Just like those of humans, insect guts are full of microbes, and the microbiota can influence the insect’s ability to transmit diseases. A new study reports that a bacterium isolated from the gut of an Aedes mosquito can reduce infection of mosquitoes by malaria parasites and dengue virus. The bacterium can also directly inhibit these pathogens in the test tube, and shorten the life span of the mosquitoes that transmit both diseases.
The above story is based on materials provided by PLOS. Note: Materials may be edited for content and length.
Jose Luis Ramirez, Sarah M. Short, Ana C. Bahia, Raul G. Saraiva, Yuemei Dong, Seokyoung Kang, Abhai Tripathi, Godfree Mlambo, George Dimopoulos. Chromobacterium Csp_P Reduces Malaria and Dengue Infection in Vector Mosquitoes and Has Entomopathogenic and In Vitro Anti-pathogen Activities. Plos Pathogens, October 23, 2014 DOI: 10.1371/journal.ppat.1004398
Herbal medicines such as licorice, Indian rennet and opium poppy, are at risk of contamination with toxic mold, according to a new study. The authors of the study say it’s time for regulators to control mold contamination. An estimated 64% of people use medicinal plants to treat illnesses and relieve pain. The herbal medicine market is worth $60 billion globally, and growing fast. Despite the increasing popularity of herbal medicine, the sale of medicinal plants is mostly unregulated.
RxClass is a new application from researchers in the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM). RxClass allows users to search and browse drug classes and their RxNorm drug members through a simple Web interface (see Figure 1). Unlike RxNav, a related application from NLM LHNCBC which focuses on browsing and searching individual RxNorm drugs, RxClass provides a class-centric view of the drug information in RxNorm.
Figure 1: RxClass Homepage.
Drug Class Sources
RxClass includes drug classes from the following data sources:
ATC – The Anatomical Therapeutic Chemical (ATC) drug classification is a resource developed for pharmacoepidemiology purposes by the World Health Organization Collaborating Centre for Drug Statistics Methodology.
MeSH – The Medical Subject Headings (MeSH), developed by NLM, provides a rich description of pharmacological actions for the purpose of indexing and retrieval of biomedical articles.
NDFRT – The National Drug File-Reference Terminology (NDFRT), developed by the Department of Veterans Affairs (VA), provides clinical information about drugs, such as therapeutic intent and mechanism of action.RxClass includes six sets ofNDFRT drug classes:
Established Pharmacologic Classes (EPC)
Chemical Structure (Chem)
Mechanism of Action (MoA)
Physiologic Effect (PE)
Drug Class Relationship Sources
RxClass includes five sources which assert relationships between drugs and drug classes from ATC, MeSH, and NDFRT:
ATC – provides relationships between ATC drugs and ATC drug classes.
MeSH – provides relationships between MeSH drugs and MeSH pharmacologic actions.
DailyMed – provides relationships between substances in DailyMed Structured Product Labels (SPLs) and NDFRT EPC, Chem, MoA, and PE classes.
NDFRT – provides relationships between NDFRT drug concepts and NDFRT Chem, Disease, MoA, PE, and PK classes.
FDA SPL – provides relationships between NDFRT drug concepts mapped to DailyMed SPL substances and NDFRT EPC, Chem, MoA, and PE classes.
RxClass includes drugs from the sources mentioned above, which are mapped to ingredients (IN), precise ingredients (PIN), and multiple ingredients (MIN) in RxNorm. RxNorm is a normalized naming system for generic and branded drugs developed by NLM to allow computer systems in hospitals, pharmacies, and other organizations to communicate drug-related information efficiently and unambiguously.
Browse Drug Classes
RxClass provides a simple tree browser for navigating through drug class hierarchies. You can click on the orange arrow next to a class to reveal its subclasses in the tree. Clicking on the name of a drug class populates the results area under the search box with the members of that class, if applicable, and the name, source identifier, class type, and contexts for that class (see Figure 2).
Figure 2: RxClass Class Browser. Navigate drug classes by clicking the arrows or class names.
Search by Drug Class/RxNorm Drug
RxClass also provides access to drug classes and their RxNorm drug members through a simple search box (see Figure 3). You can search RxClass by:
Drug class name or source identifier
RxNorm drug name or RxNorm identifier (RXCUI)
For drug classes and RxNorm drugs in multiple contexts, RxClass presents all of the contexts, allowing you to select the desired drug class context to populate the results area.
Figure 3: Search RxClass by drug class or RxNorm drug name.
When browsing or searching RxClass, the results display is populated with the drug class you selected and the RxNorm drugs that belong to the class (see Figure 4). For each RxNorm drug, RxClass displays the:
Type (RxNorm term type)
Source ID (Unique identifier from drug class source)
Source Name (Name from drug class source)
Relation (Relationship between the drug and the selected drug class (direct or indirect))
All classes (All drug classes of which this drug is also a member)
Figure 4: RxClass results display: Shows RxNorm and drug class source data for your results.
Application Programming Interface (API)
Behind the RxClass Web application is a set of API functions. The RxClass API can be used independently for integrating drug class information into programs.
See the RxClass Overview and RxClass FAQ for more information about browsing and searching drug classes on RxClass. An RxClass turorial is forthcoming.
Summary: Scientists have uncovered a surprising way to reduce the brain damage caused by head injuries — stopping the body’s immune system from killing brain cells. A new study showed that in experiments on mice, an immune-based treatment reduced the size of brain lesions. The authors suggest that if the findings apply to humans, this could help prevent brain damage from accidents, and protect players of contact sports like football, rugby and boxing.
The above story is based on materials provided by BioMed Central. Note: Materials may be edited for content and length.
Richard P Tobin, Sanjib Mukherjee, Jessica M Kain, Susannah K Rogers, Stephanie K Henderson, Heather L Motal, M Rogers, Lee A Shapiro. Traumatic brain injury causes selective, CD74-dependent peripheral lymphocyte activation that exacerbates neurodegeneration. Acta Neuropathologica Communications, 2014; 2 (1): 143 DOI: 10.1186/s40478-014-0143-5
Bacterial infections remain a major threat to human and animal health. Worse still, the catalog of useful antibiotics is shrinking as pathogens build up resistance to these drugs. There are few promising new drugs in the pipeline, but they may not prove to be enough. Multi-resistant organisms—also called “superbugs”—are on the rise, and many predict a gloomy future if nothing is done to fight back.
The answer, some believe, may lie in using engineered bacteriophages, a type of virus that infects bacteria. Two recent studies, both published in the journal Nature Biotechnology, show a promising alternative to small-molecule drugs that are the mainstay of antibacterial treatments today.
From basic to synthetic biology
Nearly every living organism seems to have evolved simple mechanisms to protect itself from harmful pathogens. These innate immune systems can be a passive barrier, blocking anything above a certain size, or an active response that recognizes and destroys foreign molecules such as proteins and DNA.
An important component of the bacterial immune system is composed of a family of proteins that are tasked specifically with breaking down foreign DNA. Each bug produces a set of these proteins that chew the genetic material of viruses and other micro-organism into pieces while leaving the bacterial genome intact.
In vertebrates, a more advanced system—called the adaptive immune system—creates a molecular memory of previous attacks and prepares the organism for the next wave of infection. This is the principle on which vaccines are built. Upon introduction of harmless pathogen fragments, the adaptive immunity will train specialist killer cells that later allow a faster and more specific response if the virulent agent is encountered again.
Until recently, people thought bacteria were too simple to possess any sort of adaptive immunity. But in 2007, a group of scientists from the dairy industry showed that bacteria commonly used for the production of cheese and yogurts could be “vaccinated” by exposure to a virus. Two years earlier, others noticed similarities between repetitive sections in bacterial genomes and the DNA of viruses. These repetitive sequences—called CRISPR for “clustered regularly interspaced short palindromic repeats”—had been known for 20 years, but no one could ever explain their function.
Ever wondered how people figure out what is fair? Look to the brain for the answer. According to a new Norwegian brain study, people appreciate fairness in much the same way as they appreciate money for themselves, and also that fairness is not necessarily that everybody gets the same income.
Economists from the Norwegian School of Economics (NHH) and brain researchers from the University of Bergen (UiB) have worked together to assess the relationship between fairness, equality, work and money. Indeed, how do our brains react to how income is distributed?
More precisely, the interdisciplinary research team from the two institutions looked at the striatum; or the “reward centre” of the brain. By measuring our reaction to questions related to fairness, equality, work and money, this part of the brain may hold some answers to the issue of how we perceive distribution of income.
“The brain appreciates both own reward and fairness. Both influence the activation of the striatum,” says Professor Alexander W. Cappelen. “This may explain why a lot of people are willing to sacrifice monetary rewards when this results in a fairer balance.”
Inequality vs. fairness
Cappelen works at the Department of Economics at NHH and is co-director of the Choice Lab, which consists of researchers devoted to learning more about how people make economic and moral choices.
Along with his NHH Choice Lab colleagues Professor Bertil Tungodden and Professor Erik Ø. Sørensen, Cappelen wanted to explore how the brain’s reward system works. To help them answer this question, the NHH team got in touch with brain researchers Professor Kenneth Hugdahl, Professor Karsten Specht and Professor Tom Eichele, all from the Bergen fMRI Group and UiB’s Department of Biological and Medical Psychology.
Together, the NHH and UiB researchers set out to prove that the brain accepts inequality as long as this inequality is considered fair. The researchers published their results in the article Equity theory and fair inequality: A neuroeconomic study, which was published in the scientific journal PNAS on 13 October 2014.
People’s preferences for income distribution fundamentally affect their behaviour and contribute to shaping important social and political institutions. The study of such preferences has become a major topic in behavioural research in social psychology and economics.
“Our research showed that the striatum shows more activity to monetary rewards when the reward was judged to be fair,” says Kenneth Hugdahl.
IMAGE:Here are five of the six NHH and UiB researchers behind the new study that shows how the brain responds to questions regarding fairness and inequality. Left to right: Bertil…
Despite the large literature studying preferences for income distribution, there has so far been no direct neuronal evidence of how the brain responds to income distributions when people have made different contributions in terms of work effort.
Inspired by an article in Nature
The background for the joint study between the NHH and UiB researchers was an article in Nature in February 2010, where an interdisciplinary team of American researchers found evidence that people’s brains react negatively to inequality. The American researchers reached their conclusion by studying how the striatum responded to different levels of inequality in a situation where everyone had made the same contribution….
You knew that drinking sugary sodas could lead to obesity, diabetes and heart attacks — but, according to a study published in the American Journal of Public Health, it may also speed up your body’s aging process.
What got my attention was his remark about celery.
You know: the dieters’ wishful thinking on whether eating celery is a sum negative activity, or not.
He was certainly entitled to speak. His name is Dr. Gerald Krystal and he’s a professor of pathology and laboratory medicine at University of British Columbia, as well as Distinguished Scientist at the Terry Fox Laboratory at the BC Cancer Agency.
We were perched like vultures over a buffet table, commenting on the many ways to die. Fats, salts, sugars, alcohol: pick your delicious poison. I like ’em all.
As you age, caps on the end your chromosomes called telomeres shrink. In the past several years, researchers at the University of California at San Francisco, have analyzed stored DNA from more than 5,300 healthy Americans in the National Health and Nutrition Examination Survey (NHANES) from some 14 years ago. And they discovered that those who drank more pop tended to have shorter telomeres.
The shorter the telomere, the harder it is for a cell to regenerate — and so, the body ages.
“We think we can get away with drinking lots of soda as long as we are not gaining weight, but this suggests that there is an invisible pathway that leads to accelerated aging, regardless of weight,” psychiatry professor Elissa Epel, senior author of the study, told CBS San Francisco….
The headlines in the opening to this story are not taken from today’s newspapers. They were published in the Chicago Tribune 96 years ago. From 1918 to 1919, the world was in the throes of the greatest plague in recorded history. It was called the Spanish Flu, named for the country where people thought it had originated..
The headlines we are seeing today over fear of the spread of the Ebola virus are very real. Many of the events that have already taken place — such as the cruise ship being banned from entering Belize — adds to our fears, although the restrictions were probably unnecessary. We are a country that is totally unprepared for an epidemic of national proportions, yet this is not the first time wehave been tested.
The headlines in the opening to this story are not taken from today’s newspapers. They were published in the Chicago Tribune 96 years ago. From 1918 to 1919, the world was in the throes of the greatest plague in recorded history. It was called the Spanish Flu, named for the country where people thought it had originated……
On July 20 a man who was ill flew on commercial planes from the heart of the Ebola epidemic in Liberia to Lagos, Nigeria’s largest city. That man became Nigeria’s first Ebola case—the index patient. In a matter of weeks some 19 people across two states were diagnosed with the disease (with one additional person presumed to have contracted it before dying).
But rather than descending into epidemic, there has not been a new case of the virus since September 5. And since September 24 the country’s Ebola isolation and treatment wards have sat empty. If by Monday, October 20 there are still no new cases, Nigeria, unlike the U.S., will be declared Ebola free by the World Health Organization (WHO).
What can we learn from this African country’s success quashing an Ebola outbreak?
Every minute counts in the event of an overdose. ETH professor Jean-Christophe Leroux and his team have developed an agent to filter out toxins from the body more quickly and efficiently. It can also be used for dialysis in patients suffering from hepatic failure.
To date, antidotes exist for only a very few drugs. When treating overdoses, doctors are often limited to supportive therapy such as induced vomiting. Treatment is especially difficult if there is a combination of drugs involved. So what can be done if a child is playing and accidentally swallows his grandmother’s pills? ETH professor Jean-Christophe Leroux from the Institute of Pharmaceutical Sciences at ETH Zurich wanted to find an answer to this question. “The task was to develop an agent that could eliminate many different toxic substances from the body as quickly as possible,” he says.
Leroux and his team knew that lipid emulsions can bind to drugs when injected into the blood stream. The researchers pursued this approach in their own studies, developing an agent based on liposomes, which are tiny bubbles with a lipid membrane as an outer layer. Instead of an intravenous injection, the agent is used as a dialysis fluid for so-called peritoneal dialysis. This method of dialysis is less common than haemodialysis, which is mainly used as a long-term form of treatment of kidney failure.
[Deep down I believe that climate change should not be addressed as a threat to our security, but as a threat against all of us humans. If we do not unite on a global basis, surely this will be a disaster for all of us. Climate disruption (it is not simple change!) knows no boundaries. The effects cannot be stopped at any border.]
Changes in sea level during the last 9,000 years (Photo credit: Wikipedia)
Climate change is a threat multiplier, and the Defense Department is taking steps to incorporate this issue into all planning.
ASHINGTON, Oct. 13, 2014 – Climate change is a threat multiplier, and the Defense Department is taking steps to incorporate this issue into all planning, Defense Secretary Chuck Hagel said in Peru today.
Climate change has the potential to exacerbate many of the challenges the world already confronts, from the spread of infectious diseases to spurring armed conflicts, Hagel said at the Conference of the Defense Ministers of the Americas.
“The loss of glaciers will strain water supplies in several areas of our hemisphere,” he said. “Destruction and devastation from hurricanes can sow the seeds for instability. Droughts and crop failures can leave millions of people without any lifeline and trigger waves of mass migration.”
This already happening in the Sahel region of Africa, where desertification is placing millions at risk, and climate extremes in Australia are worrying leaders there. The Western Hemisphere is not immune, Hagel said. “Two of the worst droughts in the Americas have occurred in the past 10 years – droughts that used to occur once a century,” he added.
“In the Caribbean, sea level rise may claim 1,200 square miles of coastal land in the next 50 years, and some islands may have to be completely evacuated,” the secretary said. “According to some estimates, rising temperatures could melt entire glaciers in the Andes, which could have cascading economic and security consequences.”
These climate trends clearly will have implications for regional militaries, Hagel said, as more extreme weather will cause more natural disasters and military personnel will be called on to deliver humanitarian assistance and relief.
“Our coastal installations could be vulnerable to rising shorelines and flooding, and extreme weather could impair our training ranges, supply chains and critical equipment,” the secretary said. “Our militaries’ readiness could be tested, and our capabilities could be stressed.”
Climate change roadmap
Hagel announced a Defense Department Climate Change Adaptation Roadmap during his speech. The roadmap is based on science, he said, and describes the effects of climate change on DoD’s missions and responsibilities.
“We have nearly completed a baseline survey to assess the vulnerability of our military’s more than 7,000 bases, installations and other facilities,” Hagel said. “Drawing on these assessments, we will integrate climate change considerations into our planning, operations and training.”
Climate change affects everyone, and DoD will work with partner nations bilaterally and multilaterally to address the threat, the secretary said. “We will share our findings, our tools for assessment and our plans for resiliency,” he added. “We will also seek to learn from partner nations’ experiences as well.”
Hagel encouraged the Western Hemisphere nations represented at the conference to participate in the Defense Environmental International Cooperation program. “I recognize that our militaries play different roles and have different responsibilities in each of our nations,” he said. “I also recognize that climate change will have different impacts in different parts of the hemisphere. But there are many opportunities to work together.”
Peru will host a United Nations convention on climate change in two months, Hagel noted, adding that the militaries of the world must be part of the discussion. “We must be clear-eyed about the security threats presented by climate change, and we must be pro-active in addressing them,” he said.
The Climate Science, Awareness and Solutions (CSAS) team at Columbia University has a specific, targeted goal: a near universal carbon fee on fossil fuels. The group’s mission statement, under About Us, is a great place to start. Then explore Dr. James Hansen’s TED talk, an eighteen minute argument for the political responsibilities of climate scientists as well as regular citizens. The section titled Our Work will take readers to five headings – Climate Research, Climate Data, Public Awareness and Policy Solutions, 350.org, Citizen’s Climate Lobby, and Our Children’s Trust – each of which links to timely and educational projects. Finally, the In the News section features videos and articles showcasing the work of Dr. Hansen and his fellow climate activists. [CNH]
Many military personnel and veterans experience chronic pain, a condition that can be debilitating and is often difficult to treat. Post-traumatic stress, traumatic brain injury, depression, and substance use are other conditions that tend to co-occur in these same service members and are also challenging to treat. Opioid medications are often prescribed for chronic pain conditions, but use and misuse of opioids resulting in hospitalizations and death has been on the rise. A study published in the journal JAMA Internal Medicine examined the prevalence of chronic pain and opioid use among U.S. soldiers following deployment. The researchers found that of the more than 2,500 participants surveyed, 44 percent had chronic pain and 15 percent regularly used opioids—rates much higher than the general population.
Many military, veterans, and their families turn to complementary and integrative health approaches such as mindfulness meditation and other practices in an effort to enhance the options for the management of pain and associated problems. This page provides resources and information on health conditions of special concern to military, veterans, and their families and the complementary and integrative health practices being studied for this population.
A new research review from AHRQ’s Effective Health Care Program found that while the evidence on the effectiveness and harms of opioid therapy for chronic pain treatment is limited, there is an increased risk of serious harms based on the opioid dose given. The research review assesses observational studies that suggest that use of long-term opioids for chronic pain is associated with increased risk of abuse, overdose, fractures and heart attack, when compared with patients who are not being prescribed opioids. The review noted that more research is needed to understand the long-term benefits, risk of abuse and related outcomes, and effectiveness of different opioid prescribing methods and strategies. The review is titled, “The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain.” AHRQ has also released a statistical brief from the Healthcare Cost and Utilization Project titled, “Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993-2012.” According to the brief, hospitalization rates for opioid overuse more than doubled from 1993 to 2012 and increased at a faster rate for people age 45 and older. In addition, AHRQ Director Rick Kronick, Ph.D., has published a blog about opioids.
New research by biomedical engineers at the University of Minnesota shows that people who practice yoga and meditation long term can learn to control a computer with their minds faster and better than people with little or no yoga or meditation experience. The research could have major implications for treatments of people who are paralyzed or have neurodegenerative diseases.
The research is published online in Technology, a new scientific journal featuring cutting-edge new technologies in emerging fields of science and engineering.
In the study, researchers involved a total of 36 participants. One group of 12 had at least one year of experience in yoga or meditation at least two times per week for one hour. The second group included 24 healthy participants who had little or no yoga or meditation experience. Both groups were new to systems using the brain to control a computer. Both groups participated in three, two-hour experiments over four weeks in which they wore a high tech, non-invasive cap over the scalp that picked up brain activity. The participants were asked to move a computer cursor across the screen by imaging left or right hand movements.
The participants with yoga or meditation experience were twice as likely to complete the brain-computer interface task by the end of 30 trials and learned three times faster than their counterparts for the left-right cursor movement experiments.
“In recent years, there has been a lot of attention on improving the computer side of the brain-computer interface but very little attention to the brain side,” said lead researcher Bin He, a biomedical engineering professor in the University of Minnesota’s College of Science and Engineering and director of the University’s Institute for Engineering in Medicine. “This comprehensive study shows for the first time that looking closer at the brain side may provide a valuable tool for reducing obstacles for brain-computer interface success in early stages.”
Researchers have been increasingly focused on finding ways to help physically disabled individuals who are paralyzed, have lost limbs, or suffer from diseases such as ALS or cerebral palsy. In these cases, brain function remains intact, but these people have to find a way to bypass muscular control to move a wheelchair, control an artificial limb, or control other devices.
Professor He gained international attention in 2013 when members of his research team were able to demonstrate flying a robot with only their minds. However, they found that not everyone can easily learn to control a computer with their brains. Many people are unsuccessful in controlling the computer after multiple attempts. A consistent and reliable EEG brain signal may depend on an undistracted mind and sustained attention. Meditators have shown more distinctive EEG patterns than untrained participants, which may explain their success.
Professor He said he got the idea for the study more than five years ago when he began his brain-computer interface research and noticed one woman participant who was much more successful than other participants at controlling the computer with her brain. The woman had extensive experience with yoga and mediation, referred to by researchers as Mind-Body Awareness Training (MBAT).
The next step for He and his team is to study a group of participants over time who are participating in yoga or meditation for the first time to see if their performance on the brain-computer interface improves.
“Our ultimate goal is to help people who are paralyzed or have brain diseases regain mobility and independence,” He said. “We need to look at all possibilities to improve the number of people who could benefit from our research.”
This research was funded by the National Science Foundation, the National Institutes of Health, and the University of Minnesota’s Institute for Engineering in Medicine. In addition to He, the University of Minnesota research team included research lab technician Kaitlin Cassady, biomedical engineering undergraduate student Albert You, and biomedical engineering master’s and medical student Alex Doud.
From the article at Philosophical Society of the Royal Society
As long ago as the sixteenth century, Paracelsus recognized that ‘the dose makes the poison’. Indeed, environmental concentrations of pharmaceuticals excreted by humans are limited, most importantly because a defined dose is given to just a fraction of the population. By contrast, recent studies have identified direct emission from drug manufacturing as a source of much higher environmental discharges that, in some cases, greatly exceed toxic threshold concentrations. Because production is concentrated in specific locations, the risks are not linked to usage patterns. Furthermore, as the drugs are not consumed, metabolism in the human body does not reduce concentrations. The environmental risks associated with manufacturing therefore comprise a different, wider set of pharmaceuticals compared with those associated with risks from excretion. Although pollution from manufacturing is less widespread, discharges that promote the development of drug-resistant microorganisms can still have global consequences. Risk management also differs between production and excretion in terms of accountability, incentive creation, legal opportunities, substitution possibilities and costs. Herein, I review studies about industrial emissions of pharmaceuticals and the effects associated with exposure to such effluents. I contrast environmental pollution due to manufacturing with that due to excretion in terms of their risks and management and highlight some recent initiatives.
Despite recent advances in health care policy, American households continue to struggle with medical debt, and it’s only getting worse. Americans are putting more of their take-home pay toward medical costs than ever before.
NerdWallet Health has found that Americans pay three times more in third-party collections of medical debt each year than they pay for bank and credit card debt combined. In 2014, roughly one in five American adults will be contacted by a debt collection agency about medical bills, but they may be overpaying – NerdWallet found rampant hospital billing errors resulting in overcharges of up to 26%.
NerdWallet found 63% of American adults indicate they have received medical bills that cost more than they expected. At the same time, 73% of consumers agree they could make better health decisions if they knew the cost of medical care before receiving it.
Between 2010 and 2013, American households lost $2,300 in median income, but their health care expenses increased by $1,814.Out-of-pocket spending is expected to accelerate to a 5.5% annual growth rate by 2023 – double the growth of real GDP.
In a follow-up to last year’s study that found medical debt is the largest cause of personal bankruptcy, NerdWallet Health investigated the mounting financial obstacles facing the American patient.
Obtaining access to private outpatient psychiatric care in the Boston, Chicago and Houston metropolitan areas is difficult, even for those with private insurance or those willing to pay out of pocket. Researchers, who posed on the phone as patients seeking appointments with individual psychiatrists, encountered numerous obstacles, including unreturned calls, and met with success only 26 percent of the time.
he foundation of evidence-based research has eroded and the trend must be reversed so patients and clinicians can make wise shared decisions about their health, say Dartmouth researchers in the journal Circulation: Cardiovascular Quality and Outcomes.
Drs. Glyn Elwyn and Elliott Fisher of The Dartmouth Institute for Health Policy & Clinical Practice are authors of the report in which they highlight five major problems set against a backdrop of “obvious corruption.” There is a dearth of transparent research and a low quality of evidence synthesis. The difficulty of obtaining research funding for comparative effectiveness studies is directly related to the prominence of industry-supported trials: “finance dictates the activity.”
The pharmaceutical industry has influenced medical research in its favor by selective reporting, targeted educational efforts, and incentivizing prescriber behavior that influences how medicine is practiced, the researchers say. The pharmaceutical industry has also spent billions of dollars in direct-to-consumer advertising and has created new disease labels, so-called disease-mongering, and by promoting the use of drugs to address spurious predictions.
Another problem with such studies is publication bias, where results of trials that fail to demonstrate an effect remain unpublished, but trials where the results are demonstrated are quickly published and promoted.
English: Example of promotional “freebies” given to physicians by pharmaceutical companies (Photo credit: Wikipedia)
esponding to the large number of people with serious mental illnesses in the criminal justice system will require more than mental health services, according to a new report.
In many ways, the criminal justice system is the largest provider of mental health services in the country. Estimates vary, but previous research has found that about 14 percent of persons in the criminal justice system have a serious mental illness, and that number is as high as 31 percent for female inmates. Researchers are defining serious mental illnesses to include such things as schizophrenia, bipolar spectrum disorders and major depressive disorders.
“It has been assumed that untreated symptoms of mental illness caused criminal justice involvement, but now we’re seeing that there is little evidence to support that claim,” said Matthew Epperson, assistant professor at the University of Chicago School of Social Service Administration. Specialized interventions for people with mental illness in the criminal justice system have been developed over the past 20 years, such as mental health courts and jail diversion programs, Epperson said.
“But we need a new generation of interventions for people with serious mental health issues who are involved in the criminal justice system, whether it be interactions with police, jails, probation programs and courts,” he said. “Research shows that people with serious mental illnesses, in general, display many of the same risk factors for criminal involvement as persons without these conditions.”
: Criminal Justice Center (Photo credit: Wikipedia)
Jazz is good for you. Patients undergoing elective hysterectomies who listened to jazz music during their recovery experienced significantly lower heart rates, suggests a study presented at the ANESTHESIOLOGY™ 2014 annual meeting.
But the research also found that silence is golden. Patients who wore noise-cancelling headphones also had lower heart rates, as well as less pain.
The results provide hope that patients who listen to music or experience silence while recovering from surgery might need less pain medication, and may be more relaxed and satisfied, note the researchers.
“The thought of having a surgical procedure — in addition to the fears associated with anesthesia — creates emotional stress and anxiety for many patients,” said Flower Austin, D.O., anesthesiology resident, Penn State Milton S. Hershey Medical Center, Hershey, Pa., and lead study author. “Physician anesthesiologists provide patients with pain relief medication right after surgery. But some of these medications can cause significant side effects.”
American Journal of Preventive Medicine supplement addresses critical challenges to public health
Ann Arbor, MI, October 16, 2014 – Although disease outbreaks and epidemics drawing worldwide attention emphasize the importance and acute need for public health professionals, the world faces a longer-term challenge—a public health workforce that is truly effective in the 21st century. In a new supplement to the American Journal of Preventive Medicine, ***experts address critical challenges to public health, from workforce development, capacity building, partnership and collaborations, and changes and needs in workforce composition.
As the U.S. healthcare system evolves and communities gain more access to care, diverse forces are driving change, and the practice of public health is adapting. Given the challenges to the public health system and those faced as a nation—including urgent health threats (e.g., antibiotic resistance, prescription drug use and overdose, global health security) and decreased funding for addressing public health concerns—having trust in public health practitioners, their scientific knowledge, and particularly the public health system, has never been more important.
“The public health workforce is now not only required to take a lead in protecting citizens’ health, but it also must provide the evidence base needed for linking public health information with clinical services and activities; offer targeted, scalable public health interventions; and support clinical services in a way that affects populations at large,” notes Guest Editor Fátima Coronado, MD, MPH, Deputy Associate Director for Science, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA. “This supplement is both timely and important because it reviews some of the critical challenges faced by the public health workforce, discusses selected changes under way, and highlights data-driven research to advance the field of public health services and systems research.”
This groundbreaking supplement, The Public Health Workforce, includes 22 articles from more than 30 institutions, agencies, foundations and public companies and covers two major areas: public health workforce capacity building and public health workforce size and composition.
Key topics in the Supplement include:
How to clearly define the public health workforce challenges using cause-and-effect diagrams and a concise roadmap.
Use of Massive Open Online Courses (MOOCs) by the School of Public Health at Harvard and concerns about retention of the knowledge gained using that method of instruction.
How the CDC conducts workforce development within its own organization.
Do students who receive adequate training in Public Health and Community Medicine tend to practice in areas with physician shortages?
How do we count public health workers? In the first study since 2000, 50% of all public health workers are employed at the local level, with 30% and 20% at the state and federal levels, respectively.
How can we define public health workers properly? A taxonomy has been developed which is a necessary step to continuously monitor the size and composition of the workforce to ensure sufficient capacity to deliver essential public health services.
Data show that part-time public health workers are a low percentage of the total workforce and the percentage has decreased over the last 5 years.
Despite relatively uncompetitive pay, local health departments experience lower rates of employee turnover than state health agencies and lower rates than state and local government in general.
How can we align public health workforce competencies with population health improvement goals?
How the Public Health Accreditation Board (PHAB) developed the standards and measures to encourage health departments to strengthen the current public health workforce and strategically develop the workforce of tomorrow.
Do Internal Medicine Residency Programs develop public health competencies?
How a training program for racial and ethnic minorities for careers in public health sciences has resulted in 60% of the students entering public health careers.
Will epidemiology education change rapidly enough to keep up with trends in communications and computing?
How the growth of cities, “Big Data,” and cognitive computing will change the public health workforce.
Building a Culture of Health – How the public health workforce will not only provide medical care but will help to establish a Culture of Health.
Nursing as a critical driver of the Culture of Health.
Guest Editors Dr. Coronado and Denise Koo, MD, MPH, Office of Public Health Scientific Services, CDC, Atlanta, GA, and Kristine Gebbie, DrPH, RN, Faculty of Health Sciences, Flinders University, Adelaide, South Australia, write that “we are buoyed by the increased efforts to meet workforce challenges and the valuable contribution of researchers and practitioners to strengthen the public health workforce. Efforts to strengthen the public health workforce should be a continuing priority involving well-planned, evidence based, and coordinated actions from decision makers undaunted by the mission of transforming public health and improving the population’s health while facing the complex landscape of the 21st century.”
***The article may be available for free or low cost at your local public, academic, or hospital/medical center library. Call ahead and ask for a reference librarian.
s fear of the Ebola virus escalates, Eric Topol thinks that we’re missing an important weapon. And you just need to reach into your pocket to find it. “Most communicable diseases can be diagnosed with a smartphone,” he says. “Rather than putting people into quarantine for three weeks – how about seeing if they harbour it in their blood?” A quicker response could also help prevent mistakes, such as the patient in Dallas who was sent home from hospital with a high fever, only to later die from the infection.
It’s a provocative claim, but Topol is not shy about calling for a revolution in the way we deal with Ebola – or any other health issue for that matter. A professor of genomics at the Scripps Research Institute in California, his last book heralded “the creative destruction of medicine” through new technology. Smartphones are already helping to do away with many of the least pleasant aspects of sickness – including the long hospital visits and agonising wait for treatment. An easier way to diagnose Ebola is just one example of these sweeping changes.
SAN DIEGO – When parents take a sick or injured child to the doctor or emergency room, they often expect tests to be done and treatments given. So if the physician sends them on their way with the reassurance that their child will get better in a few days, they might ask: “Shouldn’t you do a CT scan?” or “Can you prescribe an antibiotic?”
What families — and even doctors — may not understand is that many medical interventions done “just to be safe” not only are unnecessary and costly but they also can harm patients, said Alan R. Schroeder, MD, FAAP, who will present a plenary session at the American Academy of Pediatrics (AAP) National Conference & Exhibition. Titled “Safely Doing Less: A Solution to the Epidemic of Overuse in Healthcare,” the session will be held from 11:30-11:50 a.m. PDT Monday, Oct. 13 in Ballroom 20 of the San Diego Convention Center.
Dr. Schroeder, chief of pediatric inpatient services and medical director of the pediatric intensive care unit at Santa Clara Valley Medical Center in San Jose, Calif., will discuss some of the reasons why doctors provide unnecessary care (i.e., barriers to safely doing less), including pressure from parents and a fear of missing something.
“We all have cases where we’re haunted by something bad happening to a patient. Those tend to be cases where we missed something,” he said. “We tend to react by doing more and overtreating similar patients.”
He also will give examples of where overuse commonly occurs in pediatrics, such as performing a CT scan on a child with a minor head injury, and the negative consequences.
“You may find a tiny bleed or a tiny skull fracture, and once you’ve found that you’re compelled to act on it. And generally acting on it means at a minimum admitting the child to an intensive care unit for observation even if the child looks perfectly fine,” Dr. Schroeder said. “The term for that is overdiagnosis. You detect an abnormality that will never cause harm.”
Finally, he will suggest ways to minimize overtesting and overtreatment, highlighting the Choosing Wisely campaign. More than 60 medical societies including the AAP have joined the initiative and have identified more than 250 tests and procedures that are considered overused or inappropriate in their fields.
“I’ve devoted much of my research to identify areas in inpatient pediatrics where we can safely do less — which therapies that we are doing now are unnecessary or overkill,” Dr. Schroeder said.
The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit http://www.aap.org.
From the 10 October 2014 posting by Roy Benaroch, MD
This week’s posts have all been about infections, new and old—infections newly found, and infections sneaking back. On the one hand, the media is agog with news of Ebola and the mysterious paralysis virus; on the other hand, threats that are far more likely to kill us are being largely ignored.
One infection is on the verge of sneaking back, which is a shame. We had it beaten, and now we’re allowing it to gain a foothold. We’ve got a great way to eradicate measles, but fear and misinformation have led to pro-disease, anti-vaccine sentiment, especially among those white, elite, and wealthy. As we’ve seen, we’re all in this together—so those anti-vaccine enclaves are going to affect all of us.
Measles, itself, is just about the most contagious disease out there.
English: This is the skin of a patient after 3 days of measles infection; treated at the New York – Presbyterian Hospital. Prior to widespread immunization, measles was common in childhood, with more than 90% of infants and children infected by age 12. Recently, fewer than 1,000 measles cases have been reported annually since 1993. 日本語: 麻疹患者の発疹. 中文: 感染了痲疹的皮膚. Українська: Як кір поражає шкіру. עברית: פריחה על עורו של חולה חצבת. (Photo credit: Wikipedia)
he results of a four-year international study of 2060 cardiac arrest cases across 15 hospitals published and available now on ScienceDirect. The study concludes:
The themes relating to the experience of death appear far broader than what has been understood so far, or what has been described as so called near-death experiences.
In some cases of cardiac arrest, memories of visual awareness compatible with so called out-of-body experiences may correspond with actual events.
A higher proportion of people may have vivid death experiences, but do not recall them due to the effects of brain injury or sedative drugs on memory circuits.
Widely used yet scientifically imprecise terms such as near-death and out-of-body experiences may not be sufficient to describe the actual experience of death. Future studies should focus on cardiac arrest, which is biologically synonymous with death, rather than ill-defined medical states sometimes referred to as ‘near-death’.
The recalled experience surrounding death merits a genuine investigation without prejudice.
Recollections in relation to death, so-called out-of-body experiences (OBEs) or near-death experiences (NDEs), are an often spoken about phenomenon which have frequently been considered hallucinatory or illusory in nature; however, objective studies on these experiences are limited.
In 2008, a large-scale study involving 2060 patients from 15 hospitals in the United Kingdom, United States and Austria was launched. The AWARE (AWAreness during REsuscitation) study, sponsored by the University of Southampton in the UK, examined the broad range of mental experiences in relation to death. Researchers also tested the validity of conscious experiences using objective markers for the first time in a large study to determine whether claims of awareness compatible with out-of-body experiences correspond with real or hallucinatory events.
Results of the study have been published in the journal Resuscitation and are now available online on ScienceDirect.
Dr Sam Parnia, Assistant Professor of Critical Care Medicine and Director of Resuscitation Research at The State University of New York at Stony Brook, USA, and the study’s lead author, explained: “Contrary to perception, death is not a specific moment but a potentially reversible process that occurs after any severe illness or accident causes the heart, lungs and brain to cease functioning. If attempts are made to reverse this process, it is referred to as ‘cardiac arrest'; however, if these attempts do not succeed it is called ‘death’. In this study we wanted to go beyond the emotionally charged yet poorly defined term of NDEs to explore objectively what happens when we die.”
Thirty-nine per cent of patients who survived cardiac arrest and were able to undergo structured interviews described a perception of awareness, but interestingly did not have any explicit recall of events.
“This suggests more people may have mental activity initially but then lose their memories after recovery, either due to the effects of brain injury or sedative drugs on memory recall”, explained Dr Parnia, who was an Honorary Research Fellow at the University of Southampton when he started the AWARE study.
Among those who reported a perception of awareness and completed further interviews, 46 per cent experienced a broad range of mental recollections in relation to death that were not compatible with the commonly used term of NDE’s. These included fearful and persecutory experiences. Only 9 per cent had experiences compatible with NDEs and 2 per cent exhibited full awareness compatible with OBE’s with explicit recall of ‘seeing’ and ‘hearing’ events.
One case was validated and timed using auditory stimuli during cardiac arrest. Dr Parnia concluded: “This is significant, since it has often been assumed that experiences in relation to death are likely hallucinations or illusions, occurring either before the heart stops or after the heart has been successfully restarted, but not an experience corresponding with ‘real’ events when the heart isn’t beating. In this case, consciousness and awareness appeared to occur during a three-minute period when there was no heartbeat. This is paradoxical, since the brain typically ceases functioning within 20-30 seconds of the heart stopping and doesn’t resume again until the heart has been restarted. Furthermore, the detailed recollections of visual awareness in this case were consistent with verified events.
“Thus, while it was not possible to absolutely prove the reality or meaning of patients’ experiences and claims of awareness, (due to the very low incidence (2 per cent) of explicit recall of visual awareness or so called OBE’s), it was impossible to disclaim them either and more work is needed in this area. Clearly, the recalled experience surrounding death now merits further genuine investigation without prejudice.”
Further studies are also needed to explore whether awareness (explicit or implicit) may lead to long term adverse psychological outcomes including post-traumatic stress disorder.
Dr Jerry Nolan, Editor-in-Chief of Resuscitation, stated: “The AWARE study researchers are to be congratulated on the completion of a fascinating study that will open the door to more extensive research into what happens when we die.”
[Full text of this article may be available at your local public, academic, or hospital library. Call ahead and ask for a reference librarian. Many academic and hospital libraries have at least some services for the public]
Canada is paying more than double for six commonly used generic drugs compared with other developed countries because of a “highly unusual” purchasing plan, according to a new study released Tuesday.
Researchers found that through a mix of negotiations with drug companies and calls for tender, countries such as New Zealand, the United Kingdom and Germany are paying less than Canada for generic medications that treat everything from high blood pressure to depression. It’s all thanks to a model the author of the study, Amir Attaran, calls “a uniquely Canadian stupidity.”
The model implemented by the provinces and territories (except for Quebec) in April 2013 simply sets the price for the six generic drugs at 18 per cent of the price of the brand-name versions. At the time, the premiers, under the auspices of the Council of the Federation, said the six drugs represented 20 per cent of publicly funded spending on generic drugs and that the new spending plan was expected to save up to $100 million.
“The Canadian approach of setting a single price ceiling for multiple medicines is highly unusual,” says the study. “All other countries studied here have preferred competition or negotiation to varying extents.”
n a new study, 12 out of 14 supplements marketed for weight loss were found to contain a stimulant that has not been studied for human use. This chemical, known as DMBA (1,3-dimethylbutylamine) is pharmacologically similar to DMAA, which was banned by the FDA in 2012 due to multiple adverse effects, including death. Furthermore, DMBA containing products may have synonymous names printed on the label, such as AMP Citrate and 4-amino-2-methylpentane citrate. Some brands are even trying to market this product as an herbal product derived from tea. Given this recent finding, it is important to steer our patients away from using these weight loss and athletic enhancement supplements until further investigation takes place. Are there any specific supplements that you would feel comfortable recommending for weight loss? How do you promote a healthy diet and lifestyle to your patients?
Global food trade has come a long way. Is it for the better or has it made survival, nutrition, diversity and safety better. There is a vast, complicated web of food systems throughout the globe. I think it is an essential topic that influences public health or vice versa. Consumers have a variety of fruits and vegetables at their fingertips due to even more complex trade agreements. We have become dependent on import/export of foods, that many of us have completely lost touch or are growing up not knowing where our foods come from and how it came to be in its form. It is what we eat. Be advised that a good portion of what I do write about (rusty) will pinpoint New Mexico. However, much of what I write is based on a perspective of think local, act global and I feel that foodshed research is essential to that kind of thinking. Below are some examples.
High Food Price Index Coincides with Civil Unrest: Surely people fight over this stuff as it posits a large portion of a nation’s wealth. There are numerous studies done by economists and Food and Agriculture Organization that negatively correlate a global hunger index and food price index and incidences of civil unrest. According to a Cornell University study, an analysis of Arab nation uprisings coincided with food index price increases. They did also acknowledge and control for other social justice and political issues, but it would be difficult to ignore the relationship between food and other issues in a country.
This could be for a number of reasons, and I believe that this has to do with balancing expenses and food being the highest expense. It is one of my biggest monthly expenses and has been getting much harder to budget into the household income. And I cook often and find myself scratching my head wondering why $20 doesn’t go as far as it used to, but at least that is all I do and that is a privilege-not the case across the globe. This reached a high in 2010 and the anger was very apparent in Egypt.
Food shed and Local Economies: There is a significant economic impact that the food industry has on local markets, such as small rural communities that can make or break job opportunities and small business entrepreneurships. In New Mexico 90% of agricultural products directly or indirectly related to the food industry are exported as reported in Dreaming New Mexico. The same goes for imported food. However, much of the imported food is not the same shape as when it was imported and has been transformed into a food product.
f you want to defend yourself against poison, eat yogurt.
That’s the – simplified – idea behind research published by experts in London.
A study led by scientists at Lawson Health Research Institute showed that probiotic yogurt can reduce the absorption of certain heavy metals and environmental toxins by as much as 78 per cent in pregnant women. They have said it’s the first clinical evidence that yogurt can cut the health risks of mercury and arsenic.
But don’t race to the grocery store just yet. This is a scientific study, so its results don’t suggest a miracle cure. Also, it was a specific type of yogurt, with specific bacteria, so it’s not so easy to find on the shelves.
“It’s not something you can take as a preventative measure,” Bisanz, the first author on the paper.
He warned that acute poisoning would mean different, more conventional treatments. But these findings about yogurt are exciting, the researchers said, and a “starting point” for further research about foodstuffs as a defence against environmental toxins. It could have a “massive” impact on the quality of life for many people, Bisanz added.
“When we try and get funding for this kind of stuff, it’s difficult because people think it’s farcical, or it’s too simple, or it’s Africa; it’s not here,” Reid said. “We kind of go out on a limb to say, ‘Let’s do the study and not worry so much about how to do it,’ but then you get the results back and you think, ‘This is cool’.”
Next up is more study into more strains of bacteria, the scientists said. Other types could block other toxins, and Bisanz is spearheading more research.
English: A graph of age-adjusted percent of adults who have used complementary and alternative medicine in 2002 in the United States according to the National Center for Complementary and Alternative Medicine. (Photo credit: Wikipedia)
Discussing alternative medicine choices for better health outcomes
In the field of medicine there has often been a divide between those who focus on modern medicine and those who prefer alternative practices. But pediatrician Sunita Vohra is a firm believer there should be room for both.
A new study from Vohra, a professor in the Faculty of Medicine & Dentistry’s Department of Pediatrics at the University of Alberta, and a pediatric physician for Clinical Pharmacology with Alberta Health Services, is giving insight into the use of alternative medicines by pediatric cardiac patients and how effective they are seen to be. “We wanted to know if the use of alternative therapies helped or not, and we wanted to know if it hurt them or not,” she says.
The study, published in the journal CMAJ Open, examined the use of alternative therapies such as multivitamins, minerals, chiropractic care and Aboriginal healing in 176 patients at the Stollery Children’s Hospital in Edmonton, Alberta, and the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa, Ontario.
It found 64 per cent of patients at the Stollery Children’s Hospital reported using complementary and alternative medicine products and practices, compared with just 36 per cent at CHEO. Of those patients, Vohra says most had no regrets about their choices.
English: Classification of complementary and alternative therapies Italiano: Classificazione di terapie complementari e alternative (Photo credit: Wikipedia)
“The vast majority felt that they had been helped by the complementary therapy that they took and it was extremely unusual for them to report that they felt an adverse event had occurred because of it.”
The study also found one third of patients and their families did not discuss the use of alternative medicines with their physicians. Vohra believes it shows that patients may be reluctant to discuss their choices if they’re not sure how it will be received by health care providers.
That decision could have important health consequences, says Vohra, who also serves as director of the Complementary and Alternative Research and Education (CARE) program at the University of Alberta, and that patients’ discussing alternative therapies with health professionals is vital in order for them to make informed choices.
“There may be some therapies that help children feel better, but there may be others that, unbeknownst to the family, cause interaction between a specific natural health product and a prescription medicine. In that setting, instead of helping the child get better, harm may actually be happening.”
Vohra stresses the need for open communication and says children’s hospitals in Canada need to do a better job of providing information to patients looking at other avenues to health.
“That communication is essential because the health-care providers and the parents—together we are a team. And everyone’s hope is for that child’s better health.”
Other highlights from the study:
Multi-vitamins were the most common complementary and alternative medicine products with 71 percent of patients using them, followed by vitamin C (22 per cent), calcium (13 per cent) and cold remedies (11.8 per cent)
The most common practices include massage (37.5 per cent), faith healing (25 per cent), chiropractic (20 per cent), aromatherapy (15 per cent) and Aboriginal healing (7.5 per cent)
Almost half (44 per cent) of patients used complementary and alternative medicine products along with conventional treatments. The study’s research was supported by funding from the Sick Kids Foundation and Alberta Innovates Health Solutions.
For benign ovarian surgery, conventional laparoscopy causes fewer complications, is less expensive, than robot-assisted surgery
NEW YORK, NY (October 8, 2014)—For benign gynecologic conditions, robot-assisted surgery involves more complications during surgery and may be significantly more expensive than conventional laparoscopic surgery, according to a study by researchers at Columbia University Medical Center (CUMC). The results were published online today in Obstetrics & Gynecology.
Robot-assisted surgery was first widely used for radical prostatectomy. For procedures such as prostatectomy, where there were previously no minimally invasive options, robot-assisted laparoscopy often offered a dramatic improvement. But in the two gynecologic surgeries looked at in this study—oophorectomy (removal of one or both ovaries) and cystectomy (removal of an ovarian cyst) —surgeons already had laparoscopic options. The rate of robot-assisted surgery increased from 3.5 percent in 2009 to 15.0 percent in 2012 for oophorectomy and from 2.4 percent in 2009 to 12.9 percent in 2012 for cystectomy.
The CUMC researchers analyzed data on conventional laparoscopic and robot-assisted procedures performed on 87,514 women for benign gynecologic conditions between 2009 and 2012. The procedures took place at 502 U.S. hospitals.
The study showed a small but statistically significant overall increase in intraoperative (during surgery) complications, mainly ureteral and bladder injuries, with the robot-assisted procedures—3.4 percent for robot-assisted oophorectomy vs. 2.1 percent for conventional laparoscopic oophorectomy; 2.0 percent for a robot-assisted cystectomy vs. 0.9 percent for a conventional laparoscopic cystectomy. It is possible that the rate of complications will decline as surgeons become more experienced in robotic technology.
“The findings raise questions about the potential utility of robotic-assisted surgery for ovarian cancer and suggest that further studies are needed prior to considering these procedures as a standard of care,” said co-author Jason Wright, MD, Sol Goldman Associate Professor of Gynecologic Oncology and chief, Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons.
The researchers also found robot-assisted procedures to be more expensive. The median total cost for robot-assisted oophorectomy was $7,426, while for conventional laparoscopic oophorectomy it was $4,922. The median total cost for robot-assisted cystectomy was $7,444; for conventional laparoscopic cystectomy it was $4,133.
“With the rapid rise in the cost of cancer care, we need to make sure that public policies encourage comparative studies prior to widespread dissemination of new technologies,” said another co-author, Dawn L. Hershman, MD, MS, associate professor of medicine at the College of Physicians and Surgeons, associate professor of epidemiology at Columbia’s Mailman School of Public Health, and leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia.
The paper is titled, “Comparative Effectiveness of Robotic-Assisted Compared to Laparoscopic Adnexal Surgery for Benign Gynecologic Disease.” The other authors are: Alessandra Kostolias, MD (CUMC), Cande V. Ananth, PhD, MPH (CUMC), William M. Burke, MD (CUMC), Ana I. Tergas, MD (CUMC), Eri Prendergast, MS (CUMC), Scott D. Ramsey, MD, PhD (Fred Hutchinson Cancer Research Center), and Alfred I. Neugut, MD, PhD (CUMC).
Dr. Wright (R01CA169121-01A1) and Dr. Hershman (R01 CA166084) are recipients of grants and Dr. Tergas is the recipient of a fellowship (R25 CA094061-11) from the National Cancer Institute.
The authors declare no financial or other conflicts of interest.
Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.
Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs. These associations persist after controlling for plausible confounding variables in longitudinal studies. This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors. Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco.
The latest edition of the Taking Stock report details pollutant releases and transfers across the region from 2005 through 2010, with an in-depth review of releases from the pulp and paper industry.
Montreal, 1 October 2014—The Commission for Environmental Cooperation (CEC) has released a comprehensive report on the changing face of industrial pollution in North America, covering the years 2005 through 2010. This is the first time an edition of the CEC’s Taking Stock series, which gathers data from pollutant release and transfer registers (PRTRs) in Canada, Mexico and the United States, has analyzed North American pollutant information over an extended timeframe.
This volume of Taking Stock documents pollutant releases and transfers reported over the six-year period by approximately 35,000 industrial facilities across the region. Key findings include:
Total reported amounts of pollutants increased by 14 percent (from over 4.83 billion kilograms in 2005 to more than 5.53 billion kilograms in 2010), driven by releases to land (108-percent increase) and off-site disposal (42-percent increase). These increases reflect the introduction of Canada’s more comprehensive reporting requirements on tailings and waste rock, as well as on total reduced sulfur (TRS), resulting in more complete reporting by the metal ore mining and oil and gas extraction sectors in Canada.
Most other types of releases and transfers declined over this period—including releases to air from electric utilities, mainly in the United States, which declined by 36 percent. Changes in regulations for fossil fuel–based power plants, along with facility closures, were the drivers of these decreases.
There was also a 38-percent decrease in releases to air of substances in four categories that have significant potential to cause harm to human health or the environment: known or suspected carcinogens, developmental or reproductive toxicants, persistent, bioaccumulative and toxic (PBT) substances, and metals.
By providing details at the country level, Taking Stock also highlights the gaps in the picture of North American industrial pollution that are created by differences in national PRTR reporting requirements and practices. For example:
Of the more than 500 pollutants reported across the region every year, only 60 are common to all three PRTRs.
Oil and gas extraction, a key sector tracked in Canada and that ranks among the top sectors for reported releases and transfers each year, is not subject to reporting in the United States. Mexican data show a low level of reporting by oil and gas extraction facilities.
Compared to the United States and Canada, Mexican data show wider fluctuations in reporting between 2005 and 2010, reflecting the fact that Mexico’s PRTR is relatively new.
“As a result of ongoing collaboration among the three countries’ PRTR programs and the CEC, we are now able to track industrial pollutant releases and transfers across North America and over time to identify tendencies, as well as important gaps, in reporting. By establishing linkages between PRTR data and facilities’ environmental sustainability efforts, Taking Stock supports the needs of the private sector, governments, citizens, and communities concerned with and affected by North American industrial pollution,” said Irasema Coronado, CEC Executive Director.
Decreases in pollutant releases from pulp and paper mills—a look at the driving factors
This year’s report also takes advantage of six years of North American PRTR data to examine releases reported by pulp and paper mills—which have consistently ranked among the top sectors for releases to air and water in North America. The data show that between 2005 and 2010, the sector’s releases to air decreased by 19 percent and releases to water by 6 percent. Taking Stock identifies the drivers of these decreases, through data analyses, a survey of mills, and information from industry representatives. Among the findings:
A key driver of the decreases seen over this period has been the shutdown of several facilities in Canada and the United States (the two countries with the most reporting from this sector).
Emissions typically associated with pulp and paper mills include volatile organic compounds (VOCs), methanol, hydrogen sulfide, phosphorous, and formaldehyde, among others. However, some of these pollutants are not subject to reporting in one or more of the three countries (e.g., methanol in Mexico), creating challenges when analyzing the pollution profiles of pulp and paper mills.
While factors such as new emissions regulations have played a role in the decline in releases over this period, the report also shows that facilities’ own environmental engagement, as well as customer demand for environmentally-friendly products, have had impacts—with mills adopting environmental management decisions that include pollution prevention and mitigation practices.
Explore North American PRTR data online
The data presented in the Taking Stock report can be searched using the CEC’s Taking Stock Onlinetool, which is updated annually with data from North America’s three PRTRs. It allows users to:
explore information on industrial pollutant releases and transfers;
generate reports in a variety of formats, including pie charts and spreadsheets;
create maps and view them using Google Earth; and
analyze PRTR data with respect to other information, such as locations of watersheds, rivers, lakes, and population centers, using geospatial data from the North American Environmental Atlas.
Keeps you informed about news in public health, upcoming meetings, and new public health online resources
Partners in Information Access for the Public Health Workforce is a collaboration of U.S. government agencies, public health organizations and health sciences libraries. This comprehensive collection of online public health resources includes the following topic pages. Each has links to news items; links to relevant agencies, associations, and subtopics; literature and reports; data tools and statistics; grants and funding; education and training; conferences and meetings; jobs and careers; and more
Anyone who operates a vehicle of any type—car, bus, train, plane, or boat—needs to know there are over-the-counter medicines that can make you drowsy and can affect your ability to drive and operate machinery safely.
Over-the-counter medicines are also known as OTC or nonprescription medicines. All these terms mean the same thing: medicines that you can buy without a prescription from a healthcare professional. Each OTC medicine has a Drug Facts label to guide you in your choices and to help keep you safe. OTC medicines are serious medicines and their risks can increase if you don’t choose them carefully and use them exactly as directed on the label.
According to Ali Mohamadi, M.D., a medical officer at FDA, “You can feel the effects some OTC medicines can have on your driving for a short time after you take them, or their effects can last for several hours. In some cases, a medicine can cause significant ‘hangover-like’ effects and affect your driving even the next day.” If you have not had enough sleep, taking medicine with a side effect that causes drowsiness can add to the sleepiness and fatigue you may already feel. Being drowsy behind the wheel is dangerous; it can impair your driving skills.
Choosing and Using Safely
You should read all the sections of the Drug Facts label before you use an OTC medicine. But, when you know you have to drive, it’s particularly important to take these simple steps:
First, read the “active ingredients” section and compare it to all the other medicines you are using. Make sure you are not taking more than one medicine with the same active ingredient. Then make sure the “purpose” and “uses” sections of the label match or fit the condition you are trying to treat.
Next, carefully read the entire “Warnings” section. Check whether the medicine should not be used with any condition you have, or whether you should ask a health care professional whether you can use it. See if there’s a warning that says when you shouldn’t use the medicine at all, or when you should stop using it.
The “When using this product” section will tell you how the medicine might make you feel, and will include warnings about drowsiness or impaired driving.
Look for such statements as “you may get drowsy,” “marked drowsiness will occur,” “Be careful when driving a motor vehicle or operating machinery” or “Do not drive a motor vehicle or operate machinery when using this product.”
Other information you might see in the label is how the medicine reacts when taken with other products like alcohol, sedatives or tranquilizers, and other effects the OTC medicine could have on you. When you see any of these statements and you’re going to drive or operate machinery, you may want to consider choosing another medicine for your problem this time. Look for an OTC medicine that treats your condition or problem but has an active ingredient or combination of active ingredients that don’t cause drowsiness or affect your ability to drive or operate machinery.
Talk to your healthcare professional if you need help finding another medicine to treat your condition or problem. Then, check the section on “directions” and follow them carefully.
Here are some of the most common OTC medicines that can cause drowsiness or impaired driving:
Antihistamines: These are medicines that are used to treat things like runny nose, sneezing, itching of the nose or throat, and itchy or watery eyes. Some antihistamines are marketed to relieve cough due to the common cold. Some are marketed to relieve occasional sleeplessness. Antihistamines also can be added to other active ingredients that relieve cough, reduce nasal congestion, or reduce pain and fever. Some antihistamines, such as diphenhydramine, the active ingredient in Benadryl, can make you feel drowsy, unfocused and slow to react.
Antidiarrheals: Some antidiarrheals, medicines that treat or control symptoms of diarrhea, can cause drowsiness and affect your driving. One of these is loperamide, the active ingredient in Imodium.
Anti-emetics: Anti-emetics, medicines that treat nausea, vomiting and dizziness associated with motion sickness, can cause drowsiness and impair driving as well.
“If you don’t read all your medicine labels and choose and use them carefully,” says Dr. Mohamadi, “you can risk your safety. If your driving is impaired, you could risk your safety, and the safety of your passengers and others.”
As the Green Bay Packers were walloping the Minnesota Vikings on Thursday Night Football last night, the NFL’s “A Crucial Catch Day” campaign for breast cancer – which “is focused on the importance of annual screenings, especially for women who are 40 and older” – was on display at the stadium. Banners similar to this one appeared in the stadium. Some players wore pink gloves or other pink paraphernalia. It was the first game of October, the first of many more pink pigskin promotions to come throughout this month.
But the Breast Cancer Action group, well known for its “Think Before You Pink” campaign, calls the NFL campaign “a distraction.” The group names the NFL as part of “a six-point take-down of pink ribbon cause marketing and the broader culture of “pink” which expands BCAction’s long-standing commitment to addressing exploitation, corporate profiteering and hypocrisy in breast cancer fundraising. The six points, according to Breast Cancer Action, are:
A comprehensive reference with helpful charts and personal stories. The guide covers major diseases, aging mental health, reproductive health, nutrition and alternative medicine. It also provices advice on common screening tests and immunizations you may need. (Previous item number: 107W)
Source: U.S. Department of Health and Human Services Released: 2008 Pages: 500
I’ve criticized them many times, so now it’s time to salute them.
And let’s hope the news release writers for BMJ journals continue this practice.
This week, in a news release about a paper in one of the journals published by the BMJ, the Journal of Epidemiology & Community Health, was this caveat:
“This is an observational study so no definitive conclusions can be drawn about cause and effect, and the researchers admit that some potentially important risk factors, such as family history of heart disease/stroke and genetic influences were not known.”
Such a statement of limitations has been missing many times in past news releases from/about BMJ journals.
I can’t see everything, so I may have missed other good examples in the past.
Here is the full text of the news release in question:
Good neighbours and friendly local community may curb heart attack risk
Might extend social support network which is also linked to lower cardiovascular disease risk, say researchers
[Perceived neighbourhood social cohesion and myocardial infarction Online First doi 10.1136/jech-2014-204009]
Having good neighbours and feeling connected to others in the local community may help to curb an individual’s heart attack risk, concludes research published online in the Journal of Epidemiology & Community Health.
Current evidence suggests that the characteristics of an area in which a person lives can negatively affect their cardiovascular health. This includes, for example, the density of fast food outlets; levels of violence, noise, and pollution; drug use; and building disrepair.
But few studies have looked at the potential health enhancing effects of positive local neighbourhood characteristics, such as perceived neighbourhood social cohesion, say the authors.
They therefore tracked the cardiovascular health of over 5000 US adults with no known heart problems over a period of four years, starting in 2006. Their average age was 70, and almost two thirds were women and married (62%).
All the study participants were taking part in the Health and Retirement Study, a nationally representative study of American adults over the age of 50, who are surveyed every two years.
In 2006 participants were asked to score on a validated seven point scale how much they felt part of their local neighbourhood; if they felt they had neighbours who would help them if they got into difficulty; whether they trusted most people in the area; and felt they were friendly.
Potentially influential factors, such as age, race, gender, income, marital status, educational attainment, outlook and attitude, social integration, mental health, lifestyle, weight, and underlying health issues, such as diabetes and high blood pressure, were all taken into account.
During the four year monitoring period, 148 of the 5276 participants (66 women and 82 men) had a heart attack.
Analysis of the data showed that each standard deviation increase in perceived neighbourhood social cohesion was associated with a 22% reduced risk of a heart attack. Put another way, on the seven-point scale, each unit increase in neighbourhood social cohesion was associated with a 17% reduced risk of heart attack.*
This association held true even after adjusting for relevant sociodemographic, behavioural, biological, and psychosocial factors, as well as individual-level social support.
The researchers say their findings echo those of other studies which have found a link between well integrated local neighbourhoods and lower stroke and heart disease risk.
This is an observational study so no definitive conclusions can be drawn about cause and effect, and the researchers admit that some potentially important risk factors, such as family history of heart disease/stroke and genetic influences were not known. But a strong social support network of friends and family has been linked to better health, so friendly neighbourhoods might be an extension of that, they say.
“Perceived neighbourhood social cohesion could be a type of social support that is available in the neighbourhood social environment outside the realm of family and friends,” they write.
And tight-knit local communities may help to reinforce and ‘incentivise’ certain types of cohesive behaviours and so exclude antisocial behaviours, they suggest.
“30 years ago, the elderly were not expected to be active at all – they were actually advised not to exercise as it was considered dangerous. Playing cards were seen as a more fitting activity. Today, we are all expected to live active, healthy lives until the day we die – in good health – at the age of 90. Old age has, in a sense, been cancelled, says PhD Aske Juul Lassen from University of Copenhagen’s Center for Healthy Aging.
Aske Juul Lassen has just defended his PhD thesis entitled Active Ageing and the Unmaking of Old Age for which he has conducted field work in two activity centres for the elderly in Greater Copenhagen and analysed WHO’s and EU’s official policy papers on active ageing.
“I compare the EU and WHO perceptions of ageing with the everyday activities I have observed among the elderly. The elderly do a lot of things, which I consider active ageing and which give them an enhanced quality of life, but they are also activities that would never be characterized as “healthy” by health authorities. The question is how we define “good ageing” and how we organise society for our ageing generations.”
Billiards and beer can also be active ageing
One of the everyday activities Aske Juul Lassen observed was billiards: In one of the activity centres for the elderly, in which he conducted field work, 10-15 men between the ages of 70 and 95 meet to play billiards four times a week.
“Playing billiards often comes with a certain life style – drinking beer and drams for instance – and I am quite sure this was not what WHO and EU meant when they formulated their active ageing policies. But billiards does constitute active ageing. Billiards is, first of all, an activity that these men thoroughly enjoy and that enhances their quality of life while immersing them in their local community and keeping them socially active. And billiards is, secondly, very suitable exercise for old people because the game varies naturally between periods of activity and passivity and this means that the men can keep playing for hours. Not very many old people can endure physical activity that lasts five hours, but billiards enables these men to spread their physical activity out through the day,” says Aske Juul Lassen.
“We therefore need a broader, more inclusive concept of healthy and active ageing that allows for the communities the elderly already take part in and that positively impact their everyday lives, quality of life, and general health. It must also allow for the fact that the elderly do not constitute a homogenous group of people: activities that for some seem insurmountable will be completely natural for others.”
According to Aske Juul Lassen, one of the positive side effects of the activities at the activity centres for the elderly is that the activities take their minds off illness; they do not focus as much on their ailments when they are engaged in billiards or some of the other activities that the centres have on offer.
$29 million awarded to expand NCATS’ collaborative Rare Diseases Clinical Research Network
Physician scientists at 22 consortia will collaborate with representatives of 98 patient advocacy groups to advance clinical research and investigate new treatments for patients with rare diseases. The collaborations are made possible through awards by the National Institutes of Health — totaling about $29 million in fiscal year 2014 funding — to expand the Rare Diseases Clinical Research Network (RDCRN), which is led by NIH’s National Center for Advancing Translational Sciences (NCATS).
There are several thousand rare diseases, of which only a few hundred have any treatments available. Combined, rare diseases affect an estimated 25 million Americans. Some obstacles to developing rare disease treatments include difficulties in diagnosis, widely dispersed patients and scientific experts, a perception of high risk, and a lack of data from natural history studies, which follow a group of people with a specific medical condition over time.
“NCATS seeks to tackle these challenges in an integrated way by working to identify common elements among rare diseases,” said NCATS Director Christopher P. Austin, M.D. “The RDCRN consortia provide a robust data source that enables scientists to better understand and share these commonalities, ultimately allowing us to accelerate the development of new approaches for diagnosing and treating rare diseases.”
Many patients with rare diseases often struggle to obtain an accurate diagnosis and find the right treatments. In numerous cases, RDCRN consortia have become centers of excellence for diagnosing and monitoring diseases that few clinicians see on a regular basis.
These latest awards establish six new RDCRN consortia:
Lead Institution/ Principal Investigator
Disease Areas of Study
Brittle Bone Disorders Consortium of the Rare Diseases Clinical Research Network
Baylor College of Medicine, Houston/ Brendan Lee, M.D., Ph.D.
Bone diseases (e.g., osteogenesis imperfecta)
Clinical Research in Amyotrophic Lateral Sclerosis (ALS) and Related Disorders for Therapeutic Development
University of Miami Miller School of Medicine/Michael Benatar, M.B.Ch.B., M.S., D.Phil.
“A major benefit of our method is that we can use it to calculate unreported cases and therefore the true scale of the epidemic,” asserts Stadler. Official patient figures only take into account those cases reported to the health authorities. The actual number of infected persons is generally significantly higher. Using the data made available to them, the ETH researchers were able to calculate an unreported case rate of 30% (i.e. patients of which blood samples were not taken). “However, this applies only to the situation analysed in Sierra Leone in May and June. We do not have any blood samples since June at all,” claims Stadler.
Virus family tree created
The researchers were also able to calculate the incubation period for Ebola (five days – this value is subject to significant uncertainty) and the infectious time. Patients can pass on the virus from 1.2 to 7 days after becoming infected.
In Rome, European experts publish a ‘common vision’ of priorities for marine research and action through 2020
Some 340 European scientists, policy-makers and other experts representing 143 organizations from 31 countries spoke with one voice today, publishing a common vision of today’s most pressing marine-related health and economic threats and opportunities.
In a declaration concluding a three day meeting in Rome, EurOcean 2014 participants also released an agreed, five-year roadmap to achieve expanded, more integrated and effective policy-oriented ocean scrutiny.
In addition to a rising tide of ocean-related threats to human health and economics, the conference statement points to major opportunities in such areas as marine biotechnology, offshore energy, and sustainable aquaculture to create much-needed jobs after one of the worst economic crises in recent history.
Making such “blue growth” sustainable, however, requires a greater investment in science —research to deliver knowledge, tools and advice on sustainable management of marine resources and a better understanding of ecosystems underpinning the maritime economy.
Demands on the seas for food, energy, raw materials and transport are steadily increasing, the statement notes. And while oceans “can provide solutions to many European and global policy challenges … (they) are neither inexhaustible nor immune to damage. In the context of rapid global change and human population growth, it is imperative to balance economic benefit with environmental protection and human wellbeing.”
“As a research community, it’s now time to reassess and reinvigorate our efforts to support these policy ambitions.”
Participants identified four high-level policy goals:
1. Valuing the ocean
Promoting a wider understanding of the importance of the seas and oceans in the everyday lives of European citizens.
2. Capitalizing on European leadership
Building on our strengths to reinforce Europe’s position as a global leader in marine science and technology
3. Advancing ocean knowledge
Building a much greater knowledge base through ocean observation and fundamental and applied research
4. Breaking scientific barriers
Addressing the complex challenges of blue growth and ocean sustainability by combining expertise and drawing from a full range of scientific disciplines.
I don’t usually reblog items with ads (esp with products as alcohol!).
However, the content seemed very informative.
On a personal note, think it is a crying shame so much money and time is spent on beauty treatments. Says a lot about our culture and how we perceive others, constant comparing ourselves with others, etc….
Beauty is pain, or so the saying goes. (In the case of bikini waxing, we wholeheartedly agree.) And, while all of the tweezing, dyeing, and primping can be challenging at times, here’s what it should never be: hazardous to our health.
Unfortunately, increasing evidence suggests that some beauty treatments may be associated with a host of ills, from antibiotic-resistant infections to respiratory problems. Whether you’re a woman who gets her hair chemically straightened or you’re a salon worker who handles those chemicals, it’s important to understand potential risks — and how to protect yourself.
Of course, the majority of beauty treatments are safe when performed by a licensed professional, and our goal isn’t to stoke fear or turn you off from some much deserved Me Time. But, wouldn’t you rather be informed? After all, nothing’s quite as attractive as a woman in the know.
Here, nine beauty treatments that have the potential to cause some harmful side effects — plus, expert advice on making sure you stay as healthy as you are pretty.
SAMHSA News Release Date: 9/4/2014 9:30 AM Report reveals the scope of substance use and mental illness affecting the nation Released in conjunction with the 25th anniversary of National Recovery Month
A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides insight into the nature and scope of substance use and mental illness issues affecting America. Today, 2013 national survey data as well as information on the efforts and resources being taken to address these problems is being released in conjunction with the 25th annual observance of National Recovery Month.
The report shows that 24.6 million Americans aged 12 or older were current (past month) illicit drug users – 9.4 percent of this age group.
Marijuana was by far the most commonly used illicit drug with approximately 19.8 million current users aged 12 and older.
In terms of other illicit drugs, the report indicates that among those aged 12 and older, there were 4.5 million current nonmedical users of prescription pain relievers (1.7 percent), 1.5 million current cocaine users (0.6 percent), 595,000 methamphetamine users (0.2 percent), and 289,000 current heroin users (0.1 percent). Although an estimated 22.7 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem, only 2.5 million persons received treatment at a specialty facility.
The SAMHSA report also shows that 34.6 million adults aged 18 or older (14.6 percent of the population aged 18 or older) received mental health treatment or counseling during the past 12 months. Nearly one in five American adults (18.5 percent), or 43.8 million adults, had a mental illness in 2013. Ten million adults (4.2 percent of the adult population) had a serious mental illness in the past year. Serious mental illness is defined as mental illness that resulted in serious functional impairment, which substantially interfered with, or limited, one or more major life activities.
Current information regarding consumer health, clinical trials, AIDS–related drug information, MeSH® pharmacological actions, PubMed® biomedical literature, and physical properties and structure is easily retrieved by searching a drug name. A varied selection of focused topics in medicine and drug–related information is also available from displayed subject headings.
First, the good news: A new National Center for Health Statistics data brief shows that Americans are living longer. Overall life expectancy rose by 0.1 percent from 2011 to 2012, to 78.8 years, and was highest for non-Hispanic whites and non-Hispanic blacks. Women can expect to live an average of 81.2 years, and men an average of 76.4 years, based on the new analysis.
Now the bad news – a new report released by the Office of the Inspector General in the Department of Health and Human Services found increased costs associated with critical access hospitals. Medicare beneficiaries paid nearly half of the costs for outpatient services at critical access hospitals – a higher percentage of the costs of coinsurance for services received at these facilities than they would have paid at hospitals using Outpatient Prospective Payment System rates.
Critical access hospitals (CAHs) ensure that rural Medicare beneficiaries have access to hospital services. Reimbursement is at 101 percent of their “reasonable costs,” rather than at the predetermined rates set by the Outpatient Prospective Payment System. Medicare beneficiaries who receive services at CAHs pay coinsurance amounts based on CAH charges; beneficiaries who receive services at acute care hospitals pay coinsurance amounts based on OPPS rates.
English: CORINTO, Nicaragua (July 6, 2009) Lt. Kendra Pennington and Sgt. Dustin Turvild check the vital signs of a patient in the post anesthetic care unit aboard the hospital ship USNS Comfort (T-AH 20). Comfort is supporting Continuing Promise 2009, a four-month humanitarian and civic assistance mission to Latin America and the Caribbean. (U.S. Army photo by Spc. Nashaunda Tilghman/Released) (Photo credit: Wikipedia)
The Society for Public Health Education (SOPHE) has announced the publication of Health Education & Behavior (HE&B) supplement devoted to the latest research and practice to promote healthy aging. All articles in the HE&B supplemental issue are provided through open access.
A recent study has found a disturbing exposure of the germ-killing chemical triclosan to the fetuses of pregnant women in Brooklyn.
Triclosan has been linked to reproductive and development issues in animal testing. It is often used as the active ingredient in antibacterial soaps and appears in more than 2,000 consumer products including toothpastes, body washes, school supplies and toys.
In the study, scientists tested 181 pregnant Brooklyn women, most of them black. Half tested positive for triclosan in their umbilical cord blood samples, signifying triclosan was being transferred to fetuses.
Scientists also discovered that 100 percent of the mothers contained triclosan in their urine, while 86 percent tested positive for another antibacterial chemical, triclocarban, said co-author Benny Pycke. The levels are higher than the national U.S. average and are also the first to present “body burden” data for the ways triclosan and triclocarban can remain in the body during…
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner. (For those wishing to see pictures of a 2009 Friends of Liberia service trip to this West African country, please visit www.fol.org. My photo album is included).
Do you have an informational question in the health/medical area?
Email me at firstname.lastname@example.org I will reply within 48 hours.
My professional work experience and education includes over 10 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news,
I subscribe to the following to glean entries for this blog
Krafty (Medical)Librarian,” a collection of writings from Michelle Kraft on items of interest to medical librarians. She tends to write on technology and medical libraries but she also writes about things in general on librarianship, medicine and health”
Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998″
Free Government Information, a “place for initiating dialogue and building consensus among the various players (libraries, government agencies, non-profit organizations, researchers, journalists, etc.) who have a stake in the preservation of and perpetual free access to government information”
Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”