Choosing a nursing home
September 30, 2009 by Raquel
Filed under ALZHEIMER'S
When our mom was diagnosed with Alzheimer’s disease at the age of 68, we didn’t know what to do. Coming from a culture which strongly believes that the young should take care of the aged, it was hard for us to face the fact that we had to place her in a nursing home. Having somebody come in to take care of her 24 hours a day, 7 days a week, has become a big financial burden. Add to that the emotional burden of seeing her deteriorate each day. Luckily, we found a home for the elderly run by a religious order, with professionally trained nursing nuns to take care of her. Our guilt was appeased when we saw how her physical health improved in an environment where she gets professional medical care as well as the social interaction with people of her age. Visits on weekends became a fun affair for everybody. Her dementia did not improve but we were glad to see her happy and comfortable during the last few years of her life.
Choosing the right nursing home is the key to our loved one’s quality of life and to our peace of mind. It is also a big responsibility.
As HealthCare 411 at the Agency for Healthcare Research and Quality (AHRQ) rightly said
It is for this reason that AHRQ developed a special tool as part of their Navigation Healthcare Program. The online tool called Nursing Home Compare is aimed to help find the nursing home that suits your loved ones needs by giving detailed information about every Medicare and Medicaid-certified nursing home in the US. The homes are rated on a 5-star quality system based on health inspections, staffing levels, and quality evaluations, among others.
The Department of Health and Human Services recommends taking the following steps when using the tool:
- Step 1: Find Nursing Homes in your area. Search by name, city, county, state, or ZIP code.
- Step 2: Compare the quality of the nursing Homes you’re considering using the Five-Star Quality Ratings, health inspection results, nursing home staff data, quality measures, and fire safety inspection results.
- Step 3: Visit the nursing homes you’re considering or have someone visit for you. Use the Nursing Home Checklist and other resources under “ Additional information ” below.
- Step 4: Choose the nursing home that best meets your needs. Talk to your doctor or other healthcare practitioner, your family, friends, or others about your nursing home choices. Contact the Long-Term Ombudsman or State Survey Agency before you make a decision.
There are also alternatives to nursing homes, including community-based services, home care, or assisted living and information on these are also available in the AHRQ site.
Photo credit: stock.xchng
Those who smoke together can quit together
Does an extensive social network help in quitting? Apparently yes, acco
rding to a study partially supported by the National Institutes of Health (NIH). Smokers are known to have flocking behavior and this behavior seems to help in quitting as well. In other words, it is easier to quit as a group.
When smoking was still socially acceptable and not considered a health threat, smokers and nonsmokers tended to mix socially a lot. After evidence of the bad effects of passive or secondhand smoking came to light, smokers and nonsmokers tended to form distinct clusters. And with the recently implemented strong anti-smoking laws, smokers have become marginalized. Now more than ever does one need a social network. It makes it easier to deal with the marginalization – and with quitting.
The current study by researchers at Harvard analyzed the social network and behavior of 12,067 people who are part of the Framingham Heart Study (FHS). The FHS is a long-term study that collects comprehensive measures of cardiovascular health and risk factors in a community connected as family, friends and co-workers spanning three generations.
Analysis showed that the closer the relationship to an individual, the greater is the influence on behavioral change including quitting smoking.
Here are some of the interesting findings of the study:
- When a husband or wife quit, it decreased the chance of their spouse smoking by 67 percent.
- When a sibling quit, it reduced the chance of smoking by 25 percent among their brothers and sisters.
- A friend quitting decreased the chance of smoking by 36 percent among their friends.
- In small firms, a co-worker quitting could decrease smoking among peers by 34 percent. In larger firms, the influence was insignificant.
- Neighbors did not seem to be influenced by each other’s smoking habits.
Other interesting aspects of the study showed that geography plays a much lesser role than the closeness of a relationship. Thus, emotional ties help more that physical distance when it comes to quitting.
According to Dr. Richard Suzman, director of the NIA’s Division of Behavioral and Social Research
In all types of addiction, a support group has always been important. In quitting to smoke, it doesn’t have to be a formally organized support group. It’s family and friends that count, wherever they are. In today’s technology driven world, keeping in contact is easier than ever. An SMS, a tweet or a Facebook poke can tell us that someone out there cares and is cheering on our efforts. And that is comforting and encouraging.
Your MP3 player and hearing loss
I remember once seeing this sticker on a loud speaker in a snack bar: “If it’s too loud, then you’re too old.”
Am I too old? Maybe. Maybe not. Maybe I can simply discern what is loud from the norm. Many people nowadays can’t tell anymore because their ears may be damaged. In fact, 90% of men aged 60 or older have some form of hearing problems.
“Hearing loss is so prevalent that it has become the norm”
according to Dr. Roland Eavey who together with his team at Vanderbilt University conducted the 2002 MTV.com survey That study revealed that adolescents and young people consciously exposed themselves for loud music as a form of entertainment. At that time, the main exposure is from attending concnerts and going to discos or clubs. Nowadays it is the MP3 player.
The results of the 2nd MTV.com survey conducted in 2007 is out and the prognosis does not look good. Here are some figures to ponder upon:
- About 2,500 people participated in the survey and of these, almost 50% of these experienced symptoms such as tinnitus after exposure to loud music.
- 32% of respondents think hearing loss is a big problem (vs. 8% in the 1st survey)
- 75% of respondents owned an MP3 player.
- 24% of respondent used their music player for more than 15 hours a week.
- Almost 50% use 75 to 100% of the volume capacity of their player.
- 89% turn up their player’s sound if external sounds such as traffic noise compete with the music loudness.
What about awareness?
Awareness of the risks of loud music has improved since the last survey but is still low.
Interestingly, the survey respondents believe that the most informative source of information about prevention of hearing loss is the media whereas health care professionals are the least likely source of information.
However, those who are fond of loud music, young or old, would turn down the sound or use ear protection if told by a health care professionals of the risks. In other words, health care providers have a big capacity to alter behaviour that can prevent hearing loss.
According to Eavey
He is urging his fellow health care providers to help spread the word and the key messages are:
- Hearing loss due to loud music is preventable.
- Hearing loss is usually permanent and irreversible.
- Even hearing aids might not be able to help.
Considering the potential role of the media in hearing loss prevention, I think it is commendable that MTV.com is supporting such studies. Now that’s what I call corporate social respnosibility.
Photo credit: stock.xchng
Music therapy for children with cancer
Gabe was diagnosed with leukemia in 1996 and had to undergo 38 months of cancer treatments. Tough times for a two-year old boy. Yet Gabe survived and he’s off treatment for almost 10 years now. What helped him and his family through the difficult years of chemotherapy was music.
Music therapy (also known as or related to melodic intonation therapy, psychoacoustics, and biomusicology) has been used in different ways to promote health. It has been used in stress management and relaxation and very recently also in the management of medical problems such as stroke and neurological disorders. In people with epilepsy for example, certain pieces such as Mozart’s paino sonata K448 helps reduce the number of seizures. In children, music has been used in the management of autism, learning disabilities, and posttraumatic stress disorder. According to the American Music Therapy Association, music therapy interventions may be designed to
- promote wellness
- manage stress
- alleviate pain
- express feelings
- enhance memory
- improve communication
- promote physical rehabilitation
Researchers at the Massachussets Institute of Technology are doing research on Music Mind, and Health with directions towards music augmentation of healthy and ill individuals. Alzheimer’s disease and austism are two of diseases that the researchers at looking at.
Music therapy in cancer patients is a relatively new field. Gabe’s mother Lisa White and her family launched Rock Against Cancer, a not-for-profit organization which provides music therapy to pediatric oncology units and arranges music-related events for kids with cancer.
A 1995 study by researchers at the Center for Music Research of the Florida State University in Tallahassee reports:
Indeed in the case of children with cancer like Gabe who had to go through chemo and radiation therapy, music can be a great help in surviving through the horrible side effects of these treatments. For the parents and caregivers of these children, music can also help ease stress and anxiety.
Preventing medical mistakes by asking questions
September 28, 2009 by Raquel
Filed under HEALTHCARE
According to the he Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services, medical mistakes claim tens of thousands of lives in the US every year. After all, health professionals are only humans who can err. Medical mistakes however, can be prevented. And prevention not only depends on the health care professionals but on the patients as well. AHRQ is urging patients to take a proactive role in their health care and help prevent medical mistakes. And this can be done by asking questions. The right questions. Here are some of the questions that AHRQ (“Questions are the Answer”) recommend you should ask:
- · What is the test for?
- · How many times have you done this?
- · When will I get the results?
- · Why do I need this surgery?
- · Are there any alternatives to surgery?
- · What are the possible complications?
- · Which hospital is best for my needs?
- · How do you spell the name of that drug?
- · Are there any side effects?
- · Will this medicine interact with medicines that I’m already taking?
In addition to asking your questions, I give you a few tips on how to ask your questions.
- Be respectful and polite when you ask your 10 questions. Take note that doctors and other health professionals are only humans who are also sensitive to criticism and unreasonable demands. It is not an interrogation. It is a conversation, a patient-doctor dialogue.
- Ask questions without losing confidence in your doctor. Asking questions doesn’t mean you are questioning his capability and expertise. It is more about getting clarifications and understanding better. Remember, your doctor has your best interest at heart, otherwise you don’t go see him at all.
- Inform yourself. Aside from asking questions, you can also inform yourself beforehand by reading up at the library, and over the Internet. Remember that your doctor is a busy professional who attends to a lot of patients. The better informed you are, the faster and easier the discussion would be.
Traffic noise and your blood pressure
September 28, 2009 by Raquel
Filed under HEART AND STROKE
For those thousands who are on the road every week day, have you ever wondered about how traffic affects your cardiovascular health? I already have tackled several aspects of traffic before in this blog and how they affect health. Here’s an update and another aspect of traffic we haven’t thought about yet – noise pollution.
Air pollution
Vehicular traffic generates air pollution. Environmental problems aside, many studies have shown that air pollution affects the heart, the brain, and the immune system, leading to chronic physical health problems such as asthma and heart disease as well as cognitive problems in children. See previous posts for a comprehensive of the global air pollution problems.
Stress
You cannot deny it. Driving to and from work and getting stuck in the traffic jam generates stress. Researchers have linked increased incidence of heart attack to heavy traffic and have found indication os synergy between stress and air pollution.
Noise pollution
It’s not only what you smell and what you feel – it’s also what you hear. In a recent study by Swedish researchers, traffic noise is also associated with cardiovascular effects that lead to increased blood pressure. According to lead author Theo Bodin of the Lund University Hospital,
The researchers looked at 27,963 residents of Scania, Sweden and the effects of road traffic on their health. Results of the survey showed:
- Exposure above 60 dBA (decibels) led to changes in cardiovascular parameters, most especially elevated blood pressure.
- All age groups were exposed to traffic noise levels below 60 dBA, a level which is considered moderate.
- Effects of traffic noise were more noticeable in young- and middle-aged members of the population and less in older age groups (e.g. 60 to 80-year olds).
The authors hypothesize on the reason for the different responses between age groups:
Sweden is comparably sparsely populated relative to many other developed countries. Scania is also a relatively small city by European standards. Can you imagine the amount of traffic noise that residents of large cities like Mexico, Sao Paolo, London, or Bangkok are exposed to? In the European Union alone, 30% of the population are exposed to day-night traffic average noise of 55dB(A). So next time you are tempted to press the accelerator or the horn, think about your health and that of others. Think about heart and your blood pressure.
Health care updates, September 25
September 25, 2009 by Raquel
Filed under HEALTHCARE
Some health care updates for you this weekend.
News from the Institute of Medicine
IOM Provides Guidance on Standards of Health Care for Disaster Situations
Disaster situations usually come unexpectedly. They can be natural disasters (hurricanes, forest fires, epidemics) or man-made disasters (acts of terrorism, industrial accidents). The question we have to answer is this: can the health care facilities and local health agencies able to handle the situation? The Institute of Medicine has recently send a letter report to the U.S. Department of Health and Human Services to the U.S. Department of Health and Human Services regarding guidance on standards of health care during disaster situations.
According to committee chair Lawrence O. Gostin, associate dean and the Linda and Timothy O’Neill Professor of Global Health Law, Georgetown University.
According to the report, crisis standards of care policies and protocols are necessary to guide health professionals on how to react to crisis situations. The protocols would guidance on conserving, substituting, adapting, and doing without resources without sacrificing ethical precepts.
News from the AHRQ
Young and Uninsured – Five Million Young Americans Choose Not To Buy, Even When Available
The Agency for Healthcare Research and Quality (AHRQ) reports that millions of Americans choose not to purchase health insurance even if it is available, even if they can afford it. And most of these are young and employed. AHRQ data shows that about 5 million Americans aged 19 to 23 do not have health insurance even though almost 50% have full time jobs and some have part-time employment. Men arre twice as likely than women to forego health insurance. Their reason: it isn’t worth the cost. I suppose it is natural for the young to feel invincible. But sickness and accidents do happen even among the young.
News from the National Institute of Allergy and Infectious Diseases
H1N1 pediatric trials bring good news, national institute says
The H1N1 flu vaccine for adults has been approved but the drug is still being tested in children. The preliminary results are very promising, e.g. the vaccine seems to be effective in children as well. “Preliminary data show that children 10 to 17 seem to be protected from H1N1 with one 15-microgram dose of the vaccine, but younger children, ages 6 months to 9 years, may have to have two doses depending on their health history.”
News from the US FDA
FDA Approves New Drug to Treat Psoriasis
Ustekinumab, a new drug to treat moderate to severe psoriasis has been just approved by the US FDA. About 6 million Americans suffer from this immune system disorder that affects the skin. Ustekinumab (brand name Stelara) is is manufactured by Centocor Ortho Biotech Inc, a subsidiary of Johnson and Johnson.
Photo credit: stock.xchng
September 27 is World Heart Day
September 25, 2009 by Raquel
Filed under HEART AND STROKE
This Sunday, September 27 is World Heart Day.
Cardiovascular diseases claim 17.5 million lives worldwide every year, making it the world’s number 1 killer. The World Heart Federation (WHF), together with the World Health organization (WHO) organizes on this day various awareness events in more than 100 countries around the world. These events include
This year’s theme is “work with heart” – closely supporting the Working Towards Wellness Initiative of the World Economic Forum – is touching on a recurring issue – that businesses and employers should focus on the importance of employee health to achieve core business objectives. In fact, many companies have made wellness a part of their corporate agenda. Unfortunately, this seems to be mostly true only in developed countries. The health of many workers in low- and middle income countries is not being taken seriously by their employers. Yet, statistics from WHF indicates that businesses can actually benefit by keeping their workforce healthy. Check out these figures:
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80% of deaths from cardiovascular disease occur in low- and middle income countries
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Almost 50% of those who die from chronic diseases are in their productive years.
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The WHO estimates that between 2005 and 2015, income loss (in international dollars) due to health problems could rise to as much as $558 billion in China, $237 billion in India, $303 billion in Russia and $33 billion in the UK.
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The BRIC countries (Brazil, Russia, India, and China) currently lose more than 20 million productive life-years annually to chronic disease, and that number is expected to grow 65% by 2030.
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The losses in productivity associated with these diseases like disability, unplanned absences and increased accidents are as much as 400% more than the cost of treatment
In the US, the American Heart Association (AHA) is in the frontline of World Heart Day Efforts. It will join 197 other member organizations in supporting this global initiative.
The AHA Start! initiative, the American Heart Association is one of the most effective program in encouraging businesses into incorporating a heart-healthy lifestyle into people’s daily work life. In the September 28 issue of the Fortune magazine, AHA gives recognition to almost 1,2000American companies, the so-called Start! Fit Friendly Companies.
According to AHA president Dr. Clyde Yancy
A tooth for an eye
An eye for an eye, a tooth for a tooth. That’s how it is usually said. But in the unusual case of Sharron Thornton, it’s actually an eye for a tooth. Or is it a tooth for an eye?
60-year Thornton has been blind for 9 years, according to this CNN report. She was so depressed due her helplessness and dependence on her daughter that she even considered committing suicide.
Fortunately, Thornton qualified to undergo a rather unusual procedure at the University of Miami Bascom Palmer Eye Institute. It entails implanting one of her tooth (the canine or cuspid) in one eye as a base to hold a prosthetic lens. The procedure takes months to complete and is still at the experimental stage. However, it was worth all the time and effort. Almost 2 weeks after her eye bandages were removed, Thornton’s visual acuity is 20/70 in the treated eye.
Thornton lost her sight in 2000 due to Stevens-Johnson syndrome, a condition defined as
In Thornton’s case, the condition damaged also her hair, nails and the cells lining her eye surface.
The procedure is called modified osteo-odonto keratoprosthesis (MOOKP)and was the first of its kind ever performed in the US and has been only done about 600 times in other parts of the world mainly Asia and Europe. Here is how it is done:
The procedure is very complicated and requires a team of dentists and ophthalmologists to perform. It is only applicable in cases where severe corneal scarring blocks vision, but the eye remains healthy and can see and localize light. It is usually indicated in the worst of cases of end-stage ocular surface disease where other options such as corneal transplant are not possible.
The surgeons gave Thornton a jaw implant to replace what was taken but it had to be removed due to an infection. They will try another implant later. However, losing a tooth and a part of the jawbone is a small price in exchange of an eye that can see, don’t you think?
Photo credit: stock.xchng
Gynecologic cancer awareness month: cervical cancer revisited
September is the Gynecologic Cancer Awareness Month in the US. Cervical cancer is the most common form of gynecological cancer.
Here are the latest statistics on cervical cancer (source: Medical Minute at Physorg):
- Cervical cancer is the 5th most common form of cancer in women worldwide.
- It is predicted that 12,000 women will be diagnosed with cervical cancer in 2009.
- An estimated 4,000 women in the US will die of the disease.
- Worldwide, millions of women do have access to cervical cancer screening.
Do you know that cervical cancer is one of, if not the most easily detectable, easily cured, and most preventable forms of cancer? Compared to some other cancers and many chronic diseases, it is considered “rare”.
The keys to the success in fighting cervical cancer are
- early detection through effective screening by the Pap test
- vaccination against the most common strains of the human papilloma virus (HPV).
A study by researchers at the University of North Carolina at Chapel Hill showed that HPV infection (as indicated by genital warts) that persists for 6 months to 1 year was strongly associated to increased risk of high-grade cervical lesions that can lead to cervical cancer. Combined with the Pap test, persistence of HPV infection is a very effective tool in early screening and detection of cervical cancer.
Cervical cancer got global attention earlier this year when the cancer battle of UK’s Jade Goody was turned into a reality show. During her struggle and even after her death, health authorities reported a surge in inquiries about cervical cancer and an increased demand for HPV vaccine, the so-called “Jade Goody effect.” The latest statistics from the CDC showed that 1 in 3 girls in the US have received vaccine against HPV. The vaccination rates in the US increased to about 37% last year. The rates, however, seem to vary from state to state. The highest rates were reported in Rhode Island, New Hampshire and Massachusetts (more than 50%) while the lowest rates were reported in Mississippi, Georgia and South Carolina (less than 20%). It is noted that cervical cancer rates are among the highest in those states where vaccination rates are lowest.
The HPV vaccine is effective against the HPV strains that cause 70% of cervical cancer. It is indicated for girls starting at age 11 before they get sexually active. It comes in 3 doses over 6 months. It is said to be the most expensive of childhood inoculations but most health insurance providers cover it.
Photo credit: wikicommons
On stress and aging
September is Healthy Aging®Month in the US, an annual observance month designed to focus attention on the positive aspects of growing older. Last week, September 18 was National Aging Awareness Day in
the US.
That is why I take this opportunity to focus on the relationship between stress and aging.
Stress can put more lines on your face and turn more hairs into grey. But it is not just the outward signs of aging that is linked to stress. It’s the overall aging process that includes health problems and illnesses.
Aging (also spelled as ageing) is defined as the process of becoming older, a process that is genetically determined and environmentally modulated. One of the environmental factors that contribute to aging is stress in many different forms. Below I summarize a couple of recent research studies on the link between aging and stress.
Animal studies
According to a report by researchers at the University of Edinburgh in Scotland
The researchers studied the effect of environmental stress (e.g. harsh winters) on the health of sheep and found that stress has a long term effect on the animals’ health. What’s more, if these stressors are persistent, they actually have a cumulative effect that accelerates the aging process. Thus, animals with more stress exposure aged faster than those who had less. And with aging comes weaker immune system and age-related illnesses.
Human studies
In the recent issue of the Journal of Cell Biology, researchers from the Rockefeller University reports that prolonged stress exposure induces cells to release its calcium stores, leading to apoptosis or cell death. Apoptosis is behind many age-related diseases.
Tips on how to slow down aging
There is no such thing as an Elixir of Life that can stop aging and death. However, our lifestyle can strongly influence our longevity. Here are some tips from Medicine.Net:
- Eat a balanced diet, including five helpings of fruits and vegetables a day.
- Exercise regularly (check with a doctor before starting an exercise program).
- Get regular health check-ups.
- Don’t smoke (it’s never too late to quit).
- Practice safety habits at home to prevent falls and fractures.
- Always wear your seatbelt in a car.
- Stay in contact with family and friends.
- Stay active through work, play, and community.
- Avoid overexposure to the sun and the cold.
- If you drink, moderation is the key.
- When you drink, let someone else drive.
- Keep personal and financial records in order to simplify budgeting and investing.
- Plan long-term housing and money needs.
- Keep a positive attitude toward life.
- Do things that make you happy.
Fighting prostate cancer with power food
September is Prostate Cancer Awareness Month, and this week, September 21 to 27 is the Prostate Cancer Awareness Week.
Prostate cancer is a big big thing nowadays. Just look at the statistics as to the number of men diagnosed with prostate cancer (overdiagnosed?). Just look at the number studies focused on this type of cancer.
That’s why scientists at the University of Texas MD Anderson Cancer Center give us a list of power fruits and vegetables to help prevent and fight prostate cancer.
Beans
Beans come in all shapes, sizes. They also come in different colors – black, white, red or green. Beans are rich in proteins, fiber, and flavonols which are also antioxidants, and are said to have anti-cancer properties.
Broccoli
Bro
ccoli is a well-known cancer-fighting vegetable. Together with its cruciferous relatives Brussels sprouts, cabbage and cauliflower, it is a rich source of vitamins A and C, fiber, calcium and folate. However, the phytochemicals which give broccoli its strong anti-cancer properties are sulforaphane and glucosinate.
Garlic
As a traditional remedy, garlic is on top of the list. It is good for the heart and the immune system. Aside antibacterial properties, it is also able to repair DNA. It has been shown to be effective against colorectal cancer as well as prostate cancer.
Green tea
Tea, especially green tea is a potent weapon against cancer and cardiovascular disorder. Green tea has more antioxidants than black tea, wine or dark chocolate. A recent study showed that daily consumption of green tea decreased the levels of prostate cancer biomarkers in patients scheduled for radical prostatectomy.
Soy
Soy or soya is a rich source of isoflavones, which are plant phytochemicals. Isoflavones contain estrogens and can serve as hormone therapy to lower levels of testosterone. Soy is also supposed to be good for the heart and
the vascular system and has been a popular alternative to meat and dairy protein sources. Caveat: the health benefits of soy have been a subject of controversy lately. I will write more about the pros and cons of soy in another post.
Sweet potatoes
They are not only sweet, they are also healthy. Sweet potatoes are rich in B-carotene (hence the yellow color) and vitamin A. Just the kind of food you’d want to add to your armory of anti-cancer agents. According to the American Cancer Society, one medium-sized sweet potato is enough to provide the recommended daily allowance of vitamin A. Recently, researchers developed a purple type of sweet potato which contains anthocyanin, another antioxidant compound.
Tomatoes
Tomatoes are rich in lycopene, a natural phytochemical with power antioxidant properties. According to the American Association for Cancer Research, lycopene helps to fight cell damage that may lead to prostate cancer. Tomatoes are also special because they do not lose their nutrients and antioxidants even with processing and cooking. Thus, it is not only fresh tomatoes but tomato sauce and tomato soup that can help fight cancer.
Watermelon
Watermelons are always thought be mostly water. However, it owes its red coloring to lycopene, the same cancer-fighting phytochemical found in tomato, and also in other red or pink-colored fruoits like guava and grapefruit. In addition, watermelon is also rich in vitamin C and beta-carotene.
Photo credits: stock.xhcng
Life and cost effectiveness of health care
September 22, 2009 by Raquel
Filed under HEALTHCARE
The British government agency National Institute for Health and Clinical Excellence (NICE) is not having a very “nice” reputation at the moment. NICE is the UK body that decides which medical treatment cost-effective and that the country can afford. Welcome to the world of health economics. A report in the Nature News examines the issue with the specific example from NICE.
Last year in May, a research report by the Peninsula Technology Assessment Group stated that with the current prices of anti-drug medications, it would be too expensive to keep some British people with kidney cancer alive. The British health care system as provided by the National Health Service (NHS) is nationalized. This is fortunate in many ways because everybody, regardless of income, race, age, and gender have access to free health care services. The downside is that certain treatments, procedure, and therapies have to be regulated based on cost.
The use of four new treatments for renal cell carcinoma – bevacizumab, sorafenib, sunitinib and temsirolimus – has been shown to be effective in prolonging life up to 10 months in kidney cancer patients. The Peninsula report however concluded “the probability that any of these interventions would be considered cost effective [in Britain’s nationalized health system] is zero.” This prediction came true when NICE issued a statement a few months later stating that the said four drugs
“are not recommended as treatment options for advanced and/or metastatic renal cell carcinoma”.
There are two opposing views of NICE. The pro-NICE camp (e.g. policy makers and economists) believes it is very effective in making tough decisions on the cost-effectiveness of health care services. NICE was established for a good cause. It was set up in 1999 as a watchdog to make sure that NHS spends it budget wisely “using transparent decision-making process…based on best evidence available.”
Those who are anti-NICE (patients and drug manufacturers) believe it denies treatment that can save people’s lives with little justification, e.g. justification based on cost alone.
Indeed, the arguments from both sides are strong and tough. On the national level, policy makers have to watch out that a health care system is not misused or overburdened. For every expensive treatment endorsed, more people get displaced in the health care system. The decision about the cancer drugs was not easy and was based on research that attempted to put monetary values to the quality and cost of each additional month by which a treatment extends life. Indeed, cost of these cancer drugs go up to tens of thousands of pounds.
On the personal level, many people will give anything to prolong life. Giving life a monetary value is not something that is acceptable to many.
At the beginning of the year, NICE reconsidered its recommendations about the drugs, accepting one – sunitinib – and giving special consideration to patients with terminal diseases.
Despite the revisions, the issue has spilled over outside of the UK, as more and more countries follow the example of NICE. This issue is certainly affecting the health care reform debate currently raging in the US. Opponents to the reforms are using the NICE decision as a strong weapon.
Photo credit: stock.xchng
Fitness friendly companies: the AHA honor roll
September 22, 2009 by Raquel
Filed under Featured, HEART AND STROKE
What is Start! Fit-Friendly?
The American Heart Association (AHA) has named several American companies as Start! Fit-Friendly. The Start! Fit-Friendly Companies Recognition Program is an AHA initiative that encourages employers to 
initiate and support wellness in the workplace. This year’s awardees number more than 1,100 businesses across the US.
Why should companies invest in wellness programs?
Poor health translates into poor productivity and increased medical expenses.
According to AHA statistics
- Chronic diseases such as asthma, diabetes and hypertension account for 164 million lost work days annually in the US, worth $30 billion.
- Obesity-related health problems cost American companies $12.7 billion each year in health care expenses and $225.8 billion in health-related loss of productivity.
The Washington DC group Partnership for Prevention reports that for every dollar spent by companies on prevention, $3.50 are saved from reductions in absence from work and health care costs.
According to AHA national chairman Neil Meltzer
How does the Start! Fit-Friendly Program work?
AHA is giving tips and advice to employers on how to motivate employees to be more physically active and adopt healthier lifestyles. Some of the ways suggested by AHA are:
Walking. This is probably the easiest and cheapest activity for any employee to engage in but it is also effective. Walking trails indoors and outdoors have been introduced in many companies. An example is the Sinai hospital in Baltimore which in addition to walking trails also introduced carpeted, cushioned staircases in their 7-story building as inviting alternatives to the elevator.
Fitness centers an
d coaching. Some companies have also installed fitness centers for employees to use at break times. An alternative would be to provide employees free or reduced membership fees in nearby health clubs.
Wellness programs. Companies are encouraged to regular conduct seminars on nutrition, health risk prevention, etc. Coupled to this is the employment of wellness coaches to give employees personalized advice on reducing health risks. Online programs over the company Intranet are also offered.
Financial incentives. Incentives are given to employees who seriously participate in fitness programs. The so-called “wellness bucks” are earned when employees participate in health-related activities such as exercising, participating in weight management classes, reporting for health assessment screening, or attending health seminars. The incentives may be in the form of lower health insurance premiums, more vacation days, personal training sessions, massages, etc.
What are the criteria for recognizing companies?
The AHA gives Worksite Innovation Award to companies who thought of new, creative and innovative ways to address the fitness challenge. The Community Innovation Award is given to companies that include not only their employees but the whole community as well. Companies are conferred “Platinum” or “Gold” if they meet criteria for fitness, nutrition, and health-focused workplace culture.
If you want to know your company or employer made the grade, check out the special section in the September 28 issue of Fortune magazine or this link. The section, entitled A Fitting Solution, highlight how
Photo credit: stock.xchng
Live long or die young: it’s all about cardiovascular risk factors
September 21, 2009 by Raquel
Filed under HEART AND STROKE
Many people would give anything to live longer. However, what many of us are not aware of is that certain lifestyle factors can actually either add to or shave 10 years off our lifespan. Ten years – that’s a decade! Or even more.
This study by UK researchers at Oxford looked at 18,863 men who were part of the British Whitehall study. The participants were aged 40 to 69 who were working as civil servants in London. They were followed up, filled out questionnaires on medical history, smoking habits, employment grades, and marital status and underwent a medical exam that measured blood pressure, cholesterol, glucose concentrations, and height and weight. The study started between 1967 and 1970, and followed up the participants for 38 years.
The results of the study showed that three cardiovascular risk factors in middle age – smoking, high blood pressure, and high cholesterol levels – are increase the likelihood of vascular mortality by 3-fold. In addition, non-vascular death is also two times higher among those with these risk factors, and their life expectancy is shortened by 10 years. When looking at more extreme categorization of risk factors, the researchers found that factors like body-mass index (BMI), diabetes mellitus/glucose intolerance, and employment grade can even shorten lifespan by up to 15 years.
According to the researchers
The findings of the UK study agree with another study conducted in the US, viewed from another perspective. The study, which was part of the Physician’s Health Study, reported that the absence of the same risk factors listed above leads to exceptional longevity and better health status and quality of life at old age. The study concluded that
So you decide: what is it going to be: live longer or die younger. It is your choice.
Photo credit: stock.xchng
What’s the latest in health care, September 21
September 21, 2009 by Raquel
Filed under HEALTHCARE
What’s new in drug approval?
FDA Approves Vaccines for 2009 H1N1 Influenza Virus
The US FDA announced last week the approval of vaccines against the H1N1 flu virus. The Vaccines were manufactured by 4 pharma companies CSL Limited, MedImmune LLC, Novartis Vaccines, and Diagnostics Limited. According to FDA commissioner Dr. Margaret Hamburg
FDA Approves Donor Screening Test for Antibodies to HIV
Also approved by the FDA last week was a screening tool designed to detect the presence of certain antibodies to HIV. The tool is to be used to screen donated blood and blood specimens for HIV type 1.
What’s new on the web?
CDC Updates and Expands Social Media Tools Site
The Center for Disease Control and Prevention (CDC) has stepped up its use of social media tools to reach more people. Twitter, Facebook, MySpace, YouTube, Flickr, Second Life, you name it, CDC has it. The newly released site highlights several social media campaigns, provides information on all of the social media tools CDC uses, and showcases social media data and metrics. The site also equips partners and the public with a unified, easily accessible space to find information on CDC social media efforts and assists communicators in their planning, strategy, and evaluation.
HHS and USDA Unveil New Food Safety Consumer Web Site at www.foodsafety.gov
On September 9, Health and Human Services (HHS) Secretary Kathleen Sebelius and Agriculture (USDA) Secretary Tom Vilsack introduced to the public a new consumer web site at www.foodsafety.gov “designed to help consumers and families get all the latest information on food safety and food recalls in one convenient place.”
What’s new in safety?
National Child Passenger Safety Week: Keep your most precious cargo safe.
Last week, September 12–18 was National Child Passenger Safety Week in the US. According to the CDC, about 4 children ages 14 or younger were killed in motor vehicle crashes every day in 2008, and many more were injured. The CDC site gives us a list of ways to maximize security and reduce the risk.
Letter to Industry on Cigarettes Containing Certain Characterizing Flavors
The US FDA wrote a letter last week reminding the tobacco industry that effective Tuesday, September 22, 2009, cigarettes that contain certain characterizing flavors are considered adulterated under the Federal Food, Drug, and Cosmetic Act (FFDCA or the Act), as amended by the Family Smoking Prevention and Tobacco Control Act (FSPTCA).
Cancer in the headlines, September 18
Tribute to the cancer victims
Mary Travers of “Peter, Paul and Mary” dies, age 72
She’ an icon from my childhood. Yes, I admit I grew up with Peter, Paul and Mary even if this admission gives away my age. I grew up
humming the tunes of “Puff, the Magic Dragon”, “Stewball”, “Lemon tree” “Blowin’ in the Wind”, “500 miles” and many other folk songs. Mary Travers and her bandmates were social activists who used their music as social commentaries. I am therefore saddened to hear about the passing of Mary Travers at age 72 after battling leukemia since 2004. Travers had bone marrow transplant 3 years ago but she suffered from a relapse. Reports say she passed away on September 16 from complications of chemotherapy.
Patrick Swayze dies, age 57
Patrick Swayze, on the other hand, was part of my teen years and early adulthood. “The Outsiders”, “Dirty Dancing”, “Ghost” and “North and South” are just a few of his memorable films. Swayze battled pancreatic cancer for almost 2 years. He passed away last September 14 at the age of 57. An oncologist told CNN it was “an accomplishment” that he was able to survive that long. Pancreatic cancer that has metastasized outside the pancreas has very poor prognosis. Swayze admitted that his cancer might be largely due to his smoking.
While fighting his own battle, Swayze was also fighting on behalf of other cancer victims. He was a strong supporter of the advocacy group Stand Up to Cancer and was actively campaigning for health reforms.
Good news for the cancer survivors
News from ASCO: 6-Minute Cancer Survivorship Care
It was announced recently at the American Society of Clinical Oncology (ASCO) meeting in Orlando, Florida – a survivor care plan accessible online. This is good news for cancer survivors – about 12 million in the US and 28 million around the world. This new web service is a partnership between the Lance Armstrong Foundation and Penn Medicine at the University of Pennsylvania. It is called the LiveStrong Care Plan powered by OncoLink. Oncolink is a general cancer site which was set up by the university in 1994. With this new partnership and innovation
Photo credit: stock.xchng
Heart(y) news and events, September 18
September 18, 2009 by Raquel
Filed under HEART AND STROKE
Here are some heart-healthy events coming up.
September is Cholesterol Awareness Month
Now is the time to sit down and think about cholesterol – your cholesterol. Furthermore, you should do something about it. More than 65 million Americans have high blood cholesterol levels. Are you one of them? Cholesterol Awareness Month is a good time to
- get your blood cholesterol checked and take steps to lower it if it is high.
- learn about lipid profiles and about food and lifestyle choices that help you reach personal cholesterol goals.
- avail of the National Cholesterol Education Program of the National Heart and Lung Blood Institute.
Go healthy Month
Go healthy month is a youth-powered initiative where more 1 million strong children and young share tips and ideas on how to stay fit and healthy.
Here are some tips:
- Ride my bike to school
- Be quick to pass up junk food
- Play duck duck goose
- Play ultimate Frisbee
- Play outside
- Eat breakfast everyday
- Play active games
- Get enough sleep
- Why not add your own?
Go Red Watch Party
The Go Red TV special premiered last week and was featured on NBC’s Today Show. Why not organize a Go Red Watch party this weekend? Include family members and friends. Wear red and be sure to serve only healthy food! You download free discussion guides, talking point ideas and tip from the American Heart Association (AHA) site.
Peripheral Artery Disease (PAD) Awareness Month
September is also the Peripheral Artery Disease (PAD) Awareness Month. PAD is the most common type of peripheral artery disease and can affect the veins and arteries. It is also one of the most undiagnosed vascular disorder. People with PAD have a higher risk for stroke and heart attack. Risk factors for PAD are high blood pressure, high cholesterol, diabetes, and smoking.
According to AHA:
Alos check out the online health chat on PAD with Cleveland Clinic expert Dr. Heather Gornik:
Peripheral Arterial Disease, Tuesday, September 22 – 12 noon.
September 21 to 27 America on the Move Week
This is an event to inspire Americans to incorporate healthy activities into their daily routines. America On the Move Week with the YMCA is part of Activate America® — the YMCA’s response to the nation’s growing health crisis. Through Activate America, the YMCA is redefining itself and engaging communities across the country to provide better opportunities for people of all ages in their pursuit of health and well-being in spirit, mind and body.
During this weeklong-long event, YMCA’s all over the US will engage local communities in health-promoting activities for families, groups, or individuals. Check out your local YMCA for schedule of activities now.
Declaring war against sweets and fats
We have won the war against smoking. Anti-smoking bans, advertising regulations, and increased taxes are paying off.
Now it’s the war against sugary beverages and junk food. In the US, there is increasing demand from health advocates and consumers on increasing taxes on unhealthy food. This was brought about by the alarmingly high incidence of obesity, diabetes mellitus and heart disease among Americans. However, this problem is not only unique to the US. Many parts of the developed world are facing the same problems and have also joined the war against junk food. Legislations in terms of product labeling, marketing, and advertising are already in place in many countries. However, many experts believe that increasing levies on fattening foods is the next big step.
Proponents of increased taxes on junk food in the US put forward the following arguments:
- The taxes will raise money for health care reform.
- Increased taxes will lead to soaring prices of the affected products, thus discouraging their consumption. It is estimated that a 10% in soda prices could cut consumption by 8 to 10%.
However, there are also those who are against this so-called “sin tax” or “obesity tax” based on the following grounds:
- It would turn the US into “a nanny state, hurt business, threaten an already weak economy and place an unfair burden on low-income shoppers.”
- It gives cash hungry states and local governments a reason to boost taxes under the guise of promoting good health.
- “Taxes never made anyone healthy. Education, exercise and balanced diets do that.”, according to one ad.
The group Americans Against Food Taxes is especially vocal against the taxation and supposedly has big backers in the food industry that have the most to lose including Pepsi Co, McDonalds, American Beverage Association and Burger King.
Will the taxation strategy work?
Experts believe that what happened to the tobacco industry is the best proof that levies do work. According to Mary Story, a dietitian and public health professor at the University of Minnesota:
Other ways of discouraging junk food consumption are already going on.
New York City has been one of the most active in the war against junk food. It has forced restaurants to eliminate the use of trans fats. The NYC health department is launching an anti-sugary beverage ad campaign that says
“Are you pouring on the pounds? Don’t drink yourself fat!”
The battle is far from over. The fight will be bitter. But in the end, we hope that consumers’ health will win.
Magic glasses for the developing world
I’ve been wearing glasses for more than 30 years now and it has always been a hassle to go back regularly to the optometrist, not to mention expensive.
In the developing world, many people are suffering from poor eyesight but do have the means to obtained a pair of glasses that can help them read, work, and see better.
Magic glasses
But hey, here’s a cool invention that presents an affordable solution. According to CNN, Joshua Silver, a physics professor at the University of Oxford has developed the so-called self-refraction glasses which have lenses that can be adjusted by the wearer to the right strength.
So how do these magic glasses work?
Now, that is what I call a neat innovation although this won’t make optometrists happy.
Global Vision
However, Silver’s motivation in developing these lenses which took almost 20 years is to help people in developing countries who don’t even have any access to an optometrist. In some countries for example, there is one optometrist for every million people. An estimated billion people in the developing world need glasses.
According to Sillver
So far, 30,000 pairs of these self-refraction glasses have been distributed worldwide. Distribution has been done through the adult literacy program in Ghana, and the Global Vision 2020 initiative of the U.S. Military Humanitarian and Civic Assistance (HCA) Program.
Kevin White is the driving force behind HCA’s Global Vision 2020. In order for the initiative to be sustainable, it not only distributes glasses, it also trains people from local NGOs to dispense glasses and teach people how to use them.
The limitations
There are some limitations to overcome before White’s and Silver’s vision becomes a reality. These are:
- Logistics. Manufacturing and delivering a billion pairs of glasses by 2020 is a daunting task
- Effectiveness. The glasses do not work for those with astigmatism and not tested in children
- Cost. It costs $19 to manufacture a pair of self-refraction glasses, a pittance in the Western world, a fortune in many poor countries.
- Style. The current version of the glasses is functional but not fashionable and may not be attractive. New models are currently being developed.
Now, that’s a pair of glasses I would love to have, fashionable or not!
HART still has a lot of work to do ... if you see something that is broken, please bring it to his attention via contact page or inside Facebook! Thanks :D
