Tuesday, February 26, 2013

Hospitals Opening Up to Pet Therapy - Prevents Deaths

My opinion:  I always knew that pets helped relieve people of psychological stress, but I think this indicates that they may be even more important than once thought.  Though the chances of dying if owning a dog aren't insanely higher, I believe these figures are still significant.  I wonder what the stats are for the people who did die - did they have other friends or family members to keep them company, and was anyone living with them?  I think this would tell if interactions with humans help, too, and if they help as much as the dog therapy.  Overall, I hope that more hospitals (not just nursing homes) will allow for these programs - I didn't know hospitals lacked them.  Maybe then they could statistically determine if these programs work even if the patient doesn't own a dog, or if long-term ownership is necessary for the best results.

From: http://news.medill.northwestern.edu/chicago/news.aspx?id=216393
Kristin Callahan/MEDILL
Rou, the American pit bull, has been a therapy dog since 2008.

Rush hospital’s visitor program only the latest development in pet therapy

by Kristin Callahan
Feb 21, 2013

Kristin Callahan/MEDILL
Canine Therapy Corps is led by Beth Tap and Callandre Cozzolino.
Dogs have been called our best friends. And with good reason.

Research going back more than four decades has shown that dogs, and other pets, are good for our health. Recognizing this, Rush University Medical Center just became what is believed to be the first Chicago-area hospital to formally allow pet visits in patients’ rooms. The use of pets in medical settings is becoming more common.

In the late 1970s, researchers started to discover the scientific elements of that bond and, shortly after, one of the first studies was published.

In the 1980 issue of Public Health Reports, Dr. Erika Friedmann, professor at the University of Maryland School of Nursing, found that heart attack patients who owned pets lived longer than those who did not.

After a one-year period, only 6 percent of the patients who owned at least one pet had died. But 28 percent of the patients who did not own a pet had died. 

Saturday, February 23, 2013

Racism in the Hospital Setting

My opinion: Racism can occur anywhere, although I usually don't think about it in a medical context.  In private companies, people of minorities may only have to deal with those who work with them, who are to some extent bounded by professional ethics.  However, in a hospital, patients have their own backgrounds on ethics and never had to apply enter the hospital in the same way an employee must apply for a job.  Thus, conflict might arise more often in a hospital setting than in others.  Additionally, since the patient and their families are probably stressed out, hospitals are faced with the threat of being sued, and so they give in to the demands.  In this case, though, the hospital didn't seem to consider the possibility that the staff would sue.  Maybe they could have resolved this by forcing the family to leave the hospital, although that could have caused an even worse legal battle, especially if the baby was very ill and needed medical attention.  Should patients agree to a hospital's code of ethics in return for its services?  Do these contracts already exist, and if so, are they strong enough?  Feel free to comment.

From: http://news.yahoo.com/patients-wont-see-nurses-different-194714831.html

DETROIT (AP) -- It's been called one of medicine's "open secrets" — allowing patients to refuse treatment by a doctor or nurse of another race.
In the latest example, a white man with a swastika tattoo insisted that black nurses not be allowed to touch his newborn. That led several black nurses to sue the Michigan hospital, claiming it bowed to his illegal demands, and a rapid settlement in one of their lawsuits.
The Michigan cases are among several lawsuits filed in recent years that highlight this seldom-discussed issue, which quietly persists almost 60 years after the start of the civil rights movement.
The American Medical Association's ethics code bars doctors from refusing to treat people based on race, gender and other criteria, but there are no specific policies for handling race-based requests from patients.
"In general, I don't think honoring prejudicial preferences ... is morally justifiable" for a health care organization, said Dr. Susan Goold, a University of Michigan professor of internal medicine and public health. "That said, you can't cure bigotry ... There may be times when grudgingly acceding to a patient's strongly held preferences is morally OK."
Those times could include patients who have been so traumatized — by rape or combat, for instance — that accommodating their request would be preferable to forcing on them a caregiver whose mere presence might aggravate the situation, she said.

Wednesday, February 20, 2013

Gender Differences Strike Again - Language Acquisition

My opinion:  Perhaps girls are stereotyped to be more talkative than boys, but this might be legitimate support for that claim.  I do wish that the article mentioned whether girls may be able to learn multiple languages more easily than boys - I'm not sure if this is controlled by other brain processes or not.  What's really interesting, though, is that a lot of male animals maintain characteristics of female humans, and a lot of female animals maintain characteristics of male humans.  For example, in ducks, the male duck tends to be more brightly colored than the female, but in humans, girls tend to go for the colorful clothes.  I've read that this might be because the female human has the two X genes, but in many other animals, it is actually the male that has these and not the female.  Maybe the same thing is happening here.  Can information like this make people more understanding of gender differences, and can it pose solutions to eliminating disadvantages, or is this too far off?  Feel free to comment.

From: http://www.medicalnewstoday.com/articles/256666.php
Males and females acquire language differently: it has been well documented in children, where on average girls tend to speak earlier, with greater complexity, than boys. We also know that animals differ by sex in the ways they communicate. Now a new study from the US may go some way to explaining why, because it finds that the brains of male rat pups contain more "language protein" than their female counterparts, while in humans it appears to be the other way around, boys have less than girls.

The team behind the investigation, from the University of Maryland School of Medicine, writes about the finding in the 20 February online issue of The Journal of Neuroscience.

McCarthy, a professor with a primary appointment in pharmacology and Chair, Pharmacology & Experimental Therapeutics, at the School, says in a statement:

"This study is one of the first to report a sex difference in the expression of a language-associated protein in humans or animals."

"The findings raise the possibility that sex differences in brain and behavior are more pervasive and established earlier than previously appreciated," she adds.

Sunday, February 17, 2013

What Really Happens if Drinking Age is Lowered...

My opinion: In my high school history class, I was taught that the Prohibition actually increased the amount of drinking that occurred.  When it ended, people drank less because they lacked a purpose to do so.  Though there may be other reasons involved, too, this study is important because it reveals that binge drinking is more likely even if young people do not drink as often.  Recently, some other studies have came out saying that drinking is going down among college students, and not surprisingly, many people were commenting that lying must be going up!!  I actually think that binge drinking is already an issue at my college, even students here probably drink far less than at other schools.  So if the drinking age is lowered, will people who are already binge drinkers start even heavier binge drinking?  Could this lead to more people being seriously injured?  I know that if one drinks a lot over a long period of time, he or she might survive, but the body can only take so much alcohol at once.  Feel free to comment.

 From: http://news.wustl.edu/news/Pages/24886.aspx

Lower drinking ages lead to more binge drinking

Washington University School of Medicine
By 1975, many states had lowered the minimum legal drinking age from 21 (shown in yellow) to 18 (brown) or 19 (orange).
People who grew up in states where it was legal to drink alcohol before age 21 are more likely to be binge drinkers later in life, according to a study by researchers at Washington University School of Medicine in St. Louis.

The findings are available online in Alcoholism: Clinical & Experimental Research.
The researchers tracked the long-term drinking behavior of more than 39,000 people who began consuming alcohol in the 1970s, when some states had legal drinking ages as low as 18.
“It wasn’t just that lower minimum drinking ages had a negative impact on people when they were young,” explains first author Andrew D. Plunk, PhD, a post-doctoral research fellow in psychiatry. “Even decades later, the ability to legally purchase alcohol before age 21 was associated with more frequent binge drinking.”
The study shows that people who lived in states with lower minimum drinking ages weren’t more likely to consume more alcohol overall or to drink more frequently than those from states where the drinking age was 21, but when they did drink, they were more likely to drink heavily.

Friday, February 15, 2013

Another Blow to Doctor Shortage: Too Few Residency Spots

My opinion: This has always worried me, especially as a pre-med student.  Perhaps this suggests that there are many sides to the doctor shortage, and all must be addressed if it is to be fixed.  So far, I've also discussed that medical school have too few spots, and medical residents cannot get their licenses in time.  Now there's this.  I've heard that some people can go to medical school in foreign countries if they don't get into medical school in America.  However, many countries want to make sure their students stay to serve the domestic population.  Hence, many foreign medical schools are enticed to reject foreigners, as these students would probably go back home after graduating.  Furthermore, it may be more difficult to get into a American residency program if one is applying from a foreign school.  This issue may be most easily solved by creating more medical schools and hospitals with residency programs, as already existing hospitals and schools may be too full of students, already.  Feel free to comment.

From: http://capsules.kaiserhealthnews.org/index.php/2013/02/the-yawning-chart-med-school-students-fear

The ‘Yawning’ Chart Med School Students Fear

By Ankita Rao
February 13th, 2013, 10:40 AM
Medical school students call this chart the “jaws of death.”
The graph from the Association of American Medical Colleges displays a yawning gap between the increasing number of med school grads looking for residencies and the number of residency slots available to them.
Source: National Residency Match Program
“This is the only time in the history of the U.S. that we are going to see a decrease in practicing physicians,” said Dr. Atul Grover, chief public policy officer of the AAMC, who was speaking on a panel at the American Medical Association’s National Advocacy Conference on Tuesday in Washington, D.C.
Grover said that medical schools have responded to the physician shortage projected by the AMA by increasing admissions, but residency programs have not been able to follow suit.
Graduate medical education, from medical schools to residency programs, is partially subsidized by the government through Medicare, making it vulnerable to cuts to the federal program. Medicare payments cover 21 percent of the cost incurred to train interns and residents, but teaching hospitals absorb the rest. If the scheduled budget cuts from sequestration go into effect next month, some say the physician shortage in the U.S. could go from bad to worse because fewer doctors will complete residency, and thereby, their training.
“It’s a threat — having to go on with our training without knowing if we can complete our career,” said Amy Ho, a third year student at The University Of Texas Southwestern Medical Center in Dallas.

Tuesday, February 12, 2013

Doctors Can't Get Licenses in Time - Hospital Funding in Question

My opinion: Though this may be a problem now, it will likely be an even bigger issue in the future.  Since more and more physicians are needed, and there will be a point where the government has to put more focus into administering medical licenses, or patients will be forced to wait even longer for appointments.  Either the government can spend more money on their staff, or they might be able to cut out some red tape.  Or, since budgeting is such a huge issue today, the hospitals can help pay.  But that's probably not going to happen.  Ultimately, it probably isn't their fault that this is happening, so maybe they shouldn't have to pay.  Then again, with all the money they seem to have, I wouldn't be surprised if they could.  So how should hospitals foot the bill in administrative situations such as this?  Should they at all?  Is there any area in which they may not be paying enough?  Feel free to comment.

From: http://www.suntimes.com/news/metro/18057355-418/2800-students-could-be-delayed-in-getting-licenses-to-work-as-medical-residents.html

A fight over funding for a state regulatory agency could strain academic medical centers this summer if there’s a delay in roughly 2,800 students getting the license necessary to work as medical residents.
A $9.6 million budget gap forced the Illinois Department of Financial and Professional Regulation — which licenses and disciplines doctors — to lay off 18 of its 26 medical unit employees in January. Two competing bills in the state Legislature aim to fill the gap, and pit House Speaker Michael Madigan (D-Chicago) and the department against the Illinois State Medical Society.

Saturday, February 9, 2013

Death Certificates Often Inaccurate

My opinion:  I've honestly never thought about this before.  My dad is rather knowledgeable of the legal system, and I'm sure that this is so important, to some extent, because of the legal consequences that might follow.  What if this causes the family to believe they have a history of conditions that never existed?  Could the family sue if they are incorrectly diagnosed down the road?  Maybe this is a stretch, although there are other reasons mentioned.  For example, this could alter statistical data, which in turn could mislead health providers into focusing on less important diseases or conditions.  I also wonder if, due to the stress of treating the patient, doctors relax a little too early when the patient dies and simply try to zip through the death certificate process.  Any thought?  Feel free to comment. 

From: http://www.ama-assn.org/amednews/2013/01/21/prsa0121.htm
Death certificates are vital documents that serve as the primary source of information for families, insurance companies and authorities about a patient’s cause of death. The information also helps policymakers set public health goals and research funding priorities.
But signing a death certificate is not always a straightforward process.
Physicians often face uncertainties about an individual’s cause of death or how to answer the portions of certificates they are responsible for. Although the basic format has changed little in the last few decades, doctors face difficulties as some states attempt to convert from paper to electronic certificates.
Doctors need to recognize the importance of the documents and be as specific as possible, said Gregory McDonald, DO, chief deputy coroner of Montgomery County in Pennsylvania.
Information on death certificates is reported to the CDC and used in compiling national mortality data.
“Their duty doesn’t end when the patient dies,” Dr. McDonald said. “A lot of physicians when they’re signing a death certificate don’t realize that what they put down has some real, long-term ramifications.”

Wednesday, February 6, 2013

Pharmaceutical Companies Bribing Medical Students

My opinion:  This actually might be a bigger issue than I've realized.  I know that in many situations, professionals are not allowed to accept gifts from other groups or individuals, but I didn't know that they could do so with medical students.  I remember when I was shadowing at the hospital, and before meetings (which included about a dozen or so doctors), there would be representatives from drug companies or medical technology companies presenting their products.  These meetings would also have free food, although I don't entirely remember if it was brought by the doctors or the representatives.  Nonetheless, pharma really does reach out to the medical community, even in person.  I'm glad this study was done - I hope that this helps to remove some obstacles involved in diagnosing and treating patients.

From: http://www.boston.com/whitecoatnotes/2013/02/06/study-gift-bans-medical-school-affect-doctors-later-prescribing-patterns/jLkieCKS3et4AcvONiz3hN/story.html

Doctors who attended medical schools that limited gifts to students from pharmaceutical companies -- sponsored lunches, for example -- may be less susceptible to drug marketing, a study published last week in the BMJ found.
Researchers from Yale University looked at the prescribing practices of doctors who had attended one of 14 schools that were early adopters of such policies. They looked at how often the physicians prescribed Vyvanse or Invega, two heavily marketed drugs used to treat attention deficit hyperactivity disorder and schizophrenia, over older, similar drugs.
Compared with doctors who attended the same schools before the gift ban was in place and peers from other schools, the physicians were less likely to prescribe the two marketed psychotropic drugs.

Sunday, February 3, 2013

ADHD Nation

My opinion:  I think that doctors really could be over-diagnosing ADHD.  It almost seems as if half the kids around me are now on medication to treat it.  In my medical humanities class, we often discussed the metaphor diagnosis is health.  Diagnoses is probably one of the most difficult aspects of being a doctor, as the effects can be disastrous if the diagnosis is incorrect.  But because diagnoses are sometimes wrong, then it may not be the most accurate interpretation of our health.  I'm glad that the parents did not entirely buy into the doctor's diagnosis, and I hope that, if I end up in medical school, I will learn how to handle these situations.  Also, since Adderall is widely used as an illegal study drug, this article prompts questions about prescription drug security.  Maybe medicine should give equal weight to debates regarding purely illegal drugs and misused prescription drugs.  Feel free to comment.

From:  http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html
VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.
It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”
It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.

Friday, February 1, 2013

Contraceptives, Anyone?

My opinionI'm surprised about this - usually contraceptives are state issues, but I guess the new health care proposals are inducing widespread changes at the federal level.  Though access to contraceptives used to be a bigger issue, people are now focusing on affordable access.  However, access does remain a problem among adolescents.  As of the religious organizations, the current argument supporting them is that, since their employees understand the rules of the organization, then they know that they may not have access to contraceptives.  Apparently, since religion might allow contraceptives for medical reasons, people weren't entirely honest about their health history, so they would then obtain the contraceptives.  I learned all this after interviewing a law professor on birth control.  Feel free to comment.


From: http://www.washingtonpost.com/national/health-science/obama-proposal-allows-contraceptives-to-go-under-stand-alone-insurance-policy/2013/02/01/43c1dc1e-6cb9-11e2-ada0-5ca5fa7ebe79_story.html

Obama proposal allows contraceptives to go under stand-alone insurance policy

The Obama administration proposed new rules Friday that would guarantee widespread access to contraceptives under the Affordable Care Act, but seemed unlikely to head off legal battles that could return a part of the health-care law to the Supreme Court.
The regulations allow religious nonprofit organizations that morally object to contraceptives to not offer that benefit for their employees. But their workers would receive a stand-alone private insurance policy providing birth control coverage at no cost.
Some religious groups criticized the proposed rules. For more than a year, they have mounted a high-profile protest and filed dozens of lawsuits against the contraceptive mandate, arguing that it is a violation of their religious freedom.