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Complementary and Alternative Medicine in Cancer Care

Drawing on comparative fieldwork in the UK, Pakistan and Australia, this book provides the first systematic assessment of pathways and access to CAM and how it is used in health practice and by individuals with cancer.pGiving fresh and invaluable insights into how differing health and societal structures influence the use complementary and alternative medicine, the book explores:ullithe empirical, theoretical, and policy context for the study of CAM/TM and cancer/lilithe history and character of the eight support groups in which fieldwork took place in the UK, Australia and Pakistan/lilithe nature and structure of patient support groups’ history, affiliation and evolution/lilihow groups function on a day-to-day basis/lilithe extent to which what is being offered in these CAM-oriented groups is in any way innovative and challenging to the therapeutic and organisational mainstream/lilithe value of sociological work in the field which is not tied to immediate and narrow policy objectives./li/ulpThis is an essential resource for those studying complementary and alternative medicine sociologically, to those involved in the provision of cancer care on a day-to-day basis, and to those looking to establish a more informed (evidence-based) policy.

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Healthcare Outcomes Management: Strategies for Planning and Evaluation

Healthcare Outcomes Management: Strategies for Planning and Evaluation

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FDA Approvals and podcasts: healthcare updates, January 29

RECENT FDA APPROVALS

The US FDA has been very busy and has announced several major approvals this month.

FDA Approves New Treatment for Type 2 Diabetes
The US FDA has approved Victoza (liraglutide), a treated for type 2 diabetes to be administered an a once-daily injection. Victoza can help keeping blood sugar levels under control and should be used concomitantly with proper diet, physical execise, and other anti-diabetes medications. It is not recommended as initial therapy in patients who have not achieved adequate diabetes control on diet and exercise alone. It is manufactured by Novo Nordisk of Bagsvaerd, Denmark.

FDA Approves Ampyra to Improve Walking in Adults with Multiple Sclerosis
Another drug to get the go signal from the FDA this month is Ampyra (dalfampridine). Ampyra is indicated for patients with multiple sclerosis to improve walking and comes in extended release tablets. It is contraindicated in patients with moderate to severe kidney disease. Ampyra will be manufactured under licenses from Elan of Dublin, Ireland, and distributed by Acorda Therapeutics Inc. of Hawthorne, N.Y.

FDA Approves Morphine Sulfate Oral Solution for Relief of Acute and Chronic Pain
The FDA has also approved morphine sulfate oral solution indicated for pain relief in moderate to severe, acute and chronic pain in opioid-tolerant patients. It is available in as oral solution in concentrations of 100 milligrams per 5 mL or 20 milligrams per 1 mL. Because of the nature of the drug, the manufacturer was required by the FDA to develop “a safety program prior to approval to address the known risks of morphine misuse, abuse and overdose.”

In addition, a couple of medical devices and implants have also been approved in January and are reviewed in Heart(y) news, January 29.

AUDIO CASTS, ONLINE HEALTH CHATS

AHRQ Radio Series – Treating COPD
In this audio cast, the Agency for Healthcare Research and Quality (AHRQ) presents the latest data on chronic obstructive pulmonary disease (COPD). Dr. William Lawrence summarizes the two reports on COPD management:

“The investigators evaluated the medicine tiotropium, also known as Spiriva. They found that people who took this medicine with inhaled corticosteroids and long-acting beta-agonists had a lower rate of COPD-related death. In a different report, they evaluated the drug theophylline in combination with six different types of treatments. They found patients receiving theophylline had a slightly increased risk of death. More research is needed to understand whether theophylline actually contributed to these outcomes.”

Online health chats at Cleveland Clinic
Several health chats are scheduled for February.

• February 8: Keeping Your New Year’s Weight Loss Resolution with Dr. Maxine Smith
• February 10: Understanding Spinal Stenosis with Dr. Steinmetz
• February 17: Alternative Treatment Options for Managing Your Health with Dr. Tanya Edwards
• February 23: Diagnosis & Treatment of Chronic Pain Disorders with Dr. Jahangir Maleki

Chats on topics are listed in Heart(y) news, January 29.

Photo credit: stock.xchng

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Heart(y) news, January 29

Some news updates on heart issues for you this on this cold and snowy weekend.

FDA Approves Left Ventricular Assist System for Severe Heart Failure Patients Device Provides Support for Those Who Are Not Acceptable Transplant Candidates
There have been several FDA approvals of medical devices. One such device, HeartMate II, was approved earlier this month. HeartMate II is a continuous-flow, left ventricular assist system as a support for severe heart failure patients who are not acceptable candidates for heart transplantation. It is indicated for patients for patients waiting for more complex procedures, including transplants. Here is how the device works:
Heart assist devices are surgically implanted mechanical pumps that help the heart’s ventricle pump blood to the rest of the body. HeartMate II consists of a small, lightweight blood pump implanted in a patient’s chest just below the heart. An electrical cable that powers the blood pump passes through the patient’s skin to an external controller worn around the patient’s waist.

Meridia (sibutramine hydrochloride): Follow-Up to an Early Communication about an Ongoing Safety Review
The US FDA has issued a communication regarding the safety of the weight loss drug Meridia (sibutramine hydrochloride). Recent evidence showed that the drug can increase the risk for cardiovascular events such as heart attack and stroke. The FDA is advising health professionals not the use Meridia in patients with a history of cardiovascular disease.

FDA Approves First Percutaneous Heart Valve
The US FDA also approved this month the Melody Transcatheter Pulmonary Valve and Ensemble Delivery System by Medtronic. The device is the first percutaneous heart valve which can be implanted through a catheter, or tube, in a leg vein and guided up to the heart. The big advantage of this device is that it is less invasive than an open-heart surgery and can in fact delay the need for a more invasive intervention. It is intended to replace conduits, surgical implants used to treat patients with ccongenital heart defects of the pulmonary valve.
According to Dr. Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health:
“The FDA’s approval of Melody allows patients to undergo a much less invasive procedure to treat their heart conditionCongenital heart defects represent the number one birth defect worldwide and this approval represents a new, first-of-a-kind treatment option for some of those patients.”

Cleveland Clinic Health Chats
Several heart(y) topics are on at the Cleveland Clinic Health Chats this coming February:

• February 1: Ask the Heart Doctor with Benico Barzilai, MD
• February 8: Keeping Your New Year’s Weight Loss Resolution with Maxine Smith, R.D., L.D.
• February 10: Hypertrophic Cardiomyopathy with Harry Lever, MD
• February 22: Atrial Fibrillation – The Most Common Irregular Heart Rhythm with Bruce Lindsay, MD
• February 17: Alternative Treatment Options for Managing Your Health with Tanya Edwards, MD, MEd

Have a nice weekend!

Photo credit: stock.xchng

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Anti-Aging Manual: The Encyclopedia Of Natural Health

Anti-Aging Manual: The Encyclopedia Of Natural Health

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Don’t let death catch you sitting down

Sedentary behavior does not only increase the risk for cardiovascular disorders, it also increases the overall risk for death not necessarily due to heart disease, according to Australian researchers. And sedentary behavior in this research was equated to sitting down in front of the TV.

The researchers followed up 8,800 people for about 6 years in terms of “screen time” and their overall health. The results showed that those who watched TV for more than four hours each day has:

• 46% higher likelihood of dying from any cause
• 80% higher likelihood of dying from cardiovascular disease compared to people who spend less than two hours a day in front of the TV.
• For each hour each day spent in front of the TV, the risk of death from any cause increases by 11% and death from cardiovascular disease by 18%. A heightened risk for death from cancer wasn’t statistically significant, but the other findings held up even after adjusting not only for exercise, but for such risk factors as age, gender and waist circumference.

The researchers claim it is the long periods of inactivity that do the damage and no amount of working out or doing sports can undo the damage or decrease the risks.

According to study leader David Dunstan, a researcher at Baker IDI Heart and Diabetes Institute, Melbourne:

“It’s not the sweaty type of exercise we’re losing. It’s the incidental moving around, walking around, standing up and utilizing muscles that [doesn’t happen] when we’re plunked on a couch in front of a television.”

So what does amount to being sedentary or inactive?

It is the act of sitting down for long periods of time. When you are not on feet moving around and using your muscles, then you are sedentary.

The researchers focused on time spent in front of the tube because it is the favourite past time in many countries. In the US, for example, a Nielsen study revealed that Americans spend, on average 151 hours per month watching TV during the autumn-winter months of the 2008. This is equivalent to more than five hours a day of screen time.

Aside from TV time however, there are many other instances that amount to being sedentary. While sitting here and typing this post, for example, I am sedentary. The long periods of time we spend behind our desk or the wheel of a car, sitting down in a coffee shop,or reading by the pool, travelling by train or by plane, these are moments of being sedentary.

So what is wrong with being sedentary?

Dr. Dunstan explains that muscle movement is important in the metabolism of sugar and fats.

“The absence of movement can slow down our metabolic processes. When we’re sitting down or even lying on the couch, we’re burning the equivalent of the energy we burn when we’re sleeping.”

Another researcher, Dr. Marc Hamilton of the Pennington Biomedical Research Center in Baton Rouge says that after just a few hours of inactivity, an enzyme called lipoprotein lipase shuts down. This enzyme is responsible fortaking fat out of the blood to be transported and burned down in the muscles. Its absence leads fat accumulation in the blood stream, which will lead to damage of the blood vessels and the heart.

What about the 30-minute daily session on the treadmill or the twice-a-week soccer practice? Well, apparently this is not enough. Let us think. How much of our waking hours (16 hours!) do we spend on physical exercise? On being sedentary? Can our 30-minute morning jog make up for 8 or more hours sitting behind the desk? Apparently not.

Dr. Dunstan explains:

“The implication of these findings is that the extraordinary amount of sitting can undo the good effects that we know are a benefit when we get regular exercise.”

So in a nutshell, if we want to live longer, we should spend less time sitting down. Instead, let’s get moving. Anything helps. Here are some tips to reduce sedentary time while performing our routine daily tasks.

• Stand up and stretch regularly when working in front of the computer. Move your legs from time to time.
• Place the printer away from the computer so that you are forced to stand up to pick up your print outs.
• When watching TV, do some other activity in parallel, such as ironing or folding the laundry.
• Do not use the remote control. Stand up to change channels.
• When driving long stretches, take regular breaks and walk.
• When taking the train, try standing during the whole or part of the trip.

Can you add anything to the list?

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Allergy Gourmet

Allergy Gourmet

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Interventions to curb teenage drinking

Alcohol consumption is prevalent among teenagers. Yes, in teenagers, even if we as parents wouldn’t want to believe it. This is despite the fact the high minimum legal drinking age in the US. In Germany, coma and death due to alcohol intoxication has been reported in adolescents as young as 13. In Switzerland, a recent survey revealed that teenage girls may actually consume more alcohol than their male peers. In other words, except in Islam countries where alcohol is forbidden, teenage alcohol consumption is becoming a major health and social concern.

Previous studies (source: Medscape) on teen alcohol abuse reveal the following figures in survey of 8^th and 12^th graders:

• 16% of 8^th graders and 44% of 12th graders have had at least 1drink in the last 30 days.
• 30% of 12th graders engage in binge drinking.
• 3% of 12th graders consume alcohol every day.

Alcohol abuse in adolescents is not just about hormones and growing pains. The problems does not just stop with the abuse. Most often, alcohol consumption during adolescence is associated with more serious problems, including:

• psychosocial problems
• increased rates of mental health disorders
• neurocognitive deficits
• reduced motivation
• higher likelihood of subsequent adult alcohol abuse

There are interventions which try to curb adolescent alcoholism. These interventions can be categorized into two formats:

• Individual treatment, e.g. treatment provided directly to the teenager
• Family-based treatment, e.g. treatment provided to and through the family.

Researchers analyzed data from research studies to see how effective these interventions are. The results revealed the following:

• Cognitive behavioral therapy integrated with a 12-step was most successful in reducing alcohol consumption.
• Other effective interventions are brief motivational interviewing, active aftercare, multidimensional family therapy, and brief intervention with both adolescent and parent.
• Family-based therapies that included cognitive behavioral therapy, behavioral treatment, triple-modality social learning, multidimensional family therapy, and brief interventions had a moderate effect on alcohol consumption reduction.
• Individual therapies seems to be more effective compared to family-based  interventions in reducing alcohol consumption.
• The rate of dropping out from intervention programs is high.
• Effects of interventions wane with time, becoming less effective 6 months.

According to Dr. Stephen J. Tripodiassistant professor in the College of Social Work at Florida State University in Tallahassee.

“One of our aims as scholars is to bridge the divide between research and practice. There is a lot of valuable information here for clinicians who work in alcohol treatment centers for adolescents and for clinicians who have adolescent clients with alcohol problems. While we clearly understand the inherent flaws in the concept of evidence-based interventions, we support the steps included in the process of evidence-based practice.”

The results of the study suggest that interventions focused on the individual is more effective than family-based intervention 9in the management of alcoholism in teenagers.

Photo credit: stock.xchng

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Obesity screening at age 6

There is cancer screening. There is screening for diabetes. Now health experts urge for obesity screening in children starting at age 6 years. This is according to recommendations from an expert panel of the US Preventive Services Task Force (USPSTF) and published in the journal Pediatrics.

According to the panel led by chair Dr. Ned Calonge from the Colorado Department of Public Health and Environment in Denver.

“Since the 1970s, childhood and adolescent obesity has increased three- to sixfold. Approximately 12% to 18% of 2- to 19-year-old children and adolescents are obese (defined as having an age- and gender-specific BMI [body mass index] at >95th percentile)….Previously, the USPSTF found adequate evidence that BMI was an acceptable measure for identifying children and adolescents with excess weight.”

So what does this obesity screening in children entails? The USPSTF panel gives the following recommendations to primary health clinicians:

Routine measurements of weight and height during the so-called regular health maintenance visits in children aged 6 to 18 years old. With data on height and weight, body mass index (BMI) can be calculated. BMI is an indicator of excess weight or obesity.

Moderate-to-high interventions for those who need them. The USPSTF panel reviewed the current state of evidence and concluded that comprehensive, moderate- to high-intensity (but not low intensity) interventions can improve BMI in children with excess weight. Moderate- to high-intensity intervention programs as those which involve more than 25 hours of contact with the child and/or family during a 6-month period and include 3 components:

• healthy diet and/or weight loss
• counseling regarding physical activity recommendations or a physical activity program
• behavioral management techniques including setting goals and self monitoring.

The task force does not recommend the use of pharmacologic agents to manage obesity. Currently, there are anti-obesity drugs in the market that are used in combination with behavioral interventions but these drugs come with side effects that include increased heart rate and blood pressure and gastrointestinal problems.

The American Academy of Pediatrics (AAP) agrees with the latest USPSTF recommendations although the it would prefer to start screening even earlier – at age 2 years. According to AAP spokesperson Dr. Sandra Hassink:

“Recognition that screening is the first step to individual evaluation and counseling for obesity prevention and treatment should be standard in practice now. Working with families to screen for high-risk nutrition and activity behaviors that contribute to obesity in early childhood must be part of that task. With that said, the current USPSTF report is significant because it provides evidence that obesity treatment can be effective and extend beyond the immediate intervention and that pediatricians in the context of a medical home model that supports multidisciplinary care, with the appropriate supports of training and reimbursement, can provide effective obesity prevention and treatment for the families and children in their care.”

Photo credit: stock.xchng

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Mechanisms In Allergy;: Reagin-Mediated Hypersensitivity (immunology S

Mechanisms In Allergy;: Reagin-Mediated Hypersensitivity (immunology S

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Multisports Fitness Endurocycles Commercial 620 Exercise Bike

Multisports Fitness Endurocycles Commercial 620 Exercise Bike.Features: Flywheel: 66 lbs solid Steel Frame: 1 5/8 X 4 Handlebars: Fully Adjustable Portability Wheels: Yes Drive System: Belt Axle: Heavy duty Heat-treated Sealed Cartridge Bottom Bracket Crank: Five Star Design Resistance: Adjustable Seat: Fully Adjustable, split seat Pedals: SPD-Style Cleat Design, Cro-Moly Spindle w/ Toe Strap Finish: Electro Powder Coding, Rust and Scratch Resistant Environment: Commercial Commercial Warranty: 2 yrs. Frame & Weld, 6 Months moving parts Home Use Warranty: Limited Lifetime Frame & Weld, 1 Yr. moving parts Maximum User Weight: 350 LBS Dimensions: 48H X 48 L X 20W Weight: 162 lbs..

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Full-body scanners: are there health risks?

Airport security the world over has been tightened even more than usual due to last December’s terrorist attack attempt. One of the hottest issues in improving security is the use of the so-called full body scan. In the US, the Transportation Security Administration (TSA) is deploying the scanners at security check points all over the country.

What do the scanners do?

The full body scanner produce images of the body which are anatomically accurate and can therefore detect hidden objects and substances hidden underneath people’s clothes.

What are the possible concerns over the scanners?

• The main objection to the use of the full body scanner is privacy. According to one passenger, a 35-year old woman: “To use these scanners, I would feel rather violated. Just hearing that doesn’t really make me comfortable.”
• The second is the question about its radiation levels. After all, radiation can cause cancer.

How does the scanner work and does it have adverse effects on human health? According to the American College of Radiology (ACR), the TSA has deployed two types of scanning systems, namely:

• Millimeter wave technology uses low-level radio waves in the millimeter wave spectrum. Two rotating antennae cover the passenger from head to toe with low-level RF energy.
• Backscatter technology uses extremely weak X-rays delivering less than 10 microRem of radiation per scan — the radiation equivalent one receives inside an aircraft flying for two minutes at 30,000 feet.

The ACR further reports thewre is currently no evidence indicating that one of the technologies used in the TSA scanners may present significant biological effects on those who are screened. Here are figures given by the ACR:

• One hundred (100) backscatter scans per year is needed to reach what the National Council on Radiation Protection and Measurement (NCRP) classify as a Negligible Individual Dose.
• Based on these measurements, the ACR estimates that it will take 1,000 such scans in a year to reach the effective dose equal to one standard chest x-ray.
• In fact, an airline passenger is actually exposed to more radiation during the flight than at security checks at the airport.

It is therefore safe to assume there is very little cancer and other health risks involved in the use of full body scanners.

Considering the recent concerns about cancer-causing radiations produced by mobile phones, mammograms, and CT scans, devices which are very useful and are vent meant to save lives, these assurances from the ACR will help passenger as well as security personnel alike.

A poll conducted by the USA Today in early January revealed that 78% of travellers were agreeable to getting a full body scan. 20% were not, and 2% had no opinion.

Photo credit: stock.xchng

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It’s Monday- let it be Healthy Monday!

Today is Monday. It is the start of the new week. It is a good day to start being healthy. Take one day to be healthy. Just one day a week. On this day, you should think about your health. Refrain from smoking. Go for a walk. Eat fruit and vegetables. And maybe by the end of this Monday, you’ll ask yourself, if you managed to do it for a day, why not do it again the next day? Before you know it, the week is over and it has been a healthy week for you. This is the principle behind the Healthy Monday movement.

Healthy Monday is a public health initiative founded in 2005 in association with the Mailman School, Johns Hopkins University, and Syracuse University, Healthy Monday aims no less than to end preventable disease in the U.S.

The Healthy Monday campaign has rapidly gained a strong following, including the American Heart Association, American Diabetes Association, and American Cancer Society, academic institutions, not-for-profit organizations, and some of the big names in corporate America. Then its popularity crossed geographical borders to be adapted by political leaders in the European Union and international celebrities like Paul McCartney.

In New York, Healthy Monday is being promoted by the Harlem Health Promotion Center, a prevention research centers funded by the Centers for Disease Control and Prevention (CDC) and actively works in the Harlem and Northern Manhattan areas.

According to Dr. Alwyn Cohall, director of the Harlem Health Promotion Center and professor of Clinical Sociomedical Sciences and Population and Family Health:

“Behavior change takes time and incremental steps – sometimes three steps forward and two steps back. Healthy Monday lets people know that they can be forgiven for falling off the wagon; that the key thing is to keep trying and keep those health goals in front of you.”

That is the beauty of Healthy Monday. Even if you failed to follow your resolution during the week (and everybody fails from time to time!), there is always a Monday coming up wherein you can start anew and try as best as you could.

And it is something you can do as an individual and as a group. Now, there are people out there who would like to give healthy living a go but are too scared to try or too embarrassed to fail. Now, Healthy Monday is something you can try without announcing it to the whole world. On the other hand, once you get that good start, it would be fun to do it with family and friends.

Today is Monday. A really good day to start trying to be healthy. Let’s go!

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Living with Diabetes

Living with Diabetes

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Creating Moments of Joy for the Person with Alzheimer’s or Dementia: A

Creating Moments of Joy for the Person with Alzheimer’s or Dementia: A

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Risks Of Leukaemia And Other Cancers In Seascale From All Sources Of I

Risks Of Leukaemia And Other Cancers In Seascale From All Sources Of I

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Story Of A Death: A Family’s Journey Around Our Broken Healthcare Syst

Story Of A Death: A Family’s Journey Around Our Broken Healthcare Syst

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Cancer in the headlines, January 22

Here are some cancer news updates for you this weekend.

The Cancer Genome Atlas Identifies Distinct Subtypes of Deadly Brain Cancer That May Lead to New Treatment Strategies
The Cancer Genome Atlas (TCGA) Research Network reported an recent discovery with regards to glioblastoma multiforme (GBM), which is the most common form of malignant brain cancer in adults. A research study showed that GBM is not just one sole disease as previously thought but can actually be furthered classified into 4 different molecular subtypes. Depending on the subtype, the cancer responds differently to chemotherapy and radiotherapy. TCGA is part of the National Institutes of Health (NIH). According to NIH Director Dr. Francis Collins:

“TCGA is mobilizing the entire cancer community to find new strategies in detecting and treating cancer faster. These findings are just a hint of what we expect to result from the comprehensive data generated by TCGA over the next few years.”

Indoor Tanning: The Risks of Ultraviolet Rays
The US FDA recently issued a consumer update on indoor tanning and the risks involved.

According to scientist Dr. Sharon Miller, FDA scientist and international UV radiation expert:

“Although some people think that a tan gives them a ‘healthy’ glow, any tan is a sign of skin damage… A tan is the skin’s reaction to exposure to UV rays. Recognizing exposure to the rays as an ‘insult,’ the skin acts in self-defense by producing more melanin, a pigment that darkens the skin. Over time, this damage will lead to prematurely aged skin and, in some cases, skin cancer.”

Maine to consider cell phone cancer warning
A legislator in the state of Maine is lobbying for cell phone warning. Maine Rep. Andrea Boland wants to require cell phones to carry warnings that they can cause brain cancer. San Francisco Mayor Gavin Newsom wants to do the same thing. The Maine leaders will be discussing Boland’s proposal this month. If agreed upon, Maine will be the first state to implement such as a warning, which are supposedly exists in some countries. Currently, scientists and health authorities are divided on the phone-cancer link. Scientific evidence has been mostly inconclusive

Patients with diabetes are at increased risk for pulmonary problems but not lung cancer
California researchers report that diabetes can lead to a decline in lung function that increases the risk for pulmonary problems such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and pneumonia. The silver lining is that there is no increase in risk for lung cancer.

Photo credit: stock.xchng

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Flu updates: pork, vaccination, and ethnic susceptibility

What’s new in the flu front? Here’s the latest updates.

USDA Confirms Pork From Pigs Exposed to H1N1 Virus is Safe to Eat
Are pigs exposed to teh H1N1 flu virus safe for human consumption? The US Department of Agriculture (USDA) released the results of a study in December that showed that meat coming from pigs which were exposed to 2 strains of the H1N1 virus did not contain any virus at all and is therefore safe for eating.

According to Edward B. Knipling, administrator at USDA’s Agricultural Research Service (ARS):

“This research provides additional reassurance for consumers about the safety of pork. The information contained in the study will also benefit customers of U.S. pork products, both here and abroad.”

Interim Results: Influenza A (H1N1) 2009 Monovalent Vaccination Coverage — United States, October–December 2009
In July, the Advisory Committee on Immunization Practices (ACIP) issued recommendations for the prioritization of the influenza A (H1N1) 2009 monovalent vaccine distribution. At that time, a shortage was expected. Currently, there is enough supply (even surplus?) of the vaccine. The CDC has conducted a survey to determine the exact coverage of the vaccine. Here are the figures:

• As of January 2, about 20.3% of the U.S. population (61 million persons) had been vaccinated. This included 27.9% of persons in the initial target groups and 37.5% of those in the limited vaccine subset.
• About  29.4% of U.S. children aged 6 months–18 years had been vaccinated.

The CDC continues:

Now that an ample supply of 2009 H1N1 vaccine is available, efforts should continue to increase vaccination coverage among persons in the initial target groups and to offer vaccination to the rest of the U.S. population, including those aged ≥65 years.

 H1N1, American Indians and Alaska Natives
Data from states in the US revealed that some ethnic groups are more susceptible to the H1N1 flu than others. The two groups identified as having higher risk compared to the rest of the population, are American Indians and Alaska Natives, who are four times more likely to die of H1N1 flu.
Says the director of the Indian Health Service, Dr. Yvette Roubideaux:

“Vaccination is the best way to protect yourself, your family and your community against the flu. Ask your health care provider for both the H1N1 and the seasonal flu vaccine.”

Adult Immunization Schedule for 2010 Issued
The Advisory Committee on Immunization Practices (ACIP) of the CDC has recently issued clinical guidelines for the adult immunization schedule for 2010. Among the major revisionss compared to the previous one concerned the following:

• HPV vaccines – for women and for men
• measles, mumps, rubella (MMR) vaccines
• hepatitis A and B vaccines
• meningococcal vaccine
• flu vaccines

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Recovery after Stroke

Covering neuroscience and rehabilitation strategies, an essential handbook and reference for multidisciplinary stroke rehabilitation teams.This is a comprehensive guide to rehabilitation after stroke. It sets out the basic neuroscientific principles that underlie brain recovery and describes appropriate rehabilitation strategies for the many different functional problems that can arise after stroke. It is an essential reference for all members of the multidisciplinary stroke rehabilitation team.This is a comprehensive guide to rehabilitation after stroke. It sets out the basic neuroscientific principles that underlie brain recovery and describes appropriate rehabilitation strategies for the many different functional problems that can arise after stroke. It is an essential reference for all members of the multidisciplinary stroke rehabilitation team.One third of people after stroke, having survived the first few weeks, return home with significant residual disability, and can therefore benefit from an active, multidisciplinary rehabilitation programme. This is a comprehensive guide to rehabilitation after stroke, in which leading international authorities set out the basic neuroscientific principles that underlie brain recovery, including chapters on neural plasticity and neural imaging, and describe appropriate rehabilitation strategies for the many different functional problems that can arise after stroke. These include movement disorders, sensory loss, dysphagia and dysarthria, problems with continence and secual difficulties, and cognitive disorders. Also covered are measurement of disability and quality of life, assistive technology and vocational rehabilitation. It is therefore an essential handbook and reference for all members of the multidisciplinary stroke rehabilitation team, including medical personnel, therapists, clinical neuropsychologists and rehabilitation nurses.1. Strokes: background, epidemiology, aetiology and avoiding recurrence Gabriel R. de Fr@Tr?(õà¾Û€

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