Tuesday, July 5, 2016

HPV Vaccine Study Shows Reduction in Cervical Cell Abnormalities

Gardasil, a vaccine that helps prevent four human papilloma viruses (HPV) known to cause cervical cancer and cervical warts, was approved in the United States and Canada in 2006. Since then, millions of doses have been given, and probably an equal number of debates about its utility and safety have been argued among both the general public and healthcare professionals.

New study findings 

A new study published last week in the Canadian Medical Association Journal reviewed the efficacy and safety of the vaccine over the past eight years. The study included 10,204 women, aged 18 to 24 years, who had undergone Pap smear testing for cervical abnormalities. Most women in the group, 8,723 (85.5%) did not have any abnormalities, but 1,481 women (14.5%) did; 1,384 of these women had low-grade cervical anomalies and 97 had high-grade abnormalities.

The researchers found that 56% of the women were not vaccinated with Gardasil and 16.1% in this group had cervical abnormalities. Forty-four percent of the women received at least one dose before their screening test; 84% in this group were fully vaccinated, having received 3 or more doses; 11.8% in the fully vaccinated group had cervical abnormalities. In other words, women who had received the full dose of Gardasil had a lower incidence of cervical abnormalities that could lead to cancer.

But is the vaccine safe?

Tara Haelle did such a good job last year in her article about Gardasil vaccine that I thought it was better to refer you to her piece: Gardasil HPV Vaccine Safety Assessed In Most Comprehensive Study To Date.

But what about long-term efficacy, some people ask? What if it stops working? Yes, it's true that we don't know if the vaccine's effectiveness will last - but we didn't know that about the other vaccines we took either. I was vaccinated with the hepatitis vaccine when I first began working as a nurse. It was hospital policy and we didn't really have a choice. At the time, we weren't told that it was only effective for 25 years. We didn't know.

The morality argument

Just a few weeks ago, I read a respectful debate between a group of people who weren't sure if they wanted to vaccinate their teens, both male and female, with Gardasil. Most were in favor of the vaccine, while a few others were either hesitant or against it. I do realize that some parents are distrustful of vaccines, particularly one that appeared to come onto the scene as quickly as Gardasil. But I was surprised to see someone pull out the morality argument in the discussion - that if you gave your daughter Gardasil, you were condoning early sexual behavior.

That argument always bothers me. We will never control how or when our children have sex simply by not giving them a vaccine for a sexually transmitted infection. That just isn't going to happen. And what about all those whose teens and children whose first sexual experiences aren't their choice? We can never forget the number of teens and children who are abused, who are victims of sexual predators. Using sexual morality as an excuse to not give the vaccine just doesn't hold water.

So is Gardasil a good thing for our children?

Friday, July 1, 2016

Happy Canada Day! Let's Give Everyone Something to Be Grateful For

In this time when bad news is hitting us from all sides, I want to take a moment to wish my fellow Canadians a happy Canada Day. I hope that you are able to spend the day as you wish, whether it be with family and friends, or taking some time to yourself. If you're one of the many Canadians who are working today because you are needed, like my fellow nurses, I hope your day is a smooth one, with as few problems as possible.

Canada is far from perfect. We have serious issues that we need to not only acknowledge, but address in an effective and fair manner. There are Canadians who suffer needlessly as the result of current conditions, such as those who live in impoverished First Nations communities or those who are homeless in our bustling cities. There also many Canadians who are suffering the effects of events that occurred in the past, including residential school survivors and their families. These too, need to be resolved to the best of our ability.

I don't get political on this blog - it's a health-related project. But often the two cross over. Poverty, illness, illiteracy, abuse, violence - these all affect mental and physical health. For a country to be truly strong, these issues must be dealt with equally for all citizens, regardless of who they are and where they may have come from.

But how do we do this? It's a huge task and it's not something one person or one organization can do alone. But one person and one organization can be pieces of the bigger puzzle. I try to work on literacy. I strongly believe that the more effectively people can communicate and understand, the better the chances that they can tackle the problems life throws at them.

However any of us choose to try to help others, we have to remember that we are in this together. We can't allow petty things and small differences divide us. We need to remain a community and reach out to those who need us. This is what makes us strong.

So Happy Canada Day to my Canadian friends, colleagues, and readers. Let's spend the next 365 days finding ways to help each other, so when our 150th birthday rolls around next year, we have something even more special to celebrate.

Sunday, June 19, 2016

Lack of Sleep Makes for Cranky Teens, Says Study - You Think?

I'm on the duh-study trail again. My latest find is "Adolescent sleep duration is associated with daytime mood." Well then. What a shocking finding from a National Institutes of Health supported study.

According to the news release (I don't have a copy of the study findings), the researchers studied 97 healthy teens from 14 to 17 years old to follow their sleeping habits. The teens were allowed only 6.5 hours in bed per night for five nights in a row (sleep restriction), then a two-night break (a "washout period") and this was followed by five nights straight of 10 hours in bed per night. The researchers looked at the teens' daily self reports on nervousness, sadness, anger, energy, fatigue, ability to concentrate, and sleepiness.

According to the news release:

Results show that adolescents showed increased variability in sadness, anger, and sleepiness when sleep was restricted compared to when sleep was extended. This effect was not moderated by age, sex, race, or the order in which participants underwent the sleep conditions.
The study also showed that nightly fluctuations in sleep in healthy adolescents predict worse mood the next day, and worse mood any given day largely predicts unusually bad sleep the next night.

So here we have it - less sleep equals less happy teens. Any parent could have told us that.

In all seriousness, the authors do say that the research is necessary because they are concerned about the mental health of teens - an important issue to be sure. But their conclusion, that these findings indicate that by promoting healthy sleep habits, we may be able to reduce the risk of mental health problems among some teens, is too simplistic. We know that lack of sleep causes problems, particularly if it's chronic. We also know that teens need a lot of sleep, as they did when they were infants - a teen's body is growing and changing at incredible rates.

My issue with these Duh Studies is that they're sent out into the media world without any real meaning. Yes, teens need sleep. Yes, they're crabby and don't function well without sleep. Now what?

Wednesday, June 15, 2016

Senior Moment - Memory Clutter?

We all have our forgetful moments, a word we can't bring to mind, a name we've forgotten, or an appointment that slipped past us. We can't remember everything. Those who can, like actor Marilu Henner, are few and far between. But, as we get older, we seem to take more notice when we forget things, often making jokes about aging and memory loss, or perhaps fearing that this is what is happening.

While memory loss and the fear of dementia are concerning, they don't affect everyone who gets older. Forgetfulness though, is different, and researchers from the Georgia Technical Institute in Atlanta, Georgia, believe that a good part of the aging forgetfulness is merely a matter of us just having too much information to store. In other words, our hard drive has run out of space and certain files have to be archived.

The researchers used EEG to study the brains of two groups of subjects, those over the age of 60 years and college-age students. Both groups were shown photos of every day images and told to focus on certain things and ignore others.

At first, both groups were able to remember what they were told to focus on, and both had trouble ignoring what they were told pay attention to. But when the older subjects were questioned further about what they were supposed to focus on and remember, over time they became less sure of their responses and the other objects in the photos interrupted their memories. "[W]hen we asked if they were sure, older people backed off their answers a bit. They weren't as sure," lead author Audrey Duarte said in a release. The brain activity, recorded by EEG, showed that the older group put more effort into sorting out the appropriate memories.

"While trying to remember, their brains would spend more time going back in time in an attempt to piece together what was previously seen," she said. "But not just what they were focused on -- some of what they were told to ignore got stuck in their minds," she added.

This was a study environment, but we are faced with situations like this every day - walking to work, going out to lunch or dinner with friends, even shopping. We may be in a grocery store, with music overhead, conversations around us, and displays with food tasting, all while we're trying to concentrate on remember what we need to buy. Younger people who are asked what occurred during that time may have an easier time recalling what they saw or heard, while an older person may have to sort through different memories, clutter, trying to pull out what is relevant.

Why are details like this important to study? Duarte said that such findings could explain why seniors fall for scams that use manipulation. "If someone tells you that you should remember it one way, you can be more easily persuaded if you lack confidence," she said. "This memory clutter that's causing low confidence could be a reason why older adults are often victims of financial scams, which typically occur when someone tries to trick them about prior conversations that didn't take place at all."

It's an interesting look at memory as we age.