December 30, 2009, 8:17 AM CT

Caring of the aging patient

To assist physicians in caring for a patient demographic that is rapidly growing in size, JAMA is launching a new series, "Care of the Aging Patient: From Evidence to Action".

"The aging of the global population will be a hallmark of the 21st century, when average lifespan may reach 100 years in some countries, at least for women. Worldwide, the proportion of the population aged 60 years or older is expected to increase from 10 percent worldwide in 2005 to 22 percent in 2050, with the steepest rise in the next 25 years. Individuals aged 85 years or older are the most rapidly increasing segment of a number of populations," as per an editorial in the December 23/30 issue of JAMA

C. Seth Landefeld, M.D., of the University of California, San Francisco, and his colleagues write that aging will shape the lives of patients and the practice of medicine, and that physicians will spend more time caring for older individuals. "Eventhough physicians are knowledgeable about the pathophysiology, diagnosis, and management of organ-specific diseases such as cataract, coronary artery disease, and pneumonia, a number of geriatric syndromes are not straightforward and do not fit the conventional paradigm of disease. Are physicians ready for these challenges? How can physicians prepare to meet the needs of patients as they age?"......... Posted by: Emily      Read more         Source

December 30, 2009, 8:08 AM CT

Electronic Medical Records: Practice and problems

A gap exists between policy makers' expectations that current commercial electronic medical records (EMRs) can improve coordination of patient care and clinicians' real-world experiences with EMRs, as per a research studyby the Center for Studying Health System Change (HSC) published online in The Journal of General Internal Medicine.

Current commercial ambulatory care EMRs facilitate care coordination within a practice by making information available at the point of care but are less helpful for exchanging information across doctor practices and care settings, as per the study supported by the Commonwealth Fund.

Clinicians identified a number of areas where both the design of EMRs might be altered, and office care processes modified, to improve EMRs' support for tasks involved in coordinating patient care, as per the study.

Additionally, while current commercial EMR design is driven by clinical documentation needs, there is a heavy emphasis on documentation to support billing rather than patient and provider needs correlation to clinical management, the study found. And, current fee-for-service reimbursement encourages EMR use for documentation of billable events-office visits, procedures-and not for care coordination, which is not a billable activity......... Posted by: Emily      Read more         Source

December 30, 2009, 8:04 AM CT

Rapid flu testing

Milwaukee, WI Scientists from the Medical College of Wisconsin, the Children's Research Institute, and the Children's Hospital of Wisconsin have developed a rapid, automated system to differentiate strains of influenza. The related report by Beck et al, "Development of a rapid automated influenza A, influenza B, and RSV A/B multiplex real-time RT-PCR assay and its use during the 2009 H1N1 swine-origin influenza virus (S-OIV) epidemic in Milwaukee, Wisconsin," appears in the January 2010 issue of the Journal of Molecular Diagnostics

In pandemic infection, such as the present H1N1 influenza outbreak, rapid automated tests are needed in order to make quick and effective public health decisions. Real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR) is a sensitive and specific method for identifying flu substrains; however, technician and assay time are significantly longer than less accurate rapid influenza diagnostic tests.

A group led by Dr. Kelly J. Henrickson of the Medical College of Wisconsin have developed rapid semi- and fully-automated multiplex real-time RT-PCR assays to detect influenza A, influenza B, and respiratory syncytial virus (RSV). These assays can successfully detect human H1N1, H3N2, and swine-origin H1N1 viruses as well as distinguish these from influenza B and RSV infections. These assays could test large numbers of samples over a very short time, allowing for a significant decrease in both technician and assay time......... Posted by: Emily      Read more         Source

December 30, 2009, 7:53 AM CT

Determining ethnic origin of stem cell lines

An international team of researchers led by scientists at The Scripps Research Institute has developed a straightforward technique to determine the ethnic origin of stem cells.

The Scripps Research researchers initiated the studyreported in the January 2010 edition of the prestigious journal Nature Methodsbecause the availability of genetically diverse cell lines for cell replacement treatment and drug development could have important medical consequences. Research has shown that discordance between the ethnic origin of organ donors and recipients can influence medical outcomes for tissue transplantation, and that the safety and effectiveness of specific drugs can vary widely depending on ethnic background.

The team's analysis of a variety of human embryonic stem cell lines currently in use in research laboratories around the world observed that these cells originated largely from Caucasian and East Asian populations, with little representation from populations originating in Africa. In response to these results, the researchers used skin cells from an individual of West African Yoruba heritage to create a new stem cell line, the first to carry the genetic profile of this ethnic group.

"Ethnic origin is a critical piece of information that should come with every cell line," said Scripps Research Professor Jeanne Loring, Ph.D., who is senior author of the paper. "Everyone who works with stem cells should be doing this kind of analysis"......... Posted by: Emily      Read more         Source

December 18, 2009, 7:11 PM CT

Alcohol outlets lead to specific problems among youth

Previous studies have not only demonstrated a clear correlation between alcohol outlets and alcohol-related problems, they have also shown that certain types of outlets are linked to different types of problem outcomes. A newly released study shows that a particular group, underage youth and young adults, have specific problems injury accidents, traffic crashes, and assaults that are correlation to specific types of alcohol outlets off-premise outlets, bars and restaurants.

Results would be reported in the March 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Over the past four decades, public health scientists have come to recognize that eventhough most drinkers safely purchase and enjoy alcohol from alcohol outlets, these places are also linked to serious alcohol-related problems among young people and adults," said Paul J. Gruenewald, senior research scientist at the Prevention Research Center and corresponding author for the study.

"In the early studies, scientists believed associations were due to increased alcohol consumption correlation to higher alcohol outlet densities," added Richard Scribner, D'Angelo Professor of Alcohol Research at the LSU School of Public Health. "However, as the research area has matured, the relations appear to be far more complex. It seems that alcohol outlets represent an important social institution within a neighborhood. As a result, their effects are not limited to merely the consequences of the sale of alcohol"......... Posted by: Emily      Read more         Source

December 18, 2009, 6:28 PM CT

New ways to treat chronic infections

Scientists at Binghamton University, State University of New York, have identified three key regulators mandatory for the formation and development of biofilms. The discovery could lead to new ways of treating chronic infections.

Biofilms communities of bacteria in self-produced slime appears to be found almost anywhere that solids and liquids meet, whether in nature, in hospitals or in industrial settings. Biofilms are implicated in more than 80 percent of chronic inflammatory and infectious diseases caused by bacteria, including ear infections, gastrointestinal ulcers, urinary tract infections and pulmonary infections in cystic fibrosis patients, as per the Centers for Disease Control.

Biofilms are difficult to eradicate with conventional antimicrobial therapys since they can be nearly 1,500-fold more resistant to antibiotics than planktonic, free-floating cells. Biofilms also pose a persistent problem in a number of industrial processes, including drinking water distribution networks and manufacturing.

Karin Sauer, associate professor of biology at Binghamton University, and graduate student Olga Petrova published their findings of key regulatory events mandatory for the formation and development of Pseudomonas aeruginosa biofilms in PLoS Pathogens, a peer-evaluated, open-access journal published online by the Public Library of Science......... Posted by: Emily      Read more         Source

December 18, 2009, 6:26 PM CT

Technology in Canadian Clinical trials

A research team led by Dr. Khaled El Emam, the Canada Research Chair in Electronic Health Information at the CHEO Research Institute, reviewed the use of technology in Canadian clinical trials, and observed that a significant proportion (41%) have moved away from collecting and managing trial data using only paper records.

In his study titled "The Use of Electronic Data Capture Tools in Clinical Trials: Web-survey of 259 Canadian Trials" reported in the Journal of Medical Internet Research, Dr. El Emam and his team observed that during the 2006 and 2007 calendar years, there were approximately 950 clinical trials registered with sites in Canada. About half of these were funded by the pharmaceutical industry. Industry trials tend to be 3 to 4 times larger, on average, than academic trials. Less than 10% of Canadian trials target a pediatric population, which also tend to be significantly smaller than those targeting adult populations. Industry funded trials were more likely to be using electronic data capture (EDC) tools. There was no difference between pediatric and adult trials in terms of the use of EDC, but pediatric trials were using more sophisticated EDC systems.

Electronic data capture tools allow scientists to complete a trial in less time and with fewer errors than if they were using the old paper method to capture and process data manually before entering it into a computer......... Posted by: Emily      Read more         Source

December 18, 2009, 6:22 PM CT

Why some doctors over-prescribe antibiotics?

A newly released study led by a team of scientists at New York Medical College suggests that that medical liability concerns appears to be playing a role in the increase of MRSA in healthcare settings by encouraging clinicians to prescribe antibiotics more often and more broadly than clinical circumstances and evidence-based guidelines warrant. The study appeared in the September-recent issue of the American Journal of Therapeutics

The team analyzed census figures, statistics on population density of attorneys and physicians, and data on antibiotic utilization for the United States, Canada, and 15 European countries. They compared this to statistics on the percentage of methicillin resistance among clinical isolates of S. aureus. They found a strong connection between the prevalence of methicillin resistance and density of attorneys in countries in Europe and North America. They found no connection between prevalence of methicillin resistance and doctor density.

Investigators surveyed 162 healthcare providers to determine whether medical liability concerns were as important as antibiotic cost and formulary restrictions in selecting therapy regimens. The surveys also confirmed that physicians were more concerned about medical liability in cases of under-prescribing antibiotics rather than by over-prescribing them......... Posted by: Emily      Read more         Source

December 17, 2009, 8:09 AM CT

Omega-3 to better nervous-system function

The omega-3 essential fatty acids usually found in fatty fish and algae help animals avoid sensory overload, as per research published by the American Psychological Association. The finding connects low omega-3s to the information-processing problems found in people with schizophrenia; bipolar, obsessive-compulsive, and attention-deficit hyperactivity disorders; Huntington's disease; and other afflictions of the nervous system.

The study, published in the journal Behavioral Neuroscience, provides more evidence that fish is brain food. The key finding was that two omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) appear to be most useful in the nervous system, maybe by maintaining nerve-cell membranes.

"It is an uphill battle now to reverse the message that 'fats are bad,' and to increase omega-3 fats in our diet," said Norman Salem Jr., PhD, who led this study at the Laboratory of Membrane Biochemistry and Biophysics at the National Institute on Alcohol Abuse and Alcoholism.

The body cannot make these essential nutrients from scratch. It gets them by metabolizing their precursor, α-linolenic acid (LNA), or from foods or dietary supplements with DHA and EPA in a readily usable form. "Humans can convert less than one percent of the precursor into DHA, making DHA an essential nutrient in the human diet," added Irina Fedorova, PhD, one of the paper's co-authors. EPA is already known for its anti-inflammatory and cardiovascular effects, but DHA makes up more than 90 percent of the omega-3s in the brain (which has no EPA), retina and nervous system in general......... Posted by: Emily      Read more         Source

December 17, 2009, 7:51 AM CT

Learning styles debunked

Are you a verbal learner or a visual learner? Chances are, you've pegged yourself or your children as either one or the other and rely on study techniques that suit your individual learning needs. And you're not alone for more than 30 years, the notion that teaching methods should match a student's particular learning style has exerted a powerful influence on education. The long-standing popularity of the learning styles movement has in turn created a thriving commercial market amongst researchers, educators, and the general public.

The wide appeal of the idea that some students will learn better when material is presented visually and that others will learn better when the material is presented verbally, or even in some other way, is evident in the vast number of learning-style tests and teaching guides available for purchase and used in schools. But does scientific research really support the existence of different learning styles, or the hypothesis that people learn better when taught in a way that matches their own unique style?.

Unfortunately, the answer is no, as per a major new report published this month in Psychological Science in the Public Interest, a journal of the Association for Psychological Science. The report, authored by a team of eminent scientists in the psychology of learningHal Pashler (University of San Diego), Mark McDaniel (Washington University in St. Louis), Doug Rohrer (University of South Florida), and Robert Bjork (University of California, Los Angeles)reviews the existing literature on learning styles and finds that eventhough numerous studies have purported to show the existence of different kinds of learners (such as "auditory learners" and "visual learners"), those studies have not used the type of randomized research designs that would make their findings credible......... Posted by: Emily      Read more         Source