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Transparency In Medical Research And Education


U.S. Senators Mel Martinez (R-FL) and Herb Kohl (D-WI) of the Special Committee on Aging held a hearing to address the issue of transparency in physician-industry financial relationships. Among the hearing’s topics were the industry’s involvement in continuing medical education and its potential use as a method for promoting “off-label” prescribing. The senators heard from witnesses about different ways to achieve balance between appropriate industry involvement in continuing medical education while mitigating unethical and illegal promotion.

“To stay current in the medical field and to maintain a medical license, doctors devote substantial time to develop their medical knowledge and skills through continuing medical education,” said Martinez, the lead Republican on the Senate’s Special Committee on Aging. “Sometimes the line between medical education and improper promotion of products for “off-label” uses can be blurred, raising questions about patient well-being and stewardship of taxpayer dollars, such as through Medicaid. This is why transparency and appropriate, commonsense safeguards are necessary.”

Earlier this year, Senator Martinez introduced a Medicaid transparency effort to make all Medicaid payments to providers public, making it easier to identify potentially fraudulent billing. The Medicaid Accountability through Transparency or “MAT” act will provide transparency in billing for services and medical equipment by requiring the Department of Health and Human Services to disclose the Medicaid payment data it already collects on a public-accessible Web site. The MAT act is consistent with the goal of Senators Kohl and Grassley’s (R-IA) measure, the Physician Payments Sunshine act.”

“Patients rely on doctors to sift through all options of treatment and use that information to make sound judgments about the benefits and risks of certain medical procedures, drugs, and devices they are recommending for their patients and ultimately charging Medicare and Medicaid for,” said Martinez. “Disclosing payments to doctors, be they from Medicaid or from pharmaceutical companies, allows the public to reach their own conclusions about the appropriateness of such payment arrangements. Transparency needs to be the bedrock of our health care system.”

Parental Education Boosts Achievement In Kids


With school days just around the corner, a University of Michigan researcher has some advice for parents who want to increase their children’s academic success.

“If you want your kids to do well in school, then the amount of education you get yourself is important,” said Pamela Davis-Kean, a psychologist at the U-M Institute for Social Research (ISR). “This may mean that parents need to go back to school.

“A growing number of large-scale, long-term studies now show that increasing parental education beyond high school is strongly linked to increasing language ability in children. Even after controlling for parental income, marital status and a host of other factors, we find that the impact of parental education remains significant.”

Davis-Kean, who is also affiliated with the U-M Psychology Department, directs the ISR Center for the Analysis of Pathways from Childhood to Adulthood, funded by the National Science Foundation. She is co-editor of the July 2009 issue of the Merrill-Palmer Quarterly, a peer-reviewed journal presenting research sponsored by the center that employs multiple perspectives to analyze the impact parents have on their children’s educational attainment.

One of the studies in the special issue examines the long-term effects of parental education on children’s success in school and work, beginning when children are eight years old and extending until they are age 48.

Another study examines how language skills and school readiness of three-year-olds are positively affected when mothers return to school.

“In every case, we’ve found that an increase in parental education has a positive impact on children’s success in school,” said Davis-Kean. “And this impact is particularly strong when parents start with a high school education or less.

“These findings may be reassuring to parents at a time when many are unemployed or worried about future job prospects. They clearly show that in terms of the effect on children’s achievement, it’s more important for parents to get a good education than to get a high-paying job. Of course, the more education you have, the more likely it is that you’ll find a good job, so an increase in education often leads to an increase in income.”

The reasons behind the power of parental education are not yet fully understood, but researchers think it’s more than just providing a model that children want to imitate.

More education might mean that parents are more likely to read to their children, suggests Davis-Kean. Or it could be that parents who are in school need to be more organized in order to get everything done, so they tend to create a more structured home environment, with dinner and bedtime occurring at regular times, for example. This kind of predictable, structured environment has a positive impact on child development, many studies have shown.

Creating a more structured environment for children – as opposed to giving them lots of free time – has been getting something of a bad reputation lately, Davis-Kean notes. But she believes that for the vast majority of U.S. children, the value of free time has been exaggerated.

“There’s this idealistic, nostalgic idea that free time gives children a chance to go out and play, and just experience nature,” she said. “But in reality, in today’s world where both parents are likely to be employed outside the home, what free time means for most kids is sitting in front of the TV, playing video games and generally being bored with no stimulation.

“What’s really valuable for children is being engaged in activities that are supervised by adults. When kids are unsupervised, you see an increase in injuries. And summer down time also has negative influences on school achievement in the fall.”

So parents who are going to school themselves should not worry about the effects of arranging more supervised activities for their children, according to Davis-Kean.