By ROGER COLLIER
Key members of the Senate Health, Education, Labor, and Pensions Committee announced on Thursday what they claimed were dramatically improved cost and coverage estimates for the latest version of their health care reform bill.
Headed by Democratic Senator Christopher Dodd, HELP members (in a Muzak-marred conference call with reporters) stated that the revised bill would cost only $611 billion over ten years, a figure apparently computed by the CBO, and that with a further expansion of Medicaid would provide coverage for 97 percent of Americans.
Key features of the bill provided during the conference call included a public plan option, subsidies for lower-income individuals buying insurance through an exchange mechanism, and a play-or-pay employer mandate.
Sounds good? We’ll have to wait for details, but two big problems are already apparent.
Continue reading "HELP.

Similar posts: health journals

Latest scientific and medical technology has given more people encouragement to find a cure for herpes. Herpes is a sexually transmitted disease due to the infection of HSV1 and HSV2. Although oral medicines and herbal treatments have been commonly used for treating the condition, finding a cure for herpes is no longer as difficult as it used to be because there are now several options available.

The most prominent characteristic of a herpes outbreak is the development of blisters around the genitals or rectum. As you go about searching for a cure for herpes, remember that the first onset of herpes is usually the most critical. Treatment from the condition may require at least four weeks.

When finding a cure for herpes, the severity of the outbreak usually serves as the determinant for the kind of treatment you will receive. Here are some of the usual methods based on the severity of the outbreak.

Episodic therapy is a cure for herpes administered at the first onset of herpes. It should be given as soon as the first symptoms appear. Using this technique can shorten the duration of the herpes outbreak.

Suppressive therapy is a cure for herpes using antiviral medicines for a specified time frame depending on the prescription of the doctor. The goal of suppressive therapy is to control the replication of the virus and prevent if from going about with asymptomatic shedding.

An antiviral medicine is a cure for herpes that is widely used today. They can be used for both episodic and suppressive therapy. The most popular antiviral medicines in the market today are acyclovir, valacyclovir, and famciclovir.

The recommendation of a cure for herpes by a doctor is determined by the frequency of occurrences or if the symptoms have become a major hindrance to the patient's daily activities. Addressing these symptoms is crucial so that your doctor can make the correct recommendation.

Approximately 15 million people are diagnosed with STD on a yearly basis. Finding a cure for herpes can be difficult as majority of the patients are not aware that they have an outbreak. Consult your doctor if you suspect an occurrence of herpes so they could properly recommend a cure for herpes.

Similar posts: health journals

CIDRs are used to get anoestrus animals to start cycling, and also to "synchronise" the breeding activity of those that have started to cycle so that they all come on heat together.

Future developments
Advances in reproductive technology are the way these genes will be multiplied and made commercially available. Heres a brief description of some of these techniques which are at varying stages of commercial availability:

MOET: Multiple ovulation and embryo transfer - sometimes called super-ovulation and embryo flushing. The cow is stimulated to produce many more eggs (oocytes) than normal at ovulation, then after insemination the embryos are flushed from the uterus through the vagina. Very large numbers of embryos can be harvested but five good quality ones per flush is a realistic average. These can be implanted in to other cows treated with hormones to be at the correct stage of their cycle, or frozen for later use or sale.

TVR: Trans-vaginal recovery also called ovum pickup. In TVR oocytes are taken directly from the cows ovaries and the operation can be performed on yearlings or cows soon after calving or even in early pregnancy. Oocytes can also be taken from cows immediately after death; this is called GR or genetic rescue and is an ideal way of exploiting the genes of former top-performing cows in the herd.

IVP: In vitro production is where embryos are grown in the laboratory and there are three stages to this. First is IVM or in vitro maturation, then IVF or in vitro fertilisation and lastly IVC or in vitro culture the whole process taking eight days.

Sexed semen: This has been possible for some years (currently with 90% accuracy), but is not commercially available on a large scale yet. Its ideal for an AI programme to breed females for replacements or males for beef.


Embryo genotyping: Here the genotype of the embryo can be checked before implantation. The aim is to avoid spreading defective genes and multiplying good genes once they have been found. Currently there are only a few available but as the cow genome or genetic map is researched, more will be commercially available.

Embryo multiplication: This is the process of taking one embryo and dividing it up at the appropriate (early) stage to produce identical twins, triplets, quads or more.

JIVET: Juvenile in vitro embryo transfer. This is where IVP is done on calves (one month old) and when perfected will be a powerful tool to reduce generation interval which is limited by the age of normal puberty. Currently results are not commercially satisfactory.


Clones: Clones are totally identical in their genetic makeup and have been produced from body cells as opposed to sperm or eggs. Dolly the sheep for example was produced from a cell from her mothers udder. Cattle have been cloned and used commercially in AI to produce two bulls to meet a large demand for semen that one bull could not supply.

Short-gestation semen: Semen from bulls that have been selected to produce calves which are born less than the average 280 days gestation. The best bull currently available will shorten gestation on his calves by 8.4 days. These bulls are used by dairy farmers at the end of their AI programme to reduce calving spread.

Freeze-dried semen: When this is available commercially, it will make transport and delivery of semen easier.


Glossary
AB: Artificial Breeding ( same as AI)
Abortion: premature expulsion of the foetus.
Accessory fluids: fluids produced by glands to help sperm to flow.
Accessory glands: glands that produce accessory fluids.
Afterbirth: the membranes (placenta) that have surrounded the developing foetus and attaching it to the dam.
Amniotic fluid: the protective fluid around the foetus.
Anoestrus: the non-cycling period when oestrus is not shown.
Artificial vagina or AV: device a male serves into to for semen collection.
AI or Artificial insemination: placing sperm inside the female tract with a pipette.
Barren: failing to reproduce or incapable of reproducing.
Bearing: protruding or collapsed vagina.
Birth rank: the number born eg singles, twins, triplets, etc.
Breeding crate: a box designed to take the weight of a heavy male (eg boar) when serving a smaller female.
Bulling: see oestrus.
Buller: a nymphomaniac cow.
Amniotic fluid: the fluid around the foetus.
Castration: removal of the testicles of a male.
Cervix: the opening or neck of the uterus.
CIDR: a device in the female vagina to control breeding by slow release of hormones.
Colostrum: the first milk of the dam rich in antibodies.
Conception: fertilisation of an egg by a sperm.
Conception Rate (CR): percentage of females that do not return to oestrus, or are diagnosed pregnant.
Copulation: the act of mating.
Corpus Luteum: the structure which develops from the follicle after the egg is shed. May be called the "yellow body". Plural is "Corpora Lutea.
Corticosteriods: hormones produced from the adrenal glands and used to induce parturition or birth.
Cotyledon: the structure by which the foetal and maternal placenta are joined in the cow.
Cryptorchid: a male made infertile by pushing the testicles up into the body cavity and removing the scrotum.
Cycling: same as oestrus.
Chin ball harness: a device fitted to a bull to leave an ink mark on the mounted cow.
Dry: a animal that has not reproduced, or has finished lactating
Dystocia: birth difficulty.
Egg: same as ovum.
Ejaculate: ejecting the sperm from the penis. Or what is collected from this action and made up of sperm and seminal fluid.
Electroejaculation: collecting semen from a male using electrical stimulation.
Embryo: the early stage of development of the young in the uterus or shell
Embryo Transfer (ET): transferring embryos from one female to another.
Endoscope: same as a laproscope.
Entire: an uncastrated male.
Fecundity: a measure of the number of offspring born or reared.
Fertility: a measure of the female to conceive and produce offspring, or of the male to fertilise the female.
Fertilisation: the act of male sperm meeting female ovum and causing pregnancy.
Flushing: washing ova or embryos from the female's reproductive tract.
Flushing: in sheep feeding ewes well 2-3 weeks before joining with ram to increase the eggs shed and hence lambs born.
Foetus: the unborn animal in the womb.
Follicle: the structure in the ovary where an ovum matures.
Follicle Stimulating Hormone (FSH): hormone produced by the pituitary gland which controls ovulation in females and sperm production in males.
Fostering: making a mother accept an offspring from another dam, or giving an offspring to another dam to rear.
Freemartin: in cattle, a female born twin to a male is usually infertile.
Gamete: a reproductive cell (sperm or ovum).
Gestation: the time of pregnancy between conception and birth.
Glans: the structure on the end of the male's penis.
Gonads: a general term for the reproductive glands (ovaries testicles)
Gonadotrophins: hormones from the pituitary gland that control the reproductive system.
Heat: the period when the animal shows willingness to be mated.
Hermaphrodite: a bisexual animal that has both male and female sexual organs.
Hormone: a "chemical messenger". Secretions from special glands that circulate in the bloodstream and affects different body functions.
Induction: a technique to cause early onset of birth buy using hormones.
In utero: a term which means in the uterus.
In vitro: means outside the body.
In vitro fertilisation (IVF): fertilisation in a test tube.
Joining: putting a male with a female animal for mating.
Laparoscope: a telescope for examining inside an animal's body through a small incision.
Laparoscopy: the examination done with a laparoscope.
Luteinising Hormone (LH): hormone from the pituitary which controls ovulation in females and testosterone production in males.
Libido: sex drive or urge to mate.
Mating: the act of mating. Animals may be joined but not mate.
Mating harness: a device fitted to males to colour mark females after mating.
Mortality: a measure of offspring born dead or died soon after birth.
Mothering: same as fostering.
Mothering ability: the ability of a dam to look after its young.
Mounting: one animal jumping up on another in an attempt to mate.
Multiparous: a dam that has many offspring or had many pregnancies.
Non parous: a female which has not given birth.
Nymphomaniac: female in continuous oestrus
Oestrogens: female steroid hormones secreted by growing ovarian follicles and which are concerned with oestrus.
Oestrus: period when the animal will stand to be mated.
Oestrous (adjective): same as oestrus.
On-the-drop: female about to give birth.
Out-of-season breeding: breeding animals outside their normal season.
Ovary: the female organ that produces the ova or eggs.
Ovulate: the act of shedding the egg or ovulation.
Ovulation rate: measured by inspecting the ovary and counting the corpora lutea.
Ovum: a single egg. Plural is ova.
Ovum Transfer (OT): collecting eggs from the female and putting them into other females.
Parity: how many pregnancies and animal has had.
Parous: a dam which has had offspring.
Parturition: same as birth.
Pellet: a small lump of frozen semen.
Perinatal mortality: mortality of young around birth.
Pheromone: chemical secreted by one animal that influences the sexual behaviour of another.
Pituitary gland: gland at the base of the brain which secretes hormones that control functions like reproduction and milking.
Placenta: the organ which attaches the offspring to its dam and through which it is fed.
Pregnant Mare Serum Gonadotrophin (PSMG): a hormone used in reproduction control to stimulate ovulation.
Pregnancy diagnosis (PD): finding out which animals are pregnant by hand palpation or using an electronic instrument.
Post-calving interval: the time between calving and first heat.
Premature: an animal born before its full term.
Prepuce: the sheath of skin around the protracted (withdrawn) penis.
Progesterone: a hormone produced by the Corpus Luteum which stimulates the uterus to accept the embryo and then maintains pregnancy.
Prolapse: eversion (turning inside out) or the vagina, uterus or rectum.
Prostaglandin: hormone produced by the uterus and used in reproduction control.
Puberty: the stage when the animal reaches sexual maturity.
Reproductive wastage: loss of eggs or embryos between mating and birth.
Returns-to-service: females that do not become pregnant and continue to cycle.
Riding: same as mounting.
Rig: an animal with one or both undescended testicles.
Season: "in season" is the same as "on heat"
Semen: the male reproductive cells made up of spermatozoa and accessory fluids.
Service: the act of the male mating the female.
Service interval: the time between services received by a female.
Sheath: another name for the prepuce, or the plastic cover for the pistolette used in AI.
Synchronisation: getting animals to show oestrus all at the same time using hormones.
Sperm or spermatozoa: the male sex cells or gametes.
Speying: surgical removal of the ovaries to prevent pregnancy. The Fallopian tubes many also be tied to prevent sperm meeting ova.
Springing: showing signs of birth such as udder development.
Straw: the fine plastic tube semen is packed in for AI.
Super ovulation: stimulating the female to produce larger than normal numbers of ova.
Tail painting: Putting paint on the tail head of cows which is then rubbed off or scuffed when mounted by other cows and denotes oestrus.
Teaser female: female with ovaries removed and used to stimulate males.
Teaser male: a vasectomised male.
Testicle: the male organ where sperm are produced.
Testes: same as testicles.
Testosterone: hormone produced by cells in the testicle.
Tubal ligation: tying the Fallopian tubes as in speying.
Uterus: the female organ in which the calf grows.
Vagina: anterior part of female reproductive tract.
Vulva: the outside lips of the vagina.
Yellow body: same as Corpus Luteum.

Similar posts: health journals

Hi, I’m Rebecca Scritchfield and I’m a dietitian. I’m also a reformed IT professional. Couple that with a master’s degree in communications from Johns Hopkins University and it starts to make sense why I’m writing this post on opportunities for dietitians in social medial.                                                                                 
I recently presented at the Delaware Dietetic Association meeting on social media in Wilmington, Delaware. My task? Educate dietitians on the opportunities with social media and inspire them to take action – in one hour!
 
It was a crash course in simplification! Lucky for me, I recently read Nancy Duarte’s book Slideology, which offered great tips on getting your point across with few words and pictures.
 
So I went with it and used mostly images to describe social networking and the logos from the popular social media tools to help guide my presentation. I decided that the best way I can “explain” the benefits of social media is by providing live demos of the tools in action – a very important piece because everyone had a chance to learn by “doing” and could discover themselves that there’s nothing too scary about social media.
 
After laying the groundwork on social media characteristics, I made my case that the ultimate benefit of social media is “POWER”. I took them on a journey starting with conversations and relationships and how this ultimately leads to influence and power. (Props to my Hopkins Prof. Nicco Mele and all the wonderful texts he made me read.)
 
After looking at it from a 30,000 foot view, I thought it would be fun to include an interactive game. I couldn’t think of a catchy name so I just called it “WIIFD” – what’s in it for dietitians. I randomly asked audience members to describe a job task and I would try to brainstorm an example of how they can use social media to their advantage. It’s always a risk to do something like this… could they stump me?
 
Some of the ideas I gave them for using social media include:
Network – make new (virtual) connections
Grow a business (consulting, counseling…)
Sell more products
Land interviews
Save time
Collaborate
Discover… and be discovered!
 
I then went through the following social media tools by discussing the “lingo”, the benefits, live demo, and tips for getting started.

Similar posts: health journals

Today, many US high schools and community collegesalready offerlife sciences and biotechnology training to their students. In fact, biotechnology curriculum development and outreach has been ongoing in US for well over a decade.For example, Bio-Link, an NSF-funded consortium of community colleges that began in the late 1990s,has diligently worked to create a network of community colleges and high schools that offer biotechnology education and training ranging from biomanufacturing to bioinformatics to forensic DNA sciences.Further, a quick perusal of many high schools and science academies in biotechnology-rich locales like the Northeast, California, New Jersey, Maryland, North Carolina and others reveals that life sciences education and training are readily available to many students interested in biology and bioscience.
In my opinion, the system doesn't break down at the high school level but atthe undergraduate and graduate school levels. This is because for the past 15 years, many undergraduate life sciences courses have jettisoned their hands on laboratory components in favor of more lecture driven and e-based learning experiences. This is because these laboratories are costly to run and extremely labor intensive. Further, many undergraduate students may choose not pursue science careers because of the mistaken perception that life sciences jobs require a PhD. Ironically, there are many more jobs in the life sciences industry for students with undergraduate or masters' degrees than for those with PhD. This is because there is a glut of PhDs in today'smarket and the number of jobs in academia and the life sciences industry are growing smaller.I believe that academia and industry are responsible for the rapidly declining job market for PhD-life sciences.
First, let's look at academia.Most academicians who are charged with training PhDs and postdoctoral fellows have little appreciation or understanding of the technical and regulatory skill sets required in the life sciences industry. Second, many academics don't feel that it is their responsibility to prepare students and postdoctoral fellows for jobs in industry because that is tantamount to job traininga big no-no in academic circles. Finally,and perhaps most important, graduate programs are reluctant to provide career counseling or job-specific training for their students because it might interfere with their productivity, which in turn may reduce the amount of data principal investigators have to write papers and win grants to fund their laboratories. In other words, there is little or no incentive for education andtraining to change at the graduate level because there is no benefit or upside to principal investigators and tenured faculty members.
While the American life sciences industry has loudly and repeatedly complained about a lack of qualified job candidates to work at its companies, they have done little to support and fund efforts to reform US life science education and training. This is likely because many life sciences executives contend that they are in business not education andthe responsibility to prepare students for careers in science should not fall on them. Rather, it rightfully belongs in the purview of secondary and post secondary educational institutions.And, rather than train new employees without previous industrial experience (to inject new talent and ideas into their organizations), companies typically only hire job candidates with previous industrial experience.As many newly minted PhD and postdoctoral students frequently ask: How are we suppose to get industrial experience if nobody will hire us without previous industrial experience?Good question!
The BIOreport warns that the US is falling behind in bioscience education and American life science companies may experience workforce shortages in the future. The fact that about 100,000 (manyof whom were scientists)pharmaceutical employees have lost their jobs over the past several years, suggests otherwise. Nevertheless, American science education and training needs to be improved and reformed if the US wants to maintain its dominance in the life sciences.The piecemeal approach that has been pursued for past decade or so hasn't worked.And why should it?Neither academia nor industry, the two main players in the story, don't really have any skin in the game.In other words, they have nothing to lose right now!
I believe that its time for academia, industry and government to come together to craft a cohesive, national life science curriculum that meets the needs of all stakeholders. We have a President in the White House who believes in science, the ingenuity of the American people and change. The time is now!
Until next time...
Good Luck and Good Job Hunting!!!!.

Similar posts: health journals

While in medical school, students are supposed to know the answers. They spend hours cramming, memorizing arcane language and hard-to-remember numbers so that if the question appears on a test—or worse still, if a resident decides to quiz them during rounds—they can answer it.
“I don’t know, but I know where to look it up,” is not an acceptable response.
“Looking up the answer is considered cheating,” Dr. Denis Cortese, president and CEO of the Mayo Clinic pointed out on the opening day of Mayo’ s National Symposium on Medical and Health Care Education Reform.
Yet, Cortese observed, once the student becomes a doctor, he is supposed to “cheat”—i.e. look things up. He is not supposed to “take a stab” at the right dosage the way he might take a stab at the right answer on an exam. His patient’s well-being depends upon him knowing where and how to look up the information he needs, or whom to consult. A doctor who is reluctant to admit “I don’t know” is a dangerous doctor.
Today, we recognize that medicine is a team sport. No one doctor can know everything that he needs to know, even in his own specialty.
Yet, we continue to train would-be doctors as if they were going to be practicing medicine circa 1950, when “The Doctor” was supposed to have all of the answers.
The Symposium acknowledged that today, we are educating medical students the way we always have—preparing them to work in the old, broken system that we are trying to reform. Just as the system requires change, so does medical education.
For instance, the symposiums’ participants recommended that “Exams should test information use and information gathering rather than memorized knowledge.” Moreover, rather than spending all of their time in classrooms and hospital wards, students should spend more time learning to practice medicine in real-life settings. Voting on the best solutions to improve medical care, the majority of the audience agreed that “to understand patients, students should interface with the patients in their communities, experiencing medical care through their patients’ eyes and experiences.”
Finally, we need to change the way we choose students for admission to medical school. One speaker made a persuasive argument that today, we rely too heavily on grade point averages (GPAs) and medical college admission tests (MCATs). We need to draw medical students from a larger pool.

Similar posts: health journals

What should a national health care system look like? We will of course hear a lot of chest thumping from the thick-browed morons about how the US is already perfect and can not learn anything from the rest of the world. We will hear how every other system in the world is imperfect, and that is why any reform is impossible. We will hear how this will lead to communism and socialism despite the fact that every other industrialized nation in the world has universal healthcare and amazingly they didn't all go commy. In short, we are about to hear a bunch of denialist garbage designed to delay, to obstruct, to block, and drag down any meaningful action in healthcare.

Similar posts: health journals

Many Keele staff and students may have noticed the @ Keele logo appearing on many of their favourite information resources. Where ever you see this symbol, it means that you can click on it to check for the resources online availability. The presence of the symbol itself doesn't mean that it will be available electronically.

It has now been added to many of the publishing platforms, Keele databases, Google Scholar, Scirus and now the Library catalogue.

Click here to visit the full Keele A-Z holdings. Please note that this will search for journal titles not journal content. The databases are the best tool to used for literature searching.

NHS can access Keele journals under a walk in licence whilst using the Health Library IT Suite. Please note that due to copyright restrictions, library staff can not provide any copies of Keele articles to NHS staff directly.

Similar posts: health journals

Many of them become virtually incandescent with anger if they arent given some kind of medical test that they (or one of their friends) thinks is a good idea, but they dont really need. They insult you, they threaten you, they loudly announce that theyre going to call their lawyer or the hospital administrator, etc. Sometimes we stand up to them, and sometimes were too exhausted to fight. Sometimes its just easier to get the x-ray on the patient with back pain rather than take the abuse and argue with them for 40 minutes and then have them send an angry letter to the review board. Others are simply beyond the pale and cant put anyone else ahead of themselves. Some are incensed that I have to see a critically ill patient before I see them, because I got here first. People will literally interrupt cpr to scream that they want a sandwich or something to eat NOW. People want a blood test, a cat scan, an EKG, anything in exchange for their time. People will quote TV shows as medical authorities. All of us have our favorite methods to try and gratify these patients, from ultrasounding their skulls (safe, dramatic, shows nothing but costs nothing) to pointing an ultraviolet flashlight into their maalox before they drink it. s our version of wearing a wooden mask and shaking a rattle - we hate it, and patients love it.
The amazing thing is that when needless tests come back negative, the patient is completely satisfied. There is never a sense of regret, or how much money they just wasted, but rather one of accomplishment, even if they still have the same problem they walked in with. . . .

Similar posts: health journals

Here, for whatever reason, mep assumes I am a black person, and accuses me as well as all black people of turning the focus back onto themselves--after all black people only care about themselves, right? It's not as if white people are ever selfish, have racial solidarity, and want to turn the focus back on themselves (or away from "racy" topics)... right.

The token part of this response is not the blatant racism, but the final part about people of color "whining." One does not whine about rape or murder or theft; one "whines" about trivial, marginal things, like ordering a Pepsi and getting a Coke instead. Here, my non-confrontational, conversational post exploring race-relations to create a more healthy and diverse activist community is perceived as a waste of time. Who cares? We [i.e. white guys] don't! Do something useful, these last two commenters insist, not too differently than the old white men on the streets passing us by at demonstrations telling us to get jobs on a Sunday morning as they walk into Macy's. Essentially, these reactionaries are framing animal advocacy as fully with "us" [i.e. activists wit white privilege] -or- against "us" [and the animals] be selfishly focusing on your own little identity politics thingy... but remember, factory farming is like the holocaust and the KKK because all oppression is the same.

This is the type of attitude and thinking that is truly divisive and why people are not just frustrated, but outraged when animal advocates use such analogies. If they really cared about racial oppression, they would not be squashing voices addressing racially insensitive tactics and language! The analogies, as was discussed in part 1, are made in a socio-historical vacuum as if slavery, the KKK, and other systems no longer existed and "now it's the animals' turn."

RATIONALIZATION/REVERSAL
Many vegans and ARAs hold a consequentialist ethic in which an end (so long as the consequences are the best) justifies any reasonable means. Some advocates will thus condemn vegans and non-vegans alike for publicly criticizing a certain tactic (i.e. PETA dressing up as the KKK) intended to raise awareness, since doing so will not only distract further from the message (assuming it was being received in the first place) but also makes ARAs look bad.

Similar posts: health journals

Listen to Werner's presentation
Abstract
Evidence supporting the use of public reporting of quality information to improve health care quality is mixed. While public reporting may improve reported quality, its effect on quality of care more broadly is uncertain.
This study tests whether public reporting in the setting of nursing homes resulted in improvement of both reported and overall quality of post-acute care. Data is from the nursing home Minimum Data Set and inpatient Medicare claims over 1999 to 2005. The research team examined changes in post-acute care quality in U.S. nursing homes in response to the initiation of public reporting on the Centers for Medicare and Medicaid Services website, Nursing Home Compare. The research team used small nursing homes that were not subject to public reporting as a contemporaneous control and also control for the changing case mix of patient in nursing homes.
Post-acute care quality was measured using three publicly reported clinical quality measures and 30-day potentially preventable rehospitalization rates, an unreported measure of quality. Reported quality of post-acute care improved after the initiation of public reporting. However, rates of potentially preventable rehospitalization did not significantly improve and, in some cases, worsened.
Rachel M. Werner, M.D., Ph.D. is an assistant professor of medicine in the Division of General Internal Medicine at the University of Pennsylvania and Core Investigator with the VA HSR D Center for Health Equity Research and Promotion (CHERP).
Werner is a general internist and health economist whose research seeks to understand the role of quality improvement initiatives on provider behavior, the organization and financing of health care, racial disparities, and overall health care quality. Her work has recognized that public reporting of quality information may worsen racial disparities and she has been recognized through numerous awards including the Dissertation Award from AcademyHealth and the John D. Thompson Prize for Young Investigators from the Association of University Programs in Health Administration.

Similar posts: health journals

Early this month, yet another story surfaced about allegations of undisclosed conflicts of interest affecting the author of a highly publicized clinical trial. This story has now taken such an odd twist that it seems worth discussing in some detail. Let me first try to present some relevant facts, derived from published articles, mainly peer-reviewed, which do not seem to be in dispute, in chronologic order.

2005 - In a multi-author review article on mood disorders in the medically ill, Dr Robert G Robinson, of the University of Iowa, disclosed that he served on the speakers bureau of Forest Laboratories.(1) In an article in Stroke: Clinical Updates, he made a similar disclosure.(2)

28 May, 2008 - Dr Robinson was the first author of an article published in JAMA that described a randomized controlled trial comparing placebo, problem-solving (cognitive talking) therapy, and escitalopram (Lexapro, Forest Laboratories) in the prevention of depression in patients who have had strokes.(3) Patients who received placebo had a higher rate of depression (11 major, 2 minor cases, 22.4%) than patients who received escitalopram (3, 2, 8.5%) or who received problem-solving therapy (5,2, 11.9%). At the end of the article, Dr Robinson disclosed, "over the past 5 years, Dr Robinson reports serving as a consultant to the former Hamilton Pharmaceutical Company and Avanir Pharmaceutical Company," but made no disclosure about any financial relationship with Forest. In a news article published the day before, Dr Robinson was quoted as saying, "I think every stroke patient who can tolerate an antidepressant should be given one to prevent depression," but did not advocate the use of problem solving therapy.(4)
15 October, 2008 - In a letter to JAMA, Lacasse and Leo asked whether Robinson et al had done an analysis directly comparing problem-solving therapy and escitalopram, and noted that the reported incidence data for stroke in the two treatment groups suggest that the difference in treatment results "does not appear to be either clinically or statistically significant."(5) Robinson et al responded that there was no statistically significant differences between the groups.(6)

5 March, 2009 - In a rapid response section in the British Medical Journal, Leo and Lacasse raised their concerns about the interpretation of the results of the 2008 trial, and also stated that "during a subsequent internet search we were surprised to learn that four years previously the lead author had been listed on the speaker's bureau for Forest. The omission, however innocent or mistaken, is disturbing; neither the JAMA article nor subsequent media accounts noted that the lead author had served on the speaker's bureau for the manufacturer of Lexapro."(7) Their citation was to our reference 2.

11 March, 2009 - In a letter to JAMA, Robinson and Arndt reported that the financial disclosure for their 2008 article was incomplete, "resulting from erroneous recollection of the appropriate dates for speaking presentations sponsored by pharmaceutical companies...."(8) Dr Robinson disclosed receiving honoraria for two presentations in 2004, and serving on the Forest Laboratories speakers bureau "in 2004 and perhaps 2005." No editorial comment accompanied this letter.

So far, this seems to be a familiar story about an author who seemed to be excessively enthusiastic about a product of the company with whom he had had a financial relationship, but reluctant to disclose this relationship. But wait,

20 March, 2009 - A rather extraordinary editorial was published electronically in JAMA on 20 March, 2009.(9) Let me review its main points, section by section.

After acknowledging the attention conflicts of interest now receive, and briefly describing the 2008 study and the subsequent letter by Lacasse and Leo, the editorial stated that JAMA editors had received a communication from Leo on or after 16 October, 2008 which "indicated he had evidence that Robinson had not reported in his article that he had served on the speakers bureaus for pharmaceutical companies."

The editorial then devoted several paragraphs explaining the "due diligence" JAMA editors used to investigate this "allegation." They noted the "sensitive nature of these investigations," which required them to conduct them "confidentially," and again insisted "these investigations into undisclosed conflicts of interest are time-intensive and require careful attention." Thus, from the time Leo sent his "allegations," (apparently 16 October, 2008), it took until 31 January, 2009 to get a letter from Robinson et al acknowledging his undisclosed conflicts, and until 11 March, 2009 to publish it, a total of five months.

However, the concerns with confidentiality, and the repeated emphasis on the need for unusually painstaking investigation seemed disconnected to the particular case. It is clear that it may take quite a bit of time and effort to investigate some allegations of undisclosed conflicts of interest, especially when the allegations are vague, but the alleged conflicts are severe. However, in this case, it should have taken trivial effort to find Dr Robinson's previous, published disclosures. (It took me about 5 minutes of internet searching to find the two 2005 articles.) Once (easily) discovered, the disclosures in the 2005 articles starkly contrast with the disclosures, or lack thereof in the 2008 article. Furthermore, since these disclosures were already in the public domain, there should have been no concerns with confidentiality.

Similar posts: health journals

Sorry! We haven't created a WisdomCard for this search yet.
We are creating WisdomCards in priority order based on the most popular terms and phrases searched in health but want to hear from you.
You can search for this page title in other WisdomCards or if you would like us to create a WisdomCard for your search, send an email to requests@organizedwisdom.com and we'll be sure to add it to our list!
Have a great day.

Similar posts: health journals

If you use ad blocking software while viewing Daily Kos, you're getting all the benefits of our site but we're not getting any of the advertisement revenue associated with your visits. This site relies on ad revenue for daily operations: a decrease in the number of ads seen means a decrease in the funding available to run the site, to pay those that work on it, and to create improved site features.
We won't stop you from using ad blocking software, but if you do use it we ask you to support Daily Kos another way: by purchasing a site subscription. A subscription is an inexpensive way to support the site that eliminates the advertisements without using ad blocking software.
Revenue generated from the subscriptions goes to the Daily Kos fellowship program, providing a steady income for bloggers and allowing them to concentrate full time on expanding the reach and influence of the netroots through a variety of projects.
By using ad blocking software, you may be hiding the site ads but you're also reducing the site's primary source of revenue. So if you must use one, please do your part to support the site and the people that bring it to you by purchasing a site subscription today.

Similar posts: health journals

The Center on Health Promotion Research for Persons with Disabilities (CHP) here at UIC would like to announce the launching of its new website this month.

The CHP is located in the Department of Disability and Human Development, College of Applied Health Sciences. It was established in 1997 with the primary aim to identify people with disabilities who are at risk for developing numerous health complications (ie, secondary conditions) and provide them with the knowledge and skills necessary for promoting their own independence, equal opportunity, quality of life, and longevity. Building upon core funding from the University of Illinois at Chicago, the CHP has been able to successfully compete for federal funding from the National Institutes on Health (NIH), Centers for Disease Control and Prevention (CDC), and National Institute on Disability and Rehabilitation Research (NIDRR).

The following federally funded projects are located in the CHP:
National Center on Physical Activity and Disability (NCPAD),
Rehabilitation Engineering Research Center on Recreational Technologies and Exercise Physiology for People with Disabilities (RERC RecTech),
Personalized Health Promotion Program for Persons with a Physical Disability (PEPRx),
Health Empowerment Zones for Persons with Mobility Disability (HEZ),
Disability and Rehabilitation Research Project on Obesity and Secondary Conditions in Youth with Disabilities (DRRP),
Rehabilitation Research and Training Center on Aging with Developmental Disabilities (RRTC) - Longitudinal Health Intellectual Disability Study (LHIDS),
Illinois Disability and Health Program (ILDHP), and
Universal Design and Health Promotion (UDHP).

Similar posts: health journals

Reaction to acne tablet killed boy, inquest told - The Guardian 28th February 2009
A fit and healthy teenage rugby player died 12 hours after taking an acne treatment to try to clear spots on his back and shoulders, a coroner said yesterday.
The coroner, Mary Hassell, said she would write to the government about concerns that the pharmacist gave 14-year-old Shaun Jones an alternative to the tablets the doctor had prescribed and also because the drugs he received did not come with an information leaflet. After the hearing in Cardiff, Shauns father, Graeme Jones, said lessons must be learned following Shauns death, and the familys solicitor, Sefton Kwasnik, said many questions remained unanswered.

Similar posts: health journals

NHS criticised in half of complaints reviewed - The Times 16th February 2009
One in five NHS complaints sent for independent review relates to poor treatment or a wrong diagnosis.
The Healthcare Commission said that trusts were at fault or could have done more in almost half of the 8,939 complaints it investigated last year. Eleven per cent concerned treatment, 9 per cent delayed or wrong diagnosis and 8 per cent waiting or problems having treatment. Nearly half of complaints were upheld or referred back to trusts. The NHS receives about 135,000 complaints annually. It provides about 380 million treatments. In April unresolved complaints will be passed to the Parliamentary and Health Service Ombudsman, as the Healthcare Commission is replaced by the Care Quality Commission, covering health and social care.

Similar posts: health journals

I have found that stretching is one of the most underrated forms of exercise there is. Even I used to scoff at the time put into lengthy stretching that I have seen people do. Only when I began to realize that my muscles were becoming too big, and I had a difficult time scratching my back did I realize that I needed to take action. After just 3 weeks in a twice a week power-yoga class, I began to notice serious improvements in not only my flexibility, but also my strength gains, and lack of soreness after exercise. Impressed as I was, I needed to find out more information.
There is loads of information related to stretching in health journals and on the internet that I had consistently overlooked before. Mainly because at some point it had been engrained into my mind that I just didn’t have the flexible gene (no one in my family can touch their toes) and yoga was just too girly for a weightlifter like myself. Oh, how I was wrong…
Before we begin, keep in mind that there are several important factors that can affect your flexible abilities. The first is age: flexibility increases through adolescence up until the age of 20, after which it gradually decreases over time. The second is gender: women are generally more flexible than men. The third and the one that this post will focus on is activity: obviously people who remain active throughout their lives will generally be more supple than those who are sedentary. Being flexible is extremely important to in regards to exercise and general health, and this blog will cover the basic premises of stretching and how to do it safely and effectively.
Flexibility is defined as the ability of a joint to move through its full range of motion. Flexibility is specific to each joint, therefore having “good” flexibility implies that you have good range of motion in all your joints, not just one joint. Thankfully, flexibility is highly adaptable, and will increase with regular activity and stretching exercises. However, flexibility also has quick reversibility and decreases without inactivity. It is extremely important to any sort of physical activity especially in terms of skill-related fitness. A runner who has tight hamstrings will have restricted flexion in the hip joint, resulting in shorter stride length. Regardless of whether you are running competitively, increased flexibility in the hamstrings and other leg muscles will increase your speed and reduce the amount of energy used while running. For general well being, how easily, smoothly, and painlessly you can bend, reach, twist, and turn depends on how flexible your body is.

Similar posts: health journals

Non-compliance, or non-adherence (people not taking their medication) is a big worry for health professionals. This problem is particularly bad among people with schizophrenia where the rates of non-compliance are estimated at between 40-53% depending on the definition used. Motivational interviewing is sometimes used to improve compliance. It attempts to get over people's mixed feelings about changing their behaviour by bringing out their inner motivation to change. It has been used to get people with diabetes and asthma to take their medication, to treat drink and drugs problems and to get people to eat more healthily and take more exercise. Researchers from Marquette University in Wisconsin, U.S. carried out a review of studies into the effectiveness of motivational interviewing at improving compliance among people with schizophrenia. They found only five studies between 1965 and 2006. Two of them showed that motivational interviewing was effective but the other three found that it made no difference. The researchers concluded that the small sample of studies and their methodological limitations made it difficult to draw any meaningful conclusions.

Drymalski, Walter M. and Campbell, Todd C.

Similar posts: health journals

"In my view, we in the news media have a responsibility to hold ourselves to higher standards if there is any chance that doctors and patients will act on the basis of our reporting. We are not clinicians, but we must be more than carnival barkers; we must be credible health communicators more interested in conveying clear, actionable health information to the public than carrying out our other agendas. There is strong evidence that many journalists agree — and in particular, consider themselves poorly trained to understand medical studies and statistics.5 But not only should our profession demand better training of health journalists, it should also require that health stories, rather than being rendered in black and white, use all the grays on the palette to paint a comprehensive picture of inevitably complex realties. Journalists could start by imposing on their work a "prudent reader or viewer" test: On the basis of my news account, what would a prudent person do or assume about a given medical intervention, and did I therefore succeed in delivering the best public health message possible?
Although the primary responsibility for improving health-related journalism must lie with journalists, clinicians and researchers can help. When interviewed by journalists about a news development, such as a new study, they should offer to discuss the broader context, point reporters to any similar or contradictory studies, refer journalists to credible colleagues with differing perspectives, and mention any study limitations or caveats about the results, as well as any potential or real conflicts of interest among the study authors. It will take many expert hands to ensure that the health news the public reads really is fit to print.

Similar posts: health journals