An increased number of physicians visited Web sites that promote brand-name prescription drugs during the first six months of 2006 to seek information about dosages and side effects, according to a recent Manhattan Research study, the Newark Star-Ledger reports. According to the study, the 10 Web sites that received the most visits from physicians promoted the anticholesterol medications Lipitor, Crestor and Zetia; the osteoporosis treatment Fosamax; the attention deficit hyperactivity disorder medications Adderall XR and Concerta; the asthma treatments Advair and Singulair; the antidepressant Lexapro; and the blood thinner Plavix. “This represents a key promotional opportunity for pharmaceutical marketers today,” Manhattan Research said, adding, “It is not just experience with a product that drives physician traffic to a specific site but in many cases, the need for additional information.” According to the Star-Ledger, the Web sites “represent an aggressive move by pharmaceutical companies away from network television and into more focused direct-to-patient campaigns via the Web, cable television and direct mail” in response to “public outcry over aggressive advertising” (Newark Star-Ledger, 9/14).

“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.

View drug information on Adderall XR; Crestor; Plavix. Continue reading →

Hospitals and physician practices that form care-coordinating networks called “Accountable Care Organizations (ACOs),” under provisions of the new health-care law could reap cost-savings and other benefits. However, experts at Johns Hopkins and the University of Pennsylvania warn that such networks could potentially be designed to exclude minorities and widen disparities in health care.

In a commentary appearing in the April 27 issue of the Journal of the American Medical Association, a Johns Hopkins physician says that as a result of new provisions in the Patient Protection and Affordable Care Act, wealthy hospitals and practices may “cherry-pick” similar, wealthy institutions and groups to form ACOs, and avoid poor and minority-heavy patient populations treated elsewhere in order to lower costs and raise quality of care.

ACOs are designed to encourage patients to seek care within their own network, further accentuating the disparities between networks.

In practical terms, writes Craig Pollack, M.D., M.H.S., assistant professor of medicine at Johns Hopkins, hospitals and physician practices that treat a disproportionate share of minorities may be unable to join ACOs and fall further behind in the cost and quality of care benefits likely to occur in such networks.

“There is ample evidence of racial and ethnic disparities in health care,” says Pollack. “Hospitals and private practices that care for greater numbers of minorities tend to have larger populations of Medicaid and uninsured patients. These patients have less access to specialists, and their hospitals and practices tend to have fewer institutional resources than their counterparts.”

“There is wide difference in the ability of hospitals and practices to implement the cost and quality measures needed to form ACOs,” adds Pollack, who cites financial resources, management structure, and size as barriers to forming such networks. Under the law, ACOs must be able to provide all levels of care for at least 5,000 Medicare beneficiaries.

Pollack says ACOs could improve coordination of care across private practices and hospitals by encouraging hospitals and doctors to work more closely together on inpatient and outpatient care. Cancer care, for example, could be enhanced with “patient navigators” who coordinate services, he says. He notes that the potential benefits of ACOs have yet to be monitored and evaluated by the Centers for Medicaid and Medicare, and will be an important component to wider adoption of ACOs.

To monitor the impact of ACOs on health-care disparities, Pollack and his co-author, Katrina Armstrong, M.D., from the University of Pennsylvania, suggest measures to evaluate the process of creating ACOs from an antitrust/market consolidation perspective. Measures of quality should include details of the patient population by race and ethnicity within individual ACOs; across separate ACOs; and compared with patients not in ACOs.

Source: Johns Hopkins Medicine Continue reading →

Commenting on the resignation of the Prime Minister, Dr Gill Morgan, chief executive of the NHS Confederation which represents over 90 per cent of NHS organisations, said:

“Tony Blair will leave a lasting and positive legacy on the NHS. There is no doubt that the NHS is in a very much better state and is continuously improving.

“There has been significant progress in improving standards and quality of healthcare and reductions in waiting times that would have been unthinkable a generation ago.

“Perhaps the greatest achievement is the consensus that has been created on a tax funded NHS based on need not ability to pay. This argument has been won – at least for the time-being.

“Looking to the future, Blair’s successor will need to tackle the perception gap between patients, who are generally satisfied with the care they receive from the NHS, and the public who are much more negative.

“We also need a better narrative of NHS reforms that all staff, including clinicians and managers, buy into. Finally, it is time to see a shift in the balance of power from central government to local trusts where decisions are best made.”

The NHS Confederation represents more than 90% of the organisations that make up the NHS. Its members include the majority of NHS acute trusts, ambulance trusts, foundation trusts, mental health trusts, primary care trusts, special health authorities and strategic health authorities in England; trusts and local health boards in Wales; and health and social service trusts and boards in Northern Ireland.

www.nhsconfed Continue reading →

If you’re an older adult, chances are you take several pills a day. The average older adult uses between two and six
prescription medications and between one and three over-the-counter (OTC) medications regularly.

Taking more than one medication puts you at risk for unexpected drug interactions. The result could mean your medications
aren’t working as intended, or interactions could cause dangerous side effects.

But drug interactions are largely preventable. The June issue of Mayo Clinic Women’s HealthSource offers tips to reduce your
risk of drug interactions:

- When you receive a new prescription, remind your doctor of all prescription medications, OTC drugs, supplements and
vitamins you’re taking. Bring all medications and supplements to your appointment so the doctor can check what you are
taking.

- Read drug labels carefully, take drugs as directed and know the most serious warnings for the drugs you take.

- Keep a list of all the medications you take and carry a copy with you.

- If you’re taking a prescription, check with your doctor or pharmacist before taking an OTC drug or supplement.

If you’re taking more than one medication, especially if you have started a new drug, tell your doctor if you experience any
of these signs or symptoms of a possible drug interaction: skin rashes; easy bruising; heartburn; nausea and vomiting;
diarrhea or constipation; dizziness, drowsiness, sedation or confusion; or any new or unexplained symptoms.

Here is a highlight from the June issue of Mayo Clinic Women’s HealthSource. You may cite this publication as often as you
wish. Mayo Clinic Women’s HealthSource attribution is required. Also, you may reprint up to four articles annually without
cost. More frequent reprinting is allowed for a fee. Include the following subscription information as your editorial
policies permit: Call toll free for subscription information, 800-876-8633, extension 9PK1.

Mayo Clinic Women’s HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from
subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9PK1.

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mayo.edu/news Continue reading →

The House Appropriations Committee has approved a provision that would allow FDA to require drug makers to conduct postmarket studies as part of the fiscal year 2007 agriculture appropriations bill, the Boston Globe reports. FDA requested postmarket trials for 73% of the drugs it approved between 1988 and 2003, but pharmaceutical companies have failed to complete two-thirds of the studies they pledged to conduct, according to the Globe. Currently, FDA does not have the authority to compel pharmaceutical companies to finish the studies. Under the amendment, sponsored by Rep. Rosa DeLauro (R-Conn.), FDA would be allowed to launch proceedings to halt the sale of certain drugs if postmarket studies for the medications have not been completed. DeLauro said she decided to offer the amendment because of a recent Government Accountability Office report that highlighted problems in how FDA monitors the safety of medications after they are on the market. GAO said Congress should consider giving FDA the power to require that pharmaceutical companies follow through on postmarket study promises.

Part of FDA Overhaul
According to the Globe, DeLauro’s amendment is “among other actions taken by Democrats in advance of a comprehensive FDA reform bill expected to be introduced in the Senate this summer.” Rep. Maurice Hinchey (D-N.Y.) added an amendment to the same agriculture appropriations bill that would “sharply limit the number of outside scientists with drug company ties who vote on advisory committees that guide FDA decisions,” the Globe reports. The House is expected to vote on the “must-pass” agriculture spending bill next week, according to the Globe. Sen. Edward Kennedy (D-Mass.) said the FDA reform bill to be introduced this summer also will address problems with postmarket drug safety.

Reaction
Caroline Loew, senior vice president of the Pharmaceutical and Research Manufacturers of America, said FDA already has “broad authority to monitor and ensure the safety of prescription drug products after approval.” She added, “America’s pharmaceutical research companies and [FDA] take the postmarket surveillance of prescription drugs seriously and have taken significant steps to ensure patient safety is never compromised.” Sidney Taurel, CEO of Eli Lilly, said that strong incentives to ensure that drug companies follow through on their promises to conduct postmarket studies make sense, but he added, “I would think that taking products off the market would hurt patients in many cases” (Henderson, Boston Globe, 5/11).

Taurel’s comments were made during a Kaiser Conversations on Health event and live webcast, which 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 →

Do mothers purposely expose their offspring to their own stress? If so, why?

The question arises because it is widely accepted that exposure to maternal stress during pre-natal development can have negative impacts on offspring following birth. To examine why a stressed mother would allow this to happen, evolutionary physiologists Oliver Love and Tony Williams examined how offspring exposure to the maternally-derived stress hormone corticosterone affect maternal fitness in free-living European starlings (Sturnus vulgaris).

They experimentally increased yolk levels of corticosterone to mimic the “signal” offspring receive indicating they have a low quality mother. They then paired corticosterone-exposed hatchlings with experimentally manipulated low quality mothers to examine how these mothers fared in raising stress-exposed young compared with “normal” young.

Finally, they followed mothers within and across years to determine the long-term effects of the original manipulation on future reproductive success and maternal survival.

Their results provide the first evidence that low quality mothers benefit in the long-term from exposing offspring to their own stress: corticosterone exposure better “matches” offspring demand to a mother’s immediate offspring-rearing capability. Corticosterone-exposed sons were of lower quality at hatching and when paired with a low-quality mother these sons experienced increased mortality.

However, because these mothers now had fewer mouths to feed, and of the smaller, less-demanding sex (daughters), the offspring that survived were of better quality. More importantly, by reducing investment in their current reproductive attempt, these “matched” mothers began second broods in better condition, had increased future reproductive output, and increased survival compared to “mis-matched” mothers (low-quality mothers that raised “normal’” offspring).

In the long-term, natural selection therefore appears to favor low-quality mothers that expose offspring to quality-mediated stress.

###

“The adaptive value of stress-induced phenotypes: effects of maternally-derived corticosterone on sex-biased investment, cost of reproduction and maternal fitness” by Oliver P. Love and Tony D. Williams. American Naturalist (2008) 172:E135-E149 DOI: 10.1086/590959

Source: Patricia Morse

University of Chicago Press Journals Continue reading →

Free prescription drug samples distributed to children may be unsafe, according to a study by physicians from Cambridge Health Alliance and Hasbro Children’s Hospital. The national study, the first to look at free drug sample use among children, appears in the October 2008 issue of Pediatrics.

The authors, who also serve as researchers at Harvard Medical School and the Warren Alpert Medical School of Brown University, found that children commonly receive free drug samples from their doctors. One out of every 20 American children received free drug samples in 2004. Among children who took at least one prescription drug in that year, nearly one in 10 got free samples.

The U.S. Food and Drug Administration identified significant new safety concerns for four of the top 15 most frequently distributed samples in 2004. These four medications acquired new black box warnings or had significant revisions to existing black box warnings issued since 2004. In addition, two of the top 15 sample medications given to children were schedule II controlled substances (drugs controlled and monitored by the Drug Enforcement Agency due to high potential for abuse). Distribution of these medications, Strattera (atomoxetine) and Adderall (amphetamine/dextroamphetamine), carries risk, especially when drug sample closets in physician’s offices (or home medicine cabinets) are not strictly monitored.

Although some physicians support the use of free drug samples as a way of getting medications to indigent patients, lead author Dr. Sarah Cutrona and colleagues found that few free samples in their study go to needy children. More than 80 percent of children receiving samples were insured all year. Conversely, approximately 16 percent were uninsured for all or part of 2004, and less than one-third had low family incomes (under $38,000 for a family of four). Minority children were less likely to receive free samples than white non-Hispanic children, and free sample receipt was positively associated with markers reflecting access to health care. The authors concluded that free sample distribution does not equalize medication access for needy children.

Dr. Cutrona, a physician at Cambridge Health Alliance and an instructor of medicine at Harvard Medical School, commented, “New medications are frequently released before their safety profile is fully understood, and samples tend to be newer medications. Free samples encourage the casual use of medications in our children before enough is known about potential harm. As a mother of young children, I find that very concerning.”

Senior author Dr. Neal LeLeiko, director of pediatric gastroenterology and nutrition at Hasbro Children’s Hospital, and a professor of pediatrics at the Warren Alpert Medical School of Brown University, added, “Previous findings in adults strongly suggest that free drug samples serve as a marketing tool. Our study shows that samples can pose a serious and unappreciated risk to our children.”

The study used data on 10,295 US children and adolescents from the 2004 Medical Expenditure Panel Survey (MEPS), an annual federal survey. Dr. Cutrona’s work was supported under a National Research Service Award to Harvard Medical School.

Sarah L. Cutrona, MD, MPH, is a hospitalist at Cambridge Health Alliance. She also serves as an instructor of medicine at Harvard Medical School. Dr. Cutrona conducts research on access to health care and medications. She earned her medical degree at Columbia College of Physicians and Surgeons and completed her training at Rhode Island Hospital and Harvard Medical School.

“Free Drug Samples in the United States: Characteristics of Pediatric Recipients and Safety Concerns” published by Pediatrics. October 2008; 122 (4). Authors: Cutrona, SL, Woolhandler, SJ, Lasser, KE, Bor, DH, Himmelstein, DU, Shrank, WH, LeLeiko, NS.

Hasbro Children’s Hospital in Providence, RI, is the premier pediatric facility for southeastern New England. As the pediatric division of Rhode Island Hospital it is part of the largest teaching hospital of The Warren Alpert Medical School of Brown University. A private, not-for-profit hospital, Hasbro Children’s Hospital is a member of the Lifespan health system.

Hasbro Children’s Hospital

Cambridge Health Alliance is an innovative, award-winning health system that provides high quality care in Cambridge, Somerville, and Boston’s metro-north communities. It includes three hospital campuses, more than 20 primary care and specialty practices, the Cambridge Public Health Dept., and the Network Health plan. CHA is a Harvard Medical School teaching affiliate and is also affiliated with Harvard School of Public Health, Harvard School of Dental Medicine, and Tufts University School of Medicine. Visit us online at challiance.

Cambridge Health Alliance

View drug information on Adderall XR; Strattera. Continue reading →

Medicines and herbal remedies are not always a good combination. Some combinations could be fatal but which ones? Knowledge is on its way.

The health foods industry is large and diverse, and a lot of people take different types of dietary supplements and herbal remedies. Whether they are necessary or have any effect what so ever, is much discussed, but we still take them, just in case.

And natural herbal products can’t hurt, can they?

Like mixing wine and beer

In the doctor’s office, we find posters urging us to tell our doctor which health food products we eat. And there is a reason for that: Herbal remedies and medication affect one another in your body. It is almost like mixing wine and beer the effect is unpredictable and not always positive. The result could in the worst case be fatal.

Like if you wish to increase the effect of Viagra by flushing it down with grapefruit juice tempting, perhaps, but the adverse effects could include both angina and cardiac infarction. Or if you take some St John’s Wort as a tranquilizer the Viagra might not live up to your expectations.

St John’s Wort basically kills a lot of medication, and women need to keep in mind that birth control pills are not reliable in this combination.

How on earth are we as consumers supposed to know which combinations produce which effects?

Testing popular herbs

Help is on its way: A group of research scientists at the Faculty of Medicine at NTNU are establishing methods that could reveal which combinations of herbs and medication that are harmful and which are safe. The project is financed by the Research Council of Norway and the Norwegian Cancer Society.

“We are testing what happens when mixing popular herbs with ordinary medication,” says Project Manager and Professor Odd Georg Nilsen.

“We cannot say for sure whether garlic strengthens our immune system. But we will provide an answer to whether garlic and other herbal remedies alter the effect of ordinary medication. Our current information on the combined effects of herbal remedies and medication is highly insufficient. Particularly considering the fact that the Norwegian Medicines Agency has an overview of herbs that classifies several hundred different products as merchandise or medication over the counter or on prescription.”

Digestive soup

Anything you eat, be it food, drink or medication, goes down into your stomach and through the digestive organs. Everything is put into the same soup of gastric acid, digestive enzymes and so on.

If you are sick and need medication, the effect depends upon the dosage being right for you. Often, the dose must be adjusted according to any other medication. Ordinary drugs affect one another, and your doctor will check in the Physician’s Desk Reference (PDR) whether the medication you are taking will work together. Some drugs intensify each other while others weaken each other. Perhaps you need a double dose to get the desired effect? Your doctor knows this.

However, if you take herbal remedies together with your medication, there is very little information in the PDR that will tell you and your doctor whether the combination will affect your medicating.

No queuing in your body

The researchers aim to produce a systematic overview of the effects different herbal remedies could have in combination with different drugs. The methods they are using will reveal whether the herbal remedies need to queue up with different drugs on their way through our bodies.

It is when the drugs and the herbs are fighting for space in the body’s systems that the effect of the drugs is influenced. This competition mainly takes place in the intestines and the liver. The intestines regulate how quickly the drugs are absorbed into the body. The liver consists of enzymes that regulate how quickly medication is broken down and filtrated from your body.

“We all know what it is like when there is a queue in front of a door,” Nilsen says. “People are piling up, and the strongest or most impertinent ones get in first. It is the same with herbal remedies and medication standing in front of the same gate and wanting to go through.”

If the herbal remedy is the strongest, the medication will move more slowly to the place where it is needed. The result is reduced or delayed effect. If it is the filtration that is restrained, the medication could accumulate and cause a stronger effect, perhaps with adverse effects.

The testing is performed in different test systems in the laboratory. Cells from intestines and the liver are fed with a combination of herbal remedies and medication, and then it is possible to measure who wins the battle of the cells’ favour.

Testing directly from the case

Medical mathematics is not simple. If the researchers extract two substances from a herb and test how these affect the effect of a drug, the effects could be totally different when testing each substance separately compared to testing them both as a mixed product. The substances in a herbal remedy could change their effect on drugs if they are removed from their natural surroundings.

“We are taking the consequences of this fact,” says Nilsen.

“We are investigating the effect of extracts from the full preparation as it is sold in health food stores and at the chemist’s. You could say that we are testing directly from the case.”

“It is important to remember that drugs and herbal remedies that are said to have identical effects not necessarily reinforce one another, but could actually have the opposite effect,” says Professor Odd Georg Nilsen.

“The rule about caution still applies. And remember to tell your doctor about what you eat!”

Makes the doctor’s work difficult

In general, we can say that medication with a so called narrow therapeutic width are poorly suited in combination with herbal remedies. The effect of these drugs depends upon a constant amount being in the blood at all times. Several drugs taken in connection with organ transplants, HIV, mental illnesses, epilepsy and cancer are of this type.

If we combine this type of medication with herbal remedies that affect the amount of drug in our blood, the effect of the drug could increase or decrease. An increase could produce undesirable adverse effects while a decrease could result in the therapeutic effect failing to appear.

“It is not always possible to know what could be dangerous,” Nilsen stresses. “If you for instance just had a kidney or liver transplant, you need to stay away from St John’s Wort.”

Organ rejection is one of the problems that could arise. St John’s Wort is an example of a herbal remedy that weakens the drug that is supposed to make new organs blend into their new surroundings. And it is not enough to avoid taking the herbal remedy the day before the operation. The effect of the product could last for weeks.

Examples of horror are numerous. Many patients being hospitalized, particularly in the US, have taken herbal remedies before undergoing planned surgery. That could make the anaesthetist’s job difficult, and make the result of the operation unpredictable. The herbal remedy Valerian, which many people take to calm their nerves, could increase the effect of the anaesthesia, while Gingko biloba could weaken it. Ginkgo biloba has also proven to produce increased bleeding tendencies during and after surgery.

Tea and mushrooms with adverse effects

Nearly half of all cancer patients in Norway resort to herbal remedies to strengthen their health. As many as 70 percent admit to taking herbal remedies to boost their immune system, and the majority hope for improved quality of life. Nobody has told them that the herbs could weaken the effect of the cancer medication.

In cooperation with the hospitals in Alesund and Volda, researchers at NTNU have mapped cancer patients’ use of herbal remedies. Most of them place their confidence in garlic and green tea. Noni juice is also popular. Even though none of the patients say that they have noticed any adverse affects of the herbal products, researchers have discovered that green tea could increase the effect of certain cancer medication and thus increase the risk of adverse effects.

Several cancer patients take a product called Agaricus a Japanese mushroom extract with a price per litre of some NOK 5000. In other words, you have to dig deep into your pocket to enjoy this drink. With a price like that it would be nice to know whether the product affects your health.

“In our studies, Agaricus seems to increase the effect of other cancer medication,” says Research Fellow Silje Engdal. “It is highly worrying that the patients are ripped off financially at the same time as the risk of adverse affects increases.”

List of herbs in the PDR?

“We already know that the St John’s Wort could reduce the effect of cancer medication so much that it does not produce the desired effect,” Engedal says. “Now we know more about how many cancer patients actually use the herbal remedy, which remedies they choose and whether they tell their doctor about it. This information enables us to find out more systematically which combinations the patients need to avoid.”

“At the same time, the doctors could have a list of the herbal remedies they should instruct their patients to avoid. We also have a long-term goal of including a list of herbal remedies in the PDR.”

The project funding ends in 2008, but Nilsen is hoping for prolongation and that a permanent group could be established within this field.

The East meets the West

Numerous herbal remedies come from the East. The Chinese have used herbs for medical purposes for thousands of years and have a somewhat different view on the use of herbs in combination with drugs. If a certain herb is known to strengthen the effect of a particular drug, the treatment will be performed using a lower dose of medication in combination with the herb in question. The idea is that you will have less adverse affects from the medication since you take less of it, while obtaining full therapeutic effect.

Nilsen and his research team are currently cooperating with several research institutions in China on combination therapy with herbs and drugs.

“Chinese and herbal remedies are coming into Western medicine. That makes it important to investigate the effect these might have on Western medication,” the Professor concludes.

THE NORWEGIAN UNIVERSITY OF SCIENCE AND TECHNOLOGY (NTNU)
THE NORWEGIAN UNIVERSITY OF SCIENCE AND TECHNOLOGY

View drug information on Viagra. Continue reading →

CareFusion (NYSE: CFN), a leading, global medical device company, announced the launch of Verso™ 90 adapter, a component that enables uninterrupted access to a ventilated patient’s airway without having to disconnect the patient from the ventilator. Disconnecting a patient from the ventilator circuit can lead to life-threatening lung infections and degradation of lung function.

The new Verso 90 adapter is part of the AirLife™ Closed-Suction System which is different from traditional closed-suction catheters because of its modularity. With this system, a clinician can change catheters or perform various airway access procedures through a single port without having to disconnect the patient from the ventilator. This leads to increased patient safety because disconnecting a patient from the ventilator circuit can lead to lung derecruitment, which in some patients, may result in atelectasis or hypoxemia.

In addition, keeping a closed system when changing catheters or performing bronchoscopies, reduces the risk of cross contamination which can lead to ventilator-associated pneumonia (VAP). The incident of VAP is 22.8 percent in patients receiving mechanical ventilation(1), with a cost of $28,508 per patient(2) and increases the length of stay in the hospital by an average of 12.2 days(3).

Clinicians also have the ability to replace the closed-suction catheter independent of the adapter, which may only need to be replaced when the ventilator circuit is changed. This means that by using the CareFusion system, clinicians only need to replace half the system, which could lead to a cost-savings benefit for the hospital.

“The addition of the Verso 90 adapter into our closed suction portfolio helps to build our leading line of respiratory consumable products that directly ties with our mission to help improve health care safety and costs,” said Tony Lopez, senior vice president and general manager of Respiratory at CareFusion.

The Verso 90 adapter is currently available in the United States, with plans to launch the product in Europe in the next few months.

CareFusion is featuring the new Verso 90 adapter, along with other respiratory solutions, at the 56th American Association for Respiratory Care (AARC) International Respiratory Congress Dec. 6-9 in Las Vegas.

(1) Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med. 2005;33(10):2184-2193.

(2) Centers for Disease Control and Prevention. Public health focus: surveillance prevention and control of nosocomial infections. Morbidity and Mortality Weekly Report 1992:41:783-787.

(3) Koulenti D, et al., “Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units,” CritCare Med 2009 Aug; 37 (8):2360-8; NQF Safe Practices for Better Healthcare: 2010 Update; CareFusion Analysis, 2010.

Source: CareFusion Corporation Continue reading →

Teenagers with positive attitudes about delaying sexual activity usually are less likely to become sexually active within the next year, according to a study in the January issue of the Archives of Pediatric and Adolescent Medicine, Reuters Health reports. Susan Gray of the Boston University School of Medicine and colleagues in 1999 surveyed 11,448 adolescents between ages 12 and 17 who reported never having had sexual intercourse. Of the 7,661 participants who also completed a follow-up survey in 2000, 7.5% of the boys and 10.1% of the girls reported having had sexual intercourse during the previous year, the researchers said.

The researchers used the “postponing sexual initiation” scale to identify teens at higher risk for initiating sexual intercourse. Gray said the scientifically-validated scale provided an accurate indication of the teens’ intent to initiate sexual activity. The boys and girls who indicated that they might or would initiate sex were significantly more likely to report having sex within the following year. According to Gray, the survey found that teens were less likely to initiate sexual activity if they:

Thought that their friends were not having sex;

Reported that they had not met the right partner;

Said that they had not been in a comfortable situation to have sex;

Reported that their parents and health care providers objected to it; and

Indicated that it was against their personal beliefs.The survey also indicated that the teens “were almost universally fearful of pregnancy and sexually transmitted infections,” Gray said, adding that the concern did not affect their decision to have sex in the next year.

The researchers said that the postponing sexual initiation scale might help pediatricians gauge adolescents’ views on the topic and be a valuable tool for measuring the effectiveness of sex education curricula, Reuters Health reports. “Teens’ beliefs and attitudes about sex determine their sexual intentions, and their sexual intentions determine their sexual activity,” Gray said, adding that parents and educators should do more than warn teens about pregnancy and STIs if they want to promote abstinence successfully (Hendry, Reuters Health, 1/10).

The abstract of the study is available online.

Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2007 The Advisory Board Company. All rights reserved. Continue reading →