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Am Fam Physician. 2004;69(11):2515

What were the top health concerns of Americans in 2003? Of more than 900 adults surveyed for the American Cancer Society and the Trust for America's Health, 35 percent ranked the flu epidemic as their top health concern last year. The flu epidemic ranked higher than biologic or chemical terrorism (19 percent), West Nile virus (13 percent), mad cow disease (13 percent), and severe acute respiratory syndrome (9 percent). Respondents said that cancer and obesity were the greatest health risks for people in their communities. The survey also showed that 78 percent of respondents want the government to increase spending on protection against major health problems and chemical and biologic threats, and that 56 percent believed spending more on emerging health threats (e.g., bioterrorism) is necessary to improve homeland security.

Why do so many patients have difficulty following medication plans? In a study conducted at the University of Michigan Cardiovascular Center, researchers found that more than one half of 154 patients who had a heart attack or an episode of unstable angina did not adhere to some or all of four types of medications (antiplatelet drugs, angiotensin-converting enzyme inhibitors, beta blockers, and statins) six months after leaving the hospital. According to a press release from the university, forgetfulness, carelessness, and the feeling that symptoms were improving or worsening topped the list of reasons for not following medication regimens properly. Of the 10 percent of patients who stopped taking one medication altogether, about one half said their physicians told them that at least one of their prescribed medications was unnecessary. Side effects and cost were other reasons that patients stopped taking a medication.

E-mail may be more truthful than other forms of communication. As reported in the The New York Times, a study presented at a conference on Computer-Human Interactions in Vienna found that students who tracked their lies for one week reported lying in 15 percent of e-mail messages, compared with 20 percent of instant messaging chats, 25 percent of face-to-face conversations, and more than 33 percent of phone calls. The researchers think that people are more cautious about the information they provide in e-mail messages because of the record that this mode of communication leaves. Previous research has shown that most lies are spontaneous and emerge in give-and-take forms of conversation, whereas e-mail conversations tend to unfold more slowly.

Most patients prefer a traditionally dressed family physician. In a study published in Southern Medical Journal, questionnaires completed by 496 patients from two family practices in Knoxville, Tenn., showed that a nametag, white coat, and visible stethoscope are the most desirable features of a physician's appearance; the least desirable features are sandals, tennis shoes, and clogs. Younger patients (40 years) were more accepting of casual attire (e.g., earrings on men) than were older patients.

Study findings released by the Environmental Investigation Agency suggest that postnatal exposure to the high levels of methylmercury in whales and large fish can cause developmental problems in children. The 14-year study conducted in the Danish Faroe Islands also supports concerns about possible irreversible damage caused by prenatal methylmercury exposure. The inhabitants of the Faroe Islands have a seafood-rich diet that exposes them to high levels of mercury and methylmercury.

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