Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] The Problem of Pain: When Best Medical Advice Doesn’t Equal Patient Satisfaction

From the 4 April 2014 post by Karen Sibert, MD at The Health Care Blog


The problem of pain, from the viewpoint of British novelist and theologian C. S. Lewis, is how to reconcile the reality of suffering with belief in a just and benevolent God.

The American physician’s problem with pain is less cosmic and more concrete. For physicians today in nearly every specialty, the problem of pain is how to treat it responsibly, stay on the good side of the Drug Enforcement Administration (DEA), and still score high marks in patient satisfaction surveys.

If a physician recommends conservative treatment measures for pain–such as ibuprofen and physical therapy–the patient may be unhappy with the treatment plan. If the physician prescribes controlled drugs too readily, he or she may come under fire for irresponsible prescription practices that addict patients to powerful pain medications such as Vicodin and OxyContin.

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May 3, 2014 Posted by | health care | , , , , , , , | Leave a comment

[Reblog] Fatal Error (in Health Care)

 

The VA Palo Alto Health Care System in Palo Al...

The VA Palo Alto Health Care System in Palo Alto, California. (Photo credit: Wikipedia)

From the 4 April 2014 post by Rob Lamberts, MD at The Health Care Blog

The janitor approached my office manager with a very worried expression.  ”Uh, Brenda…” he said, hesitantly.

“Yes?” she replied, wondering what janitorial emergency was looming in her near future.

“Uh…well…I was cleaning Dr. Lamberts’ office yesterday and I noticed on his computer….”  He cleared his throat nervously, “Uh…his computer had something on it.”

“Something on his computer? You mean on top of the computer, or on the screen?” she asked, growing more curious.

“On the screen.  It said something about an ‘illegal operation.’  I was worried that he had done something illegal and thought you should know,” he finished rapidly, seeming grateful that this huge weight lifted.

Relieved, Brenda laughed out loud, reassuring him that this “illegal operation” was not the kind of thing that would warrant police intervention.

Unfortunately for me, these “illegal operation” errors weren’t without consequence.  It turned out that our system had something wrong at its core, eventually causing our entire computer network to crash, giving us no access to patient records for several days.

The reality of computer errors is that the deeper the error is — the closer it is to the core of the operating system — the wider the consequences when it causes trouble.  That’s when the “blue screen of death” or (on a mac) the “beach ball of death” show up on our screens.  That’s when the “illegal operation” progresses to a “fatal error.”

The Fatal Error in Health Care 

Yeah, this makes me nervous too.

We have such an error in our health care system.  It’s absolutely central to nearly all care that is given, at the very heart of the operating system.  It’s a problem that increased access to care won’t fix, that repealing the SGR, or forestalling ICD-10 won’t help.

It’s a problem with something that is starts at the very beginning of health care itself.

The health care system is not about health.

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For any solution to have a real effect, this core problem must be addressed.  The basic incentive has to change from sickness to health.  Doctors need to be rewarded for preventing disease and treating it early. Rewards for unnecessary tests, procedures, and medications need to be minimized or eliminated.  This can only happen if it is financially beneficial to doctors for their patients to be healthy.

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May 3, 2014 Posted by | health care | , , | Leave a comment

[Press release] Regulating legal marijuana could be guided by lessons from alcohol and tobacco, study says

From the 24 April 2014 EurkAlert

 

 

As U.S. policymakers consider ways to ease prohibitions on marijuana, the public health approaches used to regulate alcohol and tobacco over the past century may provide valuable lessons, according to new RAND Corporation research.

Recent ballot initiatives that legalized marijuana in Colorado and Washington for recreational uses are unprecedented. The move raises important questions about how to best allow the production, sales and the use of marijuana while also working to reduce any related social ills.

A new study published online by the American Journal of Public Health outlines how regulations on alcohol and tobacco may provide guidance to policymakers concerned about the public health consequences of legalizing marijuana.

Among the issues outlined in the study are how to reduce youth access to marijuana, how to minimize drugged driving, how to curb dependence and addiction, how to restrict contaminants in marijuana products, and how to discourage the dual use of marijuana and alcohol, particularly in public settings.

“The lessons from the many decades of regulating alcohol and tobacco should offer some guidance to policymakers who are contemplating alternatives to marijuana prohibition and are interested in taking a public health approach,” said Beau Kilmer, co-director of the RAND Drug Policy Research center and a co-author of the paper. “Our goal here is to help policymakers understand the decisions they face, rather than debate whether legalization is good or bad.”

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The analysis details some of the questions policymakers must confront when consideringless-restrictive marijuana laws. Those questions include: Should vertical integration be allowed, or should there be separate licenses for growing, processing and selling marijuana? What rules are needed to make sure a marijuana product is safe? Should marijuana be sold in convenience stories or only in specialized venues? Should taxes be assessed per unit of weight, as a percent of the price or on some other basis, such as the amount of psychoactive ingredients in marijuana?

“Based on the national experience with alcohol and tobacco, it seems prudent from a public health perspective to open up the marijuana market slowly, with tight controls to test the waters and prevent commercialization too soon while still making it available to responsible adults,” said Rosalie Liccardo Pacula, co-director of the RAND Drug Policy Research Center and a co-author of the paper. “Of course, perspectives other than public health objectives might motivate policymakers to adopt different or fewer regulations. These are simply lessons learned from a public health perspective.”

The article discusses a variety of strategies used to control alcohol and tobacco that also may be appropriate for regulation of marijuana. Those include keeping prices artificially high to curb use, adopting a state-run monopoly on sales and distribution, limiting the types of products sold, restricting marketing efforts, and restricting consumption in public spaces.

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Support for the study was provided by the Robert Wood Johnson Foundation’s Public Health Law Research Program and RAND. Other authors of the report are Alexander C. Wagenaar of the University of Florida College of Medicine, Frank J. Chaloupka of the University of Illinois, Chicago, and Jonathan P. Caulkins of the Heinz School of Public Policy at Carnegie Mellon University.

Since 1989, the RAND Drug Policy Research Center has conducted research to help policymakers in the United States and throughout the world address issues involving alcohol and other drugs. In doing so, the center brings an objective and data-driven perspective to an often emotional and fractious policy arena.

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May 3, 2014 Posted by | Public Health | , , | Leave a comment

[Press release] Cannabis chemistry: How scientists test pot for potency and safety (video)

From the 22 April 2014 EurkAlert

WASHINGTON, April 22, 2014 — Marijuana is in the headlines as more and more states legalize it for medicinal use or decriminalize it entirely. In the American Chemical Society’s (ACS’) newest Reactions video, we explain the chemistry behind marijuana’s high, and investigate what scientists are doing to ensure that legalized weed won’t send users on a bad trip. The video is available at http://youtu.be/4ukdUDCE56c

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May 3, 2014 Posted by | Consumer Health, Medical and Health Research News | , , , | Leave a comment

[Web site review] WHO: Public Health and Environment

     WHO: Public Health and Environment
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http://www.who.int/phe/en/

The World Health Organization (WHO) has crafted this site that is dedicated to “public health, social and environmental determinants of health (PHE).” On the site, visitors can look over the WHO’s publications and news releases, along with multimedia features and event listings. Guests should start by browsing the Publications which contain timely reports on pharmaceuticals in drinking-water and children’s environmental health. The Health Topics area contains information about how WHO is working to reduce indoor air pollution, outdoor pollution, and chemical safety. The site also contains links to its overall global strategy via working papers and policy statements. [KMG]

 

 

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May 3, 2014 Posted by | Public Health | , , , , , | Leave a comment

[Press release] The Lancet: Reducing just 6 risk factors could prevent 37 million deaths from chronic diseases over 15 years

From the 2 May 2014 press release

Reducing or curbing just six modifiable risk factors—tobacco use, harmful alcohol use, salt intake, high blood pressure and blood sugar, and obesity—to globally-agreed target levels could prevent more than 37 million premature deaths over 15 years, from the four main non-communicable diseases (NCDs; cardiovascular diseases, chronic respiratory disease, cancers, and diabetes) according to new research published in The Lancet.

Worryingly, the findings indicate that not reaching these targets would result in 38.8 million deaths in 2025 from the four main NCDs, 10.5 million deaths more than the 28.3 million who died in 2010.

This is the first study to analyse the impact that reducing globally targeted risk factors will have on the UN’s 25×25 target to reduce premature deaths from NCDs by 25% relative to 2010 levels by 2025.

Using country-level data on deaths and risk factors and epidemiological models, Professor Majid Ezzati from Imperial College London, UK, and colleagues estimate the number of deaths that could be prevented between 2010 and 2025 by reducing the burden of each of the six risk factors to globally-agreed target levels—tobacco use (30% reduction and a more ambitious 50% reduction), alcohol use (10% reduction), salt intake (30% reduction), high blood pressure (25% reduction), and halting the rise in the prevalence of obesity and diabetes.

Overall, the findings suggest that meeting the targets for all six risk factors would reduce the risk of dying prematurely from the four main NCDs by 22% in men and 19% for women in 2025 compared to what they were in 2010. Worldwide, this improvement is equivalent to delaying or preventing at least 16 million deaths in people aged 30󈞲 years and 21 million in those aged 70 years or older over 15 years.

The authors predict that the largest benefits will come from reducing high blood pressure and tobacco use. They calculate that a more ambitious 50% reduction in prevalence of smoking by 2025, rather than the current target of 30%, would reduce the risk of dying prematurely by more than 24% in men and by 20% in women.

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May 3, 2014 Posted by | Consumer Health, Medical and Health Research News | , , , , | Leave a comment

   

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