October 7, 2009, 8:40 PM CT

Insured African-Americans more likely to use emergency room

Health insurance, and the access it provides to a primary care physician, should reduce the use of a major driver of health care costs: the emergency room.

Yet in a policy brief released recently by the UCLA Center for Health Policy Research, scientists observed that in California, privately insured African Americans enrolled in HMOs are far more likely to use the ER and to delay getting needed prescription drugs than HMO-insured members of other racial and ethnic groups. The research was funded by the California Office of the Patient Advocate.

It's not that African Americans fail to see their doctors, scientists say. In fact, of all HMO enrollees, African Americans were the most likely to report seeing a doctor in the past year, as per the authors of the brief, "African-Americans in Commercial HMOs Are More Likely to Delay Prescription Drugs and Use the Emergency Room."

Patient income and illness did not predict ER or prescription drug use either. Scientists found greater ER use and delays in getting prescription drugs even among African American HMO enrollees who were generally healthy and had higher incomes.

While the reasons behind the ER use and drug delays among African Americans are the subject of future research, main author Dylan Roby, a research scientist with the UCLA Center for Health Policy Research, said the data suggests that the way health maintenance organizations or their contracted physicians provide care and the way patients respond to that care may create obstacles to timely primary care, as well as foster excessive use of the emergency room and delays in getting needed medications......... Posted by: Janet      Read more         Source

October 7, 2009, 8:01 PM CT

Why African American lung cancer patients respond differently?

Clinical research out of University Hospitals Case Medical Center has observed that African Americans with a common form of lung cancer have a lower frequency of drug-sensitizing genetic mutations, which may impact response to new cancer-fighting drugs. Published online in the Journal of Clinical Oncology, the study by Rom Leidner, MD, and his colleagues report that ethnicity plays a significant role in non-small cell lung cancer (NSCLC) genetics and more personalized therapys appears to be beneficial to cancer patients.

African American patients with NSCLC are significantly less likely than Caucasian counterparts to harbor activating mutations of the epidermal growth factor receptor (EGFR) gene in their cancers, which suggests that common oral EGFR inhibitor drugs, such as Tarceva (erlotinib), are unlikely to yield dramatic remissions. Additionally, cancer biopsy testing revealed that African American patients with NSCLC are significantly more likely to have increased copies of the EGFR gene than Caucasians. Detection of increased copies of the Her2 gene in breast cancer, a gene closely correlation to EGFR, has been the basis for major advances in treatment using drugs which target Her2.

"We are finding that ethnicity may play a significant role in a variety of cancers," says Dr. Leidner, an oncologist with Ireland Cancer Center of University Hospitals Case Medical Center and Visiting Instructor at Case Western Reserve University School of Medicine. "It was already known that a higher proportion of East Asian NSCLC patients harbor mutations of the EGFR gene than Caucasians, and that these mutations are linked to a higher likelihood of major responses to EGFR inhibitors. Before our study, however, surprisingly little data existed for African American patients with this common type of lung cancer."........ Posted by: Scott      Read more         Source

October 7, 2009, 7:58 PM CT

Autism Speaks' genetic resource exchange

Autism Speaks' Autism Genetic Resource Exchange (AGRE) and the Autism Tissue Program (ATP) continue to play an integral role in continuing genetic research and new findings in the complex autism inheritance and causation puzzle. As per a research findings reported in the October 7, edition of the journal Nature, an extensive research team of more than 75 research institutions identified semaphoring 5A, a gene implicated in the growth of neurons to form proper contacts and connections with other neurons. Prior studies have reported lower levels of this protein in blood samples from individuals with autism as in comparison to controls. In this study, the scientists were also able to extend that observation to the brain tissue of individuals with autism vs. control brains.

"Taken as a whole, results from this study are consistent with reports from the past few years implicating gene/molecules involved with cell to cell contact and communication," explained Andy Shih, Ph.D., Autism Speaks vice president of scientific affairs. "If this finding holds and is further supported with additional research such as a functional study of the variant semaphorin 5A, this molecule could represent another biological target for pharmaceutical intervention in the future and possible therapy for some individuals with autism"......... Posted by: JoAnn      Read more         Source

October 7, 2009, 7:10 AM CT

Diffuse Optical Tomography for breast cancer screening

Clemson University scientists in collaboration with scientists at the University of Bremen, Gera number of, are working to make the physical pain and discomfort of mammograms a thing of the past, while allowing for diagnostic imaging eventually to be done in a home setting.

The group is fine-tuning Diffuse Optical Tomography (DOT) to create high-resolution images from a scattering of infrared and visible light for the early detection of breast cancer. While the method is less expensive, safer and more comfortable than X-rays used in mammograms, the problem has been generating a strong enough resolution to detect smaller breast cancers.

Mathematical sciences professors Taufiquar "T.K." Khan of Clemson and Peter Maass of the University of Bremen are in the process of developing mathematical models to improve resolution.

"The problem with DOT is that it is a 3-D method where photon density waves launched from a source travel in a banana-shaped path due to multiple scattering, whereas X-rays follow straight lines which make the mathematical problem more manageable and the resolution of the image sharper." said Khan. "With DOT, near-infrared or near-visible photons make the process safer for the body than with the radiation of X-rays, but they are difficult to track because of the scattering and absorption. So we are coming up with equations that will help get us from capturing cancers that are 4 millimeters in size, down to capturing those as small as 1 millimeter"......... Posted by: Janet      Read more         Source

October 7, 2009, 7:06 AM CT

Many children are exposed to violence and abuse

A newly released study from the University of New Hampshire finds that U.S. children are routinely exposed to even more violence and abuse than has been previously recognized, with nearly half experiencing a physical assault in the study year.

"Children experience far more violence, abuse and crime than do adults," said David Finkelhor, director of the UNH Crimes against Children Research Center and the study director. "If life were this dangerous for ordinary grown-ups, we'd never tolerate it".

The research was sponsored by the U.S. Department of Justice (DOJ), Office of Juvenile Justice and Delinquency Prevention (OJJDP) and supported by the Centers for Disease Control and Prevention (CDC). The research results are presented in the journal Pediatrics and an Office of Justice Programs/OJJDP bulletin titled "Children's Exposure to Violence: A Comprehensive National Survey".

UNH scientists asked a national sample of U.S. children and their caregivers about a far broader range of exposures than has been done in the past.

As per the research, three out of five children were exposed to violence, abuse or a criminal victimization in the last year, including 46 percent who had been physically assaulted, 10 percent who had been maltreated by a caregiver, 6 percent who had been sexually victimized, and 10 percent who had witnessed an assault within their family......... Posted by: JoAnn      Read more         Source

October 6, 2009, 7:16 PM CT

Spirituality in end-of-life care

Guidelines derived from a recent Consensus Conference, including recommendations on the role of healthcare providers in the assurance of quality spiritual care to patients in a palliative care setting, are published in a comprehensive report in Journal of Palliative Medicine, a peer-evaluated publication from Mary Ann Liebert, Inc. (www.liebertpub.com). Journal of Palliative Medicine is the official journal of the Center to Advance Palliative Care (CAPC) and an official journal of the Hospice and Palliative Nurses Association (HPNA). The article is available free online at www.liebertpub.com/jpm.

The article, "Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference," represents the final Consensus Report of a conference sponsored by the Archstone Foundation of Long Beach, CA. As per Joseph F. Prevratil, JD, President and CEO, "The report's recommendations seek to ensure that spiritual care is a fundamental component of quality palliative care, which strives to prevent and relieve suffering for seriously ill patients and their families."

"For the first time we have a practical model for the implementation of inter-professional spiritual care which will result in improved healthcare outcomes for patients," says Christina Puchalski, MD, MS, FACP, Co-Principal Investigator and main author of the Consensus Report, from The George Washington Institute for Spirituality and Health (GWish) at the George Washington University Medical Center......... Posted by: Janet      Read more         Source

October 6, 2009, 8:04 AM CT

High-fat diet impairs muscle health

Skeletal muscle plays a critical role in regulating blood sugar levels in the body. But few studies have comprehensively examined how obesity caused by a high-fat diet affects the health of muscle in adolescents who are pre-diabetic.

In a paper published tomorrow in the scientific journal PLoS One, a team of McMaster University scientists report that the health of young adult muscle declines during the pre-diabetic state, which is when blood sugar levels are higher than normal but lower than during Type 2 diabetes. The scientists observed that during this period significant impairments occur in the muscle, even though it may be functioning normally.

"Based on the way the muscles performed, you would believe that they're still healthy," said Thomas Hawke, an associate professor of pathology and molecular medicine of the Michael G. DeGroote School of Medicine at McMaster University. "But the fact is the muscle is not healthy. It's undergone a lot of pathological changes".

Hawke led a team of scientists at McMaster and York universities in using mice to examine how a high-fat diet, leading to obesity, affected the form and function of skeletal muscle. The scientists found the high-fat diet resulted in insulin resistance, large increases in fat mass and weight gain. But it also led to initial adaptations in the muscle......... Posted by: JoAnn      Read more         Source

October 6, 2009, 8:02 AM CT

Body posture affects confidence

Sitting up straight in your chair isn't just good for your posture it also gives you more confidence in your own thoughts, as per a newly released study.

Scientists observed that people who were told to sit up straight were more likely to believe thoughts they wrote down while in that posture concerning whether they were qualified for a job.

Conversely, those who were slumped over their desks were less likely to accept these written-down feelings about their own qualifications.

The results show how our body posture can affect not only what others think about us, but also how we think about ourselves, said Richard Petty, co-author of the study and professor of psychology at Ohio State University.

"Most of us were taught that sitting up straight gives a good impression to other people," Petty said. "But it turns out that our posture can also affect how we think about ourselves. If you sit up straight, you end up convincing yourself by the posture you're in".

Petty conducted the study with Pablo Briol, a former postdoctoral fellow at Ohio State now at the Universidad Autnoma de Madrid in Spain, and Benjamin Wagner, a current graduate student at Ohio State. The research appears in the October 2009 issue of the European Journal of Social Psychology........ Posted by: JoAnn      Read more         Source

October 6, 2009, 8:00 AM CT

Did mom use her pump during pregnancy?

Expectant mothers who eschew asthma therapy during pregnancy heighten the risk transmitting the condition to their offspring, as per one of the largest studies of its kind reported in the European Respiratory Journal A research team from the Universit de Montral, the Hpital du Sacr-Cur de Montral and Sainte-Justine University Hospital Research Center observed that 32.6 percent of children born to mothers who neglected to treat their asthma during pregnancy developed the respiratory illness themselves.

"Uncontrolled maternal asthma during pregnancy could trigger a transient yet important reaction in the fetus that affects lung development and could subsequently increase the likelihood of a baby developing asthma in later childhood," warns main author Dr. Lucie Blais, a professor at the Universit de Montral's Faculty of Pharmacy and researcher at the Hpital du Sacr-Cur de Montral.

As part of the study, the research team examined a decade of health records for 8,226 children from birth to 10 years of age born to asthmatic mothers. Parents of these children were also mailed questionnaires requesting additional facts concerning familial medical history, lifestyle habits and environment.

"We observed that failing to control maternal asthma during pregnancy clearly has an impact on asthma in offspring a consequence that is independent of other contributing factors," says Dr. Blais. "It is of great importance for physicians to adequately treat asthmatic mothers during pregnancy, not only for the favourable outcome of pregnancy but also for the benefit of the child."........ Posted by: JoAnn      Read more         Source

October 6, 2009, 7:41 AM CT

Violent upbringing begets domestic violence

A recent study from the latest issue of Personal Relationships shows that individuals who have experienced violence at an early age may have trouble adjusting to healthy, adult romantic relationships and are at a higher risk to experience marital difficulties. The research reveals that early exposure to a violent environment is likely to lead to domestic violence situations during the later part of life. Feelings of insecurity, abandonment anxiety, and intimacy issues are also likely to plague these romantic connections.

Additionally, the dynamics of the way couples react and communicate with each other is also correlation to the likelihood of domestic violence within a relationship. For example, men tend to use violence towards their partner as a means to exert a desire for personal space or avoidance of emotional issues in response to the "clingy" or intrusive behavior of his female partner.

This research highlights the importance of domestic violence prevention efforts starting at the childhood level, within family environments as well as school and community based settings. Moreover, prevention efforts allow the victim to relate long-harbored painful childhood violent experiences and rectify internal representations of self that cause long-term damage to valuable inter-personal relationships and families......... Posted by: JoAnn      Read more         Source