Want to do something really good for your kids waistlines? Set the table, turn off the TV and send 'em to bed early.

Less TV leads to fewer pounds. (iStockphoto.com)

Kids who make a routine of eating family dinners, cutting down TV and gaming time, and getting a good night's sleep are 40 percent less likely to be obese than those who practice none of these habits, a new study finds.

The results, published in the March issue of Pediatrics, looked at a sample of more than 8,000 4-year-olds to gauge the effect of these three household habits on obesity. Regularly eating dinner as a family was defined to at least 5 meals a week, getting adequate nightly sleep meant at least 10.5 hours per night, and limited TV, computer, and gaming time on weekdays meant less than 2 hours per day.

While TV watching, sleep, and eating family meals have each previously been linked to a reduced chance of obesity, this is the first study to look at the cumulative effects of all three household routines.

Even after the researchers adjusted for other factors, such as race and ethnicity, maternal obesity, and household income, the results remained pretty consistent. For Anderson, this means that "these routines may have the opportunity for universal impact, not just in one group."

But Anderson says that fostering such habits may not be possible in every household. "We know that it's going to be more difficult in some families than in others to have these routines, and what we really need is more research to see what would help families establish and maintain these routines given their different circumstances," she says.

Anderson adds that socio-economic and racial factors had an impact on the likelihood of practicing the habits at home. For instance, children lower-income homes were less likely to follow any, and especially all, of the three routines than those from well-off households. But, in whatever circumstances they were practiced, the results were the same: lower chances of obesity, she says.

New Orleans Saints' quarterback Drew Brees may have taken the spotlight during last night's big game, but a government-sponsored advertisement offered viewers a chance to star in a major 2010 production, too: The U.S. Census.

The $2.5 million ad, directed by mockumentary pioneer Christopher Guest, who also worked on This Is Spinal Tap and Best in Show, beseeched spectators to pose for a "snap shot of America."

The Constitution requires the national head count every 10 years, and the government uses the findings to allocate around $400 billion a year, according to Census documents. A lot of that money goes to health programs, such as state-run Medicaid plans for the poor, and grants for social service programs, substance abuse clinics and hospital construction.

So, Census officials argue, participating in the survey means more money for hospitals and social services in your community, all for just filling out a ten-question packet.

But, this year, an eclectic opposition has appeared urging citizens to approach the census with skepticism, and in some cases, downright boycott it. The unlikely spectrum of Census opponents ranges from Rep. Michele Bachmann, R-Minn., an outspoken conservative who opposed the advocacy group ACORN's now-severed ties with the Census Bureau, to Hispanic-American leaders, and also includes Tea Party activists. Early last year, Republican leaders were concerned that the White House sought to impose more political control over the Census Bureau. (Administration officials refuted that allegation).

The Pew Research Center noted last month, "there are partisan differences in opinions about the values of the census, and in personal willingness to participate." The young, Hispanics, and less educated people are among those voicing skepticism, they said. Their January poll, conducted days before the Census officially began, found that 16 percent of the population may not participate. Participation is required by law, and those who refuse face an up-to-$5,000 penalty, but the fine is rarely enforced.

Enter the Super Bowl Census ad, part of a campaign that began in January. The ad -- like others in the series, which includes Web-only videos--features an eccentric fictional film director named Payton Schlewitt who seeks to capture all Americans in a single shot. Then, a member of his production team intones, "Isn't that kinda what the Census is doing?" Some industry observers say the subtle director Guest's dry style, which in this case oddly weds absurdism and civic duty, may appeal mainly to upper-middle class people already likely to participate.

The Super Bowl spot cost $2.5 million, an expense some have lambasted as an affront to taxpayers. Sen. John McCain, R-Ariz., tweeted, "While the census is very important to AZ, we shouldn't be wasting $2.5 million taxpayer dollars to compete with ads for Doritos!" To make matters more contentious, the Census received funding to up its out-reach efforts and media buys through the politically charged economic stimulus package last February.

In a rebuttal yesterday, the Census Bureau argues its investments in ads pay off: In addition to ensuring that states such as Georgia get their fair share for health care, social service and employment projects, each 1 percent increase in participation by mail-in surveys save taxpayers $85 million, because higher response rates mean the bureau must field fewer workers to go door-to-door collecting information. In 2000, the first year the bureau used ad campaigns to increase participation, they spent $100 million, but their efforts led to $305 million in savings, according to their defense, posted on the 2010 Census Web site.

This year, the bureau will spend $340 million in all, and in addition to the Super Bowl, the campaign will also target Mardi Gras, the Chinese New Year celebration in San Francisco, and the Daytona 500.

Weaver is a reporter for Kaiser Health News, a nonprofit news service.

From the annals of bright health care ideas that have unintended consequences comes a tale of what happens when Medicare pays doctors more to do bladder cancer surgery in their offices.

(Wikimedia Commons)

If you guessed those doctors did more bladder biopsies and related procedures during office visits, you'd be right. But you'd be very wrong if you figured, as Medicare officials did when they came up with the plan, that the in-office work would dramatically reduce the expense of hospital care. Overall costs to Medicare for bladder cancer rose about 50 percent, says a study of the changes at a New York practice just published online by the journal Cancer.

The basic problem is that the 2005 hike in payments occurred without any guidelines to help doctors decide what was appropriate care, explained Dr. Micah Hemani, urology resident and lead author of the report. "Medicare's intention was to save costs," he tells Shots. "And that is not what's actually happening in our practice." Hemani is at New York University Langone Medical Center.

In an accompanying editorial to the study, Dr. David Penson, a Vanderbilt urologist, writes that the increase in procedures is probably not "caused primarily by self-serving financial motives." Instead, Penson suggest the payment reduced the threshold for doctors to perform procedures. So it's less a conscious money-making decision than doing something relatively easy, just to be sure.

There are some caveats. The findings were based on data from a single medical practice affiliated with a big New York hospital. Still, Hemani told us, it's his guess "that this is a really a national problem."

He says the NYU docs are taking a closer look at which kinds of patients have the best results with office-based care and which should go the hospital route. Ultimately, he says, there need to be some rules of thumb on what's cost-effective and what's clinically efficacious. Those could wind up sending more patients to the hospital treating fewer of them in the office, he says.

Update: Dr. Len Lichtenfeld, deputy medical officer of the American Cancer Society, takes issue with bladder cancer report. Lichtenfeld, who serves on an expert committee that advises Medicare on payment, writes the researchers misunderstand what Medicare was up to:

Medicare didn't wake up one morning and decide that they wanted to pay doctors more in the hope they could save some money. They paid the doctors more money for the actual costs the doctor incurs for doing the service, just as they do for the more than 7,000 services that they cover and that are performed appropriately in the office setting.

You might be interested to know that the ACS publishes the journal Cancer, where the original article appears.

Which Super Bowl ad really grabbed our attention? Not Google's or even Audi's Green Police spot, which people seemed to love or hate.

For us, it was President Obama's pitch for health overhaul in a pre-game interview with CBS News' Katie Couric. The biggest development? Obama plans a televised summit meeting of Republicans and Democrats to be held on Feb. 25.

Watch CBS News Videos Online

He laid out a few more details of his plan to restart health overhaul and underscored its importance, even after the effort stalled in the wake of Republican Sen. Scott Brown's election in Massachusetts last month, ending the Democrats' filibuster-proof majority in the Senate.

We're not sure that a Hail Mary call for public bipartisanship will make a profound difference so late in the overhaul game. The president, as much as anything, seems to be neutralizing GOP gripes that he didn't live up to a campaign promise to broker a health care deal in the open and with Republicans at the table.

Republicans maintain that any deal on health would require shelving the already passed House and Senate bills and starting from scratch.

While welcoming the invitation for a conversation, House Republican leader John Boehner said in a widely reported statement, "The best way to start on real, bipartisan reform would be to scrap those bills and focus on the kind of step-by-step improvements that will lower health care costs and expand access."

Still, Obama may be banking on a boffo performance, like the one he pulled off at a Republican retreat last month, to make something happen.

His recent budget proposal and fresh estimates on the ever-rising proportion of the economy devoted to health care appear to be part of his political calculus. "Bending the cost curve on health care," he told Couric, "is the important thing we can do to deal with the deficit long term."

HHS Secretary Sebelius says 2.6 million more kids got health insurance last year. (Manuel Balce Ceneta/AP)

Just because Congress hasn't passed a health overhaul bill yet doesn't mean they haven't done anything to help the uninsured.

A year ago, Congress gave the Children's Health Insurance Program a serious funding boost and relaxed some of the restrictions preventing states from expanding the health coverage. CHIP is the program to get kids covered whose parents are too poor to buy private insurance but make too much to qualify for regular Medicaid.

And according to federal study released yesterday, about 2.6 million kids who didn't have health insurance before got help last year through government health programs like CHIP and Medicaid. Today, about 40 million American children get health care coverage through these programs -- 7.4 million of them through CHIP.

"Most of these families would not have had the help without" the legislation, Sebelius said at an event at a Washington D.C. child care center.

To be fair, the recession and job losses probably pushed people to enroll their kids, too.

As a result of the new laws, 19 states last year either increased eligibility in Medicaid or CHIP, eliminated monthly premiums or simplified enrollment procedures. Fifteen states scaled back coverage.

But five million uninsured children who are eligible for the state-federal coverage programs are still not enrolled -- a lingering concern for the law's champions, like Democratic Senator Jay Rockefeller of West Virginia.

Sebelius said more needs to be done, and urged the states to tap into data on families who already qualify for food stamps as a way to expand kids' health coverage even further.

But that might not be enough. There's no guarantee CHIP will survive the current health overhaul battle.

Galewitz is a reporter with Kaiser Health News.

Right now my right deltoid is slightly tender from two needle pokes yesterday--one for swine flu, one for the seasonal flu.

The swine flu shots came eventually but there weren't many takers. (Thierry Zoccolan/AP)

A new government-funded flu poll reveals I'm among just one out of five adults to get vaccinated against swine flu. That's right, just 21 percent have done what I did, despite the biggest push ever to persuade Americans to get immunized.

Even among "high priority" adults--those with heart and lung disease, neurological conditions, HIV and other conditions that put that at risk of flu complications and death--the score isn't much higher. Just 28 percent of them are protected.

The record's better among children. Pandemic H1N1 has hit children unusually hard. Forty percent of parents say they've gotten their kids vaccinated and another 13 percent intend to. If they follow through, just over half of US children will have gotten vaccinated.

Why have so many Americans sat the pandemic out? Most people say it wasn't as serious as the government made out and didn't think they were at risk of serious illness. But among those who didn't seek vaccine and aren't sure they will, more than half say they're worried about the vaccine's safety.

But Americans are nothing if not ambivalent. A straight-on question about vaccine safety found only 15 percent who say it's unsafe. And when asked what the government should do about ordering vaccine, three in five say officials should buy enough for everyone and guarantee there's no shortage--even if that means a lot of leftover vaccine.

The poll is the eighth in a series conducted by Harvard researchers under contract with the Centers for Disease Control and Prevention.

Oh, and why did I decide to get flu shots in February? Well, I wasn't in any priority group urged to be first in line. I was at the doctor's office anyway. The shots were free. It's an excellent bet that the pandemic H1N1 will be in next fall's seasonal vaccine, so my immune system will be primed against it. And maybe H3N2, a component of the seasonal vaccine, will resurface. You never know.

Your parents may have taught you about the birds and the bees, but they probably never explained exactly how human sperm get their move on.

(iStockphoto.com)

The particulars of the environment sperm find themselves in make all the difference. If the surroundings are acidic, then sperm sit tight. But if things are alkaline, or basic, which is the other side of the pH scale, then sperm hightail it.

Now some researchers in California say they've found the molecular switch that kicks human sperm into gear. Scientists at University of California, San Francisco, say a channel in the wiggly sperm tail regulates their internal pH and serves as the ignition switch for action.

Since Mom and Dad didn't tell us about this way back when, we turned to Dr. Yuriy Kirichok, lead researcher on the work, which appears in the current issue of Cell.

Kirichok's team identified the molecule that looks to play the most important role in changing the pH inside the sperm, a one-way valve, or channel, called Hv1.

The channel is "extremely sensitive" to the pH outside the sperm, Kirichok said. So, when sperm are ejaculated into the female reproductive tract, where the pH is mostly more alkaline, then the Hv1 channel opens up. That let protons leave the sperm, raising their internal pH. The sperm then start swimming furiously toward the egg. That's a complicated journey; for more scientific info try this.

It's possible that work on Hv1 could help scientists find new ways to control male fertility. "I cannot promise that something like an activator or inhibitor of Hv1 would be available in the near future," Kirichok said. "But Hv1 is a good candidate for that, definitely."

You think vaccines are just for kids? Think again.

T.C. Weber gets a swine flu shot in New York last year. (Spencer Platt/Getty Images)

If you're over 65, vaccines can go a long way toward protecting you against complications that could land you in the hospital. Older people are far more likely than younger adults to suffer flu symptoms so severe they end up with pneumonia and can even die as a result.

Nonetheless, it seems many older Americans just aren't aware how important some vaccines can be. Federal health officials recommend at least three immunizations for those over 65: shingles, flu and pneumonia. Shingles and pneumonia are one-time shots. Flu vaccines are recommended yearly.

The report suggests several key reasons why adult vaccination rates remain low. For starters, most older adults do not live in institutionalized settings and may have limited access to doctors and health care settings. They may not have adequate information about the value of vaccines. Preventive care can be limited and people may be underinsured and out-of-pocket costs may be prohibitive.

Researchers say there should be a national strategy to increase the rate of adult vaccinations, including requiring full coverage for all vaccines recommended by the Centers for Disease Control and Prevention and increasing funding for public education about the importance of such vaccines.

Every year, the report says, millions of American adults go without routine and recommended vaccinations which leads to an estimated 40,000 to 50,000 preventable deaths, thousands of preventable illnesses and $10 billion in preventable health care costs.

The president doesn't seem to think health overhaul is dead, even if you do.

President Obama works the crowd at a Washington fundraiser where he defended health overhaul. (Charles Dharapak/AP)

Last night at a Democratic fundraiser in Washington, President Obama defended what's been done so far and sketched out a path for action. Before much longer, though he didn't say exactly when, Obama wants Congress "to move forward on a vote. We've got to move forward on a vote"

There were some wonkily funny moments in the speech. Obama got a pretty good laugh with his response to criticism about the push for overhaul:

I love how the pundits on these cable shows, they all announce, 'Oh, boy, this was really tough politically for the president.' Well, I've got my own pollsters. I know. I know.

I knew this was hard. I knew seven presidents had failed. I knew seven Congresses hadn't gotten it done. You don't think I got warnings?

So what's he going to do?

We already pretty much know where he's headed. He reviewed the more than 90 percent of the Senate and House health bills that are in agreement, such as restrictions on insurers and expansion and insurance marketplaces for small businesses and the uninsured.

"It's important to have a methodical open process over the next several weeks, then let's go ahead and make a decision," he said.

Obama didn't go into detail on exactly how he sees legislation coming to a vote on Capitol Hill. Before that can happen, he said, lawmakers first have to deal with a jobs package, because that's the most pressing matter for Americans right now.

After that, though, let the chips fall where the may:

If Congress decides we're not going to do it, even after all the facts are laid out, all the option are clear, then the American people can make a judgment as to whether this Congress has done the right thing for them or not.

You can check out a video of the president's speech and his answers to four questions below. Zip ahead to just past the 16-minute mark to hear the health part of the speech. His answer to a question about the path forward starts around the 25th minute.

In the next year or two, government will become the majority shareholder in America's "capitalistic" health care system, paying for more than 50 percent of all health costs, a new report by federal officials suggests.

(iStockphoto.com)

Much has been made of that milestone--including by this reporter. But, given that we've drifted towards the 50-percent benchmark for decades, what does it really mean beyond a nice round number?

For one thing, we're inadvertently closing the gap with other developed countries. Gail Wilensky, a former director of the agency that runs Medicare, told us, "the rest of the world tends to think of us as being dominated by the private sector." She said there may be an "advantage for saying that the majority of health spending comes out of the public sector in conversations with the rest of the world."

That gap has been a target of critics at home and abroad who, like Michael Moore in his documentary "Sicko," argue a health system beholden to profit-making private companies is inefficient, costly and unfair. A Reuters report on Moore's 2007 film suggested Europeans may want to tune in "for the sheer fun of seeing Americans wallow in problems they solved years ago."

However, Canada -- a favorite effigy for opponents of "socialized" medicine--covered only about 70 percent of its health costs with public dollars in 2007, far less than most European countries. The government of Switzerland, which has a more mixed public-private health system than its neighbors, pays for slightly less than 60 percent.

While Canada and Switzerland spend more than the government-centric health systems in France or the U.K., their annual spending remains far lower than America's. Today's report says we'll shell out roughly twice as much per person this year.

That could point to another take away from today's health spending. In the U.S., health spending has increased, even as the public sector has shouldered more of the load. That could defuse the argument--posited by Moore and others who attack America's private health care sector--that the problem with the system is who pays for it. The biggest drivers of health spending for both public and private payers are rising prices, increasingly aggressive use of medical services, and an older, sicker population, according to the report.

Conservative health economist John Goodman dismissed the notion that it matters whether care is financed by government or private insurers: "There's not much difference in the way Medicare pays and the way private insurance pays. It's really all pretty much the same." And, while well-meaning people debate the fairness of both sectors, they're both pretty expensive.

Weaver is a reporter for Kaiser Health News, a nonprofit news service.

The top court in President Obama's home state just struck down a law that capped malpractice awards against doctors and hospitals.

(iStockphoto.com)

The decision, though specific to Illinois, could deal a blow to efforts to change malpractice laws elsewhere.

Recall, that last fall the administration promised to fund state experiments in dealing with medical malpractice to the tune of $25 million. Lately, the notion that changes in how malpractice is handled could save a lot of money even got a thumbs-up from the Congressional Budget Office.

The Chicago Tribune reports on the closely watched case here, and drew our attention to a passage in the decision that sounded just like dear old Mom.

Who cares if those flashy folks in California and some other states have similar laws on the books? "That 'everybody is doing it," is hardly a litmus test for the constitutionality of the statute," the majority opinion reads.

The upshot? You can apparently get used to just about anything.

We just had our 15th endoscopy and life is good! (iStockphoto.com)

Healthy volunteers in the six-month study got 15 separate endoscopic exams to see how five different drugs and aspirin affected their stomachs and the tops of their small intestines.

Along the way the eight men and two women in the study filled out a 36-question survey to gauge their quality of life. It didn't change significantly despite taking all those different medicines and being prodded regularly from the inside out.

Indeed, the German researchers said some of the people signed up for a subsequent test that subjected them to four endoscopic exams in just two hours. Yikes!

The people in the study did get paid for their time, though the doctors said it was only a modest amount. But the motivation of a volunteer for idealistic reasons may be at least as important as money, the researchers said, and could be a fruitful focus for future research.

The researchers wrote that they weren't trying to "clarify whether endoscopy-based research is ethical or not," but the results, limited as they are by small size of the study, could contribute to the conversation.

The work was funded by drugmaker AstraZeneca and appears in the World Journal of Gastroenterology.

]]> <p><a href="http://www.npr.org/blogs/health/2010/02/endoscopy_quality_life_study.html#email">&raquo; E-Mail This</a>&nbsp;&nbsp;&nbsp;&nbsp; <a href="http://del.icio.us/post?url=http://www.npr.org/blogs/health/2010/02/endoscopy_quality_life_study.html">&raquo; Add to Del.icio.us</a> </p> http://www.npr.org/blogs/health/2010/02/endoscopy_quality_life_study.html?ft=1&f=103537970 http://www.npr.org/blogs/health/2010/02/endoscopy_quality_life_study.html?ft=1&f=103537970 Research Thu, 04 Feb 2010 11:30:58 -0500 By Scott Hensley Health care overhaul may be dead, but the growth in the nation's spending on health keeps on rolling. Estimates just out from the government show that health spending climbed 1.1 percentage points to account for 17.3 percent of GDP in 2009. That's the biggest annual jump in 40 years. How much money is that? A lot. A real lot. Try $2.47 trillion, up 5.7 percent from the $2.34 trillion spent on health in 2008. The estimates, prepared by actuaries at the Centers for Medicare and Medicaid Services, appear in the March issue of the journal Health Affairs. Take a look ahead and you'll find that government spending on health care--mostly through Medicare and Medicaid--is growing faster than outlays by the private sector. By 2012, government spending on health is expected to surpass private expenditures for the first time. So whether you support or oppose greater government involvement in health care under overhaul legislation, there's no escaping the fact that Uncle Sam will be footing most of the nation's health bills very soon. One factor in the big jump in the share of GDP going to health spending--and the bigger role for the government--is the overall slowdown in the economy. Medicaid enrollment is galloping along as unemployment rises. The flip side: private insurance rolls are shrinking. Still, the weak economy is expected to slow the overall growth in spending a bit. For this year, the federal actuaries figure health spending with increase 3.9 percent. But even slow growth adds up. If the government estimates are right, the nation be spending $4.48 trillion or on health care in 2019--19.3 percent of the economy. By Scott Hensley

Health care overhaul may be dead, but the growth in the nation's spending on health keeps on rolling.

Estimates just out from the government show that health spending climbed 1.1 percentage points to account for 17.3 percent of GDP in 2009. That's the biggest annual jump in 40 years.

How much money is that? A lot. A real lot. Try $2.47 trillion, up 5.7 percent from the $2.34 trillion spent on health in 2008. The estimates, prepared by actuaries at the Centers for Medicare and Medicaid Services, appear in the March issue of the journal Health Affairs.

So whether you support or oppose greater government involvement in health care under overhaul legislation, there's no escaping the fact that Uncle Sam will be footing most of the nation's health bills very soon.

One factor in the big jump in the share of GDP going to health spending--and the bigger role for the government--is the overall slowdown in the economy. Medicaid enrollment is galloping along as unemployment rises. The flip side: private insurance rolls are shrinking.

Still, the weak economy is expected to slow the overall growth in spending a bit. For this year, the federal actuaries figure health spending with increase 3.9 percent.

But even slow growth adds up. If the government estimates are right, the nation be spending $4.48 trillion or on health care in 2019--19.3 percent of the economy.

Easy does it, even if the game is virtual. (SashaW/Flickr)

Over the years we've broken bones and hurt ourselves in all sorts of embarrassing ways. But so far, knock on wood, we haven't done any damage while playing a video game.

The opportunity for trouble is surely there, as an English doctor writes in the latest issue of the New England Journal of Medicine. A 14-year-old girl showed up at the emergency room after falling off a Wii Fit balance board and twisting her ankle very badly.

Her right foot was swollen and painful. An X-ray found she'd fractured a long bone in her foot that's connected to the little toe. Isn't that the one that goes "Wiiiiiiiii" all the way home?

In a statement, Nintendo of America said:

The Wii video game system is often credited with getting people up off the couch. But, as with any new activity, people playing the Wii system should pace themselves and not overdo it. Nintendo is committed to the safety of its consumers.

You can find Nintendo's general safety tips for Wii here.

We're all for the active exercise that Wii makes possible while staying warm in the basement this time of year. But be careful folks.

The balance board is just the latest factor in Wii-related injuries. Plenty of people have been hit by flying game controllers. Strains and dislocations are also not unheard of.

A recent roundup in a medicine journal found Wii Tennis was the most common game associated with injuries that people reported. Cuts to the hand were the most frequent problem.

Another case published last year involved a 38-year-old man who cracked a bone in his neck that appeared to be the result of "swinging his Wii game console control during a rather vigorous game." The break, called a "clay-shoveler's fracture," is usually associated with rapid heavy lifting.

Apparently even virtual sports can cause real injuries.

Yesterday, the medical journal the Lancet retracted a 12-year-old paper by Dr. Andrew Wakefield, which helped fan a scare about vaccines and autism.

The idea that vaccines could make kids sick elicits a very emotional response in many. (Jeff J Mitchell/Getty Images)

Now discredited, the report looked at just a dozen children who developed behavioral and intestinal problems. Eight of them had been recently vaccinated against measles, mumps and rubella.

So we turned to David Ropeik, a risk consultant and author of How Risky Is It Really? Why Our Fears Don't Always Match The Facts, for some insight.

Ropeik says that the Wakefield episode is a prime example of our potential to misjudge a situation based on false perceptions of risk. In emotional circumstances, where we lack an understanding and control of the situation, our emotional instincts to react may overwhelm our more logical side, he says.

How do you view Wakefield's paper as an example of risk perception gone awry?
The Wakefield paper is interesting. Its key phrase specifically says "we did not prove an association between the MMR vaccine and the syndrome described." So, there's unequivocally no link. But Wakefield hinted at one in the news conference. And the parents of the kids who had autism jumped on that. Because what parent of a sick kid wouldn't want an answer that might lead to a cure? But their reaction, as understandable as it was, was emotional, not factual.

So, everything that followed, to me, is a huge lesson to society that our risk perception system can make choices that feel right but get us into trouble. In this case, the trouble is the recurrence of measles in many places in the world -- in some cases killing children, a worry about other vaccines, and a shaken faith in science overall.

How much do you think the Wakefield case really shook up people's faith in science?
Wakefield's study came in the context of many other issues -- things that had shaken trust in science and public health institutions in the UK already. Mad cow disease, for instance, was poorly handled by the British government in the first place. There was controversy over genetically modified food too. All of this had contributed -- perhaps rightly-- to the mistrust of public health organizations.

With vaccination, generally, you have a small number of people who don't like being told they have to do it -- it's a government imposition. Well, Wakefield hinted that this government imposition might be causing kids sickness. In my opinion, that latched on to the existing undercurrent of resistance to government imposed vaccination.

How is a lay person supposed to make sense of issues like this -- when there's so much complicated or conflicting information?
That's the question. The problem for lay people, like myself, is that we don't have scientific expertise but we want our children and ourselves to survive. So we have a host of largely subconscious and instinctive ways of sensing danger. For example, if there's something we can't understand or control, evidence that it might be risky will make us more afraid. This is very natural, and we all do it. But we also have to realize that we get things wrong in ways that make things worse.

We have to recognize the potential dangers in our own perception and factor that into our thinking as well. 'Am I getting this wrong in a way that could make things worse?' is a pretty good way to check your thinking about any risk.

But if you're already lacking understanding, how can you really check for yourself?
Examples like the Wakefield case are good teaching moments. This won't be the last time a complicated issue, fraught with many emotions comes along and we have to decide [how to react]. We're smart enough to learn from the past. And this episode is a grand teaching moment for all of us to not leap to conclusions to recognize how powerful our feelings are in our interpretations of the facts. That's all I think is realistic. It's up to people to make up their own minds.

Doesn't the general public trust experts to explain though?
We only look to those we trust - in part because they're saying what we want to here. I mean, Wakefield gave parents of autistic kids hope. The other par of it is that those experts have demonstrated their competence. What matters a lot besides the science that's factual is the experts' reputation and point of view. And that's subjective -- it depends on our own points of view. Expertise is in the eye of the beholder. It's not just how many degrees you have.

What impact do you see coming from the Lancet's official retraction?
What's happening here is a continued movement away from Wakefield and the whole controversy for the Lancet. It's about Wakefield and saving-face. Despite all of the quibbles with his methodology -- which is why they say they are retracting it -- his paper says "we did not prove an association." They're distancing themselves away from the guy and the controversy, in my opinion.

The problem is that [being in the news] may make him more of a hero to those who want to believe what he says. See, its not just expertise, its emotions too. Which, again, is entirely understandable and valid, even when it causes people to not pay full and fair attention to the facts.

Where's the action now? What's the burning risk question that's causing controversy?
Oh my gracious, where to begin? Cell phones and radiation. Plastics. Mercury in seafood. Climate change. Obesity. They all are bigger or smaller risks where the emotional nature of them is leading to responses that don't seem commensurate to the risk. We're not responding to climate change nearly as dramatically as we need to -- or obesity. And we're probably reacting more fearfully about mercury in seafood than the actual threat warrants. At our peril. That's what matters -- it's the critical phrase here. I'm not just observing that people are being irrational. But if we're too afraid or not afraid enough, it can lead to choices that raise our risks.