Wednesday, November 30, 2011

Dow soars 490 pts on banks' "bold move"

(CBS/AP)�

A coordinated move by the world's central banks to ease borrowing costs sent stocks shooting higher. The Dow Jones industrial average jumped 490 points, its biggest gain since March 2009.

Big U.S. banks were among the top gainers, jumping as much as 7 percent. Markets in Europe surged, too, with Germany's DAX index climbing 5 percent.

"The central banks of the world have resolved that there will not be a liquidity shortage," said David Kotok, chairman and chief investment officer of Cumberland Advisors. "And they have learned their lessons from 2008. They don't want to take small steps and do anything incrementally, but make a big bold move that is credible."

Wednesday's action by the banks of Europe, the U.S., Britain, Canada, Japan and Switzerland represented an extraordinary coordinated effort.

But amid the market's excitement, many doubts loomed. Some analysts cautioned that the banks' move did nothing to provide a permanent fix to the problems facing heavily indebted European nations such as Italy and Greece. It only buys time for political leaders.

World's central banks act to ease market strains
Will the Fed's move to help Europe hurt the U.S.?
What you need to know about the central bank intervention

"It is a short-term solution," said Jack Ablin, chief investment officer at Harris Private Bank. "The bottom line on any central bank action is that it papers over the problems, buys time and in some respects takes pressure from politicians. ... If nothing's done in a week, this market gain will disappear."

The rally was broad; only a handful of stocks in the S&P 500 declined. Big U.S. banks led the gains. JPMorgan Chase & Co. jumped 7.7 percent, the most of the 30 Dow components. Morgan Stanley rose 10 percent and Citigroup Inc. 8.2 percent.

Surging commodity prices lifted the stocks of companies that make basic materials such as steel. United States Steel Corp. gained 14 percent, the most in the S&P 500. AK Steel Holding Corp. added 11 percent. Energy stocks also leaped. Alpha Natural Resources Inc. rose 14 percent, Peabody Energy Corp. 13 percent.

European banks hold large amounts of European government debt and would have the most to lose in the event of a default in Europe, something investors around the world have been increasingly fearful of.

Those worries ? and the reluctance of the European Central Bank to intervene ? have caused borrowing rates for European nations to skyrocket. Wednesday's decision greatly alleviated fears by cutting short-term borrowing rates to banks, giving them much easier access to money. But borrowing costs remain extremely high for indebted countries such as Italy and Spain.

The euro rose sharply, while U.S. Treasury prices fell as demand weakened for ultra-safe assets.

The Dow rose 4.2 percent to close at 12,045.

The Standard & Poor's 500 closed up 52, or 4.3 percent, at 1,247. The Nasdaq composite index closed up 105, or 4.2 percent, at 2,620.

Seven stocks rose on the NYSE for every one that fell. Volume was heavy at 5.7 billion shares.

The move by the banks takes some pressure off the financial system, which has signaled in recent days that banks were losing faith in their trading partners. Banks need dollars to fund their daily operations, and they need to trust each other to maintain healthy flows of credit. Access to dollars has dried up as American money market funds reduced their lending to European banks.

But the banks' most recent steps do little to solve the long-term debt problem in Europe.

"People are taking comfort that it's globally coordinated," said Peter Tchir, who runs the hedge fund TF Market Advisors. "In itself, it does nothing. But the bulls are anticipating that this is just the beginning of central bank and other actions" to ease market pressures.

Any successful plan would have to reduce borrowing costs for Italy and other indebted nations, Tchir said. Italy's borrowing costs edged lower Wednesday, but the nation was still paying more than 7 percent interest for 10-year borrowing ? a dangerously high level.

European finance ministers in Brussels have been meeting since Tuesday but have failed to deliver a clearer sense of how the currency union will proceed. More leaders gather next week for a summit.

In another attempt to free up cash for lending, China on Wednesday reduced the amount of money its banks are required to hold in reserve. It was the first easing of monetary policy in three years, and analysts are expecting more.

Growth in China, which has the largest economy after the European Union and the U.S., could be crucial to sustaining any recovery after the debt crisis.

A string of positive U.S. economic news also propelled the market higher. An index measuring manufacturing in the Midwest surged to a seven-month high; private company hiring jumped in November to the highest level this year, according to payroll company ADP; and the number of contracts to buy homes jumped in October to the highest level in a year.

Source: http://feeds.cbsnews.com/~r/CBSNewsMain/~3/9-2XYUCyKLA/

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Wi-fi laptops 'may damage sperm'

Man using laptop

Scientists are questioning if using wi-fi on a laptop to roam the internet could harm a man's fertility, after lab work suggested ejaculated sperm were significantly damaged after only four hours of exposure.

The benchside tests showed sperm were less able to swim and had changes in the genetic code that they carry.

Experts stress this does not mean the same would occur in a real-life setting and say men should not worry unduly.

But they are recommending more studies.

The preliminary research, published in the journal Fertility and Sterility, looked at semen samples from 29 healthy donors.

Each donor sample was separated out into two pots. One of these pots was then stored for four hours next to a laptop that was wirelessly connected to the internet. The other was stored under identical conditions, minus the laptop.

The scientists, from Argentina and the US, suspect that the effect seen is unrelated to the heat kicked out by a laptop, although heat can damage sperm.

Under investigation

The UK's Health Protection Agency has been closely monitoring the safety of wi-fi.

It says people using wi-fi, or those in the proximity of wi-fi equipment, are exposed to the radio signals it emits - and some of the transmitted energy in the signals is absorbed in their bodies.

However, the signals are very low power.

The HPA says there is no consistent evidence to date that exposure to radio signals from wi-fi adversely affects the health of the general population.

UK fertility expert Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: "The study is very well conducted, but we should be cautious about what it may infer about the fertility of men who regularly use laptops with wi-fi on their laps.

"Ejaculated sperm are particularly sensitive to many factors because outside the body they don't have the protection of the other cells, tissues and fluids of the body in which they are stored before ejaculation. Therefore, we cannot infer from this study that because a man might use a laptop with wi-fi on his lap for more than four hours then his sperm will necessarily be damaged and he will be less fertile.

"We need large epidemiological studies to determine this, and to my knowledge these have not yet been performed."

He said men should still be cautious about balancing a laptop on their thighs for hours on end.

"We know from other studies that the bottom of laptops can become incredibly hot and inadvertent testicular heating is a risk factor for poor sperm quality.

"There is a case report of a man who burnt his penis after using a laptop resting on his lap for a long time. Therefore, there are many reasons to try and use a laptop on a table where possible, and this may in itself ameliorate any theoretical concerns about wi-fi."

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-15943816

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Wi-fi laptops 'may damage sperm'

Man using laptop

Scientists are questioning if using wi-fi on a laptop to roam the internet could harm a man's fertility, after lab work suggested ejaculated sperm were significantly damaged after only four hours of exposure.

The benchside tests showed sperm were less able to swim and had changes in the genetic code that they carry.

Experts stress this does not mean the same would occur in a real-life setting and say men should not worry unduly.

But they are recommending more studies.

The preliminary research, published in the journal Fertility and Sterility, looked at semen samples from 29 healthy donors.

Each donor sample was separated out into two pots. One of these pots was then stored for four hours next to a laptop that was wirelessly connected to the internet. The other was stored under identical conditions, minus the laptop.

The scientists, from Argentina and the US, suspect that the effect seen is unrelated to the heat kicked out by a laptop, although heat can damage sperm.

Under investigation

The UK's Health Protection Agency has been closely monitoring the safety of wi-fi.

It says people using wi-fi, or those in the proximity of wi-fi equipment, are exposed to the radio signals it emits - and some of the transmitted energy in the signals is absorbed in their bodies.

However, the signals are very low power.

The HPA says there is no consistent evidence to date that exposure to radio signals from wi-fi adversely affects the health of the general population.

UK fertility expert Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: "The study is very well conducted, but we should be cautious about what it may infer about the fertility of men who regularly use laptops with wi-fi on their laps.

"Ejaculated sperm are particularly sensitive to many factors because outside the body they don't have the protection of the other cells, tissues and fluids of the body in which they are stored before ejaculation. Therefore, we cannot infer from this study that because a man might use a laptop with wi-fi on his lap for more than four hours then his sperm will necessarily be damaged and he will be less fertile.

"We need large epidemiological studies to determine this, and to my knowledge these have not yet been performed."

He said men should still be cautious about balancing a laptop on their thighs for hours on end.

"We know from other studies that the bottom of laptops can become incredibly hot and inadvertent testicular heating is a risk factor for poor sperm quality.

"There is a case report of a man who burnt his penis after using a laptop resting on his lap for a long time. Therefore, there are many reasons to try and use a laptop on a table where possible, and this may in itself ameliorate any theoretical concerns about wi-fi."

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-15943816

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Patches, Counseling, Persistence Can Help Smokers Quit

By Steven Reinberg
HealthDay Reporter

MONDAY, Nov. 28 (HealthDay News) -- Quitting smoking isn't easy for most people but medication and counseling can help them succeed, according to the results of two new studies.

In the first of the two reports published in the Nov. 28 issue of the Archives of Internal Medicine, a team led by Dr. Anne Joseph, co-leader of the Prevention & Etiology Research Program at the Masonic Cancer Center at the University of Minnesota, tried helping people by keeping in touch with them and reminding them to quit smoking.

"We looked at a model that treated smoking as a chronic condition like high blood pressure or diabetes," Joseph said. "We know that using a combination of behavioral therapy and medication therapy, people do better than quitting on their own," she said.

For the study, more than 400 smokers received counseling over the phone along with nicotine replacement therapy (such as patches, gums, lozenges) for a month. Next, the participants were randomly assigned to receive two final calls, or more calls plus nicotine replacement therapy for another 48 weeks.

After 18 months, 30 percent of those who received calls and nicotine replacement hadn't smoked for six months compared with 23.5 percent of those who didn't receive long-term help, the researchers found.

In addition, people given long-term counseling tried to stop smoking more often than those who received only a few calls. And among those given long-term counseling, even those who did not quit smoked less than the people who received only a few calls.

Joseph's team assumed people would fail along the way and make several attempts to quit. The researchers reframed that into a positive step, she said.

"This approach takes a chronic disease treatment model, instead of a one-shot model," she explained. "If you want to quit smoking, you have to keep working at it and having your treatment adjusted to accommodate the possibility that it might not work the first time. That doesn't mean it's not going to work in subsequent attempts," Joseph added.

"If someone has tried and failed, they should try again," agreed Patricia Folan, director of the Center for Tobacco Control at the North Shore-LIJ Health System in Great Neck, N.Y. "People often try to quit five to seven times before they're successful," Folan pointed out.

"The fact that long-term care, like ongoing support, results in better quit rates makes sense as we believe that nicotine addiction is like other addictions such as heroin or alcohol, which have been clearly shown to be best managed with ongoing long-term interventions," said Dr. Norman Edelman, chief medical officer for the American Lung Association.

However, if the method in Joseph's study was to be widely used by hospitals or health care providers, that would likely be more expensive than current approaches, Edelman added, and cost-effectiveness would first need to be analyzed.

In another new study, researchers from the Medical University of South Carolina wanted to see if a smoking cessation program that included nicotine replacement therapy and counseling could help people quit even though they had no desire to stop smoking.

"Nicotine replacement therapy is proven as an effective smoking cessation medication, yet few smokers use it," said lead researcher Matthew Carpenter, an associate professor in the department of psychiatry.

Although most smokers are interested in quitting, many are hesitant to try quitting in the near future. In addition, many smokers have misconceptions about what nicotine replacement therapy is, how it works, and its safety, Carpenter noted.

The team randomly assigned more than 800 smokers to various programs. Some practiced quitting alone and some with the help of nicotine replacement therapy. Those given no nicotine replacement therapy received help in motivation, confidence and coping skills.

At four weeks, 22 percent of those who received counseling and nicotine replacement therapy had tried to stop smoking for a day, as did 13 percent of those who received counseling alone. At final follow-up after treatment was stopped, 49 percent of those who received nicotine replacement therapy had made an attempt to quit versus 40 percent of those given counseling alone, the researchers found.

"Compared to those who did not receive nicotine replacement therapy samples, those who did showed stronger motivation, higher confidence and more favorable attitudes towards nicotine replacement therapy," Carpenter said.

The study suggests nicotine replacement therapy could be marketed for trial use, which might be attractive to a greater number of smokers, he noted.

However, Edelman doesn't think this study went on long enough to draw any definitive conclusions. "The study had no long-term follow-up, thus lacking what I consider to be the gold standard of smoking-cessation experimentation," he said.

Two research letters published in the same journal issue drove home that point. In the first, G. David Batty, of University College London, England and colleagues followed up people who took part in the Whitehall Smoking Cessation Survey three decades ago.

In that study, about 1,450 men either received information on the dangers of smoking or no information. After 30 years, most of those still living had quit smoking -- 81 percent in the group that got counseling and 79 percent in the group that didn't, the investigators found.

In addition, the overall risk of death was slightly lower for people who received counseling; and while the difference was not statistically significant, it was about 0.4 life-years gained, the researchers said.

In the other letter, researchers looked at the benefit of not smoking in cutting the odds of dying young. The team led by Yin Cao, from the Harvard School of Public Health, collected data on more than 19,000 men who took part in the Physicians' Health Study.

Among these men, 42 percent had been smokers and nearly 7 percent still were. About 5,600 men died in the follow-up period. Of the more than 600 deaths among smokers, nearly 14 percent died before they reached age 65, compared with about 8 percent of those who had never smoked, the researchers found.

The highest death risk was among those who smoked the most, but that risk could be cut by 44 percent within 10 years after quitting, and after 20 years it was the same as if they never smoked, the study found.

"Reduction of mortality should not be considered to be the only important outcome measure of smoking-cessation programs," Edelman said. "There is considerable morbidity, such as disability, effects of treatment for heart and lung disease, etc., to be taken into account."

David Abrams, executive director of the Schroeder Institute on Tobacco Research and Policy Studies at the American Legacy Foundation, said that evidence-based treatments "will double to quadruple your chance of successful quitting" compared to willpower alone.

MedicalNewsCopyright � 2011 HealthDay. All rights reserved.

SOURCES: Anne M. Joseph, M.D., co-leader, Prevention & Etiology Research Program, University of Minnesota, Minneapolis; Matthew J. Carpenter, Ph.D., associate professor, department of psychiatry, Medical University of South Carolina, Charleston, S.C.; Norman H. Edelman, M.D., chief medical officer, American Lung Association; Patricia Folan, MSN Ed., RN, CH, director, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, N.Y.; David Abrams, Ph.D., executive director, Schroeder Institute on Tobacco Research and Policy Studies, American Legacy Foundation; Nov. 28, 2011, Archives of Internal Medicine


Source: http://www.medicinenet.com/guide.asp?s=rss&k=DailyHealth&a=152035

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Angioplasty Patients May Be at Risk for Rehospitalization

By Denise Mann
HealthDay Reporter

MONDAY, Nov. 28 (HealthDay News) -- About one in 10 people who have angioplasty to open blocked heart arteries will land back in the hospital within 30 days, a new study indicates.

And a second, related report found that rehospitalization after angioplasty or stent placement remains a risk even three years after the procedure.

Both studies, which appear in the Nov. 28 issue of the Archives of Internal Medicine, highlight the need for better methods of identifying and treating high-risk individuals.

In the first study of more than 15,000 people who had either a balloon angioplasty or stent placement to open up their blocked heart arteries, 9.4 percent of the patients were readmitted to the hospital within 30 days. What's more, these individuals were more likely to die within a year when compared with their counterparts who were not readmitted to the hospital after their procedure. Females, individuals with unstable angina (chest pain) and those with Medicare insurance were among the most likely to be rehospitalized after their procedure, the results showed.

"I wouldn't have thought the rehospitalization rate would be that high, but it gives us an opportunity to study those factors that we could change," said study author Dr. David Holmes, a cardiologist at Mayo Clinic in Rochester, Minn.

Many of the factors that increase risk of rehospitalization can't be changed, but others can be addressed.

"Maybe people with lower education levels can't follow instructions, so maybe we need to change how we provide information so that they go out understanding what medications they need to take and what the warning signs are that should make them come back," Holmes explained.

"Coronary artery disease is a chronic condition that needs chronic care," he said. "Just because a stent is placed or bypass surgery is done does not mean that you don't need continued care in terms of preventing other episodes. You have the disease and have been treated for this episode. Now we need to treat the rest of you to decrease the chance that you will have another episode in the course of this chronic and progressive disease."

The second study looked at the readmission rate among 11,118 patients from an Italian heart registry. After three years, they had a 7 percent to 20 percent rate of hospital readmission. The 7,867 rehospitalizations were for new procedures to open arteries, heart failure, heart attack or serious bleeds.

"Hospital admissions are frequent, both in the first year and in the following years after," said study author Dr. Gianluca Campo, a cardiologist at the Azienda Ospedaliera-Universitaria di Ferrara in Ferrara, Italy. "The most dangerous adverse events are heart failure and bleeding events. These complications have a strong negative impact on long-term mortality."

Earlier identification of individuals who are at high risk for readmission after angioplasty or other cardiovascular procedures is key, said Dr. Adrian F. Hernandez, a cardiologist at Duke University who co-authored an editorial accompanying the new studies. Much of this onus falls on the hospitals that treat and release these patients, he said. "Understand the holes in your system: Do you even know your readmission rates, and can you develop metrics around readmission?" he asked.

Also, "identify the barriers in transitions of care: Do patients have the right information when they walk out the door? Do they know who to call with problems? Do they have their medications? Do they have appropriate follow-up scheduled? Can they get to the appointment?," Hernandez asked. "Follow-up ideally within seven to 10 days with a generalist or cardiologist is suitable."

Certain factors that may place a patient at high risk for rehospitalization include having several other medical problems such as heart failure, kidney disease or lung disease. "Emergent or urgent angioplasty is also higher risk, [and] whether the procedure was considered a success or whether it was complicated may influence the risk of having problems after discharge," Hernandez added.

"Of the variables identified as being independently associated with 30-day rehospitalization, the vast majority are not modifiable," said Dr. Gregg C. Fonarow, associate chief of cardiology at the University of California at Los Angeles. "Further studies are needed to determine if any of the readmissions are preventable, and that preventing readmission would reduce mortality."

MedicalNewsCopyright � 2011 HealthDay. All rights reserved.

SOURCES: David Holmes, M.D., cardiologist, Mayo Clinic, Rochester, Minn.; Adrian F. Hernandez, M.D., MHS, Duke University, Durham, N.C.; Gianluca Campo, M.D., cardiologist, the Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy; Gregg C. Fonarow, M.D., associate chief, cardiology, University of California at Los Angeles; Nov. 28, 2011, Archives of Internal Medicine


Source: http://www.medicinenet.com/guide.asp?s=rss&k=DailyHealth&a=152037

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Palliative Care Takes Off in New York

By Haydn Bush November 30, 2011

A hospital association works to build best practices around palliative care.

A few weeks ago, I wrote about a new initiative by the Center to Advance Palliative Care called Improving Palliative Care in Emergency Medicine in the context of an article I'm working on for an upcoming edition of H&HN on the increasing emergence of palliative care treatment and consultation in the acute care setting.

Afterwards, I heard from the Greater New York Hospital Association, which recently launched the Palliative Care Leadership Network to help its members discuss and share ideas around hospital-based palliative care. Lorraine Ryan, senior vice president for the GNYHA, noted that the association's members have taken varying approaches to palliative care, and are at a different stages of development, creating the need for a system of information sharing.

"We wanted to create a forum where leaders in palliative care could come together, and share best practices," Ryan said.

While most of the network's conversations to date have been informal, the group is now working on a smaller collaborative to develop a palliative care bundle addressing three major aspects of care: identifying patients for whom palliative care services may be appropriate, creating broad strategies for treatment options and developing measurements to document compliance with these tools.

"It's having a standardized protocol for contemplating the needs of these types of patients," Ryan says.

Much of the specifics of the protocols, however, will be left up to individual providers, noted Sara Kaplan-Levenson, GNYHA's project manager. For instance, details like where patients should be assessed for palliative care needs might range from the ED to the ICU, and their ultimate destination could range from a hospital room to community-based care at home.

"There will be some initial point of transition, but the treatment element is unlikely to be particularly prescriptive," Kaplan-Levenson said.

As it happens, GNYHA's efforts are coming at the same time two New York State laws, the Palliative Care Information Act and the Palliative Care Access Act, take effect. The first law requires hospitals to offer palliative care informatio to terminally ill patients; the second requires providers to "facilitate access to appropriate palliative care consultation and services."

Ryan, who notes that GNYHA and member hospitals were already moving toward their efforts when the laws were passed, says the laws do not include specific regulations and should help encourage hospitals to experiment with palliative care without pushing specific strategies.

"This will help steer providers in the right direction," Ryan says. "It sort of endorses the belief that this is an appropriate way of approaching certain types of patients that didn't exist before."

I'll be watching these initiatives closely as I continue to research the emergence of hospital-based palliative care, and I'm interested from hearing more on other grassroots, palliative care initiatives. Is your hospital or region launching an initiative around palliative care? Email me at hbush@healthforum.com.

Haydn Bush is the senior online editor for Hospitals & Health Networks magazine.

The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association.

in general. All comments will be reviewed by a moderator before being posted.

Please note: Your browser cookies must be enabled to leave comments and remember your login information. If you are having trouble posting a comment please enable your browser cookies or email us your comment at hhndaily@healthforum.com.

Source: http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=4640008544

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Worries about for-profit and policy-making philanthropy

By

First off, you should know that philanthropy in the United States is a growth market. As the New York Times noted recently in an analysis piece on philanthropists using their foundations to push policy changes: Over the past 30 years, as the gap between wealthy and poor grew ever wider, total philanthropic giving almost tripled?. ? Continue reading ?

Continued here:
Worries about for-profit and policy-making philanthropy

Related posts:

  1. My Worries About the (Still Good) Idea of Hedging for the Poor
  2. Responding to Worries about COD Aid
  3. Innovative philanthropy and the quest for unrestricted funding
  4. Fighting about the fundamentals of philanthropy
  5. Eyes Wide Shut: Philanthropy Action on the ?Rescheduled? Sachs vs?.
Posted by on Nov 29 2011. Filed under Aid & Development, Financing, Humanosphere. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry

Source: http://www.globalhealthhub.org/2011/11/29/worries-about-for-profit-and-policy-making-philanthropy/

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Palliative Care Takes Off in New York

By Haydn Bush November 30, 2011

A hospital association works to build best practices around palliative care.

A few weeks ago, I wrote about a new initiative by the Center to Advance Palliative Care called Improving Palliative Care in Emergency Medicine in the context of an article I'm working on for an upcoming edition of H&HN on the increasing emergence of palliative care treatment and consultation in the acute care setting.

Afterwards, I heard from the Greater New York Hospital Association, which recently launched the Palliative Care Leadership Network to help its members discuss and share ideas around hospital-based palliative care. Lorraine Ryan, senior vice president for the GNYHA, noted that the association's members have taken varying approaches to palliative care, and are at a different stages of development, creating the need for a system of information sharing.

"We wanted to create a forum where leaders in palliative care could come together, and share best practices," Ryan said.

While most of the network's conversations to date have been informal, the group is now working on a smaller collaborative to develop a palliative care bundle addressing three major aspects of care: identifying patients for whom palliative care services may be appropriate, creating broad strategies for treatment options and developing measurements to document compliance with these tools.

"It's having a standardized protocol for contemplating the needs of these types of patients," Ryan says.

Much of the specifics of the protocols, however, will be left up to individual providers, noted Sara Kaplan-Levenson, GNYHA's project manager. For instance, details like where patients should be assessed for palliative care needs might range from the ED to the ICU, and their ultimate destination could range from a hospital room to community-based care at home.

"There will be some initial point of transition, but the treatment element is unlikely to be particularly prescriptive," Kaplan-Levenson said.

As it happens, GNYHA's efforts are coming at the same time two New York State laws, the Palliative Care Information Act and the Palliative Care Access Act, take effect. The first law requires hospitals to offer palliative care informatio to terminally ill patients; the second requires providers to "facilitate access to appropriate palliative care consultation and services."

Ryan, who notes that GNYHA and member hospitals were already moving toward their efforts when the laws were passed, says the laws do not include specific regulations and should help encourage hospitals to experiment with palliative care without pushing specific strategies.

"This will help steer providers in the right direction," Ryan says. "It sort of endorses the belief that this is an appropriate way of approaching certain types of patients that didn't exist before."

I'll be watching these initiatives closely as I continue to research the emergence of hospital-based palliative care, and I'm interested from hearing more on other grassroots, palliative care initiatives. Is your hospital or region launching an initiative around palliative care? Email me at hbush@healthforum.com.

Haydn Bush is the senior online editor for Hospitals & Health Networks magazine.

The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association.

in general. All comments will be reviewed by a moderator before being posted.

Please note: Your browser cookies must be enabled to leave comments and remember your login information. If you are having trouble posting a comment please enable your browser cookies or email us your comment at hhndaily@healthforum.com.

Source: http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=4640008544

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Patches, Counseling, Persistence Can Help Smokers Quit

By Steven Reinberg
HealthDay Reporter

MONDAY, Nov. 28 (HealthDay News) -- Quitting smoking isn't easy for most people but medication and counseling can help them succeed, according to the results of two new studies.

In the first of the two reports published in the Nov. 28 issue of the Archives of Internal Medicine, a team led by Dr. Anne Joseph, co-leader of the Prevention & Etiology Research Program at the Masonic Cancer Center at the University of Minnesota, tried helping people by keeping in touch with them and reminding them to quit smoking.

"We looked at a model that treated smoking as a chronic condition like high blood pressure or diabetes," Joseph said. "We know that using a combination of behavioral therapy and medication therapy, people do better than quitting on their own," she said.

For the study, more than 400 smokers received counseling over the phone along with nicotine replacement therapy (such as patches, gums, lozenges) for a month. Next, the participants were randomly assigned to receive two final calls, or more calls plus nicotine replacement therapy for another 48 weeks.

After 18 months, 30 percent of those who received calls and nicotine replacement hadn't smoked for six months compared with 23.5 percent of those who didn't receive long-term help, the researchers found.

In addition, people given long-term counseling tried to stop smoking more often than those who received only a few calls. And among those given long-term counseling, even those who did not quit smoked less than the people who received only a few calls.

Joseph's team assumed people would fail along the way and make several attempts to quit. The researchers reframed that into a positive step, she said.

"This approach takes a chronic disease treatment model, instead of a one-shot model," she explained. "If you want to quit smoking, you have to keep working at it and having your treatment adjusted to accommodate the possibility that it might not work the first time. That doesn't mean it's not going to work in subsequent attempts," Joseph added.

"If someone has tried and failed, they should try again," agreed Patricia Folan, director of the Center for Tobacco Control at the North Shore-LIJ Health System in Great Neck, N.Y. "People often try to quit five to seven times before they're successful," Folan pointed out.

"The fact that long-term care, like ongoing support, results in better quit rates makes sense as we believe that nicotine addiction is like other addictions such as heroin or alcohol, which have been clearly shown to be best managed with ongoing long-term interventions," said Dr. Norman Edelman, chief medical officer for the American Lung Association.

However, if the method in Joseph's study was to be widely used by hospitals or health care providers, that would likely be more expensive than current approaches, Edelman added, and cost-effectiveness would first need to be analyzed.

In another new study, researchers from the Medical University of South Carolina wanted to see if a smoking cessation program that included nicotine replacement therapy and counseling could help people quit even though they had no desire to stop smoking.

"Nicotine replacement therapy is proven as an effective smoking cessation medication, yet few smokers use it," said lead researcher Matthew Carpenter, an associate professor in the department of psychiatry.

Although most smokers are interested in quitting, many are hesitant to try quitting in the near future. In addition, many smokers have misconceptions about what nicotine replacement therapy is, how it works, and its safety, Carpenter noted.

The team randomly assigned more than 800 smokers to various programs. Some practiced quitting alone and some with the help of nicotine replacement therapy. Those given no nicotine replacement therapy received help in motivation, confidence and coping skills.

At four weeks, 22 percent of those who received counseling and nicotine replacement therapy had tried to stop smoking for a day, as did 13 percent of those who received counseling alone. At final follow-up after treatment was stopped, 49 percent of those who received nicotine replacement therapy had made an attempt to quit versus 40 percent of those given counseling alone, the researchers found.

"Compared to those who did not receive nicotine replacement therapy samples, those who did showed stronger motivation, higher confidence and more favorable attitudes towards nicotine replacement therapy," Carpenter said.

The study suggests nicotine replacement therapy could be marketed for trial use, which might be attractive to a greater number of smokers, he noted.

However, Edelman doesn't think this study went on long enough to draw any definitive conclusions. "The study had no long-term follow-up, thus lacking what I consider to be the gold standard of smoking-cessation experimentation," he said.

Two research letters published in the same journal issue drove home that point. In the first, G. David Batty, of University College London, England and colleagues followed up people who took part in the Whitehall Smoking Cessation Survey three decades ago.

In that study, about 1,450 men either received information on the dangers of smoking or no information. After 30 years, most of those still living had quit smoking -- 81 percent in the group that got counseling and 79 percent in the group that didn't, the investigators found.

In addition, the overall risk of death was slightly lower for people who received counseling; and while the difference was not statistically significant, it was about 0.4 life-years gained, the researchers said.

In the other letter, researchers looked at the benefit of not smoking in cutting the odds of dying young. The team led by Yin Cao, from the Harvard School of Public Health, collected data on more than 19,000 men who took part in the Physicians' Health Study.

Among these men, 42 percent had been smokers and nearly 7 percent still were. About 5,600 men died in the follow-up period. Of the more than 600 deaths among smokers, nearly 14 percent died before they reached age 65, compared with about 8 percent of those who had never smoked, the researchers found.

The highest death risk was among those who smoked the most, but that risk could be cut by 44 percent within 10 years after quitting, and after 20 years it was the same as if they never smoked, the study found.

"Reduction of mortality should not be considered to be the only important outcome measure of smoking-cessation programs," Edelman said. "There is considerable morbidity, such as disability, effects of treatment for heart and lung disease, etc., to be taken into account."

David Abrams, executive director of the Schroeder Institute on Tobacco Research and Policy Studies at the American Legacy Foundation, said that evidence-based treatments "will double to quadruple your chance of successful quitting" compared to willpower alone.

MedicalNewsCopyright � 2011 HealthDay. All rights reserved.

SOURCES: Anne M. Joseph, M.D., co-leader, Prevention & Etiology Research Program, University of Minnesota, Minneapolis; Matthew J. Carpenter, Ph.D., associate professor, department of psychiatry, Medical University of South Carolina, Charleston, S.C.; Norman H. Edelman, M.D., chief medical officer, American Lung Association; Patricia Folan, MSN Ed., RN, CH, director, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, N.Y.; David Abrams, Ph.D., executive director, Schroeder Institute on Tobacco Research and Policy Studies, American Legacy Foundation; Nov. 28, 2011, Archives of Internal Medicine


Source: http://www.medicinenet.com/guide.asp?s=rss&k=DailyHealth&a=152035

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Al-Shabab Bans U.N., Other Aid Agencies From Working In Somalia; U.N. SG Condemns Actions

Al-Shabab Bans U.N., Other Aid Agencies From Working In Somalia; U.N. SG Condemns Actions

Tuesday, November 29, 2011

"Al-Shabab rebels banned some U.N. and international aid agencies from working in Somalia on Monday and began seizing and looting some of their offices in southern and central areas of the country, the Islamist group and aid sources said,"�Reuters reports (Ahmed et al., 11/28). "Among the agencies al-Shabab banned on Monday were UNICEF, the World Health Organization, UNHCR, the Norwegian Refugee Council, the Danish Refugee Council, German Agency For Technical Cooperation (GTZ), Action Contre la Faim, Solidarity, Saacid and Concern," the�Associated Press/Washington Post notes (11/28). In a statement, al-Shabab, "[t]he main Islamist insurgent group in Somalia, which is still in the throes of a major food crisis classified as famine in some regions, ... accus[ed] them of 'illicit activities and misconduct,'"�IRIN writes (11/28). "The al-Shabab statement accused the groups of exaggerating the scale of the problems in Somalia for political reasons and to raise money," according to�BBC News (11/28)

"The closure of the humanitarian agencies in Somalia could have a detrimental effect on tens of thousands of people," as "more than 250,000 people face imminent starvation and millions more are in danger,"�International Business Times writes (Tovrov, 11/28). The WHO "said on Tuesday its offices in southern Somalia were looted during rebel raids while ... UNICEF said its base in the area remained occupied,"�Agence France-Presse reports (11/29). A�statement from U.N. Secretary-General Ban Ki-moon said he "condemns, in the strongest possible terms," al-Shabab's "seizure of property and equipment" and said "[t]his brazen act prevents these organizations from providing life-saving assistance." The statement "demands that Al-Shabab vacate the premises and return seized property to the affected agencies and [non-governmental organizations]" and for the ban "to be lifted immediately" (11/28).

Source: http://feeds.kff.org/~r/kff/kdghpr/~3/9WIAJ8QLuXg/GH-112911-Al-Shabab-Somalia.aspx

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Investing in family planning: Funds needed from all sources

Source: http://www.globalhealthhub.org/2011/11/29/investing-in-family-planning-funds-needed-from-all-sources/

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Protein Discovery May Aid in New Lymphoma Treatments

Medical Daily

Last Updated 4:23 p.m.EDT, Thu October 20, 2011

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Source: http://www.medicaldaily.com/news/20111129/8042/lymphoma-fbxo11-bcl6-lymphomagenesis-nyu-cancer-institute-diffuse-large-b-cell-lymphoma-findin.htm

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Tuesday, November 29, 2011

Best Exercise for Pregnancy

Source: http://www.oralcareandhealthdaily.com/blog/best_exercise_for_pregnancy/index.html

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This Holiday: Eat, Laugh, Create a Family Health Tree

By Bill Santamour November 23, 2011

Internet tool makes it easy to share info with relatives, providers.

Whenever two or more Santamours get together for the holidays, it doesn't take long before we're cracking each other up with the same silly family tales we've been telling for a lifetime now. I bet your clan is the same way. After all, holidays are meant for making and sharing the memories that bind.

The Department of Health & Human Services suggests adding something else to the conversational mix this year: a family health history. It's an idea you might want to suggest to your relatives and pass on to your patients, too.

True, Aunt Millie's rheumatism and Uncle Walter's COPD wouldn't make for the most scintillating dinner conversation, but there will be other, more appropriate, moments during your time together to take note of who's had what ailment and when. And that information could help your physicians take better care of you and your loved ones.

"A record of people's health conditions, and where they are in the family tree, can give doctors clues about possible inherited health problems," HHS HealthBeat blogger Nicholas Garlow wrote this summer.

It couldn't be easier. The Surgeon General's "My Family Health Portrait" is a free Internet-based tool that's simple to complete and creates a downloadable, private family tree. It provides a health history that can be shared among family members and sent to health care practitioners.

One helpful feature of the tool is "re-indexing." Say Cousin Pete fills out his health history and shares it with your sister Susie. Susie then can make herself the center of the online tree and it will automatically readjust the information to show its correct relationship to her. Then Susie can start her own personal family health history.

To get the ball rolling, you might want to designate a certain family member to collect the information from the relatives on hand and start his own "My Family Health Portrait" to share with everyone.

Could be just the job for that twenty-something who rolls his eyes whenever the aunts and uncles launch into yet another round of reminiscences. He can start right after he helps with the dishes.

Bill Santamour is managing editor of Hospitals & Health Networks. Follow our tweets at www.twitter.com/hhnmag.

The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association.

in general. All comments will be reviewed by a moderator before being posted.

Please note: Your browser cookies must be enabled to leave comments and remember your login information. If you are having trouble posting a comment please enable your browser cookies or email us your comment at hhndaily@healthforum.com.

Source: http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=7640003266

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Obesity: Exercise Encourages Healthy Diet, sense of Fullness

Medical Daily

Last Updated 4:23 p.m.EDT, Thu October 20, 2011

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Source: http://www.medicaldaily.com/news/20111129/8038/obesity-exercise-fullness-healty-diet.htm

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Paralysed man seeks right to die

Tony NicklinsonTony Nicklinson is unable to speak

A severely disabled 57 year old man is to ask a High Court judge to allow a doctor to end his life. Tony Nicklinson issued proceedings in a case which will challenge the law on murder.

Mr Nicklinson was paralysed from the neck down following a stroke in 2005 and left with "locked-in syndrome". He is unable to speak and communicates by nodding his head at letters on a board or by using a computer which responds to eye movements.

Suffer

In a statement released by his lawyers, Mr Nicklinson said: "When the time is right I want to be able to die at home with a drug which a doctor could give me so that I can take it with help and go to sleep peacefully with my family around to say goodbye to me. That would be a good death. What I have to look forward to is a wretched ending with uncertainty, pain, and suffering while my family watch on helplessly. Why must I suffer these indignities? If I were able bodied I could put an end to my life when I want to. Why is life so cruel?"

Earlier this year his legal team said they would be asking the Director of Public Prosecutions to clarify the law on so-called mercy killing. Saimo Chahal from Bindmans solicitors said the DPP had made it clear there was no flexibility on the law and anyone who deliberately took someone's life would be charged with murder.

Locked-In Syndrome

  • Condition in which patient is mute and totally paralysed, except for eye movements, but remains conscious
  • Usually results from massive haemorrhage or other damage, affecting upper part of brain stem, which destroys almost all motor function, but leaves the higher mental functions intact

She said the delay in bringing the action had been due to difficulties in obtaining legal aid, which had now been granted. A full hearing before a judge in the Family Division of the High Court will begin next year.

This legal action is not being brought against the DPP but the Ministry of Justice. Ms Chahal told me it would be a "full-frontal attack on the law of murder". She said they would be seeking a declaration of the sort sometimes issued by the High Court allowing the withdrawal of nutrition and hydration from patients in a persistent vegetative state.

Murder

Last year the DPP, Keir Starmer QC issued guidance on assisted suicide in England and Wales which made it clear that deliberate killing or euthanasia, would always be prosecuted:

"It is murder or manslaughter for a person to do an act that ends the life of another, even if he or she does so on the basis that he or she is simply complying with the wishes of the other person concerned."

Last year the Scottish Parliament rejected plans to make it legal for someone terminally ill to seek help to end their life.

A spokesperson for the British Medical Association said: "The BMA is opposed to assisted suicide and to doctors taking a role in any form of assisted dying. We support the current law and are not seeking any change in UK legislation on this issue."

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-15940867

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Treasury sets 1% cap for future UK GP pay awards

By Susie Sell, 29 November 2011

Mr Osborne: raising the state pension age to 67, will ?reduce spending permanently and make the fiscal position more sustainable.'

Mr Osborne: raising the state pension age to 67, will ?reduce spending permanently and make the fiscal position more sustainable.'

In his Growth Review released on Tuesday, chancellor George Osborne said public sector pay awards will be set at an average of 1% in 2014 and 2015.

He said this and other measures, including raising the state pension age to 67, will ?reduce spending permanently in the medium and long-term and make the fiscal position more sustainable?.

But the announcement could have a knock-on effect on GP pay awards. In freezing GP pay in the previous two years the DoH has said the decision was made in light of the wider public pay freeze.

Mr Osborne called for a two-year pay freeze on all public sector workers earning more than �21,000 in his 2010 Budget, with the change largely coming into effect in April 2011.

Details of the 2012/13 GP pay award were announced earlier this month.

Source: http://www.gponline.com/channel/news/article/1106820/treasury-sets-1-cap-future-uk-gp-pay-awards/

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Seattle Times on PATH?s work with women in Nicaragua

By

One of the best ways to fight poverty and inequity is to improve the lives of women and girls, largely because this translates into healthier children and, eventually, wealthier and more stable communities overall. The Seattle Times? Kristi Heim, with photographer Erika Schultz, did a nice job describing a fairly comprehensive and innovative effort by ? Continue reading ?

Read the original:
Seattle Times on PATH?s work with women in Nicaragua

Related posts:

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  2. So what does the Seattle Times REALLY think about Gates Foundation funding?
  3. NYTimes (following Seattle Times) examines changes in Gates Fdn?s Grand?
  4. Head of PATH to leave, will head to Gates Foundation
  5. GAVI Alliance Launches Pneumonia Vaccine Project In Nicaragua
Posted by on Nov 28 2011. Filed under Humanosphere. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry

Source: http://www.globalhealthhub.org/2011/11/28/seattle-times-on-path%E2%80%99s-work-with-women-in-nicaragua/

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AA parent co. files for bankruptcy

(CBS/AP)�

Last Updated 7:39 a.m. ET

DALLAS - American Airlines' parent company, AMR, filed for Chapter 11 bankruptcy this morning.

The Texas-based AMR Corporation, the parent company of American Airlines and American Eagle, announced that the company and certain of its U.S.-based subsidiaries (including both carriers) today filed voluntary petitions for Chapter 11 reorganization in the U.S. Bankruptcy Court for the Southern District of New York, "in order to achieve a cost and debt structure that is industry competitive and thereby assure its long-term viability and ability to continue delivering a world-class travel experience for its customers."

It says the move is in the best interest of both companies and its shareholders.

The Chapter 11 reorganization process would enable to airline to continue normal business operations.

American said it is operating normal flight schedules, honoring tickets and reservations as usual, and making normal refunds and exchanges.

"American's customers are always our top priority and they can continue to depend on us for the safe, reliable travel and high quality service they know and expect from us," said Thomas W. Horton, Chairman, Chief Executive Officer and President of AMR and American Airlines.

American lost $868 million during the first nine months of this year, and was the only major U.S. airline to lose money last year.

In a press release this morning, AMR said it has approximately $4.1 billion in unrestricted cash and short-term investments, which it is said is "more than sufficient to assure that its vendors, suppliers and other business partners will be paid timely and in full for goods and services provided during the Chapter 11 process."

The Company's current cash position means the need for debtor-in-possession financing is not anticipated.

Our Board decided that it was necessary to take this step now to restore the Company's profitability, operating flexibility, and financial strength," said Horton. "We are committed to working as quickly and efficiently as possible to appropriately restructure American so that it can emerge from Chapter 11 well-positioned to assure the Company's long term viability and its ability to compete effectively in the marketplace."

American has been unable to reach a new cost-saving contract with its pilots. It has been trying to upgrade its aging fleet of planes, and has not merged with another carrier, like many of its competitors.

American was the only major U.S. airline that didn't file for bankruptcy protection after the 2001 terrorist attacks.

Source: http://feeds.cbsnews.com/~r/CBSNewsMain/~3/Fv0DrcV0PsI/

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Fifth of patients 'shun HIV test'

blood test

As UK experts call for universal HIV testing in a bid to reduce infections, latest figures reveal a fifth offered the test at a sexual health clinic refused to have it.

The Health Protection Agency is concerned too few people know their HIV status, meaning many are treated too late and risk passing it on.

It says growing numbers of people are now catching the virus within the UK.

And cases diagnosed in men who have sex with men have reached an all time high.

The figures

The number of people living with HIV in the UK reached an estimated 91,500 in 2010, up from 86,500 the year before, with a quarter of those unaware of their infection.

Some 6,660 people were newly diagnosed with HIV in the UK last year.

Data revealed infections likely acquired within the UK almost doubled in the last decade from 1,950 in 2001 to 3,640 in 2010 and exceed those acquired abroad.

This rise is mostly due to infections acquired among men who have sex with men, who remain the group most at risk of HIV infection in the UK, says the HPA.

In 2010, over 3,000 gay men were diagnosed with HIV - the highest ever annual number. One in 20 gay men is now infected with HIV nationally and in London the figure is one in 11.

The report also revealed that in 2010, one in five people visiting a sexual health or genitourinary medicine (GUM) clinic did not accept an HIV test.

Over half of the people diagnosed in 2010 came forward for testing after the point at which treatment for their infection should ideally have begun, which greatly worsens their prognosis.

The Health Protection Agency (HPA) wants universal testing for the infection in all new GP registrants and patients admitted to hospital in the areas of the country where there are high rates of HIV.

Testing call

Eight pilot projects have been carried out across England testing over 11,000 patients in hospitals and GP surgeries.

These successfully diagnosed 51 new cases of HIV, giving an overall detection rate of four in every thousand tests carried out. The HPA says this shows that universal testing would be feasible, cost-effective and acceptable.

But experience also shows not all those offered a test will agree to have one.

Dr Valerie Delpech, consultant epidemiologist and head of HIV surveillance at the HPA, says this has to change.

"People probably do not understand how easy it is to diagnose HIV and that with early treatment their chances of survival are near to normal.

"We are very concerned that a large number of people in the UK are unaware of their HIV status and are diagnosed late.

"We encourage all people to take up the offer of an HIV test in whatever health care setting."

The HPA envisages a future when no one leaves the GUM clinic without knowing their HIV status.

Just under 4% of England's population was tested for HIV in 2010. The bulk of these were people attending GUM clinics or women going for pregnancy check-ups.

Deborah Jack of the National AIDS Trust said it was time to eradicate people's fear about getting tested for HIV.

"People shouldn't be scared of HIV testing, but they should be scared of undiagnosed HIV.

"The advances in HIV treatment have been one of the biggest success stories in the 30 years since the virus first emerged, but too many people test too late and so fail to benefit from these drugs."

The Department of Health is due to publish a new Sexual Health Policy Framework in the Spring which will consider how to promote more HIV testing, especially in areas of high prevalence.

Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-15922568

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