Monthly Archives: February 2010

Health Care Summit: Significant and Pointless

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       All week President Obama and members of his administration repeatedly denounced pundit claims that the healthcare summit was an act of political theatre.  Neither side of the aisle wanted to imply that the summit had any real chance at producing a significant breakthrough in the healthcare debate.  In fact, Congressional Democrats came into the meeting having already threatened to expedite the bill through the legislative process, ironically, called ‘reconciliation’.  Congressional Republicans, prior to the assembly, planted their feet firmly into poll tested talking points and took every chance they could to mock the Presidents sincerity and willingness to act bipartisan.

As for the meeting itself? 

Well, it was too boring to be called political theatre and too theatrical to bring about any reconciliation.  There are two issues that immediately come to mind when attempting to define the reasoning behind this summits failure. The first, is that it was simply too late in coming.  Had President Obama come out immediately announced the meeting in early 2009 and challenged the two parties to discuss their differences face to face and in front of television cameras, then maybe he could have silenced much of the resistance and maintained control of the debate.  This actually brings to view the inexperience of President Obama, who deserves to take full responsibility for this disappointment.  President Obama promised to make his administration the most transparent in history only to turn around and hold closed-door meetings on healthcare reform with members of his own party long before meeting the brick wall known as the Republican Party.  This gave both instant legitimacy to Republican talking points and easy fodder to establish lasting distrust of President Obama’s agenda.  This, along with the lack of unity within the Democratic Party itself on this issue, allowed the republicans to keep the focus on bashing Obama’s proposal’s and fanning the flames of distrust that President Obama himself ignited.  Therefore, long before the summit was even announced, pundits were able to pump their rhetoric into the cynical minds of conservatives, loyal Republican Party constituents, and disillusioned moderate Democrats.  In other words, after a year of debate, minds were simply already made up and no amount of nationally televised discussion, even if it had been substantial, would have changed them. 

…and that brings me to my second point. 

President Obama challenged the Republicans to present their alternatives in front of the cameras because he viewed much of their rhetoric to be melodramatic and thought he could prove the Republicans were indeed just the party of ‘NO!’.  The Republican point of view was that this meeting of minds was just another slip up by the President and considered the offer to meet publically as a win-win scenario for their party.  If they showed up and engaged the President and Democratic Party than they could squash the partisan label that the Democrats had been trying to place on them.  Or they could walk away, regardless of how the debate went, declaring that it was the Democrats who continued to play partisan games because they refused to take the presented Republican concerns into account.

 Although both parties utilized the media’s presence with emotionally charged tales of constituent despair, it was the Republicans who maximized the attention and at times appeared to treat the event as a kind of massive campaign event.  The healthcare debate is so hot right now that Republicans knew it was not in their interest to present any in-depth, unified alternative to the Democrats plan, but instead cite polls showing the unpopularity of “Obamacare” and use the media stage to continue to present themselves as the voice of the American people. 

For the American people, the healthcare summit was really a bittersweet moment. 

I praise President Obama for orchestrating, and the representatives of both parties for participating, in a delightfully transparent view of the legislative process.  But I can’t help but feel that the conduct of our elected officials in this conference was bad for Republicans, worse for Democrats, and demoralizing for the American people.

Image Source: Reuters

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Doctors Working Less, Earning Less – BusinessWeek

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By Serena Gordon
HealthDay Reporter

   

Seven percent drop in hours may lead to physician shortages, researchers say  

TUESDAY, Feb. 23 (HealthDay News) — Although physicians still work long hours, the past decade has seen a sharp decline in the average number of hours they work each week, a new study finds. 

 From 1976 through 1996, the average work week of doctors remained steady, but between 1996 and 2008, the average number of hours physicians spent at work dropped nearly four hours a week — from 54.9 to 51 hours a week. 

 “After being stable at around 55 hours for decades, physicians’ hours have declined 7 percent in the past decade to around 51 hours a week,” said the study’s lead author, Douglas Staiger, professor of economics at Dartmouth College in Hanover, N.H. “This is an unprecedented decline that we haven’t seen before in physicians, and you don’t see it for other professions, like lawyers.” 

 Results of the study are published in the Feb. 24 issue of the Journal of the American Medical Association

 For the study, Staiger and his colleagues reviewed data on trends in physicians’ work hours from the U.S. Census Bureau from 1976 through 2008. The survey included 116,733 doctors from across the country. 

 Initially, the researchers suspected that rules instituted in 2003 limiting the amount of time that physician residents can work in hospitals might have been behind the drop in physician hours. Although residents did have a larger decline in hours — 9.8 percent on average — the drop in hours worked affected all physicians, with non-resident physicians experiencing a 5.7 percent reduction in their work week. 

 “The decline in hours was very broad-based. It’s happening among all types of physicians — young and old, working at a hospital or not,” said Staiger. 

 The biggest drops in hours worked were for non-resident physicians under 45 years old and those working outside of a hospital. 

 The study also found that the average physician’s fees dropped by 25 percent between 1995 and 2006. In areas with the lowest physician fees, the average number of hours worked was just 49 per week in 2001, according to the study. 

 “If you get paid less, you have less incentive to work harder,” said Dr. Michael Reis, the interim chairman of the Family Medicine Department at Scott & White Healthcare in Temple, Texas. “One of the problems is that physicians put off years of earning through college, medical school and residency, and are often way behind the eight ball when they’re done training. That may drive some to pick specialties that pay more for fewer hours.” 

 Staiger said that the data wasn’t broken down by specialty, so the researchers weren’t able to discern if more people were entering specialties that require fewer work hours. 

 But, he said, the researchers do believe that financial pressures probably have something to do with the decline in work hours. 

 “As fees have come down, for physicians to make the same money, they have to see more patients, and that makes it less satisfying for everybody. Patients feel rushed and physicians can’t spend the time they want to with patients,” said Reis. 

 Staiger agreed that doctors probably have to spend less time with each patient. “Physicians may be fitting more into a shorter period of time,” he said. 

 And, with an aging population that’s growing, physicians may be forced to do more in less time. Although the United States has more doctors now than ever before, the reduction in work hours is equivalent to losing about 35,000 full-time doctors, according to Staiger. 

 “We already know there’s going to be a shortage of physicians in the future, especially primary care doctors, and this is only going to multiply the problem,” said Reis. 

 More information 

 For advice on choosing your doctor, visit the U.S. National Institute on Aging. 

 SOURCES: Douglas Staiger, Ph.D., John French professor of economics, Dartmouth College, Hanover, N.H.; Michael Reis, M.D., associate regional chief medical officer, Northern Regional Clinics, and interim chairman, Family Medicine Department, Scott & White Healthcare, Temple, Texas; Feb. 24, 2010, Journal of the American Medical Association 

 Copyright © 2010 HealthDay. All rights reserved. 

 via Doctors Working Less, Earning Less – BusinessWeek.

Acupuncture shows promise for depression in pregnancy | Reuters

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Amy Norton
Mon Feb 22, 2010 5:22pm

NEW YORK (Reuters Health) – For pregnant women with depression, a couple months of acupuncture might help reduce the severity of their symptoms, a small study hints.

The study, which followed 150 pregnant women with major depression, tested “depression-specific” acupuncture against massage and acupuncture sessions that, according to traditional Chinese medicine, does not specifically target depression.

Researchers found that after eight weeks, women who received depression-specific acupuncture were more likely to have a treatment response — meaning the severity of their symptoms fell by at least half and they no longer met all of the criteria for diagnosing major depression.

Overall, 63 percent responded to the therapy, versus 37 percent of the “control” acupuncture group and half of the massage group, according to findings published in the medical journal Obstetrics & Gynecology.

But while the findings are promising, questions still remain — including whether acupuncture as practiced in the real world can reliably help women with depression.

“The acupuncture protocol we have tested appears effective,” lead researcher Dr. Rachel Manber, of Stanford University in California, told Reuters Health in an email.

“However,” she added, “unlike a pill, which always has the same ingredients, acupuncture, like psychotherapy, varies from one provider to the other.”

So while the specific regimen used in this study appeared effective, Manber said, “I do not think we can say that our study proves that acupuncture is effective for depression during pregnancy.”

It’s estimated that 3 to 5 percent of pregnant women are diagnosed with depression, Manber and her colleagues note in their report. Antidepressant medications are one treatment option, but there are safety concerns.

One recent study, for example, found that pregnant women who started taking selective serotonin reuptake inhibitors (SSRIs) in the second or third trimester had a higher risk of preterm delivery than other women. SSRIs include drugs like sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac).

Because of the potential for harm from medications, many pregnant women with depression may prefer psychotherapy or other non-drug options.

Acupuncture has been used for more than 2,000 years in Chinese medicine to treat a wide variety of ailments. According to traditional medicine, specific acupuncture points on the skin are connected to internal pathways that conduct energy, or qi (“chee”), and stimulating these points with a fine needle promotes the healthy flow of qi.

Modern research has most often focused on the effects of acupuncture on painful conditions, like chronic back pain and migraines. Researchers speculate that it may help ease pain by altering signals among nerve cells or affecting the release of various chemicals of the central nervous system.

It is unclear, Manber said, why acupuncture might help lessen the severity of depression.

For their study, she and her colleagues randomly assigned 52 women to receive depression-specific acupuncture twice a week for four weeks, then weekly for another four weeks. Another 49 women received control acupuncture and 49 received massage. All completed a standard measure of depression severity at the outset and again after four and eight weeks of treatment.

After eight weeks, patients in the depression-specific acupuncture group had a higher rate of response to treatment. They were not, however, more likely to see a complete remission in their depression; about 35 percent had a remission, versus 29.5 percent in the other two groups combined – a statistically insignificant difference.

Fourteen women who received depression-specific acupuncture reported pain during the needling, as did seven in the control-acupuncture group.

Overall, Manber’s team notes, the response to acupuncture in this study was comparable to what has been seen in studies of psychotherapy for depression during pregnancy.

SOURCE: Obstetrics & Gynecology, March 2010.

via Acupuncture shows promise for depression in pregnancy | Reuters.

Image Source: Google Images

Public Health in Pictures: The Swine Flu/H1N1 (Time.com, Life.com)

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April 27, 2009

Worshippers wear face masks in a Mexico City church amid fears that swine flu may become an epidemic.- Dario Lopez-Mills

Time.com

 
Apr 30, 2009
 
A Mexican couple kisses through surgical masks during the height of H1N1 fears in Mexico City in April. Despite what has been regarded as the biggest flu epidemic in decades, life went on.
 
Life.com
 

Swine Flue Update:

The Center for Disease Control reports  that for the week of February 7 – February 13, 2010, flu activity in the United States was relatively low, with most flu continuing to be caused by 2009 H1N1. Flu activity, caused by either 2009 H1N1 or seasonal flu viruses, may rise and fall, but is expected to continue for weeks. It’s possible that the United States could experience another wave of flu activity, or more likely, localized outbreaks of 2009 H1N1 in communities that have been relatively unaffected by illness thus far, or where 2009 H1N1 vaccination rates may have been lower.
 
 
Read more:
 
www.cdc.gov/H1n1flu/update.htm
 
 

Store Up On Sleep!…you can use it later

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This is great news for people who have mid-term exams coming up…

 

 

 

 

 

 

 

  

According to a study you can store your sleep in advance and use it later when you are more sleep deprived.

In a study conducted by the Walter Reed Army Institute of Research half of a group of volunteers were allowed to sleep extra the first week and the other half of participants kept the same sleep pattern. The following week, all of the individuals were sleep deprived and then given a variety of tests. The results showed that the individuals who slept an extra amount the first week, stored the sleep and functioned better on the tests than the individuals that kept to their original sleep schedule.  Furthermore,  the individuals who stored their sleep not only functioned better with sleep deprivation but were able to recover from the sleep deprivation at a faster rate. Tracy Rupp from the Walter Reed Army Institute of Research states that, “They showed less performance deterioration with regards to reaction time and alertness than the group that had been given the habitual prior sleep” .

This is great information for the miliatary…more incentive for R & R time and resting can be worked into the pre-touring routines by giving troops additional sleep before long-term missions.

Ms.  Rupp concludes,  “What we’re basically saying is if you fill up your reserves and pay back your sleep debt ahead of time, you’re better equipped to deal with the sleep loss challenge.”

Further research involves finding out how the body stores sleep and what is the average amount of extra sleep needed per person.

Think you can’t fall asleep at 9 pm? Take a power nap…they are effective as well…especially in the short-run.

Related Article:

http://news.bbc.co.uk/2/hi/health/8504867.stm

Image Source: Google Images

Avian Flu (H5N1 avian influenza) in Indonesia

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From the Associated Press
2010-02-12 08:52 P

Indonesia records new bird flu fatality

Indonesia has recorded a new bird flu fatality, bringing the death toll in the world’s worst-hit country to 135.

The Ministry of Health says the latest victim was a 25-year-old woman who died Jan. 25 in the West Java town of Bekasi. She is suspected to have had direct contact with poultry.

The ministry also reported Friday that it has discovered a 3-year-old Jakarta boy infected with the H5N1 bird flu virus who has since recovered.

Bird flu has killed at least 283 people worldwide since it began ravaging poultry stocks in 2003, and Indonesia is the worst-affected country with 163 confirmed infections since 2005. Twenty cases of the illness were recorded last year, of which 19 were fatal.

 

From the World Health Organization

Avian influenza – Situation in Indonesia

12 February 2010 — The Ministry of Health of Indonesia has announced a new case of human infection of H5N1 avian influenza. A 25-year-old female from South Jakarta District, DKI Jakarta Province died on 25 January 2010. Laboratory tests were positive for H5N1 virus infection. The case was possibly infected from direct contact with poultry.

Of the 163 cases confirmed to date in Indonesia, 135 have been fatal.

Photo: Courtesy of www.life.com

Articles courtesy of World Health Organization (www.who.org) and The Associated Press

Health Department to Vaccinate Rabid Raccoons in Upper Manhattan| NBC New York

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By MARIEL SMITH
Updated 7:15 AM EST, Wed, Feb 17, 2010

The New York City Health Department announced today that they will vaccinate raccoons against rabies in Upper Manhattan amid a recent surge in spottings of the potentially-rabid animals.

For the next two months, wildlife personnel will humanely trap raccoons in Central Park, Morningside Park, and Riverside Park, and then proceed to vaccinate and ID them, before releasing them in the same location where they were caught, officials said.

Trappers will repeat the process this summer to account for raccoons born in the spring.

The traps, which are a collaborative effort between the Health Department, the Parks Department, the Central Park Conservancy, and the United States Department of Agriculture, will be put in isolated areas to prevent visitors and pets from disrupting them.

According to the Health Department, 39 raccoons tested positive for rabies in Manhattan, with one raccoon in Brooklyn, so far this year.

Since December, the city had three cases of rabies attributed to raccoons; One where a dog was bitten, one in which a person was bitten, and another person who was caring for an ill raccoon.

The Health Department listed the locations of the infected raccoons on their website and will continue to update it regularly.

via Health Dpt. to Vaccinate Rabid Raccoons in Upper Man. | NBC New York.

Related Article:

http://www.dnainfo.com/20100217/central-park/rabid-raccoon-outbreak-central-park-sends-city-health-officials-on-hunt