duminică, 5 august 2012
Study Identifies Discrepancies Between National Surveys Tracking Obesity
Main Category: Obesity / Weight Loss / Fitness
Article Date: 03 Aug 2012 - 1:00 PDT Current ratings for:
Study Identifies Discrepancies Between National Surveys Tracking Obesity
Despite the increasing awareness of the problem of obesity in the United States, most Americans don't know whether they are gaining or losing weight, according to new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
Obesity increased in the US between 2008 and 2009, but in response to the questions about year-to-year changes in weight that were included in the most widespread public health survey in the country, on average, people said that they lost weight. Men did a worse job estimating their own weight changes than women. And older adults were less attuned to their weight changes than young adults. The findings are being published in the article "In denial: misperceptions of weight change among adults in the United States" * in the August edition of Preventive Medicine.
"If people aren't in touch with their weight and changes in their weight over time, they might not be motivated to lose weight," said Dr. Catherine Wetmore, the lead author on the paper. "Misreporting of weight gains and losses also has policy implications. If we had relied on the reported data about weight change between 2008 and 2009, we would have undercounted approximately 4.4 million obese adults in the US."
A range of public health campaigns in recent years have urged Americans to lose weight to lower their chances of developing heart disease, diabetes, and other chronic conditions. To understand whether people in the US are heeding this advice, Dr. Wetmore, a former Post-Graduate Fellow at IHME and now a biostatistician at Children's National Medical Center, and IHME Professor Dr. Ali Mokdad compared self-reported changes in body weight between 2008 and 2009.
They used data from the Behavioral Risk Factor Surveillance System (BRFSS), a yearly cross-sectional survey of adults in the US designed to monitor leading risk factors for morbidity and mortality nationwide. More than 775,000 people were surveyed in the years analyzed, and they were asked multiple questions about their weight, including how much they weighed on the day of their interview and how much they weighed one year prior to their interview.
The researchers found that, on average, American adults gained weight over the study period - because the reported weights increased between the 2008 and 2009 surveys - but the 2009 study participants told surveyors that they had lost weight during the previous year. Based on the weights they reported, the prevalence of obesity in the US would have declined from 2008 to 2009. Instead, the prevalence of obesity inched upward from 26% to 26.5%, and average weight increased by about one pound per person between 2008 and 2009.
"We all know on some level that people can be dishonest about their weight," Dr. Mokdad said. "But now we know that they can be misreporting annual changes in their weight, to the extent of more than two pounds per year among adults over the age of 50, or more than four pounds per year among those with diabetes. On average, American adults were off by about a pound, which, over time, can really add up and have a significant health impact."
Not everyone reported losing weight. The researchers found that reports of unintentional weight gain were more common in specific groups: men and women under the age of 40 those identifying as black, Native American, or Hispanic current and former smokers those consuming less than five servings of fruits and vegetables per day those reporting no physical activity those with diagnosed chronic diseases, frequent poor mental health, and insufficient sleep those lacking health care coverage "It's very popular right now to talk about the underlying environmental causes of obesity, whether it's too much fast food or not enough parks," Dr. Wetmore said. "While we know that the environment definitely plays a role, these results show that we need to do a better job helping people to be aware of what's going on with their own bodies." Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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The Canadian Paediatric Adverse Events Study
Main Category: Pediatrics / Children's Health
Also Included In: Public Health
Article Date: 03 Aug 2012 - 1:00 PDT Current ratings for:
The Canadian Paediatric Adverse Events Study
Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done to describe the epidemiology of adverse events among children in hospital in Canada.
We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals in Canada. We reviewed charts from patients admitted from April 2008 through March 2009, evenly distributed across 4 age groups (0 to 28 d; 29 to 365 d; > 1 to 5 yr and > 5 to 18 yr). In stage 1, nurses and health records personnel who had received training in the use of the Canadian Paediatric Trigger Tool reviewed medical records to detect triggers for possible adverse events. In stage 2, physicians reviewed the charts identified as having triggers and described the adverse events.
A total of 3669 children were admitted to hospital during the study period. The weighted rate of adverse events was 9.2%. Adverse events were more frequent in academic pediatric centres than in community hospitals (adjusted odds ratio [OR] 2.98, 95% confidence interval [CI] 1.65-5.39). The incidence of preventable adverse events was not significantly different between types of hospital, but nonpreventable adverse events were more common in academic pediatric centres (adjusted OR 4.39, 95% CI 2.08-9.27). Surgical events predominated overall and occurred more frequently in academic pediatric centres than in community hospitals (37.2% v. 21.5%, relative risk [RR] 1.7, 95% CI 1.0-3.1), whereas events associated with diagnostic errors were significantly less frequent (11.1% v. 23.1%, RR 0.5, 95% CI 0.2-0.9).
More children have adverse events in academic pediatric centres than in community hospitals; however, adverse events in the former are less likely to be preventable. There are many opportunities to reduce harm affecting children in hospital in Canada, particularly related to surgery, intensive care and diagnostic error.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our pediatrics / children's health section for the latest news on this subject. Anne G. Matlow, G. Ross Baker, Virginia Flintoft, Douglas Cochrane, Maitreya Coffey, Eyal Cohen, Catherine M.G. Cronin, Rita Damignani, Robert Dubé, Roger Galbraith, Dawn Hartfield, Leigh Anne Newhook, Cheri Nijssen-Jordan From the Department of Pediatrics (Matlow, Coffey, Cohen), Hospital for Sick Children; the Department of Pediatrics (Matlow, Coffey, Cohen), University of Toronto; University of Toronto Centre for Patient Safety (Matlow, Baker, Flintoft, Coffey, Cohen); Institute of Health Policy, Management and Evaluation (Baker, Flintoft), University of Toronto, Toronto, Ont.; the Department of Surgery (Cochrane), University of British Columbia; BC Patient Safety and Quality Council (Cochrane), Vancouver, BC; Child Health Program (Cronin), Winnipeg Regional Health Authority, Winnipeg, Man.; the Department of Quality and Risk Management (Damignani), Hospital for Sick Children, Toronto, Ont.; the Department of Paediatrics (Dubé), Centre Hospitalier Universitaire Ste-Justine, University of Montreal, Montréal, Que.; the Department of Pediatrics (Galbraith, Nijssen-Jordan), Faculty of Medicine, University of Calgary, Calgary, Alta; the Department of Pediatrics (Hartfield), University of Alberta, Edmonton, Alta.; the Discipline of Pediatrics (Newhook), Memorial University; and Janeway Child Healthcare Centre (Newhook), Eastern Health, St. John's, NL
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joi, 15 decembrie 2011
Caffeine Study Shows Sport Performance Increase
Also Included In: Nutrition / Diet
Article Date: 15 Dec 2011 - 2:00 PST
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Caffeine combined with carbohydrate could be used to help athletes perform better on the field, according to new research by a sport nutrition expert.
Mayur Ranchordas, a senior lecturer and performance nutritionist at Sheffield Hallam University, carried out studies on footballers using caffeine and carbohydrates combined in a drink. Along with improvements in endurance caused by ingesting carbohydrate, the athletes' skill level improved after taking caffeine and carbohydrate together.
Mayur said: "There is already plenty of research that shows that caffeine and carbohydrate improve endurance, but this study shows that there is also a positive effect on skill and performance.
"We carried out three different soccer-specific match simulations of 90 minutes each two 45 minute sessions that tested agility, dribbling, heading and kicking accuracy. The test was designed to mimic a football game where the participants had to carry out multiple repeated sprints, dribble the ball around cones and shoot accurately.
"We found that the combination of carbohydrate and caffeine allowed players to sustain higher work intensity for the sprints, as well as improving shooting accuracy and dribbling during simulated soccer activity.
"These findings suggest that, for athletes competing in team sports where endurance and skill are important factors, ingesting a carbohydrate and caffeine drink, as opposed to just a carbohydrate drink, may significantly enhance performance. Our findings suggest that soccer players should choose a carbohydrate caffeine drink over a carbohydrate drink to consume before kick off and at half-time."
Article adapted by Medical News Today from original press release. Source: Sheffield Hallam UniversityVisit our sports medicine / fitness section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:
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15 Dec. 2011.
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Further Study Necessary To Better Utilize Nature's Medicine Cabinet
Also Included In: Cancer / Oncology
Article Date: 15 Dec 2011 - 0:00 PST
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There are probably at least 500 medically useful chemicals awaiting discovery in plant species whose chemical constituents have not yet been evaluated for their potential to cure or treat disease, according to a new analysis by a New York Botanical Garden scientist who has more than 15 years of experience in collecting plants for natural-products discovery programs.
Currently, 135 drugs on the market are derived directly from plants; the analysis indicates that at least three times as many disease-fighting substances have yet to be found that could be developed into drugs or used as the basis for further drug research.
"Clearly, plant diversity has not been exhausted, and there is still great potential in the plant world," said James S. Miller, Ph.D., Dean and Vice President for Science at the Botanical Garden.
Dr. Miller's analysis, "The Discovery of Medicines from Plants: A Current Biological Perspective," is published in the December issue of the peer-reviewed journal Economic Botany.
To arrive at his estimate, Dr. Miller used a formula based on the ratio of the number of drugs that have been developed from plants to the number of plants that were screened to find those drugs. He then applied that ratio to the number of plant species that have not yet been screened.
Because of uncertainties in some of those numbers, the formula yields a range of potential drug discoveries. While there is no general agreement among botanists about the number of plant species that are likely to exist, Dr. Miller concluded that there are 300,000 to 350,000 species of plants. Of those, he determined that the chemistry of only 2,000 species has been thoroughly studied, and perhaps only 60,000 species have been evaluated even partially for medicinally useful chemicals.
Working with those numbers, Dr. Miller calculated that there are likely to be a minimum of 540 to 653 new drugs waiting to be discovered from plants; the actual number could be much greater.
"These calculations indicate that there is significant value in continuing to screen plants for the discovery of novel bioactive medicinally useful compounds," concludes Dr. Miller, who has run natural-products discovery programs that have collected specimens in North America, Central and Southeast Asia, and Africa for government agencies, pharmaceutical companies, and academic programs.
As part of his Economic Botany paper, Dr. Miller reviews the disappointing history of past plant-screening efforts and evaluates the potential for future programs.
Technological advances in the 1970s and 1980s gave medical researchers the capacity to evaluate large numbers of plant samples. That prompted the federal government and large pharmaceutical companies to institute aggressive plant collecting and screening programs. Those programs led to the development of several important drugs such as Taxol from Taxus brevifolia (used in cancer treatment) and Camptothecin from Camptotheca acuminata (derivatives of which are used to treat cancer). Other drugs indirectly trace their discovery to natural-products research, including the anti-viral Oseltamivir, which derives from Illicium anisatum and is marketed in the United States as Tamiflu.
The number of drug discoveries, however, was substantially less than anticipated. By the early 2000s, many of the large pharmaceutical companies had abandoned their efforts.
Dr. Miller argues that one possible explanation for the low yield is the relatively crude way in which plant extracts were tested for their pharmaceutical potential. Plants may contain as many as 500 to 800 different chemical compounds, but the screening programs of the late 20th century used extracts made from a whole plant or at best extracts that contained many hundreds of compounds.
Under those circumstances, one compound may interfere with the action of another, or the amount of one compound may be too small to register in a mix of hundreds of chemicals.
To correct this problem, new technologies now allow researchers to separate complex mixtures of natural products into a "library" of relatively pure compounds that can be tested individually. A 2002 study demonstrated that testing such libraries dramatically improves discovery rates.
Bringing these advances together with refinements in collecting strategies could lead to what Dr. Miller calls a "second renaissance" of natural-products discovery.
Miller undertook his analysis to highlight the fact that despite past collecting programs, the plant world represents a poorly explored source of potentially lifesaving drugs. That adds urgency, he said, to efforts to conserve natural habitats so that species are not driven to extinction before they can be studied.
"The natural world has a great and diverse array of interesting chemicals that have been only minimally studied and still hold considerable potential," he writes.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our pharma industry / biotech industry section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:
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15 Dec. 2011.
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Epilepsy In Children - Adverse Events of Invasive EEG, Study
Academic Journal
Main Category: Epilepsy
Also Included In: Pediatrics / Children's Health
Article Date: 15 Dec 2011 - 8:00 PST
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According to an investigation led by Dr. Thomas Blauwblomme and his team of Great Ormond Street Hospital, London, in the December issue of Operative Neurosurgery, a quarterly supplement to Neurosurgery, official journal of the Congress of Neurological Surgeons, almost half of all children suffering with severe epilepsy who receive invasive electroencephalography (EEG) recordings, experience some type of side effect.
The study reveals that no other method can obtain the vital information needed for planning complicated epilepsy procedures that EEG recordings provide.
The team examined side effects associated to invasive EEG recordings in 95 children between 1994 and 2009. The majority of epilepsy cases in children can be controlled with drugs, although surgery is highly effective when medications are not successful. In order to plan the surgery, surgeons need accurate information on the region of the brain which controls seizure activity.EEG recordings are required in some complex cases to gather this information. EEG recordings use electrodes placed on the brain surface or into the brain tissues. The novel investigation set out to obtain detailed information regarding the risks connected with EEG recordings. In the study the children had extremely severe epilepsy, averaging over 200 seizures per month. The average age of the children was around 11 years.
The researchers discovered that in total, nearly half of the children (49%) experienced some form of side effect. Approximately 30% of children had more severe events that increased the time they were hospitalized. None of the adverse events caused permanent neurological damage or death.
Side effects included: Infection - 15%Brain swelling - 6%Bleeding - 17%Cerebrospinal fluid leakage - 11%In most of the children who experienced bleeding and in some of those with infection, further surgery was required. After surgeons began using a novel type of graft material in 2002, no further problems with CSF leakage were reported.
Brain swelling was more prevalent among older children, while the complication rate was lower (20%) in children under the age of 2. Length of EEG recording, or if recordings used electrodes on the surface or implanted in the brain, was not associated with the risk of side effects.
In 69% of patients, EEG recordings successfully recorded the location of the seizure zone in brain activity during seizures. In total, 89% of children received surgery for epilepsy. The success rate of surgery was highest the more precise the invasive EEG recordings were in localizing the seizure zone.
The investigation notes the considerable risk of side effects associated to EEG recordings in children with the condition. Although the EEG is invasive, it provides "invaluable information" for locating the source of seizure activity within the brain.
The team highlight the relatively low risk of adverse events in children under 2 years - which adds to recent evidence backing early surgery for children with epilepsy that doesn't respond to drugs.
Dr. Blauwblomme and coauthors explain:
"For all children undergoing invasive EEG recordings, parents should receive detailed information on the risks and benefits of the procedure."
In addition, the researchers stress that the surgery should be performed at a treatment center with experience in invasive EEG recording, with cautious planning prior to the procedure and close patient follow-up afterward.
Written by Grace Rattue
Copyright: Medical News Today
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15 Dec. 2011.
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Study To See If Walking And/Or Memory Training May Prevent Memory Problems In People With Parkinson's Disease
Also Included In: Stroke; Rehabilitation / Physical Therapy; Clinical Trials / Drug Trials
Article Date: 15 Dec 2011 - 0:00 PST
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Researchers from the University of Maryland School of Medicine and the Baltimore VA Medical Center have launched a study of exercise and computerized memory training to see if those activities may help people with Parkinson's disease prevent memory changes. The type of memory that will be examined is known as "executive function;" it allows people to take in information and use it in a new way. Many Parkinson's patients develop problems with executive function, which can prevent them from working and may eventually require a caregiver to take over more of the complex cognitive tasks of daily living.
"Studies of normal aging show that memory and executive function can be improved with exercise, such as walking several days a week," explains Karen Anderson, M.D., principal investigator and an assistant professor of neurology and psychiatry at the University of Maryland School of Medicine. Dr. Anderson is also a neuro-psychiatrist at the Maryland Parkinson's Disease and Movement Disorders Center at the University of Maryland Medical Center and a clinician in mental health at the Baltimore VA Medical Center.
She adds, "We want to see if exercise can slow or reverse some of these memory changes in Parkinson's patients. We will also investigate whether a computer game designed to improve executive function may make a difference as well. The other question is, what happens when you put the two interventions together - if there is memory improvement, will it be even better than with one of the interventions? Or is it more efficient to do just one or the other? We really do not know."
The researchers, who received funding through a VA Merit Award, plan to enroll about 90 patients who will be divided randomly into three groups: exercisers walking on a treadmill, memory game players and those doing both exercise and memory games. Participants in each group will receive a memory assessment at the beginning of the study. They will come in three times a week for their training for three months and will be then be tested again. Three months after that, the researchers will test the participants again to see if there may be longer term benefits to the training.
With both the treadmill walking and the memory game, the exercise or video game will become more challenging as the participant improves. The memory training works like a video game with players advancing to a higher level of difficulty. For the exercisers, trainers may increase the speed or slope of the treadmill to make it more aerobically challenging.
"This new study builds on our experience from a previous study of exercise for gait and mobility in Parkinson's disease. Since both motor function and cognitive function are important for mobility and performance of daily activities, this new study will investigate the individual and combined effects of treadmill training and cognitive training," explains Lisa Shulman, M.D., co-investigator and professor of neurology at the University of Maryland School of Medicine.
"Parkinson's patients are eager to know if there is anything they can do to give them greater control over their condition. Mobility and memory are the two key components to preserve independence. If these treatment strategies are found to be effective, we will learn important new approaches to delaying disability," says Dr. Shulman who is co-director of the Maryland Parkinson's Disease and Movement Disorders Center.
The treadmill training will take place at the Baltimore VA Medical Center in the Maryland Exercise and Robotics Center of Excellence, a gym facility with specialized equipment for people with physical limitations or balance issues. For safety, participants will wear a safety harness while walking on the treadmill. Experienced exercise physiologists will supervise each training session.
The computerized memory training game will take place both at the VA and University of Maryland School of Medicine.
"This study shows the commitment of our University of Maryland faculty to exploring new approaches, such as exercise and memory training, to help patients with illnesses such as Parkinson's disease around the world," says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and dean, University of Maryland School of Medicine.
The Maryland researchers expanded the exercise studies to Parkinson's patients after first finding success with treadmill training for stroke patients. This research, also conducted at the University of Maryland School of Medicine and the VA Maryland Health Care System, found that regular exercise on a treadmill can improve stroke patients' walking ability even years after they've had a stroke.
Co-investigator Richard Macko, M.D., says, "With stroke patients, we have seen that the consistent, repetitive motion of walking may help the brain to develop new connections to compensate for the damaged ones. This new Parkinson's study takes the concept of exercise training for neurology patients in a new direction. We will be interested to see if this consistent training will produce benefits to memory." Dr. Macko is director of the Maryland Exercise and Robotics Center of Excellence at the VA Maryland Health Care System and professor of neurology at the University of Maryland School of Medicine.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our parkinson's disease section for the latest news on this subject. Parkinson's disease affects about one million people in the United States and Canada. Most people begin to develop symptoms in their late 50s or early 60s, although it can occur in younger people.
Parkinson's disease affects the brain's ability to produce dopamine, the neurotransmitter involved in the communication between the brain cells for motor control. Physical symptoms include tremor, muscle rigidity and slowness of movement. There are also non-motor symptoms such as changes in memory ability, sleep disturbances and depressed mood.
Parkinson's patients interested in enrolling in the exercise and memory study should call 443-827-0677.
University of Maryland Medical Center Please use one of the following formats to cite this article in your essay, paper or report:
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15 Dec. 2011.
University of Maryland Medical Center. (2011, December 15). "Study To See If Walking And/Or Memory Training May Prevent Memory Problems In People With Parkinson's Disease." Medical News Today. Retrieved from
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luni, 12 decembrie 2011
Treating Latent Tuberculosis - Easier Therapy, Study
Main Category: Tuberculosis
Article Date: 12 Dec 2011 - 7:00 PST
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An investigation led by Timothy Sterling, M.D., professor of Medicine at Vanderbilt University Medical Center, has resulted in a vital alteration in CDC recommendations in the plan of prevention for tuberculosis (TB). The study was published December 8 in New England Journal of Medicine (NEJM).
On December 9 in the Morbidity and Mortality Week Report (MMWR), the Centers for Disease Control and Prevention (CDC) announced that the novel method, which takes one-third the time of current treatment, provides several individuals at a high risk of developing TB an effective treatment option. Latent TB infections result from exposure to TB - the infecting bacteria are alive in the body, but inactive.
Until now, the treatment for latent TB infection involved patients taking daily doses of a medication called isoniazid (INH). Over the course of nine months, a total of 270 daily doses were taken in order to destroy the bacteria, which can remain dormant in the body for several years.
The study, which consisted of 8,000 individuals in 4 countries over a 10 year period, demonstrated that just 12 doses of INH combined with another TB medication called rifapentine, taken once-weekly was safe and effective. In addition the novel therapy improved compliance by at least 10%
Sterling explained:
"This is a game changer. Currently less than half of the people who start the current therapy complete it. The new combination would require a direct observation, but more people would complete treatment."
The CDC explained that although cases of active TB are at an all-time low, around 4% of individuals in the U.S., or 11 million people, have latent TB. Active TB cases, which can be potentially fatal to individuals who have a compromised immune system, still occur in Nashville. In order to prevent a return of active and infections disease, the Metro Nashville Public Health Department's Division of TB Elimination works with an average of 700 novel cases of latent TB every year.
One of the locations for the investigation was The Metro Nashville Public Health. The study received funding by the Centers for Disease Control and Prevention (CDC). Other Vanderbilt investigators included Amy Kerrigan, MSN, R.N., and Alicia Wright, among others.?
Sterling says further research is vital. The novel treatment is not an option for all patients, and may not work well in countries with a higher TB incidence. Children under 2 were excluded from the investigation.
Written by: Grace Rattue
Copyright: Medical News Today
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12 Dec. 2011.
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Study Of E.coli Outbreak Finds Prepackaged Raw Cookie Dough Not Ready-To-Eat
Also Included In: GastroIntestinal / Gastroenterology; Public Health
Article Date: 12 Dec 2011 - 1:00 PST
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The investigation of a 2009 multistate outbreak of Shiga toxin-producing Escherichia coli (STEC), an important cause of bacterial gastrointestinal illness, led to a new culprit: ready-to-bake commercial prepackaged cookie dough. Published in Clinical Infectious Diseases and available online, a new report describing the outbreak offers recommendations for prevention, including a stronger message for consumers: Don't eat prepackaged cookie dough before it's baked.
The report's authors, led by Karen Neil, MD, MSPH, and colleagues at the Centers for Disease Control and Prevention and at state health departments, reached two key conclusions: 1) manufacturers of cookie dough should consider reformulating their product to make it as safe as a ready-to-eat product and 2) more effective consumer education about the risks of consuming unbaked goods is needed. During the 2009 outbreak, 77 patients with illnesses were identified in 30 states, and 35 people were hospitalized.
Previous E. coli-related food-borne illnesses have been associated with ground beef, leafy green vegetables, sprouts, melons, salami, and unpasteurized apple cider. The 2009 investigation, which involved extensive traceback, laboratory, and environmental analysis, led to a recall of 3.6 million packages of the cookie dough. However, no single source, vehicle, or production process associated with the dough could be identified for certain to have contributed to the contamination.
Dr. Neil and colleagues suspected that one of the ingredients used to produce the dough was contaminated. Their investigation didn't conclusively implicate flour, but it remains the prime suspect. They pointed out that a single purchase of contaminated flour might have been used to manufacture multiple lots and varieties of dough over a period of time as suggested by the use-by dates on the contaminated product.
Flour does not ordinarily undergo a "kill step" to kill pathogens that may be present, unlike the other ingredients in the cookie dough like the pasteurized eggs, molasses, sugar, baking soda, and margarine. Chocolate was also not implicated in this outbreak since eating chocolate chip cookie dough was less strongly associated with these illnesses when compared with consuming other flavors of cookie dough, according to Dr. Neil.
The study authors conclude that "foods containing raw flour should be considered as possible vehicles of infection of future outbreaks of STEC." Manufacturers should consider using heat-treated or pasteurized flour, in ready-to-cook or ready-to-bake foods that may be consumed without cooking or baking, despite label statements about the danger of such risky eating practices, the authors conclude. In addition, manufacturers should consider formulating ready-to-bake prepackaged cookie dough to be as safe as a ready-to-eat food item.
Eating uncooked cookie dough appears to be a popular practice, especially among adolescent girls, the study authors note, with several patients reporting that they bought the product with no intention of actually baking cookies. Since educating consumers about the health risks may not completely halt the habit of snacking on cookie dough, making the snacks safer may be the best outcome possible.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.Visit our infectious diseases / bacteria / viruses section for the latest news on this subject. A Novel Vehicle for Transmission of Escherichia coli O157:H7 to Humans: Multistate Outbreak of E. coli O157:H7 Infections Associated With Consumption of Ready-to-Bake Commercial Prepackaged Cookie Dough - United States, 2009
http://www.oxfordjournals.org//our_journals/cid/prpaper.pdf
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New Study Finds Nursing One Of The Least Mobile Professions
Article Date: 12 Dec 2011 - 1:00 PST
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A study on the geographic mobility of registered nurses (RNs) recently published in the December Health Affairs magazine suggests that the profession's relative lack of mobility has serious implications for access to health care for people in rural areas.
According to the study - part of the RN Work Project funded by the Robert Wood Johnson Foundation - more than half (52.5 percent) of newly licensed RNs work within 40 miles of where they attended high school. Even more nurses reported working in the same state in which they attended high school. Nearly four in five (78.7 percent) of the nurses surveyed who held associate's degrees and more than three in four (76.8 percent) of those with bachelor's degrees practiced in the state they had attended high school.
According to the study's authors, this lack of geographic mobility means that hospitals and other health care settings must rely heavily on locally-trained RNs and find it difficult to recruit nurses when there are not enough in the local area. This may be a particular problem in rural areas where there are fewer schools of nursing.
Lead investigators for the study were Christine Kovner, PhD, RN, FAAN, professor at the College of Nursing, New York University; Carol Brewer, PhD, RN, FAAN, professor at the School of Nursing, University at Buffalo; and Sean Corcoran, PhD, associate professor of educational economics at New York University. Kovner and Brewer direct the RN Work Project.
The lack of geographic mobility is higher for nurses than for most other professions. According to the study, six in ten (60.8 percent) professional workers with an associate's degree and 53.3 percent of workers with a bachelor's degree resided in their state of birth as of the 2000 census. Among RNs with bachelor's degrees, 61.6 percent ages 20-39 were living in their state of birth compared with 56.8 percent of comparable professionals in other fields.
Most of the nurses surveyed attended their first nursing degree program in the state where they graduated from high school and 88 percent also took their first registered nurse job in the state where they received their first nursing degree. Approximately two-thirds of the RNs in the survey were working within 100 miles of where they grew up and more than a third (35.1 percent) were working within 15 miles of where they attended high school.
"Given the strong tendency for nurses to practice close to where they attended nursing school and to attend nursing school near where they graduated high school, it's not surprising that parts of the country with few or no schools of nursing are struggling to find nurses," said Kovner. "We did not investigate the reasons for nurses' lack of mobility, but this reality suggests that more needs to be done in areas with few nursing schools in order to meet the health care needs of those communities."
The authors of the study recommend four policy changes to expand the supply of nurses in underserved areas: Workforce planners should target educational support, including scholarships and loan forgiveness programs, to provide incentives to local students to pursue nursing education; Policy makers should expand the number of nursing education programs in underserved areas, including new four-year nursing programs and distance learning. This could include creating extension programs or expanding programs at local community colleges to offer bachelor's degrees in nursing; State and university leaders should review their admission policies for nursing programs and the levels of financial aid offered, in some cases giving preference to in-state applicants should be considered; and Programs and policies that offer financial incentives to attract nurses to underserved areas should be encouraged, expanded and fully-funded, including those that already exist such as the National Health Service Corps and the Area Health Education Centers. Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our nursing / midwifery section for the latest news on this subject. The findings are based on a cross-sectional survey of 1,765 RNs in Metropolitan Statistical Areas and rural areas in 15 states.
New York University Please use one of the following formats to cite this article in your essay, paper or report:
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duminică, 11 decembrie 2011
Study Challenges Decades-Old Treatment Guidelines For Anorexia
Article Date: 10 Dec 2011 - 1:00 PST
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Adolescents hospitalized with anorexia nervosa who receive treatment based on current recommendations for refeeding fail to gain significant weight during their first week in the hospital, according to a new study by UCSF researchers.
The findings, published in the January issue of the Journal of Adolescent Health with an accompanying editorial, challenge the current conservative approach to feeding adolescents with anorexia nervosa during hospitalization for malnutrition.
The American Psychiatric Association, American Dietetic Association and others recommend starting with about 1,200 calories per day and advancing slowly by 200 calories every other day. This "start low and go slow" approach is intended to avoid refeeding syndrome a potentially fatal condition resulting from rapid electrolyte shifts, a well-known risk when starting nutrition therapy in a starving patient.
The UCSF study is the first to test these recommendations, which have been in place since 2000. "Our findings show that the current recommendations are just not effective", said Andrea Garber, PhD, RD, associate professor of pediatrics in the Division of Adolescent Medicine at UCSF, who led the research with colleagues in the UCSF Adolescent Eating Disorders Program.
Study participants were hospitalized due to signs of malnutrition, including low body temperature, blood pressure, heart rate and body mass index. The vast majority of the 35 primarily white, female adolescent patients received low calorie diets based on the current recommendations. Patients were fed six small meals per day, and when they refused food, they were given high calorie liquid supplements as a replacement. The patients' vital signs were monitored closely, with their heart rates measured continuously and electrolytes checked twice a day.
While the low calorie diets did prevent refeeding syndrome for those patients, about 83 percent of them also experienced significant initial weight loss and no overall weight gain until their eighth day in the hospital. This finding represents "a missed opportunity," according to Garber.
"Studies show that weight gain during hospitalization is crucial for patients' long-term recovery," she said, "we have to make the most out of their short time in the hospital."
Although 94 percent of patients in the study started on fewer than 1,400 calories a day, it included a range of diets from 800 to 2,200 calories. This range allowed the researchers to examine the effect of increasing calories. According to Garber, two important findings emerged:
The calorie level of the starting diet predicted the amount of weight that would be lost in the hospital. In other words, those on lower calorie diets lost significantly more weight.
Higher calorie diets led to less time in the hospital. In fact, Garber said, "we showed that for every 100 calories higher, the hospital stay was almost one day shorter."
While the study finds that current recommendations are too cautious, it raises other questions, according to the research team. For example, while a shorter hospital stay may reduce insurance costs, patients may not be ready to go home yet.
"Shorter is not necessarily better" said Garber. "We have to consider the potential implications down the line, both psychological and emotional."
Another unanswered question relates to refeeding syndrome, which remains "a very real fear", according to Barbara Moscicki, MD, a professor of pediatrics in the Division of Adolescent Medicine at UCSF and senior author on the paper. Moscicki says that the team is proceeding cautiously since more aggressive approaches to feeding and supplementation have not yet been well studied.
Nevertheless, the researchers say that the study results are a promising start because no adverse events were seen in the study subjects on the higher calorie diets. "If we can improve weight gain with higher calories," Garber said, "then we're on the right path."
Article adapted by Medical News Today from original press release. Source: UCSFVisit our anxiety / stress section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:
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