Entries categorized as ‘Consumer/Patient Health’
” Despite progress in many areas over the last 25 years, the disparities in people’s well-being in rich and poor countries continue to be unacceptably wide, according to the Human Development Index (HDI) released today as part of the United Nation’s 2009 Human Development Report (HDR). This year’s HDI, a summary indicator of people’s well-being—combining measures of life expectancy, literacy, school enrollment and GDP per capita—was calculated for 182 countries and territories, the most extensive coverage ever. “
Excerpt from a press release issued by United Nations Human Development Reports Office (Oct 5 2009)
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The latest Human Development Report by the United Nations was released on Oct 5 2009, presenting data gathered in 2007 from countries around the world. Begun in 1990, the series provides analysis of health, economic, demographic and quality of life indicators globally. The current 229-page report is available for anyone to read or download, at no cost, at this link.
A 14-page HDR Executive Summary is the source of the three screenshots shown below:
Next: An excerpt from a chart showing that Norway received the top spot out of 21 countries ranked for scores on the Health Development Index:
The score given to the United States declined to 13th place on the 2009 list.
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The screenshot below shows the countries with the lowest Human Development Index; Niger scored lowest in the rankings:
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Images – All above taken from 2009 HDR Executive Summary – http://www.undp.org/hdr2009.shtml – All rights reserved – Copyright 2009
For a list of related or archival HDR publications from the United Nations, click here.
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A couple of news stories of the day illustrate some of the background issues that may be contributing to the declining quality of life scores in the U.S.
Veteran family physician Deb Richter wrote a brief article entitled “Lack of Universal Health Care is a Mass Killer“, about the serious health consequences suffered by uninsured patients seen in her Vermont practice. It was posted on The Progressive website on Oct 4 2009.
Guardian (UK) columnist Paul Harris wrote “Will California become America’s First Failed State?”(Sunday, Oct 4 2009 edition), examining a complex list of declining economic, public health, housing and quality of life management issues faced by residents (and elected government officials) living in the state of California.
An article from the Oct 6 2009 New York Times provides a brief description of how health care cost subsidies on a sliding scale for an estimated 46,000,000 people currently uninsured in the U.S. might operate.
Categories: Consumer/Patient Health · Educational Sites · Epidemiology/Public Health · Healthcare-Administration · News & Medical News
Tagged: Global Quality of Life, Health Care Costs-U.S., Health Care Inequality, Health Care Rankings-International, Human Development Report-2009, Population Demographics-Measurement 2009, United Nations, World Health
Pittsburgh, Pennsylvania has gotten much press coverage over the past 7 days, due to the G-20 Summit held there on Sept 24-25 2009. I’ve always been interested in the city because my father was born and raised there. My oldest child moved there this summer to attend Carnegie Mellon University, and loves the place.
Like San Francisco, Pittsburgh is a city of neighborhoods and the scale of the hilly landscape lends itself to walking tours.
I recently read with interest an article (published Sept 8 2009 on Fastcompany.com) about an innovative health-care facility which opened recently in the Lawrenceville section. Children’s Hospital of Pittsburgh, a 900,000 square feet, hi-tech ‘green’ building with 296-licensed beds, is a part of the University of Pittsburgh Medical Center system.
It is an architectural gem. Below is a rendering of the brilliantly-colored exterior:
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If it is scary for a grown-up to face the prospect of having major surgery or fear a lengthy hospitalization, think how much more overwhelming it is for a seven-year old child? One can see that the building interiors were designed with children in mind. These images are taken from the slideshow on Fastcompany:
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.Lobby – Children’s Hospital of Pittsburgh
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The Atrium
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One of three Intensive Care Units
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Next: a link to view digital renderings of various interior spaces in the building created by the architects (and looking very Second Life-like).
The Pittsburgh Business Times ran a feature article on the hospital – with many photographs – on May 1 2009 and you can read the article at this link.
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Finally, a friendly shout-out! to BR and CB, two former PBL students, now pursuing medical residencies in Pittsburgh.
Categories: Consumer/Patient Health · Healthcare-Administration · News & Medical News
Tagged: Children's Hospital of Pittsburgh, Hospitals-Design, Pittsburgh, University of Pittsburgh Medical Center
Image – H1N1 Influenza Virus
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Last week, in anticipation of the beginning of ‘regular’ flu season in the Northern hemisphere and the public health concerns over the pandemic spread of H1N1 influenza worldwide, it seemed logical to add a news-feed to the EBM and Clinical Support Librarians@UCHC blog from the Centers for Disease Control & Prevention for current news, advisories and practical information about Pandemic Flu (H1N1).
Flu.gov is open and available for anyone in the world to access at no cost, in English or Spanish language versions. The focus of the CDC website is on incidence of influenza among Americans, but there are also links to current information about H1N1 posted by the World Health Organization (WHO) and other sources.
A section of Flu.gov is dedicated to the information needs of clinical care providers (or medical students), and is titled “For Professionals“. Below is a screenshot of that page:
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Image/Photo Credit: http://pandemicflu.gov/index.html – All rights reserved – Copyright 2009
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Here are several links which might be of particular interest for professional (and amateur) epidemiologists. First: an excerpt of text found on the FluView page: ” Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. “
Next: true news junkies will appreciate the many updates found on the CDC H1N1: What’s New? page.
Third: Disease transmission through public or private school populations is of special concern worldwide. Dated Aug 25 2009, here is a link to an online document summarizing Vaccines Advisory for Specific Population Groups (i.e., infants, children enrolled in schools K-12, college-age students, etc.). Another recent advisory of interest to administrators of institutions of higher education (abbreviated IHE), such as the “CDC Guidance for Responses to Influenza for Institutions of Higher Education during the 2009-2010 Academic Year“.
CDC Podcasts are available on many different topics; here’s a link to one written specifically for children entitled “All You Have to Do is Wash Your Hands“.
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Lastly, here are some links to other sources for information on the 2009 H1N1 pandemic (in no particular order):
- Eurosurveillance is “an open-access peer-reviewed journal about infectious diseases surveillance prevention and control in Europe. Over 14,000 readers around the world subscribe to our weekly online edition, which is published every Thursday…. “.
- The goal of HealthMap is to ” bring together disparate data sources to achieve a unified and comprehensive view of the current global state of infectious diseases and their effect on human and animal health. This freely available Web site integrates outbreak data of varying reliability, ranging from news sources (such as Google News) to curated personal accounts (such as ProMED) to validated official alerts (such as World Health Organization) “
- An entry from Wikipedia – “2009 Flu Pandemic by Country” – features many maps for reported incidences shown both by country and continent (but note: their data lags behind that reported by other international public health sites).
- Public Health Agency of Canada provides current links to the spread of the disease throughout the country; their FluWatch interactive maps are useful (screenshot shown below):
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Finally, UCHC library users can search GIDEON, a subscription database (note: Proxy access required from off-campus). Why is GIDEON a unique resource for epidemiologists, researchers, students and public health administrators? Here is an excerpt from their “About” page:
“ GIDEON is made up of four modules: Diagnosis, Epidemiology, Therapy and Microbiology. The database includes 337 diseases, 224 countries, 1,147 microbial taxa and 306 antibacterial (-fungal, -parasitic, -viral) agents and vaccines… Data sources include the entire world’s literature and adhere to the standards of Evidence Based Medicine… There are 20,000 images, graphs, interactive maps and reference updates “.
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An earlier post about H1N1 on this blog (May 7 2009) can be read here.
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Note: Here is a link to a free 4-page H1N1 patient-education pamphlet from BMJ Clinical Evidence.
Categories: Consumer/Patient Health · Educational Sites · Epidemiology/Public Health · Healthcare-Administration · News & Medical News · Videos & Podcasts
Tagged: Center for Disease Control & Prevention (U.S.), European Centre for Disease Control and Prevention (ECDC), Flu Outbreaks-2009/2010, HealthMap, Influenza-2009, Influenza-H1N1-2009, International Society for Infectious Diseases, Public Health, Public Health Agency of Canada, World Health Organization (WHO)
Image credit: http://medbloggercode.com/ – All rights reserved – Copyright 2009
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My thanks to the good folks at Healthcare Blogger Code of Ethics who recently added the EBM and Clinical Support Librarians@UCHC blog to their lengthy list of medical bloggers.
Here is the written Code of Ethics promoted by this non-profit, volunteer group.
Link here to view the newest additions of medicine bloggers, or patient bloggers, endorsed by HBCE (updated June 26 2009).
Categories: Blogs or Wikis about Medicine · Consumer/Patient Health · Educational Sites · Healthcare-Administration · Medicine 2.0 · News & Medical News · Teaching-and-Learning in Medicine
Saturday, June 27 2009 is National HIV Testing Day
Photo credit: http://www.hivtest.org – All rights reserved – Copyright 2009
An annual event co-sponsored by the National Association of People With AIDS (NAPWA) and Centers for Disease Control & Prevention (CDC), this public health promotional effort encourages sexually-active Americans to be tested each year for infection with the HIV virus or other sexually transmitted diseases.
A separate CDC website at HIVTest.org allows a person to type in their individual zip-code or city/state location which will then bring up a directory of local sites where testing services will be available on Saturday.
Another means of finding local test site information is to call this toll-free phone number: 1-800-CDC-INFO (or 1-800-232-4636).
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A recently published report in MMWR – Vol. 58 (24);661-665 (June 26 2009) recaps the ill-effects of “Late HIV Testing in 34 States, 1996-2005″.
Here is an excerpt from that report – and one which represents a very sobering statistic for any epidemiologist: “Current estimates suggest that 21% of HIV infections in the United States are undiagnosed.”
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CDC sponsors a related consumer-health information source page called “Nine and A Half Minutes” (for the estimated frequency of new STD infections among Americans). Here is a screenshot of that site:
Photo credit: http://www.hivtest.org – All rights reserved – Copyright 2009
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A 14-page HIV Testing Fact Sheet (in English or Spanish language) is available from CDC at this link.
Finally, below is a short list of other statistical or factual sites for current sexual health information:
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Categories: Consumer/Patient Health · Educational Sites · Epidemiology/Public Health · Healthcare-Administration · News & Medical News
Tagged: Ad Campaigns-Public Health, CDC, Center for Disease Control & Prevention (U.S.), Consumer Health, HIV-Testing, Human-Immunodeficiency-Virus, Patent Education, Patient Counseling, Preventive Medicine, Public Health, Public Health Awareness, Sexually-Transmitted-Infections
” The life of a sick person can be shortened not only by the acts, but
also by the words or the manner, of a physician. It is therefore a
sacred duty to guard himself carefully in this respect. ”
—American Medical Association, Code of Medical Ethics, 1847
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Physicians are trained to seek a cure for their patients, to deliver treatments, to act promptly yet with deliberation; much less time is spent during graduate medical education on how to deliver bad news to a patient or their family.
Unfortunately, communications about treatment failure, impending death or options for end-of-life care – including emotional or psychosocial issues – can be delivered by the physician in an incomplete, ambiguous or unintentionally insensitive manner.
Poorly chosen words complicate an already emotional and anxiety-charged scenario for the patient or their loved ones. Counseling family members after an unexpected or traumatic death is even more difficult for the care provider.
UCSF physician Stephen Z. Pantilat wrote a practical, thoughtful essay about doctor-patient communications at end of life, entitled “Communicating with Seriously Ill Patients: Better Words to Say“. It was published in JAMA on Mar 25 2009 (Vol. 301, Issue 12, page 1279-1281). (Note: Subscription necessary to view the text.)
Following is an excerpt from Dr. Pantilat’s article:
” Words matter. What clinicians say and how they say it hugely affects patients. Communicating about emotionally and medically complex topics such as advance care planning, preferences for care, prognosis or death and dying is challenging. Doing so requires clinicians to attend to their own and the patient’s cognitive reactions, tone, affect and nonverbal cues… Although poor communication may harm patients by leading to unwanted invasive procedures, generating unnecessary anxiety, or creating feelings of abandonment, good communication can improve outcomes for patients and their families by promoting shared decision making and addressing patient concerns”.
Excerpt from: “Communicating with Seriously Ill Patients: Better Words to Say” – JAMA, Vol. 301, Issue 12 (Mar 25 2009) – All rights reserved – Copyright 2009
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This 3-page article should be required reading for every third-year medical student before the beginning of their clinical clerkship year.
Over the next few weeks, I will post a brief series on learning to care for dying patients’ physical and emotional needs.
Categories: Consumer/Patient Health · Educational Sites · News & Medical News · Teaching-and-Learning in Medicine
Tagged: Advanced Directives, Death-and-Dying, End of Life Care, Palliative Care, Palliative Medicine, Patient Counseling, Physician-Patient Communication, Teaching-and-Learning in Medicine
” The alarm around this particular strain [A-H1N1] has a couple of roots. First is, it’s new… it’s novel. And new is always cause for some amount of concern. Second, it does appear to have just recently jumped from one species, pigs, to another, humans. And very commonly, in the whole world of viruses – not just influenzas – when they first make the jump from one species to another is when they’re really hot viruses, dangerous viruses. That certainly was the case with SARS, which had just made the jump from bats to civets, civets to humans. So we always worry when we see a recent jump. ”
A quote from Laurie Garrett, during an interview with the Online News Hour (transcript link here) on May 1 2009.
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Ms. Garrett, author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance (1994), and The Betrayal of Trust: The Collapse of Global Public Health (2000), is currently a senior fellow for global health at the Council on Foreign Relations.
How A/H1N1 influenza – identified in Mexico in March 2009 – continues to develop in human populations is still uncertain, as the virus spreads to every continent. The good news is that clinicians seem to think it is not as virulent as first feared; the bad news is that over time, the possibility still exists that we are witnessing a phenomena that every epidemiologist dreads in his or her lifetime: the emergence of an uncontainable virus in a human population who have little or no immunity against it.
While many people thought the media hype over this emerging virus was of hysterical proportions, and discounted the severity of the strain, a different way to view these events is as a sort of dress rehearsal which demonstrated that world-wide networks of disease surveillance, data-collection and cooperative intelligence sharing are functioning reasonably well. (But I’m not a virologist so maybe I know no more than the next guy on the street.)
If nothing else, it shows that swarm-intelligence and citizen-journalism is alive and well!
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You could say that some of my reactions to public health crises have been shaped in part by having lived in city of San Francisco in the early 1980’s, when a different public health crisis unfolded with the identification of a novel viral infection which came to be known as human immunodeficiency virus. If you haven’t already read And The Band Played On by Randy Shilts, who was a reporter at the time for the San Francisco Chronicle, it is truly worth the time. *
Let’s hear it for more dress rehearsals, and fewer real-life epidemics.
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Following are a few books or online resources for background information on epidemiological investigations, medical detective work and emerging infectious diseases, for your consideration:
- “The Threat of Pandemic Influenza: Are We Ready?” A Workshop Summary, 2005 (free online full-text from National Academies Press site – link to PDF here).
- Book: The Great Influenza: The Epic Story of the Deadliest Plague in History by John Barry (Viking, 2004).
- Book: When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed by Howard Markel (Pantheon Books, 2004).
- Book: Microbial Threats to Health: Emergence, Detection and Response by Mark Smolinski, Margaret Hamburg, Joshua Lederberg (National Academies Press, 2003).
- Book: The Molecular Epidemiology of Human Viruses, by Thomas Leitner (Kluwer, 2002).
- Book: The Invisible Enemy: A Nature History of Viruses, by Dorothy Crawford (Oxford University Press, 2000).
- Online Book: Bird Flu: A Virus of Our Own Hatching by Dr. Michael Greger (Human Society Press, 2006). Free fulltext book at this link.
- Book: Man and Microbes: Diseases & Plagues in History and Modern Times, by Arlo Karlen (Putnam Books, 1994).
- Robert Preston is the author of two popular works, The Demon in the Freezer: A True Story (Random House, 2o02) and The Hot Zone: A terrifying true story (Random House, 1995).
- Book: Emerging Viruses in Human Populations by Edward Tabor (Volume 17 of Perspectives in Medical Virology, Elsevier, 2007).
- Book: Seasonal Patterns of Stress, Immune Function, and Disease by Randy Nelson (Cambridge University Press, 2002).
- Book: Human Virology: A Text for Students of Medicine, Dentistry and Microbiology by Leslie Collier (Oxford University Press, 2006).
- A professor of virology from Columbia University blogs at the Virology Blog.
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* Randy Shilts, who was a great journalist and a brave activist for gay rights, died of AIDS in 1994 at age 42.
Categories: Consumer/Patient Health · Educational Sites · Epidemiology/Public Health · News & Medical News · Other Stuff
Tagged: Emergency Management, Epidemiology/Public Health, Influenza-Epidemics, Pandemics, Public Health, Swine-Flu
Librarians at Lyman Maynard Stowe Library purchased a subscription to a course management system called LibGuides in August 2008. It has proven to be a good investment. Each of the librarians or instructors on the system can share – although we are geographically distant – in building on each others’ work, much like sharing of bookmark collections is enabled by Delicious.com.
LibGuides is an easy (user-friendly) system to learn. Reference librarians here are using it exclusively for all their online course syllabi. We have now gone officially “paperless” – no more piles of handouts for instructional sessions! If you’d like to view individual UCHC Libguides, click here.
Access to individual subject pages is open to both subscribers and non-subscribers for the system; anyone in the world can search and view a LibGuide subject page provided that the author(s) of that guide have elected to make the page “public”. According to Springshare, the owner of LibGuides, there are now 5oo libraries which subscribe.
This month I’ve been working on a LibGuide for 2nd year year medical and dental students who recently began a new segment in their curriculum called Human Mechanisms of Disease-Oncology and it is (finally) complete.
The page is a collection of oncology/cancer information resources, e-textbooks, clinical guidelines, atlases, cancer genetics, National Cancer Institute or American Cancer Society, cancer trials registry info, etc. (Link is here). There’s also a set of bookmarks on Delicious (called “Onc2009“) which I gathered to complement what is on the LibGuide and includes information for patients.
Earlier this week, while scanning through recently updated pages on LibGuides, I found a page on Pathology & Laboratory Medicine written by a health science librarian from Dana Medical Library at the University of Vermont. Her page gave me links to several oncology textbooks to add to my Oncology list – because both institutions have subscription access to books via R2Library. In order words, our shared resources I might have missed adding these clinical textbooks to my page but because of Web 2.0 and sharing of information, I was able to see what other medical librarians have done thus making shared content that much more thorough and inclusive. (Thank you, Ms. Delwich!).
P.S. If you have comments or suggestions about other Oncology resources for clinicians to add to the pages, I would enjoy your feedback.
Categories: Consumer/Patient Health · Educational Sites · Epidemiology/Public Health · Instruction · Library 2.0 · Medical Students · Medicine 2.0 · News & Medical News
Tagged: Cancer Treatment, Cancer-statistics, del.icio.us, Instructional Technologies, Library 2.0, Medicine-Bookmarks, Oncology-Clinical Research, Resources for Medical Students, Springshare-LibGuides, Teaching-and-Learning in Medicine
Mercer Consulting, owned by U.S. insurance giant Marsh & McClennan, released highlights of its’ 23rd annual United States National Health Plan Survey on Nov 19 2008, which is a major source of health benefit data for U.S. employers and health care industry. The complete report will not be available for purchase from the company until March 2009 and will include a separate appendix of tables of responses broken out by employer size, region and industry
This survey has been published for 22 years and is described on the Mercer website in the following way: “The survey is conducted using a national probability sample of [U.S.] public and private employers with at least 10 employees. Nearly 3,000 employers completed the survey in 2008… it was conducted during late summer 2008, when most employers have a good fix on their costs for the current year. The results represent about 600,000 employers and more than 90 million full- and part-time employees. The error range is +/–3 percent.”
Highlights of the 2008 data can be viewed now at this link (at no cost). Following are a few extracts of the highlights which may be of interest:
- ” Employers held health benefit cost increases to about 6 percent in 2008 for a fourth straight year – but that has meant shifting more cost to employees… The Mercer survey found that total health plan cost per employee rose by 6.3% in 2008… Employers expect a similar increase for 2009 – 6.4 percent “.
- ” Consumer-directed health plans are offered by 20 percent of large employers, up sharply from 14 percent last year.”
- “ Mercer survey finds $1,000 health plan deductible was the norm in 2008 “.
- “ More large employers add incentives to encourage health-conscious behavior. ”
- ” Employers shed retiree medical plans in 2008, but with health reform looming there was no further erosion of active employee plans “.
Text Excerpts: Courtesy of Mercer Consulting – All rights reserved – Copyright 2009
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The economic outlook worldwide has worsened significantly since data from this survey were collected. Mounting business retrenchment and daily reports of massive layoffs continue to increase (link to BBC.uk.com feature – Jan 28 2009) causing millions of individuals to face the loss of employee-sponsored health insurance coverage.
Categories: Consumer/Patient Health · Healthcare-Administration · News & Medical News
Tagged: Consumer-Patient Health Insurance Coverage, Healthcare Costs-U.S., Mercer Consulting, United States-Health Care Benefits Surveys
