What happens when doctors give patients more power?
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When patients are given the responsibility for medical decisions, they may be less willing to try a potentially risky treatment, a study published Monday suggests.
The study, of 216 patients with arthritis and other similar diseases, tested patients’ willingness to take a hypothetical “new” drug that carried important benefits but also a small risk of serious side effects.
It turned out that patients were less willing to try the drug when they were given complete power over the decision than when a doctor advised them to take the medication.
Osteoarthritis increases aggregate health care expenditures by $186 billion annually
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Osteoarthritis (OA), a highly prevalent disease, raised aggregate annual medical care expenditures in the U.S. by $185.5 billion according to researchers from Stony Brook University. Insurers footed $149.4 billion of the total medical spend and out-of-pocket (OOP) expenditures were $36.1 billion (2007 dollars). Results of the cost analysis study are published in the December issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.
The Centers for Disease Control and Prevention (CDC) estimate 27 million Americans suffer from OA with more women than men affected by the disease. Forecasts indicate that by the year 2030, 25% of the adult U.S. population, or nearly 67 million people, will have physician-diagnosed arthritis. OA is a major debilitating disease causing gradual loss of cartilage, primarily affecting the knees, hips, hands, feet, and spine.
John Rizzo, Ph.D., and colleagues used data from the 1996-2005 Medical Expenditure Panel Survey (MEPS) to determine the overall annual expected medical care expenditures for OA in the U.S. The sample included 84,647 women and 70,590 men aged 18 years and older who had health insurance. Expenditures for physician, hospital, and outpatient services, as well expenditures for drugs, diagnostic testing, and related medical services were included. Healthcare expenses were expressed in 2007 dollars using the Medical Care Component of the Consumer Price Index.
Parent mentors can improve the asthmatic care of minority children, UT Southwestern researchers find
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UT Southwestern Medical Center researchers have found that informed adults can help families stave off complications associated with asthma. The findings, available online and in the December issue of Pediatrics, suggest that interventions by parent mentors – caregivers of asthmatic children who have received specialized topical training – can effectively reduce wheezing, asthma attacks, emergency room visits and missed adult workdays.
“Childhood asthma disproportionately affects urban minority children,” said Dr. Glenn Flores, professor of pediatrics and the study’s lead author. “Asthma mortality among African-American children alone is almost five times higher than for white children. The goal for this study was to determine whether parent mentors would be more effective than traditional asthma care in improving asthma outcomes for minority children.”
Mentors in the study were parents or caregivers who got professional training from a nurse asthma specialist and a program coordinator on a variety of asthma-related topics. Training sessions and a manual were used to present examples of improving asthmatic care and focused on the importance of consistent treatment. The manual also discussed keeping asthmatic children out of hospitals, asthma medications and triggers, and cultural issues that can affect care.
Herbal supplements may raise blood lead levels
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Some herbal supplements may boost the levels of lead in the blood of women, new research shows.
Among 12,807 men and women age 20 and older, Dr. Catherine Buettner, at Beth Israel Deaconess Medical Center in Boston, Massachusetts, and colleagues found blood lead levels about 10 percent higher in women, but not men, who used specific herbal supplements.
When they examined herbal supplement use among women of reproductive age (age 16 to 45 years old), “the relationship with lead levels was even stronger, with lead levels 20 percent higher overall, and up to 40 percent higher among users of select herbal supplements compared to non-users,” they report in the Journal of General Internal Medicine.
Professional pesticide use ups risk of nasal woes
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When people think about pesticides and health, cancer and birth defects probably come to mind. But new research shows pesticide exposure may contribute to a much more common affliction: itchy, runny, stuffy noses.
“Pesticides have more potential consequences than we’ve considered. There are a lot of things they can contribute to,” Dr. Jane A. Hoppin, of the National Institute of Environmental Health Sciences in Research Triangle, North Carolina, told Reuters Health.
Hoppin is part of a team of researchers who have been studying over 57,000 licensed pesticide applicators since 1993. They began publishing their findings in 2000. Most of the people included in the current investigation, known as the Agricultural Health Study, are farmers, while the rest are workers hired to apply pesticides to crops, seed and animals.
Feeding the Clock
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When you eat may be just as vital to your health as what you eat, found researchers at the Salk Institute for Biological Studies. Their experiments in mice revealed that the daily waxing and waning of thousands of genes in the liver—the body’s metabolic clearinghouse—is mostly controlled by food intake and not by the body’s circadian clock as conventional wisdom had it.
“If feeding time determines the activity of a large number of genes completely independent of the circadian clock, when you eat and fast each day will have a huge impact on your metabolism,” says the study’s leader Satchidananda (Satchin) Panda, Ph.D., an assistant professor in the Regulatory Biology Laboratory.
The Salk researchers’ findings, which will be published in a forthcoming issue of the Proceedings of the National Academy of Sciences, could explain why shift workers are unusually prone to metabolic syndrome, diabetes, high cholesterol levels and obesity.
Chronic Pain Found to Increase Risk of Falls in Older Adults
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Chronic pain is experienced by as many as two out of three older adults. Now, a new study finds that pain may be more hazardous than previously thought, contributing to an increased risk of falls in adults over age 70. The findings appear in the November 25 issue of The Journal of the American Medical Association (JAMA).
“It’s clear that pain is not just a normal part of aging and that pain is often undertreated in older adults,” explains lead author Suzanne Leveille, PhD, RN, who conducted the research while a member of the Division of Primary Care at Beth Israel Deaconess Medical Center (BIDMC) and is currently on the faculty at the University of Massachusetts Boston. “Our findings showed that older adults who reported chronic musculoskeletal pain in two or more locations – mainly in the joints of the arms and legs – as well as individuals who reported more severe pain or pain that interfered with daily activities were more likely to experience a fall than other individuals.”
“Cancer of fraud” permeates U.S. healthcare system
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It’s a crime so profitable that even dead people are in on the act.
A U.S. Senate committee revealed last year that public health insurer Medicare had paid as much as $92 million from 2000 to 2007 for medical services or equipment ordered or prescribed by doctors who were dead at the time.
Many had died more than five years before the date when they supposedly ordered or authorized the service.
Healthcare fraud said to cost U.S. taxpayers hundreds of billions of dollars a year has garnered increased attention amid the congressional debate about overhauling the U.S. healthcare system—especially since President Barack Obama wants to cover some of the cost of reforms by fighting abuse.
Uzbekistan says closed Kazakh border due to flu
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Uzbekistan said on Wednesday it had closed the border with Central Asian neighbour Kazakhstan as part of a seasonal anti-flu quarantine.
On Monday, Kazakhstan said Uzbekistan shut the border without any explanations and Kazakh media, as well as residents of the Uzbek capital Tashkent, linked the move to fears about an outbreak of the H1N1 flu virus.
On Wednesday, the Uzbek government said in a statement carried by official media that it had enacted quarantine restrictions on the border “due to the spread of seasonal flu.”
Sweet! Sugared Polymer a New Weapon Against Allergies and Asthma
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Scientists at Johns Hopkins and their colleagues have developed sugar-coated polymer strands that selectively kill off cells involved in triggering aggressive allergy and asthma attacks. Their advance is a significant step toward crafting pharmaceuticals to fight these often life-endangering conditions in a new way.
For more than a decade, a team led by Bruce S. Bochner, M.D., director of the Division of Allergy and Clinical Immunology at the Johns Hopkins University School of Medicine, has studied a unique protein known as Siglec-8. This protein, whose name is an acronym for Sialic Acid-binding, Immunoglobulin-like LECtin number 8, is present on the surfaces of a few types of immune cells, including eosinophils, basophils and mast cells. These different cell types have diverse but cooperative roles in normal immune function and allergic diseases. When functioning correctly, they are a valuable aid to keeping the body healthy and infection-free. However, in allergic reactions and asthma attacks, the cells unleash an overwhelming response that typically harms the body more than it helps.
Afghanistan is world’s worst place to be born: UN
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Eight years after a U.S.-led invasion ousted the Taliban from power in Afghanistan, the war-ravaged state is the most dangerous place in the world for a child to be born, the United Nations said on Thursday.
It is especially dangerous for girls, the United Nations Children’s Fund (UNICEF) said in launching its annual flagship report, The State of the World’s Children.
Afghanistan has the highest infant mortality rate in the world—257 deaths per 1,000 live births, and 70 percent of the population lacks access to clean water, the agency said.
US health companies set for record lobbying in 09
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It’s not just spending on U.S. healthcare that’s hitting record levels. Drugmakers, insurers and industry groups are on track to spend an all-time high of more than $500 million this year to influence Congress’ revamp of the U.S. healthcare system.
Lobbyists for the healthcare sector will likely smash previous spending records by tens of millions of dollars this year as Democratic lawmakers attempt to reshape the industry by expanding coverage and shaving costs.
“If current trends continue, the health sector is likely to spend more than a half-billion dollars on lobbying in 2009,” said The New England Journal of Medicine’s Dr. Robert Steinbrook.
Philip Morris ordered to pay $300 million to smoker
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A Florida jury on Thursday ordered cigarette maker Philip Morris USA to pay $300 million in damages to a 61-year-old ex-smoker named Cindy Naugle who is wheelchair-bound by emphysema.
The Broward Circuit Court jury assessed $56.6 million in past and future medical expenses against the company, part of Altria Group Inc, as well as $244 million in punitive damages.
The verdict is the largest of the so-called Engle progeny cases that have been tried so far, both sides said.
Worst case H1N1 may cut UK economy by 4.3 percent
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- A severe H1N1 flu pandemic could cost the UK economy 72 billion pounds ($121 billion), British scientists said on Friday, but advised against closing schools even if the current mild pandemic takes a turn for the worse.
Researchers from the London School of Economics, London School of Hygiene and Tropical Medicine and Edinburgh University said a “high fatality” pandemic would cut gross domestic product by 3.3 to 4.3 percent, or 55.5 billion to 72.3 billion pounds.
The study, published in the British Medical Journal, said several factors could exacerbate that impact—the extra strain on an economy already in recession, the closure of schools and the absence of large numbers of people from work.
Patients happier when docs discuss side effects
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Hospital patients who suffer a side effect from treatment are more likely to give high ratings to their quality of care when hospital staff are up front about what went wrong, a new study suggests.
In a survey of nearly 2,300 patients treated at 16 Massachusetts hospitals, researchers found that 603 had some sort of “adverse event”—most often side effects from a newly prescribed drug or complications from surgery—during their hospitalization.
When asked whether hospital staff had explained the problem to them, only 40 percent of patients said they had.
