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Archive for November 23, 2012

研究称:到2025年 美国至少还需要5万2千名家庭医生

根据一项新的研究称,随着人口老龄化以及医疗保险覆盖率的增加,到2025年,美国需要超过5万两千名家庭医生。

研究人员希望估计,2010年制定的“平价医保法”通过后,将有额外的3400多万美国人获得医疗保险,到时美国的医疗保健系统将需要多少医生。

但该研究的主要作者之一,华盛顿罗伯特·格雷厄姆中心的工作人员温斯顿博士说,“主要原因不是由于医保覆盖范围扩大了,而是不断增长的人口数量。”纽约哥伦比亚大学梅尔曼公共卫生学院的约翰·罗博士说,“事实上,他们对初级护理服务的需求的估计有三方面:人口的增长、人口老龄化以及‘平价医保法’的需要。

温斯顿和他的同事在《家庭医学年报》上发表了研究结果,他们使用来自美国人口普查局的数据,预测了随着人口的增加、年龄的增长和医疗保险覆盖范围的扩大,美国将需要多少家庭医生。

2008年,研究人员估计有4.62亿人曾看过家庭医生。估计到2025年这个数字会增加到5.65亿。所以还需要3%的医生来满足这个需求,即5万两千名医生。

其中,3万3千名医生是为了满足人口增长的需要,1万是为了满足老龄化的需要,8千多名医生是为满足获得保险的人群。

医生短缺?

Liaw说,“然而,这项研究不能说明这些医生就足以满足美国人未来的需要了。”他补充道,还必须估算将有多少人从工作岗位退休。

一些看到了这些数字的组织,也相信未来几年医生会出现严重短缺。美国医学院协会估计,到2020年,美国医生短缺人数将超过9万,到2025年医生短缺人数将会增长到13万。

“平价医保法”让很多人考虑成为初级保健医生,包括政府的一些规定——如提供额外的资金,以鼓励医学院学生成为初级保健医生,而不是专家。然而,这些规定预计每年也只能提供500名额外的医生。

医药日报发布

 

皮包骨头的青少年更容易过早死亡

青少年皮包骨头或胖嘟嘟都是坏事:不仅容易被人取笑、欺负,《英国医学杂志》还发现,肌肉少的青少年更容易过早死亡。

肌肉力量高于平均水平的男孩,早期死亡(由各种原因引起的死亡)的可能性减少20%至35%。具体来说,自杀的可能性减少20%至30%,患精神疾病的可能性减少65%。

西班牙格拉纳达大学,瑞典卡罗琳斯卡医学院,芬兰赫尔辛基大学的研究人员带领了此次研究。这项研究涉及100多万参与者,他们是年龄介于16至19岁的瑞典军人。研究开始时,研究人员要求参与者进行各种演习,包括屈腿练习,手臂俯卧撑。通过这些练习,评估他们的健康水平,之后24年研究人员一直对他们进行追踪研究。

在24年的研究过程中,有2.6万人死亡,占总人数的2.3%。主要死亡原因有意外伤害,自杀,心脏疾病和中风。

研究还发现,肥胖和心血管疾病与过早死亡或55岁之前死亡密切相关。

无论是皮包骨头还是肥胖男孩儿比肌肉发达的同龄人表现地更糟,然而,肌肉力量强大的超重男孩,一般会免于过早死亡。

专家强调,拥有发达的肌肉并不一定能帮助你活得更长。研究人员说,事实上这项研究的焦点不在于告诉人们“运动有助于延年益寿”。并指出,虽然运动确实有利于健康并延年益寿,但鼓励人们积极动起来仍是个挑战。

据英国广播公司报道,英国心脏基金会的发言人说,“众所周知,运动对任何年龄段的人来说都有好处。研究还显示,运动可以帮助儿童未来免于疾病的困扰,并提高他们在学校的学习能力,有利于他们的整体心理健康和幸福感。”

医药日报发布

Bill Heck’s Old Fashioned

Bill Heck's Old Fashioned

Ingredients

  • 2 sugar cubes
  • 4 dashes of Angostura bitters
  • 1 lemon wheel
  • 1 lime wheel
  • 1 orange wheel
  • 1 maraschino cherry
  • 1/2 teaspoon grenadine
  • 1/4 cup bourbon or rye whiskey
  • Club soda
  • Ginger ale

Preparation

  • Drop sugar cubes in a rocks glass; sprinkle with bitters and add citrus wheels, cherry, and grenadine. Using a muddler or the handle of a wooden spoon, mash just to release fruit juices and oils. Add bourbon. Fill glass with ice cubes; stir to combine. Top with equal parts club soda and ginger ale.

Bonappetit

EMS ACLS Guide

The EMS ACLS app puts critical information at the fingertips of an EMT.

Advanced Life Support with ACLS

* Quick navigation to critical information
* Custom bookmarks let you quickly return to your favorite pages
* Search capability
* Add notes to a page
* Calculators

TOPICS INCLUDE

* Current ACLS Algorithms
* 12-Lead EKG Section & Acute MI
* Airway Management / RSI
* Top Prescription Drugs
* Emergency & ACLS Drugs
* IV Drips, Drug Infusions, Dosages
* Poisons & Overdose / “Rave” Drugs
* Medical Emergencies Section
* Fibrinolytics for AMI & Stroke / CVA
* Childbirth, Diabetic, Respiratory Distress
* Pediatric Resuscitation, Drug Doses, Vitals
* Trauma, Triage, MCI, Glasgow Coma Scales
* Pulse Oximetry, Infectious Diseases
* Quick EMS Spanish Translations
* Lab Values, Metrics, Notes
* Interactive calculators

“THE ORIGINAL AND STILL THE BEST” —EMS Magazine

The original EMS Field Guide® from Informed Publishing—the trusted leader in emergency reference information since 1986 —is now available as an Android Application.

Twenty-three years after publication, the EMS Field Guide remains the most widely-used reference in EMS history. Carried in the pockets, phones and emergency vehicles of millions of first responders, this is the guide EMS Magazine calls “the original and still the best.”

The EMS Field Guide app puts critical information at your fingertips with rich content, detailed illustrations and pioneering features. This app is available in two editions— Advanced Life Support (ALS) and Basic & Intermediate Life Support (BLS)—designed specifically to correspond with each tier of EMT certification and practice, so you know you have the right tool for your job.

The Advanced Life Support (ACLS) app equips the Paramedic or EMT-P to triage and address trauma. It provides fast, easy access to vital assessment information, medications, and drug doses; quick interpretation of 12-Lead EKGs; and the latest CPR and ACLS algorithms from the American Heart Association (AHA). The ACLS app is also suitable for Intermediates whose practice orders require a more detailed understanding of these topics.

Play

‘Fat’ drug could treat epilepsy

Oil capsule
Oils contain fatty acids

A substance made by the body when it uses fat as fuel could provide a new way of treating epilepsy, experts hope.

Researchers in London who have been carrying out preliminary tests of the fatty acid treatment, report their findings in Neuropharmacology journal.

They came up with the idea because of a special diet used by some children with severe, drug resistant epilepsy to help manage their condition.

The ketogenic diet is high in fat and low in carbohydrate.

The high fat, low carbohydrate diet is thought to mimic aspects of starvation by forcing the body to burn fats rather than carbohydrates.

The identification of these fatty acids is an exciting breakthrough”

Simon Wigglesworth Epilepsy Action

Although often effective, the diet has attracted criticism, as side-effects can be significant and potentially lead to constipation, hypoglycaemia, retarded growth and bone fractures.

By pinpointing fatty acids in the ketogenic diet that are effective in controlling epilepsy, researchers hope they can develop a pill for children and adults that could provide similar epilepsy control without the side-effects.

In early trials, the scientists, from Royal Holloway and University College London, say they have identified fatty acids that look like good candidates for the job.

They found that not only did some of the fatty acids outperform a regular epilepsy medication called valproate in controlling seizures in animals, they also had fewer side-effects.

Understanding epilepsy

MRI scan of brain
  • Epilepsy is a condition in which disturbances to the brain’s normal electrical activity result in seizures, sometimes known as fits
  • Seizures vary in severity from a few seconds of trance-like state to loss of consciousness and convulsions – uncontrollable jerking of the body
  • The condition is thought to affect about 500,000 people in the UK – roughly one in every 100
  • Triggers for seizures include flashing lights (such as strobe effects), excessive alcohol, lack of sleep and stress
  • Medication cannot cure epilepsy but anti-epileptic drugs (AEDs) are used to control seizures. These are effective in about 70% of cases

But many more tests are needed to determine if the treatment would be safe and effective in humans.

Prof Matthew Walker, from the Institute of Neurology, University College London, said: “Epilepsy affects over 50 million people worldwide and approximately a third of these people have epilepsy that is not adequately controlled by our present treatments.

“This discovery offers a whole new approach to the treatment of drug-resistant epilepsies in children and adults.”

Simon Wigglesworth, deputy chief executive at Epilepsy Action, said: “We know the ketogenic diet can be a highly effective treatment for children with difficult to control epilepsy and it is starting to be used for adults.

“The diet is high in fats and low in carbohydrates and the balance of the diet needs to be carefully worked out for each child. Although some children manage the diet very well, others find the diet unpleasant and difficult to follow. Children can also experience side-effects including constipation and weight loss.

“The identification of these fatty acids is an exciting breakthrough. The research means that children and adults with epilepsy could potentially benefit from the science behind the ketogenic diet without dramatically altering their eating habits or experiencing unpleasant side-effects.

“We look forward to seeing how this research progresses.”

BBC

ADHD treatment ‘may reduce risk of criminal behaviour’

Drug used to treat ADHD
Giving medication to people with ADHD in the criminal justice system may reduce crime

People with attention-deficit hyperactivity disorder who are involved in crime are less likely to reoffend when on treatment than not, a Swedish study shows.

Earlier studies suggest people with ADHD are more likely to commit offences than the general population.

Providing better access to medication may reduce crime and save money, experts and support groups say.

Researchers say the benefits of the drugs must be weighed against harms.

In the UK 3% of children have a diagnosis of ADHD, with half of them continuing to have the condition in adult life.

People with the disorder have to deal with problems with concentration, hyperactivity and impulsiveness.

Estimates suggest between 7-40% of people in the criminal justice system may have ADHD and other similar disorders, though in many cases the condition is not formally recognised.

We want people to have personal choice…no one is trying to force people to take drugs”

Prof Philip Asherson Psychiatrist

Researchers from the Karolinska Institute looked at data from over 25,000 people with ADHD in Sweden.

Less impulsiveness

They found people with ADHD were more likely to commit crime (37% of men and 15% of women) than adults without the condition (9% of men and 2% women).

The study published in the New England Journal of Medicine found when people took their medication they were 32-41% less likely to be convicted of a crime than when they were off medication for a period of six months or more.

Dr Seena Fazel, an author of the study and from Oxford University, says medication may reduce impulsive choices and may enable people to better organise their lives – allowing them to stay in employment and maintain relationships.

Co-author Prof Paul Lichtenstein says: “It is said that roughly 30 to 40% of long-serving criminals have ADHD. If their chances of recidivism can be reduced by 30%, it would clearly effect the total crime numbers in many societies.”

‘Personal responsibility’

Prof Philip Asherson, a psychiatrist and president of the UK Adult ADHD network, who was not involved in the study says: “We want people to have personal choice and personal responsibility – no-one is trying to force people to take drugs.”

He points out it costs £100-£300 a month to provide medication for someone with ADHD, and taking into account the costs of unemployment and the criminal justice system, these would “vastly outweigh” the costs of medication, he says.

The authors caution that the side effects of the drugs used, such as Ritalin, must be taken into account.

“There are of course a lot of people with ADHD in the population who are not involved in crime.

“But for some people with the condition – if you don’t treat them, they will try to treat themselves with street drugs,” says Andrea Bilbow, founder of the National Attention Deficit Disorder Information and Support Service, Addis.

“A referral to specialist adult services can cost £1,500 – compare this with the amount of money you can save if you keep people out of prison – it’s a no brainer.”

‘Better support’

The researchers looked at a variety of crimes – from petty crime to violent crime, finding a reduction in all of these when people took medication.

They acknowledge when offered medication, individuals may also get more attention from other support services – this could contribute to the reduction in criminal behaviour.

Prof Sue Bailey, president of the Royal College of Psychiatry, welcomes the study saying it “reminds us in an era of psychological therapies that medication can have a positive impact too”.

The authors of the study point out ADHD can exist alongside other conditions such as conduct disorders, calling for further work to untangle the contribution these may make to criminal behaviour.

They feel the Swedish findings are applicable to the UK and much of Western Europe where rates of ADHD in children and the medication prescribed are broadly similar.

BBC

Seeing someone scratch an itch ‘makes you itchy too’

Woman itching
Does seeing this make you feel itchy?

Seeing someone scratch an itch could make you feel itchy too, a study suggests.

The British Journal of Dermatology paper looked at whether images such as those of others scratching or ants crawling on skin, made people scratch.

The study of 30 people asked them how they felt looking at these and “non-itch” images – and found visual cues did provoke a “scratch response”.

Experts said the work could help understand skin disorders.

Visual cues

The participants in the study, overseen by researchers at Liverpool John Moores University and the University of Manchester, were shown a range of images; insects such as ants and midges on and off the skin, skin conditions or neutral images such as butterflies and healthy skin.

For each picture, people were asked how itchy they felt. The researchers also checked how often they scratched themselves while looking at the images.

It was found that visual cues did provoke the sensation of itch in people – and made them scratch.

If you have chronic itch, your life is blighted”

Prof Francis McGlone Liverpool John Moores University

And, in particular, it was watching another person scratching – rather than seeing the cause of an itch – that made people feel itchy themselves.

Prof Francis McGlone, a cognitive neuroscientist at Liverpool John Moores University, who led the study, said: “The results suggest that, whereas the sensation of itch may be effectively transmitted by viewing others experiencing itch-related stimuli on the body, the desire to scratch is more effectively provoked by viewing others scratching.”

He added: “Our findings may help to improve the efficiency of treatment programmes for people suffering from chronic itch.

“Itch has far more serious psychological consequences than people give it credit for.

“If you have chronic itch your life is blighted, but if you’re unable to scratch that itch – or if you do scratch it – it gets worse and worse.”

Brain activity

A spokeswoman for the British Association of Dermatologists said: “Itch is often the worst symptom for people with skin disorders, and any research into its causes that may lead to new methods of alleviation will be greatly welcomed by the millions of skin patients.

Another study, recently published in Proceedings of the National Academy of Sciences, used brain scans to show the same parts of the brain are activated when watching someone else scratch an itch as when someone does it themselves.

That team, including experts from Hull University, suggested that the activation of these areas could explain itching disorders where there is no physical cause.

Lead researcher Dr Henning Holle, of Hull University, said: “It was particularly interesting to see that contagious itch is not only elicited by observing someone scratching.

“Simply seeing potentially itchy stimuli, for instance ants crawling on the ground, seems to be enough to induce feelings of itchiness in one’s own body.

“This suggests that a process of motor mimicking alone cannot explain contagious itch.”

BBC

Organ donor series

Luceia Quinney-Mee
Luceia Quinney-Mee is very thankful for the organ donation

By Nicola Weir BBC NI reporter

“I’m lucky, very lucky. I’ve had a second chance to do it again.”

These are the words of a 13-year-old girl who knows that without the gift of life from a stranger, she would not be here today.

Five years ago, Ballycastle teenager Luceia Quinney-Mee developed a rare condition that meant her red blood cells started to attack her liver.

One of the symptoms was the whites of her eyes turning yellow. Doctors referred her to specialists in Belfast.

“Belfast has a shared care connection with Birmingham Children’s Hospital so they sent me over to Birmingham and within a week I was on the waiting list for a liver transplant,” she said.

“It was the morning after a liver became available to me and so I went down to theatre to get my first transplant.”

However, this was not a success and a year later, Luceia was back on the waiting list.

“It was chronic rejection that I had,” she said. “The liver just didn’t settle in my body.

Luceia had a second liver transplant in 2009.
Luceia had a second liver transplant in 2009.

 

“It was a really different experience because I wasn’t in hospital. I was allowed to come back home and wait for it.

“For those three months I was never in school and wasn’t going out that much. It was weird but I don’t remember ever feeling frightened.”

Luceia got a second liver transplant early in 2009. Three years later she is still doing well.

She takes a daily cocktail of anti-rejection drugs but the transplant has transformed her life.

Since the operation she has become an enthusiastic swimmer, competing in the Transplant Games and earlier this year carried the Olympic Torch.

Her mother, Rachel, said they will be forever indebted to the person who died to save Luceia’s life.

“We would have lost Luceia if we hadn’t had organ donation,” she said.

“She’s still here, she’s still with us, she’s fit and healthy.

“We feel it’s very important to promote the Organ Donation Register, to try and help people see that it’s really important to sign on to the register.

Luceia's mother, Rachel, says they will be forever indebted to the organ donor
Luceia’s mother, Rachel, says they will be forever indebted to the organ donor

 

“But it’s also really important to talk to your family about it. At the bedside, when your loved one is dying is not the time to make a decision.

“It’s very difficult but we know how important it is to be spoken about.”

Luceia has written a letter to the donor family but has not yet received a response.

She said she would love to contact them because, without them, she would not be living life to the full.

“Somebody had to die for me to live again and it’s really special that somebody would actually give up an organ so that I could live,” she said.

BBC

Rosnah: Graphic warnings on box only effective against newbies

THE Health Ministry is looking at innovative ways, including the packaging of cigarette boxes to deter new smokers, its deputy minister Datuk Rosnah Abdul Rashid Shirlin said.

To a question from Hamim Samuri (BN-Ledang), she said the move involved the entire cigarette box depicting graphic warnings leaving only a small portion for the brand name.

She said such warnings were only effective against new smokers and not regular smokers.

To a question from Datuk Noraini Ahmad (BN-Parit Sulong), Rosnah said there were no plans to implement the plain packaging for cigarettes, similar to that done in Australia.

“The ministry supports and welcomes the action of the Australian Government in implementing plain packaging as a move to reduce smoking.

“But we have no intention at present to follow suit owing to the dispute between the Australian Government and those from the tobacco industry at the international level,” she said.

She said comprehensive studies carried out by the Australian Government revealed that branding and packaging of tobacco products could influence and attract consumers to smoke, in particular the youths.

She said all tobacco products manufactured in Australia must be in plain packaging as of Oct 1 this year while the ruling for products sold would come into effect on Dec 1.

On a related issue, Rosnah said the Govern-ment had gazetted 21 non-smoking areas in a bid to discourage smoking.

The Star

Hospital lodges report over ‘virtual’ scam

KUALA LUMPUR: A private hospital here has lodged a police report disassociating itself from a dubious “virtual hospital” which advertised vacancies to fool expatriates into paying visa fees upfront for non-existent jobs.

Columbia Asia Hospital Setapak general manager Tom Lim said the fake Dutamas Hospital had used information from his hospital’s website to make the con more believable.

“As soon as we were alerted, we conducted investigations online and found several links from our hospital on its website,” he said after lodging a police report at the Setapak police station yesterday.

He said the website had also listed names and contact details of three staff members, namely its marketing manager, customer service manager and human resource department vice-president, to convince victims.

“I assure the public that our hospital has no affiliation with the fake hospital and we hope that it does not tarnish our reputation.

“I hope police will conduct a thorough investigation and bring those responsible to justice,” he said.

It was reported in The Star on Thursday that a “virtual hospital” was targeting prospective expatriates into parting with their money by getting them to pay for Malaysian visas upfront.

The fake Dutamas Hospital offered salaries of more than US$9,000 (RM27,000) per month for executive jobs, in addition to holidays, accommodation and other perks to lure victims.

If they take the bait, they would be asked to pay thousands of ringgit upfront as visa and contract fees.

Its website, created early this month, displayed detailed information including address, contact numbers and a list of doctors.

But checks showed that the information listed was partially lifted from Columbia Asia Hospital Setapak’s website.

Calls to the numbers listed went unanswered and the address of the “hospital”, supposedly located at Solaris Dutamas, does not exist.

The Star

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