Posts about Health Care

A Healthy Lifestyle is More About Health Care than the Sickness Management That We Call Health Care Is

American Heart Association Recommendations for Physical Activity in Adults

Being physically active is important to prevent heart disease and stroke, the nation’s No. 1 and No. 4 killers. To improve overall cardiovascular health, we suggest at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of moderate and vigorous activity). Thirty minutes a day, five times a week is an easy goal to remember. You will also experience benefits even if you divide your time into two or three segments of 10 to 15 minutes per day.

For people who would benefit from lowering their blood pressure or cholesterol, we recommend 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week to lower the risk for heart attack and stroke.

The simplest, positive change you can make to effectively improve your heart health is to start walking. It’s enjoyable, free, easy, social and great exercise. A walking program is flexible and boasts high success rates because people can stick with it.

It really is important for giving yourself the best chance for health by taking sensible steps to exercise based on your own situation (obviously some health conditions may limit your ability to exercise safely, which is something each person has to judge and see a doctor about if necessary).

Doing small things like using a treadmill while you watch TV or taking the stairs instead of the elevator for short trips can help. Another option is to walk instead of driving your car, or if you drive parking a few blocks away (or at the far side of the parking lot) walking, or if you are running several errands walk between those that you can even if you are using your car. Biking to work is another healthy lifestyle choice (if you city has made this safe – too often they fail to do sensible things).

photo of a forest

Forest hike on Hole in the Wall trail, Olympic National Park, Oregon, USA by John Hunter

Swimming is good exercise and something I took up several years ago (I was super lame at first but within a month or two it was better. I love hiking through national parks. A standing desk (or treadmill desk) is another option to reduce the damage of our sedentary lives.

Another thing to remember is losing weight is hard. It is better to avoid gaining too much weight in the first place. Avoiding the weight gain may also be a challenge but it is better than the alternative.

Too often we treat “health care” as sickness management. Doing things like creating a healthy lifestyle are are health care. Taking pills and antibiotics is mainly about sickness management.

Related: Better Health Through Exercise, Not Smoking, Low Weight, Healthy Diet and Low Alcohol IntakePhysical Activity for Adults: Inactivity Leads to 5.3 Million Early Deaths a YearHealthy Diet, Healthy Living, Healthy WeightStudy Finds Obesity as Teen as Deadly as Smoking

Using Drones to Deliver Medical Supplies in Roadless Areas

This is an awesome use of technology to tackle important problems. Engineers are great.

Humanitarian drones to deliver medical supplies to roadless areas

That idea soon became a start-up called Matternet – a network for transporting matter – which aims to help the one billion people who do not have year-round access to roads.

[Andreas] Raptopoulos said the new system would be used to leapfrog the building of infrastructure, in the same way mobile networks have overtaken fixed lines in poorly connected countries.

In sub-Saharan Africa, 85% of roads are inaccessible during the wet season, cutting off huge swaths of the population and hindering the transport of medical supplies, he said.

There are three parts to the system delivering medical goods: the UAVs themselves, landing stations where packages can be dropped off and transferred, and the software that ensures vehicles get securely from point to point. Because of their short battery life, networks of drones are needed to work together, shuttling between ground stations

Approximate costings from Matternet put the price of unmanned aerial vehicles at £6,000 each and ground stations at £3,000 each. A network of five ground stations and 10 UAVs, as well as setup and training, would cost a charity in the region of £90,000, according to Raptopoulos. An eight-propeller drone can carry 2kg and travel 10km in good weather. Batteries need to be replaced every 600 cycles.

They are hiring: software engineer and avionic engineering right now. They are Palo Alto, California.

Related: Appropriate Technology Health Care Solution Could Save 72,000 Lives a YearCellphone MicroscopePay as You Go Solar in IndiaWater and Electricity for All

Drugmakers Are Desperate to Know Why Placebos Are Getting More Effective

Fascinating article from Wired: Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why.

The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. The stakes could hardly be higher. In today’s economy, the fate of a long-established company can hang on the outcome of a handful of tests.

Potter discovered, however, that geographic location alone could determine whether a drug bested placebo or crossed the futility boundary. By the late ’90s, for example, the classic antianxiety drug diazepam (also known as Valium) was still beating placebo in France and Belgium. But when the drug was tested in the US, it was likely to fail. Conversely, Prozac performed better in America than it did in western Europe and South Africa. It was an unsettling prospect: FDA approval could hinge on where the company chose to conduct a trial.

In one study, Benedetti found that Alzheimer’s patients with impaired cognitive function get less pain relief from analgesic drugs than normal volunteers do. Using advanced methods of EEG analysis, he discovered that the connections between the patients’ prefrontal lobes and their opioid systems had been damaged. Healthy volunteers feel the benefit of medication plus a placebo boost. Patients who are unable to formulate ideas about the future because of cortical deficits, however, feel only the effect of the drug itself. The experiment suggests that because Alzheimer’s patients don’t get the benefits of anticipating the treatment, they require higher doses of painkillers to experience normal levels of relief.

Benedetti often uses the phrase “placebo response” instead of placebo effect. By definition, inert pills have no effect, but under the right conditions they can act as a catalyst for what he calls the body’s “endogenous health care system.” Like any other internal network, the placebo response has limits. It can ease the discomfort of chemotherapy, but it won’t stop the growth of tumors. It also works in reverse to produce the placebo’s evil twin, the nocebo effect. For example, men taking a commonly prescribed prostate drug who were informed that the medication may cause sexual dysfunction were twice as likely to become impotent.

Moreover, a pill’s shape, size, branding, and price all influence its effects on the body. Soothing blue capsules make more effective tranquilizers than angry red ones, except among Italian men, for whom the color blue is associated with their national soccer team—Forza Azzurri!

Medical research presents significant difficulties. The funding of the health care system also distorts behavior and pushes companies to focus on being able to justify selling drugs instead of focusing on finding effective solutions. Even without incentives distorting behavior, the challenges are difficult enough. Adding the distortions just makes it worse.

It is wonderful we have so many scientists accepting these challenges and spending their careers fighting the odds to help find us wonderful health breakthroughs.

Related: The Majority of Clinical Trials Don’t Provide Meaningful EvidenceSystem for Approving New Medical Options Needs ImprovementMedical Study Integrity (or Lack Thereof)Discussing Medical Study Results

Appropriate Technology Health Care Solution Could Save 72,000 Lives a Year

We need more medical solutions that serve the majority of humanity instead of just the rich. Some medical research is innately costly and therefore require large costs to pay back the investment. But too little concern is shown for solutions that help people (with so much focus only on solutions that will make organizations rich).

Cheap vinegar test cut cervical cancer deaths in India; could help many poor countries

This low-tech visual exam cut the cervical cancer death rate by 31 percent, the study found. It could prevent 22,000 deaths in India and 72,600 worldwide each year, researchers estimate.

More progress against cervical cancer may come from last month’s announcement that two companies will drastically lower prices on HPV vaccines for poor countries. Pilot projects will begin in Asia and Africa; the campaign aims to vaccinate more than 30 million girls in more than 40 countries by 2020.

India continues to invest in medical research for solutions that are affordable to a majority of the world. The rich health care companies largely neglect the majority to focus on the most wealthy.

Related: Using Available Technology (Cellphone) as a MicroscopeDangerous Drug-Resistant Strains of TB are a Growing Threat‘Refrigerator’ Without Electricity

Engineers Save a Life

photo of car resting in river

This photo was taken by the driver’s parents when they arrived. It doesn’t show much of what it went through to get there, but it gets most of the point across. The picture was taken 200 feet away and looking down from the road.

I got into a major accident today that I was able to somehow walk away from. I lost control of my car and went off of a cliff into boulders, and after flipping a few times, settled in the river. I walked away with cuts on my hands from the broken glass and a bruise that runs from my chest over my left shoulder where my seat belt held me in place.

I shouldn’t be alive discussion on Reddit.

swapsrox: Time to send a letter to the manufacturer thanking them for their safety design! I guarantee your letter will be put on an engineer’s wall, and they’ll know there is a reason they go to work every day.

cmdshftn: Great engineering saved your life. The vehicle’s safety systems from the seatbelt to the crumple zones to the design of the seat kept you safe and alive despite all hell going on around you. Please write a letter to the manufacturer thanking their design team, but above all, follow up with whoever you need to in that jurisdiction to find out why there isn’t a guard rail on that road! Vehicle safety helps, but great road design to prevent an accident like yours helps more!

Related: Electronic Stability Control Could Prevent 33% of Crash DeathsDriver Thanks Engineer Who Hit Him on PurposeSmokeless Stove Saves LivesToyota Scion iQ: 37 MPGEngineer Tried to Save His Sister and Invented a Breakthrough Medical Device

Continue reading

CDC Again Stresses Urgent Need to Adjust Practices or Pay a Steep Price

Untreatable and hard-to-treat infections from Carbapenem-resistant Enterobacteriaceae (CRE) germs are on the rise among patients in medical facilities. CRE germs have become resistant to all or nearly all the antibiotics we have today. Types of CRE include Klebsiella pneumoniae Carbapenemase (KPC) and New Delhi metallo-beta-lactamase (NDM). By following the United States Center for Disease Control (CDC) guidelines, we can slow the penetration of CRE infections in hospitals and other medical facilities and potentially spread to otherwise healthy people outside of medical facilities.

The CDC has worked with hospitals to successfully apply these measures. The CDC worked with Florida to stop a year-long CRE outbreak in a long-term acute care hospital. With the improved use of CDC recommendations (such as educating staff; dedicating staff, rooms, and equipment to patients with CRE; and improving use of gloves and gowns) the percentage of patients who got CRE at the facility dropped from 44% to 0.

One travesty has been how poorly health care professionals have been about prescribe antibiotics wisely We need to improve and follow CDC antibiotics guidelines (stop the overuse of antibiotics) and use culture results (for patients undergoing treatment) to modify prescriptions, if needed. Antibiotic overuse contributes to the growing problems of Clostridium difficile (c-diff) infection and antibiotic resistance in healthcare facilities. Studies indicate that nearly 50% of antimicrobial use in hospitals is unnecessary or inappropriate (per CDC web site).

Israel decreased CRE infection rates in all 27 of its hospitals by more than 70% in one year with a coordinated prevention program. The USA is at a critical time in which CRE infections could be controlled if addressed in a rapid, coordinated, and consistent effort by doctors, nurses, lab staff, medical facility leadership, health departments/states, policy makers, and the federal government.

As I have been saying for years the damage we are creating due to our actions around the use and abuse of antibiotics is likely to kill tens of thousands, or more people. Because the deaths are delayed and often not dramatic we have continued dangerous practices for years when we know better. It is a shame we are condemning so many to increased risks. The CDC, and others, are doing good work, unfortunately too much bad work is continuing in the face of evidence of how dangerous that is.

Related: CDC Urges Increased Effort to Reduce Drug-Resistant Infections (2006)Key scientific articles on Healthcare Associated Infections via CDCOur Dangerous Antibiotic Practices Carry Great RisksDangerous Drug-Resistant Strains of TB are a Growing Threat

System for Approving New Medical Options Needs Improvement

Something Doesn’t Add Up

Not only did the team find that evidence for Infuse’s benefits over existing alternatives for most patients was questionable; they also discovered in a broad array of published research that risks of complications (including cancer, male sterility and other serious side effects) appeared to be 10 to 50 times higher than 13 industry-sponsored studies had shown. And they learned that authors of the early studies that found no complications had been paid between $1 million and $23 million annually by the company for consulting, royalties and other compensation. Carragee, MD ’82, estimates Medtronic has sold several billion dollars’ worth of Infuse for uses both approved and “off label.”

Without a rigorous, data-driven context, medicine’s expensive traditions and hunch-based treatments threaten to bankrupt us. “People say that we shouldn’t delay science; people are dying; we should get new treatments out there. I do not feel the pressure to do that until we have solid evidence,” Ioannidis asserts. “The resources many procedures draw are enormous.” And that leaves insufficient funds for the prevention plans and treatments we know actually work.

I have written about the problems with our health care research system several times. The existing system is in need of improvement and is made much worse by the general state of the broken health care system in the USA. Dr. John P.A. Ioannidis, the focus of the article, is doing fantastic work in this area.

Related: Majority of Clinical Trials Don’t Provide Meaningful EvidenceStatistical Errors in Medical StudiesUSA Spends $7,960 Compared to Around $3,800 for Other Rich Countries on Health Care with No Better Health ResultsDrug Company Funding Taints Published Medical ResearchMistakes in Experimental Design and InterpretationUnderstanding Data

Toyota Human Support Robot

Toyota continues to develop their partner robot initiative. Demographics in Japan make a compelling case for the need to provide solutions to those who need assistance to support independent living.

The aim is to contribute to the maintenance and improvement of quality of life.

In cooperation of the Yokohama Rehabilitation Center, Toyota conducted experiments for disabled people, using HSR in their homes, in 2011. Toyota has been integrating the feedback to the design, based on actual user experience.

The Human Support Robot (HSR) can pick up something on and bring it to the person. Also it can do small tasks such as opening the curtains.

Controlling the robot can be done easily, by using the voice recognition function or using a tablet control. In addition, Toyota is designing it to directly assist the person, helping them get into and out of a bathtub, for example.

They are also developing new features for remote viewing and remote operation (to provide off site help to make the robot more useful). They are working with health care professionals, including nurses, and research institutions aimed at practical use for such a robot.

Toyota, along with several other Japanese companies, continue to invest a great deal to create personal care robots.

Related: Toyota Partner RobotsToyota Develops Thought-controlled WheelchairHonda’s Robolegs Help People WalkToyota Winglet, Personal Transportation

Continue reading

Man in Coma for 7 Years was Given a Sleeping Pill and Woke Up

Lazarus pill miracle for E Cape man, 9 September 2012

After reading a report in City Press last month, his wife, Nomfundo, insisted that he be given a prescription for the sleeping pill Stilnox, which has the opposite effect on those with brain injuries.

It worked – and brought him out of a seven-year coma.

But on August 12, family friend Nceba Mokoena came across an article in City Press about a miracle recovery made by another car crash victim, hundreds of kilometres away in Gauteng.

Louis Viljoen was given the sleeping pill by chance by his mother, Sienie.

She had noticed he wasn’t sleeping peacefully and asked her doctor if she could give him half a sleeping tablet. After she did, Louis opened his eyes and said “Hello Mamma”, his first words in five years.

Very cool anecdote and example that modern medicine has many miraculous cures but the medical system can’t always use them as well as we would hope. Even with all the knowledge we have today just getting that information into the right doctor’s minds is very hard. And the complexity of diagnoses and interactions makes medical care still an art as well as a science.

So is this just some freak accident. Partially, in the mother giving her son a sleeping pill to reduce his seeming restlessness in the coma. But the effect of Stilnox in bringing coma victims out of a coma has been documented previously.

Reborn from persistent vegetative state, 12 September 2006

Four three years, Riaan Bolton has lain motionless, his eyes open but unseeing. After a devastating car crash doctors said he would never again see or speak or hear. Now his mother, Johanna, dissolves a pill in a little water on a teaspoon and forces it gently into his mouth. Within half an hour, as if a switch has been flicked in his brain, Riaan looks around his home in the South African town of Kimberley and says, “Hello.” Shortly after his accident, Johanna had turned down the option of letting him die.

Three hundred miles away, Louis Viljoen, a young man who had once been cruelly described by a doctor as “a cabbage”, greets me with a mischievous smile and a streetwise four-move handshake. Until he took the pill, he too was supposed to be in what doctors call a persistent vegetative state.

Across the Atlantic in the United States, George Melendez, who is also brain-damaged, has lain twitching and moaning as if in agony for years, causing his parents unbearable grief. He, too, is given this little tablet and again, it’s as if a light comes on. His father asks him if he is, indeed, in pain. “No,” George smiles, and his family burst into tears.

It all sounds miraculous, you might think. And in a way, it is. But this is not a miracle medication, the result of groundbreaking neurological research. Instead, these awakenings have come as the result of an accidental discovery by a dedicated – and bewildered – GP. They have all woken up, paradoxically, after being given a commonly used sleeping pill.

Medical care is still today an extremely difficult area where highly trained and continuously learning doctors still have a great deal of trouble keeping up with the latest medical knowledge.

Related: Hospital Reform, IHI’s efforts to get good practices adoptedNorway Reduces Infections by Reducing Antibiotic UseMajority of Clinical Trials Don’t Provide Meaningful EvidenceContinual LearningPhysical Activity for Adults: Inactivity Leads to 5.3 Million Early Deaths a Year

Today, Most Deaths Caused by Lifetime of Action or Inaction

Chart of the Leading Causes of Death in 1900 and 2010

Our instincts lead us to fear the unknown and immediate threats (probably so we can be ready to run – or maybe fight). But today the biggest risks to an untimely dealt are not lions, other people out to get us, or even just random infection. We have to adapt to the new risks by taking action to eat healthfully and exercise, in the same way we we have evolved to avoid becoming a meal for a hungry beast.

Today the largest causes of death are heart disease and cancer (which account for more than 60% of the deaths causes by the top 10 leading causes of death). The next leading causes are non-infectious airways diseases, cerebrovascular diseases and accidents. Alzheimer’s, diabetes, nephropathies, pneumonia or influenza and suicide make of the rest of the top 10 leading causes.

In 1900 Pneumonia or influenza and tuberculosis took as many lives (per 100,000 people) and cancer and heart disease take today. We have done well decreasing the incidents of death (fewer deaths per 100,000) by greatly reducing and nearly eliminating some causes of death (the 2 leading causes from 1900 are good examples).

Continue reading

One Scientists 20 Year Effort to Defeat Dengue Fever

As I have said many times scientific breakthroughs often follow many years of effort. Here is a great example of a scientist putting in great work for years and it looks like it is about to payoff for hundreds of millions of people.

A Scientist’s 20-Year Quest To Defeat Dengue Fever

Now as I said, Scott’s been pushing this idea of using Wolbachia to control dengue for decades, for a most of that time without any success. I asked Scott what it takes to stick with something for that long.

“I think being obsessive,” he replied. “Being maybe a little ill in that regard. And it’s just that I seem to have focused my obsession onto Wolbachia instead of on to postage stamps or model trains.”

And even though his obsession has brought him to the point where he’s shown he can get his Wolbachia-infected mosquitoes to spread in the wild, that’s not the success he’s ultimately after. “Success for me is having a significant impact on dengue disease in communities,” he says.

To do that, he’ll have to release his mosquitoes in a place where there’s a lot of dengue, and then see if that brings down the number of cases of the disease in humans. Those studies are being planned now.

The stakes are high. By some estimates, more than a billion people around the world are at risk for getting dengue. Even if it doesn’t kill you, I’m told a case of dengue can make you feel so bad, wish you were dead.

But Scott says it’s not yet time to celebrate.

“We’ve got some good preliminary data, and we’re on the path. And it’s looking good. But you know I am a realist. It could fall over at any day,” says Scott.

Related: Engineering Mosquitoes to be Flying VaccinatorsScientists Building a Safer Mosquito (2006)Video showing malaria breaking into cellTreated Mosquito Nets Prevent Malaria

  • Recent Comments:

    • Jonathan Winter: Here is a good article on advantages and disadvantages of Geothermal for the home. This is...
    • Benjamin S: it’s well known that the eyes of octopus are the most complex of all nonvertebrates, but...
    • John Hunter: The disease continues to do great damage and we haven’t found a cure or treatment yet...
    • dasa: Nice to see that wind energy is taking place.
    • chaulong: Wow, loved your initiative! Gathering people’s ideas is a great way to give a lot of handy...
    • Jason Taylor: That’s incredible. I love hearing about the new ways that technology is being utilized...
    • Michael: Well Done young man….Well done indeed….. Mike
    • Aira Bongco: Who said that lizards are not smart? It seems like they can also solve simple problems which...
  • Recent Trackbacks:

  • Links