Public Health
Withdrawal of Life Support Often an Imperfect Compromise
Intensive Care Unit (ICU) doctors seeking to balance the complex needs of their patients and the patients’ families may make an imperfect compromise, withdrawing life support systems over a prolonged period of time. This practice is much more common than previously believed, and is also surprisingly associated with higher satisfaction with care-at least among surviving family members.
“We found that sequential withdrawal of life support is not as rare a phenomenon as previously believed,” wrote J. Randall Curtis, M.D., M.P.H., section chief for pulmonary and critical care medicine at the Harborview Medical Center and the University of Washington, in Seattle. “It occurred in nearly half of the patients we studied.”
The findings will be published in the second issue for October of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. The study was funded by the National Institute of Nursing Research.
Regular exercise may reduce delirium risk
Participating in an activity, especially regular physical exercise, appears to protect hospitalized elderly patients from developing delirium, according to study findings published in the Journal of the American Geriatrics Society.
“Delirium is a common, life-threatening clinical syndrome that is preventable,” Dr. Frances M. Yang, of Harvard Medical School, Boston, and colleagues write. “Given its high prevalence and incidence and its association with poor outcomes, finding mechanisms to prevent delirium remains a high priority.”
The researchers looked for factors associated with delirium in 779 newly hospitalized patients. The patients were at least 70 years of age and were free of dementia at the beginning of the study.
Study Highlights Successful Physical Activity Programs for Older Adults
Yes, America, you can take scientific research and make it work in real-world, physical activity programs for aging Baby Boomers and senior citizens who may have health and activity challenges.
Researchers at the University of South Carolina’s Arnold School of Public Health, in collaboration with researchers at the Texas A&M Health Science Center School of Rural Public Health (HSC), recently looked at data from the Active for Life® program and found that physical activity programs developed and tested in research settings can be successfully implemented and diffused through community organizations.
Active for Life was established in 2003 at the HSC-School of Rural Public Health, with funding from the Robert Wood Johnson Foundation. The program goals were to learn how research-based programs need to be adapted for large-scale dissemination, understand factors that affect program adoption by community organizations, broaden the reach of programs, and understand what is needed at the community level to sustain programs. Active for Life specifically addressed physical activity among mature adults. The program used two lifestyle interventions, Active Choices, a telephone coaching program, and Active Living Every Day, a group-based program.
Condom ring-tone a hit in India
A ring-tone that sings “condom, condom, condom” has attracted over 270,000 downloads since its launch last month and has spread the message of safe sex to many more mobile phone users in India and abroad.
The innovative “Condom a Capella” ring-tone that has the word “condom” sung in many overlapping melodies is the work of an Indian duo, Rupert Fernandes and Vijay Prakash. The website http://www.condomcondom.org, where the ring-tone can be heard, has had over 2 million hits.
The campaign has been produced by the BBC World Service trust in India and aims to target the increasing number of India’s mobile phone users, presently estimated at over 250 million.
A stronger future for the elderly
Experts at The University of Nottingham are to investigate the effect of nutrients on muscle maintenance in the hope of determining better ways of keeping up our strength as we get old.
The researchers, based at the School of Graduate Entry Medicine and Health in Derby, want to know what sort of exercise we can take and what food we should eat to slow down the natural loss of skeletal muscle with ageing.
The team from the Department of Clinical Physiology, which has over 20 years experience in carrying out this type of metabolic study, need to recruit 16 healthy male volunteers in two specific age groups to help in it’s research.
McCain and Obama on same side in US war on cancer
If there is one war John McCain and Barack Obama agree on, it’s the one against cancer.
Thirty-seven years after President Richard Nixon launched the “war on cancer,” the two U.S. presidential candidates agree on a need to fight the disease that kills more than 560,000 Americans each year.
The close personal ties each candidate has to the disease ensures that cancer advocates will find support in the White House regardless who wins the Nov. 4 election.
McCain, the 72-year-old Republican presidential nominee, survived multiple skin cancers. Democratic nominee Barack Obama, 47, lost his grandfather to prostate cancer and watched his young mother die from ovarian cancer.
Want to live a long life? Run
People who want to live a long and healthy life might want to take up running.
A study published on Monday shows middle-aged members of a runner’s club were half as likely to die over a 20-year period as people who did not run.
Running reduced the risk not only of heart disease, but of cancer and neurological diseases such as Alzheimer’s, researchers at Stanford University in California found.
WHO publishes how-to guide on fighting AIDS
What is the best way to set up an AIDS testing clinic? Which are the best drugs to give to people infected with HIV? The World Health Organization released a one-stop guidebook on Tuesday to help low- and middle-income countries seeking to battle the pandemic.
It includes advice on distributing condoms, guidance on counseling and lists of the available tests for diagnosing HIV.
“This document responds to a long-standing country need,” WHO’s HIV/AIDS Department Director, Dr. Kevin De Cock, said in a statement.
Olympics-Doping: Russia denies “systematic” doping
The Russian team on Wednesday denied accusations of systematic doping among its athletes and questioned the timing of the announcements days before the Beijing Olympics that several of them had failed drugs tests.
Some of the country’s leading medal hopes, including track and field athletes, a cyclist and a race walker, have been expelled or suspended from the Games in the past week after failed tests and accusations of switching urine samples.
The head of Russia’s athletics federation on Wednesday said doping was “a sporting crime” and called for criminal charges against athletes who use banned performance enhancing drugs.
Surgical Errors Cost Nearly $1.5 Billion Each Year
Potentially preventable medical errors that occur during or after surgery may cost employers nearly $1.5 billion a year, according to new estimates by HHS’ Agency for Healthcare Research and Quality.
In a study published in the July 28 issue of the journal Health Services Research, AHRQ’s William E. Encinosa, Ph.D., and Fred J. Hellinger, P.D., found that insurers paid an additional $28,218 (52 percent more) and an additional $19,480 (48 percent more) for surgery patients who experienced acute respiratory failure or post-operative infections, respectively, compared with patients who did not experience either error.
The authors also found these additional costs for surgery patients who experienced the following medical errors compared with those who did not:
Current Stats Severely Underestimate Costs of Medical Errors
Medical errors drive hospital costs up and while many seek ways to reduce these mistakes, not all fully understand their financial effects.
A new review suggests that current statistics on medical mistakes might not be comprehensive because they do not factor in all inpatient costs or include readmissions and patient care for the 90 days following surgery.
“Many hospitals are struggling to survive financially,” said study co-author William Encinosa, Ph.D. “The point of our paper is that the cost savings from reducing medical errors are much larger than previously thought.”
UK watchdog urges doctors to cut antibiotics
British doctors should slash the number of times they prescribe antibiotics for respiratory tract infections because the drugs rarely help, the country’s drug cost watchdog said on Wednesday.
This means doctors in the state’s health system should not prescribe antibiotics for most cases of sore throats, colds, bronchitis or other types of respiratory infections, the National Institute for Health and Clinical Excellence, or NICE, said.
They should also delay writing such prescriptions and reassure people the drugs are not needed immediately and would make little difference because most respiratory infections are viral, the new guidelines said.
U of T discovers environmental factors linked to sex ratio of plants
Environmental factors can transform the ratio of females to males in plant populations according to new research out of the University of Toronto.
The study conducted by Ivana Stehlik, a lecturer, Jannice Friedman, a PhD candidate, and Spencer Barrett, a professor, involved a novel approach using genetic markers (known DNA sequences) to identify the sex of seeds. The team investigated six natural populations of the wind-pollinated herb Rumex nivalis in the Swiss Alps and mapped the distance between females and neighbouring males. They then measured the amount of pollen captured by female flowers and collected seeds from the plants when they were mature.
“The plant has strongly female-biased flowering sex ratios in these populations. We wanted to find out the mechanism causing the bias,” said Barrett. “We found that where there were more males surrounding females, females captured more pollen, matured more seed and produced more strongly female-biased offspring.”
Analysis of Quickly Stopped Rx Orders Provides New Tool for Reducing Medical Errors
By studying medication orders that are withdrawn (“discontinued”) by physicians within 45 minutes of their origination, researchers at The University of Pennsylvania School of Medicine have demonstrated a systematic and efficient method of identifying prescribing errors. The method, they say, has value to screen for medication errors and as a teaching tool for physicians and physicians-in-training. The report is published in the July/August 2008 issue of the Journal of the American Medical Informatics Association.
Dr. Ross Koppel and colleagues at Penn’s Department of Biostatistics and Epidemiology used a hospital’s computerized physician order entry (CPOE) system to track prescriptions that were discontinued within 45 minutes. They found the rate of errors among the quickly stopped orders was 66%. The Rx problem may have been detected by the ordering physician, another physician, a pharmacist, or a nurse, but the prescribing physician issues the stop order.
Firefighters threaten strike over weighty issue
British firefighters have threatened to go on strike after bosses fired a veteran Scottish colleague for being overweight.
Fire Brigades Union branch secretary Alan Paterson said that 22-year veteran Kevin Ogilvie should have been reassigned to other duties after he was found to be too heavy to fight fires. The union has decided to hold a ballot for strike action.
“Our members have taken action because they deem that sanction far too severe. The man hasn’t committed any crime,” Paterson told Reuters.
