December 10, 2014
How Long Can Ebola Live?Pitt researcher publishes article showing that the literature is lacking, receives NSF grant to conduct further study
PITTSBURGH—The Ebola virus travels from person to person through direct contact with infected body fluids. But how long can the virus survive on glass surfaces or countertops? How long can it live in wastewater when liquid wastes from a patient end up in the sewage system? In an article published Dec. 9 in the journal Environmental Science & Technology Letters, Kyle Bibby of the University of Pittsburgh reviews the latest research to find answers to these questions.
Heand his co-investigators didn’t find many answers.
“The World Health Organization has been saying you can put (human waste) in pit latrines or ordinary sanitary sewers and that the virus then dies,” says Bibby, assistant professor of civil and environmental engineering in Pitt’s Swanson School of Engineering. “But the literature lacks evidence that it does. They may be right, but the evidence isn’t there.”
Bibby and colleagues from Pitt and Drexel University explain that knowing how long the deadly pathogen survives on surfaces, in water, or in liquid droplets is critical to developing effective disinfection practices to prevent the spread of the disease. Currently, the World Health Organization guidelines recommend to hospitals and health clinics that liquid wastes from patients be flushed down the toilet or disposed of in a latrine. However, Ebola research labs that use patients’ liquid waste are supposed to disinfect the waste before it enters the sewage system. Bibby’s team set out to determine what research can and can’t tell us about these practices.
The researchers scoured scientific papers for data on how long the virus can live in the environment. They found a dearth of published studies on the matter. That means no one knows for sure whether the virus can survive on a surface and cause infection or how long it remains active in water, wastewater, or sludge. The team concluded that Ebola’s persistence outside the body needs more careful investigation.
To that end, Bibby recently won a $110,000 National Science Foundation grant to explore the issue. His team will identify surrogate viruses that are physiologically similar to Ebola and study their survival rates in water and wastewater. The findings of this study will inform water treatment and waste-handling procedures in a timely manner while research on the Ebola virus is still being conducted.
MyFitnessPal Works If You Use It | The Health Care Blog. (November 24, 2014)
You may have seen some news regarding a study MyFitnessPalrecently did with UCLA.
I wanted to take a minute to address this study, since we participated in it directly. We are excited that we got to work with some very smart people to answer a question we also wanted to know the answer to. We jumped at the opportunity to find out—is having your physician introduce you to the app and help you sign up enough to kickstart a health journey?
What we learned is that just introducing people to MyFitnessPal wasn’t enough. People have to be ready and willing to do the hard work.
The app itself does work—if you use it. Our own data and the data from the study show that the more you log on, the more you use the app, the more success you will see. Users that logged in the most lost the most weight. In fact, we already know that 88% of users who log for 7 days lose weight.
We make tools designed to make it as clear and simple as possible for you to see the path to achieving your fitness goals. We are not, however, making a magic bullet—because there is no magic bullet. Ultimately, you’re the one who has to do the work.
And my, how much work you guys have done.
- lost over 180 million pounds
- logged over 14.5 billion foods
- burned 364 billion calories
- supported each other with over 82 million status likes in the last year alone
- and much more!
The first thing I say when people talk to me about MyFitnessPal is that user success is our true North. We are relentlessly focused on user success. We believe that if you are succeeding at reaching your goals then we will succeed as a company. We’re going to keep working to make our app even more accessible, simple to use, and motivating so we can help even more people succeed.
Of course, it’s our job to make the app as engaging and easy to use as possible. It’s not exactly where we want to be, yet. But we’ll keep working hard to get there. To that end, we’ve made lots of updates since this study was done. From a product perspective, in the last year and a half we’ve:
- streamlined the logging experience
- made logging streaks more visible
- added more ways to get push notifications and reminders
- added insights to help you get more out of logging
- made a recipe tool that allows you to quickly log recipes from anywhere across the web
As long as you keep working on your goals, we’re going to work on better ways to help you get there.
Thanks for everything you do, making the MyFitnessPal community so amazing, and helping us toward our vision of making an even healthier world.
Mike Lee is the Founder and CEO of MyFitnessPal
From the 6 November 2014 post
As technology continually expands with each passing year so do the industries it affects. This year the world has been witness to everything from wearable technology like Fitbit Google Glass to 3D printing, both of which are prime examples of tech and healthcare melding.
The healthcare industry has been no stranger to advancements in technology. These medical marvels are changing the way people are impacted and thereby changing the face of the healthcare industry.
1. Mobile Apps
3. Google Glass
4. 3D Printing
6. Digestible Sensors
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……
From the 17 October 2014 BBC article
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.
From the October 2014 press release
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.
From the 14 October article
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.”
From the 10 October 2014 article
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?
For additional information, go to LiveScience.
From the 3 October 2014 post at HealthNewsReview
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:
Excerpt from an August 2014 post by the American Public Health Association
Ebola, the serious, often fatal disease spread by interaction with the blood or fluids of a symptomatic infected person, has been making headlines across the country. And for good reason: this is the largest Ebola outbreak in history. The public is asking questions and wondering if they’re at risk.
But the truth is, unless you live in West Africa, where the latest Ebola outbreak has been focused, or if you are a health worker whoworks with Ebola patients, you’re probably safe.
1. Antibiotic-resistant bacteria
2. Severe weather
Ebola virus and the dread factor
August 25 2014 item from Musings of an Academic Family Physician (and department chair) about this (dysfunctional) healthcare world and how to fix it
Forty-five slides on how to evaluate medical/health news articles.
By Gary Schwitzer, Publisher, HealthNewsReview.org at HealthNewsReview.org on Apr 01, 2014
The Dalai Lama, the Nobel Peace Prize winner and exiled spiritual leader of Buddhism in Tibet, discussed his admiration for scientists and made some interesting remarks about emotional health during a recent speech at the National Institutes of Health.
The Dalai Lama was effusive in his praise for scientists. He said (and we quote): ‘I deeply admire my scientific friends’ (end of quote). The Dalai Lama pinpointed the open minded of scientists and what he described as a healthy skepticism about evidence and hyperbole. He also emphasized the capacity of scientists from around the world to work together and ignore differences in geography, race, ethnicity, gender, religion, and social class.
The Dalai Lama noted these traits set scientists apart and provided an international, professional role model.
However, the Dalai Lama also said he found some scientists were unhappy despite their gifts and intelligence. He briefly discussed the lack of inner peace among scientists with a sense of humor rather than admonishment. The Dalai Lama’s infectious laugh and self-deprecating humor delighted many NIH staff members who packed an auditorium to hear him.
The Dalia Lama’s discussion about emotional inner peace led to broader remarks about the impact of maternal affection in the life long health of children. The Dalai Lama explained he was pleased that scientific evidence seemed consistent with his personal, long-standing observation of the vital role of maternal love and sincerity in the development of a child’s brain and emotional health.
Similarly, the Dalai Lama noted that he had long observed a perceived link between maternal affection, attention, and sincerity for their children and the development of life long compassion for others. He encouraged behavioral and other scientists to further assess the extent of this relationship.
The Dalai Lama also was moved by a series of drawings from young patients at NIH’s Children’s Inn and underscored his appreciation for the artists. Similarly, he praised a project he saw at NIH’s Clinical Center that seeks to restore the ability to walk for young persons with Cerebral Palsy.
In response to a question from NIH Director Francis Collins M.D., the Dalai Lama confessed he sometimes gets frustrated and irritated – and even occasionally loses his temper. For example, he explained he became angry once during an interview when a New York Times columnist asked him four times to describe his probable legacy. Although the Dalai Lama noted he believed he answered the question the first time, the story revealed even renowned spiritual leaders sometimes can get cross. It also deftly reminded the audience there always is room for improvement in how we manage our lives and work.
A hospital in Staffordshire is set to become the first in Europe where doctors consult with their patients via Skype
A hospital is set to become the first in Europe to tackle waiting times by getting overworked doctors to consult with their patients via Skype.
Managers at the University Hospital of North Staffordshire claim using the online video calling service could reduce outpatient appointments by up to 35 per cent.
They argue that using Skype will help free up consultants’ time and car parking spaces – while also helping patients who are unable to take time off work.
If approved, they would become the first UK hospital to use Skype to consult with patients.
The proposals, by Staffordshire’s biggest hospital, also include doctors treating patients via email consultations……..
“The key issue for doctors will be to recognise when this mode of consultation is not sufficient to properly assess the patient and address the problem, and to arrange a face-to-face consultation instead.”
As a Returned Peace Corps Volunteer, I am acutely aware of global health disparities. For example, for every American who receives a prosthetic or implant….I often wonder how many folks worldwide do without…
Millions of prosthetics, breast implants, and pacemakers now exist – so what happens to all these augmentations when their owners die or no longer need them? Frank Swain investigates.
Under the watchful eye of the prison guards at Metro Davidson County Detention Facility, half a dozen inmates in blue overalls are wrestling with prosthetic legs. They strip each one down into a collection of screws, bolts, connectors, feet and other components. The prison workshop is home to a collaboration with Standing With Hope, a US charity based in Nashville, Tennessee that recycles unwanted prosthetic limbs for the developing world. The disassembled legs will be shipped to Ghana, where locally trained clinicians will rebuild them to fit patients there.
These legs will get a second life, but other types of prosthetics and implants usually face a different destiny. What to do with augmented human parts when they are no longer needed – often due to the owner’s death – is an increasingly common issue. Modern medicine offers a litany of replacement parts, from whole limbs to metal hips, shoulders and joints. Then there are pacemakers and internal cardiac defibrillators (ICDs), as well as more common augmentations like dentures and silicone breast implants. What happens to these augmentations when someone dies?
Once removed, implants are typically discarded – both the European Union and the US, among others, have rules that forbid the reuse of implanted medical devices. However, there is a growing trend to recover them for use in the developing world.
From the 6 February 2014 ScienceDaily article
Summary:Despite the fact that heart disease is the leading cause of death for both men and women in the U.S., about three-quarters (74 percent) of Americans do not fear dying from it, according to a recent survey.
Despite the fact that heart disease is the leading cause of death for both men and women in the U.S., about three-quarters (74 percent) of Americans do not fear dying from it, according to a recent survey from Cleveland Clinic.
Conducted as part of its “Love Your Heart” consumer education campaign in celebration of Heart Month, the survey found that Americans are largely misinformed about heart disease prevention and symptoms, and almost a third (32 percent) of them are not taking any proactive steps to prevent it. Even among those Americans with a family history of the disease (39 percent), who are at a significantly higher risk, 26 percent do not take any preventative steps to protect their heart health, according to the survey.
Perhaps even more concerning is that the majority (70 percent) of Americans are unaware of all the symptoms of heart disease, even though two out of three (64 percent) have or know someone who has the disease. Only 30 percent of Americans correctly identified unusual fatigue, sleep disturbances and jaw pain as all being signs of heart disease — just a few of the symptoms that can manifest.
“Heart disease is the No. 1 killer of men and women in this country, so it’s disappointing to see that so many Americans are unaware of the severity of not taking action to prevent heart disease, or how exactly to do so,” said Steven Nissen, M.D., Chairman of Cardiovascular Medicine at Cleveland Clinic. “This is a disease that can largely be prevented and managed, but you have to be educated about how to do so and then incorporate prevention into your lifestyle.”
Many Americans believe the myth that fish oil can prevent heart disease.
Vitamins are viewed — mistakenly — as a key to heart disease prevention.
There is a lack of awareness about secret sodium sources.
Americans believe there is a heart disease gene.
There is no single way to prevent heart disease, given that every person is different,” Dr. Nissen added.
“Yet there are five things everyone should learn when it comes to their heart health because they can make an enormous difference and greatly improve your risk:
know your cholesterol,blood pressure, and body mass index numbers,
do not use tobacco,
and know your family history.
Taking these steps can help lead to a healthier heart and a longer, more vibrant life.”
Related articles (variety of views, for informational purposes only)
Taking a cue from Apple and Coca-Cola, pharmaceutical firms are humanizing their brands
This news release is available in French.
Montreal, February 4, 2014 — By 2018, it is estimated that the global pharmaceutical market will be worth more than $1.3 trillion USD. To corner their share of profits, established drug companies have to fight fierce competition from generic products, adhere to stringent government regulations and sway a consumer base that is better informed than ever before.
New research from Concordia University’s John Molson School of Business shows that Big Pharma has begun these efforts by embracing “brand personality,” a marketing strategy traditionally employed by consumer-focused companies like Apple, Coca-Cola and Harley-Davidson.
By imbuing their brands with human characteristics, pharmaceutical companies can boost sales by developing direct relationships with their consumers. The result: patients are more likely to ask their physician to prescribe specific brand-name medication.
“Brand personalities can transform products from being merely functional to having emotional value in the eyes of the consumer,” says marketing professor Lea Katsanis, a co-author of the study that recently appeared in the Journal of Consumer Marketing.
“Pharmaceutical companies give their brands personality traits by relying on physical attributes, practical functions, user imagery and usage contexts. As a result, brand names like Viagra, Lipitor and Prozac become shorthand for the drugs themselves.”
To carry out the study, Katsanis and co-author Erica Leonard, a recent graduate of Concordia’s Master of Science in Marketing program, used an online survey to poll a total of 483 U.S. respondents. They rated 15 well-known prescription medications based on 22 different personality traits, such as dependability, optimism, anxiousness and elegance. The study included blockbuster drugs from Big Pharma companies such as Pfizer, Eli Lilly and GlaxoSmithKline.
The results show that prescription drug brand personality, as perceived by consumers, has two distinct dimensions: competence and innovativeness. Consumers typically applied terms such as dependable, reliable, responsible, successful, stable, practical and solution-oriented” to branded drugs, thus showing a preference for overall competence. Words like unique, innovative and original related to the “innovativeness” of the drug in question.
“Our findings can help marketers better understand how competing brands are positioned and act accordingly to ensure their products remain distinctive. One way of achieving this could be to appropriately focus more on either the competence or innovativeness dimensions,” says Katsanis.
“From a consumer perspective, prescription drug brand personality may make health-related issues more approachable and less intimidating, facilitating physician-patient interactions by making patients more familiar with the medications used to treat what ails them.”###
- John Molson School of Business http://johnmolson.concordia.ca/
- Lea Katsanis http://johnmolson.concordia.ca/faculty-research/departments/marketing/2131-lea-katsanis
- Journal of Consumer Marketing http://www.emeraldinsight.com/products/journals/journals.htm?id=jcm
Senior advisor, media relations
University Communications Services
Phone: 514-848-2424, ext. 5068
Related articles (For informational purposes only!)
Saying No to “Know Your Numbers” campaigns4 COMMENTS
“Know Your Numbers” campaigns can serve a useful purpose.
But they can also be guilty of non-evidence-based fear-mongering. They can fuel obsessions with numbers that fully-informed people might just as soon not know anything about. There can be harm living our lives worrying about numbers, test results – making ourselves sick when we are, in fact, healthy.
Here’s a screenshot of just a tiny part of a Google search result of “Know Your Numbers” campaigns. The list goes on and on and on.
The most recent that I saw was in the January 2014 edition of Prevention magazine. It’s entitled, “Know Your Numbers: The 5 Health Stats You Should Know.”
While we acknowledge the prestige of the Cleveland Clinic and its chief wellness officer, we point out that there is a lot of debate in medical science circles about what is laid out in this Preventionmagazine piece. For example:
- The Eighth Joint National Committee (JNC 8) recently published evidence-based guidelines for managing high blood pressure in adults. They wrote:
“There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion”
So if 140/90 is where this group starts thinking about treatment, and if even the American Heart Association says normal is “less than 120/80,” what we have with an announcement that 115/75 is “ideal” is mission creep, medicalizing normal blood pressure, or disease-mongering. Where does this “ideal” come from? It may only be a few points of difference, but with a few points, thousands of Americans suddenly become “less than ideal”…or, as we often call them, patients. One minute they’re healthy. And then – voila – with a prestigious organization’s spokesman proclaiming a new “ideal” – they’re sick, abnormal, patients.
- Cholesterol. Hmmm. Let’s see what the Cleveland Clinic website says about LDL and HDL. The Clinic’s own website says the LDL goal value should be less than 130 for people who don’t have heart or blood vessel disease or high risk. And since a Prevention magazine article reaches a broad audience, that’s the crowd we’re talking about. And the Clinic website says HDL goal value should be greater than 45. So the Prevention magazine targets of LDL under 100 and HDL over 50 are again mission creep, medicalizing normal blood tests, or disease-mongering. Please note: we could (but won’t herein) write volumes about much broader questions about being obsessed over LDL or HDL numbers, which are surrogate markers that don’t tell people everything they need to know.
- This is the one that bugs me the most. The article lists C-reactive protein as one of the “5 health stats you should know.” What you should know is that the US Preventive Services Task Force does not share in that endorsement. The USPSTF states that “the current evidence is insufficient to assess the balance of benefits and harms of using the (the test) to screen asymptomatic men and women with no history of coronary heart disease (CHD) to prevent CHD events.” Even a brief look at other guidelines by other groups shows that the promotion of this test as a “stat you should know” is not as simple and uncomplicated as the Prevention magazine article makes it out to be.
Please note that almost exactly 2 years ago we wrote, “Cleveland Clinic’s Top 5 Tests for 2012 clash with many guidelines.” C-reactive protein was on that list as well.
And you may be interested in some of my past articles about “Know Your Numbers” campaigns:
On a personal note, my husband is very sensitive to e-cigarette vapors.
He finds he has to leave any room where they are being “smoked”.
E-cigarettes are becoming increasingly popular and widely available as the use of regular cigarettes drops. Recently, the Centers for Disease Control and Prevention (CDC) reported that e-cigarette use by children doubled from 2011 and 2012. The health effects of e-cigarettes have not been effectively studied and the ingredients have little or no regulation. Mayo Clinic’s Nicotine Dependence Center experts are available to discuss what people should know before trying e-cigarettes
Electronic cigarettes, often called e-cigarettes, are battery-operated devices that provide inhaled doses of a vaporized solution of either propylene glycol or vegetable glycerin along with liquid nicotine. An atomizer heats the solution into a vapor that can be inhaled. The process, referred to as “vaping,” creates a vapor cloud that resembles cigarette smoke. Some liquids contain flavoring, making them more appealing to users.
“As of right now, there is no long-term safety data showing the impact of repeated inhalation of propylene glycol or vegetable glycerin on lung tissue,” cautions Jon Ebbert, M.D., associate director at Mayo Clinic’s Nicotine Dependence Center. “There is some short-term data suggesting that e-cigarettes may cause airway irritation, but until we have long-term safety data, we are not recommending e-cigarettes for use among cigarette smokers to help people stop smoking.”
So, what is known about electronic cigarettes?
*Manufacturers claim that electronic cigarettes are a safe alternative to conventional cigarettes.
*The Food and Drug Administration (FDA) has questioned the safety of these products.
*FDA analysis of two popular brands found variable amounts of nicotine and traces of toxic chemicals, including known cancer-causing substances (carcinogens).
*The FDA has issued a warning about potential health risks associated with electronic cigarettes, but is not yet regulating their use or standards of manufacture.
“It’s an amazing thing to watch a new product like that just kind of appear. There’s no quality control,” says Richard Hurt, M.D., director of Mayo Clinic’s Nicotine Dependence Center. “Many of them are manufactured in China under no control conditions, so the story is yet to be completely told.”
- E-cigarette regulation debate heats up (wavy.com)
- Should e-cigs be treated like regular cigarettes? (utsandiego.com)
- Conn. Lawmaker To Propose Ban On E-Cigarettes In Public Places (newyork.cbslocal.com)
- Report Finds Too Many American Children Are Smoking Flavored Cigars (counselheal.com)
- Safer Cigarrettes (powerecigs.wordpress.com)
- Don’t smoke your e-cigarettes indoors, say London’s top restaurateurs (standard.co.uk)
- Cigarette alternatives may not be ‘safe’ tobacco (universityofcalifornia.edu)
- E-Cigarettes Now Being Used To Smoke Marijuana, Worrying Some Health Officials (medicaldaily.com)
- Council bureaucrats to ban “E-Cigarettes” in order to have a “clear policy” towards smoking. (visitscunthorpe.com)
Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
The extent of caregivers’ assistance to patients — and suggested strategies for physicians to assist caregivers — are detailed in an interesting commentary recently published in the Journal of the American Medical Association.
The commentary’s author (who is a professor at Harvard Medical School) explains about 42 million Americans are caregivers and they assist patients for an average of 20 hours a week. Muriel Gillick M.D. reports the majority of caregivers are middle-aged women caring for aging parents.
Dr. Gillick notes caregivers often assist patients with daily living activities, such as shopping, cooking, bathing, and dressing. However, Dr. Gillick writes (and we quote) “Nearly half of all caregivers report responsibility for complex medical tasks that often are the province of a professional nurse or trained technician’ (end of quote).
Dr. Gillick finds caregivers report they are responsible for clinical activities including: diet adherence, wound care, treating pressure ulcers, providing medications and intravenous fluids, as well as operating medical equipment.
Dr. Gillick notes the recipients of caregiving are likely to be seniors in the last stages of their life. In the year before death, Dr. Gillick explains only 17 percent of Americans are without a disability while about 22 percent have a persistent severe disability. She reports the largest groups of caregiver-dependent adults include seniors who are frail or have advanced dementia. Dr. Gillick notes about 28 percent of Americans are frail and 14 percent have advanced dementia in their last year of life.
Dr. Gillick adds patients who are frail or have dementia often cannot participate in the management of their care, which necessitates a caregiver’s involvement. Dr. Gillick writes (and we quote): ‘If (end of life) medical care is to be patient centered, reflecting the values (patients) no longer have the cognitive capacity to articulate, clinicians must rely on surrogates to guide them. Yet, few programs caring for patients with dementia (or frailty) regularly incorporate caregivers in every phase of care’ (end of quote).
To improve assistance to caregivers, Dr. Gillick suggests physicians need to better explain a patient’s underlying health condition as well as work with caregivers to prioritize a patient’s health care goals.
Dr. Gillick adds caregivers should be encouraged to provide input about a patient’s surroundings as well as more fully participate in health care planning in a partnership with attending physicians.
Dr. Gillick notes caregivers are especially helpful in creating a continuity of patient care within different settings. She writes (and we quote): ‘In the complex US health care system, in which patients are cared for in the home, the physician’s office, the hospital, and the skilled nursing facility, the most carefully thought-out plan of care will prove useless unless its details can be transmitted across sites’ (end of quote).
Dr. Gillick concludes physicians as well as health care organizations need to provide more educational support to help caregivers.
Meanwhile, MedlinePlus.gov’s caregivers health topic page provides comprehensive information about caregiving’s medical and emotional challenges. For example, a helpful website from the American Academy of Family Physicians (available in the ‘start here’ section) helps caregivers maintain their health and wellness.
A similar website that addresses overcoming caregiver burnout (from the American Heart Association) can be found in the ‘coping’ section of MedlinePlus.gov’s caregivers health topic page.
In addition, there are special sections loaded with tips to provide caregiving to seniors as well as women and children within MedlinePlus.gov’s caregivers health topic page.
MedlinePlus.gov’s caregivers health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about caregiving as they become available on MedlinePlus.gov.
To find MedlinePlus.gov’s caregivers health topic page, type ‘caregiver’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘caregivers (National Library of Medicine).’ MedlinePlus.gov additionally features health topic pages on Alzheimer’s caregivers, child care, and home care services.
It is helpful to see JAMA address some caregiving issues. Let’s hope other medical journals will help educate caregivers and encourage more physician-caregiver communication.
Before I go, this reminder… MedlinePlus.gov is authoritative. It’s free. We do not accept advertising …and is written to help you.
To find MedlinePlus.gov, just type in ‘MedlinePlus.gov’ in any web browser, such as Firefox, Safari, Netscape, Chrome or Explorer. To find Mobile MedlinePlus.gov, just type ‘Mobile MedlinePlus’ in the same web browsers.
We encourage you to use MedlinePlus and please recommend it to your friends. MedlinePlus is available in English and Spanish. Some medical information is available in 43 other languages.
Your comments about this or any of our podcasts are always welcome. We welcome suggestions about future topics too!
Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov
That’s NLMDirector (one word) @nlm.nih.gov
A written transcript of recent podcasts is available by typing ‘Director’s comments’ in the search box on MedlinePlus.gov’s home page.
The National Library of Medicine is one of 27 institutes and centers within the National Institutes of Health. The National Institutes of Health is part of the U.S. Department of Health and Human Services.
A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.
It was nice to be with you. I look forward to meeting you here next week.
[Reblog-commentary on medical journalism] This is nuts: news coverage stating that great Dads have smaller testicles
Remember…just because two factors occur together, it doesn’t mean one necessarily causes the other!
Here, just because an involved father has smaller testicles, it does not necessarily mean that smaller
testicles enable one to be a better father!
Thinking that desires to get quick fixes or quick answers often get in the way of the necessity to take time and analyze reports objectively!
OK, I am bragging. But I have a whole Web page (with links) on how to evaluate health/medical information.
This is the kind of news coverage about a study that results in science and journalism about science losing credibility. To get warmed up, check some of the headlines:
- Great dads have smaller testicles, study suggests – CBC
- Study: Choose Dads With Smaller ‘Nads – TIME
- Study: You may be a terrible dad because you have enormous testicles – Salon.com
Or see countless other silly headlines in a simple web search that will come up with probably more than 100 news stories.
It’s all based on a study published in the Proceedings of the National Academy of Sciences, “Testicular volume is inversely correlated with nurturing-related brain activity in human fathers.”
It doesn’t appear that Emory University, home of the authors, distorted the findings. This Emory story states:
“Men with smaller testes than others are more likely to be involved in hands-on care of their toddlers, finds a new study by anthropologists at Emory University. …
Smaller testicular volumes also correlate with more nurturing-related brain activity in fathers as they are looking at photos of their own children, the study shows.
Our data suggest that the biology of human males reflects a trade-off between investments in mating and parenting effort,” says Emory anthropologist James Rilling, whose lab conducted the research.
The goal of the research is to determine why some fathers invest more energy in parenting than others. “It’s an important question,” Rilling says, “because previous studies have shown that children with more involved fathers have better social, psychological and educational outcomes.” …
The study included 70 biological fathers who had a child between the ages of 1 and 2, and who were living with the child and its biological mother.
The mothers and fathers were interviewed separately about the father’s involvement in hands-on childcare, including tasks such as changing diapers, feeding and bathing a child, staying home to care for a sick child or taking the child to doctor visits.
The men’s testosterone levels were measured, and they underwent functional magnetic resonance imaging (fMRI) to measure brain activity as they viewed photos of their own child with happy, sad and neutral expressions, and similar photos of an unknown child and an unknown adult. Then, structural MRI was used to measure testicular volume.
The findings showed that both testosterone levels and testes size were inversely correlated with the amount of direct paternal caregiving reported by the parents in the study.”
The Emory blog post listed some of the study’s limitations:
“Although statistically significant, the correlation between testes size and caregiving was not perfect.
A key question raised by the study findings is the direction of casualty (sic: I’m sure they meant causality). “We’re assuming that testes size drives how involved the fathers are,” Rilling says, “but it could also be that when men become more involved as caregivers, their testes shrink. Environmental influences can change biology. We know, for instance, that testosterone levels go down when men become involved fathers.”
Another important question is whether childhood environment can affect testes size. “Some research has shown that boys who experience childhood stress shift their life strategies,” Rilling says. “Or perhaps fatherless boys react to the absence of their father by adopting a strategy emphasizing mating effort at the expense of parenting effort.”
While it could have been stated more clearly, that excerpt nails the huge leap from the assumptions of the study to any proof of cause-and-effect. It discussed correlation – not cause. In other words, it’s nuts to have news headlines like the ones I listed above.
There are countless ways to poke holes in the fMRI analysis of 70 men, but I’ll leave that to the experts.
The clamor for cutesy cleverness outpaced real scrutiny in most of the stories we’ve seen.
- A Discover blog: “So while it certainly takes balls to be a father, bigger is not necessarily better.”
- CNN.com: “It was published Monday in the Proceedings of the National Academy of Sciences, which goes by the acronym PNAS (Yes, that’s chuckle-worthy in this context, so go ahead and laugh). …When I learned of this study, I immediately feared what could happen if it gets taken out of context. Dystopian future headline: “Deadbeat Dads Blame it on Large Family Jewels!” Dystopian future advice mothers give to daughters before marriage: “But will he be a good father? Weigh the wedding tackle!”
- TIME.com: “Perhaps it’s time to stop obsessing over penis size, and start to think more about those underloved lads underneath. A new study has suggested that testicle size plays a role in whether or not a guy is an involved dad, but this is one time less is more: the smaller the family jewels, the better the family man.”
CNN.com quoted one of the study authors succinctly: “Rilling says the study is not about “good” or “bad” dads.”
So again, where did all of those headlines come from?
And didn’t we have a possibly pending war, the unfolding Affordable Care Act, even another Anthony Weiner story to cover today instead of all the attention given this?
ADDENDUM: This is even more nuts. Each day I work really hard but may reach only relatively small numbers of people with articles that I think are important to try to improve the public dialogue about health care. Today my traffic is through the roof, and it’s all because I had testicles or nuts in my headline. And that, at least temporarily, put me in a prominent position on Google Search. Nuts.
- Study: Smaller testicles, more-involved dads? (fox2now.com)
- Dads with smaller testicles are better fathers, study shows (medicalnewstoday.com)
Those of you of a certain age, remember this? (If not, or if you want to get all the details…here’s a good summary)
The new Samsung Galaxy Gear Smartwatch was just presented and based on its features it has the potential to replace medical pagers while smartphones could not make this step.
The new Samsung Galaxy Gear Smartwatch was just presented and based on its features it has the potential to replace medical pagers while smartphones could not make this step.
- Obviously, it works like a watch.
- It can record videos.
- Play music.
- Has a pedometer
- Make phone calls
- Has its own applications
- Weather, taking notes, sending messages and many more.
- Samsung To Include Enterprise Antivirus on Smartphones – CIO Today (newestgadgetsinfo.com)
- Samsung announces Galaxy Gear smartwatch at IFA 2013 (9to5google.com)
- Spec stand off: Samsung Galaxy Gear vs Sony SmartWatch 2 (techhive.com)
Not just for teachers!
Welcome to BioEd Online, the online educational resource for educators, students, and parents. BioEd Online utilizes state-of-the-art technology to give you instant access to reliable, cutting-edge information and educational tools for biology and related subjects. Our goal is to provide useful, accurate, and current information and materials that build upon and enhance the skills and knowledge of science educators. Developed under the guidance of our expert Editorial Board, BioEd Online offers the following high-quality resources.
- Streaming Video Presentations – View timely presentations given by thought leaders on education in biology and related subjects, classroom management, science standards, and other issues in education. Presentation topics include content reviews for prospective biology teachers, content updates for experienced teachers, research lab technique demonstrations, inquiry science, and assessment. In addition, BioEd Online offers helpful presentations for teachers in training as they prepare for the classroom experience.
- Slide Library – Customize exciting and relevant lesson plans and activities from hundreds of searchable slides developed by our Editorial Board and contributors. The slide library is updated regularly. Each slide is complete with talking points and references and can be downloaded into your own PowerPoint program for personal educational use.
- Editors’ News Picks – Stay current with science news selected by our Editorial Board. Check back each week for new science stories and related discussion questions to complement your ongoing science activities, and to stimulate an exchange of ideas in your classroom. All Editors’ Picks are maintained in our archive for easy access whenever you need them.
BioEd Online is regularly updated with pertinent new slides in the slide library, presentations on breakthrough research, reviews, and virtual workshops on educational approaches and materials. Stay current with the latest research from top educators in the country by bookmarking BioEd Online for later use!
Other resources of note
- A variety of free, interactive courses designed for science educators and other life-long learners seeking to increase their knowledge of key scientific subjects. Course offerings range from cutting edge genetics to topical environmental health content and the fascinating science of water. Materials are sorted by topic, making it easy locate the content most appropriate for you.
- BioEd Online’s library contains student storybooks, magazines, supplemental materials and other items integrated with teacher’s guides and lessons found on this website. Some items may be used as stand-alone reading and language arts activities.
Yoga can improve mood and mental wellbeing among prisoners, an Oxford University study suggests, and may also have an effect on impulsive behaviour.
The researchers found that prisoners after a ten-week yoga course reported improved mood, reduced stress and were better at a task related to behaviour control than those who continued in their normal prison routine.
‘We found that the group that did the yoga course showed an improvement in positive mood, a decrease in stress and greater accuracy in a computer test of impulsivity and attention,’ say Dr Amy Bilderbeck and Dr Miguel Farias, who led the study at the Departments of Experimental Psychology and Psychiatry at Oxford University. ‘The suggestion is that yoga is helpful for these prisoners.’
Dr Bilderbeck adds: ‘This was only a preliminary study, but nothing has been done like this before. Offering yoga sessions in prisons is cheap, much cheaper than other mental health interventions. If yoga has any effect on addressing mental health problems in prisons, it could save significant amounts of public money.’
If yoga is associated with improving behaviour control, as suggested by the results of the computer test, there may be implications for managing aggression, antisocial or problem behaviour in prisons and on return to society, the researchers note — though this is not measured in this initial study.
Dr Bilderbeck, who practices yoga herself, cautions: ‘We’re not saying that organising a weekly yoga session in a prison is going to suddenly turn prisons into calm and serene places, stop all aggression and reduce reoffending rates. We’re not saying that yoga will replace standard treatment of mental health conditions in prison. But what we do see are indications that this relatively cheap, simple option might have multiple benefits for prisoners’ wellbeing and possibly aid in managing the burden of mental health problems in prisons.’
Sam Settle, director of the Prison Phoenix Trust, says: ‘Almost half of adult prisoners return to prison within a year, having created more victims of crime, so finding ways to offset the damaging effects of prison life is essential for us as a society. This research confirms what prisoners have been consistently telling the Prison Phoenix Trust for 25 years: yoga and meditation help them feel better, make better decisions and develop the capacity to think before acting — all essential in leading positive, crime-free lives once back in the community.’
- Yoga Improves Mental Health Among Prisoners (medindia.net)
- Prisoners should do yoga as a cheap way of improving their behaviour, according to academics (telegraph.co.uk)
- Teaching prisoners yoga stops them bending rules, says study (oxfordmail.co.uk)
From the Science Daily report (July 17, 2013)
Physicians and patients who are wary of addiction to pain medication and opioids may soon have a healthier and more natural alternative.A Duke University study revealed that a derivative of DHA (docosahexaenoic acid), a main ingredient of over-the-counter fish oil supplements, can sooth and prevent neuropathic pain caused by injuries to the sensory system. The results appear online in the Annals of Neurology….…
Their findings revealed that NPD1=PD1 not only alleviated the pain, but also reduced nerve swelling following the injuries. Its analgesic effect stems from the compound’s ability to inhibit the production of cytokines and chemokines, which are small signaling molecules that attract inflammatory macrophages to the nerve cells. By preventing cytokine and chemokine production, the compound protected nerve cells from further damage. NPD1=PD1 also reduced neuron firing so the injured animals felt less pain.Ji believes that the new discovery has clinical potential. “Chronic pain resulting from major medical procedures such as amputation, chest and breast surgery is a serious problem,” he said. Current treatment options for neuropathic pain include gabapentin and various opioids, which may lead to addiction and destruction of the sensory nerves.
- New Remedy for Chronic Pain Uncovered (medindia.net)
- Uncovering a healthier remedy for chronic pain (eurekalert.org)
- Advances in Neuropathic PainDiagnosis, Mechanisms, and Treatment Recommendations. (zedie.wordpress.com)
- What is chronic pain? (dailylivingwithpain.com)
- Managing Horrible Pain with Narcotics (apluscaregiver.com)
“as Americans live longer, they are living longer with illness.”
“The top driver of disease is a bad diet.”
- Disease and death in America: A poor bill of health | The Economist (dralfoldman.com)
- Disease and death in America: A poor bill of health | The Economist (policyabcs.wordpress.com)
- America’s Health Report Card Shows Improvement Needed (voanews.com)
- Higher BMI Increases Risk Of Gallstones, Especially In Women (medicalnewstoday.com)
- United States losing ground to other countries in health outcomes (eurekalert.org)
- U.S. health “mediocre” compared to other wealthy countries (cbsnews.com)
- Embracing disease, not eradicating it. (watsonfor13.wordpress.com)
Originally posted on THE POLICY THINKSHOP "Think Together":
Health insurance coverage to help you fix decades of high cholesterol will probably not save your life. This is the problem that America faces as it is found to be sick because of health behaviors it does not want to change. We have the freedom to act very unhealthy and to get sick. How much will increasing insurance coverage really improve our health?
“THE Affordable Care Act, or Obamacare, faces an immediate problem. The deadline for its insurance expansion is January 1st, but each week brings some new obstacle. Even if Obamacare overcomes these, a long-term challenge will remain: the law may not improve Americans’ health. And that health is dismal, as illuminated in vivid new detail on July 10th.
Christopher Murray and his colleagues at the University of Washington have new research on which ailments plague Americans, and why. Dr Murray is due to present his findings at the…
View original 52 more words
High school years hard on adolescent health, with spikes in drinking, smoking and drug use: Canada study
Originally posted on National Post | Life:
High school may improve young people’s minds, but it does the opposite for their bodies.
A new study out of the University of Waterloo shows Canadian students in Grade 12 are in worse health than their younger high school peers.
[np_storybar title=”Alcohol ads targeting underage girls need to be reined in: Canadian Medical Association” link=”http://life.nationalpost.com/2013/06/10/alcohol-ads-targeting-underage-girls-need-to-be-reined-in-canadian-medical-association/”]
A medical journal is raising concerns about alcohol advertising, saying young girls are being influenced by the ads.
The editorial in this week’s issue of the Canadian Medical Association Journal says health warnings should be embedded in alcohol ads, so that young girls understand the risks of drinking.
The author, Dr. Ken Flegel, says parents should also model responsible alcohol consumption for their children.
The editorial says studies from the United States show that alcohol advertising aimed at young women is being viewed more commonly by young girls.
The studies also show that increased exposure…
View original 263 more words
Am wondering if murder, planning to murder, and domestic violence are brain disorders…
If so, or even probably so, this is a real wake up call for prison reform…
From the 23 April 2013 item at the National Institute of Mental Health
A rethink is needed in terms of how we view mental illness, stated National Institute of Mental Health Director Thomas Insel, M.D., in a recent TEDx talkat the California Institute of Technology (Caltech) in Pasadena.
Deaths from medical causes such as leukemia and heart disease have decreased over the past 30 years. The same cannot be said of the suicide rate, which has remained the same. A vast majority of suicides—90 percent—are related to mental illnesses such as depression and schizophrenia.
Insel believes part of the problem is that mental illness is referred to either as a mental or behavioral disorder. “We need to think of these as brain disorders,” he said, adding that for these brain disorders, behavior is the last thing to change.
Insel walked the audience through recent advances in neuroscience, including the Human Connectome, which indicates that mental illness may be more of a neuronal connection or circuit disorder. The earlier these circuits are identified, he said, the earlier preventive treatments could be used to save the lives of people with mental illnesses.
“If we waited for the ‘heart attack,’ we would be sacrificing 1.1 million lives every year in this country,” he said. “That is precisely what we do today when we decide that everyone with one of these brain disorders, brain circuit disorders, has a behavior disorder. We wait until the behavior emerges. That’s not early detection, that’s not early prevention.”
- Toward A New Understanding of Mental Illness (thesecretkeeper.net)
- A Break From Politics: Toward a new understanding of mental illness (freakoutnation.com)
- Once, people suffering from a mental illness were hidden … (jillsmentalhealthresources.wordpress.com)
- What Does It Really Mean for Me to Have a Mental Illness? (thedancingwriterblog.wordpress.com)
- Vaughan Bell: news from the borders of mental illness (guardian.co.uk)
- Mental Health Awareness Month (irishdragon7.wordpress.com)
- Medical Brain Disorders~The Benefits of Exercise (keepchoosingconsistency.com)
Please read the entire article, there are many factors that need to be “teased out” in future studies (as the author emphasizes).
A fascinating read, nonetheless.
It’s a common lament among parents: Kids are growing up too fast these days. Parents worry about their kids getting involved in all kinds of risky behavior, but they worry especially about their kids’ forays into sexual relationships. And research suggests that there may be cause for concern, as timing of sexual development can have significant immediate consequences for adolescents’ physical and mental health.
But what about long-term outcomes? How might early sexual initiation affect romantic relationships in adulthood?
Psychological scientist Paige Harden of the University of Texas at Austin wanted to investigate whether the timing of sexual initiation in adolescence might predict romantic outcomes — such as whether people get married or live with their partners, how many romantic partners they’ve had, and whether they’re satisfied with their relationship — later in adulthood…
- Young Porn Users Need Longer To Recover Their Mojo (psychologytoday.com)
- Fathers Matter When It Comes To Their Teenager’s Sexual Behavior (medicalnewstoday.com)
- Ontario slammed for outdated sex ed and mental health curriculum (metronews.ca)
- Does Your Child Have a Mental Health Disorder? (psychologytoday.com)
From the 19 July article at Digitial Medicine
Consumer mHealth is here. There has been a spurt of entrepreneurship in this field and some Indian phone/ mobile based start-ups have been launched over the past couple of years. Mainly, they have been services meant to connect healthcare consumers with doctors via phone (like Ask a Doctor from Vodafone, Mediphone by Religare technologies, Dial UR Doctor and Mera Doctor). Most of these tools are voice based and sometimes don’t even fit the rigid definitions of mHealth. Further, they are all healthcare professional specific and have pointedly ignored patients in any decision making process.
Not that all mHealth projects in India are in the private sector. The government of India has also been active in harnessing the reach of mobile phones in the country with some projects in Public health like in ensuring treatment compliance in DOTS Program and in healthcare reporting at grass roots level. …
..The latest mHealth project by the government of India looks to strike at the alleged root of costly medical care : the widely variable costs of branded drugs. The Indian government has taken the initiative to use simple messaging services (SMS) to educate the public on drug prices.
Here is how it works: Once the person sends a text message of the prescribed brand of drug to a particular number from his mobile, he will receive two to three options of the same medicine, along with the price differential. Say, a patient is prescribed a popular anti-infective like Augmentin (GlaxoSmithKline). He types in Augmentin and sends the SMS to the designated number. He would get a return SMS, possibly mentioning Moxikind CV (Mankind), which is substantially cheaper. But sources said that all responses would come with a caution: please consult the doctor before popping the alternative (pill).
- How mobile phones have changed Africa (cnn.com)
- Seven ways mobile phones have changed lives in Africa (textually.org)
- Revolutionising Medical Care With Mobiles (epiphanysearch.co.uk)
- The Investor’s View of Pharma’s Plunge Into Mobile Apps (medmeme.com)
This morning I stumbled upon LiveScience.com while perusing January’s Internet Reviews at College and Research Library News.
Live Science provide news in the areas of science, health, and technology for a general academic audience, especially undergraduates.It is a commercial site that is part of the TechMedia Network (which also includes TechNews Daily and Business News Daily). LiveScience content is often featured at partner sites including Yahoo and MSNBC.com. Most of the professional journalists on the editorial staff hold advanced degrees in technology or the sciences.
The site can be a big overwhelming at first with its images and video links, but there is wealth of information for the patient!
The features include:
- 11 subject areas in the bar at the top of the page – “Space,” “Animals,” “Health,” “Environment,” “Technology,” “History,” “Culture,” “Video,” Strange News,” “Images,” and “Topics.”
- “Top Stories” section typically presents five current news items along with a variety of rotating images.
- Images (containing considerable archives) with links to albums, infographics, and wallpapers
From the 6 January 2012 US Food and Drug Administration (FDA)
Stem cell therapies offer the potential to treat diseases or conditions for which few treatments exist.
Stem cells, sometimes called the body’s “master cells,” are the precursor cells that develop into blood, brain, bones and all of your organs. Their promise in medical treatments is that they have the potential to repair, restore, replace and regenerate cells that could then be used to treat many medical conditions and diseases.
But the Food and Drug Administration (FDA) is concerned that the hope that patients have for cures not yet available may leave them vulnerable to unscrupulous providers of stem cell treatments that are illegal and potentially harmful.
FDA cautions consumers to make sure that any stem cell treatment they are considering has been approved by FDA or is being studied under a clinical investigation that has been submitted to and allowed to proceed by FDA.
FDA has approved only one stem cell product [Flahiff’s emphasis], Hemacord, a cord blood-derived product manufactured by the New York Blood Center and used for specified indications in patients with disorders affecting the body’s blood-forming system.
Regulation of Stem Cells
FDA regulates stem cells in the U.S. to ensure that they are safe and effective for their intended use.
“Stem cells can come from many different sources and under the right conditions can give rise to many different cell types,” says Stephanie Simek, Ph.D., deputy director of FDA’s Office of Cellular, Tissue and Gene Therapies.
Stem cells that come from bone marrow or blood are routinely used in transplant procedures to treat patients with cancer and other disorders of the blood and immune system.
Umbilical cord blood is collected from a placenta with the birth mother’s consent. Cord blood cells are then isolated, processed, and frozen and stored in a cord blood bank for future use. Cord blood is regulated by FDA and cord blood banks must follow regulatory requirements.
But there are many other stem cell products, including other cord blood-derived products, that have been reviewed by FDA for use in investigational studies, says Simek. Investigational products undergo a thorough review process as the sponsor prepares to study the safety and effectiveness of the product in adequate and well-controlled human studies (clinical trials).
As part of this review, the sponsor must show how the product will be manufactured so that FDA can make certain that appropriate steps are being taken to help assure the product’s safety, purity and potency. FDA also requires that there be sufficient data generated from animal studies to aid in evaluating any potential risks associated with the use of these products.
Consumers need to be aware that at present–other than cord blood for certain specified indications–there are no approved stem cell products.
Advice for Consumers
- If you are considering stem cell treatment in the U.S., ask your physician if the necessary FDA approval has been obtained or if you will be part of an FDA-regulated clinical study. This also applies if the stem cells are your own. Even if the cells are yours, there are safety risks, including risks introduced when the cells are manipulated after removal.There is a potential safety risk when you put cells in an area where they are not performing the same biological function as they were when in their original location in the body,” says Simek. Cells in a different environment may multiply, form tumors, or may leave the site you put them in and migrate somewhere else.
- If you are considering having stem cell treatment in another country, learn all you can about regulations covering the products in that country. Exercise caution before undergoing treatment with a stem cell-based product in a country that—unlike the U.S.—may not require clinical studies designed to demonstrate that the product is safe and effective. FDA does not regulate stem cell treatments used in solely in countries other than the United States and typically has little information about foreign establishments or their stem cell products.
Thwarting a Stem Cell Scheme
In December, 2011, three men were arrested in the United States and charged with 15 counts of criminal activity related to manufacturing, selling and using stem cells without FDA sanction or approval.
According to the criminal indictment, one of the accused, a licensed midwife who operated a maternity care clinic in Texas, obtained umbilical cord blood from birth mothers, telling them it was for “research” purposes. Instead, the midwife sold the cord blood to a laboratory in Arizona which, in turn, sent the blood to a paid consultant at a university in South Carolina. The owner of the laboratory in Arizona was convicted in August 2011 of unlawfully introducing stem cells into interstate commerce. She faces up to 3 years in prison and a fine of up to $10,000.
The consultant, an assistant professor, used university facilities to manufacture stem cell products. He then sent the products back to the lab, which sold them to a man representing himself as a physician licensed in the U.S. The man then traveled to Mexico to perform unapproved stem cell procedures on people suffering from cancer, multiple sclerosis and other autoimmune diseases.
The three defendants allegedly received more than $1.5 million from patients seeking treatment for incurable diseases.
“Scammers like these offer false hope to people with incurable diseases in order to line their own pockets with money,” says Special Agent in Charge Patrick J. Holland of FDA’s Office of Criminal Investigations (OCI), Kansas City Field Office. “FDA will continue to aggressively pursue perpetrators who expose the American public to the dangers of unapproved stem cells and ensure that they are punished to the full extent of the law.”
FDA’s OCI worked the case with the Federal Bureau of Investigations and the Internal Revenue Service’s Criminal Investigations Division.
This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.
- Stem Cells (Medline Plus) has links to overviews, news items, specific conditions, research (including clinical trials and research news from reputable organizations), directories and organizations
- Stem Cell Information(US National Institutes for Health) includes links to
- FDA Warns About Stem Cell Claims – Information You Should Know (regcompliance.wordpress.com)
- Stem Cells: Worldwide Markets for Transplantation, Cord Blood Banking and Drug Development (prnewswire.com)
- American scientist arrested in stem-cell clinic sting (blogs.nature.com)
- FBI crackdown on unproven stem cell therapies (newscientist.com)
- FBI crackdown on unproven stem cell therapies (newscientist.com)
- 3 Arrested for Peddling Miracle Stem Cell Cure (foxnews.com)
- Stem Cell Fraud: A 60 Minutes investigation (cbsnews.com)
- Legislator says stem cells helped ” Times Record News (wingright.org)
- Flexible Adult Stem Cells, Right There In Your Eye (medicalnewstoday.com)
- What Is Autologous Stem Cell Transplantation? (everydayhealth.com)
- Video: Preview: Stem Cell Fraud (cbsnews.com)
- FDA Approves Cord Blood For Stem Cell Transplant (medicalnewstoday.com)
- The FDA, Politics and Journalistic Fraud: The Stem Cell Battle in America (erasetheneed.wordpress.com)
- Texas prepares to fight for stem cells (nature.com)
Evidence on cost savings and health benefits of nutritional intervention published in the Journal of the Academy of Nutrition and Dietetics
Philadelphia, PA — The Academy of Nutrition and Dietetics has prepared a request to submit to the Centers for Medicare and Medicaid Services (CMS) to expand coverage of medical nutrition therapy (MNT) for specific diseases, including hypertension, obesity, and cancer, as part of the CMS National Coverage Determination (NCD) Process. Most chronic health conditions can be controlled or treated with medical nutrition therapy, yet Medicare will only reimburse nutrition therapy services provided by a registered dietitian for individuals with diabetes and renal disease. “That’s just not enough if we want to improve the health of the nation and rein in escalating healthcare costs,” says Marsha Schofield, MS, RD, LD, the Academy’s Director of Nutrition Services Coverage.
The article is “The Academy of Nutrition and Dietetics National Coverage Determination Formal Request [Full Text of the article],” by Prashanthi Rao Raman, Esq, MPH, and Erica Gradwell, MS, RD, in the Journal of the Academy of Nutrition and Dietetics, Volume 112, Issue 1 (January 2012) published by Elsevier.
In an accompanying podcast Ms. Schofield, Ms. Blankenship, and Ms. Gradwell discuss the NCD process undertaken by the Academy and share insights about its potential impact on healthcare and the role of the registered dietitian. The podcast is available at http://andjrnl.org/content/podcast.
- The Academy of Nutrition and Dietetics advocates for expanded nutritional coverage under Medicare (medicalxpress.com)
- The Academy of Nutrition and Dietetics advocates for expanded nutritional coverage under Medicare (eurekalert.org)
- A Dietitian Reflects on the Recent Nutrition Conference (fooducate.com)
- The ADA Needs to Change More than just its Name (fooducate.com)
- Medicare Offers Medical Nutrition Therapy (mayorshealthline.wordpress.com)
Researchers have developed a bandage that stimulates and directs blood vessel growth on the surface of a wound. The bandage, called a “microvascular stamp,” contains living cells that deliver growth factors to damaged tissues in a defined pattern. After a week, the pattern of the stamp “is written in blood vessels,” the researchers report.
A paper describing the new approach will appear as the January 2012 cover article of the journal Advanced Materials.
“Any kind of tissue you want to rebuild, including bone, muscle or skin, is highly vascularized,” said University of Illinois chemical and biomolecular engineering professor Hyunjoon Kong, a co-principal investigator on the study with electrical and computer engineering professor Rashid Bashir. “But one of the big challenges in recreating vascular networks is how we can control the growth and spacing of new blood vessels.”
“The ability to pattern functional blood vessels at this scale in living tissue has not been demonstrated before,” Bashir said. “We can now write features in blood vessels.”
Other laboratories have embedded growth factors in materials applied to wounds in an effort to direct blood vessel growth. The new approach is the first to incorporate live cells in a stamp. These cells release growth factors in a more sustained, targeted manner than other methods, Kong said. …
- Team designs a bandage that spurs, guides blood vessel growth (eurekalert.org)
- Team designs a bandage that spurs, guides blood vessel growth (physorg.com)
- Hydrogel helps grow new scar-free skin over third degree burns (gizmag.com)
Whether you call it Health 2.0, Medicine 2.0, or e-Health 2.0, the Internet is changing medicine in ways that challenge the status quo. This article explores how a group of amateurs who call themselves “health hackers” and “citizen scientists” are trying to use the Internet to connect with other patients, run experiments, and conduct clinical trials on their own diseases.
Dr. Gunther Eysenbach states “Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.” One review examined 46 different definitions of Health 2.0, and Eysenbach’s definition does not emphasize a key component of the concept: amateurs can use these new Internet tools to do work that in the past was only done by professionals….
Charles Blanke, MD, Director of Gastrointestinal Oncology at the Oregon Cancer Institute summarizes the advantages and disadvantages of their patient-initiated approach:
This is powerful and compelling work! I remain incredibly impressed by the data-coordinating abilities of the Life Raft personnel. I see the major purpose of this sort of data as hypothesis generating. Unfortunately, it cannot be free of bias and thus cannot stand by itself, but it certainly can point investigators and the Company in the right direction and let us know what we need to be looking at more closely. Thus, its importance cannot be overstated….
,,,The tension between the traditional approach to medical research and patient-initiated research can only be resolved by cooperation and two-way communication between the two groups. The Mayo Clinic and PXE examples clearly show that both groups can benefit by meaningful and respectful partnership. The AIDS and ALS examples demonstrate that patients with few options and new Internet tools will continue to push the traditional research community to be open to new ideas, new approaches, and new possibilities. Gilles Frydman, founder of the Association of Cancer Online Resources, has stated, “Better-informed people are more willing to participate in the advancement of science. Those patients taking Gleevec do not consider themselves guinea pigs. They are recipients of experimental medicine.”…
- DocGreet Steadily Grows as the Leader in Health 2.0 and Medical Social Media (prweb.com)
- Connect with Project HealthDesign at Health 2.0 (projecthealthdesign.typepad.com)
- Reflections on the Medicine 2.0 conference at Stanford #med2 (medicineandtechnology.com)
- Health IT and Patient Safety: Building Safer Systems for Better Care (jflahiff.wordpress.com)
- During the Fifth Annual Health 2.0 Conference, Dr. James Mault of HealthyCircles will Showcase Innovative Technology that will Help Transform Health Care (prweb.com)
New approach supports families dealing with ‘normal diversity’ of gender identity and expression
How should parents respond when their four years old son insists on wearing girls’ clothes, or their daughter switches to using a male version of their name? These are the questions increasingly being asked of family therapist Jean Malpas who writes in Family Process about a new approach to support parents with gender nonconforming and transgender children.
Jean Malpas, the Director of the Gender and Family Project at the Ackerman Institute for the Family, explains how families of gender nonconforming and transgender children can benefit from a multi-dimensional approach to negotiating two understandings of gender: One being a traditional system of male or female which dominates mainstream society, which contrasts with a more flexible and fluid spectrum of gender being expressed by their children.
“Parents of gender nonconforming children often struggle with how to best protect their child from bullying and ostracism, while accepting and nurturing their child’s identity and expression.” said Jean Malpas. “This research shows how coaching, education, parent support group and family therapy can support everyone in the family in negotiating this dilemma.”
Jean Malpas’ clinical findings confirm that a normal diversity of gender expression exists among children and uses anonymous case studies to demonstrate the varied paths children take when developing their identity. Some nonconforming children will grow up to be transgender, others will eventually feel comfortable identifying with their biological sex, while others will continue to display gender nonconforming traits without requesting social or medical transition.
“Research on gender nonconformity also has implications for education policy,” said Malpas. “It is important that schools are aware and sensitive to the non-binary and non-biological aspects of gender, as it means gendered activities and segregation of students based on gender lines may no longer be appropriate if our children’s understanding of gender is expressed in more complex ways.”
Clinical approaches based on the non-pathologisation of gender diversity contrast with traditional psychiatric approaches, which have used cognitive-behavioral methods to extinguish atypical behaviours and reinforce traditional gender expression.
“Our clinical findings show that gender nonconformity in children is not a psychopathology but a normal display of diversity in gender expressions and identities,” concluded Malpas. “Providing multi-dimensional support to parents of gender nonconforming and transgender children allows them to accept and affirm their child’s identity while providing valuable protection at home, in school and out in the world.”
From the 22 November 2011 article
A computer system that can read scientific papers in a similar way to humans promises breakthroughs in cancer research, according to Cambridge scientists.
By Christopher Williams, Technology Correspondent
Called CRAB, the system is able to trawl through millions of peer-reviewed articles for clues to the causes of tumours. Already, it has uncovered a potential reason why some chemicals induce pancreatic cancer only in men.
CRAB is the latest implementation of a rapidly-emerging form of artificial intelligence called natural language processing, which is also used in the Siri personal assistant software in the iPhone 4S. It allows computers to read texts and derive meaning from them, despite their complexity and abiguities, as humans do.
The system will first be used to assess the risk that new chemicals could cause cancer.
“The first stage of any risk assessment is a literature review. It’s a major bottleneck,” said Dr Anna Korhonen of the University of Cambridge, who led the development of CRAB.
“There could be tens of thousands of articles for a single chemical. Performed manually, it’s expensive and, because of the rising number of publications, it’s becoming too challenging to manage,” she said.
- Computer that reads raises hope for cancer breakthroughs (news.bioscholar.com)
- Computer that can read promises cancer breakthroughs (telegraph.co.uk)
From the 19 November 2011 mobilehealth article
By: Chris Gullo
iTriage: One of the relatively few health apps that boasts millions of users.
Some 26 percent of US adults used their mobile phones to access health information in the past year, according to a new Cybercitizen Health study by Manhattan Research. The number has nearly doubled from the 12 percent reported in 2010.
According to the study, looking up health information or reading health-related news remains the most popular mobile health activity. The survey polled 8,745 adults online and via phone during the third quarter of 2011.
Another interesting metric: 8 percent of consumers used prescription drug refill or reminder services on their mobile phones, up from 3 percent in 2011.
“Growth in mobile health is impressive, but still in line with our and several health stakeholders’ expectations,” stated Monique Levy, VP of Research at Manhattan Research in a press release. “The interesting part is when, how and from where mobile phones are being used. Getting these details will impact the success of mobile investments in 2011 and 2012.”
While not specifically mobile-related, worth noting that the report found some 56 million US consumers had accessed their medical information on an electronic health record (EHR) system maintained by their physician, with an additional 41 million expressing interest in doing so in the future.
- Call for mobile phone health warnings despite ‘inconclusive’ evidence (telegraph.co.uk)
- Emerging market for mobile health products (trendsspotting.com)
- New Report: The Internet Has More Influence Over Consumer Health Actions than Traditional DTC Channels (prweb.com)
- Who are the Top 11 Mobile Health Innovators in 2011? (prweb.com)
- Oncologists Visit Pharma Sites and Post Professional Content Online More Frequently than the Average Physician (prweb.com)
- Mobile health has huge potential in the Middle East, industry study says (thenextweb.com)
The art of medicine, the most important part of medicine, involves several components:
- Caring for patients, showing honest concern and compassion
- Giving patient’s time, not rushing in and out of the exam clinic room, being patient with them, having a great bedside manner
- Using the evidence based medicine algorithms as a guideline, as we apply them to each and every patient we see. Understanding that every patient is an individual who has individual circumstances that affect their lives
- Helping every patient to acquire the best outcome they can for themselves by working with them, educating them, coming up with a mutually agreed upon plan of action
Evidence based medicine does not teach us how to apply them to the patients we see, only the art of medicine does that. [Flahiff’s emphasis] Much unlike evidence based medicine we don’t learn the art of medicine in a classroom. We learn the art of medicine by seeing patients, one by one, year after year. As new research comes out and the evidence based medicine algorithms change, hopefully we have refined our art of medicine skills to such a fine point that we have attained the stature of a wise mentor….
- Evidence based medicine removes a physician’s autonomy (kevinmd.com)
- Compassionate care is a crucial component of care (kevinmd.com)
- Using Social Media For Practicing Evidence Based Medicine (drneel.wordpress.com)
- Substitutes for evidence based (and science based) medicine (doctorrw.blogspot.com)
- 5 tips to evaluate medical websites (kevinmd.com)
Excerpt from Is preventive health really preventative?
I am not necessarily disputing any evidence or recommendations that have been introduced, but the false sense that we have the ability to “prevent” an illness or disease from happening in the first place. This can lead to unrealistic expectations and negative backlash. Yes, we may be able to detect an early cancer prior to it’s spread or immunize individuals against certain infectious diseases. But prevent altogether? Sadly, I don’t think so – in fact, I know so.
That is why I am using the term pro-active health rather than prevention. There are actions that individuals can take to lower their risks from disease and illness and I believe that is taking a pro-active part in one’s health. We do this in the hopes of longevity, wellness, disease avoidance and early detection (if illness is identified).
- Study finds shifting disease burden following universal Hib vaccination (eurekalert.org)
- Maintaining a Flu-free Family (education.com)
- Arctic Lab Expansion Provides Early Detection of Infectious Disease and Bioterrorism (indiancountrytodaymedianetwork.com)
- NBA players not immune to serious illness from norovirus (eurekalert.org)
- Vaccine Could Prevent Mononucleosis And Cancers Linked To Epstein-Barr Virus (medicalnewstoday.com)
- Tuberculosis detector would ferret out disease by scent (theglobeandmail.com)
A few years ago, Father Tomasz Trafny was brainstorming with other Vatican officials about what technologies would shape society, and how the Vatican could have an impact. And it hit them: Adult stem cells, which hold the promise of curing the most difficult diseases, are the technology to watch.
“They have not only strong potentiality,” says Trafny, “but also they can change our vision of human being[s], and we want to be part of the discussion.”
In a rare move, the Vatican decided to collaborate with a private company, NeoStem, to do education and eventually research. The Catholic Church is investing $1 million to form a joint foundation, and next week, scientists from around the world will meet at the Vatican to discuss the future of stem cell therapies.
Trafny, who is chairman of the science and faith department at the Pontifical Council for Culture, says they believe there’s a superior alternative to embryonic stem cell research.
“We don’t see reason why we have to sacrifice human lives, while we have technologies that do the same without harming anyone and without raising any moral difficulties,” he says.
“What people don’t realize is for 30 years, we’ve been using adult stem cells,” says Robin Smith, the chief executive officer of NeoStem. “That’s called a bone marrow transplant. Diseases like leukemia, lymphoma, multiple myeloma, anemia — this is all part of the standard of care.”..
- Should I Save Stem Cells Now for Future Treatment? (everydayhealth.com)
- How Can I Mobilize Stem Cells for Myeloma? (everydayhealth.com)
- Stem cell hope for elderly patients (telegraph.co.uk)
- Scientists Clone Embryonic Stem Cells from Individuals To Aid In Cure For Diabetes as Reported by DiabeticLive.com (prweb.com)
- Pharmaceutically Speaking, Part 11: Outlawed Stem Cell Patents (tacticalip.com)
Like you, I receive a whole bunch of breaking medical news every day, from television, radio, newspapers, direct mail, email alerts, press releases, and multiple websites.
Is any of it worth my time, my attention, or even a change in my knowledge, attitude, behavior, or medical practice? How can I quickly tell?
A medical journalist from Minnesota named Gary Schwitzer recognized this problem many years ago and created a service that will help all of us, in and outside of medicine and medical journalism, to spend our time and direct our attention wisely.
Schwitzer’s service is called Health News Review and widely publicizes a set of criteria to apply to medical stories reported in the popular media.
While his approach cannot prevent fraud, liars, and fabricators, a careful use of his criteria can help the reader filter out what is likely to be real junk, or even worse, harmful.
Medical Reporting Rules to live (or die) by:
- How available is the treatment/test/product/procedure to the likely reader/viewer/listener at the time of the report?
- What is the cost or charge for the test/treatment/product or procedure mentioned in the story? To the patient? The insurance company? The government?
- Is there evidence of disease mongering in the story? Does it oversell or exaggerate a condition or create unwarranted fear?
- Does the story seem to grasp and convey the quality of the evidence supporting the basis for the study?
- Does the article provide appropriate balance about harms that might be caused by the treatment/test/product/procedure that constitutes the basis for the story?
- Does the story establish the true novelty of the approach? Much that is purported to be new, really is not.
- How does the story frame the relative quantitative value of a new treatment, test, product, or procedure and place the benefits in context with others, especially dealing with absolute and relative values?
- Did the author and editor of the medical news story rely solely or largely on a press release or did they also seek and quote other sources?
- Was there an independent source and were any possible conflicts of interests of sources disclosed in the article?
- Does the story provide the context of treatment/test/product/procedure other than those that are being reported?
- Essential tips for medical journalists (kevinmd.com)
- Comparison of good and bad reporting on leukemia gene therapy (boingboing.net)
- Health Literacy Month Is Back – Tell a Friend (engagingthepatient.com)
The American Board of Medical Specialties (ABMS) has begun publicly reporting whether specialists are meeting the continuing education requirements necessary for maintaining board certification.
Seven member boards — the American Boards of Dermatology, Family Medicine, Nuclear Medicine, Otolaryngology, Physical Medicine and Rehabilitation, Plastic Surgery, and Surgery — are the first to report via the ABMS.
Information is available on physicians certified by those boards at www.certificationmatters.org.
Search results show the name of the certifying board, and a “yes” or “no” as to whether the physician is meeting the maintenance of certification (MOC) requirements for that board. A link will take the searcher to the certifying board’s explanation of its specific requirements.
The remaining 17 member specialty boards will make maintenance of certification status available through the ABMS by August 2012.
- Clinical Informatics Wins Official Recognition (informationweek.com)
- Physicians Oppose Increased Certification Requirements (bsurgmed.wordpress.com)
- National Medical Society Advises How to Choose a Pain Specialist (prweb.com)
- Universal board certification can solve the Doctor Nurse controversy (kevinmd.com)
There are multiple costs to non-compliance, including financial, both personal and societal, and physical-emotional. When patients fail to comply with treatment protocols, fail to get prescribed tests, or fail to stop destructive behaviors, there is a societal cost.
Today, I want to address the physical and emotional costs of non-compliance. I just read a brilliant article by Roxanne Sukol, MD. Dr. Sukol’s article discussed the fact that diabetes starts 10 years prior to your doctor making a diagnosis and, if addressed early, often can be avoided. In her article, Dr. Sukol states, “I like my patient vertical. Not horizontal.” Most doctors have favorite sayings. My favorite is, “May you be so blessed as to never know what disease you prevented.” I’ll add Dr. Sukol’s to my favorite list.
Another one of my favorite sayings is “There is no such thing as pre-diabetes. Pre-diabetes is like being pre-pregnant.” …
(readers responses here, along with responses to other cases)
…..When it came to medical decisions, almost all the respondents wanted their doctors to offer choices and consider their opinions. But a majority of patients — two out of three — also preferred that their doctors make the final decisions regarding their medical care.
“The data says decisively that most patients don’t want to make these decisions on their own” said Dr. Farr A. Curlin, an associate professor of medicine at the University of Chicago and one of the authors of the study.
The challenges appear to arise not when the medical choices are obvious, but when the best option for a patient is uncertain. In these situations, when doctors pass the burden of decision-making to a patient or family, it can exacerbate an already stressful situation. “If a physician with all of his or her clinical experience is feeling that much uncertainty,” Dr. Curlin said, “imagine what kind of serious anxiety and confusion the patient and family may be feeling.”
Patients and their families also often don’t realize that their doctors may be grappling with their own set of worries. …
- Talking about faith increases hospital patients’ overall satisfaction (esciencenews.com)
- Do Patients Have the Toughest Job in Medicine? (well.blogs.nytimes.com)
- What this doctor learned when he was a patient (kevinmd.com)
- Why doctors should stop wearing ties (kevinmd.com)
- Patients want and need to take a greater role in their medical care (kevinmd.com)