Sunday, May 3, 2015

Hair loss: how does it affect women?

 On seeing a bald man walk past, most of us wouldn't take a second glance. But would this be the case if a bald woman walked past? It is doubtful. Hair loss - although distressing - is generally more accepted in men, despite women accounting for 40% of all hair loss sufferers in the US. In this Spotlight, we look at the main causes of hair loss in women, the emotional toll it can take and why research is lagging behind in treatment for female hair loss.

A brush with hair in
Women account for 40% of all hair loss sufferers in the US.
The most common cause of hair loss in both men and women is androgenetic alopecia, also referred to as male or female pattern baldness.
A hereditary condition, androgenetic alopecia is believed to be caused by dihydrotestosterone (DHT), which derives from the male hormone testosterone.
An enzyme called Type 2 5-alpha reductase - present in the oil glands of hair follicles, the skin organs that produce hair - helps convert testosterone to DHT. This derivative then binds to and shrinks hair follicles, killing healthy hair.
Because men have higher testosterone levels than women, they are likely to produce higher DHT levels, leading to increased hair loss. As such, men with androgenetic alopecia often experience a receding hairline which can progress to partial or complete baldness, while women tend to experience hair thinning on the top and sides of the scalp.
"Hair thinning in female pattern baldness is different from that of male pattern baldness in that the frontal hairline remains unaffected except for normal recession, which happens to everyone as time passes, and hair loss rarely progresses to total or near total baldness, as it may in men," Dr. Marc Glashofer, a dermatologist and fellow of the American Academy of Dermatology, explained to Medical News Today.
But androgenetic alopecia is not the only cause of hair loss in women.

What are the other common causes of hair loss in women?

Telogen effluvium is a form of hair loss that can develop when the body is put through extreme stress, such as child birth, malnutrition or major surgery.
The condition involves a sudden shift from hair growth or resting phases to the hair shedding phase, known as telogen. This can occur within 6 weeks to 3 months after a stressful experience.
According to Dr. Shani Francis, also a fellow of the American Academy of Dermatology and director of the Hair Disorders Center of Excellence at Northshore University HealthSystem in Illinois, telogen effluvium is much more common in women than men. "It is the typical 'shedding' that happens after childbirth in some women," she told us.
A woman combing her hair
Telogen effluvium is a common form of hair loss in women, which can develop when the body is put through extreme stress.
She added that some triggers of the condition - such as iron deficiency and changes in medication - are more likely to occur in women. "These triggers typically affect women more than men due to menstruation, the most common cause of iron deficiency in women, and the high prevalence of birth control use - some women change birth control quite frequently," she explained.
Traction alopecia is another form of hair loss that is more likely to occur in women. It is triggered by trauma to the hair follicles, most commonly through hair styling that continuously pulls at them - such as braiding, tight ponytails and hair extensions. "This type of hair loss is primarily seen in African-American patients," said Dr. Glashofer.
Another common cause of hair loss in both men and women is alopecia areata - an autoimmune disease that affects around 2% of the US population. The condition can be inherited; around 1 in 5 people who suffer from alopecia areata have a family member with the disorder.
It occurs when the immune system mistakenly attacks the cells in hair follicles, leading to hair loss on the scalp and other areas of the body. In alopecia areata, hair most commonly falls out in small patches. In some cases, however, the condition can lead to complete baldness.
Specific medical conditions - such as anemia and thyroid disorders - and the use of certain medications can also lead to hair loss.

The severe emotional impact of hair loss for women

It goes without saying that hair loss - regardless of gender - can be devastating. It can dent a person's self-esteem and negatively affect their overall quality of life.
"Studies on the psychosocial impact of hair loss have found patients' self-esteem, body image and self-confidence to be negatively impacted," Dr. Francis told MNT. "Known psychosocial complications include depression, low self-esteem, altered self-image and less frequent and enjoyable social engagement."
It seems experts are in agreement, however, that women are significantly more likely to suffer emotionally as a result of hair loss.
"Hair loss in a woman is so emotionally devastating that it can trigger a wide range of social and emotional issues that can negatively impact healthy daily living and overall quality of life. I have heard of women that retreat from social situations, have diminished work performance, and even alter their healthy living - avoiding exercise, overeating, not treating other medical illnesses - due to their hair loss," said Dr. Francis.
But why do women see a greater emotional impact from hair loss than men? According to Dr. Glashofer, it is down to society's perception of beauty. "Society unjustly puts an inordinate amount of pressure on beauty and a great deal of this comes from perceptions of hair," he told us.
Dr. Francis agrees. 
"For a women, the hair is the crown, a symbol of beauty/pride. It is typically what a woman identifies with as being feminine or attractive to a mate. If this starts to diminish, it can be devastating to a woman's identity and self-esteem, especially when affected at an early age. For older women, hair loss is perceived as accelerated aging and women have to deal with a sense of loss of virility and sexual attraction to their mate as well.
"Due to societal perception differences, it is much more emotional for women, as there is limited cosmetic acceptance of a bald woman and increased societal pressure on a woman to be attractive. The negative quality of life is likely worse in women."

Drug companies 'aren't falling over themselves' to test new hair loss drugs in women

It is not only support from society that is lacking for women with hair loss; it seems the medical world has been ignoring these women's needs.
There is only one medication approved by the Food and Drug Administration (FDA) for women with androgenetic alopecia - a topical treatment called minoxidil that works by stimulating the hair follicles.
As well as minoxidil, men with androgenetic alopecia can be treated with another medication called finasteride. This drug works by dramatically lowering DHT levels, halting the progression of hair loss.
Due to conflicting clinical trials, finasteride has not yet been approved for the treatment of androgenetic alopecia in women. Some studies have found that finasteride can cause fetal mutations in women of childbearing age.
Such findings, Dr. Francis believes, have deterred researchers from testing hormonally-active medications in women with hair loss. Even the American Hair Loss Association admit that women are in a "catch-22" situation when it comes to hair loss treatment.
"While many drugs may work to some degree for some women, doctors are reluctant to prescribe them, and drug companies aren't exactly falling over themselves to test existing or new drugs specifically for their ability to prevent and treat female pattern baldness," they state.
Dr. Francis also notes that researchers tend to sway more toward testing hair loss medications in men because it is easier to measure their response to treatment; their hair is generally shorter so their scalp is easier to see. "Also, women have very diverse styling and grooming practices - that many are unwilling to change - which makes research harder to standardize," she added.

Recent progress in hair loss treatment for both men and women shows promise

But while it is clear that progress in hair loss treatment for women has been slow, recent research has shown some promise - making hair loss breakthroughs that could be applied to both sexes.
In August 2014, for example, a study published in the journal Nature Medicine revealed how a drug already approved by the FDA for a rare bone marrow disease restored hair growth in patients with alopecia areata.
The researchers found that ruxolitinib fully restored patients' hair within 4-5 months by preventing immune system cells from attacking the hair follicles.
A bald woman
"Women are not able to have the same societal support [as men] for a smooth bald head," said Dr. Francis.
"There are few tools in the arsenal for the treatment of alopecia areata that have any demonstrated efficacy. This is a major step forward in improving the standard of care for patients suffering from this devastating disease," commented Dr. David Bickers, of the Department of Dermatology at Columbia University Medical Center.
More recently, in January 2015, researchers from Sanford-Burnham Medical Research Institute in La Jolla, CA, claimed they have found a way to generate hair growth using human pluripotent stem cells.
Dr. Glashofer believes such research moves us a step closer to finding effective hair loss treatments for both men and women.
"Most recent groundbreaking hair research is attempting to define the biologic and genetic basis for certain types of hair loss. This obviously has value to both sexes," he told MNT. "Research attempting to utilize stem cells has broad implications for both hair loss treatments for men and woman and may have a role in treatment within the next decade."
While it is good news that progress is being made in terms of treatment for female hair loss, it is clear that greater awareness is needed of how the condition can affect women - particularly how it can affect them emotionally.
Dr. Francis points out that most people may not realize the extent to which these women are suffering, pointing out that many of them cover up their hair loss with wigs, scalp concealer and other cosmetic devices.
Again, this comes down to the fact that hair loss is generally more accepted in men. "Men are much more willing to shave the rest of the heads if hair loss starts to take over and this is cosmetically acceptable and in some cases quite attractive. Women are not able to have the same societal support for a smooth bald head," Dr. Francis told MNT.
It should not be the case that female hair loss is deemed unacceptable. Scottish model and TV presenter Gail Porter - who was diagnosed with alopecia in 2005, which led to complete baldness - is testament to the fact women are beautiful with or without hair. In an interview with the Scottish Express last year, Porter spoke of her challenges with hair loss while being in the public eye.
"As much as they say that people don't judge you on the way you look on TV, they do," She told the newspaper. "They [television bosses] say things like 'Would you consider wearing a wig?' "When I refuse, they say 'Oh, okay, we'll get back to you.' In other words, 'We're not having you because you have no hair.' I'm in a good place and I'm not going to wear a wig for anybody."
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Pets: are you aware of the risks to human health?

There is no doubt America is a nation of animal lovers. In 2012, more than 62% of American households included at least one pet. But while most of us are aware of the numerous benefits of pet ownership, are you aware of its risks to human health?
Those of you who have a cat, dog, bird or any other animal in your household will likely consider that pet to be member of your family, and rightly so.

A woman and her dog
Though pets can offer a wide range of health benefits to humans, they can also pose a number of health risks.
Pets offer comfort and companionship, and we can't help but love them. In fact, when it comes to dogs, a recent study found the famous "puppy dog eyes" glare triggers a whopping 300% increase in owners' oxytocin levels - the "love hormone" involved in maternal bonding.
What is more, pets offer a number of benefits to human health. In December 2014, Medical News Today reported on a study that associated household pets with stronger social skills in children with autism. And in May 2013, a study published in the journal Circulation linked pet ownership to reduced risk of heart disease.
But while pets can benefit our health in a number of ways, they also have the potential to spread infection and cause human illness. In this Spotlight, we take a look at the some of the health risks associated with ownership of many of the nation's most-loved animals.


Most of us have heard of Campylobacter. The bacterium is one of the most common causes of diarrhea in the US, estimated to affect more than 1.3 million people annually.
As well as diarrhea, infection with Campylobacter - called campylobacteriosis - can cause cramping, abdominal pain and fever within 2-5 days of exposure to the bacteria.
While most cases are caused by exposure to contaminated food - particularly meat and eggs - and water, it can also be contracted through exposure to stool of an infected animal - including dogs and cats.
According to PetMD, around 49% of dogs and 45% of stray cats carry Campylobacter and shed it in their feces. It is most common in puppies and kittens younger than 6 months.
It should be noted that infection with Campylobacter is rarely life-threatening, though individuals with weak immune systems, young children and the elderly are most at risk.

Tapeworm, hookworm and roundworm

Dipylidium caninum is the most common tapeworm in both dogs and cats in the US. It is caused by ingestion of fleas that carry the tapeworm larvae. This can happen when the animal grooms itself.
D. caninum can be passed to humans, though the risk of infection is very low. It most commonly occurs in young children who accidentally swallow an infected flea.
According to the Centers for Disease Control and Prevention (CDC), flea control is the best way to reduce the risk of D. caninum infection in both pets and humans.
A hookworm
Hookworm infection in humans most commonly causes a skin condition called cutaneous larva migrans, in which the hookworm larvae penetrate the skin.
Ancylostoma brazilenseA. caninumA. ceylanicum andUncinaria stenocephala are just some of the species of hookworm that can infect cats and dogs.
The hookworm parasite can be shed in the feces of animals, and humans can contract it by coming into contact with infected feces or contaminated soil and sand where such feces have been.
Hookworm infection in humans most commonly causes a skin condition called cutaneous larva migrans (CLM), in which the hookworm larvae penetrate the skin. This causes a red, itchy and sometimes painful rash.
In rare cases, specific strains of hookworm can infect the intestines of humans, causing abdominal pain and diarrhea.
Toxocariasis is an infection caused by the transmission of Toxocara - parasitic roundworms - from dogs and cats to humans. According to the CDC, almost 14% of Americans have Toxocara antibodies, indicating that millions of us have been exposed to the parasite.
In dogs and cats infected with Toxocara, eggs of the parasite are shed in their feces. Humans can contract the parasite by accidentally swallowing dirt that has been contaminated with these feces.
Though it appears human exposure to Toxocara is high, most people infected with it do not develop symptoms or become sick. In the rare cases people do become ill from toxocariasis, the condition may cause inflammation and vision loss in one eye (ocular toxocariasis), or abdominal pain, fever, fatigue and coughing due to damage to various organs (visceral toxocariasis).


Though not as cute and fluffy as kittens and puppies, reptiles - such as turtles, snakes and lizards - are owned by around 3% of households in the US.
There is no doubt reptiles are interesting creatures and can make brilliant pets, but they are also a carrier ofSalmonella - a bacteria responsible for salmonellosis. Humans can contract the bacteria simply through touching a reptile and ingesting the germs.
According to the CDC, more than 1 million people in the US become ill from Salmonella infection each year. Of these illnesses, more than 70,000 are caused by contact with reptiles.
Within 12-72 hours of being infected with Salmonella, people may experience diarrhea, fever and abdominal cramps that last around 4-7 days. While most people fully recover without treatment, others may need to be hospitalized.
Turtles are a main culprit of Salmonella infection in the US. The sale of turtles less than 4 inches was even banned by the US Food and Drug Administration (FDA) in 1975 because of their high disease risk - particularly among young children, the elderly and people with weak immune systems.


Rabies is one of the most severe diseases that humans can contract from dogs and cats, as well as smaller animals such as ferrets. A recent study reported by MNT found the disease kills around 59,000 people worldwide every year.
Rabies is a disease that infects the central nervous system (CNS). Caused by a bite from an animal infected with rabies virus, the disease causes fever, headache and weakness, before progressing to more severe symptoms - including hallucinations, full or partial paralysis, insomnia, anxiety and difficulty swallowing. Death normally occurs within days of more serious symptoms appearing.
According to the CDC, domestic animals accounted for 8% of all rabid animals reported in 2010.
In the US, the most common way domestic animals can contract rabies is through a bite from infected wild animals, particularly foxes, raccoons, skunks and bats. Symptoms normally occur 1-3 days after infection and include excess salivation, paralysis and unusual shyness or aggression.
If an owner suspects their pet may have been bitten by a rabid animal, they must take them to a veterinarian for care immediately, even if they have been vaccinated against the virus. Any person who believes they may have been bitten by a rabid animal must seek immediate medical care.

Parrot fever

Despite its name, parrot fever does not only occur in parrots - all birds can be affected. However, human transmission of the disease most commonly involves parrots, parakeets, macaws, cockatiels and poultry - particularly turkeys and ducks.
Also known as psittacosis, parrot fever is a bacterial disease caused by a bacterium called Chlamydia psittacithat humans can contract through inhalation of birds' secretions, including urine and feces.
If a person becomes infected with C. psittaci, symptoms usually appear around 10 days after exposure. These may include fever, nausea and vomiting, diarrhea, fatigue, chest pain and shortness of breath.
In more severe cases, infection with C. psittaci can cause inflammation of the brain, liver and other internal organs. It can also reduce lung function and cause pneumonia.
It is important to note, however, that parrot fever in humans is very rare in the US. According to the CDC, fewer than 50 people a year are infected, and this has been the case since 1996.


Toxoplasmosis is a disease caused by a single-celled parasite - Toxoplasma gondii. It is most commonly contracted in humans through ingestion of undercooked or contaminated meat.
A cat using the litter tray
Cats shed T. gondii in their feces.
However, humans can also contract T. gondii by coming into contact with cat feces or any area or object contaminated with cat feces, as felines are carriers of it. T. gondii cannot be absorbed through skin, but infection can occur if the parasite is accidentally ingested.
It is estimated that more than 60 million people in the US are infected with T. gondii. However, very few people become ill from the infection as the human immune system is normally able to fight it.
If the infection does present symptoms, these may include swollen glands and muscle aches and pains. In very severe cases, T. gondii infection may cause damage to the brain and other organs, or eye damage.
Pregnant women, elderly individuals, young children and people with weakened immune systems are at highest risk of developing symptoms from T. gondii infection.

Cat-scratch disease

Although our cute little kitties very rarely mean to scratch us, it does happen. And while many of us think nothing of a small graze from a cat's claw, it has the potential to cause more damage than you may think.
Cat-scratch disease (CSD) is caused by a bacterium called Bartonella henselae, which around 40% of cats carry at some point in their lifetime, though most show no signs of illness.
B. henselae is most common in kittens under the age of 1 year, and since kittens are more likely to scratch during playtime, they are most likely to spread the bacterium to humans.
An early sign of CSD can be an infection at the site of the scratch around 3-14 days after it occurred, characterized by swelling, pain and tenderness. Headache, fever, loss of appetite and fatigue may also present, and in very rare cases, CSD can affect the brain, heart and other organs.
Children under the age of 5 years and individuals with weakened immune systems are most likely to experience severe symptoms from CSD.

What can be done to prevent pet-related infections?

It is clear pets can harbor an abundance of germs that can be passed to humans, but there are a number of ways pet-related infections can be prevented:
  • Wash your hands - hygiene is key for preventing the majority of pet-related infections. After coming into contact with pets, their saliva or feces, hands should be washed thoroughly with warm, soapy water. A scratch or bite from a pet should also be cleaned immediately
  • Pick up and dispose of feces - quickly disposing of your pet's feces, particularly in areas where children may play - can prevent the spread of disease to humans and other animals
  • Avoid scratches and bites - the best way to avoid infections from pet bites and scratches is to avert them in the first place. If you are scratched by a cat, dog or other animal, clean the wound immediately with warm, soapy water. A cat or dog bite may require medical attention due to the risk of rabies or other serious infection
  • Get your pet vaccinated and routinely evaluated - visit a veterinarian regularly to ensure your pet is healthy and to prevent infectious diseases. Also, ensure your pet is up-to-date with the required vaccinations.
It is important to note that the likelihood of a person catching a disease from their pet is low, particularly if the correct precautions are taken. With this in mind, there is no reason why the millions of pet owners in the US can't enjoy the companionship and joy their animals provide.
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How do race and ethnicity influence childhood obesity?

Obesity is a serious public health problem in the US and can affect anyone regardless of age. In particular, childhood obesity prevalence remains high. As well as compromising a child's immediate health, obesity can also negatively influence long-term health dramatically. Unfortunately, some racial and ethnic groups are affected by obesity much more than others.

Children lying down in a circle smiling.
There is a disparity in the prevalence of childhood obesity between different racial and ethnic groups in the US.
For example, the US Department of Health and Human Services Office of Minority Health (OMH) report that African-American women have the highest rates of being overweight or obese, compared with other racial or ethnic groups in the US.
Approximately 4 out of 5 African-African women were found to be overweight or obese and, in 2011, African-American women were 80% more likely to be obese than non-Hispanic white women.
Researchers have identified that disparities in obesity prevalence can be found just as readily among children as among adults. It is alarming that these disparities exist to begin with, but more so that they exist so early in life for so many.
In this Spotlight feature, we take a brief look at the prevalence of childhood obesity in the US and the disparities in childhood obesity prevalence that exist among different racial and ethnic groups. We will examine what factors may contribute to this disparity and what action can be taken to remedy the situation.

A growing problem

"Obesity is the terror within," states Dr. Richard Carmona, the former Surgeon General. "Unless we do something about it, the magnitude of the dilemma will dwarf 9-11 or any other terrorist attempt."
These are strong words, but they illustrate the scope of the obesity problem. According to the Centers for Disease Control and Prevention (CDC), in 2009-2010, over a third (35.7%) of adults in the US were obese.
On average, childhood obesity in the US has not changed significantly since 2003-2004, and overall, approximately 17% of all children and adolescents aged 2-19 years are obese - a total of 12.7 million.
There are a number of immediate health problems that childhood obesity can lead to, including:
  • Respiratory problems, such as asthma and sleep apnea
  • High blood pressure and cholesterol
  • Fatty liver disease
  • Increased risk of psychological and social problems, such as discrimination and low self-esteem
  • Joint problems
  • Type 2 diabetes.
In the long term, obese children are much more likely to grow up to be obese as adults than children with healthy weights. Not only that, but the obesity experienced by these children is likely to be more severe, leading to further and more extreme health problems.
Significant disparities exist in obesity prevalence between different racial and ethnic groups. The CDC report the following obesity prevalence percentages among different youth demographics:
  • Hispanic youth - 22.4%
  • Non-Hispanic black youth - 20.2%
  • Non-Hispanic white youth - 14.1%
  • Non-Hispanic Asian youth - 8.6%.
From these figures taken from 2011-2012, we can see that levels of obesity among Hispanic and non-Hispanic black children and adolescents are significantly above average.
When the parameters are extended to include overweight children as well, the disparity persists. Around 38.9% of Hispanic youth and 32.5% of non-Hispanic black youth are either overweight or obese, compared with 28.5% of non-Hispanic white youth.
In 2008, Dr. Sonia Caprio, from the Yale University School of Medicine, CN, and colleagues wrote an article published inDiabetes Care in which they examined the influence of race, ethnicity and culture on childhood obesity, and what their implications were for prevention and treatment.
"Obesity in children is associated with severe impairments in quality of life," state the authors. "Although differences by race may exist in some domains, the strong negative effect is seen across all racial/ethnic groups and dwarfs any potential racial/ethnic differences."
However, if there are specific factors contributing to these disparities that can be addressed, the numbers involved suggest that attention should be paid to them. The long-term health of thousands of children in the US is at stake.

Socioeconomic factors

"Rarely is obesity in children caused by a medical condition," write the National Association for the Advancement of Colored People (NAACP) in their childhood obesity advocacy manual. "It occurs when more calories are eaten than calories burned."
The NAACP outline a number of factors that contribute to increases in childhood obesity, including:
  • The development of neighborhoods that hinder or prevent outdoor physical activity
  • Failure to adequately educate and influence families about good nutrition
  • Ignored need for access to healthy foods within communities
  • Limited physical activity in schools
  • Promotion of a processed food culture.
The CDC report that childhood obesity among preschoolers is more prevalent in those who come from lower-income families. It is likely that this ties in with the disparity with obesity prevalence among different racial and ethnic groups.
"There are major racial differences in wealth at a given level of income," write Caprio, et al. "Whereas whites in the bottom quintile of income had some accumulated resources, African-Americans in the same income quintile had 400 times less or essentially none."
Children's playground.
Children living in high-poverty areas may find their access to safe outdoor play areas limited.
Fast food and processed food is widely available, low cost and nutritionally poor. For these reasons, they are often associated with rising obesity prevalence among children. According to Caprio, et al., lower-cost foods comprise a greater proportion of the diet of lower-income individuals.
If adults need to work long hours in order to make enough money to support their families, they may have a limited amount of time in which to prepare meals, leading them to choose fast food and convenient processed food over more healthy home-cooked meals.
Living in high-poverty areas can also mean that children have limited access to suitable outdoor spaces for exercise. If the street is the only option available to children in which to play, they or their parents may prefer them to stay inside in a safer environment.
Hispanic youth and non-Hispanic black youth are more likely to come from lower-income families than non-Hispanic white youth. According to The State of Obesity, white families earn $2 for every $1 earned by Hispanic or non-Hispanic black families.
Over 38% of African-American children aged below 18 and 23% of Latino families live below the poverty line. This statistic suggests that the effects of living with a low income that increase the risk of obesity may be felt much more by African-American and Latino families and their children.
Not only do these socioeconomic factors increase the risk of obesity among these demographic groups but equally obesity can compromise a family's economic standing.
The NAACP point out that families with obese children spend more money on clothing and medical care. Additionally, as obese and overweight girls frequently start puberty at a younger-than-average age, there is a possibility that their risk of adolescent pregnancy is also higher.

Cultural factors

Alongside these socioeconomic factors, a number of additional factors exist that may be linked to an increased prevalence of childhood obesity among Hispanic and non-Hispanic black youth.
The NAACP give one such example, stating that one component of body image is how a person believes others view them or accept their weight:
"This also poses unique challenges in African-American communities because of cultural norms that accept, uplift and at times reward individuals who are considered 'big-boned,' 'P-H-A-T, fat,' or thick.'"
Cultural norms such as these may lead to parents remaining satisfied with the weight of their children or even wanting them to be heavier, even if they are at an unhealthy weight. Other sociological studies have also suggested that among Hispanic families, women may prefer a thin figure for themselves but a larger one for their children, according to Caprio, et al.
As well as being influenced by socioeconomic status, the type of foods eaten by children can be influenced by the cultural traditions of their families.
"Food is both an expression of cultural identity and a means of preserving family and community unity," write Caprio, et al. "While consumption of traditional food with family may lower the risk of obesity in some children (e.g., Asians), it may increase the risk of obesity in other children (e.g., African-Americans)."
As mentioned earlier, the promotion of a processed food culture may be a contributing factor to childhood obesity. As fast food companies target specific audiences, favoring cultural forms associated with a particular race or ethnicity could increase children's risk of being exposed to aggressive marketing.
Caprio, et al., report that exposure to food-related television advertising - most frequently fast food advertising - was found to be 60% among African-American children.
The amount of television that is watched may contribute as well; one study conducted by the Kaiser Family Foundation observed that African-American children watched television for longer periods than non-Hispanic white children.
A number of these cultural factors are associated with socioeconomic factors. African-American children may be more likely to watch television for longer, for example, if they live in areas where opportunities for playing safely outside are limited.

What can be done?

This subject area is far too detailed to do justice to in an article of this size, but these brief observations suggest that there should be ways in which the disparity in childhood obesity between racial and ethnic groups can be addressed.
Family sitting down for healthy breakfast.
Increasing access to healthy food for low-income families is one step that could improve rates of childhood obesity.
Having more safe spaces to walk, exercise and play in low-income areas would give children a better opportunity to get the exercise need to burn the required number of calories each day. Improving the availability of and access to healthy food would give families more options when it came to maintaining a healthy, balanced diet.
The NAACP state that low-income neighborhoods have half as many supermarkets as the wealthiest neighborhoods, suggesting that for many low-income families, accessing healthy food can be a challenge.
These problems are ones that would need to be solved by local government and businesses that have influence over the planning and development of public living spaces.
Caprio, et al. propose that a "socioecological" framework should be adopted to guide the prevention of childhood obesity. Such a framework would involve viewing children "in the context of their families, communities, and cultures, emphasizing the relationships among environmental, biological and behavioral determinants of health."
This approach would require large-scale collaboration, involving peer support, the establishment of supportive social norms and both the private and public sector working together.
"For health care providers to have a meaningful interaction about energy intake and energy expenditure with children/families, providers should have training in cultural competency in order to understand the specific barriers patients face and the influence of culture and society on health behaviors," the authors suggest.
In order for this disparity to be adequately addressed, a lot of work will need to be done. Not only might certain cultural norms need to be altered, but most importantly, environments will need to be provided in which children will have the opportunity to live as healthy lives as possible.
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Wired Health: how are innovative technologies disrupting health care?

Last Friday, April 24th, marked the second annual Wired Health conference in London, UK, where members of the health care industry and curious spectators came together to discuss and explore how technology is shaping medicine today.

Big Ben in London, UK
Health care aficionados, technological innovators and curious spectators met in London for a 1-day summit investigating the latest advances in the medical sector.
While Wired Health 2014 focused on harnessing self-monitored data, this year's agenda targeted disruption in health care.
In 1997, Harvard Prof. Clayton M. Christensen created the term "disruptive innovation" to describe how new technologies can alter existing markets or sectors by injecting simplicity, accessibility and affordability into what has become the over-complicated, high-cost norm.
Though the term "disruption" typically carries a negative connotation, in these terms, it points to positive change that shakes up the system for the better.
At the summit in London last week, members of the health care industry proudly harnessed this term and demonstrated how departing from the standard way of doing things has made a significant impact on the existing landscape of medicine.

Changing behavior through perception

"Psychology is technology," said Rory Sutherland, vice chairman of UK-based marketing firm Ogilvy & Mather, as he took the main stage. "What you call things affects how people behave."
Addressing advancements in understanding human behavior, Sutherland cited the rise in unnecessary visits to the UK's emergency departments coinciding with a shift in what it was called. Though it was once widely known as "Accidents and Emergencies," it is now referred to as merely "A&E," taking away the inherently bloody connotations and making it sound more like the initials of two people in love.
Speaker at Wired Health
Rory Sutherland, of Ogilvy & Mather, addresses a packed audience at Wired Health 2015.
Referring to the emergency department by its full name on signs and in official literature could encourage patients to direct themselves to their GPs instead, decreasing the number of patients who unnecessarily use the emergency service and saving the UK's National Health Service (NHS) precious money.
"If you create a name for something," Sutherland added, "we automatically assume it's a norm."
He also explained that the way choices are presented can affect outcomes, particularly in the health care setting.
For example, when the NHS implemented the use of delayed prescriptions for antibiotics - when a prescription goes into effect a few days after an appointment, in a "wait-and-see approach" - unnecessary use of antibiotics decreased significantly.
In effect, changing the choice structure of things can alter behavior.

Removing the 'wrong' choice

Another man who recognizes that manipulating how choices are made can have positive effects in the field of medicine is Marc Koska, founder of the LifeSaver program. He noted that around the world, 1.3 million people die every year from infected needles that are reused.
After years of researching this problem, Koska came up with a simple solution to disrupt it: a syringe that is impossible to reuse. His K1 syringe is made on the same machinery and from the same materials as existing syringes, but it has an auto-disable mechanism that prevents reuse by employing a plunger that automatically locks in place and breaks if forced.
Koska showed conference-goers heartbreaking undercover footage of small children receiving injections with needles that had previously been used on HIV-positive patients, demonstrating the problem the global health care community faces.
The issue is so great that the World Health Organization (WHO) announced their third ever global policy, aiming to reduce unnecessary injections and ensure that only auto-disable syringes are used. This mandate will come into effect in 2020.
Koska noted that for every $1 spent on proper syringe disposal, over $14 could be saved on health care costs resulting from HIV, HBV and HCV. His charity SafePoint is working to improve this basic level of health care around the world. By taking the option of making the wrong decision out of the equation, Koska and colleagues are disrupting the unsafe practices that put patients at risk.

Bringing the element of choice to alternative limbs

For those who have lost limbs, there has been relatively little choice when it comes to what kind of prosthetic will become their new arm or leg. Though there have been advancements in so-called bionic reconstructions, the ability for a patient to take ownership over the design of their new limb has not really been an option - until now, that is.
The Alternative Limb Project, led by Sophie de Oliveira Barata, brings this choice to the patient, creating bespoke prosthetics for those who have lost their limbs. Each client can plan the design, and the company then works with product designers to create beautiful works of art that are also functional arms, hands, legs or feet.
Alternative limbs
Some of the designs featured by The Alternative Limb Project included a crystal leg, a limb with a speaker and mp3 dock, and a Japanese-inspired leg with pullout compartments for storage.
Some of the beautiful creations on display at Wired Health even included secret compartments in which the wearer can store things.
Speaking to a packed crowd, de Oliveira Barata explained that one of her clients recently had the idea to add a drone to an artificial arm that can "fly off the arm like a hawk" and take aerial photos.
Her unique approach empowers her clients to take ownership of their limbs, making them stand out as works of art, rather than as something to be hidden away.
Work from the company was recently thrust into the spotlight when the UK's Channel 4 introduced singer and performance artist Viktoria Modesta as "the world's first amputee pop artist."
In the video below, Modesta wears several creations from The Alternative Limb Project, including the "Spike," the "Crystal" and the "Light."
Writing on the company's website, Modesta explains how, after a voluntary operation to remove her leg - which was damaged from birth - she did not want to hide her altered body:
"Initially, after my voluntary operation, I mostly wanted to get a leg that provided balance to my body in its shape. Three years after the amputation, I then saw it as an opportunity to regard the leg as a fashion item and an art project which seemed rather fun and exciting."

Disrupting the aging process

Another speaker who took the stage at Wired Health was Brad Perkins, of Human Longevity, Inc. (HLI) - a company that focuses on genomics and cell therapy. They are tackling diseases caused by age-related decline by building a comprehensive database on human genotypes and phenotypes.
Perkins began his career at the Centers for Disease Control and Prevention (CDC), eventually spearheading investigations into the anthrax attacks in the US in 2001.
He explained that over the past 30 years, there has been a genomic revolution in bacteriology, in terms of how we study it, adding that "we humans are next" to go under the microscope.
HLI are currently working on building their database on human genotypes and phenotypes, and Perkins noted that "health care systems will be disrupted by this technology."
Interestingly, the integrated health records, along with clinical data that they are using to build their database, will become cloud-based and subjected to machine learning. HLI's 5-year goal is to achieve 1 million integrated health records so that they can fully interpret the meaning of the human genome.
"There is a potential to generate as many insights into health and disease as there has been in the last 100 years in the next 10 years," Perkins said, thus contributing to extended life spans.

Notable technological innovations

Between the Bupa Startup Stage - a platform for new companies to present their products and innovations - and the Wired Health Clinic - an exhibition where conference-goers were able to interact with new technologies - there was no shortage of interesting gadgets and gizmos.

Starstim cap

Starstim cap
Ana Maiques models the Starstim cap from Neuroelectrics for MNT at Wired Health.
One of the most striking gadgets was a noninvasive wireless cap, which acts as a neurostimulator. Named Starstim, the cap was created by Neuroelectrics, a company led by Ana Maiques.
The cap works by delivering a low current directly to the brain through small electrodes, and it acts as an electroencephalography (EEG) and accelerometry recording system.
Because the cap is portable, it can be used both in a clinical setting and at home, where patients can employ neurofeedback to balance their EEG.
Potential applications include treatment for ADHD, chronic pain, stroke rehabilitation, cognitive enhancement, addiction and depression.

Lumo graphic reader

When dealing with innovation, there are naturally challenges to overcome, and one of the biggest is funding. Anna Wojdecka, creator of the Lumo, spoke to Medical News Today about her search to find adequate funding to take her design from prototype to finished product. She described her product as such:
"Lumo is a low-cost graphic reader for the blind and visually impaired. It translates colors into sound and black lines into tactile feedback, enabling the user to read shapes, graphs and diagrams directly from a page and draw in color."
She added that the aim of her product is to "make learning environments more inclusive and enrich interaction between blind and sighted people." When the finished product is available, Wojdecka told it will sell for between $150-200. She can be contacted via Twitter @helloLUMO.

Tao WellShell

Tao WellShell
The Tao WellShell fits in the palm of the hand, acting as a gym on the go.
Image credit: Tao Wellness
Another notable gadget was the Tao WellShell, which is a handheld device that fits in the palm of the hand and works in tandem with an app to give the user a resistance workout anywhere. It can be used at home, sitting at a desk or even on a bus, train or plane.

Insulin Angel

In the realm of tiny handheld devices sits the Insulin Angel, which tracks a medication's temperature to help the user monitor and maintain effectiveness. In addition to warning the user in the event the medication has been forgotten, the Insulin Angel also tracks medication usage and waste, and displays results through a smartphone app.

Cupris Health smartphone otoscope

Given that smartphones have become our constant companions these days, innovations that incorporate these devices make other technologies easily accessible. Cupris Health is a company that is doing just that; they have turned smartphones into medical devices by employing clip-on attachments.
They displayed their smartphone-connected otoscope at the conference, explaining that parents can now take pictures of their children's ears and send the images and symptoms directly to the doctor, who can remotely advise on treatment.

How can these disruptions work together?

If conference-goers were hoping to be spoiled for choice, Wired Health 2015 certainly did not disappoint. The vast amount of startups, gadgets and solutions on display was staggering. Though the main theme of disruption was reinforced throughout the speakers' presentations and in the innovations shown in the main hall, there was a sense of disjointedness this year.
Whereas last year's conference was overwhelmingly focused on how to harness data, this year's focus felt a bit forced, as if there was no clear way to sew everything together. But perhaps this is indicative of just how quickly and in how many different directions the health care industry is moving.
Indeed, how data, research and innovation can be unified and harnessed to result in positive health outcomes is the challenge the medical community faces today. Perhaps Wired Health 2016 will focus on this issue.
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