The AMA has renewed calls for an immediate ban on the advertising of unhealthy food during children’s viewing hours.

AMA President, Dr Rosanna Capolingua, said obesity was becoming more prevalent in children, and urged government to act on advertising that targets children and unhealthy food.

“The health of Australia’s children, now and into the future, is of paramount importance. Food advertising influences what food children want, ask for, and eat,” Dr Capolingua said.

“Food advertising undermines the efforts of parents to provide healthy food for their children.

“Childhood obesity can lead to life-long health problems. Combating obesity is a shared responsibility. The broadcast industry and broadcast regulatory authorities have a significant role to play in these efforts.

“The Australian Communications and Media Authority must decide to prohibit advertising of unhealthy foods in children’s television viewing times.

“The ten biggest food advertisers are outspending the government by six to one to promote their food products.

“The Commonwealth and States have agreed on targets and goals around obesity reduction, particularly in children (via National Healthcare Agreements and National Public Health Partnerships). The AMA believes junk food advertising to children could undermine these efforts,” Dr Capolingua said.

The renewed call for a ban comes with the launch today of the Coalition on Food Advertising to Children (CFAC) on-line campaign aimed at putting more pressure on government to get junk food advertising out of children’s television.

The campaign material is available at : burgercorp.au

Source
Australian Medical Association Limited Continue reading →

Technology with the potential to help cut physiotherapy waiting times has been unveiled by the University of Abertay Dundee.

Researchers in Abertay’s School of Computing and Creative Technologies have developed an intelligent exoskeleton that can be programmed to remember and repeat specific limb movements.

The NeXOS system will enable physiotherapists to devise exercise programmes customized to the individual needs of any patient with lower limb problems. As well as victims of leg or spinal cord injuries, this could include stroke patients.

Such patients need regular exercise of the affected limb, to keep muscles in trim and prevent the loss of bone mineral density. There are currently 28,000 people on waiting lists for physiotherapy in Scotland.

NeXOS can exercise patients’ legs exactly as the physiotherapist wishes, but without the need for the physiotherapist to be present in person. Many more patients could be treated per therapist, leading to potentially big cuts in waiting times.

As well as providing exercise tailored precisely to each patient’s requirements, NeXOS can also monitor how well each patient is responding and send data back to the physiotherapist, using the internet if necessary.

This opens up the possibility of NeXOS being used away from conventional clinics, perhaps being installed in local gyms and sports centres or even patients’ own homes. Patients would be able to exercise almost anytime, anywhere, and physiotherapists would be able to monitor progress and adjust settings accordingly by remote control.

Abertay researchers led by Professor David Bradley developed NeXOS in conjunction with the Universities of Sheffield and Sheffield Hallam, and Barnsley Hospital NHS Foundation Trust. The project was supported by the Department of Health through its NEAT (New and Emerging Applications of Technology) programme.

NeXOS uses pneumatics technology because of its ability to be programmed to variable degrees of power and resistance. Power is needed to move immobile limbs, but gradually increasing resistance is needed to encourage muscles to regain their strength.

The device was originally intended to be an intelligent exo-skeleton that could improve the mobility of people with permanent lower limb disabilities, but Professor Bradley and his colleagues quickly realized that the basic concept could be modified into a rehabilitation tool for temporary lower limb problems as well.

Researchers videotaped dozens of physiotherapy sessions, recording exactly how the feet and legs of patients were being manipulated, and converting the movements into a range of mathematical models describing the movements in three dimensions.

These formulae were then used to programme the exoskeleton with the variety of motions it needs to work. The result is that a physiotherapist can adjust the range, speed and direction of each movement, ensuring that the patient is getting treatment appropriate to his or her condition.

As well as academics at the three universities involved, practising physiotherapists, clinicians, engineers, mathematicians, health administrators and patients were all involved in brainstorming and analysing the concept. Further research is planned on ways in which therapists could use the technology more effectively, and the Abertay-led team is now looking to stage further trials in conjunction with a potential manufacturer.

ABERTAY DUNDEE UNIVERSITY
Scotland
United Kingdom
DD1 1HG
abertay.ac/ Continue reading →

In a report out last Tuesday 19 June the BMA is calling on doctors and all health professionals to be increasingly aware of domestic abuse as an issue that needs urgent attention.

The report “Domestic Abuse” produced by the BMA’s Board of Science says doctors need to ask their patients the right kind of questions about domestic abuse and respond appropriately. It recommends that training in dealing with domestic abuse should be provided to all health professionals.

Domestic abuse is extremely common and it is important for doctors to recognise this, says the report. While this is a crime which affects both men and women, statistically 80% of reported domestic abuse victims are women.

The report states that domestic abuse is prevalent in all parts of society. Domestic abuse does not discriminate and affects many vulnerable groups, including disabled and older people.

Key points in the report include:

– around 750,000 children a year witness domestic abuse

– around 30% of domestic abuse begins during pregnancy

– partner abuse is as common and as prevalent among same-sex couples as among heterosexual couples

– the total cost of domestic abuse to services in England and Wales [criminal justice, health, social services, housing and legal] amounts to around ??3.1 billion a year

– the direct health impact of domestic abuse can include fractures, burns, depression, post-traumatic stress disorders, chronic pain syndromes, arthritis, hearing or sight deficits, seizures and frequent headaches.

– the indirect health outcomes include stomach ulcers, coronary artery disease and raised blood pressure.

Dr Vivienne Nathanson, Head of the BMA Science and Ethics, said :

“The figures we provide in this report are shocking, but perhaps more alarming is that they are likely to be grossly underestimated. Domestic abuse is an unspoken scar on our society and many individuals never report that they are victims. Sometimes this is because of social stigma or simply because they do not know who to turn to. Other times it can be because the victims are so vulnerable that they are not in a position to seek help.”

She added:

“Doctors and other health professionals are well placed to help victims and their families and our message to them today is, ‘if you suspect abuse is taking place, it is important that you help your patient to discuss this’. It is also very important for doctors to realise that men can be victims too. Men are less likely to be believed and therefore they tend not to seek help.”

The report highlights the need for health professionals to be aware of domestic abuse occurring in minority groups. For example, within the Asian community, some women are expected to uphold the honour of the family and this may even mean tolerating domestic abuse rather than leaving the family home. In extreme cases ‘honour crimes’ can take place, either in the form of assault or killings. Domestic abuse can occur in a forced marriage, where duress, physical or mental, is used to force a marriage to take place without the real consent of one or both parties.

Key recommendations from the report include:

– All health professionals should receive training in identifying and helping patients who are victims of domestic abuse – this needs to be implemented on a national scale within emergency medicine.

– Health professionals should ask patients appropriate questions in a sensitive and non-threatening manner in order to encourage disclosure of abusive experiences.

– Health professionals should recognise that men can also be victims of domestic abuse.

– The government should promote a ‘zero-tolerance’ attitude to domestic abuse

– Refuges should be more accessible to transgender, lesbian, gay, bisexual individuals.

– Domestic abuse education programmes should be implemented in all primary and secondary schools.

– A good research base already exists on domestic abuse but there needs to be more research in the following areas: domestic abuse within ethnic minority groups, the experience of disabled people who are victims of abuse, pregnant victims of domestic abuse and the number of refuges which exist for male victims.

1. The report can be accessed on the BMA website.
Please click here.

2. Domestic abuse falls into four main types:

– Physical abuse – one study has shown that of the more serious violent incidents reported by female victims of domestic abuse, 10% reported being punched in the face, 10% punched or kicked in the body, arms, or legs, and nine per cent choked. A survey of male victims of domestic abuse had found that 66% said that their partner used a weapon, and 22% said they had been stabbed by a knife or sharp object.

– Sexual abuse – the British Crime Survey 2005/06 found that 16% of women and two% of men who had been a victim of any type of partner abuse since the age of 16 had experienced sexual abuse by a partner.

– Psychological abuse – domestic abuse has long-term consequences on the mental health of its victims.

– Financial abuse – this is more commonly seen in older people as they may rely on someone to collect their pension or organise their bank accounts. Financial abuse can lead to older people being left with no access to their finances, medications or transportation.

3. A full list of recommendations can be found on page 59 of the report.

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ACR Image Metrix™, a global imaging contract research organization (CRO) with expertise in imaging trial design, techniques and data extraction, is pleased to announce a Phase III trial, conducted for Aegerion Pharmaceuticals, Inc., was published as an abstract in the online supplement of Atherosclerosis and presented at the 78th European Atherosclerosis Society Congress, which took place June 20-23, 2010, in Hamburg, Germany.

The trial, titled “Phase III Study of Microsomal Triglyceride Transfer Protein Inhibitor (MTP-I) Lomitapide in Subjects with Homozygous Familial Hypercholesterolemia (HoFH),” was a 56-week assessment of the efficacy and safety of Aegerion Pharmaceuticals’ MTP-I lomitapide in adults with HoFH. In order to measure the percentage of hepatic fat, ACR Image Metrix employed magnetic resonance spectroscopy (MRS) as the imaging modality for this study. MRS is capable of displaying minute differences in the magnetic properties of different chemical compounds to provide a unique biochemical signature.

Aegerion Pharmaceuticals is a biopharmaceutical company focused on the development and commercialization of therapeutics/pharmaceuticals to treat cardiovascular (CV) and metabolic disease. A developer of lomitapide (AEGR-733), a novel proprietary MTP-I under development for the treatment of dyslipidemia (abnormal lipid levels in the bloodstream), Aegerion Pharmaceuticals turned to the imaging experts at ACR Image Metrix to execute the trial.

Because of its unique capabilities in employing novel imaging technologies in drug development trials, ACR Image Metrix was chosen for this groundbreaking clinical trial testing the efficacy and safety of an MTP inhibitor.

“We are pleased to have partnered with Aegerion Pharmaceuticals to conduct this trial,” stated general manager of ACR Image Metrix, Michael J. Morales. “The complexity involved allowed our world class team of radiologists and imaging scientists to utilize their widespread knowledge and extensive imaging capabilities.”

At the conclusion of the trial, ACR Image Metrix was able to provide Aegerion Pharmaceuticals with the necessary results to analyze the product effects. In a preliminary analysis, of the eleven adults with HoFH treated with lomitapide, their mean low-density-lipoprotein cholesterol (LDL-C) reduction was 38 percent and hepatic fat had significantly declined.

Source:

ACR Image Metrix™ Continue reading →

Up to 20% of five to seven-year-old children experience bedwetting, and an effective treatment currently does not exist. In her article, Dawn Diaz Saldano examines bedwetting remission rates after children received one of two treatment options – an algorithm-based multimodal plan, Try for Dry (includes use of an alarm, pharmacology and managed diet), or a non-Try for Dry treatment plan (parents select and administer single aspects of the Try for Dry program).

The authors found children treated with the Try for Dry method sustained dryness (no bedwetting incidents) significantly longer than those treated with other methods. The authors note that the study did not correlate bladder capacity with relapse and recommend future studies examining outcomes.

“Sustainability of Remission of Pediatric Primary Nocturnal Enuresis – Comparison of Remission Using Try for Dry vs. Non-Try for Dry Treatment Plans”
Dawn Diaz Saldano, MSN, APN, CPNP, et al
Urologic Nursing; August 2008

About the Society of Urologic Nurses and Associates (SUNA)

The Society of Urologic Nurses and Associates is a professional organization committed to excellence in clinical practice and research through education of its members, patients, family and community. Our vision is to be the nursing authority in the management of persons with urological healthcare concerns.

Society of Urologic Nurses and Associates Continue reading →

The American Academy of Pediatrics (AAP) supports the efforts of the Florida Pediatric
Society, a chapter of the AAP, and the Florida Academy of Pediatric Dentistry to combat discrepancies in the
quality of medical and dental care delivered to children enrolled in Florida’s Medicaid program. The group filed
a lawsuit against Florida Medicaid-now currently in trial-for providing inadequate medical and dental care to
more than 1 million Floridian children.

“The 390,000 children in Florida who did not get medical check-ups in 2007 and the more than 750,000 who
received no dental care that year are proof that this discrepancy in care is failing Florida’s children,” said
pediatric cardiologist and Florida Pediatric Society Executive Vice President Louis St. Petery, MD, FAAP.

“Florida’s Medicaid payment rates are among the lowest in the country, which explains why so few doctors in
our state can afford to treat Medicaid patients,” Dr. St. Petery stated. “Medicaid paid only $32 for a physician
office visit in Florida in 2007, compared to $47 in Virginia, and the approximately $60 that Medicare pays for
the same service in Florida.”

In the current lawsuit, the Florida Pediatric Society is requesting that Florida increase its Medicaid payment
rates to at least Medicare levels for physicians and to the 50th percentile of what is customary for dentists who
treat Medicaid children up to 21 years old. The group also advocates for the elimination of administrative
barriers that prevent Medicaid children from having the same access to medical and dental care as children on
private insurance.

The American Academy of Pediatrics recognizes that the need for Medicaid payment reform extends beyond
Florida, and would very much like to see attention to this issue at the federal level as Congress debates its health
reform legislation.

“One of our primary goals within federal health reform is to ensure that Medicaid provides comprehensive
benefits, coverage and access to care to address children’s unique health needs,” said AAP President Judith S.
Palfrey, MD, FAAP. “Without appropriate payment, pediatricians cannot afford to treat Medicaid patients and
keep their doors open. This is exactly what we’re seeing in Florida, and it is unacceptable. We must do right by
our children.”

The American Academy of Pediatrics stands behind the efforts of the Florida Pediatric Society and the Florida
Academy of Pediatric Dentistry to improve medical and dental care for Florida’s children, and looks forward to
a quick and decisive verdict to reform Florida’s Medicaid system so that it provides Florida children with the
affordable, quality health care they need and deserve.

Source
American Academy of Pediatrics Continue reading →

Health Net, Inc. reminds seniors, age 65 or older, and others who are eligible for Medicare that the Medicare Open Enrollment period closes on Wed., Mar. 31, 2010.

If Medicare Advantage or Prescription Drug Plan beneficiaries are not satisfied with the choice they made in November or December of last year during the Annual Election Period, they have one last chance to switch to a different Medicare Advantage plan for 2010. This opportunity allows seniors and other Medicare-eligible individuals to ensure their coverage truly meets their needs.

“With the March 31 deadline drawing near, Medicare beneficiaries should consider whether their current plan really meets their needs,” said Scott R. Kelly, chief Government Programs officer, Health Net, Inc. “In reviewing their options, the most important factors they should consider are the 4 Cs – Cost, Customer Service, Convenience and Coverage.”

The 4 Cs

1. One fact individuals should consider when reviewing their options is the cost of monthly plan premiums, deductibles and copayments.

2. Consumers should also look at customer service. Are the people at the plan helpful? Do they understand your personal needs?

3. Then think about convenience. If their plan does not have an agreement with their favorite pharmacy, consumers will spend time traveling to different drugstores. If a Medicare beneficiary’s doctors are not in the provider network, they will have to switch doctors.

4. Coverage is one of “the 4 Cs” because every Medicare plan with a pharmacy benefit does not cover every medication. If there are prescription drugs beneficiaries currently take, or expect to take, make sure they are covered. Otherwise, they could be enrolled in a plan that does not pay for the medications they need.

For more information about “the 4 Cs” and choosing the right Medicare Advantage or Prescription Drug plan, visit abetterdecision. Health Net also has Medicare experts available on its toll-free number, 1-800-903-0944 (TTY 711), 8:00 a.m. to 8:00 p.m., seven days a week. Medicare beneficiaries also can go to medicare to review their options or contact their current Medicare Advantage provider with their questions.

Some Limitations to Switching Plans

During the open enrollment period, which runs from Jan. 1 through Mar. 31, individuals have an opportunity to switch plans, but there are limitations. Specifically, they must continue to keep prescription drug coverage if they had it as of Dec. 31, 2009. Or, if Medicare beneficiaries did not have prescription drug coverage as of Dec. 31, 2009, they cannot add it to their plan if they decide to switch.

After March 31, 2010, until the start of the next annual election period in November of 2010, individuals can join or change plans for only a few specific reasons such as moving out of a plan’s service area or turning 65, which allows first-time enrollment in a Medicare plan. A full list of reasons can be found at medicare.

Source
Health Net Continue reading →

The American Pharmacists Association (APhA) joins Representatives Mike Ross, Marion Berry and Charlie Wilson in urging the Centers for Medicare and Medicaid Services (CMS) to delay implementation of a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescription orders beginning October 1, 2007. Enacted as a cost-saving measure in the Emergency Supplemental Appropriations (Public Law 110-28), precious little time remains to educate prescribers, pharmacists and patients on this requirement, before pharmacists are forced to turn patients away for not presenting prescriptions on “approved tamper-resistant” paper.

Dennis Smith, CMS’ Director for Medicaid and State Operations, told the House Small Business Committee earlier today that it is the intention of CMS to comply with Congress’ statutory guideline for implementation. Adding that many states already have similar requirements, and asserting that implementation would only need to take place in the remaining states.

“What Mr. Smith failed to note,” explained John A. Gans, APhA Executive Vice President and CEO, “is that it took states like New York 18 months to implement such programs – a timeline that is in stark contrast to the 3 months called for by Congress. And-in almost all of these states the tamper-resistant requirement was limited to a much smaller group of medications not ‘every prescription’. So, I am pleased that Reps. Ross, Berry and Wilson introduced legislation today to limit the scope of this federal mandate to only controlled substances.”

The Congressmen circulated a letter earlier urging their colleagues to contact Medicaid officials and urge delayed implementation. In an effort to ensure that patient care does not suffer, they are urging CMS to “provide guidance on the program’s initial implementation phase, asking that pharmacists be held harmless and receive prompt payment for filling legitimate prescription orders necessary to the continuity of patient care even when those orders may not fully meet the tamper-resistant requirements.”

APhA, the largest professional society of pharmacists in the country, thanks Reps. Ross, Berry and Wilson for their continued commitment to patient care and joins in their efforts to call for delayed implementation. APhA’s letter to CMS is available at here.

The American Pharmacists Association, founded in 1852 as the American Pharmaceutical Association, represents more than 60,000 practicing pharmacists, pharmaceutical scientists, student pharmacists, pharmacy technicians, and others interested in advancing the profession. APhA, dedicated to helping all pharmacists improve medication use and advance patient care, is the first-established and largest association of pharmacists in the United States.

aphanet Continue reading →

A lot of chatter goes on inside each one of us and not all of it happens between our ears.

Researchers at McMaster University discovered that the “cross-talk” between bacteria in our gut and our brain plays an important role in the development of psychiatric illness, intestinal diseases and probably other health problems as well including obesity.

“The wave of the future is full of opportunity as we think about how microbiota or bacteria influence the brain and how the bi-directional communication of the body and the brain influence metabolic disorders, such as obesity and diabetes,” says Jane Foster, associate professor in the Department of Psychiatry and Behavioural Neurosciences of the Michael G. DeGroote School of Medicine.

Using germ-free mice, Foster’s research shows gut bacteria influences how the brain is wired for learning and memory. The research paper has been published in the March issue of the science journal Neurogastroenterology and Motility.

The study’s results show that genes linked to learning and memory are altered in germ-free mice and, in particular, they are altered in one of the key brain regions for learning and memory the hippocampus.

“The take-home message is that gut bacteria influences anxiety-like behavior through alterations in the way the brain is wired,” said Foster.

Foster’s laboratory is located in the Brain-Body Institute, a joint research initiative of McMaster University and St. Joseph’s Healthcare in Hamilton. The institute was created to advance understanding of the relationship between the brain, nervous system and bodily disorders.

“We have a hypothesis in my lab that the state of your immune system and your gut bacteria which are in constant communication influences your personality,” Foster said.

She said psychiatrists, in particular, are interested in her research because of the problems of side effects with current drug therapy.

“The idea behind this research is to see if it’s possible to develop new therapies which could target the body, free of complications related to getting into the brain,” Foster said. “We need novel targets that take a different approach than what is currently on the market for psychiatric illness. Those targets could be the immune system, your gut function…we could even use the body to screen patients to say what drugs might work better in their brain.”

Source: McMaster University Continue reading →

Taking photographs or video of unusual symptoms on an ordinary camera phone can help doctors diagnose uncommon problems, say researchers in an article published on bmj.

For example, doctors in Norway describe the case of a 25 year old pregnant woman who reported frequent episodes of severe nipple pain.

The pain came whenever her fingers, toes or nipples got cold, such as when walking barefoot on a cold floor or taking a shower, and typically lasted between five and 15 minutes and was so painful as to bring her to tears.

Along with the pain, the colour of the nipples also changed; first white combined with a tingling pain (“tightening a vice screw”), then blue with a burning pain (“pouring acid”), and finally a red phase combined with numbness as the pain decreased. After the birth of her baby, the pain became so intense that she considered giving up breastfeeding.

She presented three photographs from her camera phone showing the colour changes of a typical episode.

With the help of these photographs, doctors diagnosed Raynaud’s phenomenon of the nipple. The patient was given treatment, her symptoms completely resolved within one week, and she was able to continue breastfeeding with no side effects.

Raynaud’s phenomenon is possibly an underdiagnosed case of nipple pain, conclude the authors, partly because primary health care workers are often not aware of this condition, and partly because the symptoms have vanished before the patient reaches the GP surgery.

Link to paper

Source
British Medical Journal Continue reading →