The Attitude Doc

Feb. 27, 2009 -- The next time you're stuck on hold or zoning out during a dull meeting, you might want to reach for a pen and doodle -- and not just to ease your boredom.

Doodling might help you remember snippets of key information that's mentioned in those conversations, a new study shows.

The study comes from Jackie Andrade, PhD, of the School of Psychology at England's University of Plymouth.

Andrade asked 40 adults who had just finished another psychology test to listen to a "rather dull" audio tape play for two and a half minutes and to jot down the names of people who would definitely or probably be coming to a party, according to the tape.

As they listened to the tape, half of the participants were encouraged to doodle on a piece of paper. They didn't have to draw freehand; instead, they were given a sheet of paper filled with outlines of squares and circles to shade in. For comparison, the other half of the group didn't doodle while listening to the tape.

A minute after the tape finished, participants took a pop quiz in which they had to recall the party-goers' names and places that were mentioned on the tape. They had not been told to listen for the places.

The doodlers recalled an average of "7.5 pieces of information (names and places), 29% more than the [average] of 5.8 recalled by the control group," Andrade writes.

Why was doodling helpful? Maybe it kept participants more alert while they listened to the boring recording, Andrade suggests.

"This study suggests that in everyday life doodling may be something we do because it helps to keep us on track with a boring task, rather than being an unnecessary distraction that we should try to resist doing," Andrade says in a news release.

The study appears online in Applied Cognitive Psychology.

SOURCES:

Andrade, J. Applied Cognitive Psychology, Feb. 27, 2009; online "Early View" edition.

News release, Wiley-Blackwell.

Feb. 26, 2009 -- President Obama has proposed setting aside $634 billion in federal money over the next decade to aid his health reform plans.

The White House calls the move a "down payment" on overhauling the faltering U.S. health care system.

The money, in the form of a reserve fund, would go to a range of initiatives, including health and wellness improvements, improvements in patient safety, and an "aim" for universal health insurance coverage, according to a budget outline released by the White House.

"The President recognizes that while a very large amount of money and a major commitment, $630 billion is not sufficient to fully fund comprehensive reform. But this is a first crucial step in that effort," the outline states.

The president proposed raising the money from two main sources: dialing back tax deductions for families making more than $250,000 per year and cutting federal subsidies for insurance companies that administer the Medicare Advantage managed care program.

The budget is only the first step in a months-long debate over the entire federal budget and overall health reform plans. But it was a strong signal that the president intends to place health costs and access to care at the center of efforts to rehabilitate the economy.

Congress will have to pass its own budget plan, likely in the spring. And a debate on health care reform could go on for months after that.

Reaction in Congress

Democrats on Capitol Hill praised the proposal, saying it sets the stage for an overdue health care debate.

Sen. Edward Kennedy, D-Mass., issued a statement calling the budget "an historic commitment to the goal of quality, affordable health care for all Americans."

"I'm optimistic that Congress is now ready to answer the challenge of enacting legislation to reach that goal, and the funds proposed in the budget are an essential starting point for our effort," said Kennedy, who chairs the Senate Health, Education, Labor, and Pensions Committee.

But Republicans were less supportive. The White House proposal to cut $175 billion from payments to Medicare Advantage managed care plans riled GOP lawmakers, who broadly support a bigger role for private insurance companies in Medicare.

"I want to look at the details of the program, but obviously, if it guts the program and prohibits the program from succeeding, it's going to make people really unhappy, and it's going to hurt seniors' access to affordable care and choice," Rep. Paul Ryan, R-Wis., tells WebMD. Ryan is the senior Republican on the House Budget Committee.

In addition to tax increases on wealthier families and Medicare Advantage cuts, the White House plan also raises money for health reform by:

• Speeding lower-cost generic drugs to market with regulatory changes and making it harder for brand-name drug manufacturers to use legal suits to bar generics from the market.
• Reforming the way Medicare and Medicaid pay doctors, hospitals, and other health providers, including a plan to give doctors incentive payments for higher quality care.
• Reducing hospital readmissions.

White House officials and congressional Democrats have said they intend to pass a major health reform bill by the fall. Ron Pollack, executive director of the liberal-leaning consumer health group Families USA, says the White House proposal "augurs well for getting reform done this year."

"We'll have a bill by 2011," said Rep. Jim McDermott, D-Wash., a member of the House Ways and Means health subcommittee, when asked if Congress would meet the president's call to enact health reform this year. "I know he wants it this year, and it will take a little longer than that."

SOURCES:

White House budget outline for Fiscal 2010, Feb. 26, 2009.

Sen. Edward Kennedy, D-Mass.

Rep. Paul Ryan, R-Wis.

Ron Pollack, executive director, Families USA.

Rep. Jim McDermott, D-Wash.

Feb. 26, 2009 -- A new study reveals insights into the ancient roots of our modern-day sense of moral disgust.

Research from the University of Toronto suggests that our sense of right and wrong appears to be directly linked to a primitive survival instinct that caused our ancient ancestors to find foul-tasting, poisonous foods disgusting.

The study appears in the Feb. 27 issue of the journal Science.

"These results shed new light on the origins of morality, suggesting that not only do complex thoughts guide our moral compass, but also more primitive instincts related to avoiding potential toxins," principal investigator Adam K. Anderson, PhD, says in a news release.

Morality and Disgust

Morality has been widely considered to be a somewhat recent phenomenon, evolutionarily speaking, that is closely tied to our ability to reason. Disgust, on the other hand, is considered an ancient and primitive emotion, which helped to keep early humans from eating foods that would kill them.

Anderson, lead study author Hanah Chapman, and colleagues conducted a series of experiments designed to determine if morality and disgust are more closely related than experts have thought.

"We wanted to see if there was any truth to the expression, 'It left me with a bad taste in my mouth,' when we talk about something that is morally offensive," Chapman tells WebMD.

"Does that have anything to do with the feeling that you get when you open up that take-out container that has been in the fridge too long or walk into that subway bathroom that hasn't been cleaned in a long time?"

The researchers employed a technique known as electromyography to record electrical activity that directs muscle movements.

They focused on one specific muscle, known as the levator labii, which is involved in raising the upper lip and wrinkling the nose -- movements characteristic of the facial expressions people make in response to disgust.

'More Than a Metaphor'

In one experiment conducted to evoke the most basic, primordial form of disgust, participants drank a bad-tasting bitter liquid. In another, they looked at pictures of things generally recognized as disgusting, like dirty toilets.

In the final test, which measured moral disgust, participants were treated unfairly in a classic psychological experiment.

In all three situations, the participants showed activation of the levator labii muscle, indicating that reactions to tasting something bad, looking at something disgusting, and experiencing unfairness all involved similar disgust.

"People think about morality as being this pinnacle of human evolution and development," Chapman says. "But we showed that this very old and primitive response is playing an important role, too."

Harvard researcher Joshua D. Greene, PhD, tells WebMD that the research is consistent with studies he has done suggesting that emotion plays a key role in moral judgment.

"The idea that the emotion that causes us to reject something poisonous has been co-opted for use in social judgment is certainly intriguing," he says. "This study does not prove this, but it is pretty strong evidence for the idea that disgust in a moral context is more than just a metaphor."

SOURCES:

Chapman, H.A. Science, Feb. 27, 2009; vol 323: pp 1222-1226.

Hanah Chapman, doctoral candidate, department of psychology, University of Toronto.

Joshua D. Greene, PhD, assistant professor, department of psychology, Harvard University.

Adam K. Anderson, PhD, Canada Research Chair in Affective Neuroscience, University of Toronto.

Feb. 26, 2009 -- Driving may be more dangerous in the South than any other place in the country, the CDC says.

In 2005, the latest year for which statistics are available, 45,520 deaths in the U.S. were related to motor vehicles, according to the CDC.

The Northeast had the lowest average annual rate of motor vehicle-related fatalities, 9.8 per 100,000 people in the period 1999 to 2005. The rate in the South was almost twice that, at 19.5.

Age, gender, and race also played a factor in motor vehicle-related fatalities, according to the Feb. 27 Morbidity and Mortality Weekly Report.

The average annual death rate for young people was 26.8 per 100,000 for people between ages 15 and 24; that’s 74% higher than the overall rate of 15.4.

The average annual death rate for men was more than double that for women, 21.7 vs. 9.4 per 100,000 people. The rate for American Indians/Alaska Natives was 27.2, nearly twice the 15.7 rate for whites and the 15.2 rate for blacks.

The CDC analysis says 46% of the motor vehicle-related deaths from 1999 to 2005 occurred in the South, where the average annual rate was 19.5 per 100,000 people, followed by 14.7 in the Midwest, 14.2 in the West, and 9.8 in the Northeast.

Here are the states with the highest average annual death rates per 100,000:

1. Mississippi 31.9
2. Wyoming 27.7
3. Arkansas 25.6, Montana 25.6
4. Alabama 25.1
5. South Carolina 24.6
6. South Dakota 24.2
7. New Mexico 23.8
8. Tennessee 22.8
9. Louisiana 22.2

Here are the states with the lowest death rates per 100,000:

1. Massachusetts 7.9 (best or safest)
2. New York 8.4 (tie with Washington, D.C.)
3. Rhode Island 8.5
4. New Jersey 9.0
5. Connecticut 9.3
6. Hawaii 10.2
7. New Hampshire 11.2
8. California 12
9. Washington (state) 12.1
10. Illinois 12.3

The CDC says "vigorous measures" are needed to reduce the death rate to the national objective of 9.2 deaths per 100,000 in 2010.

The researchers say some of the variations are explained by the extent of populations to road environments.

Reasons for the disproportionately high rate in the South are unclear, the researchers say. But distances traveled in rural areas could be a factor, they say.

The CDC says states should evaluate methods to increase the use of seat belts and child-safety restraints and also work on ways to reduce alcohol consumption by drivers.

SOURCES:

CDC.

Morbidity and Mortality Weekly Report, Feb. 27, 2009, vol 58; no. 7.

Feb. 25, 2009 -- Obese teens are just as likely to die before they reach old age as teens who are heavy smokers, while those who are overweight, but not obese, have the same risk for early death as lighter smokers, a new study shows.

Researchers followed 45,000 Swedish men from the time they were drafted into the military at the age of 18 until most were in their mid-50s.

They found that those who were obese in their late teens had nearly double the risk of dying during the almost four decades of follow-up, compared to those whose weight was normal at age 18.

This was a similar increase in risk as seen in men who smoked more than 10 cigarettes a day in their late teens.

Men who were overweight, but not obese, in their teens and did not smoke had a similar risk for early death as normal-weight teens who smoked one to 10 cigarettes a day.

The study appears in the latest issue of the journal BMJ Online.

"Most parents would warn their child about the dangers of even moderate smoking, but most probably wouldn't associate being overweight with the same level of risk," study researcher Martin Neovius, PhD, of Sweden's Karolinska Institute tells WebMD.

Obesity, Smoking, and Early Death

Normal weight in the study was defined as having a body mass index (BMI) of 18.5 to 24.9, while overweight men had a BMI of 25 to 29.9; obese men had a BMI of 30 or above.

Under this definition a 6-foot-2-inch person who weighs between 144 and 194 pounds is considered normal weight, while a 195- to 233-pound person is considered overweight; 234 pounds or heavier is considered obese.

In an effort to determine the early death risk associated with being overweight, obese, or a smoker in late adolescence, Neovius and colleagues analyzed data from a national military conscription register of Swedish men born between 1949 and 1951.

Because military conscription was compulsory in Sweden during this time, the registry represents a nationally representative sample of the country's males in their late teens at enrollment.

During an average of 38 years of follow-up, 2,897 of the roughly 45,000 men included in the study died.

The study also revealed that:

• Men who were obese at age 18 had a similar risk for early death as men who were heavy smokers but whose weight was normal in their late teens.
• Men who were obese and heavy smokers at age 18 were nearly five times as likely to die before age 60 as normal-weight, nonsmoking teens. Heavy smokers who were overweight in their teens were roughly three times more likely as normal-weight, nonsmoking teens to die young.
• Men who were very underweight in their late teens had an increased risk for early death that was similar to overweight men.

Implications for Public Health

Earlier studies examining whether being overweight, but not obese, in late adolescence increases the risk for early death have presented mixed findings.

In the newly reported study, being overweight was strongly linked to an increased risk for early death. Researchers from the Harvard School of Public Health came to the same conclusion in a study involving female nurses followed for many years.

In 2006, the researchers reported that women who were overweight at age 18 had an increased risk for death in middle age.

"More teenagers are overweight than obese, so this finding has very important implications for public health," Neovius says.

Carolyn Landis, PhD, who heads the Healthy Kids, Healthy Weight program at Cleveland's Rainbow Babies and Children's Hospital, agrees, but she adds that the problem is not limited to teens.

Landis tells WebMD that she sees children as young as 10 who already have type 2 diabetes as a result of being overweight or obese.

"I don't think people really understand how quickly obesity can impact your health," she says. "Many kids who are obese already have high blood pressure and other weight-related health problems when they enter school. As a society we need to take this issue much more seriously."

SOURCES:

Neovius, M. BMJ Online First, Feb. 25, 2009.

Martin Neovius, PhD, assistant professor, clinical epidemiology unit, Karolinska Institute, Stockholm, Sweden.

Carolyn Landis, PhD, behavioral psychologist, Rainbow Babies and Children's Hospital, Cleveland.

Van Dam, R. Annals of Internal Medicine, July 18, 2006; vol145: pp 92-98.