GE Healthcare (NYSE:GE), a pioneer in digital mammography, announced the introduction of an innovative technology to aid in breast cancer diagnosis. GE Healthcare’s new SenoBright1 Contrast Enhanced Spectral Mammography (CESM) technology reduces ambiguity in mammography results, enabling physicians to detect and diagnose cancer with more confidence – even in the densest part of the breast tissue more rapidly and accurately.

Working like the multiple-flash, red-eye reduction function in a digital camera, SenoBright uses X-rays at multiple energies to create two separate exposures. These resulting images specifically illuminate and highlight areas where there is angiogenesis, growth of small blood vessels potentially related to the presence of cancer.

“A CESM exam takes from 5 to 10 minutes,” said Dr. Clarisse Dromain, Gustave Roussy Cancer Institute, France. “During my investigation of the use of CESM with my own examinations of patients, I have been able to better define the spread of a cancer compared to standard mammography and ultrasound, and follow-up exams with an MRI (Magnetic Resonance Imaging) validated exactly the same results. Moreover, in the majority of cases the confidence in the diagnosis is high enough that the patient can be told the results that same day,” she added.

The diagnostic challenge

SenoBright enables the digital mammography system to detect a whole new type of diagnostic information. Standard mammography only sees the structure of breast tissue. With SenoBright, doctors can also locate the proliferation of small blood vessels, potentially associated with cancerous tumor growth. In addition, it shows potential for measuring the extension of the lesion to help to plan surgery and treatment. Patients receive an intravenous injection of standard iodine contrast agent, and after two minutes undergo a five-minute digital mammography exam. CESM images are acquired in familiar mammography views so that that they can be quickly and easily correlated with standard results, facilitating interpretation by other specialists like surgeons or oncologists.

“Worldwide, more than 1.2 million people annually are diagnosed with breast cancer. Since 1965, GE Healthcare has made significant progress in providing solutions for breast cancer detection and diagnosis that really bring a change to people’s lives. Today through ‘healthymagination’, we continuously develop innovations to reduce costs, increase access and improve quality and efficiency of healthcare delivery around the globe,” said Reinaldo Garcia, President and CEO of GE Healthcare for Europe, Middle East and Africa (EMEA). “GE Healthcare is pleased to bring to market such advanced breast imaging technologies like SenoBright, the result of over 10 years and $12 million investment of research and clinical collaborations. This innovative technology will support the earlier diagnosis of this prevalent disease, by providing access to new diagnostic information at a lower cost.”

The product development was carried out in collaboration between GE Healthcare and Qatar Science & Technology Park (QSTP). The goal of the joint research program is to develop new and innovative technologies for aiding in the diagnosis of breast cancer using the latest developments in digital mammography.

Dr. Tidu Maini, Science and Technology Advisor to Her Highness, Sheikha Mozah bint Nasser Al Missned, and Executive Chairman of Qatar Science & Technology Park, said, “Our collaboration with GE Healthcare is a step towards making Qatar a global medical innovator while delivering real health benefits for the local community.”

Same staff, same equipment- same day

SenoBright is an easy procedure that can be conducted by the same staff, using the same mammography equipment, potentially on the same day as the exam- allowing medical professionals to cut the critical time patients often have to wait from detection to diagnosis.

“Given our proven history of breast imaging innovations, GE is proud to release yet another innovative technology, soon to be available to much of our digital installed base. We are one of the only companies today to engineer and manufacture the entire mammography imaging chain from tube, and detector to review workstation, coupled with integration of the comprehensive local requirements for each customer, ” said David Caumartin, GE Healthcare’s General Manager Mammography. “SenoBright is likely to be a key enabler of accelerated patient workflow from diagnostics to treatment planning. It is enhancing the widely accepted technology of digital mammography by adding the functional information in order to detect angiogenesis.”

Clarity of results

Digital mammography is considered a relevant means of breast cancer screening, delivering proven clinical outcomes. The sensitivity and specificity of images can, however, be affected by a range of factors. Dense breast tissue can overlap with lesions, which are not always visible on an X-ray, and radiologists’ interpretation of images can vary.

Inconclusive digital mammography presents a range of challenges to healthcare professionals and patients. Ambiguity can result in diagnostic error, demanding further tests that can include ultrasound, invasive biopsy and Magnetic Resonance Imaging (MRI) scanning – all of which could delay the diagnostic process, in some cases by weeks or even months.

SenoBright can remove this ambiguity, helping to ensure that those patients who need to go into cancer treatment do so – and do so quickly. Whereas patients who do not have malignant lesions have the potential to find out on the same day, relieving their burden of uncertainty. Compared to mammography alone, clinical studies show that SenoBright improves sensitivity and specificity:

- for every 100 cancers, there is the potential to find 13 more;
- 6 more benign lesions out of 100 can be correctly classified;
- 19 more patients out of 100 without cancer can be sent home.

“The addition of intravenous contrast to mammography gives us the possibility to obtain information in the mammogram that was previously only obtained from MRI,” said Dr. David Dershaw, Director of Breast Imaging at Memorial Sloan-Kettering Cancer Center, USA. “This has the potential to convey the advantages of MRI imaging in screening and diagnosis to women for whom this test is indicated but not currently available.”

The new CESM technology works with an upgrade to GE Healthcare’s Senographe DS and Senographe Essential digital mammography equipment. GE’s Senographe platforms are full-field digital mammography systems designed to meet clinical needs, from screening to diagnostic and interventional procedures and designed for future advanced applications.

Notes

1. The SenoBright option cannot be put into service until it has been made to comply with CE marking. It may not be available in all regions. The SenoBright option is not cleared or approved by U.S. FDA.

Source
GE Healthcare Continue reading →

Pennsylvania Gov. Ed Rendell (D) signed into law two bills related to health care and is expected this week to sign another health care bill. Summaries of newspaper coverage of the bills appear below.
Assisted-living facilities: Rendell this week is expected to sign a bill that would “place tough new regulations” on assisted-living facilities, the Philadelphia Inquirer reports. Under current law, the same rules apply to all homes for the elderly and people with disabilities. The bill would require assisted-living facilities to be licensed by the state, meet new staff-training standards and undergo unannounced inspections at least once a year. The bill also would define “for the first time” what services assisted-living facilities must provide, the Inquirer reports (Phillips, Philadelphia Inquirer, 7/20).

Infections: Rendell on Friday signed into law a bill that will require hospitals to test their highest-risk patients and patients admitted from nursing homes for infections that are resistant to antibiotics as part of his “Prescription for Pennsylvania” plan, the Inquirer reports. Hospital staff who are in contact with contagious patients also will be required to be tested for antibiotic-resistant bacteria. The bill, which will provide higher reimbursements to hospitals that meet benchmarks in preventing infections, will require most hospitals to install software to assist in tracking infections. Moreover, hospitals will be required to report infections to CDC, which then would provide the information to state agencies in Pennsylvania. The law will be phased in over several years (Goldstein, Philadelphia Inquirer, 7/20).

Nurses: Rendell on Friday signed into law a bill that will loosen restrictions on the types of care certified nurse practitioners can provide, the Inquirer reports. The legislation also is part of the “Prescription for Pennsylvania” plan. For example, nurse practitioners will be allowed to treat chronically ill patients from home and to refer patients to dieticians, occupational therapists and other specialists. “Pennsylvania is one of the last states” to grant such responsibilities to nurse practitioners, and is doing so in an attempt to “reduce health care costs and increase access to treatment,” the Inquirer reports. The bill also will allow certified midwives to prescribe medicine and will increase the number of physician assistants that a doctor can supervise to four from two (Roarty, Philadelphia Inquirer, 7/20).

“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 →

Despite the almost universal association of the right with life, right, positive and good things, and the left with death, inadequacy, negative and bad things, recent researches show that left-handed people hold the opposite association. Thus, left-handers become a critical case in which conceptual associations, result of a sensory-motor experience, and those that rely on linguistic and cultural uses, are contradictory. A sensory-motor experience in itself is capable of creating abstract conceptual associations.

These are the conclusions derived from various studies compiled by professor Julio Santiago de Torres, from the Department of Experimental Psychology and Behavioural Physiology at the University of Granada, who has conducted a bibliographic review on the subject, published in Ciencia Cognitiva: Revista Electr??nica de Divulgacion.

One of the latest works on this subject was undertaken by researcher Daniel Casasanto (Stanford University), who found out that left-handers tend to associate the left with nice and good things and the right with ugly and bad things, which goes against the enormous power of cultural context in which they live and the language they use.

Good things and bad things

In one of his experiments, Casasanto presented participants a diagram that depicts a character who was planning a trip to the zoo, and who loves zebras and thinks they are good, but dislikes pandas and thinks they are bad. The participant had to draw a zebra in the box that best represented good things and a panda in the box that best represented bad things.

Most of right-handed people located good things in the box on the right while left-handers placed them in the box on the left. Interestingly, only 14% of participants thought that his election had to do with what his dominant hand was.

Then, to see whether the left or right location could affect rating dimensions on abstract personality, he asked another group of participants to rate pairs of objects depicted in another drawing, indicating which of the two seemed more intelligent, more honest, more attractive and happier. And in a final experiment, participants were asked to assess which candidate would they chose for a job, or what product would they buy in a store.

In all tasks, right-handers tended to evaluate the object on the right better, while left-handers favoured the one on the left. Therefore, UGR professor says, “these results demonstrate that perceptuomotor experiences, in this case the greater ease and fluidity of interaction with one or another side of space, are sufficient to generate stable associations between specific dimensions, such as space, and concepts of a high degree of abstraction, such as kindness, intelligence or honesty.”

These data provide one of the first clear demonstrations that sensory-motor experience can exert a powerful influence on the conceptualization of even our most abstract ideas.

A wrong world

As professor Santiago explains, “a left-handed person has often the feeling of having been born in a wrong world. From scissors to computer keyboards designs, everything is projected for right-handers. The fact that left-handed people are able to adapt quite well to these manual controls that are contrary to their nature, indicates a first interesting fact that it is often overlooked: undoubtedly, there is a difference in motor ability between the dominant and the non-dominant hand, but it is far from being a great difference.”

In fact, the researcher points out, “speed and accuracy differences between the right and the left hand that are usually found, do not go beyond 10%. In addition, the left hand can be trained to high levels of implementation, as in the case of musicians or typists. In contrast with the intensive use of the right hand that characterizes an average right-handed person in over 90% of the tasks.

Julio Santiago recalls in his article that association between right and left with the symbolic systems of the world cultures “is deep, and reaches almost every aspect of life. Thus, right and left are respectively associated with aristocratic and common people, male and female, sacred and profane, good and bad. Eventually, these partnerships control aspects of life as varied as the position in which dead are buried, distribution of space in homes and churches, positions in which men and women sit at the table or in the temple and the hand chosen for saluting, swearing, eating or bathing.”

Moreover, Santiago points out, “even vocabulary is also full of similar facts such as, for example, the word “siniestro”, which derives from sinister, “izquierda” in Latin.

Source: University of Granada Continue reading →

A class of drugs that are used in premature infants to treat chronic lung damage can cause damage in the brain. New research at Washington University School of Medicine in St. Louis suggests the drugs may cause cognitive and motor-control problems even when they are given before birth.

The researchers have identified the cells damaged by the drugs, called glucocorticoids, as well as the time window during which brain injury can occur. They say it may be possible to avoid damage to brain cells and still aid the development of premature lungs if synthetic forms of the drugs can be replaced with hormones made naturally in the body.

The researchers reported their findings at Neuroscience 2008, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health.

Studying the effects of the drugs in mice, the investigators found that the synthetic glucocorticoids dexamethasone and betamethasone, commonly prescribed to spur the development of premature lungs, cause damage in the brain’s cerebellum, the structure that controls movement, as well as other functions.

Brain cells in the mice died following glucocorticoid treatment when the drugs were given between four and 10 days after birth. The corresponding window in human infants would be approximately 20 weeks of gestation to six weeks following birth. That’s also the time span in which these drugs are given to pregnant women at risk for preterm birth or to prematurely born infants who are having problems breathing.

“The cells that are damaged are called neural progenitor cells, which are responsible for producing new neurons,” says first author Kevin K. Noguchi, Ph.D., a scientist in the Department of Psychiatry. “So you can imagine that if you kill the cells responsible for producing new neurons, you can cause severe neurodevelopmental deficits.”

That’s exactly what the researchers found when they studied adolescent mice that had been treated with glucocorticoids during infancy. A single exposure to glucocorticoid drugs permanently decreased the number of neurons in the cerebellum of the mouse brain.

In the past, the steroid drugs were given to low-birthweight infants after they were born, but studies determined that exposure to the drugs following birth could lead to cognitive problems and neuromotor deficits, particularly difficulty with balance and coordination. In 2002, the American Academy of Pediatrics recommended post-natal glucocorticoid use be stopped unless used in clinical trials, but the drugs still are given frequently to mothers at risk for preterm birth.

“The cerebellum connects to other brain structures, so when granule cells in the cerebellum are lost, you also have detrimental effects on cognitive function in non-motor regions of the brain,” says senior investigator Nuri B. Farber, M.D., associate professor of psychiatry. “Other researchers have found I.Q. declines in children who have received these drugs early in life, and our findings may help explain why.”

But both Farber and Noguchi say therapy with these drugs may be essential for some children with immature lungs as a lifesaving measure. They believe, however, that it may be possible in the future to use different drugs to help the lungs mature without damaging brain cells.

“We’re looking at differences between glucocorticoids that are made naturally in the body and hormones that are manufactured,” says Noguchi. “The brain has some natural defenses against exposure to endogenous glucocorticoids but not the synthetic ones. So it may be possible to administer some of those natural hormones, which can help the lungs mature without putting the brain at risk.”

It also may be possible to develop other drugs that would assist with lung development without killing cells in the cerebellum. But as they study those possibilities, the investigators say they want parents to know that the observed toxic effects of steroid drugs are not a problem for adults and older children. They estimate that by about three months of age, human infants no longer are at high risk for this damage.

“The toxic effects decline when the cerebellum finally finishes its development,” Farber says. “These drugs are used for many different purposes, so there are other reasons why a baby might get prednisone or dexamethasone or another glucocorticoid, but our research in mice suggests once a human infant is a few months old, these drugs have fairly innocuous effects in the brain.”

###

Noguchi, KK, Smith DJ, Swiney BS, Farber NB. Acute exposure to multiple corticosteroids can induce selective apoptotic cell death in the neural progenitor cells of the developing cerebellum of neonatal mice. Abstract, presented Nov. 17, 2008 at Neuroscience 2008.

This research was supported by grants from the National Institutes of Health.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Source: Jim Dryden
Washington University School of Medicine Continue reading →

Telephone follow-up consultations for cancer patients could become more commonplace after research by two leading doctors at Lancashire Teaching Hospitals NHS Foundation Trust, England.

Consultant Oncologists Andrew Hindley and Shabbir Susnerwala from Lancashire Teaching Hospitals were co-authors in research published in the British Medical Journal which compared hospital and telephone follow-up after treatment for breast cancer.

The study found that telephone follow-up appointments were more convenient for patients especially in rural areas where patients might have to travel long distances for hospital appointments and for those with limited mobility. They also could help to relieve busy hospital outpatient departments

The report stated: “Patients might also feel more comfortable in their own homes, where they cannot see the “busyness” of hospital clinics, and might take the opportunity to be more proactive in seeking answers to their questions. Telephone follow-up might have broader applicability to other groups of patients. There are nurse specialists for many diseases and their skills could be harnessed to provide a quality service while reducing the burden on busy hospital clinics.”

Andrew Hindley said: “Telephone follow-up by specialist breast care nurses has positive benefits for women with breast cancer. It was better at relieving distress than hospital visits and was much more convenient for patients

“We focused on the consultation between participants and clinicians, aiming to provide participants with the information and support they needed, when they needed it, to cope with the diagnosis of cancer. The telephone intervention provided a service to participants that met their needs, with no evidence of physical or psychological disadvantage.

“This study will help to inform improvements to communication between medical staff and patients and could lead to the wider use of telephone appointments.”

Shabbir Susnerwala added: “The telephone intervention was specifically designed to provide information and those who took part reported greater satisfaction with the information received and reported appointments as more helpful in meeting their needs.

“There were no differences in time to detection of recurrence between the groups. Despite appointments taking place over the telephone, there were no undue delays in identifying potential clinical problems and instigating appropriate referral processes.

“Telephone follow-up might reduce the burden on busy hospital clinics, but other approaches might also be effective. Alternating telephone and hospital follow-up, according to patients’ preferences, could be a suitable approach, while hospital follow-up might continue to be preferred by those who do not feel comfortable discussing their concerns over the telephone.”

Breakthrough Breast Cancer Continue reading →

Together with the national science academies of the other G8 states, the German National Academy of Sciences Leopoldina has prepared two statements for the G8 states in the run-up to the G8 Summit of Heads of State and Government. The recommendations contained in these statements were now presented to the participating governments for the negotiations in Deauville, France on 26 and 27 May. In a statement on the topic of “Education for a Science-Based Global Development”, the academies urge governments to target investment to establish an infrastructure for a globalization of knowledge in science and technology. A further statement on the topic of “Water and Health” urgently recommends improving the world’s population access to clean drinking water and sanitation to protect people against serious disease and epidemics.

The science academies set forth that progress and global development are attributable to advances in science and technology. They therefore recommend targeted investment in education to achieve a globalization of knowledge. The objective here must be to make all people partners of science. This would help avoid new technologies being met with scepticism and unfounded fears, and also better equip people to assess the risks new technologies pose. This challenge must be faced in three ways: improved scientific education for the general public, in school, at university and at other national research bodies.

The science academies advise the heads of state and government to support the governments of developing countries in establishing and maintaining a functioning infrastructure for education. In their statement on education, the academies also recommend a policy of open access to scientific literature and databases and supporting international collaboration to set up new e-learning facilities. Furthermore, they stress the importance of using new findings derived from brain research and cognitive sciences to improve teaching and learning programmes. Moreover, a collaborative network of research centres should be created for various innovative topics in education. Current successful programmes to facilitate exchange between scientists, the general public, the media and decision-makers should also be further expanded.

Given the fact that the investment of large sums of money over the past decade has provided access to clean drinking water for over one billion people for the first time, the science academies indicate in their statement on “Water and Health” that, in the same period, much less has been done to improve sanitation for these people. Around 40 percent of the world’s population still lack access to adequate sanitation, and 20 percent of the global population do not have access to a toilet connected to a wastewater system, which results in an additional 300 million tons of untreated human excreta polluting vital drinking water resources every year. The academies point out that diarrhoea-related diseases kill more children under the age of five than AIDS, malaria and measles combined. The majority of these cases are due to unsafe water, inadequate sanitation or insufficient hygiene.

The academies strongly recommend politicians to regard access to drinking water and sanitation as a unity, in accordance with the Millennium Goals of the World Health Organisation (WHO). The G8 states should work towards ensuring that people all over the world have access not only to drinking water of acceptable quality, but also to basic sanitation. This involves providing technical support and training local technicians, supporting researchers developing vaccines against waterborne pathogens, and local capacity-building initiatives to increase awareness for improved hygiene standards.

Every year since the G8 Summit of Heads of State and Government in Gleneagles, Scotland in 2005, the national academies of the G8 states – Canada, France, Germany, Italy, Japan, Russia, the United Kingdom and the US – have prepared science-based statements on global issues relevant to society, with the aim of supporting governments in their negotiations at the annual G8 summits. The statements for this year were prepared at a conference of the representatives of the science academies in Paris on 24 and 25 March 2011. Alongside the science academies of the G8 countries, the academies of South Africa, Brazil, India, Mexico and Senegal participated in the conference. In this group of academies of science, Germany is always represented by the Leopoldina – National Academy of Sciences.

The English-language statements and Leopoldina’s German translations of the texts are available here.

Source:
Caroline Wichmann

Leopoldina Continue reading →

The House on Wednesday voted 286-140 to approve a $463.5 billion fiscal year 2007 omnibus appropriations bill that includes increased funds for NIH, health care for veterans and other health programs, the AP/San Francisco Chronicle reports (Taylor, AP/San Francisco Chronicle, 1/31). The 109th Congress last year approved two of 11 FY 2007 appropriations bills and passed a continuing resolution to fund most federal agencies at FY 2006 levels until Feb. 15. Late last year, incoming House Appropriations Committee Chair David Obey (D-Wis.) and incoming Senate Appropriations Committee Chair Robert Byrd (D-W.Va.) said that they would complete the other FY 2007 appropriations bills through an omnibus appropriations bill and focus on FY 2008 appropriations bills. The omnibus appropriations bill — which would fund most federal agencies until Sept. 30, the end of FY 2007 — would increase funds for NIH by $619 million over FY 2006 levels (Kaiser Daily Health Policy Report, 1/31). The legislation also would increase funds for health care for veterans by $3.6 billion (AP/San Francisco Chronicle, 1/31). In addition, the legislation would increase funds for health education and education programs by $2.3 billion and funds for community health centers by $207 million (Kaiser Daily Health Policy Report, 1/31). More than 25% of Republican lawmakers voted in favor of the continuing resolution, although some Republicans “protested that the bill was not entirely stripped of special-interest funding, or earmarks, as the Democratic leaders asserted, and that they were denied the opportunity to offer amendments,” the Washington Post reports. The Senate must pass the legislation by Feb. 15 to avoid a partial shutdown of the federal government, and the White House has indicated that President Bush would sign it (Kane, Washington Post, 2/1).

Senate Consideration
The Senate is expected to approve the bill, but Senate Democratic leaders will have more difficulty limiting proposed amendments from Republicans, CQ Today reports. Senate Majority Leader Harry Reid (D-Nev.) has not indicated whether he will fill an “amendment tree,” a move that essentially would block the consideration of the amendments. That prospect “has angered some Republicans,” CQ Today reports. Sen. Tom Coburn (R-Okla.) said, “We can’t do much now, but there is going to be a significant price to pay if that’s how they are going to do it.” Sen. Ted Stevens (R-Alaska) said, “I personally am offended that they are going to fill the tree on the CR.” Sens. Stevens and Kay Bailey Hutchison (R-Texas) are expected propose amendments restoring funding for military base closures and realignment. Amendment approval would require either the House to pass the legislation again or the Senate and House to negotiate a compromise (CQ Today, 1/31). House Passes $463.5B FY 2007 Omnibus Appropriations Bill That Includes Increases for Health Programs
[Feb 01, 2007]

      The House on Wednesday voted 286-140 to approve a $463.5 billion fiscal year 2007 omnibus appropriations bill that includes increased funds for NIH, health care for veterans and other health programs, the AP/San Francisco Chronicle reports (Taylor, AP/San Francisco Chronicle, 1/31). The 109th Congress last year approved two of 11 FY 2007 appropriations bills and passed a continuing resolution to fund most federal agencies at FY 2006 levels until Feb. 15. Late last year, incoming House Appropriations Committee Chair David Obey (D-Wis.) and incoming Senate Appropriations Committee Chair Robert Byrd (D-W.Va.) said that they would complete the other FY 2007 appropriations bills through an omnibus appropriations bill and focus on FY 2008 appropriations bills. The omnibus appropriations bill — which would fund most federal agencies until Sept. 30, the end of FY 2007 — would increase funds for NIH by $619 million over FY 2006 levels (Kaiser Daily Health Policy Report, 1/31). The legislation also would increase funds for health care for veterans by $3.6 billion (AP/San Francisco Chronicle, 1/31). In addition, the legislation would increase funds for health education and education programs by $2.3 billion and funds for community health centers by $207 million (Kaiser Daily Health Policy Report, 1/31). More than 25% of Republican lawmakers voted in favor of the continuing resolution, although some Republicans “protested that the bill was not entirely stripped of special-interest funding, or earmarks, as the Democratic leaders asserted, and that they were denied the opportunity to offer amendments,” the Washington Post reports. The Senate must pass the legislation by Feb. 15 to avoid a partial shutdown of the federal government, and the White House has indicated that President Bush would sign it (Kane, Washington Post, 2/1).

Senate Consideration
The Senate is expected to approve the bill, but Senate Democratic leaders will have more difficulty limiting proposed amendments from Republicans, CQ Today reports. Senate Majority Leader Harry Reid (D-Nev.) has not indicated whether he will fill an “amendment tree,” a move that essentially would block the consideration of the amendments. That prospect “has angered some Republicans,” CQ Today reports. Sen. Tom Coburn (R-Okla.) said, “We can’t do much now, but there is going to be a significant price to pay if that’s how they are going to do it.” Sen. Ted Stevens (R-Alaska) said, “I personally am offended that they are going to fill the tree on the CR.” Sens. Stevens and Kay Bailey Hutchison (R-Texas) are expected propose amendments restoring funding for military base closures and realignment. Amendment approval would require either the House to pass the legislation again or the Senate and House to negotiate a compromise (CQ Today, 1/31).

“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 →

Commenting on the latest row over polyclinics, Karen Jennings, UNISON Head of Health said:

“Polyclinics should only be introduced following consultation with local communities and staff and they will not be appropriate for everywhere. They may suit some densely-populated urban areas, but greater centralisation will almost certainly be resisted strongly in rural areas and by patients from poorer communities who may have to travel greater distances.

“The real danger is that they will almost certainly open up lucrative opportunities for large private healthcare companies, with damaging consequences for the NHS. This is particularly the case where the commissioners themselves have been outsourced and have a bias towards the private sector.”

UNISON Continue reading →

One in two women at high risk of bone fractures don’t receive preventative treatment, according to new research presented at the British Pharmaceutical Conference (BPC) in Manchester.

Pharmacists in Northumberland,* where the hip fracture hospital admission rate is one of the highest in the UK, conducted the study. The study groups also included North Tyneside, which has a high mortality rate after falls.1

According to the National Institute for Health and Clinical Excellence (NICE), women who have had a previous “fragility” bone fracture or are diagnosed with osteoporosis1; and women over 75 with osteoporosis, or who have had a fragility fracture; should receive treatment with calcium/vitamin D3 and bisphosphonate.1

The new research aimed to find out if the NICE criteria and bone protection treatments were being met in a general practice population. The results showed that of the patients found to be at risk of future fractures, only half were receiving the recommended bone protection treatment (calcium/vitamin D3 with a bisphosphonate).

Those aged below 74 and at risk should have treatment based on the results of a bone scan, but the study showed this occurred in only a quarter of all cases.

Pharmacy research into medicine-taking for osteoporosis in Glasgow, Scotland, looked at whether patients were compliant with taking medications they had been prescribed for osteoporosis. They found that of the 353 at-risk patients, 70% were taking a bisphosphonate and calcium supplement as osteoporosis prevention therapy, but almost a quarter did not always take their medication.

The reasons patients listed for not taking their medicine included that they: forgot (46%); disliked the taste (22%); were fed up taking it (7%) and were unsure of the indication (2%). Others did not understand sufficient detail about the appropriate way to take the medication.

In Scotland, one in three women and one in 12 men over the age of 50 are affected by osteoporosis, resulting in 20,000 bone fractures every year.2

Wasim Baqir, the Research and Development Lead Pharmacist for Northumbria Healthcare NHS Trust and a Primary Care Pharmacist said: “It’s very important that people who are at risk of falling and fracturing bones receive appropriate bone protection treatment. Pharmacists have a key role to play in helping patients understand the importance of why they are prescribed these preventative medicines, and what the consequences can be if they don’t take them.”

* Pharmacists took part in the research from Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, Sunderland University, and The Science Complex.

Northumberland/Tyneside research:

The medical system of a 12,500 patient practice in North Tyneside was searched for patients with documented fragility fractures and osteoporosis. Records of these at-risk patients identified the number of fractures, whether bone scanning was undertaken and what bone protection treatments were being used. Poor or no compliance with bone protection treatment was defined as having not ordered at least one prescription or not ordering any prescriptions, in the last six months, respectively.

128 patients were identified as being at risk of future fractures.

Scottish research:

Fifty two pharmacies administered a structured questionnaire on osteoporosis medication to 353 patient or carers.

The British Pharmaceutical Conference – entitled “The medicines maze: balancing risks and benefits
” – takes place from 10th to 12th September, 2007, at Manchester Central (formerly Manchester International Convention Centre). The theme of BPC 2007 is reflected throughout the programme, with keynote speeches and workshops addressing crucial technical and professional issues that are facing pharmacy today. The conference will showcase the latest developments in pharmaceutical science and practice research and include discussion and debate led by expert speakers.

References

1. Sibal, Bharat. North Tyneside Falls Mortality and Related Indicators. June 2006.

2. Scottish Intercollegiate Guidelines Network (SIGN) management of Osteoporosis. Edinburgh: SIGN; 2004 (SIGN publication no.71).

Royal Pharmaceutical Society of Great Britain Continue reading →

Ohio State University scientists have created software that can identify traffic accident hotspots on state roadways.

The software is publicly available and can be adapted for use by any state, said Christopher Holloman, associate director of the Statistical Consulting Service in Ohio State’s Department of Statistics. Currently, the Ohio State Highway Patrol is using it to help position its cruisers during major holidays.

“We can make predictions for every major roadway in Ohio, under all possible road conditions, for every hour of the day, for every day of the week,” Holloman said.

The software relies on reports of injuries and fatalities from the highway patrol, and incorporates statistics about what makes accidents happen.

Common accident causes such as speeding or alcohol consumption are fairly easy to model using computers, Holloman explained. Others — such as when a driver will be distracted by a cell phone — are impossible. So the software makes general forecasts.

“Everyone would love to be able to predict exactly where and when the next crash would be, but there are just too many factors involved, and too much randomness to do that,” he said. “We can confidently make broad statements, like whether a particular piece of roadway is riskier at a particular time.”

Not surprisingly, the software indicates that most speeding accidents in Ohio happen during weekday rush hours, and most drunk-driving accidents happen on the weekends between 2:00 and 3:00 a.m. — after the bars close. But it did reveal some facts that weren’t so obvious.

In Columbus, for instance, most speeding accidents happen on the northern potion of the outer beltway, Interstate 270. But Interstate 71, which divides the city north to south, is a hotspot for drunk-driving accidents.

Ohio is the seventh most populated state in the United States, and most residents live in and around the cities of Columbus, Cleveland, and Cincinnati.

Holloman expected to find that most fatal traffic accidents happen near those three cities. He didn’t expect to find that most fatalities around Columbus and Cincinnati happen on the interstates, while near Cleveland more fatalities occur on the U.S. routes and state routes, as people cross the border to and from Pennsylvania. He says that his contacts at the highway patrol didn’t seem surprised.

“It confirmed what they already knew, which is fine,” he said. The software can’t indicate the underlying cause of why a particular area is prone to a particular type of accident, but it may help the highway patrol find those answers. “We see the software as a supplement to officer expertise, and to the efforts of the highway patrol’s quantitative analysis group, which does its own analysis of crash data.”

“It’s just one more tool in the patrol’s toolbox.”

Holloman and his colleagues have been issuing reports to the highway patrol in advance of every major holiday since July 4, 2005. That first report only covered interstates around major Ohio cities. Last fall, they expanded their computer model to include all Ohio interstates, U.S. routes and state routes for which crash data was available. Now they’ve combined the software with Google Earth, which Holloman said will make the tool even easier to use.

Google Earth offers an interactive map of the entire globe, including major roadways. The Ohio State software color-codes the roadways in Ohio, so that users can zoom in to see the general likelihood of accidents in any region of the state.

It’s not something the average person would run on their home computer, however. The software uses a 900-megabyte database that details every traffic accident that occurred on Ohio highways from 2001-2005, and generates 50 gigabytes of output data. The equations that Holloman and his colleagues developed to connect all that data took two weeks to process at the Ohio Supercomputer Center.

The software would have to be modified to fit other states, and Holloman said the university’s Statistical Consulting Service would like to do that. Other states would benefit from the fact that the Ohio State Highway Patrol paid the $50,000 development costs; customizing the software for a new state would cost about half as much.

The key to making the software work in a particular state is the quality of the accident data, Holloman said. The Ohio State Highway Patrol was able to gather precise data from nearly all 88 Ohio counties, including the location of crashes.

“I have to wonder if other states have such good data collection,” Holloman said. “Having the latitude and longitude of the crashes was fantastic.”

The Ohio Supercomputer Center donated the computing resources for this study.

###

Pam Frost Gorder

Contact: Christopher Holloman

Ohio State University Continue reading →