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Your body produces the vast majority of cholesterol in your blood, it doesn't come from what you eat. In fact, you would be DEAD without cholesterol, it is a building block of the body. This is a well-known and accepted fact.

Now - can what you eat affect the amount and type of cholesterol in your blood? Yes. Is high cholesterol always bad? No. Is LDL always "bad" and HDL always "good"? NO. There is so much nuance to this that it isn't even funny. Our bodies are highly complex, we need to stop representing everything in such simplistic polar answers. This summary is bunk and can't even be taken at face value. It uses terms like "associated with" and a percentage of risk, which by themselves mean nothing. Is that relative risk or absolute risk? What other factors were controlled for, or not controlled for, in the study.

These things are mentioned in the paper abstract, and it really can't be effectively summarized without reading the full paper (which you have to purchase). Here is the meaning based on the findings:

Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner.

There are definitely some red flags in that statement. "dietary cholesterol or eggs". I would also like to know what other dietary and lifestyle factors were controlled for.

Indeed, the study is being reported in a scaremongering way. For example the risk being reported is an increase from 38 to 40 people out of 100 dying over 30 years. It also does not prove an association between eating eggs and cholesterol, it could be an association between fried breakfasts and cholesterol because people who eat fried breakfasts eat more eggs. So yes, it is just scaremongering. See more analysis here https://jamanetwork.com/journa...

The actual study is paywalled.

That's nice.

https://sci-hub.tw/10.1001/jam...

It's fairly muddled in the article, and the summary here isn't much clearer. The last sentence in the summary is consistent with the below excerpt from the study, which is clear that the researchers were measuring independent risks from (1) an additional 300 mg of cholesterol per week from any source, and (2) an additional 3-4 eggs per week.

Findings Among 29615 adults pooled from 6 prospective cohort studies in the United States with a median follow-up of 17.5 years, each additional 300 mg of dietary cholesterol consumed per day was significantly associated with higher risk of incident CVD (adjusted hazard ratio [HR], 1.17; adjusted absolute risk difference [ARD], 3.24%) and all-cause mortality (adjusted HR, 1.18; adjusted ARD, 4.43%), and each additional half an egg consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.06; adjusted ARD, 1.11%) and all-cause mortality (adjusted HR, 1.08; adjusted ARD, 1.93%).

The actual study is paywalled.

Just so happens there is a clear trend in BMI and the number of pushups too.
Also a clear trend in age.
Also a clear trend in being a current smoker.

Study: https://jamanetwork.com/journa...

My take from it is firefighters who are old, fat and smoke are more likely to have a heart attack.

Their lower limit of 10 was also in a test group of 1100 firefighters.
37 of those 1,104 people had a cardiovascular issue.

Globally, 31% of all deaths are CVD related, so it's entirely possible that even those in this 1,104 people who couldn't do 10 push ups were at a generally lower risk anyway.

The 96% figure comes from 36 of those couldn't do more than 40, one of them could.
The article doesn't say how many of those 36 could do more than 10.
The median age was nearly 40 years old.

Not only that, there is a clear correlation between age and BMI in the pushup groups.
0 - 10 push ups has a median age of 48.4 and a BMI of 33.1
> 31 is 35.1 years and a BMI of 26.8

The stddev gets lower as you go up too, so the 41 is 28 to 42.2 (seeing as how all participants were over 18 in the beginning and the test period was 10 years, the > 41 group is probably skewed towards more people a little younger than 35 and a few older.

With the exception of the 0-10 group and 11-20 group in the "previous smoker" category, the more pushups you can do, the fewer in the group are current or previous smokers.

So you could also say being older and fatter and a smoker is correlated with how many push ups you can do if you're a firefighter.

The data is all here https://jamanetwork.com/journa...

is it though? all it shows us is that upper body strength and potentially having less fat around upper body strength is a better indicator of health then lower body/leg strength.

No, all it shows is that older people have more cardiovascular events than younger ones.

The ones who could do fewer push-ups were older. By 13 years.

(see the first row in table 1 of the article, here: https://cdn.jamanetwork.com/am... )

is it though? all it shows us is that upper body strength and potentially having less fat around upper body strength is a better indicator of health then lower body/leg strength.

No, all it shows is that older people have more cardiovascular events than younger ones.

The ones who could do fewer push-ups were older. By 13 years.

(see the first row in table 1 of the article, here: https://cdn.jamanetwork.com/am... )

ERAS for the win.

https://jamanetwork.com/journa...

Indeed. There is a component of Internet users who apparently have a huge lack of social skills, respect for others, or even basic moral values.

In the US, we call them, "Trump voters". But in their defense, a large number of them appear to be addicted to opioids, bless their hearts.

https://jamanetwork.com/journa...

We've finally reached the point where progressives are actually citing feminist studies as citable science. At this point one can no longer deny that progressivism is simply a religious movement that cannot get over its dogma.

Here's another study you can try to pretend isn't "citable science" because you don't like the way it portrays you.

https://jamanetwork.com/journa...

but this is exactly the kind of rhetoric that lead to Trump in office.

No, and fuck you. This has been how Trumpist jackoffs have been spinning anything they don't like: "This is how Trump got elected". It's all horseshit and you should not believe it.

Trump got in office by lighting up the lizard brains of racists, nazis and the most fucked up 20% of our society who respond to authoritarians and bullies. He got in office through voter suppression. He got in office because 304 members of the electoral college voted for him, even though most voters did not.

Also, by maximizing the oxycontin vote, as has been proven by peer reviewed studies:

https://jamanetwork.com/journa...

Exactly, neither one of you have READ THE STUDY YET! https://jamanetwork.com/journa... Why would you ALREADY have pre-formed conclusions about it? Exactly.

Actually I did read the study, though I don't really have the training (or time) to fully understand everything they did I understood enough to validate that.
a) They did a good job trying to control for other variables.
b) They couldn't control for everything because it's really tough to do.

The point isn't that their research is useless, a 25-ish% drop in cancer is really significant. The point is that this study alone doesn't provide the answers that people want. They found a big correlation between organic food consumption and lower cancer rates, now future studies can start narrowing in on that. Was it the organic food and something in the non-organic pesticides? Was it the types of food that organic food eaters eat? Was it another lifestyle choice that correlates with organic food consumption.

The rest can't stop thinking that his ilk are what got trump elected in the first place.

We already know what got Trump elected in the first place. There have been peer-reviewed studies published in the Journal of the American Medical Association.

https://jamanetwork.com/journa...

Drugs in general, and opiods in particular, are not the problem. Drug abuse is a symptom of deeper issues like isolation, depression, and hopelessness. It's literally self-medicating. This is not an epidemic among healthy, well-adjusted adults with stable incomes and functional social support networks. There is some of that, to be sure, but not an epidemic. It's impoverished areas of the country among people who have given up and feel left behind that are hardest hit. And again, drug abuse is a symptom of that.

The overwhelming majority of people don't become addicted to their prescription painkillers. All available evidence supports this. Of course corporations are greedy, and they need regulation, but opiods are the best treatment currently available for pain management, and if you've ever needed them, you know they are the difference between agony and relief. Limiting their availability or doctors' ability and discretion in prescribing only harms people who genuinely need them. Addicts will find a way regardless. Should we have support systems in place for those who do? Absolutely. But demonizing the supply side misses the point entirely.

For some reason, most people understand that brewers and distillers -- despite their much heavier advertising and glamorizing of alcohol than, say, opioid manufacturers of fentanyl -- don't create alcoholics, and that prohibition just made the problem worse, but everyone wants to believe that it's completely different this time. Because opiods. Yes, it's a compelling and easy-to-believe story that "big pharma" is responsible, but it doesn't really make sense at the end of the day. If manufacturers and prescribers were responsible, we might expect to see people with the most access to healthcare and the most dollars to spend have the most problems as a percentage of the respective demographics, but the reverse is true.

Nobody wants to talk about the socioeconomic drivers of addiction, because it means a) admitting a problem with the social structure in our country, b) it's hard to generate the same emotion and outrage about underprivileged segments of society as a story about a big bad enemy does and c) it's a much more difficult problem to solve.

I came across this in looking for supporting data, and it seems to be a good description of the real problem: https://tonic.vice.com/en_us/a...

See also:
https://jamanetwork.com/journa...
https://www.drugabuse.gov/abou...

What got Trump elected was ...

Here is what really got Trump elected, explained by a peer-reviewed study:

https://jamanetwork.com/journa...

Findings: This cross-sectional analysis of a national sample of Medicare claims data found that chronic use of prescription opioid drugs was correlated with support for the Republican candidate in the 2016 US presidential election. Individual and county-level socioeconomic measures explained much of the association between the presidential vote and opioid use.

https://jamanetwork.com/journa...

Findings: This cross-sectional analysis of a national sample of Medicare claims data found that chronic use of prescription opioid drugs was correlated with support for the Republican candidate in the 2016 US presidential election. Individual and county-level socioeconomic measures explained much of the association between the presidential vote and opioid use.

The latest findings come from a study published Monday in JAMA Internal Medicine that included about a half-million people in England, Scotland and Wales. "We found that people who drank two to three cups per day had about a 12 percent lower risk of death compared to non-coffee drinkers" during the decade-long study, says Erikka Loftfield, a research fellow at the National Cancer Institute

And what other factors did they control for? Age, income, working conditions, gender, diet, age, and many other things can affect longevity. This sounds like yet another idiotic study that found a correlation and jumps to the hasty generalization about its implications. The abstract provides no indication any effort was made to control for other possible causes. The real question is whether coffee is the proximal cause or if it is just a convenient correlation result due to other factors.

I'm also curious who funded this particular study... Hate to be cynical but one has to wonder.

This is what happens when you ignore a sizable portion of the country. They find somebody who'll listen.

Did you know that the average wages for someone in non-supervisory jobs has gone down under Trump? Have you seen the price of gasoline? Know anyone who works at the Harley-Davidson plant in Wisconsin (I do)?

The problem is that those people who were being "ignored" have now shot themselves in the foot and are starting to feel the fallout, as are we all. Maybe there's a good reason those people were being ignored, if their solution was to elect this jackoff.

Did you know that only 4% of US workers got a pay raise since the Republicans passed their tax bill 6 months ago? That's why we've got this whole hard-line immigration bullshit going on, because the biggest things Trump has done have been unpopular with real Americans, and all he can hope is that he can gin up enough White Extinction Anxiety to get the oxycontin-dosed disability-collecting racists to act as his human shields.

https://jamanetwork.com/journa...

Show me where people are staving in this country. And, no, not 'food challenged' or whatever they are calling it when you don't get three meals a day, every day.

Before you dismiss food insecurity, please read this research paper on its "particularly toxic" effects: https://jamanetwork.com/journa... This should make the connection between poverty and poor academic performance clear enough to you.

That's from an editorial in Mother Jones about 5 years back which made a big splash on the Internet, but didn't provide much evidence (mainly it just asserted the correlation was strong enough to be irrefutable).

A perusal of recent research on the topic turns up this recent JAMA paper which concluded that after controlling for childhood socioeconomic status, "Findings failed to support a dose-response association between BLL and consequential criminal offending." That would suggest that it's growing up in poverty which leads to future criminal behavior. And indeed if you look at the historical poverty rate, it dropped substantially right around 1970, around the time leaded gasoline began being phased out. And if you compare poverty rate by race, you find that the two races with the highest crime rates (black and hispanic) also have the highest childhood poverty rates.

This study which states "The consequences of lead exposure for later crime are theoretically compelling, but direct evidence from representative, longitudinal samples is sparse," reaches pretty much the same conclusion, but may be more useful as it provides direct links to other Google Scholar papers on the topic.

This isn't to say lead is safe. It's known to depress IQ, and though the link with future criminal behavior is weak, it is more strongly linked to antisocial behavior and delinquency. Just that the "irrefutable" link between leaded gasoline and crime presented in the Mother Jones article may in fact just have been a random correlation, not causation.

dcollins117 blathered:

Acting in the best interests of their patients is what doctors get paid to do. They have extensive training, knowledge, and first-hand experience to rely on.

-1 Offtopic.

Antibiotics are indicated for viral infections because they prophylactically prevent secondary infections. It's not because doctors are conspiring to eradicate mankind.

Bullshit, bullshit, bullshit.

And don't put words in my mouth. I never said or implied the widespread (mal)practice of prescribing antibiotics for viral infections was a conspiracy. It's not. It is - or was, at any rate - extremely common, especially among GPs, however.

As to why the practice is/was so prevalent, the internists with whom I've discussed the issue (all of whom are bitterly critical of their fellow MDs for engaging in it) have fairly unanimously agreed that their GP cohorts basically give in to their patients' demands for antibiotics because those patients are largely ineducable on the subject - and because, for decades, there was a mistaken belief among them that prescribing useless antibiotics was merely a harmless concession to those imbecilic patients' conviction that penicillin was a universal panacea for diseases of all kinds. That's strictly anecdotal, of course, but it certainly rings true.

What the studies I cited and anecdotal evidence from MDs with whom I've discussed the problem both strongly indicate is that prophylaxis ("preventative prescription" for lay readers) is absolutely not the primary reason most doctors who engage in the practice of antibiotic prescription for viral infections do so.

Doctors are human. They cater to their patients' demands for medication that is of absolutely no value beyond placebo for those patients' actual medical issues simply to get them off their necks - and thereby preserve their positive regard. As long as MDs can persuade themselves that there's no harm in them doing so, it's simply easier to humor their patients than to say, "No," and risk alienating them ...

Basically, anyone I can find who has any direct experience with the issue and any sort of credentials which might lend them some credibility seems to agree that guns are not the problem and there's some greater force making us want to kill each other in the US. Unanimously, and regardless of their status as a gun owner, anyone who's actually dealt with or earnestly studied gun violence and is qualified to understand human interaction and behavior agrees that guns would just be replaced with some other weapon if we didn't have them.

I simply don't believe this statement. It defies not only logic, but reality. It's simple economics. Guns are an easy way to kill people, knives are more personal, more dangerous to use, require more effort, and are less effective. It's much easier to shoot 100 people, than it is to stab 100 people. That means reducing access to guns will both reduce the number of incidents, and reduce the severity of the incidents as it becomes harder to obtain guns. Basically, the desire to kill people is a demand curve, and the easier it is to carry out the objective the more people die. And beyond the simple logical understanding, there is plenty of research that disagrees. Which makes your comments fail the "no true Scotsman" sniff test because you seem to be excluding everyone who disagrees with you from your pool of experts.

And think about it: what makes guns so powerful? There's nothing magical about a gun that makes it more deadly as the best available weapon than a knife would be if that was the best we had. A bit easier to kill with? Sure, and harder to stop with anything other than another gun. But a knife will kill you just as dead as a gun and, if we didn't have anything more powerful than a knife, someone with a knife would be just as hard to stop with anything but a knife.

Do you even know what a gun is? It's point and shoot. It's not magic that makes it more deadly than a knife. It's the little pieces of metal travelling at around 1,700 mph that we call bullets that make them more deadly than running around trying to stab people with a knife.

So we get rid of guns. Then what? Knives take their place. We get rid of knives? Okay, then we've got people running each other down in vehicles. So we get rid of those, right? What next? You can sharpen a spoon into a weapon, we should get rid of those as well. Follow that to its logical conclusion and we find ourselves back in the stone age.

This is both a strawman argument and a slippery slope argument. Most people don't want to get rid of all guns, they'd just like to see more restrictions on who can own them, and more respect for their death dealing capabilities. Also, restricting access to knives is not likely to significantly impact murder and assault rates, because the difference between a knife and a blunt object isn't nearly as big as the difference between a knife and a gun.

My friend, again, you are absolutely correct. But you need to realize that you're arguing against people who fear guns more than they fear people wielding guns; as though it's the gun who wants to kill them, rather than the person holding it. They won't ever admit that there's a people problem, because it would force them to admit that they, themselves, are flawed.

Once again, you are completely wrong. Murder is a people problem, but there are many different ways to deal with the problem, and reduced access to guns is one method that will reduce the effects of the people problem. Increase the barrier to commit the crime, and there is less of that crime. There are other approaches that also need to be taken, because it's a demand curve, so increasing barriers only reduces the effect of the problem, it doesn't eliminate it. It's not a silver bullet. So reducing violent

You don't know the difference between your opinion and evidence?

https://www.webmd.com/diet/fea...

Benzyl Alcohol, Benzoic Acid, and Sodium Benzoate are safe:
https://www.ncbi.nlm.nih.gov/p...

Azodicarbonamide is safe:
https://www.ncbi.nlm.nih.gov/p...

Aspartame is safe:
https://jamanetwork.com/journa...

No evidence that organic based foods are safer than regular foods (a review of 240 studies)
http://annals.org/aim/article-...

No evidence that GMOs pose health risks:
https://www.csicop.org/si/show...

What is actually going on here:
https://sciencebasedmedicine.o...

they choose

Really?

high prevalence of mental illnesses and other psychiatric disorders

-- https://jamanetwork.com/journa...

80% of respondents reported some form of mental health issue, 45% had been diagnosed with a mental health issue.

-- http://www.homeless.org.uk/fac...

Around 70 per cent of people accessing homelessness services have a mental health problem.

-- http://www.nhsconfed.org/resou...

Society has failed them, seriously?

Civilised society, yes.

Since the only people I see with fitness trackers are obese and the fit people I see don't have fitness trackers, I conclude that other strategies work better.

Is there research that shows they help?

I searched before posting. This Journal of the American Medical Association published study found "the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches."

The study's subjects aren't everyone, but it seems that for many, no fitness tracker is best.

Vaping by itself is completely harmless with nicotine being on par with caffeine in terms of harm and effects.

No
it's
not

This is nothing more than the anti cigarette brigade getting their panties in a wad over the fact that people flat out love nicotine and want to enjoy it without the bad effects of cigarettes (which are bad).

If that's what you think then maybe you should actually read the article... or the summary.

Better the young'ins be vaping rather than smoke cigarettes.

Did you bother even reading those studies before you posted them?

And if that is where it stopped we wouldn't be commenting on this story.

Study 1 only had 42 participants. Wow, I bet we're supposed to assume 42 people equal the whole of humanity right?

Study 2 claims nicotine causes damage to DNA. You know what else causes damage to DNA? Everything from food to the sun dingus. That's why our bodies developed a way to work against that with antioxidants.
http://www.whydontyoutrythis.c...

Study 3: a complete duplicate of study 2 hosted on a different server.

Did you even bother reading these studies before you posted to my reply or were you just anxiously looking around on Google for weak proof that all things nicotine are bad?

The anti smoking brigade are almost as bad as the temperence twats.

Vaping by itself is completely harmless with nicotine being on par with caffeine in terms of harm and effects.

No
it's
not

This is nothing more than the anti cigarette brigade getting their panties in a wad over the fact that people flat out love nicotine and want to enjoy it without the bad effects of cigarettes (which are bad).

If that's what you think then maybe you should actually read the article... or the summary.

Better the young'ins be vaping rather than smoke cigarettes.

And if that is where it stopped we wouldn't be commenting on this story.

Some who would start smoking will use ecigs instead. That's bad how?

As for helping you quit, ecigs helped me quit. After a number of years vaping, I found that I just wasn't interested in the nicotine anymore. No drama, no nail biting, no eating the entire refrigerator, nothing. Just no more interest in nicotine.

While you are one of the (rare) "success stories" of people being able to quit using e-cigs, there are much larger issues at stake. E-cigs are being promoted as a safe alternative to tobacco (quoted from article true link here) and were not designed to help people quit, just channel their addiction/dependence onto a new (probably) more profitable platform, that may be slightly more socially acceptable:

"As tobacco usage declined over time in the United States, industries introduced an alternative known as electronic cigarettes (e-cigarettes) claiming they were a healthier alternative to tobacco smoking.3

Since then, the number of e-cigarette users has increased significantly because of the perception that they serve as a healthy substitute to tobacco consumption with minimal or no harm, a lack of usage regulations (although that has now changed), and the appealing nature of these devices, among other reasons."

And it goes on to state that the these products are increasingly used by teenagers:

"Consequently, e-cigarettes became the most commonly used smoking products, especially among youth, with more than a 9-fold increase in usage from 2011 to 2015.5"

The purposed of this article was to illustrate that these products are not benign as most users believe.

That's the part that really hacks them off, I sinned by smoking and they want to see some serious suffering as penance.

No, they are not out to punish anyone, rather they are trying to dispel incorrect claims from a formerly unregulated industry. Please be happy that someone is actually studying the effects so that we can make informed decisions instead of relying on industry propaganda.

Link for the second article referenced here

Study Recruitment In 2008, as a collaboration among the VA Boston Healthcare System, Bedford VA, Boston University (BU) School of Medicine, and Sports Legacy Institute (now the Concussion Legacy Foundation [CLF]), a brain bank was created to better understand the long-term effects of repetitive head trauma experienced through contact sport participation and military-related exposure. The purpose of the brain bank was to comprehensively examine the neuropathology and clinical presentation of brain donors considered at risk of development of CTE. The institutional review board at Boston University Medical Campus approved all research activities. The next of kin or legally authorized representative of each brain donor provided written informed consent. No stipend for participation was provided. Inclusion criteria were based entirely on exposure to repetitive head trauma (eg, contact sports, military service, or domestic violence), regardless of whether symptoms manifested during life. Playing American football was sufficient for inclusion. Because of limited resources, more strict inclusion criteria were implemented in 2014 and required that football players who died after age 35 years have at least 2 years of college-level play. Donors were excluded if postmortem interval exceeded 72 hours or if fixed tissue fragments representing less than half the total brain volume were received (eFigure in the Supplement).

It sounds like they selected from donated cadavers for people who had played football. This is quite different from football players who suspected they had brain damage from football donating their brains. There would still be bias, as families who were convinced their loved ones were suffering from brain damage would be more likely to say yes to being in the study. But that's likely NOT NEARLY as big a bias as what GP is suggesting.

Seems about on the level of, "Doctors claim vaccines don't cause autism, but Jenny McCarthy doesn't agree," which started from and is largely maintained by the left.

Started by "the left"? Say what? "Left" and "Right" have nothing to do with this. "Doctors" are at least as likely to be members of "the left" if by that you mean social liberals as opposed to conservatives. Oh, wait, they are more likely:

https://www.psychologytoday.co...

http://www.reuters.com/article...

http://jamanetwork.com/journal...

The last article is very thoughtful and analyzes trends in political contributions specifically, fractionated by gender, race, and subspeciality. It indicates that left/right even for physicians is more likely to be a question of income, gender, race, speciality, and age than it is of "intelligence" per se, but it is a simple matter of fact that on average liberals are smarter than conservatives.

Now, if you want to get into pseudoscience, we can talk about the "conservatives" in Texas and Kansas and Missouri who are passing legislation to make masturbation a misdemeanor crime (Texas), teach intelligent design on a par with evolution in the schools, rewrite history so that the founding fathers are Good Christians as opposed to deists or atheists and suppress evidence to the contrary to prevent it from being mentioned in school, let alone taught.

Personally, I tend to think of science as mostly being social value neutral, but the glaring exception to this is when science collides (as it so often does!) with religion. This is beautifully reflected in surveys like this:

http://www.pewresearch.org/fac...

although it is perhaps better summarized by this piece:

http://www.huffingtonpost.com/...

To quote:

The more religious a person is, the more conservative he is, and this relationship is strongly mediated by the value placed on tradition — respect for customs and institutions. But even though religiousness and spirituality are highly correlated, the more spiritual a person is, the more liberal he is. This relationship is mediated by the value placed on universalism — social tolerance and concern for everyone’s welfare.

As with previous studies, conservatives were more conscientious (organized and self-disciplined), while liberals were more agreeable and more open to new ideas and experiences. The trend of conservatives being more religious and liberals being more spiritual held even when controlling for these personality factors, and when controlling for age, gender and socioeconomic status.

As a scientist, I interpret this as the more orthodox religious a person is, the more likely they are to accept absolute nonsense as truth just because it is written down in a scriptural text somewhere and hence exempted somehow from the ordinary rules and methods of reason. The more spiritually religious they are, the more likely they are to accept absolute nonsense as truth just because they "feel" like it must be true and their feelings are again exempt from the ordinary rules and methods of reason. You can see the problem -- liberals and conservatives are almost equally likely to accept at least some nonsense as truth if they are religious, and liberals and conservatives who are intelligent enough not to do this are, almost by definition, less likely to accept nonsense as truth whether or not it is religious simply because they apply the rules

Doctors over 60 are disproportionately male. The gender ratio for young doctors is relatively balanced.
It has been shown that female doctors have slightly better statistics for outcomes than male doctors.
http://jamanetwork.com/journal...
The JAMA study uses the same patient group as the old-vs-young study, that is hospitalized Medicare patients.
And they both looked at performance of hospitalists.
As near as I can tell, the gender ratio for hospitalists is more balanced than the all-doctors gender ratio, but I can't easily find numbers of age vs sex for hospitalists.

Another factor might be that hospitalists can migrate to be a specialist (waaaay more money), but that's not an option if you're not a very good hospitalist, so perhaps the old ones are a combination of dedicated hospitalists (the ones with large patient loads and good outcomes), and the ones that didn't advance (who may be just marking time).

So, I got curious and looked at both studies (but only the abstract for the JAMA). The difference in outcome between male and female hospitalists is smaller than the difference between young and the over 60 year old doctors. If I read correctly, the female vs male patient death difference was 11.07% vs 11.49%, but the young vs old was 10.8% vs 12.1%.
So it appears that age is a much greater factor than sex.

Yeah I don't want to keep a fat chain smoker alive for a few extra years. Thank you Trump!

Look here the largest cluster of lagging lifespan is neatly outlined by the Bible Belt. Further if you read the actual journal abstract you would find

Question
  Are inequalities in life expectancy among counties in the United States growing or diminishing, and what factors can explain differences in life expectancy among counties?

Findings
  In this population-based analysis, inequalities in life expectancy among counties are large and growing, and much of the variation in life expectancy can be explained by differences in socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors.

Meaning
Policy action targeting socioeconomic factors and behavioral and metabolic risk factors may help reverse the trend of increasing disparities in life expectancy in the United States.

Thus the actual journal describes it as a variety of causes, not smoking and drinking. The slashdot summary is moronic clickbait - dare I say "fake news" - by insunuating that these people deserve to die solely because of their bad choices. But don't let me spoil the hackneyed rebublican narrative.

A behavior factor is exactly that, and when the fattest states seem to always hover around the same areas with the lowest life expectancy, then YES, it can be accurately concluded that shitty life choices such as eating unhealthy and using tobacco and alcohol products are relevant factors. The main reason TFS brought them up is because regardless of location, smoking and heart disease are still our largest killers.

If you want further proof, see where the highest rates of smokeless tobacco and cigarette use is, or rates of obesity and heart disease. It's no fucking surprise or mystery that "southern cooking" practically centers around the concept of unhealthy, innocently relabeling it as "comfort food."

I'm sure the new republican health care plan will provide more comprehensive coverage at much lower costs thus solving americas poor living in third world conditions. /s

For those who want a good visualization, here is the US map of the study results,

and here's the study, click on the "figures and tables" link in the overly complex mishmash of a web page for visualizations and caption explanations.

I'm sure the new republican health care plan will provide more comprehensive coverage at much lower costs thus solving americas poor living in third world conditions. /s

For those who want a good visualization, here is the US map of the study results,

and here's the study, click on the "figures and tables" link in the overly complex mishmash of a web page for visualizations and caption explanations.

Yeah I don't want to keep a fat chain smoker alive for a few extra years. Thank you Trump!

Look here the largest cluster of lagging lifespan is neatly outlined by the Bible Belt. Further if you read the actual journal abstract you would find

Question
Are inequalities in life expectancy among counties in the United States growing or diminishing, and what factors can explain differences in life expectancy among counties?
Findings
In this population-based analysis, inequalities in life expectancy among counties are large and growing, and much of the variation in life expectancy can be explained by differences in socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors.
Meaning
Policy action targeting socioeconomic factors and behavioral and metabolic risk factors may help reverse the trend of increasing disparities in life expectancy in the United States.

Thus the actual journal describes it as a variety of causes, not smoking and drinking. The slashdot summary is moronic clickbait - dare I say "fake news" - by insunuating that these people deserve to die solely because of their bad choices. But don't let me spoil the hackneyed rebublican narrative.

" I also know a lot of kids that moved and had social issues."

I also know a shed load of kinds that stayed put and have social issues!!

To provide some focus, I wondered if there was any research available. Turns out there is:

http://jamanetwork.com/journals/jama/article-abstract/408450

Yes, while that's just one study, it shows some negative impact caused by frequent family relocation...

Try reading the article preview and stop being stupid: http://jamanetwork.com/journal...

First of all, let's forget the wearable devices. Cause study participants sure did.

Out of 24 months, they wore them on average 170 days. That's about the quarter of the time.
And that's median value. They actually wore them 68-347 days.
Oh... and it's only 80% of the "wearable device" group (i.e. technology-enhanced weight loss intervention group) members that were using said devices.
Also, when they were using monitors, median values was 241.1 minutes per day (99.3-579.1).

I.e. Monitors were mostly ignored.

Of the 237 participants randomized to enhanced intervention, 191 participants received the wearable device that was a component of the intervention starting after month 6 and wore the device for 1 day or longer (median days worn, 170.0 [25th-75th percentile: 68.0-347]).
On days that the device was worn, the median wear time was 241.1 min/d (25th-75th percentile: 99.3-579.1).

Secondly, groups were not random.
They took a group of people they KNEW were leaning towards underperforming and lazyness and gave them monitors (which they ignored) - while the higher performing "standard" group was selected to self-monitor.

For first six months both groups had the same regimen.
They were one group, with similar, self-reported baselines for physical exercise.
Then, AFTER six months, during which they've gathered data - researchers formed two groups.

One group had 118.8 minutes less of light physical exercise per week when compared to the other group.
Same group had 98.6 minutes less of medium-to-vigorous physical exercise, per week.
354.3 minutes less of metabolic equivalents of medium-to-vigorous physical exercise, per week.
76 minutes of 10+ minutes sessions of medium-to-vigorous physical exercise, per week.

They gave that group the monitors.
Negative trends continued, as expected, though the differences between the groups WERE decreasing with time.
But by the end of the study, differences in various exercise durations was still around 30 minutes in favor of "standard" group.

I.e. Researchers selected for lazy people with a tendency to overestimate personal physical performance - and gave them devices which should promote lazy behavior.
Lo and behold - people with devices performed worse.

It's like dividing a class of students into those with higher grades and those with lower grades.
Then giving those with lower grades computers and those with higher grades pencils to keep notes while studying French.
Then publishing a study titled something like "Computers - a detriment to education".

So get another kid to do it. There's got to be at least one kid around who's on insulin.

You might want to look up some actual data before spouting off something so stupid and easily disproven. The prevalence among children is somewhere around 1 to 2 per 1000.

And "training"? - it's simple as sh*t. Literally so easy that a kid can do it.

Missing the point. Unless you are going to provide training to basically everyone on injecting drugs then it isn't "easy as shit". Furthermore training the general public on how to administer drugs? The same general public with a HUGE drug problem? Oh yeah, no predictable side effects of that...

Seriously you think public health officials haven't thought about any of this stuff? If it was really that easy there would be no market for something like an epipen.

Kids with diabetes are sticking themselves all the time.

Kids with diabetes receive a lot of coaching and learn how to administer and dose insulin. They do not learn how to administer and dose epinephrine. Nobody is arguing that people are incapable of doing it with adequate instruction. The argument is that THEY HAVEN'T RECEIVED INSTRUCTION and there are a serious logistical problems with ensuring availability and proper dosing of the medication. Anyone who argues this is a trivial problem has no idea what they are talking about.

Flexeril (cyclobenzaprine) is a dangerous drug. https://en.wikipedia.org/wiki/... It's not that effective and I think you were saying it wasn't effective at all.

In some patients, particularly the elderly, it causes confusion, delerium and hallucinations, from which patients take a long time to recover, if they recover at all. An article in JAMA Internal Medicine described how the author's mother died from complications of cyclobenzaprine. http://archinte.jamanetwork.co... “Mom, you have to trust me” doi: 10.1001/jamainternmed.2015.3659

One of the problems is that we don't have good treatments for back pain. (I say this as someone who used to have back pain about once a year so severe that I couldn't get out of bed or walk down the street.) Right now, the best advice is to try to return to normal activity as best as you can despite the pain, and to console yourself with the knowledge that most back pain goes away by itself after a week to a month. But there are exceptions, which is why you can sometimes benefit from seeing a doctor. I realize that finding a good doctor is like shooting craps. But if he recommends spinal injections, I would get a different doctor.

I don't think you're suggesting that people should be allowed to buy Flexeril or other drugs after an internet consultation, but I don't think that would work too well.

I wish there was some way to make doctors more competent in dealing with back pain, but I don't know of any. As for costs, you might look at the ways other countries make medical care cheaper.

by Anonymous Coward on Tuesday June 21, 2016 @06:48AM (#52358049)

trying to see a Doctor in the UK is an exercise in frustration in trying to navigate the labyrinthine system set up to manage their 48 hour waiting targets.... you have to be really dedicated to push yourself forward to get a same day appointment... if lucky, you'll get a telephone appointment or else be seen by the practice nurse

They release appointments for the next day at 12:30pm and they go very fast...

Isn't single-payer medicine GREAT!!!

I assume you are an American anonymous coward. I wonder when the last time was that you needed to get health care in the American free market system.

http://archderm.jamanetwork.co...

The Accuracy of Dermatology Network Physician Directories Posted by Medicare Advantage Health Plans in an Era of Narrow Networks

Jack S. Resneck Jr, Aaron Quiggle, Michael Liu, BS3; David W. Brewster
JAMA Dermatol. Published online October 29, 2014. doi:10.1001/jamadermatol.2014.3902

48.9% of physicians were reachable, accepted the listed plan, and offered an appointment for our fictitious patient. Many of the dermatologists listed had incorrect contact information, were deceased, retired, or had moved, were not accepting new patients, did not accept the insurance plan, or were subspecialized.

Ask the US veterans who died waiting for care from the US Department of Veteran's Affairs!

I know some veterans who go to the VA health care system. I would trade my health plan for theirs tomorrow, and they would never trade their plan for mine.

Bernie Sanders is on the Senate committee that covers VA health care, and he said that people complain about access, but once they're in the system, their care is excellent.

The problem was that the Republicans wanted to have wars but they don't want to pay for health care for the soldiers who fought that war. Their solution is, "cut the budget and privatize." Adopt the methods of our MBAs and private corporations. Give them impossible goals to meet, and if they can't meet them, fire them and hire somebody else. That worked so well for BP and Enron.

I'm not going to defend the indefensible. There were reports of veterans who had for example bladder cancer, who didn't get treated in time, and whose bladder cancer went from treatable to untreatable. But that happens (all the time) in the free market health care system, when people can't afford to go to a doctor at all. And it happened because the Republican budget-cutters cut the VA budget, under the Republican "Bricks without Straw" policy.

I do a lot of medical literature searches. The outcomes of the VA system are among the best. If you need, say, coronary bypass surgery, your chances of surviving are as good in the VA system as anywhere in the world. Including Sweden.

They've done a lot of the major studies in treating heart disease, cancer, diabetes, COPD, and all the conditions that affect veterans. If you go to a medical conference, and they're trying to decide what the best treatment is, they're always talking about the "VA study," which is often the definitive study.

Oh yeah -- the other benefit of the VA system is that when a VA doctor recommends surgery, it's because he (and his colleagues) think you'll really be better off, not because he gets a $3,000 surgical fee, like a doctor in the private sector. And they have the evidence to prove it.)

You're going to hate the facts. More than 1/3 of American adults are obese. Obesity is #2, right behind tobacco at #1, as causes of death.

And with fewer people smoking because of the stigma associated with it from shaming smokers, obesity becomes #1. Sounds like a deadly epidemic to me.

You absorb lead through your skin, so touching it is pretty bad as well. Can't imagine eating it.

http://www.ncbi.nlm.nih.gov/pu...
Abstract

A 45-y-o male with a history of schizophrenia was admitted to a local VA psychiatric unit. Five days later, endoscopy due to abdominal pain, gastrointestinal bleeding and blood hemoglobin of 5.6 g/dL revealed bullets in the stomach. On subsequent radiograph, > 50 bullets were visualized in the stomach and intestines. Poison Center recommendations included whole bowel irrigation and a blood lead level. After poor results with gastrointestinal decontamination and a repeat radiograph showing > 100 cartridges, surgical intervention was considered but not performed due to perceived risk of bullet detonation from electrocautery. The blood lead was reported as 391 mcg/dL. Calcium EDTA therapy was initiated, followed by aggressive gastrointestinal decontamination. Four days of whole bowel irrigation facilitated passage of 206 cartridges over the next 10 days. The patient was discharged on a 14-day course of 600 mg Succimer tid to treat the bone lead deposits and blood lead level of 49 mcg/dl. An outpatient visit 6 w later showed the blood lead level had dropped to 24 mcg/dl. Aggressive gastrointestinal decontamination and calcium EDTA and Succimer administration successfully treated an ingestion lead bullets and the resulting lead poisoning.

or this one... sad...
http://archpedi.jamanetwork.co...

The study described in the web page accessible from the login-protected link (which is not the primary source) has been published on the Journal of the American Medical Association: http://jama.jamanetwork.com/ar... (protected too, but at least is the real thing).
Here the AMA news release about the results, sufficiently informative: http://media.jamanetwork.com/n...

The study described in the web page accessible from the login-protected link (which is not the primary source) has been published on the Journal of the American Medical Association: http://jama.jamanetwork.com/ar... (protected too, but at least is the real thing).
Here the AMA news release about the results, sufficiently informative: http://media.jamanetwork.com/n...

You say that like you are a member of the cult of scientology.

There is a myth that all mass shooters are on anti-depressants.

(1) It's false. For example the Sandy Hook shooter had no medication in his bloodstream.
(2) The origin of the myth is a scientology front
(3) Mass-shootings are a form of suicide and anti-depressants reduce suicidal thoughts and behaviors.
(4) Anti-psychotics cut homicide rates in patients by 93%
(5) People who are happy don't commit suicide. Given that some 20% of the adult population is taking anti-depressants it is not surprising that some mass-shooters would be on anti-depressants. It would be anomalous if they weren't.

From their very own reference: https://jama.jamanetwork.com/a...

Another case of people making non news out of misinterpreting statistics. The statistics are from hospital admissions of cycling related injuries "per 100,000 persons" NOT 100,000 cyclist persons. This is no different to saying roads are getting more dangerous because there are more people driving and thus proportionally more driving injuries, get your base line right.

Opponents of "Hillarycare" in the 1990s predicted that her plan's rating of doctors based on outcomes would lead to excellent doctors who took-on difficult cases and very ill patients getting lower grades than bad doctors who only took on healthy young patients with the result being that doctors would avoid patients who were very sick or severely injured. Hillary's supporters expressed outrage at the criticism.

When "Obamacare" came up for debate and similarly proposed to reduce costs and increase quality by rating doctors based on outcome, the same criticism arose from opponents, and the same left-wing supporters of "universal healthcare" similarly claimed this was a false argument.

This big lie at the heart of "universal healthcare" plans that promise to do opposing things (limit costs while improving quality) within a big bloated institutional (government and/or corporate) scheme have long been known and predicted as even the LA Times (hardly a Republican rag) noted in 2005 long before Obama was even running for President. In fact, it has long been known, and there are studies to prove it, that many things about the patient drive the outcomes more than the quality of the doctor (within reason, of course - frauds and quacks in ANY field should not be lumped-in with valid practitioners).

Some of the leftist true-beleivers who were architects of both Hillarycare and Obamacare (guys like Rahm Emmanual's brother) actually embrace this sort of effect as a natural form of rationing (some people get denied care, but without a government order and therefore with full-deniability for government). This goes hand-in-hand with various plans favored by fans of Eugenics and advocates for "whole life" systems of healthcare resource allocation, where the young and the old and the sick and handicapped are discarded in favor of those who are productive and in their reproductive years. Most people see "Logan's Run" as a cautionary tale, but these people fetishize it as an ideal.

Sadly, no matter how many times anti-Marxists predict things that are absolutely predictable because they result from physical or economic laws, Marxists will deny them and convince the ignorant masses that they have a way to violate the laws of physics or the laws of economics.