News media including the Wall Street Journal are commenting on some initial research on mice suggesting that red wine can make you live longer. At the same time the nutritional supplement makers are rushing to produce pills that will supposedly make you live longer, while the FDA ignores and refuses to take any position on the issue. At some point we may come to realise how harmful and wasteful all these supplements are.
An editorial in the Lancet this week (Volume 368, Issue 9549 , 18 November 2006, Page 1744 ) asks why, with the evidence of the installation of sanitary improvements in developed countries cutting infant death rates in the early 1900s, don't we push for such action in developing countries rather than focussing on medical care?
This week's NEJM has an interesting discusison by Dr T.J. Curiel about the need for better disaster training at all hospitals, particularly large hospitals with critical care patients. This discussion, based on experience during hurricane Katrina, should be read by all of us who have any responsibility for health care management during disasters.
From the Guttmacher Institute comes inormation about what it means to be a man, woman or young person living with HIV can be very different now than 25 years ago when AIDS was first identified, in large part because of the availability of antiretroviral treatment. For those with access to treatment services, a diagnosis of HIV infection is no longer an imminent death sentence; although still incurable, HIV now can be managed as a chronic disease. The number of people in low- and middle-income countries receiving treatment more than tripled between 2003 and 2005, from 400,000 to 1.3million. The global public health community has increased its focus on quality-of-life issues as well as length-of-life issues.
A quote from a discussion at a meeting reported in the BMJ today �CMS is clearly the big kahuna, paying out over $300 billion for health care last year. CMS is managing a "care improvement program", a huge randomized trial of 20,000 Medicare enrollees, each of whom is in some sort of disease management program. It’s called Medical Health Support. Too soon for results. “Medicare patients with five or more chronic conditions see an average of 14 different physicians and get 57 different prescriptions a year.�
What kind of quality can this approach possibly provide? No wonder our system costs so much and performs so badly!
In a recent blog I revisited Ivan Illich's essay on the dangers of the medical profession to the health of the population. From the BMJ news this week is an interesting report: Disease awareness campaigns turn healthy people into patients. We need to be careful. the the medical marketplace can detract from the public health message.
The conference on disease mongering, held in Newcastle, Australia, was timed to coincide with a theme issue of the journal PLoS Medicine, published by the US Public Library of Science (PLoS).
April's issue of PloS (US Public Library of Science) Medicine carries 11 peer reviewed articles on disease mongering, which is defined by this month's guest editors as "the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments."
One of the TV vacuum cleaner salesmen pushes the value of his HEPA Filter. This new study from the University of Manchester shows that "High efficiency" vacuum cleaners no better at protecting against dust mites.
Researchers at the North West Lung Centre, run by The University of Manchester and based at Wythenshawe Hospital, have discovered that vacuum cleaners with "high-efficiency particulate air" or HEPA filters are no more effective than standard models at reducing exposure to dust-mites.
The team compared nasal air samples taken before and during vacuum cleaning using both HEPA and non-HEPA vacuum cleaners. They found a small increase in exposure to dust-mite during vacuuming with either type of machine, which was increased when emptying the dust compartments of either.
Lead investigator Dr Robin Gore said: "These vacuum cleaners are marketed to allergy-sufferers on the basis that they reduce a person's exposure to air-borne particles raised from carpeted floors. For allergy sufferers, such particles can trigger asthma attacks. However, we have already found that both HEPA- and non-HEPA vacuum cleaners can actually increase an individual's exposure to particles containing cat allergens.
One more reason to urge women to breast feed their children. Researchers at the University of Rochester Medical Center have found another reason to keep those fancy baby spoons in the drawer until infants reach 6 months old. Babies who are breastfed – exclusively – for the first six months have fewer cases of pneumonia and ear infections than babies who were introduced to other foods between 4 and 6 months.
Lack of clarity may by why many public health messages receive little attention. According to new research from the Princeton University in New Jersey Writers who use long words needlessly and choose complicated font styles are seen as less intelligent than those who stick with basic vocabulary and plain text, according to new research from the Princeton University in New Jersey, to be published in the next edition of Applied Cognitive Psychology.
This week's editorial in the BMJ deals with the horrors of medically supervised dying. As the first paragraph of the editorial states: "Ask friends about the deaths of their loved ones, and the "bad death" stories crowd out the "good death" ones. Reflections along the lines of "They wouldn't let a dog die like my old Dad died," recur uncomfortably often. This is presumably one of the reasons why public support for legislation to permit assisted dying exceeds 80%. While doctors' attitudes are harder to summarise, there are signs that a majority of UK doctors now favour legalisation of physician assisted suicide with stringent safeguards" This may be a forum in which public health professionals could take a lead, it is much more a community than a medical issue.
For those of us old enough to have made house calls a regular part of our practice this research, from Autrallia, comes as no surprise, for the 90% of physicians today who have never been inside their patient's home we need to reinvent history.
"This novel research, just published in the Medical Journal of Australia, demonstrates the value of home-based care, when supported by experienced medical and nursing staff. The research has been carried out by Dr Dee Richards from the Department of Public Health and General Practice at the School, in partnership with Pegasus Health and the Canterbury Respiratory Research Group and is one of a number of studies being undertaken into the effectiveness of community health care.
In this study a randomised controlled trial examined 55 Emergency Department patients from Christchurch Hospital and found that mild to moderately severe pneumonia can be managed at home by primary care teams, given adequate resources.