Virtual Health Care May Be Better Than In-Office Visits

Doctor's hand reaching out of computer holding a stethoscopeA five-year study of HIV patients found a telehealth system, including a virtual pharmacy and community forums, to be as effective as in-office visits to the doctor. The study could mean increased virtual health care and cheaper medical costs around the world, especially for high-maintenance chronic illnesses such as HIV.

From autonomous robotic surgeries to advanced computerized diagnoses, many recent technological breakthroughs have benefited the medical industry and the patients it serves. Now, results from a five-year study have revealed an exciting conclusion: Virtual check-ups can be just as effective as, if not more than, in-office visits to the doctor.

In the study, a group of Barcelona-based physicians successfully treated 200 HIV patients via an online home care system called “Virtual Hospital.” The technology covers all aspects of managing the health of chronic HIV-infected patients, who require frequent and careful care. This month, PLoS One published the results, which found telehealth to be as effective as in-office visits.

Continue reading Virtual Health Care May Be Better Than In-Office Visits

Grin and Bear It?

 

green bear with marijuana leaf t-shirt
"Hey Boo Boo, I need a pic-a-nik basket!"

The Montana Supreme Court has thrown its backing behind a Workers Compensation Court ruling that a man who was mauled while feeding the bears at a tourist attraction is eligible for workers comp coverage.

According to the Associated Press, Brock Hopkins filed a claim with the Uninsured Employers Fund, which denied it due to the fact Hopkins had smoked marijuana prior to entering a bear enclosure at Great Bear Adventures near West Glacier on Nov. 2, 2007.
Park owner Russell Kilpatrick claimed that Hopkins was a volunteer and fed the bears after Kilpatrick informed him not to.

The Workers Compensation Court
stated Hopkins was an employee and claimed there was no evidence that impairment from smoking marijuana led to the mauling.

Patients and Clinicians Must Share Healthcare Decisions, Say Experts

Clinicians have an ethical imperative to share important decisions with patients, and patients have a right to be equal participants in their care, say a group of experts.


doctor with mother and young son
So draw me a picture

In December 2010, 58 people from 18 countries attended a Salzburg Global Seminar to consider the role patients can and should play in healthcare decisions. Today, they publish a statement urging patients and clinicians “to work together to be co-producers of health.”

It comes as the government in England finalises plans to give people more say and more choice over their care than ever before.

The experts argue that much of the care patients receive is based on the ability and readiness of individual clinicians to provide it, rather than on widely agreed standards of best practice or patients’ preferences for treatment.

Results from the 2010 Cancer Patient Experience Survey seem to support this view. It found significant variations in the choice and information patients are given, and their involvement in decisions about treatment.

The experts also say that clinicians are often slow to recognise the extent to which patients’ wish to be involved in understanding their health problems, in knowing the options available to them, and in making decisions that take account of their personal preferences.

As such they call on clinicians to stimulate a two-way flow of information with patients, to provide accurate information about treatment, to tailor information to individual patient needs and allow them sufficient time to consider their options. In turn, they urge patients to ask questions and speak up about their concerns, to recognise that they have a right to be equal participants in their care, and to seek and use high-quality health information.

They also call on policymakers to adopt policies that encourage shared decision making and to support the development of skills and tools for shared decision making.

One of the signatories, Professor Glyn Elwyn from Cardiff University, says that despite considerable interest in shared decision making, and clear evidence of benefit, implementation within the NHS “has proved difficult and slow.”

Angela Coulter from the Foundation for Informed Medical Decision Making agrees and points to recent evidence showing that most patients want choice, but that many clinicians remain ambivalent or antagonistic to the idea. She believes the government’s new commitment to shared decision making presents a challenge to entrenched attitudes and the need for big change in practice styles.


Story Source: The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.

 

Daylight Savings Time May be Hazardous to Your Health

silhouette of man with clock
The semi-annual tradition of changing the clock an hour ahead and an hour back has been reported to result in a high incident of work-related illness.
A study in the New England Journal of Medicine reports, “More than 1.5 billion men and women are exposed to the transitions involved in daylight saving time: turning clocks forward by an hour in the spring and backward by an hour in the autumn. These transitions can disrupt chronobiologic rhythms and influence the duration and quality of sleep, and the effect lasts for several days after the shifts.”
This may result in an increase of work-related accidents in the days following the time adjustment.
Republished with permission from Jon L. Gelman

To Lose Weight & Prevent Stroke … Talk to Your Doctor Over Coffee

by ADAM COLE (NPR)

Back when smoking topped the list of America’s health woes, researchers found that smokers who had a brief conversation with a doctor — just a three minute chat that addressed their habit — were significantly more likely to quit.

Now the nation is smoking less, but a whopping two-thirds of Americans are overweight. Can doctors help patients shed weight, the way they have helped them kick cigarettes? A couple of recent papers suggest the answer is yes.

In one study, obese patients whose doctors talked to them about their weight did a better job at preventing further weight gain. In the other, patients who were told they were overweight by their physicians were more likely to want to do something about it.

However, fewer than half of overweight people and fewer than two-thirds of obese people in the second study had been told by their physicians that they wereoverweight.

“Physicians need to tell more overweight and obese patients that they are overweight,” the authors of the second study say. “This may help encourage them to change their behavior to lose weight and lower their risk for many diseases.”

So why aren’t more physicians talking to their patients about weight?

We asked Dr. David Katz, the founding director of Yale University Prevention Research Center, who told Shots some doctors feel it just isn’t their place. They aren’t confident in obesity treatments, aren’t trained to counsel patients about weight loss, and aren’t paid do so. And they’re afraid of offending patients.

“Doctors saying, ‘don’t you realize your fat and its bad for your health,’ is about as constructive as putting pins in a voodoo doll,” Katz said. “Sometimes I joke that if you make your patient feel one foot tall, and they are already overweight, their body mass index goes through the roof.”

To be constructive, doctors have to choose their words carefully. “Patients really feel that words like ‘fat’ and ‘obesity’ can be negative,” Dr. Rebecca Puhl of the Rudd Center for Food Policy and Obesity told us. “Neutral terms like ‘body mass index’ or even ‘body weight’ are better.”

There’s one way to bring up the problem without fear of offense. “Blame it on the government,” Dr. Robert Baron, who directs the UCSF Weight Management Program, told us only half jokingly. “Say, ‘Your body mass index puts you in a range the federal government would call overweight.'”

Comparing patients to standardized definitions brings obesity into the realm of less stigmatized risk factors, such as high blood pressure.

Still, Baron stressed that weight loss may not be the answer for everyone. “We live in a society with all the wrong food choices, and all the wrong messages telling us to do all the wrong things,” agreed Katz. “This problem is not a clinical one, but I think clinicians need to be a small part of the solution.”

CAN COFFEE REDUCE STROKE RISK FOR WOMEN?

DALLAS – Women who enjoy a daily dose of coffee may like this perk: It might lower their risk of stroke.

Women in a Swedish study who drank at least a cup of coffee every day had a 22 to 25 percent lower risk of stroke, compared to those who drank less coffee or none at all.

“Coffee drinkers should rejoice,” said Dr. Sharonne N. Hayes, a cardiologist at Mayo Clinic in Rochester, Minn. “Coffee is often made out to be potentially bad for your heart. There really hasn’t been any study that convincingly said coffee is bad.”

“If you are drinking coffee now, you may be doing some good and you are likely not doing harm,” she added.

But Hayes and other doctors say the study shouldn’t send non-coffee drinkers running to their local coffee shop. The study doesn’t prove that coffee lowers stroke risk, only that coffee drinkers tend to have a lower stroke risk.

“These sorts of epidemiological studies are compelling but they don’t prove cause,” said Dr. David S. Seres, director of medical nutrition at Columbia University’s College of Physicians and Surgeons in New York.

The findings were published online Thursday in the American Heart Association journal Stroke.

Scientists have been studying coffee for years, trying to determine its risks and benefits. The Swedish researchers led by Susanna Larsson at the Karolinska Institute in Stockholm said previous studies on coffee consumption and strokes have had conflicting findings.

“There hasn’t been a consistent message come out,” of coffee studies, said Dr. Cathy Sila, a stroke neurologist at University Hospitals Case Medical Center in Cleveland.

For the observational study, researchers followed 34,670 Swedish women, ages 49 to 83, for about 10 years. The women were asked how much coffee they drank at the start of the study. The researchers checked hospital records to find out how many of the women later had strokes.

There were a total of 1,680 strokes, including 205 in those who drank less than a cup or none. Researchers adjusted for differences between the groups that affect stroke risk, such as smoking, weight, high blood pressure and diabetes, and still saw a lower stroke risk among coffee drinkers. Larsson said the benefit was seen whether the women drank a cup or several daily.

“You don’t need to drink so much. One or two cups a day is enough,” she said.

Larsson, who in another study found a link between coffee drinking in Finnish men who smoked and decreased stroke risk, said more research needs to be done to figure out why coffee may be cutting stroke risk. It could be reducing inflammation and improving insulin sensitivity, she said, or it could be the antioxidants in coffee.

Larsson and others point out that those who want to reduce their chances of a stroke should focus on the proven ways to lower risk: Don’t smoke. Keep blood pressure in check. Maintain a healthy weight.

OSHA Issues Guide To Help Businesses Comply With Cranes Rule

Washington, DC (CompNewsNetwork) – The Occupational Safety and Health Administration today issued the Small Entity Compliance Guide for Cranes and Derricks in Construction to help businesses comply with the recently published Cranes and Derricks in Construction rule.
OSHA published the rule in August 2010 to address the number of worker injuries and deaths associated with the use of cranes and derricks in construction. The rule also addresses technological advances in equipment since the old rule was issued in 1971.

“Over the past four decades, we’ve continued to see a significant number of worker injuries and deaths from electrocution, crushed-by and struck-by hazards while performing cranes and derricks operations,” said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. “This guide will help employers understand what they must do to protect their workers from these dangerous, sometimes fatal incidents.”

The small business guide is divided into chapters that correspond to sections of the standard. This guide accompanies other OSHA compliance materials on crane-related topics available on the agency’s Web site including a PowerPoint overview, Web chat transcript, Webinar, list of frequently asked questions, and fact sheets. Visit OSHA’s Cranes and Derricks in Construction Web page to view these products.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to assure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance.

An MD Explains How Stretching Helps Relieve Postural Strain Complaints in the Upper Back

various stretching exercises illustrated
There's a reason you see dogs & cats do this!

Ed Donahue, Physical Therapist for Central Coast IndustrialCare, has repeatedly stressed the importance of simple stretching exercises in the workplace. Mr. Donahue included a detailed discussion of various stretching exercises as part of our “Ergonomics in the Workplace,” free lunchtime seminars in 201o. Obviously, Ed is not alone!

Click this link to download our PDF, “Guide to Office Stretches”
————————————————————————————————–

Doctor Alice M. Martinson gives us a perspective on this complex upper back injury. We often hear about lower back pain, but upper back pain can be just as troublesome.
Persistent burning discomfort between the shoulder blades is a common complaints and one that is frequently behind excessive evaluator and treatment efforts. When muscles are put on stretch and then subjected to tension, the result is burning pain that has an almost-vibratory character. Cervical disc disease can refer to the medial scapular area and should be easily distinguishable from postural strain complaints on a clinical basis alone.

Individuals with
this condition typically spend long hours working with their hands and arms in front of them and are usually concentrating on what they are doing. Examples of these types of occupations are clerical workers, fruit sorters/packers, newspaper editors, Pentagon staffers and tax accountants (for the several months prior to April 15).

In the office
a stoop-shouldered posture is visible and the patient may not be able to actively reverse it upon command. In addition to a typical job history, obese individuals and women with macromastia, frequently present with these complaints. A thorough physical exam will show no evidence of nerve root dysfunction. Tenderness is usually present in the rhomboids and levator scapulae.

The only treatment
found to benefit individuals with this problem is frequent active stretching of the anterior chest muscles to allow retraction of the scapulae. Attempting to bring the flexed elbows together behind the back for 30-60 seconds every 10 to 15 minutes will relieve the complaints. Rarely the symptoms will be severe enough so that a single xylocaine/corticosteroid injection will be helpful in both establishing the diagnosis and beginning improvement. (WCxKit)

Imaging evaluation
is not indicated, except in older individuals when a true fixed thoracic kyphosis is present. In these cases plain films of the thoracic spine confirms the clinical situation. Since there will be no specific objective physical findings pointing to the cervical spine as the source of pathology, MRI should not be done, especially in young individuals with no history of specific injury. “Trigger point” injections will not provide lasting benefit in these cases. Lasting benefit comes only from a commitment by the patient to a self-directed program of frequent short periods of shoulder girdle stretching.

Author:
Alice M. Martinson, MD has practiced for 40 years as a board-certified orthopaedic surgeon, 25 of which were as a Naval Medical Officer. Relying on her extensive military experience with injury evaluation, she performs IMEs and consults on loss control issues. Contact: 870-480-7475 or docalice@aol.com. To read more about “Doc Alice,” go to our Directory at: http://reduceyourworkerscomp.com/workerscomp-medical-doctor-advisors.php.
08 March, 2011 08:52:04 Republished with permission from ReduceYourWorkersComp.com

CDPH Warns Consumers Not To Eat Certain Hazelnuts

photo hazelnuts
Sometimes you DON'T feel like nut!

Contact: Al Lundeen, Michael Sicilia (916) 440-7259

Dr. Howard Backer, interim director of the California Department of Public Health (CDPH), today warned people not to eat certain hazelnuts distributed by DeFranco and Sons from Los Angeles, because the nuts may be contaminated with Escherichia coli O157:H7 bacteria (E. Coli). The company’s voluntary recall was initiated after the hazelnuts were linked to seven illnesses, including one in Michigan, three in Minnesota and three in Wisconsin.

The hazelnuts affected by the recall were sold under the brand names Sunripe, George Packing, Firestone Farms, and Northwest Hazelnut. They were distributed nationwide from Nov. 2 to Dec. 22, 2010. Consumers are advised that the large bags of hazelnuts and mixed-nuts with hazelnuts (50 lbs.) may have been repacked or sold from bulk containers to consumers.

Consumers who have hazelnuts or mixed nut products containing hazelnuts identified by this recall should discard them. Consumers are urged to check with retailers to determine if the hazelnuts or mixed nut products containing hazelnuts are subject to the recall.

People who develop symptoms after consuming hazelnuts should seek immediate medical attention. Symptoms of E. Coli infection may include abdominal cramps and diarrhea which is often bloody. Most infected people recover within a week. Some, however, may develop complications that require hospitalization. Young children and the elderly are at highest risk for a potentially life-threatening complication known as hemolytic uremic syndrome, which includes kidney failure.

To learn more about E. Coli bacteria, click here.    Consumers that observe the product being offered for sale are encouraged to report the activity to the CDPH toll-free complaint line at (800) 495-3232.

How Doctors Can Monitor Fitness From Afar

Computer with hands holding stethoscope emerging from screen
"Cough and double click, please.

By Brian Mossop Email Author

Whether they need to simply shed a few pounds, or are recovering from a near-miss heart attack, many people are under their doctor’s strict orders to get more exercise. Physical activity prescriptions have become a de facto medical intervention, a structured counterattack to the sedentary American lifestyle and fat-fueled diet.

And now, doctors may be able to keep tabs on how well their patients have heeded their advice, even when they’re miles apart, thanks to a new remote monitoring device from Alive Technologies.

There’s no clearer example of the divide between our intentions and actions than the case of a person starting a mandated exercise routine. Today’s scheduled gym time easily becomes tomorrow’s prolonged procrastination when our minds unjustly rationalize that our daily choices have little effect on our long-term health.

For dire conditions, like those involving the heart where the exercise prescription is crucial, hospitals and health clinics may provide cardiac rehabilitation — an outpatient service much like physical therapy, where physicians or licensed exercise physiologists design a custom activity program and monitor the patient’s progress.

But people much prefer to get their exercise at home. After all, who wants to have to drive to the clinic just to have someone watch you march along on the treadmill?

Doctors are sometime reluctant to allow patients to exercise on their own, in case something goes awry, like a potentially life-threatening irregular heartbeat. Alive Technologies, a company based in Queensland, Australia, is addressing these concerns with their new Heart and Activity Monitor, which may jointly satisfy the rigor that physicians need, as well as the freedom that patients desire.

Continue reading How Doctors Can Monitor Fitness From Afar