Researchers have found that those in rural populations have inadequate accessibility to drug abuse services, according to an article in the fall 2007 issue of the Journal of Rural Health. The authors found that while there is increasing literature on access to mental health services, there is a lack of it concerning drug abuse services in rural areas.
"A survey of Iowa's acute care hospitals found that 40 percent of rural facilities needed but did not offer substance abuse prevention and mental health promotion services," said the study.
When it comes to utilized access, rural drug addicts have equal or worse utilized access than urban residents. The study concludes that much more research needs to be done in this area to improve both the amount of treatment available and the actuality of a person utilizing it.
Thursday, April 24, 2008
Link between education and mortality and life expectancy
A study in the March/April 2008 issue of Health Affairs shows a link between education and life expectancy. "Between the 1980s and 2000, life expectancy increases occurred nearly exclusively among high-education groups," stated the report.
Comparing the years 1981-88 with 1991-98, life expectancy at age twenty-five grew 1.4 years for people with a high school education but only 0.5 years for those with a low education. Also, in 2000, "life expectancy for a 25-year-old with a high school diploma or less was fifty years. For a person with some college, life expectancy was nearly 57 years."
The gap was largest among women in general. Life expectancy at 25 declined for the less educated women and rose a year or more for more educated women.
Heart disease, cancer and COPD contributed to 60 percent of the deaths in the sample in 1990 and 2000. It was also shown that increased education differences among the elderly account for much of the growing gap in mortality and life-expectancy. Smoking was also a big factor and results showed that smoking was more prevalent among the less educated. Obesity is also more common among the less-educated. Thus, the study concluded that better efforts to provide successful health interventions among less-educated groups may be needed to reduce socioeconomic disparities in health.
Comparing the years 1981-88 with 1991-98, life expectancy at age twenty-five grew 1.4 years for people with a high school education but only 0.5 years for those with a low education. Also, in 2000, "life expectancy for a 25-year-old with a high school diploma or less was fifty years. For a person with some college, life expectancy was nearly 57 years."
The gap was largest among women in general. Life expectancy at 25 declined for the less educated women and rose a year or more for more educated women.
Heart disease, cancer and COPD contributed to 60 percent of the deaths in the sample in 1990 and 2000. It was also shown that increased education differences among the elderly account for much of the growing gap in mortality and life-expectancy. Smoking was also a big factor and results showed that smoking was more prevalent among the less educated. Obesity is also more common among the less-educated. Thus, the study concluded that better efforts to provide successful health interventions among less-educated groups may be needed to reduce socioeconomic disparities in health.
Improving breast cancer treatment
In addition to standard chemotherapy for breast cancer, one study shows that weekly treatment with a therapy called paclitaxel improves disease-free and overall survival in women with breast cancer.
Published in The New England Journal of Medicine, the study compared two different drugs--docetaxel and paclitaxel--in the treatment of breast cancer.
A previous study showing the benefits of paclitaxel established a new standard of care for operable breast cancer and led to approval of paclitaxel for a certain type of breast cancer. Another study caused a similar occurrence with docetaxel. This study however, showed that paclitaxel was most helpful.
Published in The New England Journal of Medicine, the study compared two different drugs--docetaxel and paclitaxel--in the treatment of breast cancer.
A previous study showing the benefits of paclitaxel established a new standard of care for operable breast cancer and led to approval of paclitaxel for a certain type of breast cancer. Another study caused a similar occurrence with docetaxel. This study however, showed that paclitaxel was most helpful.
Limited food choices and obesity
Is there a link between obesity and food sufficiency (or insufficiency) in the household? There is no strong evidence to suggest such a link, according to a study published in April's American Journal of Public Health.
Similar U.S. and Canadian studies in the past provided varying and inconclusive results, which largely relied on self-reported data concerning height and weight. Recent trends show that rates of obesity are higher when the data is self-reported than when it is measured.
The new study looked at both self-reported and measured height and weight data among a sample population in Canada. Also, two different models were used to determine sufficiency of food in the household. For example, one question was "Were you or anyone in your household concerned that there would not be enough to eat because of lack of money?"
"When self-reported height and weight data were used, obsesity was significantly higher in households experiencing any of the dimensions of food insecurity," reported the authors. "Rates were not different on any of these dimension when measured height and weight data were used." The four household food security status groups created were: food secure, food insecure without hunger, food insecure with mild hunger, and food insecure with severe hunger.
However, further analysis showed an association between obesity and food insecurity with mild hunger. Under one of the models, when measured height and weight were used, females living in households with food insecurity and mild hunger were almost three times more likely to be obese than those living in food-secure households.
Despite the one association, there appears to be no link (or a weak one) between obesity and the level of food sufficiency in the household. One hypothesis is that "decreased food purchasing power results in the purchasing of energy-dense foods and thus increased energy intakes." This person may tend towards obesity as a result of eating energy-dense, nutrient poor foods. Still no study shows any conclusive evidence of this.
Wednesday, April 23, 2008
Study finds improvements to be made in pre-hospital stroke training in rural Montana
Improvement in stroke-care training is needed for first responders and emergency medical technicians in frontier areas of Montana, according to the spring 2008 issue of Journal of Rural Health. A 2006 telephone survey amongst rural and urban Montana technicians revealed that while both had similar levels of stroke knowledge, stroke screens and stroke protocols were less likely to be used in the frontier areas.
Respondents in frontier counties were more likely to be older, have fewer EMS personnel working in their service and to be located farther away from a health care facility with CT scan compared to respondents in urban counties.
The new drugs being used to treat stroke are most effective if administered within three hours of symptom onset. Patients are more likely to arrive at the emergency department within these three hours if transported by EMS rather than private vehicle. This has caused many states to implement stroke protocols and screening tools to be administered by EMS providers.
From the survey, opportunities for improvement were found and a high level of interest in further training was identified.
Respondents in frontier counties were more likely to be older, have fewer EMS personnel working in their service and to be located farther away from a health care facility with CT scan compared to respondents in urban counties.
The new drugs being used to treat stroke are most effective if administered within three hours of symptom onset. Patients are more likely to arrive at the emergency department within these three hours if transported by EMS rather than private vehicle. This has caused many states to implement stroke protocols and screening tools to be administered by EMS providers.
From the survey, opportunities for improvement were found and a high level of interest in further training was identified.
Saturday, March 29, 2008
Hospitals: bacterial breeding grounds
My favorite session at the journalism conference so far has been the one Friday on the reporting and prevention of hospital acquired infections. Each of the panelists spoke very passionately about the subject. Especially emotional was hearing from the woman on panel who's son died two years ago from hospital acquired MRSA.
Fortunately I have not had to spend much time in a hospital but when I am there, or even in the doctor's office I am very aware of the invisible bacteria lurking on every surface. I am a firm supporter of better cleaning habits in hospitals yet I can't help but think that spread of bacteria is inevitable. Nevertheless, it sounds like there are certain things hospitals and employees can do that are fairly simple, such as washing or changing out their lab coats more regularly.
The session reminded me of when my grandmother was in the hospital two years ago with cancer. My aunt took it upon herself to disinfect the room herself. At least patients or their families have some control. Of course it should be the responsibility of the hospital to adequately disinfect the room after each patient, but as is often the case, individuals must look after their own health.
Something else comes to mind: hospital cafeterias. Whenever I hear of people who go to the hospital just to eat lunch there, I wonder what risk is involved. Panelists mentioned that certain cleaners won't kill a bacteria called c. diff. We pick up all kinds of bacteria in our everyday lives but why spend more time at a place that is full of sick people than we have to?
Fortunately I have not had to spend much time in a hospital but when I am there, or even in the doctor's office I am very aware of the invisible bacteria lurking on every surface. I am a firm supporter of better cleaning habits in hospitals yet I can't help but think that spread of bacteria is inevitable. Nevertheless, it sounds like there are certain things hospitals and employees can do that are fairly simple, such as washing or changing out their lab coats more regularly.
The session reminded me of when my grandmother was in the hospital two years ago with cancer. My aunt took it upon herself to disinfect the room herself. At least patients or their families have some control. Of course it should be the responsibility of the hospital to adequately disinfect the room after each patient, but as is often the case, individuals must look after their own health.
Something else comes to mind: hospital cafeterias. Whenever I hear of people who go to the hospital just to eat lunch there, I wonder what risk is involved. Panelists mentioned that certain cleaners won't kill a bacteria called c. diff. We pick up all kinds of bacteria in our everyday lives but why spend more time at a place that is full of sick people than we have to?
Friday, March 28, 2008
Mental Illness: How do we treat it?
Panelists at the conference session on violence and mental health disagreed with the ways that mental illness should be viewed and treated.
One of the speakers, Harvey Rosenthal, is a man who works at a hospital and also has bipolar disorder strongly advocated for better services that are more attractive and engaging. He said that many programs today have low expectations for a mentally ill person's recovery and have an overemphasis on medication.
I have always thought that certain types of severe mental illness seem to leave the people that are afflicted with them in a hopeless situation. I would like to hear about cases in which these people show great progress with treatment. The panelists did talk about how people who are treated can show substantial recovery rates and are no more likely to commit acts of violence than anyone else. However, I rarely read or hear about people who are in effective treatment programs. I agree with Harvey Rosenthal in thinking these positive stories would be good for journalists to tell because it could reduce the stigma associated with mental illness, as well as highlight the kind of treatment programs that lead to happy healthy people.
I am also skeptical and wary of most medication. While it seems like some mental illnesses require medication I think that any look into alternative methods of treatment is an excellent idea.
About a year ago I heard one particular horror story from a parent who's son was on anti-depressant medication as treatment for another non-mental problem. In his supposedly "rare" case, the treatment not only made him hear voices that told him to kill himself, he also began experiencing other symptoms that included memory problems. Luckily he told his mother what he was experiencing and got to the doctor. His mother told me he almost experienced permanent brain damage. This confirmed my opinion that these types of medication are suspicious. I'm no expert and I'm sure they help a lot of people but I guess my point is that people should be aware of a medication's potential side effects and try to stay informed on what their doctor is prescribing, rather than blindly following their orders.
One of the speakers, Harvey Rosenthal, is a man who works at a hospital and also has bipolar disorder strongly advocated for better services that are more attractive and engaging. He said that many programs today have low expectations for a mentally ill person's recovery and have an overemphasis on medication.
I have always thought that certain types of severe mental illness seem to leave the people that are afflicted with them in a hopeless situation. I would like to hear about cases in which these people show great progress with treatment. The panelists did talk about how people who are treated can show substantial recovery rates and are no more likely to commit acts of violence than anyone else. However, I rarely read or hear about people who are in effective treatment programs. I agree with Harvey Rosenthal in thinking these positive stories would be good for journalists to tell because it could reduce the stigma associated with mental illness, as well as highlight the kind of treatment programs that lead to happy healthy people.
I am also skeptical and wary of most medication. While it seems like some mental illnesses require medication I think that any look into alternative methods of treatment is an excellent idea.
About a year ago I heard one particular horror story from a parent who's son was on anti-depressant medication as treatment for another non-mental problem. In his supposedly "rare" case, the treatment not only made him hear voices that told him to kill himself, he also began experiencing other symptoms that included memory problems. Luckily he told his mother what he was experiencing and got to the doctor. His mother told me he almost experienced permanent brain damage. This confirmed my opinion that these types of medication are suspicious. I'm no expert and I'm sure they help a lot of people but I guess my point is that people should be aware of a medication's potential side effects and try to stay informed on what their doctor is prescribing, rather than blindly following their orders.
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