New behavioral science research published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, found that constantly emphasizing the negative consequences of a lack of cancer screening among minorities can actually make them less likely to go for screening.

“We have typically assumed that one of the best ways to motivate individuals is to point out disparities in health, but we may be having negative unintended consequences,” said Robert Nicholson, Ph.D., an assistant professor in the Department of Neurology and Psychiatry at the St. Louis University School of Public Health. “Instead of motivating people who would be less likely to get these services in the first place, we may be driving them away.”

Minority communities have been historically underserved by cutting edge medical efforts, and leaders in cancer and other health groups have tried to increase awareness and compliance with known prevention and treatment strategies. However, whether this communication was effective was not known.

Nicholson and colleagues conducted a double-blind, randomized trial among 300 African-American adults. The adults were asked to read one of four articles about colon cancer and then answer questions about their likelihood of getting screened.

The first article emphasized that colon cancer was an important problem for African-Americans. The second emphasized that outcomes for blacks with colon cancer were worse than for whites, while a third said that although outcomes for African-Americans were improving the improvement was less than seen among whites. Finally, a fourth article discussed how outcomes for blacks with colon cancer were improving over time.

If African-Americans read the article that said outcomes for blacks were improving over time, they were more likely to have a positive emotional response than if they read any of the other three articles. The article most likely to cause a negative response was the one that simply stated the problem.

Similarly, those that read the article about African-Americans making progress in outcomes for colon cancer were far more likely to want to be screened than those who read any of the other three articles.

The mean age of the participants was 54.4 years, 76 percent were women and 89 percent had completed high school. Comprehension analysis found that all participants understood what they had read.

Nicholson said they did not ask questions about motivation, but he suggests that a general mistrust of the medical community may be playing a role. If information reinforces that mistrust, then African-Americans are less likely to be screened.

“We believe that a positive message would go a long way toward overcoming mistrust,” Nicholson said. “We need the right kind of message for the right kind of person, and not to assume that what we have always done is working.”

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and 80 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. The AACR’s most recent publication and its sixth major journal, Cancer Prevention Research, is dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

American Association for Cancer Research

The national not-for-profit group Mentoring in Medicine on Saturday hosted a conference in Harlem, N.Y., aimed at encouraging minority students to pursue careers in medicine, the AP/Staten Island Advance reports. According to a 2006 American Medical Association survey, less than 4% of the nation’s more than 920,000 doctors are black, while 5% are Hispanic and 12% are Asian. A 2004 American Nurses Association found that 5% of nurses were black, 3% were Asian and 2% were Hispanic of any race. Blacks make up 12% of the U.S. population, while Hispanics represent 15% and Asians make up 4% of the population, according to 2006 U.S. Census Bureau data.

The conference seeks to boost the number of minority health care professionals in an effort to address racial disparities in health care. Roughly 1,300 students ranging from third-grade to professional school students were expected to attend the conference. Lynne Holden, co-founder of the group who also works in Montefiore Medical Center emergency department in the Bronx, said many minority students are not exposed to the full range of available medical careers, which includes 80 health-related professions, nor are they academically prepared. The Mentoring in Medicine program provides students with career guidance, scholarship and internship help, and also promotes healthy living.

Holden said, while medical schools seek to have diverse student populations, “every year, that task becomes increasingly difficult because of the relatively small number of academically well-prepared minority students who apply.” She added, “This pipeline issue must be addressed if we are to attain the racial and ethnic diversity necessary in the next generation of doctors” (Franklin, AP/Staten Island Advance, 11/21).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Every day, 72 children in Europe die from domestic accidents, the equivalent to 3 per hour. In the UK alone, it is estimated that 1/3 of all accidental death happen in the homes. The causes of these deaths are all too familiar: electrocution/motor accidents (34%), drowning (13%), poisoning (5%), falls (4%) are the most common. Most of these according to the World Health Organization are perfectly avoidable. If the number of death from accident has decreased since 1997, the proportion of domestic death has however increased to over 30% even though progress has been made over the years to improve the awareness of parents to the dangers their children face.

On a survey performed in Germany, 2,082 respondents or nearly 1 in 4 (24.4%) of the total sample of 8,519 persons reported accidents during the last 12 months. Just 4 types, cuts, falls, burns and collisions account for nearly 94% of all accidents. With the combination of types, these 4 types affect 96% of all accident victims and 23.5% of the total population.

Why are the statistics showing no decline in children’s domestic accidents? There are several potential causes to this:

1. There might be Safety Warning fatigues. The risks of lawsuits has fuelled an inflation of warning signs on anything from toys bags in McDonalds’ Happy Meals® to every supermarket shopping bags or household items. This might have driven parents to just not pay attention to the warnings anymore as pretty much anything seems to not be suitable for children under three anymore. The cure might be defeating the purpose in other words. However, there are still plenty of dangerous elements at home for children to play with while at the same time, and the attention of parents might be down. Matches, lighters, gas stoves, pills, plastic bags, electrical plugs and a plethora of new electrical equipments are still within little hands’ reach.

2. It is harder to reach homes with messages and regulations than it is to reach businesses. The perception is often that these accidents are unavoidable and therefore more awareness is still needed.

3. Even if the parents are more exposed to the household’s dangers, that knowledge is not necessarily passed on to the younger children. With the pressure of modern society, both parents often work in an average household, dramatically cutting the time spent with children and limiting sharing time for risk prevention education, a gap which schools cannot compensate for. There are tools to mitigate this for small children such as the game for young children “Watch Out! – A Safe Start to Life” (4bambini) which helps children through visual cues memorize the appropriate behaviors to early life’s most common dangers. There are as well plenty of internet sites dedicated to home safety but more often than not, the audience is the parents and not the children.

The insurance companies are trying to push the topic of home safety as a way to lower the amount of claims filed as a result of accidents, but it seems that no short term improvements are in sight.

For more information, please visit the World Health Organization and their web site at who.

World Health Organization

More people being helped to stay in work rather than drifting into
extended sick leave is the focal point of a package of initiatives
announced today by Work and Pensions Secretary James Purnell and
Health Secretary Alan Johnson.

The announcements come in response to Dame Carol Black’s
groundbreaking report into the health of Britain’s working age
population, which was published in March.

The package will support disabled people or those who become ill to
return to, or stay in work, by helping them manage their condition
and get the right help to keep their jobs.

New measures announced in the report ‘Improving health and work:
changing lives’, include proposals to replace the paper-based ‘sick
note’ with an electronic ‘fit note’ and pilots for ‘Fit for Work’
services which will support people on a period of sickness absence to
return to work.

Other proposals include:

A National Centre for Working-Age Health and Well-Being – which will
form an independent, authoritative body providing a range of core
functions related to the health and well-being of working-age people.
The Centre will identify evidence gaps and encourage research to
close those gaps.

Health, Work and Well-being Co-ordinators – who will stimulate action
on health, work and well-being issues in their areas, offering advice
and support to help local partnerships and engagement with smaller
businesses in particular.

Pilot an occupational health helpline for smaller businesses – the
helpline will offer help to smaller businesses by providing business
hours access to professional occupational health advice on individual
employee health issues (including mental health).

A Challenge Fund – which will encourage local initiatives that
improve workplace health and well-being through innovative approaches
to ensure worker engagement.

Review of the Health and Wellbeing of the NHS workforce – this will
be done in partnership with employers and staff and will identify
action to improve the health and wellbeing of the NHS workforce.

Alan Johnson said:

“Sick leave costs an estimated ВЈ100 billion per year – but helping
people stay in work doesn’t just have an economic imperative, it has
a moral and social one too. Poor health can prevent people fulfilling
their potential, leaving them more likely to slip into poverty and
social exclusion.

“That is why we have set out a comprehensive framework to help
support employers and the NHS encourage individuals back into the
world of work as soon as possible.

“I’m particularly pleased to announce a review of the health and
wellbeing of the NHS workforce, which will benefit staff and help
drive up the quality of care for patients.”

Work and Pensions Secretary James Purnell said:

“Now more than ever it’s important to help people who are sick to
stay in work so that they can support themselves and their families.

“These proposals will help do just that. Everyone has the right to
work and we want to design a fair system which supports people so
they can work when they are able.

“We also plan to extend the help available for small businesses so
they have the tools they need to be able to support employees with
health problems carry on working if they can or return to work as
soon as they are ready.”

Dame Carol Black, National Director for Health and Work said:

“I welcome this response and am glad to see that the Government has
taken on board my recommendations and is committed to action. I am
especially pleased the fit note and the Fit for Work pilots will be
implemented along with support for small businesses.

“I believe the measures unveiled by the Government will help make our
society a healthier and happier one, where everyone recognises the
link
between good health and good work.

“But to ensure it happens we need to work together to change
attitudes
and behaviours. The Government has taken this first important step,
but
we need to work in partnership, with business leaders, employers and
individuals all having a role to play.”

1. The full Government response to Dame Carol Black’s report can be
found here from 10am on Tuesday, 25 November
workingforhealth/Government-Response

2. Dame Carol Blacks review ‘Working for a Healthier Tomorrow’ was
published in March 2008. Copies of the original report can be found
here.

3. Key Statistics

– Cost to the British economy of working age ill-health in terms of
working days lost and worklessness is over ВЈ100bn each year (as
estimated in Black Review).

– Over 29 million people in employment in UK; an employment rate of
74.4 percent.

– About 172 million working days lost in 2007 due to sickness absence
(CBI survey).

– Absences that last over four weeks make up around 40 percent of
days lost to absence (CBI survey).

– About 2.6 per cent of working time lost to illness in 2007.

– 34 million days lost in 2007/08 to work-related illness.

– 2.6 million people on incapacity benefits in May 2008. Fallen from
2.77 million in 2004.

– Around 600,000 per year makes claims to incapacity benefits and
survey data suggests that half of these had been in work immediately
prior to there claim.

– 5.9 million people in employment in Great Britain say that they
have a long-standing health condition.

Department of Health, UK

Scientists from A*STAR’s Institute of Medical Biology (IMB) in Singapore and the University of Hong Kong’s Department of Medicine have produced the world’s first human cell model of progeria, a disease resulting in severe premature ageing in one in four to eight million children worldwide. This model has allowed them to make new discoveries concerning the mechanism by which progeria works. Their findings were published this month in the prestigious scientific journal, Cell Stem Cell.

Hutchinson-Gilford Progeria Syndrome, also known as progeria, is caused by a mutation in the gene encoding for the protein lamin A, an important component of the membrane surrounding a cell’s nucleus. The mutation results in a truncated form of lamin A called progerin, which in turn causes misshapen cell nuclei and DNA damage. Children with progeria suffer symptoms of premature ageing, including growth retardation, baldness, and atherosclerosis (hardened arteries), and all die in their early teens from either heart attack or stroke.

Led by IMB’s Profs Alan Colman and Colin Stewart, the team used a novel technique of deriving induced pluripotent stem (iPS) cells from cells of human progeria patients. This human progeria model allows the group to trace and analyse the distinctive characteristics of progeria as it progresses in human cells. Previously, only mouse models of the disease were available.

Said Prof Colman, “While mouse models of progeria have been informative, no one mouse model recapitulates all the symptoms seen in humans. Our human progeria model allows us to examine the pathology of the disease at a much closer resolution than previously possible.”

The researchers used their iPS cells to identify two types of cells – mesenchymal stem cells (MSCs) and vascular smooth muscle cells (VSMCs) – that were particularly adversely affected by progeria. This means that a young patient with progeria would typically have fewer MSCs and VSMCs than other children. MSCs were found to be very sensitive to a low oxygen environment and their losses could delay renewal of the various tissues they gave rise to, thus exacerbating the patient’s symptoms of ageing. The same effect on VSMCs could explain why their number was reduced in the patient’s heart vessels.

The group’s findings are a significant boost to existing research on over 10 diseases associated with lamin gene mutations. Prof Stewart previously led a study in mice at IMB showing that progeria affected the connective tissues, potentially via defects in a signaling pathway connecting the nuclear lamina with the extracellular matrix and which was associated with death of the smooth muscle in major blood vessels.

Said Prof Stewart, “This new study provides further evidence for the role of lamin processing in connective tissue function, as well as insights into the normal ageing process. We hope to soon find new routes of intervention to treat this incurable disease. Such interventions may be of use in treating atherosclerosis in general, a condition afflicting many millions of individuals.”

Source:
Adela Foo

Agency for Science, Technology and Research (A*STAR), Singapore

The International Alliance of Patients’ Organizations has launched an advocacy toolkit for patient groups to inform and support their activities, advocating for improved patient safety, at a regional meeting of patient groups in Uganda. The toolkit, “Addressing Global Patient Safety Issues: An Advocacy Toolkit for Patients’ Organizations”, is the first multi-issue resource for patient groups, providing the means for patients and patients’ organizations to engage in the provision of healthcare and contribute to a quality and safe healthcare system, and a reduction in harm to patients.

The prevalence of patient safety incidents is shocking. The rate of adverse events in hospitals in the UK, New Zealand and Canada is estimated to be around 10 percent (1 in 10 people that stay in hospital) (World Alliance for Patient Safety 2005 Forward Programme). The human cost is unacceptable, but the financial cost is also significant. In 1999, the Institute of Medicine in the USA, published the report “To err is human: Building a safer healthcare system”, in which they estimated that the cost of medical error was up to US$29 billion per year in hospitals nationwide.

When we receive healthcare we expect it to be safe. This is not always the case. Patient safety incidents commonly affect patients worldwide, regardless of the status of their national healthcare systems. The safety of patients can be compromised in many ways including medical errors, counterfeit or substandard medicines and inadequate cleanliness of hospitals. In many cases, simple measures are all it takes to significantly reduce the risk of causing harm. In others, the problem may be more complex, but in all cases a solution should be developed that is patient-centred which requires the full involvement of patients in the decision making process.

The IAPO Advocacy Toolkit contains background information, facts, and figures on key patient safety issues identified by IAPO’s 200 patient group members as of immediate concern to them. These are: Medical Error; Taking Medicines Correctly, Hospital Acquired Infections, Quality and Safety of Medicines, Re-Use of Single Use Medical Devices, Injection Safety; Maternal and Child Health; and Participation in Clinical Trials. The Toolkit also provides detailed advice and tips on how to advocate and build partnerships to achieve patient safety goals and on communicating messages to patients and other health stakeholders.

Hussain Jafri, IAPO Chair Elect and Chair, Alzheimer’s Pakistan, stressed that “…everyone has a role to play in protecting patient safety. However, it is imperative that all healthcare providers, in particular governments, support measures that can protect patients from adverse events. The IAPO Toolkit will provide patients and their representatives with the information and confidence to hold

all healthcare stakeholders to account and ensure that they receive the highest achievable level of quality and safe healthcare.”

About IAPO

IAPO is the only global alliance representing patients of all nationalities across all disease areas and promoting patient-centred healthcare worldwide. Our members are patients’ organizations working at the local, national, regional and international levels to represent and support patients, their families and carers. IAPO’s has 200 members which span over 40 countries and 50 disease areas and through membership represents an estimated 365 million patients worldwide.

International Alliance of Patients’ Organizations

Todd Landry, director of the Division of Children and Family Services for the Department of Health and Human Services, said a 15-year-old girl from Douglas County was left at Immanuel Hospital in Omaha through LB 157, Nebraska’s “safe haven” law, late yesterday afternoon (Nov. 3).

Landry said the girl’s legal guardian left her at the hospital.

This is the 19th instance of use of LB 157 and the 27th child left at a hospital under the law since September 13. LB 157 went into effect on July 18.

More information about Nebraska’s safe haven law, as well as information about local resources for families, can be found on the Department’s Website at dhhs.ne/SafeHaven

Nebraska Department of Health & Human Services

No matter what you see in the movies, archaeology isn’t really about finding ancient temples or golden idols. It’s about the day-to-day “stuff” – the material culture – of people’s lives. It doesn’t even have to be ancient, as a study of homeless peoples’ stuff in Indianapolis is showing. Instead of being an exotic field, archaeology may even help the homeless to live better lives.

Larry J. Zimmerman, Ph.D., an Indiana University-Purdue University Indianapolis professor of anthropology and museum studies at the School of Liberal Arts and Jessica Welch, an IUPUI student and a formerly homeless woman, have completed a unique study of the material culture of the homeless. The researchers discovered that the problem of homelessness is broader and much more complex than previously thought.

They presented their findings this summer at the World Archeological Congress in Dublin, Ireland. Results of the study are to be published early next year in the peer-reviewed journal Historical Archeology.

Archeological perspectives on the production, use and disposition of material culture – clothing, utensils and other “stuff” that helps people to survive can provide insight into lives. Homeless people, often invisible to those around them, have, use and dispose of material culture as they move across the landscape, But because people are homeless, many Americans think they lack material culture.

“Archeology can help in the way a story is told, can raise issues of social justice and can inform the public and policy makers,” said Zimmerman. “This study of the material culture of the homeless is preliminary in every way, but we believe that it shows the utility of applying archeological methods to help understand a contemporary social problem. Archeology can be a tool for making decisions, not just for understanding the past.”

Past anthropological studies of the homeless have been mostly ethnographic – focusing on everything from HIV/AIDS to drug use or job training – and primarily have been done in the controlled settings of shelters. Yet, according to Zimmerman, most homeless individuals, especially men, live most of their lives outside of shelters, and we know almost nothing about it. This is the first study to use the tools and techniques of archeology to understand the broader environment and activities of the homeless. “We tend to see the homeless as a small extension of our lives but they are not; this is almost a different culture,” said Zimmerman.

It’s different because priorities change when finding food and having a place to sleep are your top concerns. Many people in the mainstream culture are closer to slipping into homelessness than they realize,” said study co-author Jessica Welch, an IUPUI student who was herself homeless, living under trees and squatting in abandoned houses in Long Beach, Calif., in the early 1990s. Welch recently completed a bachelor’s degree in psychology and anthropology this and plans to go into public service working with the homeless.

“You develop coping mechanisms – a fight or flight response – when you are homeless that are probably not appropriate in mainstream culture. You get increasingly defensive and desperate. This is just one of the many things that make it difficult for homeless people to re-enter ‘normal society. We have to understand that a goal of simply creating more affordable housing units is not enough; we need a complete social safety net, including better treatment and counseling options, and plenty of compassion and understanding on the part of the community,” she said.

For this study, Zimmerman and Welch focused on sites near downtown Indianapolis where homeless sought outdoor shelter. They avoided direct interaction with the homeless so as not to interfere with the lives of this vulnerable population. They did not open homeless “caches,” often sealed black trash bags partly hidden in out of the way places, in which homeless individuals store items they wish to keep or have access to in the future.

They located camps – many of them in use for long periods of time – where the homeless found or created shelter. They photographed these sites and conducted inventories of what the homeless threw away or left behind when they were away from the camp. They looked for patterns or clusters of certain types of materials such as clothing, shoes, food, cardboard laid out as furniture, or tarps providing shelter.

“We always kept in mind that these sites were peoples’ homes and we respected them. They already have difficult lives and we did not want to make them more difficult,” said Welch.

Some of their findings and even what they did not find surprised them. “We found a large number of food cans. Most had been opened, often not very successfully, with knives or by banging them against rocks or even by heating them until the contents exploded. We rarely found cans that had been opened by a can opener. That made us realize that they didn’t have can openers, which must have been very frustrating to them,” said Zimmerman.

“We also found a lot of hotel-size bottles of shampoo and conditioner, deodorant and toothpaste. Only the toothpaste was used. This tells us that giving things like shampoo and conditioner to individuals without access to water doesn’t make sense. It would be better to send these kinds of things to shelters and not distribute then to people living on the streets. When we try to deliver aid to the homeless we tend to give them what we think they need. A much better way to deliver aid is to target what they actually need, and our work on the material culture of the homeless may help us find out what that really is,” said Zimmerman.

According to Zimmerman and Welch, their study provides evidence that some homeless survive well, occasionally living in organized camps. “This work is an odd reaffirmation of how adaptable our species is. As an anthropologist I know this, but it’s good to have it reaffirmed,” said Zimmerman.

###

Source: Cindy Fox Aisen

Indiana University

A provocative debate in this week’s PLoS Medicine examines whether the private sector should step up its involvement in delivering health care in
low-income countries.

These countries suffer a disproportionate burden of disease, and often struggle with weak health systems. Both the public and private sector deliver
health care in these countries, but the appropriate role for each of these sectors in health system strengthening remains controversial.

Richard Smith (Ovations Chronic Disease Initiative, London, UK) and colleagues argue that in the developing world “the private sector’s role in
health care should be strengthened and more closely aligned with the public interest.” They discuss evidence showing that “private contractors
can operate on a large scale, be more cost effective than government-provided services, and increase coverage in poor and remote areas.” The
authors argue the case for supporting public-private partnerships for health system strengthening. Improving health care for the world’s poor, they
say, “means harnessing everyone’s capacity, not just that of governments.”

But Kara Hanson (London School of Hygiene and Tropical Medicine, UK) and colleagues argue that “there is no alternative to strengthening the public
role in the health system.” Even where private services are low cost, they say, they are not necessarily affordable-even short bouts of illness
can have a catastrophic impact on welfare when households are poor. There is no evidence, say Hanson and colleagues, that private risk sharing
schemes such as commercial insurance can reach the poorest groups. Public financing of health care, they say, “can help achieve protection both
against the cost of care and also against loss of income caused by illness.”

Citation:
Is private health care the answer to the health problems of the world’s poor?
Hanson K, Gilson L, Goodman C, Mills A, Smith R, et al. (2008)
PLoS Med 5(11): e233. doi:10.1371/journal.pmed.0050233
Click here to view article online.

About PLoS Medicine

PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of
human health and disease, together with commentary and analysis of important global health issues.

PLoS Medicine

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world’s scientific and medical
literature a freely available public resource.

Public Library of Science

Who

Health Department workers in every county

What

There are drive-through clinics in many locations. See local residents receive their flu shots.

Flu shots will be given at no charge for one day clinics, but those who are eligible for Medicaid and Medicare are asked to bring their ID cards, and state employees are asked to bring their insurance cards.

Where

See locations in your county at: healthyarkansas/flu/flu_2008.htm

When

Wednesday through Saturday, November 5-8, 2008. See website for time and location listings in your area.

Askansas Dept of Health