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We give you many useful information about health

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We give you many useful information about health

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We give you many useful information about health

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Tampilkan postingan dengan label their. Tampilkan semua postingan
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Minggu, 04 Desember 2011

2 Out of 3 Medical Students Don't Know When to Wash Their Hands

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It's cold and flu season, which means you should be washing your hands — a lot. And that rule should apply to health care workers most of all, to protect not just themselves but their patients. Problem is, most doctors are confused about when they're supposed to hit the sink, a new study of medical students finds.

Researchers at Hannover Medical School in Germany surveyed 85 medical students who were about to enter their clinical training — when they deal with actual patients. The surveys were administered as part of a lecture class that students must pass before initiating patient contact.

The doctors-to-be were given seven scenarios, five of which required hand-washing: before contact with patients, before preparing IV fluids, after removing gloves, after contacting patients' beds and after contact with vomit. (The other two scenarios did not require hand-washing.)

Only 1 in 5 students correctly identified what to do in all seven situations. And just 1 in 3 got all five hand-washing scenarios correct. Most students knew that they were supposed to wash their hands before contacting a patient, after touching their bed and after contacting vomit, but 15% to 20% could not correctly identify the other two hand-washing situations. (Last month, a study found that wearing gloves made health care workers less likely to wash their hands, which is dismaying since germs can travel through latex gloves.)

From the results, published in the American Journal of Infection Control, it's clear that doctors-in-training need more education about the importance of hand-washing, and more specifically, practical lessons on when to use either hand sanitizers or the sink. Previous studies have suggested that health care workers are confused about the protocol: a 2006 British survey found that 58% of medical students didn't know when to use the alcohol-based hand sanitizers.

So how can health care workers improve on their hand-washing compliance? This is a source of constant concern and study in hospitals. One thing that helps is to remind them that it's not only their own health, but also the health of their patients that's at stake. So, the next time you're in the hospital or at the doctor's office, and your physician doesn't wash his hands before beginning an exam, you might want to point him toward the sink.

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.



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Rabu, 09 November 2011

Halloween Humor: Did Jimmy Kimmel Go Too Far Encouraging Parents to Deceive their Kids?

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Late-night shows are, by definition, irreverent, but Jimmy Kimmel may have taken it a bit far last week when he challenged parents to record themselves telling their kids that they'd binged on all their Halloween candy.

Last Monday, I took issue on Healthland with the mean parents who scheme to deny their kids of their Halloween loot: they collaborate with neighbors to hand out only healthy snacks, they let them trick-or-treat only to force them to hand out their stash to kids who ring their doorbell later in the evening; they whisk it away and leave books and toys in its place.

But Kimmel elevated the “trick” to a whole new level, instructing parents to title their kids' reaction, “Hey, Jimmy Kimmel, I Told My Kids I Ate All Their Halloween Candy!” and upload the protests to YouTube.

As a third-party viewer, the footage was hilarious — the dire parental declaration predictably followed by tears and wails. My fave: the toddler at the end who chastises his mother (who reveals her good taste in candy by saying how much she enjoyed the peanut-butter cups): “You sneaky mom!” he cries out. Babble delighted in the dad who upped the reality quotient by strewing candy wrappers all over the dining room table. And TIME's Newsfeed warmed to the “adorable pair of brothers at the end who turned the tables and lectured their parents for the faux-transgression.”

I think I have a pretty good sense of humor, but I found the vigor with which parents delighted in deceiving their kids a little jarring. Cruel might be another word for it. It's kind of hard to imagine intentionally trying to make your kids cry — even for a few minutes of late-night glory. As a Huffington Post reader noted, “breaking your kids' trust for your amusement at their reaction and hurt feelings…is not cool.” Others dubbed it “emotional bullying" and “sadism masquerading as humor.”

What the parents didn't film was their rapprochement with their kids, post-lie. What must that have been like? I asked my kids if they would have forgiven me had I answered Kimmel's call. It wouldn't have come to that, they assured me. Said my 8-year-old: "We never would have believed you."

Guess the joke's on me.

Bonnie Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.



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Mosquitoes Engineered To Kill Their Own Kind

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Reporting in Nature Biotechnology, researchers write of genetically engineering mosquitoes to pass lethal genes to their offspring, in hopes of crashing populations of one dengue-transmitting species. Science writer Bijal Trivedi talks about recent tests of the bugs, and the concerns of critics.

Copyright © 2011 National Public Radio®. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

IRA FLATOW, host: This is SCIENCE FRIDAY. I'm Ira Flatow. Mosquitoes infect up to 100 million people with Dengue fever every year, according to CDC estimates. There's no vaccine. There is no cure. Other than keeping that person hydrated, there's little the doctors can do.

So to control Dengue fever today, we eliminate standing water where mosquitoes lay their eggs. We use insecticides and for all our efforts cause - cases of Dengue are still on the rise. But there may be a better solution, which my next guest writes about in Scientific American this month, a way to get at the problem using the mosquitoes themselves, by engineering them to pass on lethal genes to their children, killing off new generations of the bloodsuckers one batch of eggs at a time.

One company has already conducted tests of these mosquitoes in the wild, reducing the number of mosquitoes, they say. How safe is this technique? Might there be some unintended consequences to releasing these genetically engineered bugs? And is this tactic effective enough to warrant the risk?

Bijal Trivedi is a freelance science writer and author of that feature on engineering mosquitoes in the current issue of Scientific American. You can find a link to her article on our website, at sciencefriday.com. Bijal joins us from NPR in Washington. Welcome back to SCIENCE FRIDAY, Bijal.

BIJAL TRIVEDI: Oh hi, Ira, thank you.

FLATOW: Good to have you back, no longer just an intern. Tell us about the - this is an interesting study. They genetically modify the mosquitoes.

TRIVEDI: That's right. The paper that actually just came out in Nature by Technology is the first one that the - the company is publishing about open field trials. And with their mosquitoes, the progeny die. So it's basically a death gene that they're passing down, and they - the mosquitoes lay the eggs, and - but, you know, there are no offspring.

They sent me down to Mexico to observe field trials of a - field cage trials of another type of anti-Dengue mosquito, and with those mosquitoes, they are engineered to just kill off the female offspring. So the idea is that you send out genetically modified males, they mate with the wild females, and when the offspring are born, the females don't make it. So it crashes the population very quickly.

FLATOW: So they have two different techniques then?

TRIVEDI: There are two different techniques. They - the British biotech company Oxitec did their trials in the Cayman Islands, and the field trials that I observed, which were all within cages, very large cages in the middle of a farming community on the edge of Tapichulo, which is right near the Guatemalan border, those were in cage trials, and that was sort of the female-specific kill switch.

FLATOW: Does one kind, one technique have an advantage over the other?

TRIVEDI: In terms of the genetic capabilities of the mosquitoes, I don't think they know yet. But in terms of practicality, the female's kill switch might better because with Aedes aegypti, which are the mosquitoes, the species that primarily spread Dengue virus, you can literally dry these eggs, the mosquito eggs, and with the ones that were done in the Grand Caymans, you know, you have to pick out the sterile males and only release them.

With the ones with the female kill switch, you can release - you know, you can release these mosquitoes. They'll mate with the wild females. They'll lay their eggs. And the males will survive, and the females will just die in the water. They don't develop their wings, and they can't fly, and they just squat on the water, and they die.

So from a practical, you know, point, you don't have to just release males. You can let everybody out there, and, you know, only the males will survive.

FLATOW: Because it's the females that do the biting.

TRIVEDI: Yeah, they do the biting, they spread disease. They're the ones that you really don't want.

FLATOW: So the other ones, if males survive, we don't care because they're not...

TRIVEDI: Because they don't bother us.

(SOUNDBITE OF LAUGHTER)

FLATOW: I guess when speaking about males, that's a good thing...

(SOUNDBITE OF LAUGHTER)

TRIVEDI: Those genetically sterile males don't bother us, let's put it that way.

FLATOW: Let's not go there.

(SOUNDBITE OF LAUGHTER)

FLATOW: Let's talk about the trials, the field trials. There are no international laws that prevented them from trying these field trials out there?

TRIVEDI: No, I mean, and this is the really tricky thing here. The trials that were done in the Cayman Islands, on Grand Cayman Island by the British biotech firm Oxitec, they released these mosquitoes. Now, they said they did some community engagement, and I'll tell you what that means. That means they sent out a pamphlet that they were releasing sterile mosquitoes, and they had basically a five-minute spot on the daily nightly news that they were doing these experiments.

And then they started releasing them in this plot at, you know, sort of an isolated end of the island, and no, there is no body that sort of polices these trials. And, you know, when you're dealing with genetically engineered organisms, I mean, this is a very, very touchy issue.

And for the trials in Mexico, you know, they haven't done an open release yet. Everything is still in these gigantic, huge cages with a lot of biosecurity measures on the cages. And you know, Mexico has signed the Cartagena Protocol, which, you know, governs how you move genetically modified organisms around.

And so they're doing everything very by-the-book there, and it was only sort of after the trials were being done and were in progress on Grand Cayman that the scientists really sort of came out and said, hey, we've been doing this, and these are the results, that they took a lot of people, including a lot of people in the field, by surprise.

FLATOW: Well, what could be unintended consequences, the side effects of this?

TRIVEDI: They claim that the technology is very safe. And you know, the fact that, you know, these mosquitoes do not do well after - basically, I mean, they are engineered to die, which is, you know, if there's a problem, that's a good thing. You know, they'll die off pretty quickly.

Some people have said, you know, you could be hurting some organism that depends on mosquitoes for food, and you could be affecting food webs. But the - what the proponents of the technology argue is that, you know, this Aedes aegypti mosquito, you know, it is native only to parts of West Africa, and it sort of hitched a ride on slave ships and on trade vessels about 400 years ago and spread everywhere.

So it's really an invasive species. So you know, what the scientists argue is, you know, nobody's going to miss this mosquito if we drop the levels a bit. I mean, it's very, very hard to eradicate something. So what we're talking about is suppressing the population such that, you know, you don't transmit the disease. It's - I mean, we all know it's really hard to get rid of mosquitoes.

FLATOW: Well, how effective are these engineered mosquitoes at crashing that population?

TRIVEDI: Well, you know, not the recent paper, but, you know, at a meeting a year ago, Oxitec announced - and this hasn't to my knowledge been published yet - that, you know, they had released not just a few mosquitoes but three million mosquitoes in this area of the island over a period of six months, and they had managed to crash the mosquito population by 80 percent.

And this is what they announced at the - it was the American Society for Tropical Medicine and Hygiene, the annual meeting about a year ago. And so that's pretty dramatic. You know, crashing a population by 80 percent. But like I said, you know, they haven't published that release yet, that research yet.

FLATOW: Let me to go to Jackie(ph) in Arlington. Hi, welcome to SCIENCE FRIDAY.

JACKIE: Hi, thanks. You kind of almost touched on what I was going to bring up, which is, you know, if you kill mosquitoes, are you eradicating an ecological niche? I mean, I'm a molecular biologist. I'm not afraid of transgenic organisms, but it does sound like this - and I've read just in the past few weeks about several others that are really targeting mosquitoes for eradication. I'm not sure that that's really smart.

But you did kind of just touch on that; you're not going to eradicate all of them, I guess.

What about in areas where that's an indigenous species though? I mean, maybe that's helpful in areas where it's invasive, but what about the areas that are maybe the worst affected?

FLATOW: Good question, thank you, Jackie.

TRIVEDI: Well, these - the places that they're talking about are places where, you know, insecticides have failed, public health measures have failed, and you had this rising and falling of the population of mosquitoes. So like I said, they're not talking - it's not eradication. It's something that could be done at peak mosquito season to really stem the population at a low level so that you wouldn't get disease transmission.

FLATOW: And when you say peak mosquito season, we're not talking about a mosquito here and there, right? It's really flying all over the...

TRIVEDI: We are - I mean, when I was down in Tapichula, I visited the community where these trial cages are installed. And they did a very broad - because, you know, GM has such a stigma attached to it that they wanted to go very by-the-book. They wanted to be very open with the community, get feedback from the community in terms of what they thought of having genetically modified organisms near them.

And I sat with a family in their - well, the houses are all open. So you can't prevent mosquitoes from coming in and out. I sat at the kitchen table with a family, and there wasn't a moment when I wasn't swatting myself. And I'm sure I looked ridiculous. But it was low mosquito season, and I was slapping myself probably every 10 seconds. I mean, it was swarming.

FLATOW: And so the family welcomed this...

TRIVEDI: The family welcomed this. I mean, they had - I mean, they couldn't tell you - I mean, you know, you'd be hard-pressed to find somebody who could understand the genetics, you know, very well at the molecular level amongst the general community. But, you know, they understood, you know, the type of technology that was being brought in, and they welcomed it because the insecticides that they use to curb outbreaks, they're horrible.

I mean, they were fogging one part of the town with the insecticide while I was visiting, and they actually refused to take me there because it's associated with breathing difficulties. So they didn't want me anywhere near the area where they were fogging.

And then this family, two of the children had had hemorrhagic Dengue. You know, and with hemorrhagic Dengue, more people get Dengue hemorrhagic fever than all the other hemorrhagic viruses combined. You know, we're talking Ebola and Marburg. More people get this than all of those.

So they'd had experience with the hemorrhagic form...

FLATOW: And they'd rather do this than try that again.

TRIVEDI: Yes.

(SOUNDBITE OF LAUGHTER)

FLATOW: All right, Bijal, thank you very much. We've run out of time. Bijal Trivedi is a writer and author of the feature on mosquitoes in the current issue of Scientific American. After the break, we're dialing the clock back 100 years, back to those first explorations of Antarctica. That would be going on about right now, 100 years ago. We'll talk about it. Stay with us. We'll be right back after this break. I'm Ira Flatow, this is SCIENCE FRIDAY from NPR.

Copyright © 2011 National Public Radio®. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to National Public Radio. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.



Health Management



Education Information

Sabtu, 08 Oktober 2011

Diet tricks the pros tell their friends

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Variety, color and presentation go a long way toward fooling your stomach. Variety, color and presentation go a long way toward fooling your stomach. Taste buds learn to love the food they're with -- so make a commitment to wholesome foodsEat small amounts of dark chocolate every day to avoid bingeing on sweetsHide your craving food in a hard-to-get-to place so you have to work to find it

(Health.com) -- Wish you had your own get-slim dream team? Well, you're in luck: We tapped celebrated weight-loss pros and asked them to share the one strategy they feel makes the biggest difference.

Weave these seven wonders into your daily routine, and you'll be wowed by how the little changes really do add up.

1. Trick your taste buds

"Taste buds are malleable little fellas. When they can't be with the foods they love, they learn to love the foods they're with. Make a short-term commitment to choosing more wholesome closer-to-nature foods with less added salt, sugar, saturated fat, and trans fat. Within weeks, you'll start to prefer these now-familiar foods."

-- David Katz, M.D., director of the Yale University Prevention Research Center

Health.com: 25 foods with tons of hidden salt

2. Indulge every day

"Eat a small amount of dark chocolate -- I'm talking a 100-calorie piece that's made of at least 70 percent cacao -- every day. I consider it 'the daily dark chocolate escape.' Doing this curbs your cravings for both sweet and salty foods. You're much more likely to be satisfied and not reach for those cookies or chips. My clients say this allows them to pass up samples at the market without feeling deprived."

-- Cynthia Sass, R.D., author of "Cinch! Conquer Cravings, Drop Pounds, and Lose Inches" and co-author of "The Ultimate Diet Log"

3 . Bury your cravings

"If you're a soda-lover -- or have another favorite calorie-laden indulgence like potato chips -- hide your stash in a really inconvenient place, like your basement. I do this myself. You'll be less likely to go and grab it. And if you do make the trek, you'll have to burn extra calories to get the treat."

-- Brian Wansink, Ph.D., director of the Cornell Food and Brand Lab and author of "Mindless Eating: Why We Eat More Than We Think"

Health.com: How the pros curb food cravings

4. Go for omega-3s

"Get into the habit of popping DHA-based omega-3s -- take two 200-milligram capsules about 30 minutes before both lunch and dinner. Or have 4 ounces of non-fried salmon or trout three times per week, along with six walnuts before each meal. This will decrease your desire for food later on, since this type of omega helps release the hormone cholecystokinin, which reduces appetite. Less food equals a smaller waist!"

-- Michael Roizen, M.D., chief wellness officer at the Cleveland Clinic and co-author of "You: On a Diet" and "You: Stress Less"

5. Order with ice

"At a restaurant, make sure your water glass is always topped off and that it's ice cold. Drinking water throughout your meal makes you feel fuller faster, and the coldness causes you to burn more calories to bring the water's temperature up."

-- David Kirsch, New York City-based celebrity trainer (clients include Heidi Klum and Liv Tyler) and author of "The Ultimate New York Diet"

Health.com: Tricks to help you feel full

6. Plate like a French woman

"French women eat smaller portions of more things, and American women eat larger portions of fewer things. So plate your meal like a French woman! For breakfast, eat a slice of toast, a sliver of butter, a bit of jam, and a fruit—like half a banana—plus coffee or tea. Variety, color, and presentation go a long way toward fooling the stomach into thinking you're eating more than you actually are."

-- Mireille Guiliano, author of "French Women Don't Get Fat"

7. Up the burn

"Eating protein within 45 minutes after a moderate to intense workout (of at least 45 minutes to an hour) helps your muscles rebuild and repair -- and also helps increase the number of calories you burn. So for maximum fat-melting throughout the day, bring a small protein-rich 100- to 200-calorie snack with you to the gym, or keep a stash of yogurt or string cheese at work."

-- Teddy Bass, L.A.--based celebrity trainer who has worked with Cameron Diaz and Christina Applegate

Copyright Health Magazine 2010



Education Information



Technology

Rabu, 28 September 2011

Americans get too much healthcare, their docs say

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Devices used to take blood pressure, temperature, and examine eyes and ears rest on a wall inside of a doctor's office in New York March 22, 2010. REUTERS/Lucas Jackson

Devices used to take blood pressure, temperature, and examine eyes and ears rest on a wall inside of a doctor's office in New York March 22, 2010.

Credit: Reuters/Lucas Jackson

By Frederik Joelving

NEW YORK | Mon Sep 26, 2011 5:45pm EDT

NEW YORK (Reuters Health) - Here is a diagnosis of what's wrong with health care in America, straight from the horse's mouth: There's too much.

In a new poll of primary care physicians, nearly half of them said their patients received too much medical care and more than a quarter said they were practicing more aggressively than they'd like to.

That could mean ordering more tests, prescribing more drugs or diagnosing people with diseases, although they would never have experienced any symptoms.

On the other hand, just six percent of doctors believed their patients were getting too little care.

"Physicians at the frontline of medical care are telling us that their patients are getting too much care," said Dr. Brenda Sirovich of the VA Medical Center in White River Junction, Vermont, who worked on the survey. "And we don't think we are just talking about the 627 physicians that we surveyed."

The findings come at a time when the healthcare budget is already overstretched and many fear it is about to spiral out of control.

"We spend a lot on healthcare in this country, more than anywhere else," Sirovich, also at the Dartmouth Medical School, told Reuters Health. "We realize that this is unsustainable."

According to Organization for Economic Cooperation and Development (OECD), the U.S. spent $7,960 per capita on healthcare in 2009. That's $2,608 more than Norway, the runner-up, shelled out.

Dr. Lisa Schwartz and Dr. Steven Woloshin, who also worked on the new study, were two of the three authors of a book called "Overdiagnosed: Making People Sick in the Pursuit of Health."

THE TALE OF THE MORPHINE PUMP

And it's not only your wallet that could end up hurting from excessive testing, experts say. In a short article published along with the poll in the Archives of Internal Medicine, one doctor recounted the story of a man who developed intractable pain after falling on an icy driveway.

He had several tests at the hospital, but all of them came up empty, writes Dr. Philip Wickenden Bale of the T.J Sampson Hospital in Glasgow, Kentucky.

All along, the man's wife had been telling doctors that her husband had a morphine pump in his back to treat chronic pain and that he'd fallen onto the pump. But no one had listened.

"I was beating my head against a wall," she said, according to Bale.

His prescription? Just listen to your patient.

"Much science and technology, with associated expense, was used to eliminate conditions he didn't have, while the art of listening well might surely have led to a faster, cheaper remedy," Bale writes.

Excessive tests may also lead to diagnosing conditions that would never have caused any problem in the first place, such as a slowly developing prostate cancer or a slightly elevated blood pressure.

Yet after such a diagnosis, it's difficult for doctors not to proceed to treatment, which may cause side effects.

"When you do anything to somebody, whether it is an intervention or a test, you are putting them in to the healthcare system in a way that exposes them to risk," said Sirovich. "Unnecessary care is potentially harmful."

REIMBURSEMENT MODEL TO BLAME?

So why would doctors order tests that they themselves believe are excessive?

Three reasons stood out in the survey, which is based on a random sample of U.S. doctors: fear of malpractice lawsuits, performance measures and too little time to just listen to patients.

Four in 10 also believed that other primary care physicians would order fewer tests if those tests didn't provide extra income. (Of course, just three percent thought that financial considerations influenced their own practice style.)

"I'm not saying that physicians do tests in order to make money -- there is a potential to be a real cynic here -- but I think that the reimbursement model for most healthcare encourages utilization in a variety of ways," Sirovich said.

"It's a time for us to reflect about what incentives we have built into our healthcare system, and what directions they are taking us in."

SOURCE: bit.ly/7qXyI Archives of Internal Medicine, online September 26, 2011.

(This story changes paragraph two to say that more than a quarter of doctors said they were practicing more aggressively.)



View the original article here



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