Heat Illness Prevention in Agriculture Gets Focus in California
A 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.
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.”
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.
Influenza outbreaks have been peaking in California recently so Central Coast UrgentCare is offering a FREE Flu Clinic on Friday, February 25th from 8 AM to 5 PM. So if you and your family haven’t gotten you flu shots this season, now’s your chance. And it’s free.?Friday, February 25th, 8 AM to 5PM. ?All patients will be seen on a walk-in basis.
And a reminder for parents of school-age children; All 7th -12th grade students will need to have received a dose of the pertussis vaccine before starting classes this coming fall. This is a state law (AB 354).
If you want to avoid the summer rush, and take advantage of our low cost vaccination, come in to Central Coast UrgentCare, Friday, February 25th from 8 AM to 5PM.
The Division of Workers’ Compensation (DWC) has posted a new time of hire pamphlet on its Web site. This optional pamphlet meets the requirements under Labor Code section 3551 to notify new employees about California workers’ compensation rights and benefits either at the time of hire or by the end of the first pay period.
“This pamphlet is one way we can help employers and claims administrators ensure employees know what to do if they get hurt or sick because of work,” said DWC Chief of Legislation and Policy Susan Gard. “We want to provide easy to understand information in multiple languages that meets the needs of California’s diverse workforce.”
The pamphlet, posted in English and Spanish, was developed in response to requests from claims administrators and provides employees with information about what to do if they are injured on the job and ways to resolve disputes over workers’ compensation benefits. In addition, it discusses the role of the primary treating physician and medical provider networks (MPNs). Predesignation forms are included as part of the document.
This optional time of hire pamphlet is presented in a graphic format that can be customized to meet individual needs and is also offered in “text only” format in English and Spanish, which gives claims administrators the option to more fully customize the presentation. The text of the pamphlet meets the “time of hire” legal requirements.
A.B. 11 would be funded by allocating $200 million presently available under the seldom used small-business hiring credit to the workers comp credit.
As the New Year begins, the Department of Industrial Relations (DIR) reminds employers of new labor laws becoming effective in 2011. The intent of the new legislation varies from providing more flexibility to employers, to expanding paid leave for employees. The following new laws will go into effect on January 1, 2011:
New Off- Duty Meal Break Exemptions
AB 569 provides greater legal clarity to Labor Code section 512(a) which requires employers to provide their employees, who work more than six hours in a day, one 30-minute off-duty meal break after five hours of work. The new law adds section 512.7 to the Labor Code and will exempt from the off-duty meal break requirement workers in specific industries who are covered by a collective bargaining agreement that contains meal period provisions. The employee groups include: construction workers, commercial drivers, security officers and employees of electrical and gas corporations or local publicly-owned electric utilities. These are industries or positions where it was deemed an off-duty meal break can be impractical. The revision was made to better meet the requirements of the particular positions. The bill was introduced by Assembly Member Bill Emmerson (R-Hemet).
Workers’ Compensation Extended Eligibility for Public Service Workers
AB 2253 expands workers’ compensation eligibility for firefighters and law enforcement officers who have developed certain types of cancer that are reasonably linked to their jobs. Existing law establishes that this presumption be extended for a period of three months for each full year of service the employee worked, not to exceed 60 months beyond their last day of service. The pending legislation will expand that time frame to up to 120 months and will amend Labor Code section 3212.1. The bill was introduced by Assembly Member Joe Coto (D-San Jose).
Organ / Bone Marrow Donors’ Leave and Benefits for Employees of Private Employers
SB 1304 requires private employers to permit employees to take paid leaves of absence for organ and bone marrow donation, similar to provisions existing for California state employees. Under the new law, private employers are prohibited from interfering with employees taking organ or bone marrow donation leave and after the conclusion of the leave of absence must allow them to return to the same job or an equivalent job. The bill, introduced by Senator Mark DeSaulnier (D-Concord), further prohibits retaliation of the employee for taking the leave and provides employees to seek restitution if these rights are violated.
New Procedures Established and Definition Clarified for Cal/OSHA Serious Citations
California employers are legally bound to provide employees a safe workplace. California law has authorized DIR’s Division of Occupational Safety and Health, better known as Cal/OSHA, to enforce applicable safety and health regulations and issue citations when investigations reveal that an employer has committed violations of those standards, including serious violations that cause an employee to suffer or potentially suffer, among other things, “serious injury or illness” or “serious physical harm”. AB 2774, introduced by Assembly member Sandré R. Swanson (D-Alameda), amends labor code section 6432 to define serious physical harm and establishes a rebuttable presumption as to when an employer commits a serious violation of these provisions. The bill further establishes new procedures and standards for an investigation when issuing serious citations. (See IR #2010-28, “Cal/OSHA enforcement strengthened with signing of new law”
In the summer of 2010, an ambitious heat illness prevention campaign was conducted in California to reduce heat-related fatalities and illness among low-wage, non-English speaking outdoor workers. The campaign strategy involved working at multiple levels to: 1) educate workers, employers and the community as a whole about needed prevention measures both during work and outside of work; 2) develop a ?community norm? that views heat illness as a serious issue which requires action in the workplace and community; and, 3) increase the visibility of the Division of Occupational Safety and Health (DOSH) as an agency responsive to workers’ needs.
• Effective messaging was developed and tested with input from representative workers, employers and community organizations.
• There was significant media coverage in the targeted, hottest regions of the state, and the media mix included billboards, large format posters, ads on lunch trucks and vans and radio ads.
• Media was developed in five languages:
• Print ads: Spanish, English, Hmong and Punjabi
• Radio ads: Spanish, Hmong and Mixteco
• A broad outreach component reached 178 community organizations, a large portion of which extended the campaign’s efforts by distributing materials and providing trainings in their communities.
• The impact evaluation findings indicate that the heat illness prevention campaign was effective in reaching non-English speaking workers, community organizations and employers. A large majority of workers reported awareness of campaign materials and positive attitudes towards the media messages.
Download attachment >> HeatIllnessPreventionCampaignReport_702005691.pd
The California Department of Public Health (CDPH) breast cancer detection program announced it is reopening enrollment to women age 40 and older effective today, Dec. 1. The Every Woman Counts program provides breast cancer screening and diagnostic services to low-income women.
“Our top priority is to provide breast cancer screening services to as many low-income California women as possible under the Every Woman Counts program,” said CDPH Director Dr. Mark Horton. “We are very pleased to be able to reopen the program to qualifying low-income women age 40 and older. Early detection can save a life, and I strongly encourage all eligible women to take advantage of this service.”
The Every Woman Counts program was established by the federal Breast and Cervical Cancer Mortality Prevention Act of 1990 and the state Breast Cancer Act of 1993. Due to an unprecedented fiscal challenge resulting from an increased demand for breast cancer screening services and declining tobacco tax revenues, all new enrollment into the program was frozen on Jan. 1, 2010.
However, as a result of a $20 million budget augmentation approved by Governor Schwarzenegger and the Legislature, as well as additional savings realized from programmatic changes and efficiencies, the Every Woman Counts program is now able to reopen enrollment for breast cancer screening services for women age 40 and older.
As of Dec. 1, the Every Woman Counts breast cancer screening program will provide services to qualifying women age 40 and older. It is estimated that the program will provide services to more than 300,000 women during the current fiscal year. Women can call the program’s toll free number to determine if they are eligible (800) 511-2300.