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Host Alison Sweeney and guest Nastia Liukin

Host Alison Sweeney and guest Nastia Liukin

In last night’s episode of The Biggest Loser, Olympic gymnast Nastia Liukin delivered an important message to the contestants. With a bright smile and her child athlete’s familiarity with total self-denial, she was a beacon of hope, a kindred spirit to our friends on their journeys. She was also there to address a crucial topic: food, which is something rarely discussed on the show. Aside from tossed-away tips and food-related challenges, America’s $100 million weight-loss juggernaut is mostly silent about what to eat while slimming.

However, Nastia had some helpful information: “Staying fit is a process and part of that is eating right and maintaining a healthy lifestyle. The great thing about Subway is, it fits perfectly no matter what your needs are.”

You see, leaving the ranch loomed large on last night’s Biggest Loser.  With six contestants remaining and two of them about to go home, everyone began to worry about how they would fare outside of the show’s artificial bubble. Bob and Jillian decided it was time for a fireside chat.

“Contestants are going home soon. Historically speaking, it’s a really difficult transition for them,” said Jillian, with her trademark crooked smirk.

Bob went for a more colorful (and confusing) metaphor to describe the contestants’ situation: “You guys have pulled the curtain back. You’ve met the wizard….You have the strength. You have the knowledge. You can do it. If you decide you’re worth it enough to do it.”

But the soon-to-be-eliminated Mark voiced the fear that all the sweatshirt-clad were feeling:

“I honestly don’t know what to do when I get home.”

Host Alison Sweeney and guest Nastia Liukin

Host Alison Sweeney and guest Nastia Liukin

In last night’s episode of The Biggest Loser, Olympic gymnast Nastia Liukin delivered an important message to the contestants. With a bright smile and her child athlete’s familiarity with total self-denial, she was a beacon of hope, a kindred spirit to our friends on their journeys. She was also there to address a crucial topic: food, which is something rarely discussed on the show. Aside from tossed-away tips and food-related challenges, America’s $100 million weight-loss juggernaut is mostly silent about what to eat while slimming.

However, Nastia had some helpful information: “Staying fit is a process and part of that is eating right and maintaining a healthy lifestyle. The great thing about Subway is, it fits perfectly no matter what your needs are.”

You see, leaving the ranch loomed large on last night’s Biggest Loser.  With six contestants remaining and two of them about to go home, everyone began to worry about how they would fare outside of the show’s artificial bubble. Bob and Jillian decided it was time for a fireside chat.

“Contestants are going home soon. Historically speaking, it’s a really difficult transition for them,” said Jillian, with her trademark crooked smirk.

Bob went for a more colorful (and confusing) metaphor to describe the contestants’ situation: “You guys have pulled the curtain back. You’ve met the wizard….You have the strength. You have the knowledge. You can do it. If you decide you’re worth it enough to do it.”

But the soon-to-be-eliminated Mark voiced the fear that all the sweatshirt-clad were feeling:

“I honestly don’t know what to do when I get home.”

No scientific evidence supporting physical harm exists stating emergency contraception (EC), also referred to as Plan B, should not be available to women under the age of 17.  If you are a female and think your birth control failed, unlike women over the age of 17, you must find a health care provider and get a prescription to buy EC. Not an easy task for most young women who know that you must take Plan B within 72 hours of sexual intercourse in order for it to be effective; actually, the sooner, the better.

Barriers exist for women over the age of 17 too.  Many FDA regulations for EC were made in the name of politics – not because science dictated these actions. The Center for Reproductive Rights (CRR) is doing something about this – it’s bringing the FDA to court.

One complaint in this suit by CRR also addresses access – emergency contraception, a non-prescription item, is not displayed on a shelf but stored behind a pharmacy counter and must be asked for by the purchaser.  Remember when condoms were stored out of sight so you had to ask out loud for them? Another unheard of requirement when making a drug purchase: the person buying EC must present a government issued ID. Another few minutes at the counter showing a photo ID in a crowded pharmacy may increase anxiety in someone already worried his or her birth control method had failed.  These two obstacles were already raised and litigated against the FDA, and resulted in a judge demanding the FDA reconsider these regulations.  So far, nothing has changed.

CRR discusses how these practices set a precedent:

“No drug besides Plan B is subject to a two-tiered prescription/over-the-counter structure based on age. And no other over-the-counter drug requires production of identification for purchase. The testimony of FDA employees and officials makes clear that the FDA’s decisions regarding emergency contraception were made on the basis of politics, rather than on considerations of the drug’s safety and efficacy. This influence appears to have come from as far up as the White House.”

To make matters worse, some Walgreens pharmacies in Texas and Mississippi are refusing to sell Plan B to men. Earlier in the year the ACLU was made aware of this problem, which resulted in Walgreens administering a bulletin clarifying the law about emergency contraception to all of its pharmacists.  Reports that men who arrive without a female over the age of 17 (or under 17 years of age with a prescription and valid ID) continue to be turned away.  According to FDA policy, men and women over age 17 may purchase EC without proof of whom the pill will be for.  However, this policy has not been enforced.

The bottom line really is: Will the FDA, an organization founded on scientific principles and clinical data, uphold its commitment to, as they say, “helping the public get the accurate, science-based information they need to use medicines”?  Or, will they support political decisions as opposed to clinical evidence to create policies?

There is further information about this on the CRR’s website here.

Jen Busse, RN, MPH is an intern at CHMP and is currently pursuing her MSN as a Family Nurse Practitioner at Columbia University School of Nursing.

No scientific evidence supporting physical harm exists

typhoid-mary“Typhoid Mary” is the story of Irish immigrant Mary Mallon, who was the first to be identified as a healthy carrier of typhoid. Her intriguing story was a breakthrough in bacteriology: she was the first person in the United States to be identified as a healthy carrier. This fact would have gone undetected if it were not for Mallon’s profession as a cook, in which she unknowingly infected others. Another fascinating aspect was that she was then quarantined on an island for the remainder of her life without due process.

What I found most fascinating about this film was the emphasis it placed on ethics and rights. After all public health is the science and art of preventing disease and promoting health through the organized and informed choices of organizations, communities and individuals. Another interesting aspect of this film is how it addresses a community’s safety at the cost of individual rights. When is it appropriate for public health officials to act without the consent of their patient? There is still quite a bit of uncertainty surrounding individual rights versus what government officials perceive as best.

Public officials mostly agreed that one person’s civil liberties could be infringed upon for the benefit of the whole. But this sort of logic brings about an opening into ethically ambiguous work. When is it right to draw the line of the individual and the whole? Such questions must have definitely been asked in the Guatemala experiments conducted from 1946 to 1948, in which doctors, with the approval of the US Department of Health, infected natives of Guatemala with Syphilis and Gonorrhea to test the effectiveness of penicillin. The same events occurred in 1907 with Mary Mallon, as she was forced to take experimental drugs doctors believed would cure her.

As much as I would love to claim that this was a thing of the early 1900s, and we have learned better, sadly I cannot. The Tuskegee Experiments was a clinical study conducted by the U.S. Public Health Service. They recruited 399 impoverished African-American sharecroppers who had syphilis and did not offer any medicine in order to see the natural progression of the disease. What’s more showing and disturbing is that this experiment lasted until 1972.

Typhoid Mary – The Most Dangerous Woman in America raises more questions than it provides answers. Is it ever right to pursue scientific inquiry at the expense of an individual’s health? Would it be ethical to inform a patient’s lover of their partner’s infectious disease, or should we maintain patient confidentiality? The tragic story of Mary Mallon, who died on a small quarantined island, emphasizes the social, ethical and legal dilemmas faced by public health workers.

Jennifer De Jesus is a student in the Macaulay Honors College at Hunter College and an avid movie watcher. She is also an employee of the Health Professions Education Center, which has one of the largest collections of health films in New York City.

This is the first entry in a new blog post series, “Must See!” Films Public Policy Films from a Student’s Perspective.

“Typhoid Mary” is the story of Irish