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In the next 60 seconds, another child will be on his/her way to the hospital to be treated for serious burns; it happens more than 300 times a day in this country.* Now, one of the largest studies ever done on burn injuries in kids is out from experts at Nationwide Childrens Hospital and the results are mixed while overall injuries are down, there are some kids who are still at serious risk.

Lily McKinney has always loved spending time in the kitchen; whenever anyone is cooking shes willing to do anything to help. But in an instant, Lillys eagerness to help ended up getting her hurt.

“My husband was checking on the lasagna that was in the oven and she snuck right around him and just put her hands right on the oven door,” says Lillys mother Danette McKinney.

Lilly was left with seconddegree burns on both hands. She spent a night in the hospital and weeks in bandages. Its kids like Lilly that are still getting burned at a surprising rate, according to the study.

“We found that kids under age six were actually injured the most, representing about 60 percent of all burnrelated injuries,” says Lara McKenzie, PhD, a researcher at Nationwide Childrens Hospital.

Dr. McKenzie found that while burn injuries have dropped 31 percent overall since 1990, the numbers are still disproportionately high in children under six years of age.

Over the 17year study period, there were more than 2 million burnrelated injuries in this age group, or about 120,000 burns annually.

“For younger children, particularly kids under six, have thinner skin than older Trustedtablets.com children or adults, and theyll actually burn faster, even when exposure time is short,” says McKenzie.

Dr. McKenzie, who is also with Ohio State, says many hazards are at eyelevel in this age group and in toddlers, their newfound mobility often catches parents offguard.

“I think we tend to overestimate the reach and ability of children, especially young children and toddlers. They can really reach a lot of surfaces and different hazards,” she says.

Experts suggest you sit on the floor in danger zones in your house, like the kitchen, to see your home from your kids perspective. Seeing the world from their eyes, they say, can help open your eyes to dangers you may not have noticed.

Sources *Pediatric Burn Injuries Treated in Emergency Departments in the United States 19902006; Pediatrics, Vol. 124 No. 5, November 2009.

Burns are a common cause of pediatric injury worldwide, typically resulting from hot water, flames, hot surfaces, chemicals and electrical appliances. A recent study conducted by the Center for Injury Research and Policy of The Research Institute at Nationwide Childrens Hospital, found that from 19902006 more than 2 million children younger than 21 were treated in hospital emergency departments for burnrelated injuries. The good news that resulted from the 17year study period is that researchers saw a 31 percent decrease in the rate of burnrelated injuries. The bad news is that children are still being injured from burns about 120,000 each year.

“The decrease in the burnrelated injury rate over the study period is notable,” said study author Lara McKenzie, PhD, principal investigator at the Center for Injury Research and Policy at Nationwide Childrens Hospital. “However, the disproportionately high number of injuries and the severity of these burns to young children is still cause for concern.”

Data from the study, being released online October 5 and appearing in the November issue of Pediatrics, show that children younger than 6 accounted for more than half of all burnrelated injuries. Among that age group, most injuries occurred in the home, and the majority (60 percent) resulted from thermal burns. The hands and fingers were the most frequently injured body parts (36 percent), followed by the head and face (21 percent).

Dr. McKenzie, also a faculty member of The Ohio State University College of Medicine, said that reasons why younger children suffered a majority of burnrelated injuries during the study period may be due to parents underestimating the reach ability of toddlers, and the fact that younger children have thinner skin.

“Parents should be aware of the capability of reach that their toddler may have,” continued Dr. McKenzie. “Items that seem out of reach for young children may not be. That risk should be eliminated. Also, young children, especially those under age 6, have thinner skin, and the severity of a burn can be greater for them even at a reduced exposure time.”

Parents can help protect their children from burns by setting the water heater thermostat to no higher than 120 degrees Fahrenheit, keeping kids away from the stove, locking up chemicals and covering unused electrical outlets. Parents should prohibit young children from operating microwaves or other electrical appliances, preparing hot food or drinks, and playing near the kitchen during food preparation.

“Burnrelated injuries are potentially preventable with better education, warnings and instructions on consumer products,” said Dr. McKenzie. “Increased efforts are needed to improve burn prevention strategies and target households with young children.”

Data for this study were collected from the National Electronic Injury Surveillance System (NEISS), which is operated by the U.S. Consumer Product Safety Commission. The NEISS dataset provides information on consumer productrelated and sports and recreationrelated injuries treated in hospital emergency departments across the country.

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Marti Leitch

When the skin and surrounding tissues are directly exposed to low temperatures, they can freeze and frostbite occurs. The medical term for frostbite is congelatio. The general term is cold injury, but frostbite is commonly used by doctors. It can happen to anyone who is exposed to temperatures below freezing for an extensive amount of time, and without sufficient protection to keep the person warm at all times.

Individuals practicing outdoor sports, such as climbing, hiking, skiing and sailing are particularly at risk of getting frostbite, since they are regularly exposed to longer periods in outdoor extreme cold weather.

Frostbite typically affects parts of the body that are located far from the heart. The body extremities, such as the fingers, toes, nose, ears and penis are most likely to be affected.

The damage to the skin and tissue is caused by the creation of ice crystals. They swell, causing cells to rupture.

Damage to tissue is also caused by the shutting down of arteries and blood vessels that transport critical oxygen and blood supply to the affected areas.

The extent of frostbite differs depending on the length of exposure to the cold weather, and how badly damaged the tissues are. The injury will be considered superficial if only the skin and surface tissues are affected, and it is likely that the affected person will recover fully. On the other hand, if the blood vessels are affected, the damage is more likely to be permanent. If gangrene (dead tissue) occurs, even amputation may be considered indispensable.Risks from frostbiteAnyone who spends long periods outdoors and is exposed to extremely cold temperatures can be at high risk of getting frostbite. Individuals who know they are going to be exposed to belowfreezing temperatures should make sure they are well protected this means wearing appropriate clothing.

Young children and elderly people are more vulnerable to frostbite because their bodies are not as efficient at controlling body temperature.

People with delicate medical conditions will have an increased risk of getting frostbite, especially those suffering diabetes or Raynauds syndrome, which cause blood vessel damage or circulation problems. This is also the case if a person is taking certain medicines, such as betablockers. Those who have poor health due to smoking, drinking alcohol, or eating highfat diets, are also more likely to get frostbite when exposed to subzero temperatures.What are the signs and symptoms of frostbite Research studies have shown that at zero degrees Celsius (32 Fahrenheit) or below, blood vessels that are close to the skin tissue of the extremities react to the low temperatures by contracting in order to help conserve interior body temperatures. However, the if period of exposure is longer than what the body is either used to or prepared for, three potential stages of frostbite may develop.

Frostbite can happen very quickly. Everybody should be aware and alert to the signs and symptoms. Because intense cold has an anesthetizing effect (numbing effect), the skin and tissue may freeze without the person realizing it. Therefore, it is vital to recognize the tingling sensation of frostnip that occurs on the first stage in order to take steps to treat the affected area before more severe symptoms build up.First degree frostbite

First degree frostbite, also called frostnip, causes skin to appear yellow or white and feel cold to the touch. Slight burning sensations may be felt as well as other discomforts, such as tingling, soreness or aching in the affected area. Considering all these symptoms, this first stage of frostbite is relatively moderate and can easily be reversed by the gradual warming of the affected area.
Second degree frostbite

Second degree frostbite develops after a continued and prolonged exposure in cold weather.

In this stage the disappearance of pain and reddening and swelling of the skin is noticeable.

The affected area will become white, numb, and hard, and when the tissue is thawed out, the skin will turn red with exposed and painful blisters.

Swelling and itching will also be felt during the process of warming and thawing of the affected areas. More severe tissue damage will likely occur.

Treatment in this stage may consist of curing blisters and also peeling of the skin.
Third degree frostbite

Third degree frostbite is extremely dangerous.

The skin will feel waxy and stiff, and tissues will feel frozen or wooden. There may also be damage to tendons, muscles, nerves and bones It is at this stage that the skin. This may occur as a result of the lack of blood circulation to the affected areas.

If third degree frostbite is not treated immediately the damage most likely will become permanent, nerve damage will occur due to oxygen deprivation and all feeling is lost. Frostbitten areas will become discolored, purplish at first, and soon turn black. This is known as gangrene. If gangrene occurs, the affected body part will usually have to be amputated. Treating frostbite Preventing frostbite, by taking the necessary precautions, should always be a priority.

However, if frostbite does occur, it is imperative to seek medical attention immediately.

If medical assistance is not available, there are several steps that can be taken to treat frostbiteMovement

If the fingers and toes are affected, moving them will help improve circulation, if it is possible to do so. However, the affected area should not be rubbed or massaged. It is important to remove any wet clothes, and keep the body as warm as possible.
Reheating

The affected areas need to be rewarmed if frostbite is suspected. Warming a frostbitten area of the body can be very painful and preferably should be performed under medical supervision. However in an isolated location, it may not be possible to get medical assistance.

If there is a possible risk of frostbitten areas refreezing, they should not be rewarmed. If they refreeze, they may become permanently damaged. If there is no risk of refreezing, the affected area should be rewarmed slowly for approximately half an hour. This can be done by immersing the area in lukewarm but not hot water.

As the affected area progressively starts to warm, its normal color should begin to come back. The area can be removed from the water once it starts to appear red and swollen. If warm water is not available, softly wrap the person in blankets, or a sleeping bag. Also, another persons body heat can be used to warm the affected person.

It is essential to never rewarm frostbitten skin using direct heat, such as a fire or hot water bottle. The lack of sensation in the skin may cause it to burn.
Following reheating

The area should be used as little as possible after it has been thawed. It is imperative to keep the skin clean and to avoid infection. The area should be wrapped in clean bandages. Fingers and toes should be wrapped separately. After recovery, the skin of the area will be discolored and will blister. The blisters should be bandaged in a sterile dressing.

When frostbite is superficial, new pink skin regenerates underneath the discolored skin. Typically, within six months the area will be healed. However, some people have lasting problems. These can include pain, numbness and stiffness in the affected area. In some cases, rehabilitation using physical therapy (UK physiotherapy) can improve circulation.

In the case of severe frostbite, gangrene can develop in the affected area. It will turn a blue or black color. The damage is then permanent. The affected body part will usually require amputation. How can you prevent frostbite? Frostbite can occur extremely rapidly at temperatures below freezing. It is essential to take basic measures to guarantee that the skin is properly protected. Dont forget the windchill factor (chill factor), which can heighten the effects of frostbite and the velocity of its progression.

Extremities, which are the most vulnerable areas and the first to be affected, must be very well protected. If exposed to subzero temperatures for any length of time, a warm hat that protects the head and ears is indispensable, as a significant proportion of body heat is lost through the head. Gloves, or mittens, thick socks, and well insulated boots are essential.

Clothes should always fit well (not too tight or loose). Wearing a number of thin layers is more effective than wearing just a few thick ones. This is because thin layers trap air that warms to the bodys temperature and acts as additional insulation. To prevent local pressure and constraint, make certain that each layer of clothing is larger than the one below.

If you work in a chemical laboratory remember than even brief exposure to liquid nitrogen and other cryogenic liquids can cause frostbite wearing gloves and protective gear is vital.

If you get caught in a severe snowstorm or some outdoor situation where temperatures are very low you should seek shelter as soon as possible. A small cave, ditch, hollow tree or vehicle can help significantly reduce the risk of frostbite, especially if conditions are windy. Physically move your body to keep it warm, especially your hands and feet. If your hands are not adequately protected keep them inside your clothing, next to your body to keep them as warm as possible. Protect your face and nose.

Being diagnosed with a new illness and going through treatment can be an overwhelming event. For children and teens with cancer at St. Jude Childrens Research Hospital, a team of child life specialists work to manage the stress and anxiety that patients may experience in the hospital setting.

A childs normal development can be affected when battling a serious illness. Child life specialists coordinate closely with patients to provide nonthreatening, ageappropriate explanations and preparations. This individualized education not only helps children understand what is happening, but also fosters trust and confidence so that they know what to expect during this time of many changes. The specialists also create therapeutic opportunities for play and expressive activities that promote patients development, an outlet for feelings, peer interaction, a sense of mastery or developed coping.

“Children and teens might feel stressed with feelings of anxiousness, sadness or confusion about what is happening to them,” said Jennifer Smith, St. Jude child life specialist. “By making the hospital environment less threatening, we can help patients cope better with treatment.”

Coping refers to what a person does in order to avoid, remove or minimize a stressful situation and is the process of making adaptations to meet personal needs and to respond to the demands of the environment. The coping process uses personal resources to manage routines, frustrations and challenges of daily life in ways that seek to maintain or enhance feelings of wellbeing. The way a child copes in a hospital environment can be influenced by many things, including age, past medical experiences, family support, comprehension of diagnosis and hospitalization, developmental level and any other current stressors.

Appropriate coping skills exist within every child, but sometimes the stress of hospitalization causes the skills to be temporarily threatened or minimized. Coping strategies are unique, and skills that work for one person may be different from techniques that work for another.

Smith sites common coping techniques and common reactions children use to get through difficult situations

Anger or aggression Although the frustration is derived from the uncontrollable situation, it can often be misplaced and directed at surrounding people.

Crying This is a natural, emotional release.

Deep breathing or selfcalming techniques These techniques are intended to divert or distract attention from the stressful situation.

Denial The overall disbelief and shock that the situation is actually happening. This can sometimes carry over to rejecting necessary medicine, procedures etc.

Escape Similar to denial, focusing on a specific activity (for example, video games or play) in order to avoid or pretend the stressful situation doesnt exist.

Information seeking Desire to know more about a situation in order to process or further understand. Some adults hesitate to allow their informationseeking children to be privy to more indepth information, but when sought out by the child, allowing this access encourages their coping.

Play Can be used as a release and distraction. Some children talk about feelings or reenact reallife situations in their play.

Rebelliousness Reasserting their independence in an effort to gain some control.

Regression Reverting to old routines or behaviors (for instance, being more clingy) may remind them of a time when life seemed easier. Newly learned skills like potty training may be temporarily abandoned while they are adjusting to the many changes in their routine.

Selective silence Choosing not to talk reasserts their independence and is an overt sign of something they will always be able to control with whom they choose to speak.

Submission The child may react to challenges by becoming passive or withdrawn.

Use of fantasy This can be helpful; for example, children may view themselves as “superheroes,” which can be a great motivator especially during procedures. Parents should also be the childs “bridge to reality”; for example, when the child demands that superheroes do not do chores, etc.

St. Jude child life specialists assist patients and siblings in creating and developing positive coping skills, plans and techniques for events that will be challenging for them. Involving the child or teen in the process of choosing the positive method that works best for them gives them back the control they seek.

“Arriving at the hospital, families often find themselves in a situation that they never thought possible,” Smith said. “Our goal is to provide support to patients and their families and make the hospital a less intimidating place.”

St. Jude Childrens Research Hospital

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

A promising new molecular imaging technique may provide physicians and patients with a noninvasive way to learn more information about a type of cancer of the uterus lining called “endometrial carcinoma” one of the most common malignant female tumors. This research was presented in a study published in the October issue of The Journal of Nuclear Medicine.

“Endometrial carcinoma is one of the most common female malignant tumors,” says Hidehiko Okazawa, M.D., Ph.D., professor in the division of medical imaging at the biomedical imaging research center at the University of Fukui in Japan and one of the lead researchers of the study. “The method of positron emission tomography (PET) imaging we used in the study is noninvasive, and it has tremendous potential to save women with endometrial carcinoma from undergoing unnecessary operations and biopsies that could sabotage their reproductive potential.”

If the disease is caught early enough, the fiveyear survival rate is higher than 90% for patients with endometrial carcinoma. PET imaging may provide physicians with a tool that lets them recognize the extent of the disease before it reaches advanced stages.

This study shows that PET is a promising molecular imaging technique for personalized therapy. Molecular imaging and nuclear medicine provide the possibility of determining the invasiveness and aggressiveness of malignant tumors in the uterus earlier on, before disease progresses. With this technique, physicians gain the advantage of a more precise diagnosis along with the ability to better predict the tumors growth patterns and plan for the most appropriate therapeutic treatment strategy.

“The article in the JNM from Dr. Tsujikawa and colleagues provides an example of the unique capacity of molecular imaging to measure in vivo cancer biology,” says David A. Mankoff, M.D., Ph.D., professor of radiology, medicine and bioengineering at the University of Washington and Seattle Cancer Care Alliance in Seattle. “Most notably, it shows how imaging multiple facets of tumor phenotype in this case, estrogen receptor expression and glucose metabolism can provide insight into the clinical behavior of cancer. The broad implication of this study, and other similar studies that have tested PET and molecular imaging to characterize cancer characteristics, is that imaging can help direct cancer patients toward optimized, individualized treatments.”

In the study, the researchers used a specialized form of PET imaging called “estrogen receptor expression imaging” for 22 patients with endometrial adenocarcinoma and nine patients with endometrial hyperplasia (a thickening of the uterine lining that is a risk factor for developing endometrial cancer) to evaluate diagnostic accuracy. All patients underwent preoperative PET scans with 18Ffluoroestradiol (18FFES) a tracer that has been successfully used in diagnosing breast cancer and 18Ffluorodeoxyglucose (18FFDG) to compare differences in tracer accumulation.

The researchers confirmed that endometrial carcinoma reduces estrogen dependency with accelerated glucose metabolism as it progresses to a higher stage or grade. By combining the two tracers, researchers were able to use a new index of uptake ratio that can better predict pathologic stages and aggressiveness of tumors. The results of the study were encouraging, with the combined techniques having 86% accuracy.

For endocrinerelated tumors (including endometrial cancer), tumors vary from welldifferentiated and close in character to the tissue of origin to poorly differentiated tumors, which are aggressive and bear less resemblance to the tissue of origin. The welldifferentiated tumors tend to be more slowgrowing and less aggressive than poorly differentiated tumors. They also retain their endocrine function and/or responsiveness.

For endometrial cancer, estrogen receptor expression is related to endocrine responsiveness and indicated by FES uptake. Poorly differentiated tumors often have increased and abnormal breakdown of glucose, indicated by FDG. The combination of the two, as indicated by the study, was better than either alone at indicating the aggressiveness of the tumor.

Personalized cancer therapy involves treatment that is individualized for patients based on patient characteristics and the tumors biology. By studying the tumors properties, physicians can predict the tumors path and formulate the best strategy for treating the disease.

Coauthors of “Functional Images Reflect Aggressiveness of Endometrial Carcinoma Estrogen Receptor Expression Combined with 18FFDG PET” include Tetsuya Tsujikawa, Takashi Kudo, Yasushi Kiyono, Masato Kobayashi, Yasuhisa Fujibayashi, Biomedical Imaging Research Center, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Yoshio Yoshida, Fumikazu Kotsuji, Tetsuji Kurokawa, Department of Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; and Tatsuro Tsuchida, Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.

Source
Amy Shaw

Walgreens (NYSEWAG)(NASDAQWAG) launched a broad initiative for 90day prescriptions that promotes delivery of maintenance and chronic care medication through its national network of more than 7,000 community pharmacies and employer worksite centers. As part of this program, Walgreens pharmacists will work with patients, physicians, insurers, employers and managed care organizations to implement a comprehensive 90day at retail prescription program for maintenance medications including, where appropriate, the conversion of traditional 30day chronic care prescriptions into 90day prescriptions.

Today, many pharmacy benefit plans allow for a 90day supply of certain medications from local community pharmacies, but many employers and other payors are not taking full advantage of this benefit. Other benefit plans penalize patients financially if they seek to fill prescriptions from their local pharmacy, and certain patients are often required to use only mail order programs. Patients want choice, and Walgreens 90day at retail provides costeffective access to medications where patients prefer to receive their prescriptions.

“Studies conducted by a range of health care professionals show that adherence to medications one of the most critical components of any health care program significantly increases through facetoface interaction with trusted health care professionals like pharmacists,” said Greg Wasson, Walgreens President and CEO. “In fact, for many chronic care conditions, Walgreens has seen an approximately 15 percent increase in adherence to medications for patients receiving a 90day retail prescription versus those receiving a 30day supply.

“As a provider of communitybased pharmacy and health and wellness services, we can positively impact adherence by encouraging our patients to receive a 90day supply for their chronic medications. This program will lead to improved outcomes for patients and payors. With 25,000 highlytrained pharmacists in more than 7,000 locations across the country, Walgreens is uniquely positioned to deliver the counseling and coaching needed to ensure patients properly take their prescription medications.

“It is worth noting we have already seen significant success with 90day at retail utilization in targeted Walgreens programs. Taking into account that each 90day prescription fill equals three times the volume of a 30day fill, more than 24 percent of our Medicare Part D beneficiaries prescription volume and 47 percent of our Prescription Savings Club members prescription volume are filled as 90day supplies at our retail pharmacies. Based on that experience, we are confident this program will be extremely well received.”

Many insurers and managed care organizations offer a 90day retail benefit at a lower cost than the traditional 30day retail prescriptions, realizing that increased adherence reduces overall health plan costs.

In fact, Walgreens consumer research indicates that patients prefer to use their local pharmacy for prescriptions, due in part to the opportunity to consult with a trained community pharmacist to answer questions and obtain support for managing their condition. Obtaining a 90day supply at a conveniently located pharmacy encourages improved adherence to medication therapy, consistent interactions with a trusted and informed pharmacist and better health outcomes.

Stanley B. Blaylock, President of Walgreens Health Services, said, “Reducing costs, while at the same time providing better outcomes, is job No. 1 in health care today. Walgreens is currently in many meaningful discussions with insurers and managed care companies about the costsaving benefits inherent in our program. We encourage insurers and managed care companies to extend this 90day at retail benefit to their members and pass on the savings through reduced copays. Many are already doing so and we applaud them. We know that a 90day supply program combined with access to local community pharmacist care can greatly improve overall health spend and help patients manage their own costs and care.”

Source

A new US study appears to confirm the notion that population health improves during recession researchers from the US found that life expectancy rose during the Great Depression and other times of economic recession.

The study was the work of researchers from the University of Michigan at Ann Arbor, and is published online before print in the 28 September issue of PNAS, Proceedings of the National Academy of Sciences.

The Great Depression years from 1930 to 1933 hit the US economy hard it was the most important economic downturn the country experienced in the 20th century.

For the study the authors examined economic growth and historical life expectancy and death rates for the period 1920 to 1940 and looked for links between annual changes in health indicators and annual changes in economic activity.

The results showed thatPopulation health did not go down, in fact it generally improved during the Great Depression.
Rates of death (mortality) went down for nearly all age groups.
Life expectancy went up from 57.1 in 1929 to 63.3 years in 1932.
Life expectancy went up by several years in males, females, whites and nonwhites.
For most age groups, rates of death tended to peak during years of strong economic expansion (eg 1923, 1926, 1929, and 1936 to 1937).
In contrast, periods of recession (1921, 19301933, and 1938) coincided with declines in rates of death and increases in life expectancy.
There was only one exception death rates due to suicide (2 per cent of all deaths) went up during the Great Depression.
Correlation and regression methods confirmed that economic expansion appeared to have a significant negative effect on health gains.The authors concluded that

“The evolution of population health during the years 19201940 confirms the counterintuitive hypothesis that, as in other historical periods and market economies, population health tends to evolve better during recessions than in expansions.”

First author Tapia Granados, who is a researcher at the UM Institute for Social Research (ISR) said

“The finding is strong and counterintuitive.”

“Most people assume that periods of high unemployment are harmful to health,” he added.

For the study, Granados and coauthor Ana V. Diez Roux, a researcher with the UM School of Public Health, analyzed agespecific mortality rates and rates due to six causes of death that accounted for two thirds of deaths in the 1930s cardiovascular and renal diseases, cancer, influenza and pneumonia, tuberculosis, motor vehicle traffic injuries, and suicide.

Although the study did not investigate why population health tends to improve during recessions but not expansions, in a separate press statement Granados and Diex Roux suggested some possible reasons

“Working conditions are very different during expansions and recessions,” said Granados.

“During expansions, firms are very busy, and they typically demand a lot of effort from employees, who are required to work a lot of overtime, and to work at a fast pace. This can create stress, which is associated with more drinking and smoking,” he explained.

“Also, new workers may be hired who are inexperienced, so injuries are likely to be more common. And people who are working a lot may also sleep less which is known to have implications for health. Other healthrelated behaviors such as diet may also change for the worse during expansions,” added Granados.

In contrast, during recessions, people slow down because there is less work to do, and there is more time for sleep, and because people have less money, they cut back on alcohol and tobacco.

Also, during economic expansion atmospheric pollution rises, and there are welldocumented short term effects of this on deaths due to cardiovascular and respiratory problems.

Other reasons why economic expansion may damage health is the possible increase in social isolation and decrease in social support that occur when people spend more time at work.

The authors noted that their study did not examine what happens at the level of the individual they were looking at population effects, thus highlighting the curious effect that while becoming unemployed may have adverse health problems for a given person, at the level of the population, the result appears to be beneficial.

Granados said that while social science is not physics, some patterns from the past may help us predict the future with some confidence.

“Historical experience tells us that no particular deterioration of mortality is to be expected as a consequence of a recession beyond an increase in suicides which, although clearly important, is of small magnitude compared to the reduced number of fatalities from other causes,” said Granados.

He said he hoped the study highlights why it is important to make sure suicide prevention services, often the victim of budget cuts, continue to get financial support during economic downturns.

Other studies have shown that the link between population health and economic cycles may be weakening, at least in the US and in Japan, where sudden death from overwork, “karoshi”, a phenomenon seen among salaried Japanese workers, dramatically illustrates the dangers of life during economic boom times.

“Life and death during the Great Depression.”
José A. Tapia Granados and Ana V. Diez Roux
PNAS Published online before print September 28, 2009.
doi10.1073/pnas.0904491106

Additional source UM News Service.

Written by Catharine Paddock, PhD

An Indiana University study published in the September issue of the International Journal of Sexual Health found that women who feel more positively about womens genitals find it easier to orgasm and are more likely to engage in sexual health promoting behaviors, such as having regular gynecological exams or performing vulvar selfexaminations.

“These are important findings about body image,” said Debby Herbenick, associate director of the Center for Sexual Health Promotion in the School of Health, Physical Education and Recreation. “Our culture often portrays womens genitals as dirty and in need of cleaning and grooming. Some women may have had greater exposure to such negative messages or may be more susceptible to their impact.”

Herbenicks study created a scale for measuring mens and womens attitudes toward womens genitals. Such a scale, she wrote in the study, could be useful in sex therapy, in medical settings to help better understand decisionmaking that goes into gynecological care and treatment, and in health education settings involving women and their sexual health. The study also found that men had more positive attitudes about womens genitals than women.

“Women are often more critical about their own bodies and other womens bodies than men are,” Herbenick said. “What we found in this study is that men generally feel positive about a variety of aspects of womens genitals including how they look, smell, taste and feel.”

Herbenick, also a sexual health educator for The Kinsey Institute for Research in Sex, Gender and Reproduction, offers the following suggestions regarding the findings Body image. Parents might consider how they can help their daughters to feel more positively about their bodies, such as by teaching them accurate names for their body parts, including their genitals (e.g., “vulva” rather than “down there”) and responding in supportive ways to their selfexploration. “Rather than saying, dont touch down there its dirty, parents might let their children know that its OK for them to touch their genitals, but in private spaces such as their own bedroom or the bathroom,” Herbenick said.

Advertisements and marketing. Health educators might consider ways that they can teach women and men about their bodies in positive, sexpositive ways by openly discussing how some products or marketing campaigns make people feel about their bodies. The survey component of the study involved 362 women and 241 men, most of whom were white/Caucasian and between the ages of 18 and 23.

“Our study builds on previous research that demonstrates that the mind and body are highly connected in regard to sex,” said Herbenick. “When women feel more positively about female genitals, they likely feel more relaxed in their own skin, more able to let go and thus more likely to experience pleasure and orgasm.”

The study was supported by The Joseph Miller Foundation. For a copy of the study, visit informaworld.com/smpp/content~db=all~content=a914661190.

Journal citation “The Development and Validation of a Scale to Measure Attitudes Toward Womens Genitals,” International Journal of Sexual Health, 21153166, 2009.

Source
Debby Herbenick

One out of every eight strokes is preceded by a “warning stroke,” which is a transient ischemic attack (TIA) or mild stroke, according to research published in the September 29, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology.

“These results illustrate the need for better risk assessment tools for preventing strokes before they occur,” said study author Daniel G. Hackam, MD, PhD, of the University of Western Ontario in London, ON. “Other studies have shown that up to 80 percent of strokes after TIA can be prevented when risk factors are managed intensively.”

For the study, researchers identified all people at Ontario hospitals with a diagnosis of stroke over four years. Of the 16,400 patients, 2,032, or 12.4 percent, had a TIA prior to the stroke. During a TIA, stroke symptoms last for less than 24 hours and then resolve.

Those who did not have a warning stroke were more likely to have a more serious stroke than those who did have the warning stroke. Those with no warning were more likely to die while at the hospital (15.2 percent compared to 12.7 percent), more likely to have a heart arrest while in the hospital (4.8 percent compared to 3.1 percent) and less likely to be able to go home after the hospital stay, rather than to a nursing home or rehabilitation center (40.1 percent compared to 43.1 percent).

Those with the warning stroke were typically older than those without warning strokes. They were also more likely to have diabetes, high blood pressure and heart problems.

“Its possible that the blood vessels of those with warning strokes were preconditioned to the lack of blood flow, which protected them from the full result of the larger stroke. Any person who experiences even a minor stroke should get to the emergency room immediately.”

The study was supported by the Canadian Institutes of Health Research and Ontario Ministry of Health and LongTerm Care.

Source
Rachel Seroka

The Bill & Melinda Gates Foundation on Thursday announced the launch of the Living Proof Project that aims to highlight how U.S. foreign aid contributes to improving global health, the Associated Press reports. Bill Gates said in a statement, “We want to show Americans that their investments in global health are working” (Pace, 9/24).

The project includes a new Web site, “an advertising campaign in Washington, D.C., that will feature children and adults helped by U.S. global health aid, and a presentation by Bill and Melinda Gates on Oct. 27 in Washington, D.C., that will be highlighting opportunities to build on todays global health successes,” the Puget Sound Business Journal writes (9/24). The Chronicle of Philanthropys blog, “Government and Politics Watch,” reports that the campaign is geared toward “the public and politicians” (Moore, 9/24).

The campaigns message is that millions of “children and adults are surviving and leading more productive lives, living proof that U.Ssupported initiatives to fight malaria, AIDS, and other diseases are working,” the Seattle Times blog, “The Business of Giving,” reports. Senior program officer at the foundation, Cynthia Lewis, “said [the Gateses were] struck by the disconnect between the optimism and progress they saw on their trips and the pessimism they were hearing about when they came home,” the blog reports. Melinda Gates said in a statement, “We think if more Americans learn about progress in global health, theyll be inspired to maintain these investments even in difficult economic times so that we can do even more” (Heim, 9/24).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

The National Association of Psychiatric Health Systems (NAPHS) has published a 2010 Membership Directory. The directory is a comprehensive referral resource providing information on the nations behavioral healthcare systems.

The NAPHS directory is designed to help clinicians, admissions staffs, employee assistance directors, school counselors, nursing home staffs, librarians, legal system personnel, and others who must quickly identify sources of help for individuals with psychiatric and addictive disorders.

The directory includes the name, address, phone/fax, and officers (by name) of each behavioral health system. The facilities operated by each system including specialty hospitals, psychiatric units in general hospitals, residential treatment centers, partial hospital programs, and outpatient centers are also listed. To help locate services in particular states, a geographical listing of facilities including the name of the chief operating officer of each is included.

How to Order

Copies of the 2010 NAPHS Membership Directory are available from NAPHS for $35 (which includes shipping and handling). D.C. residents add 6% sales tax. American Express, MasterCard, and Visa are accepted. To order, call 202/3936700, ext. 106, or send a check to NAPHS Membership Directory, 900 17th Street, NW, Suite 420, Washington, DC 200062507.

About NAPHS

The National Association of Psychiatric Health Systems advocates for behavioral health and represents provider systems that are committed to the delivery of responsive, accountable, and clinically effective prevention, treatment, and care for children, adolescents, adults, and older adults with mental and substance use disorders. Its members are behavioral healthcare provider organizations that own or manage more than 600 specialty psychiatric hospitals, general hospital psychiatric and addiction treatment units and behavioral healthcare divisions, residential treatment facilities, youth services organizations, and extensive outpatient networks. The association was founded in 1933.

Source National Association of Psychiatric Health Systems