You love all things medical. You love the idea of the rush of the emergency room. You love the idea of helping those in need. You even love the idea of wearing scrubs and the smell of anesthetic. If you know the hospital is the place for you to etch out your career, you just need to figure out what it is you want to do there. If you’re considering a career in the healthcare industry, here are some things to consider first.

How much education are you ready to complete?

Physicians need to complete about 15 years of school. If you don’t like school, you may want to reconsider this as your future profession. Even if you are into school, but are anxious to get into the field sooner rather than later, there are several ways to get into the healthcare field. A Nurse Practitioner or a Physician’s Assistant operates in a very similar way to a doctor. They see patients, they write prescriptions, and they solve problems for people. Nurse practitioners and physicians assistants need a few years beyond a bachelor’s degree. High-level nurses with nothing more than a bachelor’s degree can make a good living and can participate as intensely in the healthcare world as doctors can.

What role in the healthcare world fits you best?

Some people swear off the healthcare industry because they don’t like blood and guts, but what they fail to understand is that the healthcare industry includes so many facets that pretty much everyone can find a place if they want one. If you’re interested cardiology, you don’t have to be a cardiologist. You can be involved on the technology side. You can be a nurse involved in cardiac health, or you could be a perfusionist. Often, cardiologists aren’t able to have much of life. Ask a cardiologist’s wife. It may be worthwhile to take a different route into heart health. If you’re interested in taking advantage of the growing healthcare industry, but you don’t like blood and guts, consider a healthcare administration job. In this position, you can use your management and analytical skills to help organize a hospital’s needs.

What is the environment in which you want to work?

Environment is crucial to your happiness and wellbeing in the work world. If a hospital is too big and too clinical, consider finding a smaller and more private place to work. If you enjoy a lot of action, you won’t be happy in a one-doctor private practice. If you are a people person, don’t work in a lab. If you’re not a people person, do research. The bottom line is there’s a place for everyone in the healthcare industry.

How do you want your job to impact your personal and social life

If you can have a nine to five job, you can still have a really healthy personal and social life. If you are working an 80-hour work week and are on call most every weekend, you might have a harder time in the social and family realm. It’s not that it can’t be done; it’s just that it won’t be easy.

The health care industry is growing by leaps and bounds, and there’s a lot of room for people with every personality, skill set and background. Just make sure that you consider your background and future plans before you choose your place in the health care industry.

About The Author:
Natanya Pulley is a full-time writer for higher education blogs and journals nationwide. Several schools offer degrees in the health field, including University of Southern California and Berkeley University.

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I just found this health related video on YouTube … and thought you might enjoy it!

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For obstetrician/gynecologist Sandeep Rao, MD, the main goal is to keep women and their babies healthy. But Dr. Rao’s calling goes beyond health to safety. Drawing upon the lessons of empowerment he learned in Tae Kwon Do, he offers advice for how women can keep themselves safe in public. (c) Heritage Broadcasting Group, used by permission from TV 9&10.

Tell us what you think about this video in the comments below, or in the Battling For Health Community Forum!
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I just found this health related video on YouTube … and thought you might enjoy it!

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www.YourGoodHealthInfo.com — Best Exercise To Lose Belly Fat Everything about best exercise to lose belly fat, and related information and latest news on best exercise to lose belly fat. If you would like to learn more about losing belly fat, you can do so by visiting us at: www.YourGoodHealthInfo.com

Tell us what you think about this video in the comments below, or in the Battling For Health Community Forum!
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I just found this health related video on YouTube … and thought you might enjoy it!

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Dr. Mimi Guarneri, medical director of Scripps Center for Integrative Medicine, gave tips on women and heart health. Dr. Guarneri discusses the risk factors for heart disease in women and how to minimize them through a healthy lifestyle and stress management. The clip was originally aired on KSWB in San Diego.

Tell us what you think about this video in the comments below, or in the Battling For Health Community Forum!
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I just found this health related video on YouTube … and thought you might enjoy it!

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This is tribute to Siddha medicine by Dr.B.Yogavidya BSMS . Siddha is the earliest medicine every documented in the world & the oldest medical system in existence. Siddha Vaidya can be considered as the crown of all the traditional arts of the ancient world owing to its richness and simplicity.

Tell us what you think about this video in the comments below, or in the Battling For Health Community Forum!
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HHS Launches First of Its Kind Consumer Focused Website in Spanish
The US Department of Health and Social Services recently launched www.CuidadodeSalud.Gov, the partner site of HealthCare.gov in Spanish. Consistent with the mandate in the Affordable Care Act, it is the first of its kind to provide Spanish-speaking consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool. According to HHS Secretary Kathleen Sebelius:

“CuidadoDeSalud.gov like HealthCare.gov is an unprecedented website which provides consumers with the power of information at their fingertips. Individuals, families, and small businesses will be able to easily compare both public and private health coverage options tailored specifically for their needs… CuidadoDeSalud.gov will give Latinos across the nation better information about the choices they have, how much they cost, and what they can expect from their doctor–specific to their life situation and local community.”

AHRQ releases new Spanish-language guides for patients
Other agencies of HHS also go Espanol. The Agency for Healthcare Research and Quality AHRQ release this week “a series of free evidence-based guides designed to help Spanish speakers understand and compare the risks, benefits and side effects of treatments for eight health conditions,” including gestational diabetes, breast cancer, hypercholesterolemia, osteoarthritis of the knee, and type 2 diabetes These guides were previously only available in English. According to AHRQ director Dr. Carolyn M. Clancy:

“Many Spanish speakers don’t have access to credible, easy-to-understand information about health care conditions and their treatment options, and that can be a significant barrier to seeking medical care. These guides represent important resources that will help encourage patients to seek care and work with their doctors to discuss all of their treatment options.”

The 8 guides are as follows:

• Insulina premezclada para la diabetes tipo 2. Guía para adultos (Premixed Insulin for Type 2 Diabetes: A Guide for Adults);
• Tratamientos para el cholesterol alto. Guía para adultos (Treating High Cholesterol: A Guide for Adults);
• Osteoartritis de la rodilla. Guía para adultos (Osteoarthritis of the Knee: A Guide for Adults);
• Diabetes gestacional. Guía para la mujer embarazada (Gestational Diabetes: A Guide for Pregnant Women);
• Cuando se tiene una biopsia del seno. Guía paralas mujeres y sus familias (Having a Breast Biopsy: A Guide for Women and Their Families);
• Ablación con radiofrecuencia para tartar la fibrilación auricular. Guía para adultos (Radiofrequency Ablation for Atrial Fibrillation: A Guide for Adults);
• Reduzca el riesgo de cáncer del seno con medicamentos. Guía para la mujer (Reducing the Risk of Breast Cancer With Medicine: A Guide for Women); and
• ¿Está pensando que le induzcan el parto? Guía para la mujer embarazada (Thinking About Having Your Labor Induced? A Guide for Pregnant Women).

New docs linked to death spike in July
Deaths  due to medical errors are highest in July in the US and the reason for this, according to  researchers at the University of California in San Diego is the influx of new medical residents at this time of the year.
July is the month when new residents start to get more responsibilities for patient care with less supervision. During this month, cases of medical errors (e.g. drug overdose and mix-ups, surgical mistakes, etc.) peak – 10% higher than in other months. This increase is especially evident in teaching hospitals and is not reflected in increased death rates in the general population. More about this next week.

Mail-Order Pharmacy Use Could Improve Patients’ Medication Adherence
Many of us associate buying medications online as dangerous, not to mention stupid, due to our experience with all the email spams and scams we receive every day. But there are some bonafide mail-order pharmacies out there, and these providers, according to a new study, actually help patients to comply with their pharmacological therapies. Researchers at Kaiser Permanente looked at patients who use the center’s personal electronic health record, My Health Manager, which allows patients to view online lab results, refill prescriptions, schedule appointments and send secure emails to their doctors. The results showed that patients are more likely to adhere to medication regime when medications are sent by mail than those who have to pick up their medication refills personally.

“Our findings suggest that there is a lot that health care systems can do to provide support that makes it easier for patients to take care of themselves and do the right thing.”  

Stanford/Packard study finds surprising disparity in where chronically ill kids hospitalized
Chronically ill children need specialized pediatric care, yet a California study showed that provision of this type of care varies widely. For example, children from San Francisco and San Mateo counties are more likely to be admitted to a pediatric specialty-care center than children from neighboring countries. What is even more interesting is that fact that children with private insurance are actually less likely to received specialized care than those with public insurance. In 2007, for example, 67% of pediatric beds at pediatric specialty care centers were occupied by publicly insured patients. The reasons for this disparity are not clear and might be very complex.

Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public
Meet MONAHRQ—My Own Network Powered by AHRQ—a free, MS® Windows®-based software application just launched by the Agency for Healthcare Research and Quality (AHRQ).  The software supposedly “significantly reduces the cost and time a State, hospital or other organization would need to spend to compile, analyze and post data on quality of hospital care, its cost and how that care is used. MONAHRQ allows users to create a customized Web site with data that can be used for internal quality improvement or reporting quality information to the public.”

A pre-Christmas round up of health care news for you…

HHS Announces $27 Million from Recovery Act to Help Older Americans Fight Chronic Disease
The US Department of Health and Human Services (HHS) is allocating $27 million to help the elderly improve their health, thereby reducing health care costs. The funds are made possible through the American Recovery and Reinvestment Act.

According to HHS Secretary Kathleen Sebelius

“This program is about getting money to communities to help seniors manage chronic conditions that threaten their ability to remain in their own homes. Through HHS’ national aging-services network which reaches into nearly every community in America, we are helping people living with chronic conditions and others better manage their own health,”

FDA Expands Presence Outside U.S. with Opening of Mexico City Post
The US FDA has recently opened a post in Mexico City. This is to facilitate cooperation with the body’s regulatory partners overseas, a move that is important in ensuring food and medical product safety in the US. According to FDA Commissioner Dr. Margaret A. Hamburg

“The opening of this office represents an important step as we re-design our product safety strategy. We, like our partners in the Mexican Government, realize that prevention is the key. For example, more than a third of the fresh fruits and vegetables we eat come from Mexico as do a large amount of our medical devices. Having FDA experts located permanently there will be mutually beneficial to both our countries and respective citizens.

US National Survey Tracks Rates of Common Mental Disorders Among American Youth
A survey partially sponsored by the US National Institute of Mental Health (NIMH) on the prevalence of common mental disorders revealed that only about 50% of children and adolescents in the US who are suffering from some kind of mental disorders receive professional help. The specific disorders surveyed were:

• •8.6 percent had ADHD, with males more likely than females to have the disorder;
• •3.7 percent had depression, with females more likely than males to have the disorder;
• •2.1 percent had conduct disorder;
• •0.7 percent had an anxiety disorder (GAD or panic disorder);
• •0.1 percent had an eating disorder (anorexia or bulimia).

The good news is that except for ADHD, these prevalence rates are lower than previously reported. The bad news is that only 32% of young people with anxiety disorder consulted a mental health specialist. This is especially true among African-Americans and Mexican-Americans compared to the white.

Interactive Timeline on H1N1: The Year in Review
US health officials give a summary of events surrounding the H1N1 2009 outbreak and discuss the next phase of the response to the pandemic at www.flu.gov

Somebody told me once that it all boils down to the right location, whether it’s real estate, business venture, or vacation. It seems it is the same when it comes to health care. In previous posts for example, I have tackled how geography can influence health, from based on the levels of air and noise pollution as well as UV radiation

A study published in the July issue the journal Circulation lists the best and worst states to be in, in order to survive a heart attack. This is based on the quality of care that hospitals in the states can deliver in terms of the treatment and management of heart attack and heart failure.

Of the best states, New Jersey tops the list, with “the least deaths and fewest hospital readmissions following a heart attack or heart failure.” The top 5 states are listed below:

• New Jersey
• Vermont
• New Hampshire
• Washington
• Oregon

The US national average for heart attack mortality is 16.6% and 11.1% for heart failure. The best performing states have a maximum mortality rate of 10.9 and 6.6% for heart attack and heart failure, respectively.

Most of the states are sort of middle of the road when it comes to heart disease care but some states performed worse than the others. The 5 worst states to be in for patients of heart attack or heart failure are:

• Oklahoma
• Arkansas
• Tennessee
• Missouri
• Louisiana

In these states, mortality rates from heart attack were about 24.9% and rates from heart failure were about 19.8%.

Aside from mortality rates, the rankings also took readmission rates into account. In the worst performing hospitals, 1 in 4 heart failure patients and 1 in 5 heart attack patients were readmitted within 30 days of their first admission due to many reasons including:

• Medication problems
• Infection
• poor follow up care
• Recurrence of the heart attack or failure.

Readmission and complications are preventable and in preventing these, deaths are also prevented.

According to study author Dr. Gregg Fonarow, professor of cardiovascular medicine at UCLA

“Being able to prevent preventable deaths is very important. Preventing early hospitalization again is also very important. The large difference highlights that more could be done.”

The researchers, however, were quick to emphasize that the ratings were general averages and do not necessarily reflect the performance of all hospitals in the said state. The state of Florida, for examples, has hospitals which were ranked among the bets but also has others which were ranked among the worst. A more detailed ranking of individual hospitals clinics according to different therapeutic areas is given by the US News and World Report. The top 4 hospitals are

• Johns Hopkins Hospital
  Baltimore, MD
• Mayo Clinic
  Rochester, MN
• Ronald Reagan UCLA Medical Center
  Los Angeles, CA
• Cleveland Clinic
  Cleveland, OH

None of these hospitals are located in the top ranking states.

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.

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

“Today’s approval is good news for our nation’s response to the 2009 H1N1 influenza virus. This vaccine will help protect individuals from serious illness and death from influenza.”

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).

What’s new about swine flu?

Here are the latest figures on the H1N1 (swine) flu:

• US, as of August 20
  hospitalized 7,983; deaths 522
• Europe, as of August 13
  hospitalized more than 32,000; deaths 53
• Worldwide, as of August 13
  hospitalized 182,166; deaths 1799

FDA Authorizes Emergency Use of H1N1 Test for U.S. Troops Serving Overseas
The US FDA issued and Emergency Use Authorization (EUA) earlier this week allowing testing for the H1N1 flu virus in US troops serving overseas. “An EUA authorizes the use of unapproved medical products or unapproved uses of approved medical products during a declared public health emergency.”

Duncan, Sebelius unveil new CDC H1N1 Guidance for Colleges, Universities, and Institutions of Higher Education
In anticipation of the start of the new school year, US Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and US Department of Education (ED) Secretary Arne Duncan and Dr. Beth Bell, Deputy Director, National Center for Immunization and Respiratory Diseases at the CDC unveiled new guidance on how to mitigate and respond to the upcoming flu season. Schools, colleges, and dormitories are hotspots for epidemic outbreaks. Concerns about the H1N1 flu virus are especially big because young people seem to be highly susceptible. The new guidance suggests that the most important actions institutions can take are: to encourage and facilitate good hand washing and covering coughs and sneezes; to encourage flu vaccination for recommended groups when vaccine becomes available; and to separate sick people from well people as soon as possible.

WHO recommended use of antivirals
The World Health Organization (WHO) issued last week the latest guidleies for the use of antiviral agents in the management of H1N1 flu. The guidelines represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs. Emphasis was placed on the use of oseltamivir and zanamivir to prevent severe illness and deaths, reduce the need for hospitalization, and reduce the duration of hospital stays.

What’s new in health care?

Four in Ten Emergency Department Visits Billed Public Insurance
According to data from the Agency for Healthcare Research and Quality (AHRQ), 50 million emergency department visits were billed to Medicaid and Medicare in 2006. This indicates that a large number of emergency patients do not have health insurance coverage. These uninsured patients are also more likely to be “treated and released” rather than admitted, indicated that the patients use the ER for non-emergency issues.

America’s Seniors and Health Insurance Reform: Protecting Coverage and Strengthening Medicare
The HHS Secretary Kathleen Sibelius issued a new report on health reforms and how these can affect America’s senior citizens. The report highlighted problems with the status quo that includes

• Overpayments to Private Plans
• High Prescription Drug Prices
• Imminent Doctors’ Payment Cut will Limit Access
• Preventing Medicare from Going Bankrupt

The entire report is available for download.

Hospitals with hospitalists seem to deliver better quality care than those without, especially in cases of myocardial infarction. This is based on a study by Massachusetts General Hospital researchers reported in the recent issue of Archives of Internal Medicine. But wait a minute… what are hospitalists?

The term “hospitalist” is rather new, so new that one cannot find it in the Medline medical encyclopedia. According to the Society of Hospital Medicine,

hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to hospital care.The majority of hospitalists (85%) are specialized in general internal medicine and some underwent extra training pulmonary/critical care.

The study looked at 3619 hospitals and medical centers in the US. It compared two groups of hospitals, one group which employed hospitalists (N=1461, 40%) and another group which did not (60%).

The two groups of hospitals were assessed based on health care provided in patients who suffered from heart attack, heart failure and pneumonia, which are the three most common clinical diagnoses in inpatients in the US. The researchers looked at the performance of the hospitals in treatment and diagnosis, and counseling and prevention of these 3 conditions for a one-year follow up period.

The results indicate that hospitals with hospitalists scored better in evaluations that reflect adherence to Hospital Quality Alliance (HQA) care measures for acute heart attack and pneumonia. Other differences also noted. In general, hospitals employing hospitalists

• are more likely to be private, nonprofit teaching centers with at least 200 beds.
• are more likely to have intensive care units.
• have fewer Medicare patients and more Medicaid patients
• had higher nurse-staffing ratios and more nurses per patient-hour

The hospitals with hospitalists scored much better in the care and treatment of patients of with heart attack and pneumonia but not those with heart failure.

Those who had the lowest scores were hospitals which were public and with fewer that 50 beds.

The results indicate that hospitalists and nurses do play an important role in delivering quality care to patients. However, the researchers warn from jumping into conclusions. According to co-author Dr Leroi S Hicks

“We’re not saying it was the hospitalists themselves who improved the quality of care in these conditions. We adhered very closely to saying that if having a hospitalist were itself a metric, there’s something about these hospitals that is associated with better care.”

Other factors, including bedside manners, as well as the difference between outcomes in heart attack and heart failure, need to be looked into.

Let’s start the week with latest updates on health care.

What’s bad?

More Americans Become Bankrupt Due To Medical Bills
Another sad fact of a health care system gone wrong. According to a recent study conducted by the Harvard Medical School, more than 60% of personal bankruptcies in the US are brought about by high medical bills. This is even more evident during the current financial crisis, with bankruptcies due to medical debt increasing from 46% in 2001 to 62.1% in 2007. What is even surprising is the fact that the majority of medical-based bankruptcies were filed by “middle-class, well-educated homeowners” and 75% had health insurance. According to principal author Dr. Steffie Woolhandler of the Harvard Medical School, of the study

“Unless you are a Warren Buffett or Bill Gates, you are one illness away from financial ruin in this country. If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that is the major finding in our study.”

The health conditions that brought about the high medical expenses are as follows (ranked from higest to least):

• Neurological
• Diabetes
• Injuries
• Stroke
• Mental condition
• Heart problems

What’s good?

Top Obama Administration Officials Hold Rural Health Community Forum
Four US cabinet secretaries are on a “Rural Tour” visiting rural communities all over the US. The most recent stop was last Monday, July 20, 2009 St. John Parish, La. The 90-minute rural health forum aimed “to share information about the federal government’s efforts to rebuild and revitalize rural America.” At the same time, the local residents could also express their perspectives and address their questions to the following four senior cabinet members:

• Kathleen Sebelius, Secretary of Health and Human Services
• Tom Vilsack, Secreatry of Agriculture
• Hilda Solis, Secretary of Labor
• Eric Shinseki, Secretary of Veteran Affairs.

What’s mysterious?

Mystery of HIV vaccine failure deepens
What went wrong with the once very promising vaccine against HIV? Remember the STEP trial which was prematurely halted in 2007 because it seemed to actual increase rather than reduce the risk of HIV infection? Researchers are continuing to unravel the riddle that made the vaccine fail by following up the patients who receive the vaccine. The major hypothesis at that time was more sensitivity of some patients to adenovirus %, a modified cold virus from which the HIV vaccine was made from. However, recent results seem to rule out the cold virus vulnerability theory. According to STEP trial investigator Larry Corey

“The role that [adenovirus 5] immunity plays has taken a back seat to the role that lack of circumcision has played, and also, to some extent, to the role that genital herpes plays,” Corey said. “The issues are getting increasingly more complex as time goes on.”

What’s new?

Web Site and Toll-free Line Will Help Unemployed Workers Appeal Denials of COBRA Premium Assistance Under Recovery Act
The Centers for Medicare & Medicaid Services (CMS) launched a new website last week “where certain unemployed workers may request expedited review of a denial by their former employers of eligibility for COBRA premium assistance under the American Recovery and Reinvestment Act of 2009 (ARRA).” Most Americans are health-insured through their employers and involuntary termination leaves them without coverage. The website (www.ContinuationCoverage.net) plus a toll-free helpline (1-866-400-6689) will “help displaced workers maintain health care coverage for themselves and their families.”

Photo credit: stock.xchng

Late last week, there were several events that may have a major impact on health care so that I deemed it wise to have a special health care update post first thing on Monday morning.

What’s the latest on the H1N1 flu epidemic?

• Swine Flu (H1N1) Reaches Level 6 Pandemic
  On Thursday, June 11, the World Health Organization elevated the flu pandemic level to the highest level – level 6. Level 6 means that the “spread of the virus continues and activity has become established in at least two regions in the world.” The last time this has happened was 41 years ago during the pandemic Hong Kong flu of 1968 which killed about 1 million people worldwide. As of June 12, the number of cases in the US has reached 17,855 in all states and territories. 45 deaths have been reported. Worldwide, the number of confirmed cases has reached 29,669, with 145 fatalities covering 74 countries.
• Hong Kong closes all primary schools
  On June 12, Hong Kong officials ordered the closure of all kindergartens and primary schools as mitigation against the H1N1 swine flu epidemic. Several students have tested for the flu virus last week. The closure is estimated to be for two weeks and is affecting 510,640 students at 1,626 schools.
• H1N1: Origins and evolution of the current epidemic
  A group of scientists have traced the evolutionary origins and genomics of the H1N1 swine flu epidemic. They found out “that the initial transmission to humans occurred several months before recognition of the outbreak.”
• Novartis says it has produced first swine flu vaccine batch
  Also last week, the Swiss pharma giant Novartis announced it has pronounced its first batch of swine flu vaccine. However, the vaccine is still at the experimental stage and still need to be tested in humans for safety and efficacy.

What’s the latest health-related legislations?

• Senate passes the most sweeping tobacco-control bill
  Also last week on June 11, the US Senate passed then Family Smoking Prevention and Tobacco Control Act, a historic and unprecedented legislation that gives the US Food and Drug Administration full authority to regulate tobacco and tobacco products. For details on the new tobacco bill, see post at Battling Cancer.
• Rhode Island Senate passes medical marijuana bill
  Another medically-related legislation was passed last week. Rhode Island becomes the third state in the US to allow selling marijuana for medical purposes. The patients qualified for medical marijuana include those suffering from chronic pain, severe nausea, seizures, multiple sclerosis or Alzheimer’s disease. The marijuana will be sold by licensed dispensaries run by non-profit organizations.

Have a nice week!

Photo credit: stock.xchng

What’s new in health care research?

Making Hospital Discharges Safer for Seniors
This Healthcare 411 podcast at the site of U.S. Agency for Healthcare Research and Quality (AHRQ) focuses on the welfare of elderly patients just returning from the hospitals. In many cases, these patients suffer from medications mishaps. The latest AHRQ data suggests that American hospitals spent nearly $31 billion on care that could have been prevented with more timely and effective outpatient treatment… new information technology system helps to make the transition from hospital to home safer.

New Reports Show Weak Progress on Health Quality
Good news and bad news about American health care. The good news: An AHRQ study reveals an improvement – albeit weak – in the overall health quality. The bad news: patient safety is getting worse. More details in another post!

Eating Disorder Hospitalizations Rising
The latest AHRQ figures on eating disorders show an 18% increase in hospitalizations due to eating disorders between 1999 and 2006.

What’s new in health care reform?

A Strategy for Health Care Reform – Toward a Value-Based System
Dr. Michael E. Porter of Harvard Business School gives his perspectives (published in the June issue of the New England Journal of Medicine) on how to go about reforming the US health care system. He proposes a series of critical steps, namely:

• Change the nature of health insurance competition, e.g. insurers, private ot public should only profit if they improve their subscribers’ health.
• Keep employers in the insurance system.
• Address the unfair burden on people who have no access to employer-based coverage, who therefore face higher premiums and greater difficulty securing coverage.
• Make individual insurance affordable, e.g. through statewide or multistate insurance pools.
• Give income-based subsidies to help lower-income people buy insurance.
• Require everyone to purchase health insurance so that younger and healthier people cannot opt out.

What’s new at the regulators?

FDA Awards $1 Million in Grants to Three States to Enhance Food and Feed Safety
The US FDA awarded onye-year grants to Arkansas, Nebraska, and Wisconsin Food Safety and Security Monitoring. The funds will be used to fund/set up Food Emergency Response Network (FERN) labs. FERN labs play an essential role in food safety monitoring, especially in large-scale events affecting food or food products.

FDA Forms Transparency Task Force
This task force has the job of developing recommendations that will enhance the transparency of the US FDA’s decision-making process, especially in drug approval. The agency has been criticizes before about conflicts of interest and political influences in their operations. According to Health and Human Services Secretary Kathleen Sebelius “Our administration is committed to making government open and transparent. The Transparency Task Force will give the American people a seat at the table and make the FDA more open and accountable.”

Who’s new?

New York’s health commissioner to head CDC
The US Centers for Disease Prevention and Control (CDC) has a new head. New York City health commissioner Thomas Frieden has been recently appointed as CDC head by the White House, a position that does not require Senate approval. Frieden is not the only NY commissioner to move up to a national level leading role. The US FDA head Margaret Hamburg also used to be NYC health commissioner.

What’s needed?

Guidelines needed for informing patients of medical errors
Canadian researchers are calling for clear national guidelines that health care professionals should follow when communicating medical errors that affect a large number of patients. This lack of guidelines is not only true in Canada but in other countries as well. The researchers “call for clear communications, an external analysis to identify cause and a review that focuses on actions to ensure quality of care rather than punishment.”

What’s new about the swine flu?

Old seasonal flu antibodies target swine flu virus
Here is a silver lining in the current H1N1 flu epidemic. It seems that antibodies that developed against previous seasonal flu strains may actually actively attack the novel H1N1 flu virus. This is one of the reasons why the younger segment of the population, especially children, are more susceptible to the swine flu than older people. Older people may have more antibodies that are likely to work against the new flu virus. These antibodies may have developed from previous seasonal flu infections or from seasonal flu vaccination.

Industry Coalition Advises Against Use of Dietary Supplements as Swine Flu Remedy, Cure
The American Herbal Products Association (AHPA), the Consumer Healthcare Products Association (CHPA), the Council for Responsible Nutrition (CRN), the Natural Products Association (NPA) and the United Natural Products Alliance (UNPA) are advising against the use of dietary supplements and herbal treatments as remedy or cure for the novel H1N1 flu. According to the advisory, there is “no scientific evidence currently supports the use of dietary supplements for the treatment of this disease.”

More frequent CDC updates
The CDC increases email news updates on the now H1N1 flu from once to three times a week -Monday, Wednesday, and Friday. The updates will coincide with the official release of the updated case counts at 11:00 AM ET on the said days.

What’s on for June?

Health webchats at Cleveland Clinic

• Robotically and Minimally Assisted Heart Surgery by Tomislav Mihaljevic, MD
  Tuesday, June 2, 2009 – 12 noon (EST)
• New Options to Improve Your Odds of Becoming Pregnant by Dr. Julie Tan
  Tuesday, June 9, 2009 – 12 noon (EST)
• About Face: Plastic Surgery Webchat by P. Daniel Knott, MD
  Friday, June 5, 2009 – 12 noon (EST)
• Pain, Pain Go Away – How Behavioral and Rehabilitation Therapies Helps Kids Manage Chronic Pain by Gerard Banez, PhD
• Is your memory failing you? Let’s do something about it by Randolph Schiffer, MD
  Friday, June 19, 2009 – 12 noon (EST)
• Heart Devices: Pacemakers and ICDs by Bruce Wilkoff, MD
  Friday, June 26, 2009

Presenations at the Buck Institute for Age Research

Anti Aging Effects of Diet and Exercise
Thursday, June 4, 2009, 6:00 pm
Mill Valley Community Center
180 Camino Alto, Mill Valley CA

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It’s lean times due to the current recession. Yet, instead of all losing all those excess fat, more and more people are actually gaining weight! This video at ABC news presents results of a survey conducted by the American Heart Association (AHA) and it’s not good news at all. The current economic problems are forcing people to skimp on things which are essential to their health.

The results of a national omnibus survey of 1,000 people conducted in March 2009 by the AHA show that:

• 57 percent said the economy has affected their ability to take care of their health.
• 32 percent have made a change in the last six months to save money, such as delaying preventive care appointments, not taking medications or skipping the dentist.
• 25 percent of those with gym memberships have cancelled in the previous six months.
• 42 percent plan to make changes in the next six months that may impact their health, such as buying fewer fruits and vegetables.

The results are a bit worrying considering that the effects of investment (or rather non-investment) in health care and healthy lifestyle can only be seen years from now.

It is understandable that people should cut down on certain things in order to save money. However, it is important to set priorities straight and cut down on things that are non-essential but keep things which are essential for our health going. So what should be the things that we should prioritize?

• Health care, e.g. routine check ups and screening, including dental care. Remember that early detection is the key to disease management and dental health is linked to heart health.
• Healthy food. Now, more than ever, is a healthy diet necessary. There is a flu epidemic going on and many of us cannot afford to be ill. Cut down on eating out and partying but not fresh fruit and vegetables.
• Physical activity. This is actually something you need not cut back because this is something you can do anywhere, everywhere – for free. Save on gym membership fees, golf club or tennis club fees but keep going. Cycle to work. Walk whenever you can. [The AHA] “encourages walking because it’s the most accessible form of physical activity and it has the lowest drop out rate among Americans. The association supports the federal government’s recently revised guidelines for physical activity, which focus more on a cumulative amount of activity over a week, rather than a specific amount each day.”

Here are however some things that you can and should cut down:

• Cigarettes and other tobacco products. Now is the best time to quit. Save money, save your health.
• Alcohol. Alcohol is fattening, calorie-rich, and expensive. Your body won’t miss it.
• Eating out. Maybe it’s time to brush up on your culinary skills and eat more often at home. It need be complicated. A salad doesn’t take much time to prepare and is healthy.

For more tips, check out a previous post on keeping healthy in a sick economy.

As the ABC video rightly said so: “Don’t put your health on hold.”

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Some health care updates coming up…

What’s on?

May 10 to 16 is National Women’s Health Week
This week is US National Women’s Health Week and the U.S. Agency for Healthcare Research and Quality (AHRQ) has prepared a radio podcast for this occasion. The AHRQ has also prepared a checklist on Screening Tests for Women: What You Need and When which includes

• Get recommended screening tests.
• Be tobacco free.
• Be physically active.
• Eat a healthy diet.
• Stay at a healthy weight.
• Take preventive medicines if you need them.

 Recreational Water Illness Prevention, 2009: Charting a Course through Stormy Waters
As we look forward to swimming outdoors come summer time, we should be aware that recreational waters are source of infectious agents and environmental pollutants that can cause Illnesses. This illnesses are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, water parks, interactive fountains, spas, lakes, rivers, or oceans. Next week (May 18 to 24) is Recreational Water Illness Prevention Week in the US. The week-long observance highlights the importance of healthy swimming, healthy swimming behaviors, and recreational water illness prevention.

What’s new?

FDA to allow morning-after pill over the counter for 17-year-olds
The US FDA has decided to grant over-the-counter (OTC) access of the so-called “morning after” birth control pill to 17-year olds. The pill was only previously available OTC to those 18 and older. This reduction in the age limit is characterized from two fronts. Pro-life activists believe this is not acceptable on ethical grounds. Pro-choice advocates are happy with this small victory but still feel the age limit should even be lowered. This is after a federal court has ruled that the pill, marketed as Plan B “be made available over the counter to those 17 and older.

Debating the Wisdom of ‘Swine Flu Parties’
There are parties and there are parties. But this one is designed to make you sick  -literally. Based on the principle of “having it now mild or having it later serious”, people are thinking that catching the swine flu now will protect them from the more virulent form feared to be coming in the not so distant future. This is based on anecdotal evidence from the 1918 pandemic flu. However, health authorities are not too keen on the idea, as The New York Times reports. According to Dr. Anne Moscona, a flu specialist at Weill Medical College of Cornell University “I think it’s totally nuts. I can’t believe people are really thinking of doing it. I understand the thinking, but I just fear we don’t know enough about how this virus would react in every individual. This is like the Middle Ages, when people deliberately infected themselves with smallpox. It’s vigilante vaccination – you know, taking immunity into your own hands.”

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What’s new about the swine flu?

• Same flu, new name
  It is now called officially called novel H1N1 influenza. As of May 7, 2009, 23 countries have reported 2,368 confirmed cases. In the US, 896 cases in 41 states have been confirmed, with 2 fatalities.
• Outwitting mutating flu during a pandemic
  An article in PLoS Medicine explores how to optimize the effectiveness of drug stockpiles for the pandemic flu. Based on a mathematical model, scientists believe that widespread use of primary antiviral agent oseltamivir can easily lead to the emergence of resistant strains. They proposed a strategy using a secondary agent to reduce resistance.
• Scientists learn why the flu may turn deadly
  So far, the death toll on swine flu is low. But can this flu virus turn deadly? Scientists say that the virus kills by paralyzing the immune system and making flu patients susceptible to secondary bacterial infections such as pneumonia. And this immunological paralysis seems to be long lasting.
• FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products
  It was to be expected. The scammers simply have to take advantage of the pandemic flu hysteria. Websites are sprouting all over the place which are marketing medications and diagnostic tests for the N1N1 influenza virus. According to Michael Chappell, acting FDA Associate Commissioner for Regulatory Affairs: “Consumers who purchase products to treat the novel 2009 H1N1 virus that are not approved, cleared or authorized by the FDA for the treatment or prevention of influenza risk their health and the health of their families. In conjunction with the Federal Trade Commission, the FDA has developed an aggressive strategy to identify, investigate, and take regulatory or criminal action against individuals or businesses that wrongfully promote purported 2009 H1N1 influenza products in an attempt to take advantage of the current flu public health emergency.”

What’s going on this week?

• May 5 was World Asthma Day
  This year’s theme: “you can control your asthma.”
• May 3 to 9 is US National Drinking Water Week
  Each year, the American Water Works Association and an alliance of organizations, including the U.S. Environmental Protection Agency (EPA), sponsor National Drinking Water Week to highlight the importance of tap water and the need to reinvest in our nation’s drinking water infrastructure.
• May 6 to 12 is US National Nurses Week.
  And this year’s theme is Nurses Building a Healthy America. According to the American Nurses Association, “… [nursing] is an art and a science, and a profession that embraces people with varied interests, strengths, and passions because of the many opportunities the profession offers.”

What’s the latest on patient-doctor relationships?

How to turn conflict into collaboration when patients and physicians disagree
This isn’t the first time that patients and doctors can’t agree on a diagnosis or treatment. The book “Breaking the Cycle: How to Turn Conflict Into Collaboration When You and Your Patients Disagree” is supposedly a valuable resource for health professionals. The book was written by three doctors and published by ACP Press, the book publishing program of the American College of Physicians.

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