ve had the operation. If they give birth before that 2 to 3 year interval, there’s a higher risk of their infant requiring an ICU admission, or their infant being low weight, or premature.”

    (B-ROLL: babies in hospital in middle of sot)

     

     

     

    AUDIO

    VO:

    1. PARENT SAYS BARIATRIC OR WEIGHT LOSS SURGERY HAS MANY POTENTIAL BENEFITS BUT RECOMMENDS WAITING AS LONG AS POSSIBLE BEFORE CONCEPTION IN ORDER TO DECREASE RISKS FOR THE MOTHERS AND THEIR INFANTS.

    (B-ROLL: bariatric surgery/pregnant woman/baby in hospital)

     

     

    LAURA BERGER THE JAMA REPORT

    (B-ROLL: babies in hospital)

     

    TAG: DURING THE PAST THREE YEARS IN WASHINGTON STATE, ABOUT 200 WOMEN A YEAR HAVE HAD A BARIATRIC OPERATION PRIOR TO GIVING BIRTH.

  • October 11, 2016

    Trends in Dietary Supplement Use

    Trends in Dietary Supplement Use

    INTRO: Over the past two decades, numerous studies of diet supplements use have found little evidence of benefit. But the industry continues to grow. Does this abundance of new information affect supplement use among U.S. adults? A new study in JAMA looked at the trends in dietary supplement use from 1999-2012. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:  IN RECENT YEARS, DIETARY SUPPLEMENTS HAVE GROWN INTO A 32 BILLION DOLLAR A YEAR BUSINESS. AND AS THE INDUSTRY HAS EXPANDED, SO HAS RESEARCH INTO THE POSSIBLE BENEFITS AND RISKS OF TAKING SUPPLEMENTS.

     

     

    (B-ROLL: Supplements in bottles on table/powder supplement with graphic $32 billion/bottle close up/person taking pills)

     

     

    AUDIO:

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

    Super@: 12

    Runs: 14

    (b-roll in middle of doctor w bottles)

     

    “Supplements are tremendously popular.  In the late 1980s, more than a third of Americans were using these sort of products. And today a little more than half of all American adults use dietary supplements.”

     

     

    AUDIO:

    VO: IN THE CURRENT ISSUE OF JAMA, DR.  PIETER COHEN DISCUSSES THE RESULTS OF A NEW STUDY EXAMINING TRENDS IN DIETARY SUPPLEMENT USE AMONG U.S. ADULTS BETWEEN 1999-2012.

     

    A TOTAL OF 38,000 PEOPLE WERE ASKED ABOUT WHAT VITAMINS, MINERALS, AND SUPPLEMENTS THEY USED.  THE RESULTS WERE COMPARED OVER THE 13 YEAR PERIOD TO IDENTIFY TRENDS AND CHANGES OVER TIME.

     

    THIS TIME PERIOD WAS ALSO AN ERA OF INTENSE INVESTIGATION INTO THE HEALTH EFFECTS OF SUPPLEMENTS. THE NATIONAL INSTITUTES OF HEALTH INVESTED SEVERAL HUNDRED MILLION DOLLARS INTO RESEARCH ON SUPPLEMENTS ONLY TO FIND MOST HAVE NO SIGNIFICANT BENEFIT.

    (B-ROLL: Doctor working/person taking pills/doctor at desk/pill bottles/ pills)

     

     

    AUDIO

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

     

    Super@: 1:04

    Runs: 15

     

    “… there was very high use of supplements going into, at the start of the study in 1999, 52%. What’s interesting is that did not budge at all over the next 13 years and it was exactly the same, 52% at the end of the 13 years.”

     

    AUDIO:

    VO:

    (B-ROLL Doctor walking/doctor with pills)

    1. COHEN SAYS HE IS SURPRISED THAT SUPPLEMENT USAGE HAS STAYED THE SAME EVEN THOUGH STUDIES HAVE SHOWN THAT MANY SUPPLEMENTS HAVE LITTLE TO NO BENEFIT.

     

     

    SOT/FULL

    Pieter Cohen, MD, Cambridge Health Alliance

    Super@: 1:28

    Runs: 14

    “And how will a consumer know if a supplement has certain side effects or risks? These are things that are not well presented given today’s regulatory environment. And I think those are some major questions for the near future.”

     

    (BROLL: pill bottles/labels/pills)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: MULTIVITAMIN OR MULTIMINERAL USE DECREASED FROM 37% IN 1999-2000 TO 31% IN 2011-2012.

  • October 06, 2016

    Estrogen Blocking  Drugs Can Decrease Risk of Breast Cancer in Opposite Breast

    Estrogen Blocking  Drugs Can Decrease Risk of Breast Cancer in Opposite Breast

    INTRO: Can certain drugs help women with breast cancer decrease the risk of developing cancer in the opposite breast? A new study in JAMA Oncology found that estrogen blocking drugs can decrease the risk of contralateral breast cancer, especially among women whose breast cancer was estrogen receptor positive. The study found the women who took the drugs longer had a lower risk of developing cancer in their opposite breast.  Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

    DURING THE 10 YEARS AFTER BREAST CANCER DIAGNOSIS, 5% OF WOMEN DEVELOP CANCER IN THEIR OPPOSITE BREAST KNOWN AS CONTRALATERAL BREAST CANCER.

     

    (B-ROLL Doctor and patient looking at scans, mammogram exam, doctor looking at monitor)

     

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 9 Runs: 22

     

     “We know from clinical trials that there are medications that can be used to reduce risk of contralateral breast cancer.  Particularly for women who are diagnosed with estrogen receptor positive breast cancer, tamoxifen and aromatase inhibitors may be used. We wanted to evaluate these medications in a general community health care setting to see how well they work in the real world.”

     

    AUDIO:

    VO:

    1. GRETCHEN GIERACH FROM THE NATIONAL CANCER INSTITUTE AND CO-AUTHORS REVIEWED THE RECORDS OF MORE THAN 7500 WOMEN DIAGNOSED WITH INVASIVE BREAST CANCER FROM 1990 TO 2008.

     

    THEY FOLLOWED THE WOMEN THROUGH 2011 TO SEE WHICH ONES DEVELOPED BREAST CANCER IN THE OPPOSITE BREAST.  THE RESEARCHERS ALSO RECORDED WHO TOOK TAMOXIFEN OR AROMATASE INHIBITORS, TWO TYPES OF MEDICATIONS THAT BLOCK ESTROGEN. 

     

    DR GIERACH’S TEAM FOUND THAT WOMEN TAKING THESE MEDICATIONS FOR A LONGER PERIOD HAD A LOWER RISK OF CONTRALATERAL BREAST CANCER. 

     

    THE STUDY APPEARS IN JAMA ONCOLOGY.

     

    (B-ROLL: Dr. Gierach at her desk/talking to co-worker looking at scans/ Doctor looking at scan/ mammogram/prescription bottles/ pharmacist working)

     

     

    AUDIO

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 1:06 Runs: 10

     

    “So for women who took the drug for 4 years or longer, we observed reduced risk of contralateral breast cancer for up to 5 years after they stopped taking the medication.”

     

    AUDIO:

    VO:

    WOMEN GOING THROUGH BREAST CANCER TREATMENT HAVE MANY TOUGH DECISIONS TO MAKE IN CHOOSING A THERAPY PLAN.  DR. GIERACH SAYS IF THEY DECIDE TO USE THESE DRUGS AND CAN STICK WITH THEM, THERE ARE LONG TERM BENEFITS.

    (B-ROLL :Doctor talking to patient/scan close up/pills on shelf/girl walking up to pharmacy counter )

     

     

    SOT/FULL Gretchen Gierach, PhD-Investigator, National Cancer Institute Super@: 1:28 Runs: 14 B roll middle to end of bite of pill bottles

     

    “These medications are known to have side effects which might impact or challenge women in being able to complete her full treatment course… The longer they took the drug the greater the risk reduction, so we know that therapy duration really does make a difference.”

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: IN THE STUDY, THE AVERAGE AGE FOR WOMEN AT TIME OF CANCER DIAGNOSIS WAS 61.

     

     

  • September 27, 2016

    Early Stroke Treatment Improves Patient Outcomes

    Early Stroke Treatment Improves Patient Outcomes

    INTRO: After a large vessel stroke, how long does a patient have to get treatment in order to prevent long lasting effects? A new study in JAMA found that a shorter time to treatment after a stroke is critical to having the best recovery. But just how long does a patient have to restore blood flow to the brain? Laura Berger has more in this week’s JAMA Report.

     

    AUDIO:

    VO:

     

    STROKE IS THE 5TH LEADING CAUSE OF DEATH IN THE U.S. AND THE 2ND LEADING CAUSE OF DEATH WORLDWIDE. EACH YEAR MORE THAN 750,000 AMERICANS EXPERIENCES A STROKE.

     

    (B-ROLL ambulance arriving at hospital with a patient)

    (Graphic of 750,000 Americans each year)

     

     

    AUDIO:

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@: 11

    Runs: 13

     

    “So it’s critically important for patients to recognize the warning signs of stroke, get to the hospital as soon as possible and for doctors, nurses and health systems to then rapidly treat patients when they arrive.”

     

    AUDIO:

    VO:

    1. JEFFREY SAVER FROM UCLA AND CO-AUTHORS REVIEWED THE OUTCOMES OF OVER 1200 PATIENTS EXPERIENCING ACUTE ISCHEMIC STROKE IN 5 LARGE RANDOMIZED CLINICAL TRIALS. SOME PATIENTS RECEIVED STANDARD MEDICAL THERAPY, OTHERS RECEIVED STANDARD THERAPY PLUS TREATMENT WITH A THROMBECTOMY DEVICE.

     

    THE AUTHORS FOUND THAT THE SOONER THE DEVICE, WHICH PULLS CLOTS OUT OF THE AFFECTED ARTERY AND HELPS RESTORE BLOOD TO THE BRAIN, IS USED, THE BETTER THE PATIENT’S OVERALL RECOVERY.

     

    THE STUDY APPEARS IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. 

     

    (B-ROLL: Saver and other dr. looking at brain scans//Saver and dr. looking at thrombectomy device and holding it up.)

     

     

    AUDIO

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@:57

    Runs: 25

     

    “There was some benefit of therapy up to 7 1/3 hours after onset that’s an important new aspect…If you get the artery open at 3 hours then 65% of patients will be able to live independently 3 months later.  If it takes 8 hours to get it open, then only 45% will be able to live independently, it makes a major difference in outcome.”

     

    AUDIO:

    VO:

    IT IS CRITICAL FOR THE PUBLIC TO BE AWARE OF THE SIGNS OF STROKE.  DOCTOR SAVER SAYS USE THE ACRONYM FAST—IF YOU SEE FACIAL DROOPING, ARM WEAKNESS, AND SPEECH DIFFICULTY, IT’S TIME TO CALL 911.

    (B-ROLL patient wheeling into hospital//GRAPHIC WITH FAST ACRONYM)

     

     

    SOT/FULL

    Jeffrey Saver, M.D.-Director UCLA Comprehensive Stroke Center

    Super@: 1:34

    Runs: 15

     

    “Often the patient can’t make the call themselves because the stroke is affecting their speaking or their ability to recognize they are having a stroke. So it’s very important for family, friends, witnesses, if you see someone having stroke symptoms, call 911.  Every minute matters.”

     

    (BROLL: 2 doctors looking at brain scans, close up of the scans)

     

    VO:

    LAURA BERGER, THE JAMA REPORT

     

    TAG: DR. SAVER SAYS HOSPITALS SHOULD USE THIS PROCEDURE WITHIN 75 MINUTES OF A PATIENT’S ARRIVAL.

  • September 20, 2016

    Wearable Technology’s Effect on Weight Loss

    Wearable Technology’s Effect on Weight Loss

    INTRO: Does adding wearable technology to a program of diet and exercise help with weight loss?  A new study in JAMA reports that adding physical activity tracking gadgets to a lifestyle modification program did not result in more weight loss among a group of obese and overweight young adults. Laura Berger has more in this week’s JAMA Report.

    AUDIO

    VO:

    IN THE FIGHT AGAINST OBESITY MANY AMERICANS ARE TURNING TO WEARABLE DEVICES TO HELP MEET THEIR FITNESS GOALS.  BUT ARE THESE GADGETS EFFECTIVE?

    (B-ROLL group exercising, treadmill running, elliptical, woman with wearable arm band)

    AUDIO:

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@ 8

    Runs:  14

    “… when we gave people these strong behavioral weight loss programs that are kind of group based…we actually that thought adding wearable technologies to that program would help them lose more weight over 24 months and to our surprise, that isn’t what we found.” (B-roll in middle w devices and person working out)

    VO:

    1. JOHN JAKICIC (JA-KEY-SICK) FROM THE UNIVERSITY OF PITTSBURGH AND CO-AUTHORS STUDIED 471 OVERWEIGHT OR OBESE YOUNG ADULTS FROM 2010 TO 2012. ALL STUDY PARTICIPANTS RECEIVED COUNSELING ON DIET AND EXERCISE. 6 MONTHS INTO THE STUDY, HALF WERE RANDOMLY ASSIGNED TO GET A WEARABLE DEVICE TO HELP TRACK PHYSICAL ACTIVITY AND DIET. 

    THE AUTHORS FOUND THAT THE GROUP THAT DID NOT USE THE WEARABLE DEVICE, LOST MORE WEIGHT THAN THE GROUP WHO DID.  AN AVERAGE OF 5.3 POUNDS MORE.

    THE STUDY APPEARS IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. 

     (B-ROLL: Dr. walking through hall//B-roll overweight people//people working out// wearables//more working out)

    AUDIO

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@: 53

    Runs: 15

    “ …they may give people a false sense of security that they don’t pay attention to some of the key behaviors that they need to pay attention to. They are relying on the device too much and that’s why we saw less weight loss in that group. “

    AUDIO

    VO:

    ALTHOUGH WEARABLE TECHNOLOGY HAS CHANGED AND IMPROVED SINCE THE STUDY STARTED, THERE IS STILL NO ONE SIZE FITS ALL FITNESS TRACKING DEVICE.  (B ROLL: of newer wearable technology)

    AUDIO

    SOT/FULL

    John M. Jakicic Ph.D.-Chair of the Department of Physical Activity, U of Pittsburgh

    Super@:

    Runs:

    “…maybe we shouldn’t just think broadly about using these devices across everyone. I think we need to understand more about how to use them and for whom.”

    Laura Berger, the JAMA Report.

    (B-ROLL: people lifting weights and working out

    Tag: THE YOUNG ADULTS IN THIS STUDY ARE DEFINED AS AGES 18-35.

  • September 14, 2016

    JAMA Report: Using Hospital Records to Predict Death by Suicide

    JAMA Report: Using Hospital Records to Predict Death by Suicide

    “Using Hospital Records to Predict Death by Suicide”

     

     

    INTRO: Although suicide is the 10th leading cause of death in the United States, predicting just who is at increased risk of suicide can be challenging. Is there a better way to determine an individual’s risk for suicide? The authors of a new study in JAMA Psychiatry examined hospital discharge reports using natural language processing, and found several key predictors that can highlight potential suicide risk. Laura Berger has more in this week’s JAMA Report.

     

    AUDIO

    VO:

    ON AVERAGE THERE ARE 117 SUICIDES PER DAY IN THE UNITED STATES. AND EACH YEAR, MORE THAN 40,000 AMERICANS DIE BY SUICIDE. ALTHOUGH IT’S THE 10TH LEADING CAUSE OF DEATH IN THE UNITED STATES, EXACTLY WHO IS AT RISK OF SUICIDE IS STILL HARD TO PREDICT.

     

    (B-ROLL WITH GRAPHIC people walking down the street with a graphic over it with text of statistics)

     

     

    AUDIO:

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@16

    Runs:  9

    “…what we hope to do is understand if you are in the hospital for any reason and then you are discharged can we say something about your risk of death from suicide.”

     

    SOT/FULL

    Thomas H. McCoy, Jr., M.D., – Director of Research, Center for Quantitative Health, MGH

    Super@31

    Runs:  17

    “To try and better understand who would go on to die by suicide… we drew on…typical risk factors…But we also added a newer risk predictor and that was the words that the doctors had written about the patient at the time of discharge.“

     

    VO:

    1. THOMAS MCCOY JR. AND DR. ROY PERLIS AND CO-AUTHORS FROM MASSACHUSETTS GENERAL HOSPITAL EXAMINED THE HOSPITAL DISCHARGE NOTES OF MORE THAN 450,000 PATIENTS FROM 2005 TO 2013.

    RESEARCHERS ANALYZED THESE NOTES BY A COMPUTER PROGRAM USING SENTIMENT ANALYSIS—WHICH LOOKS FOR POSITIVE OR NEGATIVE WORDS LIKE LOVELY, DELIGHTFUL, PLEASANT– OR DREADFUL, UNFORTUNATE OR POORLY. THEY FOUND THAT CERTAIN WORDS CAN PREDICT A HIGHER RISK FOR SUICIDE.

     

    THE STUDY APPEARS IN JAMA PSYCHIATRY. 

    (B-ROLL of the two doctors walking, doctors at desk, computer screen, medium shoot of doctors, wide shot doctors, Graphic of computer with words highlighted, JAMA logo)

     

     

    AUDIO

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@: 1:12

    Runs:  14

    “The value of using natural language processing is it’s a tool that lets us pull things out we would otherwise miss if we just looked at diagnostic codes and medicines, and peoples age and gender and so forth.”

     

    AUDIO

    VO:

    DOCTORS MCCOY AND PERLIS HOPE OTHER HOSPITALS ACROSS THE COUNTRY CAN EVENTUALLY ADOPT THIS NEW APPROACH AND HELP BRING MORE INSIGHT INTO PREVENTING SUICIDE.

    (B ROLL: doctors in office talking)

     

    AUDIO

    SOT/FULL

    Roy H. Perlis, M.D.-Director of the Center for Quantitative Health MGH

    Super@: 1:35

    Runs:  8

    “…And if we can make predictions about who’s at high risk, we can better target resources, we can better target interventions to reduce this risk.”

    (BROLL: some sot covered with 2 doctors in office)

     

    Laura Berger, the JAMA Report.

    (B-ROLL: doctors at computer looking at graphs)

     

     

    Tag: IN THE STUDY ONLY 1.3% OF THE PATIENTS IN THE STUDY HAD A PRIMARY PSYCHIATRIC DIAGNOSIS.

  • September 06, 2016

    MRI Exposure During Early Pregnancy Not Associated with Increased Fetal Harm

    MRI Exposure During Early Pregnancy Not Associated with Increased Fetal Harm

     

    VNR Script

    68 seconds

    Audio: Video:
    VO:Should women take a pregnancy test before having an MRI? A new study published in The Journal of the American Medical Association looked at the safety of magnetic resonance imaging during pregnancy, especially during the first trimester.13 secs Female patient in doctor officeDoctor/Patient interactionMRI Scan
    SOT:“We already have a fair amount of data on CAT scan safety in pregnancy, but MRI was lacking.”TC 5:53 – 6:007 secs Dr. Joel Ray on camera
    VO:Dr. Joel Ray and his colleagues at Saint Michael’s Hospital in Toronto analyzed data collected over 12 years and concluded that MRI in the first trimester was not harmful to the developing fetus.11 secs Exterior of hospital, B-roll of Dr. Ray looking at data, etc.
    SOT:“An MRI in the first trimester is unlikely to be harmful, so special pregnancy testing or measures are unlikely to be required.”TC 2:34 – 2:439 secs Dr. Joel Ray on camera
    VO:Women undergoing an MRI with the contrast agent gadolinium at any point during pregnancy were also included in the study. These MRIs with contrast were associated with a higher risk of fetal death and a variety of inflammatory and skin conditions in the newborn.13 secs Female patient undergoing MRI
    SOT:“It reinforces a to date evidence-free notion that gadolinium might harm the fetus.TC 4:53 – 5:01<CUT> 

    “Gadolinium contrast would be best avoided in pregnancy.”

    TC 2:52 – 2:56

     

    12 secs

    Dr. Joel Ray on cameraB-roll of MRI scans or procedure as necessary to cover cut
     VO: This is Laura Kelly for the JAMA Report.

     

     

  • August 23, 2016

    Reducing the High Cost of Prescription Drugs in the U.S.

    Reducing the High Cost of Prescription Drugs in the U.S.

    INTRO:Prescription drug costs in the United States continue to rise well above inflation rates and make up an increasingly large share of total health care spending. A new report examines the reasons for these higher prices and also suggests policy changes that could help contain drug costs. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    People walking on street, pharmacy sign, doctor holding drug bottles, shelves of prescription drugs

    AUDIO
    VO
    For many Americans, a trip to the pharmacy can result in sticker shock. People in the United States pay more for their prescription drugs than anywhere else in the world.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:08
    Runs:06
    “There’s a lot of frustration about high drug costs and how they impact the delivery of patient care.”

    VIDEO
    B-ROLL
    Dr. Kesselheim walking in clinic, various shots of him sitting at computer

    AUDIO
    VO
    Dr. Aaron Kesselheim and his colleagues at Brigham and Women’s Hospital reviewed the medical and health policy literature on prescription drug prices in the U.S. The researchers say high drug costs stem from several factors.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:25
    Runs:15
    “The provision of market exclusivity that allows drug companies to charge whatever the market will bear and then limitations on payers and their ability to negotiate drug prices and the limitations on competition, that might drive drug prices down.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@:49
    Runs:08
    “Another factor; a lot of physicians don’t know what the price of the drugs are to patients and so will prescribe drugs without thinking about the price of the product.”

    (Video covering 1st part of bite: pills being counted)

    AUDIO
    VO
    This contributes to patients sometimes not filling prescriptions and spreading out doses or splitting pills to reduce costs.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:00
    Runs:07
    “We need more education for physicians and patients about the implications of high drug prices on the delivery of care.”

    VIDEO
    B-ROLL
    Pan of prescription drugs on shelf, doctor looking at drug bottle

    AUDIO
    VO
    Also, more information on identifying high and low value drugs, so resources aren’t wasted.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:15
    Runs:09
    “And insuring that there is both reasonable periods of market exclusivity as well as adequate competition when those market exclusivity periods end.”

    VIDEO
    B-ROLL
    Push in to pile of drugs, pan of drugs

    AUDIO
    VO
    And timely availability of high quality and safe generic drugs.

    AUDIO
    SOT/FULL
    Aaron S. Kesselheim, M.D., J.D., M.P.H., – Brigham and Women’s Hospital
    Super@1:26
    Runs:13
    “There have been a number of studies showing, when generic drugs enter the market that drug prices fall substantially. Money that is spent unnecessarily on expensive drugs cannot be spent in other areas of health care delivery.”

    (Video covering 2nd half of bite: pills being poured out of bottle and counted)

    VIDEO
    B-ROLL
    Pills being counted

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Another justification for higher drug prices is that it will help encourage innovation.  However, according to the authors, most innovation comes from publically funded science in government labs and academic research settings.

  • August 16, 2016

    New Medication for High Cholesterol Not Cost-Effective

    New Medication for High Cholesterol Not Cost-Effective

    INTRO: Statins are a common medication used to lower L-D-L or “bad” cholesterol levels. However, for some patients, statins alone aren’t enough. Last year, a new type of medication known as P-C-S-K-9 inhibitors became available for use along with statins.  Although effective, these drugs are very expensive. A new study evaluated the cost-effectiveness of this therapy and how increased use might affect the U.S. health care system. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Video of people walking, Graphic

    AUDIO
    VO
    Millions of people struggle to lower their L-D-L or “bad” cholesterol. A new type of therapy called a P-C-S-K-9 inhibitor can help reduce L-D-L or “bad” cholesterol by nearly 50 percent.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@:11
    Runs:12
    “They block a specific enzyme in the cholesterol pathway. In doing so, they increase the removal of LDL cholesterol from the blood into the liver and lower LDL cholesterol levels.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@:23
    Runs:20
    “They were approved to be used for individuals who are at higher risk for heart disease, who have had a heart attack, a stroke or who have a family history of very high cholesterol. These drugs were approved to be used in addition to the statin medications in these particular individuals.”

    (Video covering  middle of bite: dye being injected into artery)

    VIDEO
    B-ROLL
    Dr. Bibbins-Domingo and Dr. Kazi walking down hall, looking at blocked artery on computer screen, Graphic

    AUDIO
    VO
    Doctors Kirsten Bbibbins-Domingo and Dhruv (drewz) Kazi from the University of California San Francisco and their co-authors examined the cost-effectiveness of P-C-S-K-9 inhibitors and their potential effect on U-S health care spending. Using a simulation model that included all U-S adults 35 and older, they evaluated outcomes like expected numbers of deaths due to cardiovascular disease, heart attacks and strokes and balanced this with the cost and potential benefits of these drugs. The authors estimated that about 9 million people would be eligible for this therapy.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of Californ ia San Francisco
    Super@1:13
    Runs:06
    “This innovation comes at a price. They were launched at a little over 14 thousand dollars per patient per year.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@1:19
    Runs:07
    “It would increase our total expenditure on prescription drugs by almost 40 percent.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@1:30
    Runs:09
    “All health care expenses would go up 4 percent. That’s a large increase in our total U.S. health care expense based on one set of drugs alone.”

    AUDIO
    SOT/FULL
    Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S., – University of California San Francisco
    Super@1:39
    Runs:08
    “Our analysis suggests that price tag should be closer to just over 4 thousand dollars a year for them to be cost-effective.”

    AUDIO
    SOT/FULL
    Dhruv S. Kazi, M.D., M.Sc., M.S., – University of California San Francisco
    Super@1:47
    Runs:07
    “Should that not happen we would expect to see an unprecedented strain on health system budgets across the country.”

    VIDEO
    Dr. Kazi on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The P-C-S-K-9 inhibitors would also help a small portion of patients who are unable to take statins to lower their bad cholesterol.

  • August 09, 2016

    Device Reduces Risk of Brain Injury After Heart Valve Replacement

    Device Reduces Risk of Brain Injury After Heart Valve Replacement

    INTRO: Patients who need a heart valve replacement but are too ill for major surgery sometimes undergo a less invasive procedure that uses a catheter to replace their damaged valve. As a complication of the procedure, up to 10 percent of these patients experience a stroke. A new study looked at whether or not a filter device inserted into the blood vessels can help protect the brain from stroke by removing debris that is dislodged during the procedure. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of TAVI procedure

    AUDIO
    VO
    A procedure is underway to replace this patient’s diseased heart valve. It’s called trans-catheter aortic valve implantation or “TAVI.” Instead of open heart surgery, doctors use a catheter to implant a new valve inside the old one. During this process, tissue and plaque in the blood vessels can become loose, traveling through the bloodstream to the brain.

    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@:19
    Runs:08
    “Because of the material you have neurologic injuries, like little strokes or little cerebral infarcts.”

    VIDEO
    B-ROLL
    Preparing catheter with filters in solution

    AUDIO
    VO
    A cerebral protection device is a type of filter that is placed by catheter, directly into the vessels that supply the brain.

    AUDIO
    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@:34
    Runs:17
    “By using the filter we are trying to capture this material and protect the brain. The device is designed to save brain tissue that would otherwise be killed by particles that occlude little vessels that supply the brain with blood and oxygen.”

    (Video covering 2nd part of bite: catheters inside heart on screen)

    VIDEO
    B-ROLL
    Dr. Linke sitting at his desk, procedure, heart monitor, filter being prepared, patient undergoing MRI, procedure

    AUDIO
    VO
    Dr. Axel Linke (Lin-keh) from the University of Leipzig Heart Center, In Germany and co-authors studied 100 patients with an average age of 80 who underwent the “TAVI” procedure. Half the patients received the filter device. The other half did not. They also underwent an M-R-I of the brain before and again at two and seven days after the procedure.

    AUDIO
    SOT/FULL
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@1:09
    Runs:11
    “By using the filter device, the number of lesions in the brain was reduced by 50 percent and the volume was reduced by 50 percent as well.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    Axel Linke, M.D., – University of Leipzig Heart Center
    Super@1:24
    Runs:22
    “You’re reducing the number of lesions, which means the number of holes in the brain, and you’re reducing the amount of dead tissue in the brain. You have more functional neurons and more alive brain tissue present as compared to somebody without the embolic protection.”

    (Video covering last part bite: pan of procedure)

    VIDEO
    B-ROLL
    Patient undergoing procedure

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Larger studies are needed to prove whether this device can also result in better neurological and cognitive outcomes in patients.

  • August 01, 2016

    Eating More Plant Protein Associated with Lower Risk of Death

    Eating More Plant Protein Associated with Lower Risk of Death

    INTRO Understanding what kinds of food provide the best health outcomes is an important area of research. In particular, the types of protein we eat, both animal and plant-based, can have long-term effects on overall health. A new study examined how diets heavy in either animal or plant-based protein sources can influence mortality. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Various shots of different foods AUDIO
    VO
    Figuring out the components of a balanced diet can often mean endless choices. Both animal and plant based proteins are part of those choices.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:07 Runs:05
    “Someone’s protein intake is potentially associated with long-term health outcomes and mortality.”

    AUDIO SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@:13 Runs:11
    “People should not only care about how much protein they consume, but also pay attention to what kind of food they consume to gather the protein.”

    VIDEO
    B-ROLL Dr. Song and Dr. Chan walking down hallway, sitting at desk talking, shot of fish, olives, people walking outside, various other shots of food, including sandwiche

    AUDIO
    VO
    Doctors Mingyang Song and Andrew Chan from Massachusetts General Hospital and co-authors examined how animal and plant based protein sources influence long-term health. They looked at more than 131 thousand adults participating in two long-running, national health studies. Participants provided 25 to 30 years of detailed information on diet, lifestyle, and medical conditions. Researchers reviewed detailed food questionnaires that were sent to the participants every four years.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:49 Runs:10
    “Individuals that consumed the highest amounts of animal based proteins had a somewhat higher risk of mortality, in particular, cardiovascular mortality.” AUDIO SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@1:00 Runs:07
    “And this association is stronger among people with unhealthy lifestyle factors.”
    VIDEO
    B-ROLL Man with cigarette, beer and wine, overweight people

    AUDIO
    VO
    Those with a healthier lifestyle did not see an increase in their risk of dying.

    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    VO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Mingyang Song, M.D., Sc.D., – Massachusetts General Hospital Super@1:29 Runs:11
    “When we look at animal protein versus plant protein, we found that replacement of animal protein with plant protein is associated with substantial reduction of mortality.”

    AUDIO SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@1:46 Runs:11 “Clearly over the long-term a diet which is comprised of primarily plant-based proteins tends to be more favorable for longevity than someone who consumes most of their protein from animal sources.” (Video covering 2nd half of bite: various foods)

    VIDEO
    B-ROLL Dr. Chan on camera
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say previous studies have only looked at the amount of protein intake, not the type of protein sources consumed.

  • July 25, 2016

    Unintentional Marijuana Exposure Increases among Colorado Children

    Unintentional Marijuana Exposure Increases among Colorado Children

    INTRO: As of 2015, four U-S states, including Colorado, have legalized recreational marijuana. The drug is available in various forms, including cigarettes and edibles like candy and baked goods. These products are sometimes unintentionally ingested by children. A new study evaluated these unintentional marijuana exposures among young children in Colorado. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Pics of sour gummies, chocolate chip cookie, brownie, marijuana AUDIO
    VO
    Sour gummies, this chocolate chip cookie and this brownie may look like regular candy and baked goods, but they aren’t. They are made with marijuana.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:08 Runs:08
    “And so they would look highly attractive and taste just like any other food that a child would like to get into.”

    VIDEO
    B-ROLL Dr. Wang walking in the emergency department, looking at papers in nurses station, walking into exam bay, park, various children in park
    AUDIO
    VO
    Dr. G. Sam Wang (Wong) from Children’s Hospital Colorado and co-authors evaluated the number of children seen for unintentional exposure to marijuana from 2009 thru 20-15, before and after recreational use became legal in the state. They identified children from zero to nine years old coming to the Children’s Hospital and also reviewed calls to the regional poison center.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:37 Runs:18
    “Between 2009 through 20-15, we saw a pretty big jump in kids annually coming here for marijuana exposures. There was one in 2009 and there was 16 in 2015. Calls to the poison center for marijuana exposures in the same age group increased from nine to 47.”

    GXF FULL
    JAMA PEDIATRICS LOGO

    AUDIO
    VO
    The study appears in JAMA, Pediatric.

    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@:57 Runs:09
    “The majority of these kids got into marijuana by route of ingestion, meaning they ate a marijuana product, and a large percentage of them were actually edible products.”
    VIDEO
    B-ROLL Little girl walking in the park

    AUDIO
    VO
    Their average age: just over 2 years old.
    AUDIO
    SOT/FULL G. Sam Wang, M.D., – Children’s Hospital Colorado Super@1:09 Runs:12
    “Most kids who became symptomatic had some sort of degree of sleepiness. We’ve had children who’ve become comatose had such difficulty breathing that they actually needed a breathing tube to help them breathe.”

    (Video covering middle of bite: Emergency room sign on building, insides exam room)

    VIDEO
    B-ROLL Dr. Wang talking with hospital colleague, various shots of edible marijuana products

    AUDIO
    VO Dr. Wang (Wong) says it’s important to keep marijuana edibles in their original child-resistant packaging and store them safely and out of reach.

    AUDIO
    G. Sam Wang, M.D., – Children’s Hospital Colorado Super@1:28 Runs:14
    “As more states decide to legalize marijuana we have to make sure the public health impact gets evaluated and we have to continue surveillance on how legalization of marijuana does impact the pediatric population.”

    (Video covering middle of bite: pan of marijuana canisters. Video covering end of bite: children in park) VIDEO
    B-ROLL Children in park AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say in the overwhelming majority of cases, the marijuana was found in the child’s home.

  • July 18, 2016

    Bariatric Surgery Can Improve Mobility and Pain for Obese Teens

    Bariatric Surgery Can Improve Mobility and Pain for Obese Teens

    INTRO: Many adults who undergo bariatric surgery not only lose weight, but they also see improvements in muscle and joint pain and the ability to walk around. What about teenagers that undergo these procedures? A new study followed a group of teens that had bariatric surgery to see whether the procedure also helped decrease pain and improve mobility. Catherine Dolf explains in this week’s JAMA Report.
    VIDEO
    B-ROLL Girl looking over a fence, young girl walking in the park, elevator door closing, going up flight of stairs
    AUDIO
    For most teenagers, worrying about things is a normal part of growing up. But teens who are severely obese may worry about being able to walk around and keep up with their friends, or even whether a building has an elevator so they don’t have to climb several flights of stairs.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@:15 Runs:04
    “And what this can do is really decrease the quality of life for these individuals.”

    AUDIO
    SOT/FULL Justin R. Ryder, Ph.D., – University of Minnesota Medical School Super@:19 Runs:12
    “Bariatric surgery is a viable treatment option for youth with severe obesity. But with that comes risks but also comes substantial benefits.”

    VIDEO
    B-ROLL Dr. Ryder and Dr. Kelly walking down hallway, various shots of bariatric surgery, teens walking down the street

    AUDIO
    Doctors Justin Ryder and Aaron Kelly from the University of Minnesota School of Medicine and co-authors are tracking long-term outcomes for 242 teens that underwent bariatric surgery at 5 centers around the U-S. Surgery like this one, performed by Dr. Thomas Inge at the Cincinnati Children’s Hospital. The current study includes 206 of these teenagers and focuses on improvements in mobility and joint pain. All patients participated in a quarter mile walk test before and after surgery.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@:57 Ends:14
    “We figured from the outset that bariatric surgery, because of the magnitude of weight-loss that accompanies it, that these teenagers would be able to walk further and have less pain but we were surprised about just how much that improved.”
    AUDIO
    GXF FULL
    JAMA PEDIATRICS LOGO

    AUDIO
    VO
    The study appears in JAMA, Pediatric.

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota Medical School Super@1:14 Ends:07
    “They were able to walk this distance faster and with a lower heart rate, indicating that their fitness levels improved.”
    AUDIO
    SOT/FULL Justin R. Ryder, Ph.D., – University of Minnesota School of Medicine Super@1:21 Runs:08
    “They were about 30 seconds faster at six months and those benefits were sustained up to two years post-surgery.”

    AUDIO
    SOT/FULL Aaron S. Kelly, Ph.D., – University of Minnesota School of Medicine Super@1:29 Runs:13
    “In addition, they were able to do it relatively pain free compared to before they had the surgery. Many of them will be more likely to engage in physical activity and exercise over time, which we think will give them a better shot of keeping the weight off in the long-term.” (Video covering end of bite: girl walking)
    VIDEO
    B-ROLL Girl walking AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Teenagers participating in the study were at least 13 but less than 19 years old.

  • July 11, 2016

    Increased Risk for Chronic Opioid Use After Surgery

    Increased Risk for Chronic Opioid Use After Surgery

    “Increased Risk for Chronic Opioid Use After Surgery”

    INTRO: Chronic use of prescription pain medications known as opioids is increasing in the United States. Many patients who have not previously taken this type of medication are prescribed these drugs to help manage pain after surgery. A new study examined whether these patients are also at an increased risk for using opioids long-term. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO
    B-ROLL Wide shot of surgery
    AUDIO
    VO
    Each day, thousands of surgeries are performed across the United States.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:04 Runs:06
    “It’s pretty normal to get a pain killer after you, after you go home from your surgery and during your surgery.”

    VIDEO
    B-ROLL Various shots of medication, Dr. Sun walking down steps, various shots of Dr. Sun sitting at desk looking at computer, surgery shots

    AUDIO
    VO What’s not normal is to still be taking those pain medications many months after surgery. Dr. Eric Sun and his colleagues at the Stanford University School of Medicine reviewed the records of more than 641 thousand patients who were not taking pain medication during the year prior to surgery. they had one of 11 common operations, including joint replacements, gall bladder removal, and C-sections, during a 12-year-period.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:32 Runs:15 “We wanted to see at the year out after their surgery, were they at increased risk of using opioids chronically compared to patients who didn’t get surgery. Some opioid use is to be expected shortly after surgery, so we did exclude the first 90 days following their surgery.”

    VIDEO
    B-ROLL Various shots of pharmacy and medication

    AUDIO
    Chronic use was defined as filling at least 10 prescriptions, or more than 120 days worth of opioids, during the first year after surgery.

    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    VO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@:57 Runs:15
    “Patients who didn’t use opioid prior to surgery were at an increased risk for chronic opioid use following their surgery. The risks range from about one and a half to five times depending on the surgery. Overall, the risk is pretty low, it was about less than one percent for most of the surgeries we looked at.”
    VIDEO
    B-ROLL Various shots of opioid medications

    AUDIO
    VO
    Men and older patients were at an increased risk of chronic opioid use along with patients with a history of certain medical conditions.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@ 1:19 Runs:10
    “Patients who use benzodiazepines, that’s a fairly common drug people use for anxieties and also patients with a history of drug abuse and alcohol abuse are at high risk for chronic opioid use following their surgery.” VIDEO
    B-ROLL Various shots of surgery

    AUDIO
    VO
    Dr. Sun says physicians should be aware of this risk even though the overall risk is small.

    AUDIO
    SOT/FULL Eric C. Sun, M.D., Ph.D., – Stanford University School of Medicine Super@ 1:38 Runs:10
    “Physicians should closely monitor their surgical patients to see how much opioid they are or aren’t taking, and just be aware that they may be at high risk for using opioids chronically.”
    (Video covering end of bite: Medication on counter)

    VIDEO
    B-ROLL Medication on counter AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say more research is needed to better manage the pain patients experience after surgery.

  • July 05, 2016

    Availability of Euthanasia and Physician-Assisted Suicide Around the World

    Availability of Euthanasia and Physician-Assisted Suicide Around the World

    INTRO:Worldwide, euthanasia and physician-assisted suicide are increasingly being legalized but remain controversial. A new study examined how the public’s attitude toward the practices has changed, as well as what types of patients that are using the procedures and why. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@:02
    Runs:05
    “There’s been an increase in legalization of euthanasia and assisted suicide in developed countries.”

    VIDEO
    B-ROLL
    Graphic-Maps, Dr. Emanuel walking and in his office

    AUDIO
    VO
    Both are legal in the Netherlands, Belgium, Luxembourg, Columbia, and Canada. Switzerland, along with 5 U-S states: Oregon, Washington, Montana, Vermont, and California offer physician-assisted suicide.  Dr. Ezekiel Emanuel and his colleagues from the University of Pennsylvania reviewed all available data on these interventions from the late 1940s through 20-16.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@:26
    Runs:16
    “Public support for euthanasia and assisted suicide is quite interesting. It’s more supportive of euthanasia. It increased from 1947 to about 1990 and then plateaued and over the last few years there’s been about a five or ten percent decline in support.”

    GXF FULL
    JAMA LOGO

    VIDEO
    B-ROLL
    Graphic-Map

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association. The interventions are rare.  In the Netherlands and Belguim, less than 5 percent of all deaths are by assisted suicide or euthanasia.  In Washington and Oregon, only 3 in a thousand deaths are by assisted suicide.  However, not every case is reported so it’s impossible to tell if these are true rates.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@1:02
    Runs:14
    “70 to 75 percent of the patients who get assisted suicide or euthanasia, no matter what the country, tend to be patients with cancer. It’s people who have really sort of given up on life…or they fear the loss of autonomy and dignity.”

    VIDEO
    B-ROLL
    Graphic

    AUDIO
    VO
    They tend to be older, white, well- educated, and well insured.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@1:20
    Runs:20
    “We know these aren’t flawless procedures, we know that they have mistakes and complications, we just don’t know the exact rate and the full nature of them. Worries about widespread abuse of these practices, that people who don’t have insurance or poor people might be predominantly targeted, do not seem to be borne out by the data.”

    VIDEO
    B-ROLL
    Dr. Emanuel at his desk

    AUDIO
    VO
    Dr. Emanuel also says these practices occur whether they are legal or not.

    AUDIO
    SOT/FULL
    Ezekiel J. Emanuel, M.D., Ph.D., – University of Pennsylvania
    Super@ 1:44
    Runs:10
    “It behooves us to actually look at the practices and try to understand how they work, how well they work, what the problems are before we rush to legalize it in a lot of other countries.”

    VIDEO
    B-ROLL
    Dr. Emanuel on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: Study authors say public support for these interventions is about 65 percent but the support is much less among physicians.

  • June 28, 2016

    Rethinking Blood Pressure Control in Older Adults

    Rethinking Blood Pressure Control in Older Adults

    INTRO: Three-quarters of people who are 75 and older have high blood pressure. Having high blood pressure increases the risk of heart attack, heart failure and stroke. A new study examined what would be the best target blood pressure to reduce the risks of these complications in older adults. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Mary walking from her car into hospital

    AUDIO
    VO
    Living independently is important to Mary Powers and her husband of 63 years.

    AUDIO
    SOT/FULL
    Mary Powers – Study Participant
    Super@:04
    Runs:06
    “We’re still in our home and we have a garden, we travel a little and enjoy life.”

    VIDEO
    B-ROLL
    Mary walking into hospital, getting blood pressure checked, cu of blood pressure machine, cu of Mary

    AUDIO
    VO
    Like a lot of people in their 80s, Mary has high blood pressure.  She works with her doctor to manage the blood pressure so she can be as healthy as possible for as long as possible.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@:19
    Runs:07
    “The most common reasons that people end up losing their independence are often complications of hypertension.”

    VIDEO
    B-ROLL
    Dr. Williamson walking down hall, talking with colleague, older people walking and shopping in the community

    AUDIO
    VO
    Dr. Jeff Williamson from Wake Forest School of Medicine and co-authors released the latest results from the systolic blood pressure intervention trial also known as the “sprint” trial.  They enrolled more than 26 hundred people, 75 and older.  All participants were living in their own home and could get back and forth to the doctor. they were randomly assigned to two groups.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@:43
    Runs:18
    “We wanted to test and see whether a systolic blood pressure target of less than 120 millimeters of mercury, that’s the top number measured in the doctor’s office, was more effective than 140 at reducing the risk of stroke, heart attack, heart failure
    and death.”

    VIDEO
    B-ROLL
    Mary’s blood pressure being monitored, taking a memory test and a walking test

    AUDIO
    VO
    In addition to recording those outcomes, researchers monitored blood pressure along with memory skills, and the ability to walk a little more than 13 feet, every three to four months. The trial was scheduled to run five years.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@1:12
    Runs:15
    “After just over two years, the study was stopped by the National Institutes of Health because we found a strongly favorable result in those individuals assigned to a blood pressure treatment target of less than 120.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@1:31
    Runs:09
    “The blood pressure target of 120 systolic is much more effective than a target of 140 in reducing the complications of high blood pressure.”

    VIDEO
    B-ROLL
    Various shots of people walking in the community

    AUDIO
    VO
    Even those individuals who were somewhat frail appeared to benefit from the lower blood pressure target.

    AUDIO
    SOT/FULL
    Jeff D. Williamson, M.D., M.H.S., – Wake Forest School of Medicine
    Super@ 1:45
    Runs:09
    “This should remove a great deal of confusion for patients and their physicians about what the blood pressure target should be for older people.”

    VIDEO
    B-ROLL
    Cu of blood pressure monitor, wide shot of Mary getting blood pressure checkeD

    AUDIO
    Mary’s blood pressure has been well controlled and she has just one word for how she feels these days.

    AUDIO
    SOT/FULL
    Mary Powers – Study Participant
    Super@1:59
    Runs:01
    “Great.”

    VIDEO
    B-ROLL
    Mary smiling on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag: To achieve the lower blood pressure goal, participants required, on average, one additional medication per day.  90 percent of the medications used were generic.

  • June 15, 2016

    Updated Recommendations for Colorectal Cancer Screening in Adults

    Updated Recommendations for Colorectal Cancer Screening in Adults

    INTRO: Colorectal cancer is the second leading cause of cancer death in the United States. Screening can accurately detect early stage colorectal cancer and precancerous polyps. The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services, including cancer screening. The Task Force has just issued updated recommendations on colorectal cancer screening for adults. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    VO
    In the United States this year, an estimated 134 thousand people will be diagnosed with colorectal cancer and about 49 thousand will die from the disease.

    VIDEO
    B-ROLL
    Various shots of people down the street

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:09
    Runs:05
    “Most colorectal cancer occurs after people are 50 and the rates go up as you get older.”

    VIDEO
    B-ROLL
    Dr. Owens walking outside, sitting at desk looking at graphs on a computer, colonoscopy screening

    AUDIO
    VO
    Dr. Douglas Owens, an author of the recommendation and a former member of the U-S Preventive Services Task Force, says the group strongly recommends screening average risk adults age 50 to 75 for colorectal cancer, and then making individual screening decisions for adults age 76 to 85, taking into account the patient’s overall health and screening history.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:32
    Runs:06
    “There are a number of ways to be screened for colorectal cancer and the good news is, is that they are effective.”

    VIDEO
    B-ROLL
    Patient undergoing colonoscopy, technician working in lab

    AUDIO
    VO
    Those include direct visualization tests like a colonoscopy and also stool based tests.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:44
    Runs:04
    “The important thing is that you choose one and be screened.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The new Task Force recommendations appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@:51
    Ends:18
    “For people 76 to 85, the benefits of screening are smaller but some people may still benefit. People who’ve never been screened before and who are healthy enough to undergo treatment for colorectal cancer, should it be diagnosed, and who don’t have other conditions that would limit their life expectancy.”

    VIDEO
    B-ROLL
    People walking on the street

    AUDIO
    VO
    The decision to screen for colorectal cancer in this older age group should be individualized and take that patient’s overall health into account.

    AUDIO
    SOT/FULL
    Douglas K. Owens, M.D., – Former Member U.S. Preventive Services Task Force
    Super@1:16
    Ends:09
    “About a third of people in the United States who should be getting screening for colorectal cancer are not being screened currently, and that’s an important missed opportunity.”

    VIDEO
    B-ROLL
    Dr. Owens on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The Task Force does not have a recommendation for screening after age 85.

  • June 07, 2016

    U-S Obesity Rates Increase In Women, Stay Stable In Men

    U-S Obesity Rates Increase In Women, Stay Stable In Men

    INTRO: Obesity rates in the United States have increased, especially during the 1980s and 90s.  In the decade after, those rates appeared to have stabilized but what about now? A new study examined the latest trends in obesity rates among men and women in the U-S. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:01
    Runs:07
    “It’s really important to monitor trends in obesity and extreme obesity in the United States because obesity has an impact on our health.”

    VIDEO
    B-ROLL
    Overweight men and women walking on the street, Dr. Ogden walking outside, Dr. Ogden walking with colleague, various shots of Dr. Ogden at working at her desk

    AUDIO
    VO
    Obesity is closely linked to several health problems including diabetes, hypertension and heart disease. Dr. Cynthia Ogden and her colleagues from the National Center for Health Statistics examined trends in obesity among U-S adults from 2005 to 2014. They used data provided by the long-running National Health and Nutrition Examination Survey or N-HANES.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:26
    Runs:13
    “We were able to measure weight and height which are used to calculate BMI. Obesity is actually a BMI at or about 30. Class 3 obesity is a BMI above 40 and that’s sometimes also called extreme obesity.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    VIDEO
    B-ROLL
    Various shots of overweight people walking

    AUDIO
    VO
    To examine trends over the decade, the researchers looked at a nationally representative sample of more than 13 thousand men and 13 thousand women.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@:51
    Runs:19
    “We saw that there had been no change in men in either obesity or extreme obesity but there had been an increase in women in both obesity and extreme obesity and when we adjusted for potential contributors of obesity by age, race, Hispanic origin, education and smoking status that didn’t change the results.”

    (Video covering end of bite: man walking into building)

    VIDEO
    B-ROLL
    Various shots of overweight men and women walking on the street

    AUDIO
    VO
    They also examined data from 26 hundred men and 28 hundred women in the most recent survey period, two thousand 13 thru two thousand 14.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@ 1:18
    Runs:12
    “The prevalence of obesity among men was about 35 percent and among women was about 40 percent and the prevalence of extreme obesity was 5 and a half percent in men and almost 10 percent in women.”

    VIDEO
    B-ROLL
    Graphic:
    Obesity Rates
    Asian Men
    Age 20 to 39

    AUDIO
    VO
    They also saw obesity rates increase among Asian men, age 20 to 39.

    AUDIO
    SOT/FULL
    Cynthia L. Ogden, Ph.D., – National Center for Health Statistics
    Super@1:35
    Runs:08
    “The prevalence was about 23 percent and that compares to about 6 percent in middle aged Asian men and 4 percent in older Asian men.”

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Black and Hispanic women continue to have a higher prevalence of obesity compared to non-Hispanic white women.

  • May 24, 2016

    Rates of Obesity and Diabetes Lower In More Walkable Neighborhoods

    Rates of Obesity and Diabetes Lower In More Walkable Neighborhoods

    INTRO: Despite public health efforts to reduce obesity through diet and exercise, the rates of overweight, obesity and diabetes continue to rise. A new study from Ontario, Canada examined whether living in more walkable neighborhoods is associated with a slower increase in rates of obesity-related diseases compared to less walkable neighborhoods. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of people walking in the city

    AUDIO
    VO
    Neighborhoods that are more walkable tend to be more densely populated.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:03
    Runs:07
    “And they tend to be zoned so that there’s retail and other services within the neighborhood. So there’s more places people can reach on foot.”

    VIDEO
    B-ROLL
    Various shots of cars driving

    AUDIO
    VO
    In less walkable suburban neighborhoods, stores and services are harder to reach on foot.  People usually have to drive to get places.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:17
    Runs:10
    “It seems that neighborhoods that are more walkable and are designed to make it easier to walk may actually help people to be more physically active.”

    VIDEO
    B-ROLL
    Dr. Booth walking down hospital hallway, sitting and working at her desk, people walking down the street, driving shots of neighborhood from car, people walking

    AUDIO
    VO
    Dr. Gillian Booth from St. Michael’s Hospital and co-authors studied almost 9000 neighborhoods in southern Ontario looking at walkability scores, along with government health data and survey results during a 12-year period.  They examined whether rates of overweight, obesity, and new cases of diabetes were rising more slowly in neighborhoods that were easier to walk in.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@:46
    Runs:16
    “Rates of overweight and obesity were much lower in the most walkable neighborhoods compared to less walkable ones and were actually stable over time in the most walkable neighborhoods, whereas they were continuing to increase in less walkable areas.”

    (Video covering middle of bite: people walking on the street)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@1:05
    Runs:11
    “Rates of diabetes were actually going down, and then least in terms of the number of new cases in the most walkable areas, whereas rates were not falling in less walkable areas.”

    VIDEO
    B-ROLL
    Various shots of people walking, riding bikes and buses going down street

    AUDIO
    VO
    Neighborhoods with lower rates of obesity and diabetes also had higher rates of walking, biking and mass transit use.

    AUDIO
    SOT/FULL
    Gillian L. Booth, M.D., – St. Michael’s Hospital
    Super@ 1:23
    Runs:16
    “It doesn’t mean that if we build neighborhoods differently that rates of overweight and obesity will fall, but it’s certainly hopeful and it gives us more information and some potential solutions that we can test in the future.”

    VIDEO
    B-ROLL
    People walking on the street

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say that the number of car trips per capita was also lower in more walkable neighborhoods.

  • May 17, 2016

    Surrogate Decision Makers for Critically Ill Patients Often Have Overly Optimistic Expectations

    Surrogate Decision Makers for Critically Ill Patients Often Have Overly Optimistic Expectations

    INTRO:When critically ill patients are unable to speak for themselves, a family member or close friend is often asked to serve as a surrogate decision maker.  Sometimes these surrogates and physicians have different expectations about a patient’s prognosis. A new study examined how often this happens and why it happens. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Graphic: Pictures of Mary Ann

    AUDIO
    VO
    Mary Ann Flati was a loving mother and grandmother.

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@:05
    Runs:10
    “My mom was, the kind of mom the whole world needs. She was very loving and she did everything she could for us and for her friends.”

    VIDEO
    B-ROLL
    Graphic: Pictures of Mary Ann

    AUDIO
    VO
    Before she died, Mary Ann spent 15 days in the I-C-U after a serious autoimmune disease affected her lungs.

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@:19
    Runs:08
    “The actions were a little of hope, of trying things, but it seemed contradictory with seeing her on a ventilator.”

    VIDEO
    B-ROLL
    Cara walking down hallway

    AUDIO
    VO
    Mary Ann’s daughter was one of her surrogate decision makers.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@:31
    Runs:07
    “We set out to understand how often physicians and surrogates in ICUs have different expectations about the patient’s prognosis.”

    VIDEO
    B-ROLL
    Dr. White walking with colleague, standing with colleagues talking, various shots of patient in the ICU

    AUDIO
    VO
    Dr. Douglas White from the University of Pittsburgh Medical Center and co-authors enrolled 99 physicians and 229 surrogates who made decisions for 174 critically ill patients in 4 I-C-U’s at a major medical center. They were interested in discordance, defined as at least a 20 percent difference between the physician’s and surrogate’s expectations about a patient’s prognosis.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super:59
    Runs:12
    “In roughly half the cases surrogates had substantially more optimistic expectations about prognosis compared to the physicians and that the physician’s estimates were much more accurate than the surrogate’s.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@1:15
    Runs:13
    “In almost all cases, surrogates misunderstood physician’s prognostic expectations. In about half of cases, surrogates held systematically different beliefs about the prognosis compared to what they heard from the physicians.”

    (Video covering middle of bite: patient in ICU)

    VIDEO
    B-ROLL
    Graphic over video of ICU patient
    COMMON SURROGATE BELIEFS
    -MAINTAINING HOPE
    -RELIGIOUS BELIEFS
    -UNIQUE STRENGTHS

    AUDIO
    VO
    Those beliefs most commonly included the need to maintain hope in order to improve the patient’s outcome, religious beliefs and a belief that the patient had unique strengths, unknown to the physician that would make the prognosis better.

    AUDIO
    SOT/FULL
    Douglas B. White, M.D., M.A.S., – University of Pittsburgh Medical Center
    Super@1:40
    Runs:16
    “Sometimes clinicians think that all they need to do is to communicate clearly about the patient’s prognosis. They may need to explore family members’ and surrogates’ beliefs about prognosis rather than merely conceptualizing their role as conveying the information clearly.”

    AUDIO
    SOT/FULL
    Cara Flati – Mary Ann’s Daughter
    Super@ 2:01
    Runs:11
    “Knowing what I know now, I think I would have asked to just have an honest conversation. This is what I am feeling and how does that square with what your understanding is as a medical team.”

    (Video covering 1st part of bite: Cara looking out window)

    VIDEO
    B-ROLL
    Picture of Mary Ann with her grandchildren

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say that when surrogates have overly optimistic expectations about a prognosis, they tend to choose more aggressive, invasive treatment than they would if they had more accurate expectations.

  • May 09, 2016

    Lowering Prescription Drug Costs Using Similar, Cheaper Alternatives

    Lowering Prescription Drug Costs Using Similar, Cheaper Alternatives

    INTRO:The United States spends more per capita on health care and prescription drugs than any other country. Using generic instead of brand name medications is one way to decrease costs. A new study examined whether therapeutic substitution, another way to lower drugs costs, could also save money on prescription medications. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL Various shots of a pharmacy
    AUDIO
    VO
    This pharmacy is filled with thousands of different medications. some are brand name, some are generic and some can be used in a process known as therapeutic substitution.
    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@:08 Runs:15
    “This is theoretically different than generic drugs. Generic drug substitution is substitution of the exact same drug. Therapeutic substitution is the use of a similar but not the same drug within a drug class.” (Video covering middle of bite: pharmacist counting pills)
    VIDEO
    B-ROLL Dr. Johansen walking down hallway, various shots of Dr. Johansen talking with person in pharmacy and holding pill bottles
    AUDIO
    VO
    Dr. Michael Johansen from The Ohio State University along with his colleague reviewed the records of more than 107 thousand patients between 2010 and 2012. They looked at prescription drug use and estimated how much money could be saved using therapeutic substitution.
    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@:39 Runs:18 “There were 26 included drug classes that spanned cardiovascular health, mental health, allergies, urology and many other aspects of medicine. 62 percent of people in the United States used prescription drugs. Around one third of people took a drug from the included classes.”
    (Video covering middle part of bite: Dr. Johansen looking at medications, pan of pharmacy)
    GXF FULL
    JAMA INTERNAL MEDICINE LOGO

    AUDIO
    The study appears in JAMA Internal Medicine.

    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super1:00 Runs:19
    “In total 73 billion dollars over three years or nearly one out of every 10 dollars spent on prescription drugs could have been saved with therapeutic substitution. Importantly, the consumer paid just over one third or 24.6 billion dollars of the total 73 billion that could have been saved.”

    (Video covering middle of bite: pharmacist preparing prescription)
    VIDEO
    B-ROLL Various shots of Dr. Johansen handling and pouring out medications

    AUDIO
    VO
    Dr. Johansen says that therapeutic substitution is somewhat controversial because it could impede decisions about medications that are made between doctors and patients.

    AUDIO
    SOT/FULL Michael E. Johansen, M.D., M.S., – The Ohio State University Super@1:29 Runs:17
    “There is tremendous potential savings from undertaking of therapeutic substitution on a large scale. However, therapeutic substitution is controversial, it needs to be done in a respectful manner of patients health because that’s really what we’re here for is to try to make patients healthier.”

    (Video covering middle of bite: Dr. Johansen looking at medications) VIDEO
    B-ROLL Pharmacists working
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the number of drug classes that could be included in therapeutic substitution is wide ranging.

  • May 04, 2016

    Better Telephone C-P-R Instruction Improves Outcomes after Cardiac Arrest

    Better Telephone C-P-R Instruction Improves Outcomes after Cardiac Arrest

    INTRO:When a cardiac arrest occurs outside the hospital, it’s important for bystanders to perform effective C-P-R as soon as possible, but that doesn’t always happen. A new study examined whether providing C-P-R instruction over the phone with help from trained 9-1-1 dispatchers would improve survival rates for people who experience cardiac arrest. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Pics of Dr. Gailey and his dental staff
    AUDIO
    VO
    Dentist Tim Gailey began his day like any other…seeing patients.

    AUDIO
    SOT/FULL
    Tim Gailey, D.M.D., – Cardiac Arrest Survivor
    Super@:03
    Runs:04
    “I sat down, that was the last thing I remembered, I just collapsed.”

    VIDEO
    B-ROLL
    Dr. Gailey and Valerie talking outside, various shots of 911 dispatcher

    AUDIO
    VO
    Dr. Gailey experienced a cardiac arrest. With the 9-1-1 dispatcher on the phone, his staff began C-P-R.

    AUDIO
    SOT/FULL
    Valerie Ruiz – Performed CPR
    Super@:10
    Runs:04
    “I’m so grateful that you know I had 911 and someone helping direct me.”

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super:18
    Runs:10
    “People don’t always think about 911 dispatchers as the first medical responders, but they really are. It turns out that they really have this enormous, life-saving potential.”

    AUDIO
    NATSO/FULL
    Runs:01
    “…are the paramedics there…”

    B-ROLL
    911 dispatcher on the phone, cu of Dr. Bobrow talking to dispatcher, another dispatcher on the phone, cu of keyboard, people performing CPR on dummies, cu of hands doing CPR

    AUDIO
    VO
    Many 9-1-1 dispatchers already offer C-P-R instruction over the phone. But Dr. Ben Bobrow (Bob-roe) from the Arizona Department of Health Services and co-authors provided additional training to 9-1-1 disptachers in two regional centers in the Phoenix metropolitan area. The dispatchers were trained to be more confident and assertive with rescuers on the phone. They measured outcomes from more than 23-hundred out of hospital cardiac arrests during a three-year period.

    AUDIO
    VOICE OF:
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super@:52
    Runs:12
    “Training them to say you need to do chest compressions, I’m going to help you, let’s start. We’ve actually found that subtle thing is very important in motivating lay rescuers.”

    AUDIO
    SOT/FULL
    Hannah Roether – 911 Dispatcher
    Super@1:09
    Runs:07
    “We have to use a very strict tone of voice to kind of get them to listen to us and pull all that chaoticness away from them.”

    (Video covering 1st part of bite: Hannah talking on phone)

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., – Arizona Department of Health Services
    Super@1:14
    Runs:11
    “Our dispatchers did well. They gave telephone CPR instructions significantly more often. They got first chest compressions started much sooner.”

    (Video covering 1st part of bite: Dr. Bobrow talking to dispatchers)

    GXF FULL
    JAMA CARDIOLOGY LOGO

    AUDIO
    VO
    The study appears in JAMA Cardiology.

    AUDIO
    SOT/FULL
    Bentley J. Bobrow, M.D., Arizona Department of Health Services
    Super@:1:24
    Runs:21
    “We found a 32 percent relative increase in the proportion of patients that survived to hospital discharge, so they went home from the hospital and remarkably a 43 percent relative increase in functional outcome, which means patients that actually went back home in good shape.”

    VIDEO
    B-ROLL
    Dr. Gailey and Valerie walking

    AUDIO
    VO
    That’s exactly what happened to Dr. Gailey, a husband and father of 13. Thanks to everyone working together, he survived.

    AUDIO
    SOT/FULL
    Valerie Ruiz – Performed CPR
    Super@1:52
    Runs:07
    “I was just praying that he would be okay, thinking about his children and I would do the right things that he needed.”

    (Video covering 2nd part of bite: picture of his children)

    AUDIO
    SOT/FULL
    Tim Gailey, D.M.D., – Cardiac Arrest Survivor
    Super@2:00
    Runs:08
    “I just remember giving them hugs and crying and telling them how grateful I was that they saved my life and how grateful my family was to them for saving me.”

    (Video covering 2nd half of bite: Picture of Dr. Gailey and his family)

    VIDEO
    B-ROLL
    Pic of Dr. Gailey and his family

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Bystander C-P-R has been shown to double or even triple survival from out of hospital cardiac arrest.

  • April 26, 2016

    Rotating Night Shift Work and the Risk of Heart Disease in Women

    Rotating Night Shift Work and the Risk of Heart Disease in Women

    INTRO: An estimated 15 million Americans do some kind of rotating shift work, including overnights, evenings and early morning shifts. But can this type of shift work increase the risk of coronary heart disease? A new study examined the link between rotating night shift work and heart disease in a group of female nurses. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various night time outside shots, hospital workers walking at night

    AUDIO
    VO
    At night, when most of us are heading to bed, many health care workers, including nurses, are just beginning their work day. But does working these rotating shifts take a toll on their health?

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super:09
    Runs:07
    “The link between shift work and coronary heart disease has been an open question for several decades now.”

    VIDEO
    B-ROLL
    Dr. Vetter and colleague walking down hall, Dr. Vetter looking at computer, nurse working, gurney rolling by, outside of hospital

    AUDIO
    VO
    Dr. Céline Vetter from Brigham and Women’s Hospital and co-authors examined that link. Tthey used data from the long running Nurses Health Study ONE and TWO, which has followed 240 thousand female nurses over a 24 year period. The researchers specifically looked at 189 thousand women who reported their lifetime exposure to rotating night shift work.

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@:36
    Runs:09
    “Over the course of the study period a little more than 10 thousand cases of newly developed coronary heart disease occurred.”

    GXF FULL
    JAMA LOGO

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@:48
    Runs:24
    “Rotating night shift work is associated with modest risk of coronary heart disease even after taking into account known risk factors such as elevated BMI, smoking, poor diet quality and low levels of physical activity. Once you stop working shifts, the time since quitting shift work is associated with a decreased risk.”

    (Video covering middle of bite: nurse walking into exam room, various shots of heart monitors, nurse pushing hospital bed)

    VIDEO
    B-ROLL
    Nurses walking in hospital hallways

    AUDIO
    VO
    Rotating shift work was defined as working at least three night shifts per month in addition to morning and evening shifts.

    AUDIO
    SOT/FULL
    Dr. Céline Vetter, Ph.D., – Brigham and Women’s Hospital
    Super@1:19
    Runs:22
    “Even though the absolute risks we observed were small and the contribution of shift work to coronary heart disease is modest, there is an opportunity to help and prevent coronary heart disease by trying to find out which are the characteristics of shift schedules that may carry the highest risk.”

    (Video covering middle of bite: heart monitor)

    VIDEO
    B-ROLL
    Nurse walking outside

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:the Study authors call for further studies to determine those characteristics.

  • April 19, 2016

    New Treatment for Melanoma Targets the Immune System

    New Treatment for Melanoma Targets the Immune System

    INTRO:Melanoma is a type of cancer that develops from pigment-containing cells, most commonly from the skin. If diagnosed early, many patients can be cured with surgery.  However if melanoma spreads through the body, the prognosis for long-term survival is poor.  A new way of treating advanced melanoma allows a patient’s immune system to fight the tumor without the need for chemotherapy or radiation. In a new study researchers examined the response to this type of therapy. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Tom walking into office

    AUDIO
    VO
    When Tom Stutz was diagnosed with melanoma about 5 years ago, it had spread to several of his organs.

    AUDIO
    SOT/FULL
    Tom Stutz – Melanoma Patient
    Super:05
    Runs:09
    “I was whipped to be honest with you and I thought that was pretty much the end of the line for me.”

    VIDEO
    B-ROLL
    Tom checking in for treatment, Graphic

    AUDIO
    VO
    Tom enrolled in a clinical trial, receiving a new type of immunotherapy called pem-bro-liz-u-mab, an antibody that blocks a protein called P-D-1. These proteins prevent the body’s immune system from attacking the cancer.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super:25
    Runs:11
    “With pembrolizumab what we’re trying to do is to redirect that immune response to fight the cancer. Pembrolizumab binds to PD-1 and then the immune system cells attack the cancer.”

    VIDEO
    Dr. Ribas and colleague walking, Tom receiving his treatment, cu of Tom’s arm, various shots of medication

    AUDIO
    VO
    Dr. Antoni Ribas from the University of California-Los Angeles and co-authors tested this drug on more than 650 patients. The trial was conducted at U-C-L-A and other sites in North America, Europe and Australia. Early in the study, several patients showed a clinical response to pembrolizumab, which later received “break through” therapy status from the Food and Drug Administration.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@:55
    Runs:10
    “When we compared the baseline tumors to the tumors after dosing, the metastases or the lesions around the body were smaller in one third of the patients.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@1:10
    Runs:10
    “The patients who responded, the great majority, continued to respond at one or two years, 75 percent of them maintained the response.”

    VIDEO
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    Tom receiving treatment

    AUDIO
    VO
    The drug was well tolerated in the majority of patients.

    AUDIO
    SOT/FULL
    Antoni Ribas, M.D., Ph.D., – University of California-Los Angeles
    Super@1:22
    Runs:22
    “The median survival of the 655 patients was 23 months, which by all practical means is much better than we would have expected in a group of patients like these. With this new generation of immunotherapies we’re now having a sizable number of patients who have a response to the therapy and are going on to live normal lives, three or four years later.”

    (Video covering middle of bite: Dr. Ribas looking at scans)

    VIDEO
    B-ROLL
    Tom walking outside

    AUDIO
    That’s exactly what happened for tom, who continues to receive the therapy.

    AUDIO
    SOT/FULL
    Tom Stutz – Melanoma Patient
    Super1:48
    Runs:10
    “I’ve been to family events, I’ve gone on vacations with my kids, I’m feeling great, so what can I say, no complaints.” (Hold for laugh)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:4 PERCENT OF PATIENTS HAD TO STOP THE THERAPY BECAUSE OF SIDE EFFECTS.

  • April 12, 2016

    Better Air Quality Decreases Respiratory Symptoms in Children

    Better Air Quality Decreases Respiratory Symptoms in Children

    INTRO: Air pollution is associated with chronic health problems in children, like bronchitis and asthma. In southern California, air pollution levels have been decreasing over the past 20 years. A new study examined whether those reductions have helped to improve respiratory symptoms in the state’s children. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Plane flying, trains on track, cars on freeway, skyline of Los Angeles

    AUDIO
    VO
    Planes, trains, and automobiles are ever present in southern California. They all contribute to what’s called ambient air pollution.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@:10
    Runs:14
    “Ambient air pollution is particulate matter, which are microscopic particles, some of them especially the fine ones, actually deposit deep into the lung and are known to cause a lot of respiratory problems in children and humans in general.”

    VIDEO
    B-ROLL
    Dr. Berhane walking in office, various shots of children playing in park, cars on freeway, young girl with inhaler, nurse examining younger girl

    AUDIO
    VO
    Dr. Kiros Berhane (bur-rah-nee) from the University of Southern California and co-authors followed just over 46-hundred children in 8 southern California communities across 3 different time periods from 19-93 t0 2012. In addition to monitoring air quality, the researchers looked at children with and without asthma and whether they reported respiratory symptoms like bronchitis, congestion, phlegm production, or a daily cough for 3 months in a row during the previous year.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@:47
    Runs:13
    “In the children with asthma, we found at the beginning of the study, in the first cohort, almost 48 percent of them had bronchitic symptoms in the last year. Now in the children without asthma, this number was only about 11 percent.”

    AUDIO
    VO
    Air pollution levels dropped significantly during the observation period. Bronchitic symptoms were compared in three groups of children from 19-93 to 2012.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@1:08
    Runs:11
    “The prevalence of bronchitic symptoms went down by about 32 percent in those children with asthma. We also found that it went down by about 21 percent in those children without asthma.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Kiros Berhane, Ph.D., – University of Southern California
    Super@1:23
    Runs:16
    “These reductions were significant and important in both children with asthma and children without asthma. So all children benefitted from this reductions in air pollution. Protecting our environment really leads to better respiratory health in children.”

    (Video covering 2nd part of bite: wide shot of city)

    B-ROLL
    Wide shot of playground

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Dr. Berhane says the findings from southern California can help guide air quality efforts in other locations in the U-S and around the world.

  • April 10, 2016

    Summary Video

    Summary Video

    Income inequality is the topic of heated discussion in the United States, and now researchers have used deidentified federal income tax returns and death records to better understand if differences in income are associated with differences in life expectancy at age 40.

     

    They report that men in the top percentile of household income lived almost 15 years longer than those in the lowest, and women in the top percentile of household incomes lived about 10 years longer than those in the lowest.

     

    Women lived longer than men at any income percentile, with a 6-year advantage among the poorest 1% diminishing to a 1.5-year advantage for thee wealthiest.

     

    Despite differences at the highest and lowest percentiles, gains in life expectancy leveled off above a median household income of about $200,000.

     

    Life expectancy increased over the 14-year study period, an average of about 3 years for men and women in the top income quartile compared to an average of about 1 year for those in the bottom quartile.

     

    In an accompanying editorial, Nobel laureate Angus Deaton writes, ‘The infamous one percent is not only richer, but much healthier. Individuals in the top 100% of income have 10 to 15 more years to enjoy their richly funded lives and to spend time with their children and grandchildren, and they are pulling away from everyone else.”

     

    Where people live makes a difference.

     

    Life expectancy was 6.4 years less for the poorest men in Detroit compared to New York City, and about 5 years less for the poorest women in Detroit compared to New York City, between-city differences that largely disappeared at the highest incomes.

     

    Nevada, Indiana, and Oklahoma had the lowest life expectancies; California, New York, and Vermont had the highest.

     

    People in the top income quartile were expected to live longest in of Salt Lake City and die younger in Las Vegas, while those in the bottom income quartile were expected to live longest in New York City and die youngest in Gary Indiana.

     

    People in the top income quartile gained the most life expectancy over the study period in El Paso Tx and lost the most in Lakeland Florida, while those in the bottom quartile gained the most in Toms River NJ and lost the most in Tampa Florida.

     

    ‘It is as if the top income percentiles belong to one world, the world of the elite, wealthy US adults, whereas the bottom income percentiles each belong to separate worlds of poverty, each unhappy and unhealthy in its own way,” writes Deaton.

     

    Behavior-related variables, such as smoking, exercise, and obesity, were highly correlated with difference in life expectancy by geographic area, the researchers write,  and they suggest that lower income individuals do better in more affluent cities with highly educated populations and high levels of government expenditures, such as New York City and San Francisco.

     

    Other explanations for the observations include reverse causality,  meaning, poor health causes reduced income rather than the other way around; parental rather than personal income; and education.

     

    “The next step is to extend the analysis by including education [to] advance the understanding of factors underlying the relationship between income and life expectancy.”

  • April 05, 2016

    Pain and Physical Function Improve After Weight-Loss Surgery

    Pain and Physical Function Improve After Weight-Loss Surgery

    INTRO: Severe obesity can lead to joint pain and interfere with a person’s ability to bend, lift, carry, and even walk. Undergoing bariatric surgery helps with weight-loss, but can it also help alleviate joint pain and improve a person’s overall physical function? A new study examined whether pain levels and physical function improved for patients after weight-loss surgery. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Earl riding stationary bike

    AUDIO
    VO
    Earl McConnell had gastric bypass surgery three years ago after being diagnosed with diabetes.

    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@:05
    Runs:03
    “I did have back problems. They told me I had to lose weight.”

    VIDEO
    B-ROLL
    Earl riding stationary bike

    AUDIO
    VO
    Now, his diabetes is controlled and so is his back pain.

    AUDIO
    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@:12
    Runs:09
    “It was definitely easier to get around, easier to get up and down off the floors, playing with my grandkids, and goin’ running around, chasing them.”

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@:19
    Runs:08
    “Patients come to bariatric surgery for all sorts of reasons, some of them it may be their diabetes but for many of them it’s major health issues.”

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@:27
    Runs:11
    “Most commonly knee and hip pain that prevents people from doing walking activities and other activities. Primarily in clinical practice, what I hear are concerns with joint function.”

    VIDEO
    B-ROLL
    Dr. Courcoulas and Dr. King sitting at desk and talking, bariatric surgery, various shots of patient questionnaire, Earl doing a walking test

    AUDIO
    Doctors Anita Courcoulas and Wendy King from the University of Pittsburgh and co-authors studied more than 22 hundred bariatric surgery patients from 10 U-S hospitals over a 4-year period. Patients filled out questionnaires about their pain and physical function before surgery and each year, for three years, after surgery. patients also participated in a 400 meter walking test.

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@:58
    Runs:09    “There was 50 to 70 percent improvement in pain and physical function at the one year time point and then some continued improvements up to three years as well.”

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@1:08
    Runs:07
    “And although there is deterioration of improvement in some patients from one to three years, the majority still by three years, are much better off than they were before surgery.”

    (Video covering 1st part of bite: Earl walking)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Wendy C. King, Ph.D., – University of Pittsburgh
    Super@1:23
    Runs:19
    “With our objective walking test we also saw that about a quarter of patients still had mobility deficits post-surgery. We looked at patients who had severe pain and disability in their hips and knees, indicative of osteoarthritis and three fourths of them had improvements in their hip and knee pain and function through three years of follow-up.”

    (Video covering middle of bite: Earl walking in PT Room)

    AUDIO
    SOT/FULL
    Anita P. Courcoulas, M.D., – University of Pittsburgh
    Super@1:35
    Runs:09
    “This sends the message that bariatric surgical procedures may have a big impact on people’s ability to improve their physical function over time.”

    VIDEO
    B-ROLL
    Earl and physical therapist working on steps

    AUDIO
    Earl maintains his weight-loss and recently received praise from his cardiologist.

    AUDIO
    SOT/FULL
    Earl McConnell – Bariatric Surgery Patient
    Super@1:47
    Runs:08
    “It’s the first time I’ve ever seen him smile too, when I went in there after I had the gastric bypass done. I’m looking for a long and happy life and see the grandkids get married.”

    VIDEO
    Earl and therapist working on steps

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Younger patients, those with fewer depressive symptoms and a higher income pre-surgery had a greater likelihood of improvements in their pain and function levels after surgery.

  • March 22, 2016

    Alternative Mind-Body Therapies Help Improve Chronic Back Pain

    Alternative Mind-Body Therapies Help Improve Chronic Back Pain

    INTRO:Low back pain, millions of Americans live with it every day. A variety of treatments are used to treat back pain including medication, massage, manipulation and physical therapy. There are also therapies that include a mind-body component.  A new study examined whether two approaches that focus on the mind rather than directly on the body, could help improve longstanding back pain. Catherine Dolf explains in this week’s JAMA Report.

    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super:01
    Runs:09
    “One of the most important new understandings of chronic pain and chronic low back pain is that the mind plays a very important part.”

    VIDEO
    B-ROLL
    Various shots of Dr. Cherkin walking and looking at his computer, Dr. Balderson conducting a cognitive behavioral therapy class

    AUDIO
    VO
    Dr. Daniel Cherkin from Group Health Research Institute in Seattle and his co-authors studied two mind-body therapies. One is already shown to be effective for treating depression and other chronic conditions.

    AUDIO
    SOT/FULL
    Benjamin H. Balderson, Ph.D., -Group Health Research Institute
    Super@:24
    Runs:13
    “Cognitive behavioral therapy or CBT is a therapy that tries to address what are the behaviors that we do because of pain and what are the behaviors that might actually help to alleviate pain versus help to actually create or keep pain going.”

    (Video covering first part of bite: Dr. Balderson talking to group)
    VIDEO

    AUDIO
    NATSO/FULL
    Runs:04
    “…how do I gradually get back to those activities I’ve given up because of pain…”

    VIDEO
    B-ROLL
    Carolyn leading mindfulness meditation

    AUDIO
    VO
    The other, mindfulness-based stress reduction, has not been well studied.

    AUDIO
    NATSO/FULL
    Runs:08
    “…so you’re bringing an atmosphere of friendliness and kindness observing your experience just as it is…”

    AUDIO
    SOT/FULL
    Carolyn McManus, P.T., M.S., M.A., – Mindfulness and Meditation Leader
    Super@:50
    Runs:18
    “One of the things that I think mindfulness empowers people to recognize is that everything’s always in a state of change. Breathing in, I’m aware, I’m feeling this sensation, it’s uncomfortable, breathing out, I meet myself with compassion, a friendliness, an openness.”

    VIDEO
    B-ROLL
    Man rubbing his back, various shots of people participating in mindfulness meditation

    AUDIO
    342 patients between 20 and 70 years old with back pain that had lasted for at least three months, participated in 8 weekly, 2-hour sessions of either mindfulness or cognitive therapy. A third group received usual care. Outcomes were assessed at 6 months and one year.

    AUDIO
    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super@1:25
    Runs:13
    “Cognitive behavioral therapy and mindfulness based stress reduction led to an increased likelihood of having clinically meaningful improvement in back pain than those who were only receiving usual care.”

    (Video covering 2nd part of bite: Dr. Balderson talking to group)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    VO
    SOT/FULL
    Daniel C. Cherkin, Ph.D., – Group Health Research Institute
    Super@1:42
    Runs:10
    “Benefits in decreased pain and improved function lasted for a full year, which is not common amongst treatment for chronic pain.”

    AUDIO
    SOT/FULL
    Benjamin H. Balderson, Ph.D., -Group Health Research Institute
    Super@1:51
    Runs:04
    “It’s something they can add to their tool box for things that they do in different various times.”

    AUDIO
    SOT/FULL
    Carolyn McManus, P.T., M.S., M.A., – Mindfulness and Meditation Leader
    Super@1:57
    Runs:12
    “It empowers people with the skills to make choices and changes that enhance their well-being, reduce their pain and increase their function.”

    (Video covering 2nd part of bite: people mediating)

    VIDEO
    B-ROLL
    People meditating

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:These mind-body interventions can also be used in addition to traditional therapies.

  • March 15, 2016

    The Role of Vaccine Refusal in Recent Outbreaks of Measles and Whooping Cough

    The Role of Vaccine Refusal in Recent Outbreaks of Measles and Whooping Cough

    INTRO:Measles and pertussis, or whooping cough, have been effectively controlled in the United States with the use of vaccines. However, recent outbreaks of these vaccine-preventable diseases have prompted many to examine why this is happening. A review of recent research looks at whether the reluctance of some parents to have their children vaccinated plays a role in these outbreaks.  Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    NATSO/FULL
    Runs:01
    “…hello, how are you…?”

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:05
    Runs:13
    “Most parents do the right thing and get their children vaccinated. Even if you go out and do the right thing your child’s risk depends on other people as well.”

    (Video covering beginning of bite: nurse in exam room with mother and child)

    VIDEO
    B-ROLL
    Children playing swings, going down a slide, three children and parent walking on to playground

    AUDIO
    VO
    Like whom they interact with on the playground, in school, and even within their own family.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:19
    Runs:09
    “If there is a group of people which are unprotected, they can increase the risks of even those who are vaccinated.”

    VIDEO
    B-ROLL
    Dr. Omer walking down the hall, sitting at a table talking with his team, graph on computer screen, same graph on big screen, MMR vaccine vial, MMR vaccine in boxes

    AUDIO
    VO
    Dr. Saad Omer, from Emory University, and his colleagues reviewed published reports for both measles and pertussis. They specifically looked at the role vaccine refusal plays in outbreaks of both diseases.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:38
    Runs:16
    “In the post-elimination era for measles, vaccine refusal has played a role in these recent outbreaks. A majority of those cases occurred in those who did not get vaccines for philosophical or religious reasons.”

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@:58
    Runs:18
    “The contribution of vaccine refusal is higher in early part of epidemics compared to later parts, indicating that vaccine refusers provide those pockets of susceptibility, that tinder, that can start the fire of an epidemic.”

    VIDEO
    B-ROLL
    Syringe being filled with vaccine, little child getting vaccinated

    AUDIO
    VO
    For whooping cough, outbreaks are harder to control because the vaccine’s protective immunity can wane over time.

    AUDIO
    SOT/FULL
    Saad B. Omer, M.B.B.S., M.P.H., Ph.D., – Emory University
    Super@1:22
    Runs:13
    “Waning immunity is a problem but even in the context of waning immunity you have vaccine refusal which is playing a role. It is in everyone’s benefit that everyone stays protected.”

    (Video covering 2nd part of bite: People in park)

    VIDEO
    B-ROLL
    People in park

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:One of the more important public health achievements in the last 10 to 20 years has been the elimination of measles from the U-S.

  • March 08, 2016

    Identifying Children at Risk for Persistent Symptoms After Concussion

    Identifying Children at Risk for Persistent Symptoms After Concussion

    INTRO:Each year, emergency departments across the United States treat about 750 thousand children with concussions. For many patients, concussion-related symptoms resolve within 2 weeks of injury but some go on to experience persistent symptoms. Researchers have developed a new clinical score that may help predict which patients are at higher risk for prolonged symptoms. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of Johnny and teammate playing hockey

    AUDIO
    VO
    Johnny Coburn is back on the ice after being sidelined with a concussion.

    AUDIO
    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@:04
    Runs:03
    “It was a really bad headache. Just really bad.”

    VIDEO
    B-ROLL
    Various hockey shots

    AUDIO
    VO
    His parents watched him carefully. While his symptoms initially improved, after about a week, the headaches returned.

    AUDIO
    SOT/FULL
    Mike Coburn – Johnny’s Father
    Super@:13
    Runs:07
    “I knew that the severity of the concussion was much greater than 5 days or 7 days of rest would fix.”

    VIDEO
    B-ROLL
    Various hockey shots

    AUDIO
    More than half of these children treated at emergency departments end up with headaches after concussion.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@:26
    Runs:19    “Parents usually ask about, well how long is my son or daughter going to have symptoms and what’s going to go on after that and what do I have to do? But there’s no good way at this moment in time to actually predict those that are going to go on to have persistent symptoms following the emergency department visit.”

    VIDEO
    B-ROLL
    Dr. Babcock and Dr. Kurowski talking and looking at computer screen, various shots of Dr. Kurowski doing different tests with young boy

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    In an editorial, Doctors Lynn Babcock and Brad Kurowski from Cincinnati Children’s Hospital discuss new research designed to help predict which children are at higher risk for developing persistent symptoms after concussion.   Canadian researchers evaluated just over three thousand patients, age 5 to 18. about 30 percent ended up with persistent post concussion symptoms at 28 days.

    Both the study and editorial appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@1:13
    Runs:10
    “They actually had 46 predictors that they were looking at. After they evaluated those 46 variables they came up with 9 variables that were fairly predictive of post-concussive symptoms.”

    (Video covering middle of bite: Dr. Kurowski examining young boy)

    AUDIO
    NASOT/FULL
    Runs:03
    “I want you to just follow my finger with your eyes, ok?”

    VIDEO
    B-ROLL
    Young boy being examined by Dr. Kurowski, Graphic lower third,right over video: Age, Sex, Migraines, Depression, Prior Concussion, Balance

    AUDIO
    VO
    The clinical variables were used in a 12-point risk score. They included things like age, sex, history of migraines or depression, prior history of concussion, and problems with balance.

    AUDIO
    SOT/FULL
    Lynn Babcock, M.D., M.S., – Cincinnati Children’s Hospital
    Super@1:34
    Runs:11
    “Some of these things have been shown before in smaller studies but nothing together as a collective summary of symptoms. It’s variables that we would normally capture in the emergency department but now it’s compiled into one decision rule.”

    VIDEO
    B-ROLL
    Johnny on skating on the ice with teammate

    AUDIO
    VO
    Johnny says he is feeling much better. He doesn’t have any more headaches and is back, playing hockey.

    AUDIO
    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@1:55
    Runs:09
    (Video covering 1st half of bite: Johnny and teammate skating)

    “I’m looking forward to playing with my team for a few years, playing really good hockey in college and hoping that I get to the NHL.”

    SOT/FULL
    Johnny Coburn – Concussion Patient
    Super@1:55
    Runs:09
    “I’m looking forward to playing with my team for a few years, playing really good hockey in college and hoping that I get to the NHL.”

    (Video covering 1st half of bite: Johnny and teammate skating)

    VIDEO
    Johnny on the ice

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Before this new scoring system is adopted for use in clinical practice, further research is needed to validate and confirm the study outcomes.

  • March 03, 2016

    Long-Term Aspirin Use Associated With Decreased Cancer Risk

    Long-Term Aspirin Use Associated With Decreased Cancer Risk

    INTRO:Taking a daily low dose aspirin is recommended to prevent heart disease and more recently, colorectal cancer. But does daily aspirin, over the long-term, also help prevent other types of cancers? A new study examined the potential cancer prevention benefits among people who have been taking aspirin regularly for years. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    B-ROLL Person taking an aspirin
    AUDIO
    VO
    Aspirin—you can buy it without a prescription and it’s relatively easy to take.

    AUDIO SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:05 Runs:09
    “There’s very strong evidence that aspirin can prevent colorectal cancer but the association of aspirin with other cancer types isn’t really as well established.” VIDEO
    B-ROLL Dr. Chan walking down hallway into exam room, looking at papers, graphic: 135,965 Health Professionals, pan up from papers to Dr. Chan AUDIO
    VO
    Dr. Andrew Chan from Massachusetts General Hospital and co-authors examined data from two large national studies that include almost 136 thousand health- professionals, both men and women, who have been providing detailed information about their overall health for decades.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:29 Runs:08
    “We were able to actually look at aspirin data they had provided us over the years and link that up with their diagnosis of various diseases, including cancer.”

    VIDEO
    B-ROLL Aspirin being poured out, aspirin bottle, aspirin outside of bottle AUDIO
    VO
    Individuals who took various doses of aspirin on a regular basis did have a lower overall risk of developing any type of cancer.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:44 Runs:10
    “It was about a 3 percent lower incidence of cancer. Much of those cancers however, were cancers of the gastrointestinal tract. So cancers that affect the esophagus, the stomach.” GXF FULL JAMA ONCOLOGY LOGO AUDIO
    The study appears in JAMA, Oncology.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@:58 Runs:15
    “There was about a 15 to 20 percent reduction in the risk of developing colon cancer if you were using an aspirin on a regular basis. We also found that it did take about six years of use for a benefit to emerge but you know, once there was this benefit, it was sustained over time.”

    VIDEO B-ROLL Aspirin pills, patient undergoing colonoscopy, cu over doctor’s shoulder looking at screen AUDIO
    VO
    Dr. Chan also says daily aspirin may have an added benefit on top of routine colorectal cancer screening.

    AUDIO
    SOT/FULL Andrew T. Chan, M.D., M.P.H., – Massachusetts General Hospital Super@1:19 Runs:16
    “And in addition, for folks that do not undergo screening for whatever reason, the effect of aspirin also is quite pronounced, and because we know that cancer and heart disease are really the two leading causes of death in the U-S population, the public health impact of these findings might be substantial.”
    (Video covering middle of bite: slide of polyp in colon)

    VIDEO
    B-ROLL Dr. Chan on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Aspirin use was not associated with the risk for breast, prostate, or lung cancer.

  • February 22, 2016

    Updated Definitions And Clinical Criteria For Recognizing Life-Threatening Sepsis And Septic Shock

    Updated Definitions And Clinical Criteria For Recognizing Life-Threatening Sepsis And Septic Shock

    INTRO:Sepsis is a common and potentially life-threatening manifestation of infection, affecting millions of patients worldwide. Sepsis can also be difficult to diagnose. A new study summarized the findings of an international group of experts who set out to update the previous definitions of sepsis. They also describe a more streamlined way to recognize patients with sepsis, so that treatment can be started more quickly.  Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@:01
    Runs:04
    “As soon as you get an infection, the body starts responding to infection.”

    AUDIO
    SOT/FULL
    Christopher W. Seymour, M.D., M.Sc., – University of Pittsburgh School of Medicine
    Super@:05
    Runs:06
    “Sepsis is when the body’s response to infection injures its own tissue and organs.”

    VIDEO
    B-ROLL
    Dr. Seymour and Dr. Angus walking into lab, Dr. Seymour and Dr. Angus looking at slides of infections, graphic

    AUDIO
    VO
    Doctors Christopher Seymour and Derek Angus from the University of Pittsburgh School of Medicine and co-authors summarized the findings of an international task force who updated the definitions of sepsis.  In a related study, they reviewed the electronic health records of more than 1 million patients to assess the usefulness of a clinical score known as “SOFA”, used to identify patients with sepsis.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@:31
    Runs:11
    “SOFA behaved very well especially in ICU patients. But a lot of time outside the ICU, you haven’t done all the measurements for a full SOFA score.

    (Video covering middle of bite: out of focus shoot of ICU)

    AUDIO
    SOT/FULL
    Christopher W. Seymour, M.D.,  M.Sc., – University of Pittsburgh School of Medicine
    Super@:41
    Runs:20

    “The Task Force also identified something new called the Q-SOFA or quick SOFA, which can be used as a clinical prompt at the bedside for doctors and nurses. This uses only vital signs such as altered mental status, low blood pressure, as well as difficulty breathing. Two of those will identify a patient most likely to be septic.

    (Video covering middle of bite: Dr. Seymour and others talking with patient, monitor, pan from machines to Dr. Seymour)

    GXF FULL
    JAMA LOGO

    AUDIO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@1:05
    Runs:14
    “If you have an infected patient that scores two points or more on Q-SOFA, you should be worried about that patient. In more austere settings, where you can’t get the blood tests this may actually be a very practical tool.”

    SOT/FULL
    Christopher W. Seymour, M.D., M.Sc., – University of Pittsburgh School of Medicine
    Super@1:19
    Runs:11
    “Sepsis is difficult to recognize. The Task Force provides us with these criteria so this helps doctors and nurses recognize sepsis quicker and get treatment started right away.”

    (Video covering middle of bite: ICU patient’s hand, nurse checking medication bags)

    AUDIO
    SOT/FULL
    Derek C. Angus, M.D., M.P.H., – University of Pittsburgh School of Medicine
    Super@1:30
    Runs:28
    “We expect and look forward to this being improved. We want to see this change over time and we hope that using data to validate the definitions is ushering in a new era. We’ve been trying to help people come up with simpler rules that will help promote early, simple, easy identification of patients to then prompt early and appropriate intervention and management.”

    (Video covering 2nd half of bite: doctors and nurse walking into an ICU room)

    VIDEO
    B-ROLL
    (Doctors and nurse walking into an ICU room)

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Sepsis carries an enormous public health burden, accounting for more than 5 percent of total U-S hospital costs.

  • February 15, 2016

    Caregivers Likely to Experience Emotional, Physical, and Financial Difficulties

    Caregivers Likely to Experience Emotional, Physical, and Financial Difficulties

    INTRO:When an older adult becomes ill, most often it’s a spouse or adult child who becomes the primary caregiver, usually without compensation. A new study examined just how many of these family or unpaid caregivers are out there and also the physical, emotional and financial difficulties they experience. Catherine Dolf explains in this week’s JAMA Report. VIDEO B-ROLL Judith walking down the hall, sitting at table reading AUDIO
    VO
    Judith Vick is back in medical school after taking a year off to help care for her mother, who experienced a devastating stroke.

    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super:10 Runs:07
    “My mom’s husband, my mom and I are really part of a team and we help each other in big and small ways every day.”
    (Video covering 1st part of bite: Pic of Judith, her mom and mom’s husband)
    VIDEO
    B-ROLL Looking at medication list on computer
    AUDIO
    VO
    Judith had a lot to learn including how to manage the 14 different medications her mother was taking.

    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super@:21 Runs:12
    “I spent hours translating that vague list to a very specific schedule of what she was supposed to take, when. It was like a puzzle to figure out that schedule.”

    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@:33 Runs:07
    “Although the caregiving role is highly varied it often involves considerable time and may affect caregivers own health and well-being.” VIDEO
    B-ROLL Dr. Wolff walking down hallway into her office, sitting and working at computer, couple walking on street, houses in neighborhood, graphic

    AUDIO
    VO Dr. Jennifer Wolff from the Johns Hopkins Bloomberg School of Public Health and co-authors used data from two nationally representative samples that provided insight into older adults and the caregivers who help them, living in communities like this around the U-S. The researchers estimate that nearly 15 million of these caregivers are helping almost 8 million older adults with health related disabilities.
    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@1:01 Runs:16
    “About 6 and a half million or 45 percent provided substantial health care help, on the order of 28 hours of care per week, were about twice as likely to experience physical, financial or emotional difficulty than caregivers who did not provide this help.” GXF FULL JAMA LOGO AUDIO
    The study appears in JAMA, Internal Medicine.

    AUDIO
    SOT/FULL Jennifer L. Wolff, Ph.D., – Johns Hopkins Bloomberg School of Public Health Super@1:20 Runs:07
    “About 1 in 4 reported their own health to be fair or poor and about half were helping an older adult with dementia. VIDEO
    B-ROLL Caregiver walking with patient, Graphic, man with a walking cane, Pic of Judith’s mom and her husband
    AUDIO
    VO
    These caregivers also participated in fewer social or leisure activities and if they worked outside the home, they were more than three times as likely to experience a loss in job-related productivity compared to individuals who didn’t provide this type of help. Judith says her mom is continuing to improve and this whole experience has brought them closer.
    AUDIO
    SOT/FULL Judith Vick – Family Caregiver Super@1:46 Runs:11
    “There are difficult parts of caregiving but it really is such a privilege to be so involved in her care. It has definitely been an enriching and meaningful experience.”

    (Video covering 2nd half of bite: Pic of Judith and her mom)

    VIDEO
    B-ROLL Pic of Judith and her mom

    AUDIO
    “There are difficult parts of caregiving but it really is such a privilege to be so involved in her care. It has definitely been an enriching and meaningful experience.”

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Researchers add that only one in four of these caregivers used supportive services, got education or training about how to provide care or participated in support groups.

  • February 11, 2016

    BRCA Testing Increasing Among Younger Women Diagnosed with Breast Cancer

    BRCA Testing Increasing Among Younger Women Diagnosed with Breast Cancer

    INTRO:For younger women diagnosed with breast cancer, genetic counseling along with testing for B-R-C-A 1 and 2 is a standard recommendation. But how many young women are undergoing testing and do the results have an effect on treatment decisions? A new study looked at these questions. Catherine Dolf has more in this week’s JAMA Report.
    VIDEO B-ROLL Breast image showing tumor AUDIO
    VO
    A breast cancer diagnosis in a young woman leaves her with a choice of whether or not to undergo genetic testing.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:07 Runs:04
    “So, what I always say to my patients is knowledge is power.”
    VIDEO
    B-ROLL Dr. Partridge walking with patient, sitting at table and talking with patient, slide being loaded and looked at through microscope

    AUDIO
    VO
    Dr. Ann Partridge from the Dana Farber Cancer Institute says current guidelines recommend every young woman diagnosed with breast cancer should be counseled about and receive testing for B-R-C-A 1 and 2.
    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:21 Runs:09
    “We’re making strides and improving over time how we get the message to young women that they should consider testing.”
    VIDEO
    B-ROLL Women walking outside, graphic: shot freezes: 897 Women -Genetic Testing Rates -Barriers to Testing -Treatment Decisions AUDIO
    VO
    Since 2006, she and her co-authors began following women, 40 and younger, diagnosed with breast cancer. For this study they focused on nearly 900 of these women, looking at genetic testing rates, barriers to testing, and how the test results affected treatment decisions.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:45 Runs:10
    “In 2006 the rates of testing were in the 70 percent range and they went all the way up to about 95 percent by 20-12 and 20-13.”

    GXF FULL JAMA LOGO AUDIO
    The study appears in the journal, JAMA Oncology.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@:58 Runs:16
    “While the majority of women are being tested many are not and a small minority, but an important minority, report that nobody even talked to them about the possibility of harboring a genetic predisposition for breast cancer and they should get tested.”

    VIDEO
    Dr. Partridge walking down hallway, woman getting mammogram, cu of breast image

    AUDIO
    VO
    Dr. Partridge also says not every woman will choose to be tested. However, it appeared genetic testing or the concern about genetic predisposition did affect treatment decisions.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@1:24 Runs:11
    “The majority of these women said that it affected whether or not they underwent a unilateral mastectomy or lumpectomy followed by radiation or a bilateral mastectomy.”
    (Video covering middle of bite: breast cancer surgery)

    VIDEO
    B-ROLL Technician preparing chemotherapy medication AUDIO
    VO
    And fewer women reported that concerns about genetic risk affected whether or not they received chemotherapy or hormonal therapy.

    AUDIO
    SOT/FULL Ann H. Partridge, M.D., M.P.H., – Dana Farber Cancer Institute Super@1:42 Runs:19 “It’s imperative that we not only help women to get this information but that we also counsel them, help to support them as they make these treatment decisions especially in the context of a newly diagnosed patient who is stressed and anxious and needs to have good communication with her providers and good support.” VIDEO B-ROLL Dr. Partridge on camera
    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The study says concerns about genetic risk also affected a woman’s treatment decisions even if she tested negative.

     

  • February 02, 2016

    Eating Seafood May Help Lower The Risk Of Dementia

    Eating Seafood May Help Lower The Risk Of Dementia

    INTRO:Many people eat seafood because of its health benefits. However, seafood also contains mercury and at very high levels, mercury has been linked to problems with cognitive function and brain changes associated with dementia. A new study examined mercury levels in the brains of deceased older people, to see if there was a relationship between seafood consumption and the type of brain changes commonly seen with dementia. Catherine Dolf explains in this week’s JAMA Report.

    VIDEO
    B-ROLL
    Various shots of seafood

    AUDIO
    VO
    These days many people are eating more seafood because of its health benefits. But seafood also contains mercury.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@:06
    Runs:09
    “There’s concerns about if people eat seafood are they also consuming more mercury and that is impairing their health.”

    VIDEO
    Dr. Morris sitting in her office, graphic showing retirement communities, still pic of group of older people, technician looking at slices of brains

    AUDIO
    VO
    Dr. Martha Clare Morris from Rush University Medical Center in Chicago, and co-authors enrolled older people living in public housing and retirement communities in an ongoing study of memory and aging. Participants had normal memory function when they entered the study. They were asked to keep track of their diet, using a detailed questionnaire. participants also agreed to brain donation after they died. In total, 286 brains were examined.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@:39
    Runs:17
    “So we have a very comprehensive assessment of people’s seafood consumption during their older age years and then we can relate seafood consumption to brain changes associated with dementia when they die.”

    (Video covering second part of bite: technician examining brain slices)

    VIDEO
    B-ROLL
    Graphic: slide of brain tissue with plaques and tangles circled

    AUDIO
    VO
    These changes include plaques and tangles seen in the brain, hallmark features of Alzheimer dementia.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@1:01
    Runs:23
    “Seafood consumption of at least one meal per week decreased the occurrence of the amyloid plaques and tangles associated with Alzheimer’s dementia. We observed this however, only in people who had the apolipoprotein e4 allele. This is a genotype that puts one at increased risk of dementia.”

    (Video covering middle of bite: technician looking at brain slides under microscope)

    GXF FULL
    JAMA LOGO

    AUDIO
    The study appears in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Martha Clare Morris, Sc.D., – Rush University Medical Center
    Super@1:28
    Runs:11
    “The increased level of seafood consumption did increase brain levels of mercury, but that the mercury didn’t appear to have an impact on brain health.”

    VIDEO
    B-ROLL
    Various kinds of seafood, Dr. Morris sitting at microscope looking at slides

    AUDIO
    VO
    Dr. Morris also says seafood consumption was only associated with less brain changes specific to Alzheimer dementia, not vascular or Lewy Body dementia. Catherine Dolf, the JAMA Report.

    Tag:Study participants who ate seafood had between one and 6 seafood containing meals per week.

  • January 26, 2016

    Updated Recommendations for Depression Screening in Adults

    Updated Recommendations for Depression Screening in Adults

    INTRO:Depression is an important clinical problem worldwide. The U-S Preventive Services Task Force, an independent group of medical professionals, continually reviews the latest information on a wide range of preventive services. The Task Force has just issued updated recommendations on depression screening for adults in the primary care setting. Catherine Dolf has more in this week’s JAMA Report.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@:01
    Runs:13
    “Depression is a really important health topic in the United States and worldwide. It’s one of the leading causes of disability in adults and is often times under recognized and under treated.”

    VIDEO
    B-ROLL
    Patient filling out depression screening questionnaire

    AUDIO
    VO
    Adults visiting their primary care provider should, at some point, be screened for depression.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@:17
    Runs:15
    “The primary care doctor has an important initial role in identifying people with depression and directing them towards treatment and appropriate follow up.
    Preventive Services Task Force always evaluates both the potential benefits and the potential downsides of any clinical preventive
    service.”

    (Video covering middle of bite: doctor talking with patient)

    VIDEO
    B-ROLL
    Dr. Pignone walking down clinic hallway, people walking down the street

    AUDIO
    VO
    Dr. Michael Pignone (pin-yoh-nee), one of several members of the U-S Preventive Services Task Force, says the group continues to recommend that adults, 18 and older, be screened for depression.

    GXF FULL
    JAMA LOGO

    AUDIO
    The new Task Force recommendations appear in JAMA, Journal of the American Medical Association.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:04
    Runs:15
    “We have additional evidence about the effectiveness of screening and treatment in pregnant women and peripartum women. There’s much more information available in that population to make us confident screening that was effective.”

    (Video covering middle of bite: pregnant women getting blood drawn, mother walking with child on the street, mother pushing stroller)

    VIDEO
    B-ROLL
    New mom walking with her child down hospital hallway, pregnant woman getting an ultrasound

    AUDIO
    VO
    While several treatments are available for pregnant and peri-partum women, the Task Force recommends that clinicians and patients work together to determine the best approach to treatment.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:27
    Runs:09
    “Because there is some suggestion that some medications that are used for treating depression may have adverse effects on the fetus.”

    VIDEO
    B-ROLL
    Older man walking, older people sitting in wheel chairs

    AUDIO
    The Task Force also continues to recommend depression screening in older adults.

    AUDIO
    SOT/FULL
    Michael P. Pignone, M.D., M.P.H., – Member, U.S. Preventive Services Task Force
    Super@1:49
    Ends:18
    “We still need more evidence in older adults about the effectiveness of screening and treating depression on outcomes. We really need to be a little bit more active in finding patients with depression and treating them effectively and this recommendation reinforces that.”

    (Video covering 1st half of bite: older people outside)

    VIDEO
    B-ROLL
    Patient and doctor talking

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:The Task Force recommends depression screening be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow up for patients.

  • January 19, 2016

    Fewer U.S. Cancer Patients Dying in the Hospital but I-C-U Care Remains Common

    Fewer U.S. Cancer Patients Dying in the Hospital but I-C-U Care Remains Common

    INTRO:There’s a common perception that the United States spends a lot more on health care because it spends so much more on end of life care than other developed countries. So, how does the U-S compare to other nations? A new study examined several health care measures at the end of life for cancer patients in five European countries, Canada and the United States. Catherine Dolf explains in this week’s JAMA Report.

    AUDIO
    SOT FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:01
    Runs:11
    “We know that end of life care is intensive, we know it’s expensive, we know that still too many people are dying in the hospital, even today.”

    (Video covering 2nd half of bite: nurse in hospital room)

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@:12
    Runs:06
    “The United States is not the worst in end of life care, at least when it comes to cancer patients, nor is it the best.”

    VIDEO
    B-ROLL
    Dr. Emanuel and Dr. Bekelman walking, nurse walking into hospital room with patient, nurse talking to patient, Graphic: Map with 7 different countries shown

    AUDIO
    VO
    Doctors Ezekiel Emanuel and Justin Bekelman from the University of Pennsylvania Perelman School of Medicine and co-authors compared the health care experience for cancer patients, older than 65, in six countries and the U-S in 20-10. Those countries included, Canada, Belgium, Germany, England, the Netherlands and Norway. They examined several clinical measures six and one month before death.

    AUDIO
    SOT FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:39
    Runs:05
    “The United States and the Netherlands had the lowest proportion of patients dying in the hospital.”

    VIDEO
    B-ROLL
    Graphic: Empty Hospital room, percentages wipe in over video

    AUDIO
    VO
    About 22 percent of U-S cancer patients died in hospitals. Almost 30 percent in the Netherlands; and Belgium and Canada had just over 50 percent of patients die in the hospital.

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@ :53
    Runs:05
    “We have the fewest hospitalizations and we have the shortest number of hospital days of all patients.”

    (Video covering end of bite: hospital bed being pushed down the hall)

    AUDIO
    SOT/FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@:59
    Runs:04
    “The U-S wasn’t as expensive as we might have thought or might have predicted.”

    VIDEO
    B-ROLL
    Graphic: Map with hospital costs of each country

    GXF FULL
    JAMA LOGO

    B-ROLL
    Dr. Bekelman and Dr. Emanuel looking over study information

    AUDIO
    VO
    During the last six months of life, patients in Norway and Canada had higher hospital costs than patients in the U-S. There was less spending in Germany and Belgium but the lowest expenditures were in the Netherlands and England.

    The study appears in JAMA, Journal of the American Medical Association.  Both researchers note that there are areas where care can be improved for U-S patients.

    AUDIO
    SOT/FULL
    Ezekiel Emanuel, M.D., Ph.D., – University of Pennsylvania Perelman School of Medicine
    Super@1:23
    Runs:19
    “The United States has far and away the most patients who end up in the intensive care unit in the last six months of life. About 40 percent of patients actually end up in the intensive care unit.  They spend the longest time of any country in the world. We also give a lot of chemotherapy to patients in the last six months of life.”

    (Video covering end of bite: lab worker preparing chemotherapy treatment)

    AUDIO
    SOT/FULL
    Justin E. Bekelman, M.D., – University of Pennsylvania Perelman School of Medicine
    Super@1:44
    Runs:13
    “A question is for our patients, if they wrote the chapter about their last six months or about their last month, would it resemble the findings that we’re reporting? And I’ll bet the answer is no and that means we have more work to do.”

    (Video covering end of bite: Various shots of patients and staff in ICU)

    VIDEO
    B-ROLL
    Dr. Bekelman on camera

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:This study helps set a baseline about how the United States and other countries can learn from each other in order to improve end of life care.

  • January 12, 2016

    New Procedure Helps Patients with Severe Emphysema

    New Procedure Helps Patients with Severe Emphysema

    INTRO:Emphysema is a lung disease that makes breathing very difficult.  Patients with severe emphysema experience shortness of breath and often have poor quality of life. There is no cure and current therapies, including lung reduction surgery, can be risky. A new study examined a minimally invasive procedure to see if it could improve breathing and also be a safe and cost effective way to treat emphysema. Catherine Dolf has more in this week’s JAMA Report.

    VIDEO
    -ROLL
    Patient walking down hallway and breathing heavily

    AUDIO
    VO
    This patient has severe emphysema.

    AUDIO
    NATSO/FULL
    Runs:03
    “…haaa…haaa…”

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:05
    Runs:05
    “Emphysema is characterized by destruction of the lung.”

    VIDEO
    B-ROLL
    X-ray showing destruction of lung tissue

    AUDIO
    VO
    Air becomes trapped in the spaces created by the damaged lung tissue.

    AUDIO
    SOT/FULL
    Voice of:
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:14
    Runs:06
    “Too much air in fact, in the lung, it’s very difficult for the patient to breathe.”

    (Video covering bite: x-ray of lung, patient on breathing machine)

    VIDEO
    B-ROLL
    Dr. Deslée walking down hospital hallway, looking at x-ray of lungs, cu of coil

    AUDIO
    VO
    Dr. Gaëtan (gay-taun) Deslée (des-lay) from the University of Reims, in France, and co-authors investigated a new procedure, permanently placing several coils like this into the lung.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@:30
    Runs:14
    “They help to induce the recoil of the lung which is impaired in severe emphysema and it improves the elasticity of the lung.”

    (Video covering middle of bite: showing coils in lung, showing the coil expanding in his hand)

    VIDEO
    B-ROLL
    Man taking breathing test, graphic showing coils inside lungs, patient taking walking test

    AUDIO
    VO
    The study included 100 patients from 10 centers across France. 50 patients had an average of 10 coils placed in their lungs and the other 50 received standard medical treatment. Both groups were followed closely and assessed at 6 and 12 months. They participated in a six-minute walk test to see if their breathing had improved, allowing them to walk farther.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@1:09
    Runs:27
    “Coil treatment improved exercise test after 6 months. 36 percent of the patients treated by coil treatment had an improvement of at least 54 meters or 177 feet in the 6 minute walk test compared to only 18 percent in the control group.”

    (Video covering 1st part of the bite: patient taking the walking test)

    (Video covering middle of 2nd part of bite: patient walking with nurse)

    GXF FULL
    JAMA LOGO

    AUDIO
    VO
    The study appears in JAMA, Jurnal of the American Medical Association.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@ 1:33
    Runs:11
    “There was a significant improvement of quality of life at 6 and 12 months in the group treated by coil treatment.”

    VIDEO
    B-ROLL
    Dr. Deslée holding the coil in his hand

    AUDIO
    VO
    Coil placement was safe but quite expensive in the short-term.

    AUDIO
    SOT/FULL
    Dr. Gaëtan Deslée, M.D., Ph.D., Hôpital Universitaire de Reims, France
    Super@ 1:47
    Runs:13
    “We need the data after three and five years of follow up to get the final information about the cost and cost effectiveness of this new technology.”

    (Video covering 2nd part of bite: x-ray with coils in lungs)

    VIDEO
    B-ROLL
    Coils in lungs

    AUDIO
    VO
    Catherine Dolf, the JAMA Report.

    Tag:Study authors say the patients who did not receive the coil treatment in this study will be offered the coil treatment going forward.

  • January 05, 2016

    Combination of Weight Loss and Exercise Offers Benefits in Patients with a Common Type of Heart Failure

    Combination of Weight Loss and Exercise Offers Benefits in Patients with a Common Type of Heart Failure

    INTRO:An increasingly common type of heart failure occurs when the heart is pumping normally but doesn’t fill with enough blood. As a result, patients experience shortness of breath and fatigue with physical exertion. So far, medications have been unsuccessful in treating this disorder. A new study examined whether weight loss, exercise, or a combination of the two would result in improvement for patients with this type of heart failure. Catherine Dolf explains in this week’s JAMA Report.

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    Lynora walking on track

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    These days you can hardly keep up with Lynora Essic. But it wasn’t always that way.

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    Lynora Essic – Program Participant
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    “When I first started the study and I found out I was going to have to walk, I about had a panic attack. I was like ‘this is really not going to work for me.’”

    (Video covering 2nd half of bite: Lynora walking on track)

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    Lynora walking on track

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    She could barely do four laps without struggling for breath, but not now.

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    Lynora Essic – Program Participant
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    “My last time around I was up to 32 laps.”

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    Lynora getting blood pressure checked

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    Lynora has an increasingly common type of heart failure.  Although her heart pumps normally, it doesn’t fill with enough blood because the lower chamber of the heart is too stiff.

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    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
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    “This form of heart failure is the most common one in America, it’s the fastest growing. However, despite all of our efforts we’ve not found any medication treatments that improve the outcomes in patients with this disorder.”

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    People riding exercise bike and walking

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    More than 80 percent of these patients are also overweight or obese.

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    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
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    “About 5 years ago we tested exercise for these patients and found that it improved their main symptom which is exercise intolerance, or shortness of breath and fatigue with physical exertion.”

    (Video covering middle of bite: Lynora exercising)

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    Dr. Kitzman walking down hallway, Lynora talking with staff member, going over her numbers

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    Dr. Dalane Kitzman from the Wake Forest School of Medicine and co-authors studied whether weight loss and exercise might help symptoms in a group of 100 patients with this form of heart failure. Patients were randomly assigned to a calorie restricted diet, exercise training, or both.

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    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
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    “With exercise, participants lost about six and a half pounds of body weight. With diet, they lost more than twice as much. When we put diet and exercise together they lost 22 pounds.”

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    JAMA LOGO

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    Lynora and Dr. Kitzman greeting each other and talking

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    The Study appears in JAMA, Journal of the American Medical Association. Dr. Kitzman says patients who were in the combination group also saw the most improvement in physical symptoms.

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    Dalane W. Kitzman, M.D., – Wake Forest School of Medicine
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    “With a significant improvement in exercise tolerance with diet alone and with exercise alone but when you added them together you had a large improvement in exercise tolerance.”

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    Lynora in study kitchen picking up her meals, being weighed

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    After 12 weeks of diet and exercise, Lynora is down 15 and a half pounds.

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    Lynora Essic – Program Participant
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    “I feel good all the time and to me that’s really important. My family is really, really active and I don’t want to be the one on the sidelines anymore, I’ll be right there with them.”

    (Video covering 1st part of bite: Lynora on scale)

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    Lynora on camera

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    Catherine Dolf, the JAMA Report.

    Tag:Study authors also found that diet alone appeared to show a larger improvement in quality of life for the participants than exercise alone.