Public Health
Americans more confident on healthcare costs: poll
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Fewer Americans are afraid that they will be unable to pay for healthcare services and fewer expect to postpone medical treatments due to costs, according to a Thomson Reuters survey published on Monday.
Researchers found a steady increase in people’s confidence about their ability to pay for healthcare services—it rose 12 percent between March and July this year.
The survey of 3,000 households showed, unsurprisingly, that people who made more money were more confident they could pay for medical care, and people who had insurance were far more confident about paying than those who lacked insurance.
The effect of economic recessions on population health
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Paradoxically, mortality rates during economic recessions in developed countries decline rather than increase, according to an analysis http://www.cmaj.ca/press/cmaj090553.pdf in CMAJ (Canadian Medical Association Journal) http://www.cmja.ca. In poor countries with less than $5000 GDP per capita, economic growth appears to improve health by increasing access to food, clean water and shelter as well as basic health services.
“In terms of business cycles, mortality is procyclical, meaning it goes up with economic expansions and down with contractions, and not countercyclical (the opposite), as expected,” writes Dr. Stephen Bezruchka, from the School of Public Health, University of Washington in Seattle, USA.
Studies of wealthy countries show that greater national wealth does not equate with better health for its citizens. “The United States, with the highest GNP per capita in the world, has a lower life expectancy than nearly all the other rich countries and a few poor ones, despite spending half of the world’s health care bill,” states the author. It also has the highest poverty levels of any wealthy country, with large health disparities and poor health outcomes.
New European guidelines on syncope revise diagnostic definitions and re-evaluate extent of risk
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Barcelona, Spain, 31 August: A new definition of syncope – most commonly perceived as an episode of fainting – makes its diagnosis more precise and now dependent on a specific cause. New 2009 ESC Guidelines for the Diagnosis and Management of Syncope define syncope as “a transient loss of consciousness due to transient global cerebral hypoperfusion characterized by rapid onset, short duration and spontaneous complete recovery”.(1)
The definition, says Professor Angel Moya from the University Hospital Vall d’Hebrón in Barcelona and Chair of the Guideline Task Force, now includes an aetiological requirement of reduced cerebral blood flow, which is new to the 2009 Guidelines. Indeed, he explains, a sudden cessation of cerebral blood flow for as short as six to eight seconds is sufficient to cause complete loss of consciousness. “Without this diagnostic addition,” he says, “the definition of syncope becomes wide enough to include other disorders such as epileptic seizures and concussion - in fact, would be nothing more than ‘loss of consciousness’, irrespective of mechanism and duration.”
The Guidelines note that syncope is also associated with a decrease in systolic blood pressure to 60 mmHg or lower, which in turn is determined by cardiac output and total vascular resistance; a fall in either can cause syncope, but a combination of both mechanisms is often present.
Kennedy’s death another chapter in healthcare saga
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Senator Edward Kennedy’s death comes as a political struggle appears to be chipping away at the Democratic power-broker’s vision for what he called “the cause of my life,” providing affordable healthcare coverage to all Americans.
After decades of laying the groundwork to overhaul the U.S. healthcare system, Kennedy, who died late on Tuesday at age 77, was forced into a limited role in the fight to enact such legislation since being diagnosed in May 2008 with brain cancer.
Yet despite being away from Congress most of the year, Kennedy, one of the most effective lawmakers in U.S. history, managed to help draft a preliminary bill to overhaul the $2.5 trillion U.S. healthcare system.
Fluent in Fun
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For therapists, knowing how to talk to their patients and understand them is critical. When a roadblock occurs between an adult patient and their doctor, it can be easy to work through, but for kids, it’s much more difficult. Many can’t express themselves in ways that adults understand; they might lash out, cry or withdraw entirely.
A core group of therapists say that this is because children speak their own language – the language of play. These mental health professionals are trained to observe how children play in a safe environment with the toys they choose, to reveal their deepest wishes, fears, and hopes.
“Play therapists use play as a way to help children who are experiencing difficulties return to a state of balance,” said Jean Camberg, RPT-S, an instructor of play therapy at Temple University Harrisburg. “It is this skill in understanding play as language that sets the trained play therapist apart.”
“Brat Pack” director John Hughes dies of heart attack
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Filmmaker John Hughes, who made some of the most memorable teen comedies of the 1980s and turned Macaulay Culkin into a major star, died suddenly of a heart attack in New York on Thursday. He was 59.
Hughes, who had largely turned his back on Hollywood in the past decade to become a farmer in the Midwestern state of Illinois, collapsed while strolling in Manhattan, where he was visiting family.
His films, such as “Sixteen Candles,” “The Breakfast Club” and “Ferris Bueller’s Day Off,” are considered standard-bearers of the teen genre, exploring American adolescent behavior with warmth and affection. He supplied his awkward characters with natural dialogue, allowing audiences to empathize with their travails.
Worried about baby bust? Study says births may rise
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- Wealthy countries worried about their shrinking birth rates may have had their prayers answered. If they get just a little richer, birth rates should head up again, U.S. researchers reported on Wednesday.
They studied 24 countries over 30 years, looking at fertility rates and a measure of education, income and lifespan called the human development index.
“Although development continues to promote fertility decline at low and medium human development index levels, our analyses show that at advanced human development index levels, further development can reverse the declining trend in fertility,” Hans-Peter Kohler of the University of Pennsylvania and colleagues wrote in the journal Nature.
WHO keeps 2 billion estimate of likely H1N1 cases
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The World Health Organisation stuck on Tuesday to its statement that about two billion people could catch H1N1 influenza by the time the flu pandemic ends.
But the estimate comes with a big health warning: no one knows how many people so far have caught the new strain, known as swine flu, and the final number will never be known as many cases are so mild they may go unnoticed.
“By the end of a pandemic, anywhere between 15-45 percent of a population will have been infected by the new pandemic virus,” WHO spokeswoman Aphaluck Bhatiasevi said in a statement.
Antidepressant use doubles in U.S., study finds
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Use of antidepressant drugs in the United States doubled between 1996 and 2005, probably because of a mix of factors, researchers reported on Monday.
About 6 percent of people were prescribed an antidepressant in 1996 - 13 million people. This rose to more than 10 percent or 27 million people by 2005, the researchers found.
“Significant increases in antidepressant use were evident across all sociodemographic groups examined, except African Americans,” Dr. Mark Olfson of Columbia University in New York and Steven Marcus of the University of Pennsylvania in Philadelphia wrote in the Archives of General Psychiatry.
Four in 10 Emergency Department Visits Billed to Public Insurance
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More than 40 percent of the 120 million visits that Americans made to hospital emergency departments in 2006 were billed to public insurance, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.
According to the analysis by the federal agency, about 50 million emergency department visits were billed to Medicaid and Medicare. The uninsured accounted for another 18 percent of visits for emergency care, while 34 percent of the visits were billed to private insurance companies and the rest were billed to workers compensation, military health plan administrator Tricare and other payers.
The agency’s study of hospital emergency department use in 2006 also found that:
Healthcare reform looms large in Texas
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At Ben Taub General Hospital in the rich U.S. oil hub of Houston, 52 people wait in a holding room designed for 26, in beds crammed so close together that patients can touch one another.
“They can’t even go to a doctor, most of these people,” because they lack health insurance, said Angela Siler Fisher, an associate medical director there. “We are their doctor.”
The Texas Medical Center—which is the size of Chicago’s downtown Loop and has its own distinct skyline—draws patients from around the world to its private rooms and specialized, cutting-edge treatments.
Houston, the fourth-largest American city, is a case study in the extremes of the U.S. healthcare system.
Breastfeeding could save 1.3 million child lives: WHO
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Teaching new mothers how to breastfeed could save 1.3 million children’s lives every year, but many women get no help and give up trying, the World Health Organization said on Friday.
Less than 40 percent of mothers worldwide breastfeed their infants exclusively in the first six months, as recommended by the WHO. Many abandon it because they don’t know how to get their baby to latch on properly or suffer pain and discomfort.
“When it comes to doing it practically, they don’t have the practical support,” WHO expert Constanza Vallenas told a news briefing in Geneva, where the United Nations agency is based.
Summer camp flu outbreaks presage fall surge: CDC
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Outbreaks of the H1N1 flu among children attending U.S. summer camps presage a surge in cases this fall as students return to school, an official at the U.S. Centers for Disease Control and Prevention warned on Wednesday.
“This is just a harbinger of what we will see in the fall,” Dr. Richard Besser, who led the U.S. response to the virus outbreak last spring, told a meeting of public health officials.
Besser, who was the CDC’s acting director for the first half of this year, later told Reuters that the number of outbreaks in summer camps was in the hundreds.
Democrats aim for new vote on U.S. food safety law
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House Democratic leaders may try for the second time in two days on Thursday to pass a sweeping reform of the U.S. food safety system that would step up federal inspection of food makers.
The bill, drafted in response to recent outbreaks of illnesses linked to peanut butter, spinach and peppers, would give the Food and Drug Administration the power to order food recalls, require facilities to have a food safety plan in place and give FDA more access to company records.
Representatives defeated the bill on Wednesday, when it was debated under special rules that limited debate to 40 minutes but required a two-thirds majority for passage. The vote of 280-150 fell short of the 288 needed to pass.
Many heart disease patients not referred for rehab
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Despite evidence that cardiac rehabilitation helps patients following discharge from the hospital, almost half of heart disease patients eligible for such rehabilitation are not referred for it, according to a new study.
Cardiac rehabilitation involves exercise and counseling on diet and other risk factors. It has been shown to decrease the likelihood of future heart problems.
Dr. Todd M. Brown, from the University of Alabama at Birmingham, analyzed data from the American Heart Association’s Get With The Guidelines program. Included were 72,817 patients who were discharged from 156 hospitals in the US after a heart attack or procedure such as placement of a stent or bypass surgery to clear blocked arteries feeding the heart, between January 2000 and September 2007.
