What Is Mesothelioma? Lung Cancer From Asbestos
Leave a CommentMesothelioma is a form of lung cancer that is almost always caused by asbestos exposure and is most commonly found in the outer lining of the lungs called the mesothelium. A majority of the people who develop mesothelioma contract this cancer through breathing in asbestos fibers or being exposed to asbestos dust while on the job. In cases where mesothelioma is found in a person with no previous occupational exposure, it is summized that the exposure may have stemmed from asbestos fibers found on the clothes of someone in their home who worked in an area where asbestos dust was found.
There are a number of reasons that make diagnosing mesothelioma in its early stages extremely difficult. The symptoms of mesothelioma can have a latency period of anywhere between 20 to 50 years after the initial asbestos contact, which means by the time the symptoms begin to show, the cancer is already within its advanced stages. Once symptoms are present, diagnosis is still not a speedy process. There are a number of diseases that mirror the symptoms that are found in mesothelioma patients and because of this mesothelioma is often the last stop – usually without prior mention from the patient about the possibility of previous asbestos exposure.
The success of treatment for mesothelioma is dependent on the stage in which the cancer is found. As it is found that most mesothelioma is not discovered until the advanced stages, mesothelioma treatment is often referred to as “unsuccessful.” Studies show that when found within either stage I or II, treatment for mesothelioma – usually with a combination of radiation and chemotherapy – is successful in extending the patient’s life for five years at a rate of 74.6% (Wikipedia). There are also alternative forms of therapy that can be used in conjunction with conventional treatments, that have been shown on occasion to decrease the size of mesothelioma found in a patient.
Asbestos was used for many years in a wide array of household and industrial products because of its multiple types and uses. It is fireproof, and can also be used as an insulator, thus allowing it to become very popular during the Industrial Revolution. It is unknown whether or not people were aware of the dangers of asbestos fibers at that time, but by the 1900’s the risk of asbestos was becoming more obvious. People who lived in mining towns would develop lung problems, and general studies showed that asbestos workers died at a young age. Asbestos, in an undisturbed state, seems to pose no threat. However, as soon as it becomes damaged or friable, the fibers are able to be ingested, thus potentially leading to these or other health problems. Although some companies were aware of this danger, they continued to work with products containing asbestos with no regard to their employees. These blatant injustices are the reason for the popularity of mesothelioma in the field of litigation.
Written by Michelle Griffin
The Asbestos Cancer and Mesothelioma Support Center at Asbestos.Net
http://www.asbestos.net
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Calls For Compulsory Flu Jabs For NHS Staff
The Royal College of General Practitioners has called for hospital doctors, GPs, nurses, carers and other staff to have compulsory flu jabs. It is reported that Department of Health figures show fewer than one in seven frontline NHS staff had a flu jab last year! Such low levels of vaccination among staff were identified by the Health Protection Agency as a significant factor in the flu outbreak which affected a number of hospitals at the end of last year.
Dr George Kassianos of the Royal College of General Practitioners
said: “The only way to boost the effectiveness of the flu vaccine is to immunise the people who are delivering the care. You are placing patients’ at risk if you give them the flu.”
Protecting yourself and those you care for
This is a most concerning state of affairs – particularly for older people more likely to be receiving medical treatment or attending appointments. Quite clearly, it’s wise to take precautions to protect yourself or those you are caring for from the risk of flu infection – and the potentially dangerous consequences that might follow.
It’s comforting, therefore, to know that, in addition to a flu jab, many self-help measures can be taken – to avoid infection, to build up natural immunity and to obtain effective natural relief. Care
Directions presents a comprehensive guide to Colds & Flu Protection.
Read it now
here.
http://www.caredirections.co.uk
Pitt Study Finds Children Of Bipolar Parents Have Increased Risk Of Psychiatric Disorders
Children and teens of parents with bipolar disorder have an increased risk of early-onset bipolar disorder, mood disorders and anxiety disorders, according to a study by University of Pittsburgh School of Medicine researchers published in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
An estimated one in 100 children and teens worldwide has bipolar disorder. Identifying the condition early may improve long-term outcomes, potentially preventing high psychosocial and medical costs. Researchers from the Pittsburgh Bipolar Offspring Study suggest that having family members with bipolar disorder is the best predictor of whether their children will go on to develop the condition.
“A bipolar diagnosis at a young age deprives children of the opportunity to experience normal emotional, cognitive and social development, and this is why there is an urgent need to identify, diagnose and treat these patients early on,” said Boris Birmaher, M.D., director of the Child and Adolescent Anxiety Program and co-director of the Child and Adolescent Bipolar Services at Western Psychiatric Institute and Clinic of UPMC, endowed chair in Early Onset Bipolar Disease and professor of psychiatry at the University of Pittsburgh School of Medicine.
Compared with the offspring of control parents, children with bipolar parents had a 14-fold increased risk of having a bipolar spectrum disorder, as well as a two-to three-fold increase of having a mood or anxiety disorder. Children in families where both parents had bipolar disorders also were more likely to develop the condition than those in families containing one parent with bipolar disorder. However, their risk for other psychiatric disorders was the same as children who had one bipolar parent.
Bipolar disorder, commonly called manic-depression, often emerges in adolescence, and is characterized by intense swings between depression, mania and periods with mixed symptoms. Bipolar spectrum disorders consist of three sub-types. Bipolar I (BP-I) is characterized by episodes of full-blown mania and major depression; bipolar II (BP-II) involves episodes of less severe mania, called hypomania, and major depression; and the third sub-type is called Bipolar Not Otherwise Specified (BP-NOS), which involves symptoms consistent with elated or irritable moods that are disruptive to daily living, plus two to three other symptoms of bipolar disorder.
In this blind study, researchers compared 388 children and teens, ages 6 to 18, of 233 parents with BP-I and BP-II to 251 offspring of 143 demographically matched control parents. Parents were assessed for psychiatric disorders, family mental health history, family environment, exposure to negative life events, and also were interviewed about their children. Children were assessed directly for bipolar disorder and other psychiatric disorders by researchers who did not know their parents’ diagnoses.
“Consistent with prior research, most parents with bipolar disorder recalled that their illness started before age 20 and about 20 percent had illness that started before age 13,” said Dr. Birmaher. “In contrast, most of their children developed their first bipolar disorder episode before age 12, suggesting the possibility that parents were more perceptive of their children’s symptoms early in life or perhaps that bipolar disorder appears earlier in new generations.”
The researchers note that these findings have important clinical implications. “Clinicians who treat adults with bipolar disorder should question them about their children’s psychopathology to offer prompt identification and early interventions for any psychiatric problems that may be affecting the children’s functioning, particularly early-onset bipolar disorder,” said Dr. Birmaher. “Further studies are needed to help determine the clinical, biological and genetic risk factors that may be modified to prevent the development of psychiatric disorders in the children of those with bipolar disorder.”
Co-authors of the Pittsburgh Bipolar Offspring Study include David Axelson, M.D., Kelly Monk, R.N., Catherine Kalas, R.N., Benjamin Goldstein, M.D., Mary Beth Hickey, B.A., Mihaela Obreja, M.S., Mary Ehmann, M.A., Satish Iyengar, Ph.D., Warl Shamseddeen, M.D., David Kupfer, M.D., and David Brent, M.D., all from WPIC and the University of Pittsburgh Department of Psychiatry.
The Pittsburgh Bipolar Offspring Study was supported in part by funding provided by the National Institute of Mental Health.
Western Psychiatric Institute and Clinic (WPIC) is considered to be one of the nation’s foremost university-based psychiatric care facilities and one of the world’s leading centers for research and treatment of mental health disorders. WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine and is the flagship of UPMC Behavioral Health, the psychiatric specialty division of the University of Pittsburgh Medical Center.
University of Pittsburgh Medical Center, U.S. Steel Tower, 600 Grant St., 57th Floor, Pittsburgh, PA 15213 United States
http://www.upmc.com
Tamiflu-Resistant Flu On The Rise
The type A seasonal flu virus (a subtype of the H1N1 strain) appears to be developing increasing restistance to the most widely used flu drug in
the US, Tamiflu (generic name oseltamivir). For the first time, type A viruses were starting to show increased resistance to Tamiflu in the 2007-2008
flu season, but this year the resistance is higher and more widespread.
These are the findings of a study that has been published early online in Journal of the American Medical Association, JAMA because of its
public health importance said a press release from the publisher.
The study was the work of Dr Nila J. Dharan, of the Centers for Disease Control and Prevention (CDC), Atlanta, and colleagues who looked at trends
and characteristics of patients infected with H1N1 type A Tamiflu-resistant and susceptible flu.
The viruses were tested as part of ongoing surveillance and were identified and submitted to the CDC between September 2007 and May 2008, and
then a year later, between 28 September 2008 and 19 February 2009.
The researchers found that during the 2007-2008 flu season, the H1N1 type A flu strains accounted for about 19 per cent of circulating flu strains in
the US. Of the 1,155 US H1N1 type A viruses tested during that season, 142 of them (12 per cent) showed resistance to Tamiflu (oseltamivir).
From that period (2007-2008) the researchers found data was available for 99 people infected with Tamiflu-resistant and 182 people infected with
Tamiflu-susceptible flu. For the resistant cases the median (the midpoint of the range) age was 19, while 5 patients ended up in hospital and 4
died.
On analyzing the demographic, illness and symptom characteristics available on the infected people, the researchers found no significant differences
between those infected with Tamiflu-resistant and those infected with Tamiflu-susceptible flu strains and neither did they find any links between use of
Tamiflu and flu cases due to infection with H1N1 type A in the US.
The data on the current flu season, 2008-2009 is obviously not complete since the season is not yet finished, but an analysis on that which has been
gathered so far shows that Tamiflu resistance in H1N1 type A strains continue at a high level. Up to 19 February 2009, Tamiflu resistance was found
in 264 of 268 (98.5 per cent) of the H1N1 type A viruses tested by the CDC.
The authors wrote that:
“The emergence of oseltamivir resistance has highlighted the need for the development of new antiviral drugs and rapid diagnostic tests that determine
viral subtype or resistance, as well as improved representativeness and timeliness of national influenza surveillance for antiviral resistance.”
In December last year the CDC issued draft guidelines for the use of antiviral flu medications in line with what they found after analyzing the data
coming in for the current season. They recommended that doctors and other health professionals:
“Consider the results of patient testing and local influenza surveillance data on circulating types and subtypes of influenza viruses in deciding whether
oseltamivir [tamiflu] alone could be used. These guidelines provide options, including preferential use of [the anti-viral drug] zanamivir or a
combination of oseltamivir and [the anti-viral drug] rimantadine, which might be more appropriate in treating patients who might have influenza
caused by an oseltamivir-resistant virus.”
In an accompanying editorial, Dr David M. Weinstock of the Dana-Farber Cancer Institute, Boston, and Dr Gianna Zuccotti of Brigham and Women’s
Hospital, Boston, who is also Contributing Editor, JAMA, Chicago, wrote:
“The understanding of influenza biology and epidemiology has advanced markedly; however, the global dissemination of oseltamivir [Tamiflu]-
resistant influenza came as a great surprise.”
There is no doubt that further new susprises will occur in the “perpetual struggle with influenza” they warn, since the one thing we all know for sure is
that the organism will evolve and at a pace that we need to outstrip with faster diagnosis down to identifying speciments at the molecular level, with
extensive surveillance among humans and animals, and, they add:
“More rapid and [flexible] systems for translating basic and epidemiological discoveries into clinically applicable interventions.”
But for now, our best defence is the tried and tested foursome:
“Vaccination, social distancing, hand washing, and common sense,” they wrote.
“Infections With Oseltamivir-Resistant Influenza A(H1N1) Virus in the United States.”
Nila J. Dharan; Larisa V. Gubareva; John J. Meyer; Margaret Okomo-Adhiambo; Reginald C. McClinton; Steven A. Marshall; Kirsten St. George;
Scott Epperson; Lynnette Brammer; Alexander I. Klimov; Joseph S. Bresee; Alicia M. Fry; for the Oseltamivir-Resistance Working Group.
JAMA. 2009;301(10).
doi:10.1001/jama.2009.294.
Early Release Article, posted March 2, 2009
Click here for Article.
Sources: JAMA Archives press release, journal article and editorial.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Be Aware Of Limitations In Clinical Software Systems
Research conducted by the National Prescribing Service Limited (NPS) has found that while most clinical software systems pick up important drug interactions, improvements need to be made to ensure doctors and pharmacists do not become desensitised to prompts and alerts.
The study, published in the latest edition of the Medical Journal of Australia, looked at six prescribing software systems commonly used by GPs, three dispensing software systems commonly used by pharmacists and a range of drug interactions reference sources.
While most systems picked up the 20 clinically important drug interactions and all gave alerts for 2 potentially life-threatening interactions, they provided little or no information on clinical effects of the interaction and advice on management.
“GPs and pharmacists need to be aware of the limitations of the decision support features in software systems, including the quality and source of the underlying evidence,” Dr Lynn Weekes, NPS CEO, said.
“Deficiencies in drug interaction decision support can impede the quality use of medicines, both in terms of individual patient management and more broadly by causing “alert fatigue”, desensitising users to prompts and alerts.”
Previous NPS research showed that some GPs and pharmacists were dissatisfied with the drug interaction alerts in their systems, citing too many alerts, and concerns about comprehensiveness and accuracy.
“We believe what users need is more information about the clinical effects of an interaction and advice on patient management, fewer alerts about minor interactions, and clearer presentation. We know that some software vendors have already taken steps to improve their systems and we congratulate them on this,” Dr Weekes said.
The lack of national guidelines or standards for pharmaceutical decision support tools has been identified as one reason why there are inconsistencies and limitations in Australian systems.
“The Government has identified the need for national standards for decision support in clinical software in its National e-Health Strategy. We agree that this would make it easier for software vendors to improve the quality of their systems, and enable greater consistency between systems,” Dr Weekes said.
“We have been and will continue to work with drug information publishers, software vendors, pharmacists and GPs, and the Medical Software Industry Association. The outcomes of this and future research will enable us to make recommendations for features that should be in software to support quality and safety.”
National Prescribing Service Limited (NPS) is an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.
National Prescribing Service Limited
Announcement Of EMEA Authorisation Of Celgene’s VIDAZA (Azacitidine) For Treatment Of MDS And AML
The granting by EMEA of full marketing authorisation for Celgene’s VIDAZA
will bring new hope to MDS patients, particularly those with high risk forms
of these diseases that historically have been associated with a bleak
outlook.
Patients who are ineligible for stem cell transplant therapy are often
subjected to the discomfort, inconvenience and complications that can be
associated with essential, regular blood transfusions, a life saving
procedure which remains the mainstay of MDS treatment.
Recent published studies indicate that Celgene’s VIDAZA presently has the
unique potential to increase, significantly, survival of many, although not
all, patients with high risk MDS, at the same time reducing suffering and
improving quality of life.
However, in UK, EMEA approval is no guarantee of patient access to such a
new and potentially highly effective therapy. Until the National Institute of
Clinical Excellence (NICE) has, in turn, exercised its lengthy approval
procedure, prescription of demonstrably efficacious drugs may only be at the
discretion of local Primary Care Trusts (PCT’s). The experience of our Group
is that a combination of procedural inertia, ignorance of the degree of
patient suffering and misplaced costing assumptions, make it extremely
unlikely, in the majority of the UK regions, that the required levels of
funding will be authorised. This, coupled with the long approval cycle from
NICE, represent a frustrating, unnecessarily long and painful wait for
medication, after EMEA’s imprimatur.
Let’s hope that the introduction of this new, powerful medication from
Celgene, with significant, demonstrable benefits to many of the more severe
aspects of MDS, will attract an appropriately urgent and sympathetic response
from those charged with its availability and distribution to the patient
base.
David R Hall
Chairman – MDS UK Patient Support Group
http://www.mds-foundation.org
World Health Organization Regional Office For Europe
The WHO Regional Office for Europe calls on governments, health professionals, civil society and donors rapidly to scale up national immunization programmes, as outbreaks of measles grow larger and cross country borders. This highly contagious respiratory illness could spread because many children are not immunized or have received less than the required two doses of measles vaccine.
The decline in immunization rates is attributable to a combination of vaccine scepticism born of ideological positions and, ironically, the success of immunization programmes in earlier generations. In addition, some hard-to-reach vulnerable groups in every country still lack access to immunization. Further, the challenges to immunization are fed by disturbing and dangerously misleading anti-vaccination advocacy campaigns.
Paradoxically, although measles can be avoided through simple and inexpensive vaccines, children in affluent countries have a greater risk of infection. Nine of the ten countries in the WHO European Region with the lowest average measles immunization rates, from 2000 through 2007, are members of the European Union.
Over the last 12 months, over 8145 measles cases have been reported in the Region. Six western countries – Austria, Germany, Italy, Spain, Switzerland and the United Kingdom – and Israel accounted for 86% of them.
According to the latest reports, the provisional total number of measles cases in England and Wales was 1348 in 2008. In Switzerland, a measles outbreak began in November 2006 with 73 reported cases, and peaked in March 2008, with 2195 reported cases for that year; 500 of them involved complications. This outbreak is continuing. In up to 98% of all cases, the sick children were unvaccinated or only partly vaccinated, mainly by the decision of their parents. In 2008, outbreaks caused by the virus strain from Switzerland were reported in Germany (50 cases), Austria (202 cases) and Norway (4 cases).
Measles can lead to serious complications, such as pneumonia, encephalitis and death. In 2005-2008, 25 deaths from measles were reported in the Region (14 in 2005, 10 in 2006 and 1 in 2008). This number is widely believed to be a significant underestimate, as measles deaths are often listed as being due to other causes, such as pneumonia and encephalitis. During a large outbreak in the Netherlands 10 years ago, concentrated in groups that chose not to have the children vaccinated for religious reasons, almost 20% of cases suffered serious complications: 3 children died; 53 were admitted to hospital with pneumonia, encephalitis or other complaints; 130 were treated for pneumonia at home; 152 had otitis media (middle-ear infection); and 87 had other complications, mostly respiratory-tract infections.
“Today we have a safe and effective vaccine to prevent measles, but children still die of the disease. This needs to change,” says Dr Nata Menabde, Deputy Regional Director at the WHO Regional Office for Europe. “The Region has achieved substantial success in controlling this disease: we are very close to reaching our goals for measles elimination by 2010. Unfortunately, in 2008 measles incidence in the Region increased from the 2007 level. We must scale up vaccination coverage to ensure that the gains made so far are not jeopardized.”
European Immunization Week 2009
The WHO Regional Office for Europe, the United Nations Children’s Fund (UNICEF) and other partner organizations will hold European Immunization Week, an annual Region-wide campaign, on 20-26 April 2009. It is expected to increase the community’s awareness of the importance of vaccination. The campaign aims to help Member States fulfil their obligations for universal immunization, and analyse and tackle deficiencies in their immunization programmes.
In 2008, 32 of the 53 Member States in the Region took part in European Immunization Week. “We are optimistic that many more countries will take part in the campaign this year. Although it seems obvious, we still have a lot of work to do to spread the word about how important vaccines can be in helping protect children,” stresses Dr Menabde.
The WHO headquarters web site offers more information on measles The Regional Office web site provides information on:
– immunization (http://www.euro.who.int/vaccine), including why it must remain a priority (http://www.euro.who.int/vaccine/20081210_1) in the European Region;
– European Immunization Week (http://www.euro.who.int/eiw); and
– publications giving detailed surveillance data (http://www.euro.who.int/vaccine/publications/toppage) on the Region.
WHO
Insulin Drug Study Shows Significant Improvements In More Than 52,000 Diabetic Patients
A major international diabetes study of more than 52,000 patients from eight
countries has shown that using biphasic BIAsp 30 insulin resulted in significant
clinical improvements and greater patient satisfaction.
The findings, reported in the March issue of IJCP, the International Journal of
Clinical Practice, show that 53 per cent achieved a blood glucose (HbA1c) level of
less than seven per cent, the target set by the International Diabetes Foundation.
Based on the largest database of Type II Diabetes patients ever compiled, the first
phase of the IMPROVE study covered eight countries: Canada, China, Greece,
India, Italy, Japan, Poland and Russia.
Data for the Gulf region, Iran and South Korea will be available later this year.
The study looked at the safety and effectiveness of using the biphasic insulin, which
contains both fast-acting and intermediate components, prescribed by family doctors
and hospital consultants.
“Patients with Type II Diabetes who used the biphasic insulin saw their blood glucose
levels drop by up to 31 per cent and episodes of major hypoglycaemia, where the
glucose levels become very low, fell by an average of 94 per cent” explains
Professor Paul Valensi, head of the Department of Endocrinology-Diabetology-
Nutrition at the Jean Verdier Hospital in France, who led the research.
“They also expressed greater satisfaction in the treatment they received, with the
percentage rising from 10 per cent at baseline to 59 per cent at the end of the study.”
A total of 52,419 patients were enrolled from three pre-study treatment groups:
-17 per cent were not receiving any antidiabetic treatment when they joined the
study. Time since diagnosis averaged two years and HbA1c levels averaged 9.9
per cent.
-65 per cent were on oral antidiabetic drugs. Time since diagnosis averaged 7.4
years and HbA1c levels averaged 9.2 per cent.
-18 per cent were on injectable insulin, with or without oral antidiabetic drugs. Time
since diagnosis averaged 10.4 years and HbA1c levels averaged 9.3 per cent.
“Patients are usually not started on insulin when they are diagnosed with Type II
Diabetes” explains Professor Valensi. “Lifestyle changes and oral antidiabetic drugs
are usually the first therapeutic steps, but some patients are unable to control their
blood glucose levels using this method and insulin is the next step.”
Each patient took the biphasic insulin (marketed as NovoMix 30) as directed by their
clinician for 26 weeks and data was recorded on each patient at baseline, three
months and at the final visit. More than 95 per cent of the patients completed the
study.
Reductions in blood glucose levels were significant in all three groups. Patients who
had not previously received any diabetes treatment before they were included in the
study achieved the biggest HbA1c reduction, down by an average of 31 per cent.
Patients who had only received oral medication before achieved an average fall of
23 per cent and patients who had received injectable insulin, with or without oral
medication, achieved an average reduction of 22 per cent.
This took their average HbA1c levels down to 6.8 per cent, 7.1 per cent and 7.3 per
cent respectively, with more than half of the patients achieving the seven per cent
target set by the International Diabetes Foundation.
The study in IJCP contains detailed results for the 52,419 patients from the first eight
countries to complete the study – Canada (1,594 patients), China (21,729), India
(17,890), Japan (2,095), Poland (4,117), Russia (4,662), Greece (114) and Italy
(218).
Patient demographics and clinical characteristics included:
-Study participants had an average age of 55 and 57 per cent were male. They
had an average body mass index of 26. Their average HbA1c (blood glucose
level) was 9.3 per cent and average time since diagnosis was seven years.
-Male patients were more likely to be receiving no pharmaceutical therapy at
baseline than women (66 per cent versus 34 per cent), with 51 per cent of men
and 49 per cent of women receiving insulin, with or without oral anti diabetic
drugs.
-Patients receiving no treatment had a lower average BMI (25) and average
weight (69.7kg) than those who were on insulin, with or without oral antidiabetic
drugs (BMI 27.5 and weight 73.6kg).
Just under a hundred patients (0.19 per cent) reported 110 serious adverse drug
problems. The most common was major hypoglycaemia, where glucose levels
become very low, with 69 patients reporting 81 incidents. Other less frequent
reactions included drug hypersensitivity, injection site reaction and rash.
“Initiating insulin therapy with BIAsp 30, or switching patients from other medication
to the drug, resulted in improved blood glucose control, fewer major incidents of
major hypoglycaemia and improved patient satisfaction” concludes Professor
Valensi.
“These statistically significant results were observed in the cohort as a whole, across
the three subgroups and in the eight individual countries that have so far reported
their detailed results.”
For further information on the study and free access to the paper please visit
http://www.ijcp.org/improve
Notes
– Initiating insulin therapy with, or switching existing insulin therapy to, biphasic insulin
aspart 30/70 (NovoMix ® 30) in routine care: safety and effectiveness in patients with
type 2 diabetes in the IMPROVE™ observational study. Valensi et al. IJCP, the
International Journal of Clinical Practice 63.3, pp522-531 (March 2009). The paper can
be viewed free at http://www.ijcp.org/improve
– IJCP, the International Journal of Clinical Practice was established in 1946 and is edited
by Dr Graham Jackson. It provides its global audience of clinicians with high-calibre
clinical papers, including original data from clinical investigations, evidence-based
analysis and discussions on the latest clinical topics. The journal is published
by Blackwell Publishing Ltd, part of the international Blackwell Publishing group.
http://www.ijcp.org
About Wiley-Blackwell
Wiley-Blackwell was formed in February 2007 as a result of the
acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with
Wiley’s Scientific, Technical, and Medical business. Together, the companies have
created a global publishing business with deep strength in every major academic and
professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peerreviewed
journals and an extensive collection of books with global appeal. For more
information on Wiley-Blackwell, please visit http://www.blackwellpublishing.com or
http://interscience.wiley.com
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Educational Materials For New Mothers May Prevent Shaken Baby Syndrome, CMAJ Study Shows
Educational materials on how to deal with crying newborns lead to increased knowledge about infant crying and behaviours that are important to preventing shaken baby syndrome, found two new studies being published online March 2 in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/press/do-barr.pdf and Pediatrics.
The CMAJ study involved 1279 mothers in a randomized controlled trial in Greater Vancouver, BC, Canada who were provided materials from the Period of PURPLE Crying program, an 11-page booklet and DVD developed by the National Center on Shaken Baby Syndrome in Ogden, Utah. Half the participants received the PURPLE materials and the other half received materials with parent safety tips and sleeping position guidelines. Materials were delivered by public health nurses during routine visits within 2 weeks of birth.
Mothers who received the PURPLE materials scored 5% higher in knowledge about crying compared with mothers who received the control materials. The PURPLE recipients walked away 1.7 times more frequently from inconsolable infant crying. They were 13% more likely to warn about the danger of shaking infants and to share advice about walking away if frustrated.
The PURPLE materials indicate that the following behaviours are normal but frustrating for parents and suggest coping mechanisms:
– Peak pattern, where crying increases, peaks during the second month, then declines
– Unexpected timing of prolonged crying
– Resistance to soothing
– Pain-like look on the face
– Long crying bouts
– Evening and late afternoon clustering
To help caregivers deal with a crying infant, the PURPLE materials suggest:
– calming responses (carry, comfort, walk and talk)
– put the baby down in a safe place, then walk away to calm yourself
– NEVER shake a crying baby
The annual rate of inflicted brain injury is estimated at 30 per 100,000 children aged 1 year or younger.
The researchers suggest that additional communication could result in increased awareness about the dangers of shaken baby syndrome. In this study, the nurses did not know which materials they were delivering. “The intervention may have had stronger effects if the nurses had reinforced the messages, or if the messages were reinforced by multiple exposures through prenatal, maternity and postnatal health care providers, media and community support organizations,” write Dr. Ronald Barr and coauthors. Dr. Barr is head of community child health at the Child & Family Research Institute and professor of pediatrics in the Faculty of Medicine at the University of British Columbia.
“These findings complement the small number of reports that have reported that practical and contextually relevant materials presented to parents before or shortly after birth can change knowledge and behaviours and perhaps reduce the incidence of shaken baby syndrome,” conclude the authors.
CMAJ
Doctors Support Tough Action To Address Scotland’s Destructive Relationship With Alcohol
Welcoming the Scottish Government’s framework for action on alcohol, published today [Monday 2 March 2009], Dr Peter Terry, chairman of the BMA in Scotland, said:
“Tough action is needed to tackle alcohol misuse in Scotland. BMA Scotland supports this wide-ranging framework which tackles price and availability, and in particular proposes measures to end the deep discounting of alcohol where it is sold for ridiculously cheap prices. “
The health consequences of binge drinking or regularly drinking over and above the recommended daily limits are serious and severe. Alcohol misuse is related to over 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems. Binge drinking and severe intoxication can cause muscular incoordination, blurred vision, stupor, hypothermia, convulsions, depressed reflexes, respiratory depression, hypotension and coma.
Dr Terry added: “Doctors witness first hand how alcohol misuse destroys lives. The facts are simple – voluntary measures supported by the drinks industry have failed to reduce the damage of alcohol misuse in Scotland. It’s time to step up, legislate and take action.”
Dr Sally Winning, a member of the BMA’s Scottish Council, said:
“There has been limited work on Fetal Alcohol Spectrum Disorders (FASD) in the UK and consequently, there are currently no reliable data on the incidence of FASD in Scotland. We are therefore very pleased that the Government has committed to arrange a survey of the incidence of Fetal Alcohol Syndrome in Scotland.”
55 per cent of women in the UK report drinking alcohol during their pregnancy. Heavy drinking during pregnancy can lead to FASD. FASD is a term used to encompass a wide range of physical, mental and behavioural effects that can occur in the children of mothers who consume alcohol during pregnancy. FASD are completely preventable through the elimination of alcohol during pregnancy.
BMA Scotland also welcomed plans to continue to press the UK Government to give serious consideration to a reduction in the drink driving limit and the introduction of new police powers for random breath testing.
The Scottish Government Framework is available online at: http://www.scotland.gov.uk/publications.
In 2008, BMA Scotland published a briefing paper on ‘Tackling alcohol misuse’.
BMA Scotland Public Affairs Office
14 Queen Street
Edinburgh
EH2 1LL
http://www.bma.org.uk
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