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US Patients Five Times More Likely To Spend Last Days In ICU Than Patients In England

Patients who die in the hospital in the United States are almost five times as likely to have spent part of their last hospital stay in the ICU than patients in England. What’s more, over the age of 85, ICU usage among terminal patients is eight times higher in the US than in England, according to new research that compared the two countries’ use of intensive care services during final hospitalizations.

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Statewide Teen Smoking-Cessation Trial Is The First To Achieve Significant Increase In Prolonged Quit Rates.

Researchers at Fred Hutchinson Cancer Research Center have demonstrated that it is possible to successfully recruit and retain a large number of adolescent smokers from the general population into a smoking intervention study and, through personalized, proactive telephone counseling, significantly impact rates of six-month continuous quitting. The trial, funded by the National Institutes of Health, involved 2,151 teenage smokers from 50 high schools in Washington. Half of the schools were randomly assigned to the experimental intervention; teens in these schools were invited to take part in confidential, personalized telephone counseling designed to help motivate them to quit.  COMMENT. Despite the praise for the study, the difference in quit rates for test and control groups was only 4%.  This was despite a highly intensive effort.  No Cost[benefit analysis was done but it is highly unlikely for the process to work in the general population because of cost.

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Quality Improvements.

The Commonwealth Fund just released its State Scorecard on Health System Performance. The scorecard points to substantial opportunities to improve. If all states could reach the level achieved by the top performing states:

•Twenty-nine million more people would have health insurance—cutting the number of uninsured by more than half;

•Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care;

•Nine million more adults age 50 and older would receive recommended preventive care, and almost 800,000 more children would receive key vaccinations;

•Five billion dollars could be saved annually by avoiding preventable hospital admissions and readmissions for vulnerable elderly and disabled residents.

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Young Adults Visit Doctors Least At An Age When Risky Behavior Peaks

A study performed at  The University of Rochester Medical School   showed that when adolescents graduate to young adulthood, their preventive care tends to fall by the wayside. A recent study has found that young adults are much less likely to use ambulatory or preventive care, even though their mortality rate is more than twice that of adolescents. COMMENT: I have difficulty understanding why this should surprise anyone when the  various insurance programs, including Medicaid fail to pay for counseling by primary care practitioners. Further once the individual reaches 18 years of age eligibility for Medicaid vanishes.

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Kaiser survey says family health plan could cost $30,083 per year by 2019.

“The most important healthcare document released this week was not Sen. Max Baucus’s Healthy Future Act. It was the Kaiser Family Foundation’s 2009 Employer Benefits Survey.” The survey, “which polls employers about health benefits to assemble a detailed look at the actual cost of healthcare, fits it squarely in our pocketbooks. The truth is we all pay, and much more than we recognize, for healthcare.” According to Kaiser, “the average healthcare coverage for the average family now costs $13,375.” Over the past decade, “premiums have increased by 138 percent.

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New Rabies Vaccine May Require Only A Single Shot, Not Six

ScienceDaily (Sep. 20, 2009) — A person, usually a child, dies of rabies every 20 minutes. However, only one inoculation may be all it takes for rabies vaccination, according to new research published in the Journal of Infectious Diseases by researchers at the Jefferson Vaccine Center.

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Showerheads can be a breeding ground for infectious bacteria.

According to a recent study by researchers from the University of Colorado at Boulder, dirty showerheads in homes may well be a potential breeding ground for infectious bacteria – Mycobacterium avium, which can cause lung infections when inhaled or swallowed.  The study, funded by the National Institute of Occupational Safety and Health and the Alfred P. Sloan Foundation, is part of a larger effort that is analyzing the microbiology of the indoor environment and its role in spreading to illness within the house. Comment: BUT, what evidence is there that people have been made ill by taking a shower? This seems to be an example of money looking for a spending source. In a depressed economy it is this kind of research that makes academics look bad,  It is certainly not a random sample of homes in the US. Ivan Illich would have loved this action.

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Researcher Questions Federal Guidelines For Seasonal And Swine Flu Vaccines.

New research published by Yale School of Public Health has found that more people are likely to avoid illness if vaccines are given out first to those most likely to transmit viruses, rather than to those at highest risk for complications. This research differs from current vaccination recommendations of the Centers for Disease Control (CDC) and the Advisory Committee on Immunization Practices (ACIP). The Yale study appears in the August 20 issue of the journal Science online at the Science Express website, http://www.sciencemag.org/sciencexpress .

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Tobacco plants yield the first vaccine for the dreaded ‘cruise ship virus.

Scientists have used a new production technology to develop a vaccine for norovirus, the unpleasant package of diarrhea and vomiting that has destroyed the costly holidays of thousands of cruise ship vacationers.  Norovirus is the second most common viral infection in the U.S. after the flu, “can spread like wildfire through passenger liners, schools, offices and military bases.”

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No Evidence Of ‘Unhealthful’ Relation Between Animal Foods And Breast Cancer.

The September 2009 issue of The American Journal of Clinical Nutrition reports the results of 3 human studies designed to better delineate the relation between animal foods and breast cancer risk. “These studies highlight two very important points,” said American Society for Nutrition Spokesperson Shelley McGuire, PhD. “First we all need to remember that there are really no such things as ‘bad’ foods. Second, observational studies that show associations between diet and health need to be considered with a proverbial grain of salt. These studies clearly provide additional and strong evidence that consumption of meat and dairy products by women does not, by itself, increase breast cancer risk. Further, moderate and mindful consumption of these foods can be very important in attaining optimal nutrition for most women who often do not consume sufficient iron and calcium.”

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