How Promoting Handwashing Got One 19th Century Doctor Institutionalized

iStock
iStock

Regardless of how often we actually do it, it's common knowledge that washing our hands before eating, after coughing, and after using the bathroom is good for us. But the connection between handwashing and health wasn't always accepted as fact. As Danielle Bainbridge explains in the PBS web series Origin of Everything, the first doctor to campaign for cleanliness in hospitals was not only shunned by other medical professionals, but ended up in an insane asylum.

Prior to the 19th century, handwashing primarily existed in the context of religious ceremonies and practices. It plays a role in Christianity, Islam, Judaism, Sikhism, and Buddhism in some form or another. But washing up to stop the spread of disease wasn't really a thing for most of history. People weren't aware of germs, so instead of microbes, they blamed illness on everything from demons to bad air.

Then, in 1846, a Hungarian doctor named Ignaz Semmelweis made a breakthrough observation. He noticed that women giving birth with the help of midwives were less likely to die than those treated by doctors. He determined that because doctors were also performing autopsies on victims of puerperal fever (a bacterial infection also known as childbed fever), they were somehow spreading the disease to their other patients. Semmelweis started promoting handwashing and instrument sterilization in his clinic, and the spread of puerperal fever dropped as a result.

Despite the evidence to support his theory, his peers in the medical community weren't keen on the idea of blaming patient deaths on doctors. Partly due to his commitment to the controversial theory, Semmelweis was shunned from his field. He suffered a mental breakdown and ended up in a mental hospital, where he died a few weeks later.

Germ theory did eventually become more mainstream as the century progressed, and washing hands as a way to kill unseen pathogens started gaining popularity. Even so, it wasn't until the 1980s that the CDC released the first official guidelines instructing people on best handwashing practices.

If this story suddenly has you in the mood to practice good hygiene, here's the best way to wash your hands, according to experts.

[h/t Origin of Everything]

Why You Should Be Wary of Prescription Drug Ads on TV

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iStock

In 1997, the Food and Drug Administration permitted prescription drug companies to start publicizing their products directly to consumers in television advertisements. Compelled by the persuasive spots, patients petitioned their physicians for drugs to alleviate mood disorders, cardiovascular issues, and various other chronic conditions. But two studies released this year both came to a sobering conclusion about this direct-to-consumer approach: While advertising is persuasive by nature, drug spots may actually be misleading.

In a report published in the Journal of General Internal Medicine, researchers at Yale University looked at 97 drug ads that aired on television in 2015 and the first half of 2016. Most were targeted to people with arthritis, diabetes, and other ailments that require continuous care. None of them offered objective information about the potential risks of the drugs; the focus was instead on relative improvement in quality of life. In 13 percent of the ads, the drug companies suggested that various diabetes medications could be used off-label to reduce weight or lower blood pressure, a violation of FDA policy.

The spots also emphasized positive results of clinical trials. These efficacy statements dominated the narrative, with statements like “most people using [the drug] saw 75 percent clearer skin,” or “my doctor said [the drug] helps my bones get stronger.” The Yale study concluded that these and similar claims were potentially misleading and difficult to analyze objectively.

Another recent study published in the Annals of Family Medicine [PDF] examined the abundance of lifestyle depictions in the spots. Rather than dwell on risk factors, the 61 ads that researchers analyzed were predominantly made up of footage that made a direct connection between using the drug and an improved quality of life. Many of the ads were addressing conditions (like diabetes and depression) that might benefit from therapies other than medication. Roughly 59 percent of ads depicted a person losing control of their life as a result of their condition, while almost 69 percent suggested the advertised drugs enabled a more active and healthy lifestyle.

The FDA is responsible for making sure companies don't mislead consumers, but critics charge that the agency is not doing its part. It doesn't review prescription drug ads in advance, nor does it restrict ad spending. “Everyone on the ads appears healthy, happy, dancing, and they get better,” internist Andy Lazris, M.D. told Health News Review. “So people are led to believe a) the drug will be effective (which is often not the case), and b) that they should replace their old therapy with the newer one because it’s better (again, which is often not the case)."

“And if they give you any numbers at all, they’re almost always the deceptive relative numbers that look really good, not the more realistic absolute numbers," Lazris added. "So the benefits are over-exaggerated, the harms are downplayed or missed, and that’s how patients can get hurt.”

Because the spots are so short—usually 30 to 60 seconds—it’s difficult to communicate the risk-to-benefit ratio clearly. Even when ads go into a laundry list of side effects, it can become white noise compared to the happy, smiling faces appearing onscreen. (Soon, the FDA might even allow companies to shorten that list, based on its own study that found fewer mentioned side effects allow consumers to retain more information about the drug’s risks.)

The one part of the spots most critics agree is accurate? When they urge viewers to talk to their doctor. Weighing the risks and benefits of prescription medication outside of the fictional and persuasive images of drug spots is the only way to be sure a product is right for you.

[h/t Los Angeles Times]

Move Over Life Alert: New Apple Watch Can Tell When You Fall and Will Call For Help

Apple
Apple

Senior citizens aren’t usually the first people lining up to buy the latest high-tech gadget, but Apple’s new Series 4 watch could provide a potentially life-saving service to the elderly—and others. As The Telegraph reports, the watch is equipped with technology capable of detecting when someone has fallen.

If a hard fall occurs, a message on the dial prompts the wearer to select “emergency SOS” or “I fell, but I’m OK.” If the user is motionless for 60 seconds afterward, the watch automatically places a call to emergency responders, and sends a message to emergency contacts with location information.

A message on the watch reads "It looks like you've taken a hard fall" and includes an option to send out an emergency SOS
Apple

The watch, whose features were highlighted at the annual Apple product launch in Silicon Valley on Wednesday, could prove a serious competitor to Life Alert, a popular medical alert system.

An accelerometer and gyroscope inside the watch allow it to analyze the wearer’s “wrist trajectory and impact acceleration,” according to an Apple statement, but determining when someone has fallen isn’t so simple. Apple had to figure out a specific algorithm based on a range of bodily motions.

“Identifying a fall sounds straightforward, but it requires a large amount of data and analysis,” Jeff Williams, Apple’s chief operating officer, said. “With falls, there’s this repeatable motion pattern that happens. When you trip, your arms go forward; but when you slip, your arms go upward.”

This isn’t the only new health feature, either. The new Apple Watch also contains an electrical heart rate sensor, which lets it take an electrocardiogram (ECG or EKG) and monitor for any irregularities. This marks the first time a product containing an EKG is available over-the-counter to consumers, according to The Telegraph.

The GPS version of the Apple Watch Series 4 is priced at $399, and the GPS and cellular model costs $499. Orders can be placed beginning September 14, and watches will be available in stores on September 21.

[h/t The Telegraph]

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