A new study indicates there may be yet another reason to reduce childhood obesity it may help prevent allergies. The study published in the May issue of the Journal of Allergy and Clinical Immunology showed that obese children and adolescents are at increased risk of having some kind of allergy, especially to a food. The study was funded by the National Institute of Environmental Health Sciences (NIEHS) and the National Institute of Allergy and Infectious Diseases (NIAID), both parts of the National Institutes of Health.

“We found a positive association between obesity and allergies,” said Darryl Zeldin, M.D., acting clinical director at NIEHS and senior author on the paper. The researchers analyzed data on children and young adults ages 2 to19 from a new national dataset designed to obtain information about allergies and asthma. “While the results from this study are interesting, they do not prove that obesity causes allergies. More research is needed to further investigate this potential link,” Zeldin said.

The study is the first to be published using new data from the National Health and Nutrition Examination Survey (NHANES). NHANES is a large nationally representative survey conducted by the National Center for Health Statistics, a part of the Centers for Disease Control and Prevention. NHANES is designed to assess the health and nutritional status of adults and children in the United States. An allergy/asthma component was supported by NIEHS and added to the 2005 – 2006 NHANES study, making it the largest nationally representative dataset of allergy and asthma information ever assembled in the United States.

“We have all the pieces of the puzzle in this dataset,” said Zeldin. “The allergy and asthma component of NHANES provides allergen exposure information, allergic sensitization information, as well as disease outcome information. There is a wealth of knowledge we will be able to gain by analyzing these data that will be useful to allergy and asthma sufferers.”

In this study, the researchers analyzed data from 4,111 children and young adults aged 2 – 19 years of age. They looked at total and allergen-specific immunoglobulin E (IgE) or antibody levels to a large panel of indoor, outdoor and food allergens, body weight, and responses to a questionnaire about diagnoses of hay fever, eczema, and allergies. Obesity was defined as being in the 95th percentile of the body mass index for the child’s age. The researchers found the IgE levels were higher among children who were obese or overweight. Obese children were about 26 percent more likely to have allergies than children of normal weight.

The signal for allergies seemed to be coming mostly from food allergies. The rate of having a food allergy was 59 percent higher for obese children,” said NIEHS researcher Stephanie London, M.D., a co-author on the study.

“As childhood obesity rates rise, NIEHS will continue to work to determine how environmental factors affect this epidemic,” said Linda Birnbaum, Ph.D., NIEHS director. “Seeing a possible link between obesity and allergies provides additional motivation for undertaking the challenge of reducing childhood obesity.”

“Given that the prevalence of both obesity and allergic disease has increased among children over the last several decades, it is important to understand and, if possible, prevent these epidemics,” said Cynthia M. Visness, Ph.D., lead author on the paper and a scientist at Rho Federal Systems Division, Inc. in Chapel Hill, N.C.

NIAID conducts and supports research at NIH, throughout the United States, and worldwide to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses.

The National Institutes of Health (NIH) The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

Reference: Visness CM, London SJ, Daniels JL, Kaufman JS, Yeatts KB, Siega-Riz AM, Liu AH, Calatroni A, Zeldin DC. Association of obesity with IgE levels and allergy symptoms in children and adolescents: Results from the National Health and Nutrition Examination Survey 2005 – 2006. Journal of Allergy and Clinical Immunology. May, 2009. Doi:10.1016/j.jaci.2008.12.1126.

Source: National Institute of Environmental Health Sciences (NIEHS) Continue reading →

Patients of the Mammography Department at NHS Fife’s Queen Margaret Hospital are now benefitting from faster treatment due to the installation of a Full-Field Direct Digital Mammography system from Siemens Healthcare. The MAMMOMAT Inspiration™ includes a stereotactic biopsy attachment and syngo® MammoReport workstation.

The stereotactic biopsy attachment provides the clinician with valuable guidance through the biopsy procedure enabling vertical and lateral access to breast lesions, of particular use when trying to access technically challenging areas in the breast. The attachment has an easy to use set up and is lightweight, weighing less than 5kg. It also allows clinicians to control the tube angle directly from the workstation, eliminating the need to walk between the system and station.

The biopsy attachment is easy to use due to automated features. After sliding the unit onto the detector, the configuration settings will automatically switch to stereotactic biopsy mode and activate the biopsy examination tab card at the workstation. Combined with the fully motorised needle-holder that moves automatically to the correct position, the attachment streamlines workflow for a swifter and more precise examination. More accurate results minimises the need for repeating any uncomfortable procedures on patients.

The syngo MammoReport workstation facilitates improved workflow, uploading examination results in just one second for fast and accessible viewing. Up to eight mammogram images can be viewed simultaneously. The examination process is also swifter as images can be seen straight away. If the patient needs to be re-positioned for another scan, this can be done whilst they are still at the system rather than having to undress again and repeat the process.

“The Inspiration enables fast and accurate breast examinations to be carried out, enhancing the quality of care provided to women,” said Lynn Blackburn, Product Manager for Special Products at Siemens Healthcare. “The system also provides a highly flexible platform for upgrades such as stereotactic biopsy and Tomosynthesis, enabling hospitals to provide their patients with efficient, modern treatment procedures without having to continually purchase expensive new equipment.”

The MAMMOMAT Inspiration is fresh in design to meet the needs of the patient, user and clinician. The system includes a unique MoodLight feature that emits changing and calming colours into the patient examination area to help ease patient anxiety and improve the chances of getting a good quality image first time. The system includes new compression technologies and paddle design for the latest in patient comfort, plus the isocentric rotation of the X-ray tube makes system handling simpler to improve workflow. It also offers an advanced image resolution of the whole breast for detailed diagnosis.

Source
Siemens Healthcare Continue reading →

The Health Protection Agency is reminding consumers about advice on the safe storage of sliced-at-the-counter cooked meats.

Current advice from the Food Standards Agency (FSA) states that the vast majority of perishable chilled foods, including sliced-at-the counter cooked meats, should be stored according to the retailer’s instructions or, in the absence of any instructions, eaten within 48 hours.

A study carried out in the North West, initiated by the Cheshire, Cumbria, Greater Manchester, Lancashire and Merseyside Food Liaison Group and the Health Protection Agency’s Food and Environmental Microbiology Services North West, reemphasises the importance of using these meats as soon as possible after purchase.

The study looked for levels of the food poisoning bacterium listeria (Listeria monocytogenes) in freshly sliced cooked meats purchased from a number of retailers. Laboratory tests found that 7.3% of samples were contaminated on their day of purchase.

In a few cases (0.4%) the meat sample had levels of this organism which failed to comply with food safety legislation. This could have been potentially hazardous, particularly to people vulnerable to listeria such as the elderly, those with weakened immune systems and pregnant women. Listeria is particularly dangerous in pregnancy as it can cause a mild ‘flu-like’ illness which is not serious to the mother but can cause miscarriage, premature delivery, stillbirth or severe illness in a newborn child.

Listeria is unusual because it not only grows at normal room temperature and up to about 40° C, but can grow at low temperatures, including refrigeration temperatures of below 5° C.

Further laboratory tests showed that when the meats were tested again following storage in a refrigerator for 48 hours at 6° C, L.monocytogenes had multiplied in some cases, resulting in a larger percentage of samples (2.7 %) being potentially hazardous to vulnerable people if consumed.

Professor Peter Borriello, Director of the Health Protection Agency’s Centre for Infections, said:

“Proper cooking of foods, proper storage of ready to eat foods and good kitchen hygiene will all help to prevent cases of food poisoning.”

Note

Survey

The testing for this survey was undertaken in laboratories in Preston, Chester and Carlisle on 1127 cooked meat samples sold loose and purchased in a variety of food retail outlets by Environmental Health Officers from 42 North West local authorities.

When examined on the day of purchase L. monocytogenes was detected in 82 of the 1127 samples (7.3%).

Only 5 of the 1127 samples (0.4%) were unacceptable due to levels of L.monocytogenes on the day of purchase.

After 48 hours refrigeration at 6° C the L.monocytogenes levels in 31 of the 82 contaminated samples (38%) had increased to more than 100 L. monocytogenes per gram of meat, numbers of L. monocytogenes that are considered to pose a potential risk to health in vulnerable people.

The meat samples were purchased from the following retail outlets:

- Butchers: – 390 samples of which 24 (6%) were contaminated with low levels of L. monocytogenes on day of purchase.
- Delicatessens: – 207 samples of which 16 (7%) were contaminated with low levels of L.monocytogenes on day of purchase.
- Local grocers: – 71 samples of which one (1.4%) was found to contain low levels of L. monocytogenes on day of purchase.
- Market stalls: – 184 samples of which 26 (14%) had low level contamination on day of purchase.
- Supermarkets: – 275 samples of which 15 (5%) were contaminated on day of purchase.

The samples comprised beef, brawn, corned beef, ham, heart, lamb, pork, poultry and tongue.

In total 863 (77%) of the meat samples purchased were not labelled with “use by” advice:

- Market stalls: – 173 unlabelled (94%)
- Butchers: – 362 samples unlabelled (93%)
- Delicatessens: – 191 unlabelled (92%)
- Local grocers: – 65 unlabelled (92%)
- Supermarkets: – 72 unlabelled (26%)

Food businesses which sold the samples of meat which had unacceptable levels of Listeria monocytogenes on the day of purchase or after storage for 48 hours in a fridge were re-visited by Environmental Health Officers from the relevant Local Authorities in the region to investigate the source of the problem.

The study was initiated by the Cheshire, Cumbria, Greater Manchester, Lancashire and Merseyside Food Liaison Group and the Health Protection Agency’s Food and Environmental Microbiology Services North West.

Listeria

Listeria is a rare, but potentially life-threatening disease. Although some adults experience only mild infections of the eye and skin, and gastroenteritis, it can lead to severe blood poisoning (septicaemia) or meningitis.

Listeria monocytogenes is unusual because it can grow and multiply from temperatures ranging from below 5° C (a well-controlled refrigerator’s temperature) to 45 ° C.

The FSA currently advises that the vast majority of perishable chilled foods including sliced-at-the counter cooked meats should be stored according to the retailer’s instructions or, in the absence of any instructions, that they should be eaten within 48 hours. The main type of food to which this advice does not apply is cooked rice, which should be stored in the fridge for no more than 24 hours.

More information about listeria is available on the Health Protection Agency website.

Anyone with concerns about their health should contact NHS Direct on 0845-4647 or visit the website nhsdirect.nhsor consult their family doctor.

Health Protection Agency Continue reading →

NPR’s “Morning Edition” on Thursday reported on skepticism among some consumers and physicians over the accuracy of a test launched in June that allows pregnant women in the U.S. to determine the sex of their fetus as early as five weeks’ gestation (Boyce, “Morning Edition,” NPR, 9/29). The $25 Baby Gender Mentor test, marketed by Mommy’s Thinkin’ and available online at pregnancystore, includes a finger-prick kit for pregnant women to collect a blood specimen. Women then send the blood sample to a laboratory based in Lowell, Mass., which analyzes fetal DNA in the pregnant woman’s blood for an additional charge of $250. Lab technicians test the blood for the presence of a Y chromosome, which would indicate the fetus is male, or the absence of the chromosome indicating the fetus is female. The pregnant woman receives the test results in two to three days (Kaiser Daily Reproductive Health Report, 6/28). The test, which is manufactured by Acu-Gen, is classified as nonmedical and therefore not regulated by FDA. According to NPR, thousands of pregnant women have ordered the test, but several women have come forward to say their results were incorrect. The segment includes comments from Diana Bianchi, an expert on fetal and neonatal genetics at Tufts University whose work is cited on Acu-Gen’s Web site as proof of the science behind the test; Sherry Bonelli, owner of pregnancystore; physicians whose pregnant patients have taken the test; a woman whose test indicated that she was pregnant with a male fetus, although a sonogram indicated that she was carrying a female fetus; and a woman who was told by Acu-Gen that she was pregnant with twins, although a sonogram showed she was carrying only one fetus (“Morning Edition,” NPR, 9/29).

The complete segment is available online in RealPlayer. Expanded NPR coverage is available online.

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

St. Jude Children’s
Research Hospital investigators and collaborators have shown how to predict
if a child who is infected with respiratory syncytial virus (RSV) while
being treated for cancer or another catastrophic disease is at high risk
for developing severe infection. The finding will help clinicians improve
guidelines for managing these infected children.

RSV is a common cause of pneumonia among infants, children and adults
during winter, frequently causing fever, runny nose and coughs. It can be
much more severe in patients who are undergoing cancer treatments and whose
immune systems are suppressed. In these patients, the virus can move into
the deep lung, causing pneumonia and other respiratory problems that can be
fatal. However, it is difficult to predict which infected patient is likely
to develop a serious lower respiratory tract illness and which one will
continue to simply have a mild runny nose and cough.

The St. Jude team and collaborators found that if these children are
under 2 years old and have very low levels of immune system cells in their
blood called lymphocytes, they are at high risk for the RSV infection to
become serious by moving into the lung. Such infections are especially
dangerous because they can be fatal in some immunocompromised children, and
there is no standard effective treatment for these infections, the
researchers said. A report on the retrospective findings appears in the
February issue of the journal “Pediatrics.”

The new information is important because it helps identify children who
are most at risk for severe disease using easily available clinical
information,” said Aditya Gaur, M.D., assistant member of the St. Jude
Department of Infectious Diseases and the paper’s senior author. “This
narrows down the patient population who needs to be considered for
antiviral therapy, which is costly and often inconvenient to receive from a
child’s perspective. For example, one treatment for RSV infection is to
have the child breathe an aerosolized form of the antiviral drug ribavirin
for 12 to 18 hours, which is tough for the child and the parent.”

The findings of this study require confirmation in prospective studies,
Gaur said. Results of the study also help define which children should
receive medications that can help prevent RSV infection.

Another significant finding was that–unlike some previous reports in
immunocompromised adults with RSV–neutropenia is not a risk factor for
lower respiratory track infection, Gaur said. Neutropenia is an abnormally
low level of neutrophils, immune system cells that engulf and digest germs.

“This finding is important because with cancer patients, clinicians are
used to identifying those at risk for bacterial and fungal infections based
on a patient having neutropenia,” Gaur said. This study shows that for RSV,
which is a viral infection, lymphopenia and not neutropenia is what
identifies children at risk.

Previous studies have shown that lower respiratory track infection, is
more common in children whose immune system is suppressed, who are
receiving chemotherapy or who have received a hematopoietic stem cell
transplant (HSCT). However, while some studies report that lower
respiratory track infection, due to RSV is fatal in 50 to 100 percent of
infected adults, there is little information about this type of infection
in immunocompromised children. “We decided to analyze the course of RSV
infection in children being treated for cancer to identify factors that
could help us predict which ones were at highest risk for severe disease or
death due to a lower respiratory tract infection with this virus,” Gaur
said. HSCT is the transplantation of special cells from the blood or bone
marrow that can give rise to all the blood cells of the body (red and white
cells and platelets).

The St. Jude team studied clinical and laboratory information from the
records of 58 patients who had tested positive for RSV infection. Among
these children, 23 (40 percent) had acute lymphoblastic leukemia, 11 (19
percent) had solid tumors and 24 patients (41 percent) had acute myeloid
leukemia (AML), severe combined immunodeficiency syndrome (SCIDS), or had
undergone bone marrow transplantation. RSV disease in these infected
children was classified as upper respiratory track infection only or lower
respiratory tract infection; and children with both upper and lower
respiratory track infections, were defined as having lower respiratory
track infection.

Overall, 16 (28 percent) of these children developed lower respiratory
track infection, due to RSV. The frequency of this type of infection was
highest (42 percent) in patients who had undergone HSCT or who had AML or
SCIDS. Five patients (31 percent) with LRTI died, an overall mortality rate
of 8.6 percent. All deaths occurred in lower respiratory track infection
patients who were severely immunocompromised from their cancer, from
chemotherapy or from the HSCT.

Other researchers include C. M. El Saleeby (formerly of St. Jude and
now at MassGeneral Hospital for Children, Boston), G. W. Somes (Department
of Preventive Medicine, University of Tennessee, Memphis) and J.P.
DeVincenzo (Le Bonheur Children’s Medical Center and University of
Tennessee, Memphis).

This study was supported by the National Institutes of Health and
ALSAC.

St. Jude Children’s Research Hospital

St. Jude Children’s Research Hospital is internationally recognized for
its pioneering work in finding cures and saving children with cancer and
other catastrophic diseases. Founded by late entertainer Danny Thomas and
based in Memphis, Tenn., St. Jude freely shares its discoveries with
scientific and medical communities around the world. No family ever pays
for treatments not covered by insurance, and families without insurance are
never asked to pay. St. Jude is financially supported by ALSAC, its
fundraising organization. For more information, please visit
stjude.

St. Jude Children’s Research Hospital
stjude Continue reading →

UroToday – AT1 receptor blockers (ARBs) possessing our experimental demonstrations may offer clinical efficacy in patients with hormone refractory prostate cancer (HRPC).

In practice, we conducted a pilot clinical study to examine whether an ARB (candesartan) was able to clinically elicit an antiproliferative effect on hormone-refractory prostate cancer. Surprisingly, a quarter of patients with a PSA decline of more than 50% showed an improvement in performance status.

We experienced some cases in which the PSA response was delayed for several months after starting ARB treatment. Thus, we presume that the administered dose of candesartan was too low to overcome multiple metastases.

Finally, we believe that ARBs have the potential to delay the PSA increase in cases whose cancer tissues possess AT1 receptors.

Hiroji Uemura MD, PHD, as part of Beyond the Abstract on UroToday. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc… of their research by referencing the published abstract.

Link to full abstract

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
www.urotoday

—————————-
Copyright © 2007 – UroToday
Reproduced for blog with permission of UroToday.
—————————- Continue reading →

The House Energy and Commerce Subcommittee on Health on Wednesday held a hearing on the potential effects of increased price transparency for health care providers, CQ HealthBeat reports. Supporters said that increased price transparency will help consumers make health care decisions and lead to reduced costs. House Energy and Commerce Committee Chair Joe Barton (R-Texas) said, “Instead of a marketplace, we have a system that prevents patients from seeing how much their health care services actually cost. The health care system hides prices, and it blurs quality.” Former House Speaker Newt Gingrich (R-Ga.), founder of the Center for Health Transformation, added, “Health care is the only area of America’s economy where the consumer and the provider have no idea what the good and services they trade cost.” However, opponents said that increased price transparency will not address the issues of high health care costs and the uninsured. Rep. Henry Waxman (D-Calif.) said that increased price transparency “is no substitute for real coverage,” adding that individuals enrolled in group health plans receive lower prices than those who purchase health care on their own. In addition, he said that increased price transparency might shift more health care costs to individuals. Paul Ginsberg, president of the Center for Studying Health System Change, said, “Consumers’ experiences with markets for self-pay services … have been romanticized and do not offer much encouragement as a model of effective shopping for health care services.” Rep. Sherrod Brown (D-Ohio) also said that increased price transparency should include health insurers and pharmaceutical companies, as well as providers (Carey, CQ HealthBeat, 3/15).

Price Disclosure Examined
In related news, the Washington Post on Friday examined the Bush administration’s plan in the coming weeks to post online the prices that Medicare pays for common medical procedures. The published rates are part of a larger initiative to disclose price and quality data from hospitals, a plan the administration says will allow consumers to compare prices at different hospitals and decrease costs. In the next few months, the government also will post online rates negotiated by the Defense Department, the Federal Employees Health Benefits Program and private health plans in six communities. CMS Administrator Mark McClellan said hospitals will be required in 2007 to release mortality data on common illnesses, such as heart attacks and infection. According to the Post, some advocates for the poor say the published prices “will pressure hospitals to give uninsured patients the discounts provided to people with insurance.” HHS Secretary Mike Leavitt said, “When people have information on price and quality, whether it’s an individual consumer or a corporate payer, they’ll be a better informed consumer.” He added, “Prices will go down, and quality will go up. That happens whenever a competitive market is fully informed.” However, Rick Pollack, executive vice president of the American Hospital Association, said the plan will not lower costs because, “[o]n average, Medicare pays less than the cost of delivering the service” (Connolly, Washington Post, 3/17). The Hill on Wednesday also examined the administration proposal, which has “not been warmly received by the hospital sector” (Young/McCormack, The Hill, 3/15).

Opinion Piece
“A more transparent pricing system would help give providers and patients more control over their health care dollar,” Rep. Michael Burgess (R-Texas) writes in a Washington Times opinion piece, adding, “Patients with portable health care dollars that can be paid at point of service are extremely attractive to most health care providers who normally have to wait for an insurance company” to reimburse them. Burgess writes that a lack of price transparency “has created a system where customers don’t have the ability to hold providers and payers accountable” and has led to “double-digit cost increases” annually. According to Burgess, the “opportunity to plug into a fully transparent system would transform the American health care system in a radical manner, improving care for all Americans, rich and poor” (Burgess, Washington Times, 3/16).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

If existing maternal and child nutrition interventions were implemented in poor countries, cases of stunting among under 3s could be reduced by a third, and deaths by up to a quarter, according to new research published yesterday 16 Jan.)

Professor Simon Cousens, of the London School of Hygiene & Tropical Medicine, is one of the authors of a paper which appears as part of the Lancet Maternal and Child Undernutrition Series, which is being launched this week. Professor Cousens, along with four other series authors, is presenting his findings at a press event at the Science Media Centre.

178 million children under five are stunted, and most of these live in Sub-Saharan Africa and south-central Asia. 160 million stunted children (90%) live in just 36 countries, and make up 46% of the 348 million children in those countries. In addition, 19 million children are affected by severe acute malnutrition.

Historical evidence of improvements in nutrition in developed countries has shown that stature, living standards, reduced disease exposure and education are linked, and that almost all stunting is avoidable. Stunting is difficult to reverse after the age of three, so it is important to focus on interventions in pregnancy and in young children, especially those aged under two. In the past most nutrition programme reports and assessments have focused on weight gain rather than linear growth, and linear-growth retardation has been viewed as difficult to change. However, in the short term, about one third of stunting could be averted with existing interventions, say the authors. These include strategies to promote improved complementary feeding, micronutrient interventions, and interventions aimed at reducing the burden of disease.

In addition to reducing stunting, nutrition interventions, including breastfeeding promotion, could prevent about one quarter of child deaths in the 36 countries in which 90% of the world’s stunted children live, while universal supplementation with calcium, iron and folic acid of women during pregnancy could prevent around 100,000 maternal deaths (24% of the total) and 3.12 million DALYs.

Professor Cousens comments: ‘Much can be done now to improve the nutritional status of mothers and children with simple, evidence-based interventions. Although there are intergenerational effects of undernutrition which will take many years to eliminate, promotion of breastfeeding, improved complementary feeding practices, interventions to improve micronutrient status and interventions to reduce the burden of child disease can all have an immediate impact on child nutrition. Attention to the continuum of maternal and child undernutrition is essential to attainment of several of the Millennium Development Goals and must be prioritised globally and within countries. Countries with a high prevalence of undernutrition must decide which interventions should be given the highest priority, and ensure their effective implementation at high coverage to achieve the greatest benefit.”

###

Source: Gemma Howe

London School of Hygiene & Tropical Medicine Continue reading →

The NHS Chief Executive has recently warned that the NHS could have to
make ‘unprecedented’ efficiency savings of up to ??20 billion between 2011 and
2014. David Nicholson’s Annual Report1 also emphasised that services should
where possible move out of hospital to primary care and into the community, to
allow both better quality and improved productivity.

Following this, a new analysis published today by the School of Pharmacy,
University of London, in partnership with Boots – Better Practices, Better
Health – calls for innovative solutions to the challenge of enabling closer
working between GPs and community pharmacists. Without such progress the
NHS may not be able to make both service quality improvements and the
productivity gains it needs to achieve.

Author Professor David Taylor commented today:
‘After 2011, the NHS is unlikely to enjoy significant growth in its real overall
spending for several years. We will have to make better use of existing
resources and focus more on effective preventative measures – including life
style changes and safe and affordable medicine taking – to go on improving
health outcomes. More effective joint working by community pharmacists and
GPs and their practice colleagues will be essential for this. Without it, counterproductive
rivalries between community pharmacy and GPs would leave
patient needs unmet and the professionals involved vulnerable.’

Better Practices, Better Health highlights pharmacist led Medicine Use
Reviews and NHS Health Checks for vascular disease risks as examples of
areas where the effective co-ordination and targeting of complementary GP and
pharmacist services is needed. Unnecessary duplication of tests or poor
communication of findings thorough lack of computer record linkages can
inconvenience service users and waste NHS resources.

The new report concludes that both competition and co-operation are needed to
meet patient and community needs. Closer working within the primary care
system could be achieved in a number of ways, including:

- creating shared financial incentives which reward both pharmacies and
GP practices when they work efficiently together to deliver good quality
care;

- using IT links between GPs and pharmacists for exchanging (with
patient permission) screening and treatment information, in order to
enhance care standards and increase both cost effectiveness and safety;

- promoting premises sharing and linked new practice models which
encourage ‘joined up care’ and easier patient access to services. One
option is for GP practices to be based in pharmacy owned and managed
premises, as well as in other types of health centre.

Better Practices, Better Health notes the importance that many NHS GPs place
on establishing holistic relationships with those for whom they provide care. It
argues that to further enhance the contributions they make to their communities,
primary care professionals need also to consider more fully their relationships
with each other, in order build trust and work together to ensure that patients
receive the best quality care.

Peter Gibson, a pharmacist and Director of Public Policy for Alliance
Boots, said ‘This report is a timely reminder of the opportunity for policy
makers and health professionals to help make our primary care system even more
effective and efficient. We know patients value greatly their individual
relationships with their GPs and pharmacists. We now need to work together to
move beyond silo thinking and ensure that care is joined up and seamless, to
bring about the step change in the quality of care we all want to deliver for patients.’

Notes

Better Health, Better Practices can be accessed at pharmacy.ac It was written
by Professor David Taylor and Dr Jennifer Newbould.

1 The Year 2008/09 was launched on Wednesday 20 May 2009 at the annual NHS
Chief Executives’ Conference.

Source
NHS Continue reading →

Colleges and universities should seize the opportunity to make premedical and medical education more interactive and interdisciplinary, says Peter J. Bruns, vice president for grants and special programs at the Howard Hughes Medical Institute (HHMI).

That challenge is part of a bold new approach to premedical and medical education proposed by Association of American Medical Colleges (AAMC) and HHMI in the report “Scientific Foundations for Future Physicians,” which was published in June 2009. The report outlines specific scientific topics, called competencies, that undergraduates should know before they enter medical school and medical students should know before they become doctors.

The idea is to allow universities and medical schools to wean themselves off a strict list of required courses and instead teach science in the most innovative possible ways. “The tyranny of being connected to a series of specific courses has hampered change in science education,” Bruns says. “These competencies allow colleges to teach integrated science courses that bring together different scientific disciplines.”

A group of scientist-educators will discuss the report and the road forward at a meeting of the American Association for the Advancement of Science in San Diego this week. The panel will be moderated by Sharon R. Long, a professor of biological sciences and former dean at Stanford University. In addition to Bruns, the speakers include “Scientific Foundations for Future Physicians” committee members Julio de Paula, a chemistry professor and dean at Lewis and Clark College, and Wayne M. Samuelson, a professor of internal medicine and associate dean for admissions at the University of Utah School of Medicine.

Bruns notes that HHMI has long played an important role in invigorating science education at all levels in the United States. But he traced the Institute’s decision to get involved in finding new ways to approach medical and premedical education to “Bio 2010,” a report issued by the National Academy of Sciences in 2003. The report, which called for improvements to undergraduate science education, noted that undergraduate courses are taught within strict disciplinary silos but that research biologists often work across disciplines. “Modern biology is a real mix of disciplines coming together to solve problems,” Bruns says. “That is the way it should be taught.”

In 2007, HHMI joined forces with the AAMC to see if the two institutions could work together to address this problem. They convened a committee of researchers, physicians, and science educators representing a wide range of scientific and medical disciplines. Committee members were chosen from the faculty at selected small colleges, large universities, and medical schools across the country. Long and Robert J. Alpern, dean of Yale University School of Medicine, co-chaired the committee.

The resulting report recommends eight scientific competencies that students should know before entering medical school and eight additional natural science competencies that they should master before receiving their medical degrees. The committee supplemented the broad competencies with specific learning objectives and examples. To see the full report, go to hhmi/grants/sffp.html.

The report has been circulating among science educators since its release in June 2009. Several applicants for HHMI’s ongoing competition for a new round of undergraduate education grants at research universities included plans to create just the type of courses that the AAMC-HHMI report envisions. In addition, the National Science Foundation said several of its current competitions would be a good fit for the interdisciplinary curriculum development, including Course, Curriculum, and Laboratory Improvement (CCLI) grants for undergraduate education.

The report’s findings were being considered in AAMC’s review of the MCAT, the medical school admissions exam, and several members of the MCAT review panel were also on the AAMC-HHMI committee. That review is expected to be completed in 2012.

Bruns hopes that colleges and universities across the country will respond to the call for change. “We are arguing that future physicians need to be prepared in contemporary science, and that is no different from the way future scientists need to be prepared,” he says. “It’s an opportunity to create new ways to teach science, not an obstacle.”

In addition to Peter Bruns, speakers included “Scientific Foundations for Future Physicians” committee members Julio de Paula, Lewis and Clark College, and Wayne M. Samuelson, University of Utah School of Medicine. The panel was moderated by Sharon R. Long, Stanford University.

Source:
Jennifer Michalowski
Howard Hughes Medical Institute Continue reading →