Ebola vs. COVID-19: public health lessons from Liberia

There is a plethora of literature, addressing public health policies regarding COVID-19. The following paragraphs are excerpted from an article by Anfaara et al. published in Social Science and Medicine, January 2025

"Like elsewhere in the world, care work is gendered, with women bearing the brunt of caregiving during disease outbreaks or health emergencies. However, in Liberia, we argue that the inadequacies of the health system and past political administrations further exacerbated the care burden on women. While this aligns with our theoretical framework, it is noteworthy that despite both governments (Sirleaf and Weah) representing the elite ruling class in Liberia, our participants seem to credit one administration for being more responsive to disease containment. For instance, our participants perceived the Sirleaf administration's willingness to include grassroots organisations and other major stakeholders in Ebola management as a collective effort and a critical reason for the success of Ebola containment. This is probably because, during the initial crisis stage of Ebola, the Sirleaf administration created the National and County-level Ebola task force to brainstorm and initiate strategies to mitigate the spread of Ebola before the arrival of international support. Women's groups, in particular, were invited to be part of the national Ebola response, and there was regular Ebola messaging and communications from the government during this period; as well, on multiple occasions, Sirleaf called for an "all-hands-on-deck" approach to Ebola containment (WHO, 2015; BBC, 2014). Study participants observed that similar strategies were not fully implemented during the COVID-19 pandemic.

 

Certainly, the Weah administration implemented some of the post-Ebola disease management strategies to contain COVID-19. These included early surveillance, implementing a state of emergency, and restricting local and international travel (Babalola et al., 2022). Yet, participants perceived the administration's approach to COVID-19 management as unitary due to its exclusion of grassroots community-based groups in its response strategies and the government's promotion of alternative COVID-19 remedies. It is possible that the Weah's administration promotion of an alternative solution to COVID-19 containment (see News Public Trust, 2020) may have undermined vaccine uptake and reinforced conspiracy theories about the disease. This experience is not unique to Liberia; in fact, many studies have shown that leadership by positive examples reinforce scientifically proven disease management strategies while negative examples erode trust (Kutor et al., 2022; Nyenswah et al., 2016)."

Well Being Not a Priority

Working overtime may cost you your health, according to a Kansas State University doctoral researcher.

Sarah Asebedo, doctoral student in personal financial planning and conflict resolution, Edina, Minn., conducted a study using the National Longitudinal Survey of Youth 1979. She and her colleagues -- Sonya Britt, assistant professor of family studies and human services and director of the university's personal financial planning program, and Jamie Blue, doctoral student in personal financial planning, Tallahassee, Fla. -- found a preliminary link between workaholics and reduced physical and mental well-being. The study, "Workaholism and Well-Being," will appear in Financial Services Review, a journal of individual financial management.

"We looked at the association between workaholism and physical and mental well-being," Asebedo said. "We found workaholics -- defined by those working more than 50 hours per week -- were more likely to have reduced physical well-being, measured by skipped meals. Also, we found that workaholism was associated with reduced mental well-being as measured by a self-reported depression score."

The link between workaholism and well-being has been assumed for years; however, there was a lack of research supporting the link until this study, Asebedo said. To understand why people work overtime even when they know it is not good for their well-being, the researchers used Gary S. Becker's Theory of the Allocation of Time, a mathematical analysis for choice measuring the cost of time.

"It looks at the cost of time as if it were a market good," Asebedo said. "This theory suggests that the more money you make, the more likely you are to work more. If you are not engaged in work-related activities, then there is a cost to the alternative way in which time is spent. Even if you understand the negative consequences to workaholism, you may still be likely to continue working because the cost of not doing so becomes greater."

According to Asebedo, Becker's theory suggests that not only can working more make a person wealthier but it also creates less leisure time to spend money. As income increases a person may be more likely to work more and create an unhealthy habit.

As a full-time wealth manager for Accredited Investors in Edina, Asebedo has found the research useful in counseling clients. She advises workaholics to be aware of the effect excessive work has on their physical and mental well-being and to be prepared for what they can do to mitigate or counteract the effects during busy work periods.

"From a financial planning and counseling perspective, it's good to be aware of workaholism," Asebedo said. "It helps me understand what can be the cause of my clients' stress. It's just a reminder that you may want to dig a bit deeper into clients' work lives. Sometimes you might find that they don't like what they are doing and they want to make a change, yet financially, they don't know how they can accomplish that."

Asebedo received her bachelor's and master's degrees from Kansas State University. She returned to the university to get her doctorate in personal financial planning through the Division of Continuing Education distance program because she was interested researching the role conflict resolution plays in financial planning.

Data for the study was taken from the National Longitudinal Survey of Youth 1979 cohort, a nationally representative sample of 12,686 young men and women who were interviewed on an annual basis from 1979 through 1994 and are currently interviewed on a biennial basis.

Source: Kansas State University

Business and Healthcare;Entrepreneurship Joints?

Part-maverick, part-unconventional, part-smart business owner Sir Richard Branson has business lessons to share in spades. Since I recently read his third autobiographical book Business Stripped Bare: Adventures of a Global Entrepreneur, I wanted to pass on some of what I learned from the book.

Without knowing exactly why, I have long admired his acumen and chutzpah. His story has provided me insights into why I’ve been so drawn to his adventures in business and his larger-than-life personality.
For those of you who don’t know much about him, Branson is the product of a somewhat privileged middle-class upbringing (he descends from a line of barristers and judges) and an English public school (what we in the US call a private school). A self-proclaimed poor student with dyslexia, he failed to complete any college degree, but opted instead to start a business, first as a magazine publisher and then as a mail-order record company owner. He went on to found Virgin Records, and this single venture expanded over the decades to become the Virgin Group, a conglomerate of businesses focused on travel (planes, trains, space travel), entertainment and lifestyle (including humanitarian ventures like fighting HIV, AIDS and climate change).
I came away with many business lessons. Here are a few.
Branson’s business philosophy is crystallized in these words, when asked why he went into business:
I’ve never been interested in being ‘in business’. I’ve been interested in creating things … Business is creative. It’s like painting. You start with a blank canvas. You can paint anything – anything – right there, is your first problem. For every good painting you might turn out, there are a zillion bad paintings just aching to drip off your brush. Scared? You should be. You start. You pick a color. The next color you pick has to work with the first color … People who succeed in business have swallowed their fear and have set out to create something special, something to make a difference to people’s lives …
Lesson: To thrive in business, it really helps to be passionate about creating something worthwhile. As a relative newcomer to entrepreneurship, I have maintained for years now that being an entrepreneur is a radical act of creativity, and it makes an every day “practice” so much more fun once you think of it as an entrepreneurial venture.
His fiercely independent path to success, in the face of rampant naysayers and critics, is both inspirational and hard to imagine duplicating. His gut instincts have won out many times over the analytics and pompous prognostications of others. He’s a master as staying on course with his vision and sense of purpose and ignoring the conventional wisdom.
I’m not good at theory. Almost everything I’ve learned, I’ve learned by doing.
Lesson: While you may draw insight and inspiration from someone else’s success story, you must rely on knowledge about your own marketplace, along with your inner talents and skills, to forge your own path.
Branson has been driven by the desire to innovate, partly I suspect because it’s in his genetic make-up and partly because he has been an astute observer of his own ecosystem’s evolution.
The best, most solid way out of a crisis in a changing market is through experimentation and adaptation.
Lesson: Healthcare is in crisis and the market is changing. It’s vital that we, as providers in an unstable setting, experiment and adapt. New business models? New levels of customer service? New joint ventures, relationships, partnerships?
His two greatest secrets of business success, in my opinion?
1. His relentless focus on the Virgin brand, along with his absolute clarity about what the brand stands for.
2. His dogged insistence on placing the people who work for him first. Wouldn’t that be nice, in healthcare?
by Philippa Kennealy, MD, MPH

Imaging's Torrid Growth Rate Is Slowing

 Is the era of rapid growth in medical imaging procedure volume over? The volume of advanced imaging services delivered to Medicare beneficiaries decreased in 2009 -- the first decrease in 11 years, according to a study released Wednesday.
Washington, DC-based research and consulting firm the Moran Company found that the volume of advanced imaging services billed within the Medicare system decreased by 0.1% in 2009 compared with 2008, while overall imaging services declined by 7.1% for the same year-to-year comparison.

"It's pretty clear the era of very rapid growth in advanced medical imaging seems to have come to an end at this point in time," said Don Moran, president of the Moran Company. "All the data point to a leveling. It's unclear whether we will see further declines, but the prior growth of these modalities and the advantages they offer to clinicians seems to be peaking."
The study, released today by the Access to Medical Imaging Coalition (AMIC), reviewed Medicare claims data from 1999 through 2009, examining both spending and volume of advanced imaging services, such as CT, MRI, nuclear medicine, and PET, as well as overall imaging services, including mammography.

Declining Volume

The analysis also found that the total volume of mammography screenings decreased by 0.3% in 2009, compared with a 2.8% compound annual growth rate in the past decade. In addition, the total volume of dual-energy x-ray absorptiometry (DEXA) exams fell by 2.2%, while spending on this technique decreased by 16% from 2008 to 2009.
The new findings are comparable to a 2008 analysis of Medicare claims data that showed a 19.2% reduction in Medicare spending on advanced imaging from 2006 to 2007. It also revealed a significantly reduced procedure volume growth rate of only 1.9%, which was less than the overall rate of physician-payment growth.
In addition, a study presented by David C. Levin, MD, and colleagues at the 2010 RSNA meeting found that imaging procedure volume grew at a compound annual growth rate (CAGR) of 1.4% between 2005 and 2008, well down from the 4.1% CAGR experienced between 1998 and 2005.
Imaging industry observers have attributed the slowing growth rate to reimbursement cuts for medical imaging such as those enacted by the Deficit Reduction Act of 2005. The healthcare reform legislation passed in 2010 includes additional reimbursement reductions.
The study shows that "medical imaging has been decimated by these cuts," said Tim Trysla, executive director of AMIC. "The impact of these cuts, even by the government's own estimates, has 'de facto' caused access problems for patients and providers. We are very concerned about choking off the access to these lifesaving technologies."
John Patti, MD, a radiologist at Massachusetts General Hospital in Boston and chair of the American College of Radiology Board of Chancellors, said he and fellow radiologists are concerned with imaging's declining growth rate, because the Medicare population is increasing and the incidence and prevalence of disease remain the same.

Early Diagnosis

"One of the tremendous benefits of advanced imaging over the years is that it has obviated the need for more costly and evasive diagnostic evaluation," Patti said. "This reversal of trend suggests that Medicare patients may not be receiving those appropriate exams and thus the benefit of early diagnosis."
In addition, he said the decrease may have "negative downstream effects on the health of our aging citizens and on the cost of providing the more complex care that may be necessary to treat disease if it is discovered in advanced stages."
One potential victim of the decline is outpatient imaging center owners and operators. Because of reimbursement cuts for outpatient imaging, some physicians have sold or given their imaging activities to hospitals, which are reimbursed at a higher rate under the Hospital Outpatient Prospective Payment System (HOPPS). That scenario, in turn, could lead to less access to advanced imaging services.
In other study data, Medicare spending for advanced imaging services increased by less than half the spending growth for physician services overall. With a 1.2% increase in spending for advanced imaging, compared with 2.6% for services overall, imaging was one of the slowest-growing segments of the physician fee schedule in 2009.


Some Optimism
Despite the volume downturn in 2009, Trysla believes that advanced medical imaging will continue to contribute to patient care. "Medicine will not turn its back on advanced technology, especially with the benefits of early detection of disease, such as Parkinson's disease and cancer," he said. "I think you will see growth through new applications in technology, and medicine will continue to evolve from exploratory surgery toward early and more exact detection."
ACR's Patti also speculated that the dip in growth in 2009 would be temporary. "I don't think there are any physicians who are taking direct care of patients who don't understand the value of advanced imaging," he added. "And, I don't think there are any physicians who are willingly withholding [advanced imaging] from patients."


by : Wayne Forrest

10 Doctors Who Shamed Their Profession

If you think about it, the comparison of doctors to mechanics is pretty apt. Given the specialized nature of their work and the general helplessness of most patients, doctors, like mechanics, are rarely held accountable for their actions. Sure, for the most part, doctors have your best interest at heart, but like in any profession, there are both good and bad apples. According to the National Patient Safety Foundation, 42 percent of people believed they had personally experienced a medical mistake. Additionally, numerous statistics have shown that a staggering amount of people die each year due to medical error. The following doctors made such blatant mistakes and/or lapses in judgment that they, at the very least, have a reputation that garnered them recognition on this list.
1.Dr. Earl Bradley, Monster: Nothing is worse than violating the trust of a child, which is why Bradley, a former pediatrician from Lewes, Delaware, is such a monster. In February of 2010, he was indicted on 471 charges of child sex abuse involving 103 children. Initial allegations against Bradley surfaced during the mid-’90s, but the hospital for which he worked was unable to verify the claims. They were enough, however, to prompt him to move to Delaware, where more allegations surfaced a decade later, including that he had abused his own son. Bradley was initially arrested in December of 2009 after a year-long investigation, which prompted the indictments two months later.


2.Dr. Robert Ricketson, Screw Up: Ricketson is no longer practicing medicine and the world is better for it. During a spine operation he performed on 73-year-old Arturo Iturralde in 2003, Ricketson intentionally inserted a piece of a screwdriver into the patient’s spine instead of a titanium rod. The rod he had intended to use went missing prior to the surgery, so he took it upon himself to improvise. As a result, Iturralde endured three additional surgeries to insert the proper rod and correct complications. After one of the operations, pieces of the screwdriver were recovered by nurses and the family was alerted. Iturralde became a paraplegic and died two years later, and his family was awarded $5.6 million in a malpractice lawsuit in 2006. During the aftermath, it was discovered that Ricketson’s medical license had been suspended in Oklahoma and Texas and he was denied consideration for a medical license in Kansas in 2002, a year after the botched surgery. He had previously been sued for malpractice several times and had history of narcotics abuse. Not a very impressive resume to say the least.
3.Dr. Jan Adams, Plastic Surgeon Imposter: Adams is most famous for performing the breast augmentation surgery on Donda West, Kanye West’s mom, that resulted in her death in 2007. But that’s not the only blemish on his record. In a malpractice suit against Adams, a previous patient claimed that she didn’t receive proper preoperative or postoperative care, leading to an infection that needed two more surgeries. What’s more, one patient claimed he got her drunk after a surgery and impregnated her, and another claimed a surgical sponge was left inside of her after a breast augmentation. Adams, who attended Harvard University, never received his diploma despite apparently completing his academic requirements. He’s also not a board certified plastic surgeon despite claiming to be one. How was this guy getting work?


4.Julie Ponder and Connell Watkins, Child Killers: Alternative medicine can be a risky proposition given the unproven nature of many of its methods. Attachment therapy in particular can yield tragic results when taken to an extreme. The treatment is used to remedy attachment disorders primarily suffered by adopted and fostered children who persistently misbehave or display little affection toward their new caregivers. In 2000, 10-year-old Candace Newmaker was killed during such treatment when she was suffocated during an intensive rebirthing session. Wrapped in a flannel sheet by psychotherapists Julie Ponder and Connell Watkins, she told to free herself from it while Ponder and Watkins held her down. She pleaded for her life, but was told by Ponder "You want to die? OK, then die. Go ahead, die right now." Newmaker was declared brain dead the next day due to asphyxia. The entire session was videotaped and presented as evidence against Ponder and Watkins, who were each given 16-year prison sentences — Watkins was paroled in 2008 after serving seven years.

5.Dr. James Burt, Ghastly Gyno: The notorious Dr. Burt was exposed for his harmful and downright bizarre practices in the late 1980s when numerous former patients came forward and initiated lawsuits. Beginning in the late 1960s, Burt took it upon himself to perform "love surgeries" in which he altered his patients’ vulvas without their consent. He justified his work in a book he authored in 1975, explaining that "Women are structurally inadequate for intercourse. This is a pathological condition amenable by surgery." He stated the procedure turns them into "horny little mice," though in reality, many of them suffered sexual dysfunction, infection and required corrective surgeries as a result. A $21 million suit was filed against Burt that couldn’t have come close to covering the physical and emotional damages endured by the at least 40 women he hurt.

6.Dr. Cecil Jacobson, Seed Spreader: As a fertility doctor, it was Dr. Jacobson’s duty to assist women in conceiving, and in the 1980s, it appeared he was doing a pretty good job. His patients reported high success rates due to his use of hCG, a hormone released during pregnancy that causes the typical bodily changes. During the supposed pregnancies initiated by hCG, he would identify the fetuses during an ultrasound, but they would usually "die" after about three months. Patients who suspected something was amiss informed a local television station, which investigated and exposed Jacobson. In the process, they discovered he used his semen to artificially inseminate patients who were told they were matched with an anonymous donor. Genetic testing later showed that he was the biological father of at least seven of his patients’ children. Jacobson, who won the Ig Nobel Prize for Biology in 1992 and claimed to have successfully oversaw the impregnation of a male baboon in the 1960s, was stripped of medical license and sentenced to five years in prison.


7.Dr. Rolando R. Sanchez, Accidental Amputator: To be fair to Dr. Sanchez, he has done a fine job of rehabilitating his reputation after the costly mistake he oversaw in 1995 — in fact, he’s still practicing. Even still, it’s the kind of inexcusable error you’d never wish on your worst enemy. In the process of amputating Willie King’s leg, Sanchez was informed by a nurse that he had cut into the wrong one. It was too late, however, and he had to finish what he started — King would later have the original leg amputated by another doctor. Consequently, Sanchez was suspended on the grounds that he presented an "immediate and serious danger to the health, safety and welfare of the public," and King later settled with the hospital.

8.Dr. Red Alinsod, Organ Tattoo Artist: Ingrid Paulicivic certainly won’t be recommending Dr. Alinsod given what occurred during her June 2009 hysterectomy. According to Paulicivic’s lawsuit, while putting the finishing touches on the surgery, Dr. Alinsod decided to brand his work by using an "electrocautery device to carve and burn" her name into her removed uterus. Alinsod claimed the move was necessary to ensure he wouldn’t confuse the uterus with others. Paulicivic became aware of the branding during a follow-up visit in which she complained of the resulting burns on her legs.

9.Dr. Elias Hanna, Carvey Carver: Dr. Hanna nearly caused the premature death of yet another Saturday Night Live legend. In 1998, he botched Dana Carvey’s heart bypass surgery by connecting a healthy portion of his artery to a healthy diagonal vessel instead of the damaged arterial section. It wasn’t until two months after the operation that Hanna discovered the mistake, resulting in an emergency angioplasty for Carvey — his fourth in less than a year. Before it was corrected, he was susceptible to suffering a fatal heart attack. Carvey filed a medical malpractice lawsuit and eventually settled for $7.5 million.


10.Alan Hutchinson, Dirty Dentist: Hutchinson, a dentist from Batley, West Yorkshire, UK, made headlines in 2007 when he was accused of using sterilized instruments to clean his ears and fingernails, working on teeth without washing his hands or using gloves, and urinating in a surgical sink. Complaints from a patient and his nurse, Claire Pygott, eventually led to a guilty verdict from the General Dental Council in London. Pygott said that she was "shocked, disgusted and appalled" by the dentist’s actions, which she had witnessed on more than one occasion.
 
Source : http://www.mastersinhealthcare.com/blog/
special thanks to Celina Jacobson

On Impact of Physician Burnout

by : Kevin Pho
I wrote last year in USA Today about the impact of physician burnout. Not only do doctors suffer, but so do their patients.

Burnout starts early in residency, with entering interns having a depression rate of 4%, similar to the general public. But after the first year of residency, that number balloons to 25%.
Now, another study adds fuel to this disturbing trend.
A paper published in the Archives of General Surgery looks at the prevalence of physician burnout in surgeons:
In a national survey, one in 16 surgeons reported contemplating suicide, researchers reported.
An increased risk of suicidal ideation was linked to three factors: depression, burnout, and the perception of having made a recent major medical error …
… But only about one in four of those who reported thinking about taking their own lives sought psychiatric or psychologic help.
The rate of suicidal ideation in surgeons, at 6.3%, was almost double of that in the general population (3.3%).
Physician burnout is a phenomenon that’s often ignored. The practice environment is deteriorating, with increasing time pressures and worsening bureaucratic burdens. Little of this is addressed in the national health conversation, or in the recently passed health reform law.
As more doctors burnout and quit medicine, patients will suffer. It’s certainly not an ideal situation as more than 30+ million newly-insured patients will be looking for physicians to care for them in the coming years.
And for the physicians who stay, burnout will impact the care they give to patients — including a decrease in empathy and an increase in medical errors.
Burnt out doctors feel they have little recourse. In the Archives study,
Only 130 surgeons — 26% of those who had recent suicidal thoughts — had sought psychiatric or psychologic help.
Among the 501 doctors who reported suicidal thoughts, 301 said they were reluctant to seek help because of worry that it could affect their medical license.
That’s unacceptable. Hospitals need to better recognize the signs of burnout and increase the support they give to depressed physicians.
Another consideration would be to better monitor work hours to ensure proper work-lifestyle balance. Today, doctors in training are strictly regulated to ensure they work no longer than 80 hours a week. Once they graduate and practice in the real world, that oversight ceases. There is nothing to prevent doctors from working days at time, which can happen at an understaffed, rural hospital, for instance.
The same zeal that goes into limiting residents’ work hours should be applied to doctors in the real world, to ensure their workload doesn’t drive them to burnout and potential suicide.

Study: Self-referral for advanced imaging is common

The Center for Studying Health System Change (HSC) of Washington, DC, said its study is unique in focusing broadly on ownership of advanced imaging equipment rather than on specific healthcare services. The data indicate that policymakers may want to reconsider the in-office exemption to the Stark anti-self-referral law, which enables nonradiologist physicians to own and operate imaging equipment in their offices.


HSC researchers asked physicians whether they owned or leased medical equipment as part of its 2008 Health Physician Tracking Survey, a mail survey of U.S. physicians working at least 20 hours per week in direct patient care. The survey sample was limited to 2,750 physicians practicing in community-based, physician-owned settings. Physicians who practiced in hospital-based settings or who were employed by hospitals were excluded.
They reported ownership of medical equipment by the type of devices being used, as well as according to physician practice size and specialty. Among the survey's findings:
Among all physicians, one in six respondents (17.4%) reported that they owned or leased advanced imaging equipment.
For basic x-ray equipment, 22.7% of all physicians reported owning or leasing equipmentOwnership of advanced imaging equipment was highest among surgical specialists: 30.3% reported owning equipment. That compares to 15.7% of procedure-based medical specialists such as cardiologists, 13.5% of nonprocedure-based medical specialists such as neurologists, and 10.6% of adult primary care physicians.
Ownership varied by the size of the physician practice, from a high of 52.9% of groups larger than 51 physicians owning advanced imaging equipment, to a low of 6.7% for solo practitioners.
The report went on to note that Congress and the U.S. Centers for Medicare and Medicaid Services (CMS) have made physician ownership of advanced imaging less attractive by cutting Medicare reimbursement. Also, the healthcare reform law passed earlier in 2010 includes provisions that as of January 1, 2011, will require self-referring physicians to disclose their financial interests to patients and to provide them with a list of alternative service providers.
"Given the growing evidence that physician self-referral contributes to unnecessary and costly care, policymakers might reconsider the broadness of the in-office ancillary service exemption to the Stark law," the report states. "Ultimately, moving away from fee-for-service payment toward payment mechanisms that reimburse physicians for a broader unit of service, such as an episode of care, or putting physicians at least partially at risk for the cost of care will alter the financial incentives that now encourage physician self-referrals."


By : Brian Casey

McKesson completes purchase of US Oncology

Healthcare information systems and pharmaceutical distribution corporation McKesson announced today that it has completed its acquisition of US Oncology.

US Oncology, headquartered in The Woodlands, TX, is the largest community-based cancer care and research network in the U.S., with more than 500 affiliated sites of care, including 100 radiation therapy treatment centers.

The acquisition, for $2.16 billion in cash, was announced by McKesson of San Francisco on November 1 and was approved by the U.S. Federal Trade Commission and the Antitrust Division of the U.S. Department of Justice on December 20. However, the sale was halted on December 21 by an order from the Supreme Court of the State of New York, based on a complaint filed by Cancer Clinics of Excellence (CCE) of San Rafael, CA. An evidentiary hearing was scheduled for January 10, 2011.
J. Ike Nicoll, president and CEO of CCE, announced that a settlement agreeable to both CCE and McKesson had been reached, and that the complaint was withdrawn from the New York Supreme Court today. A spokesperson for McKesson Specialty Care Solutions concurred, stating that terms of the settlement had been successfully negotiated.

Not Exactly A Friend !

“I researched my condition on Wikipedia.” That’s what more doctors, myself included, are hearing from patients every day.
Wikipedia is the Web’s most popular online encyclopedia. Its more than 13 million articles cover almost every topic imaginable. It is among the most visited sites primarily because its articles routinely show up near the top of search engine results, like those from Google.The ability to research diseases and drugs on the Web has empowered patients in managing their health. More than 160 million adults in the U.S. have gone online to look for medical information. With two-thirds of them beginning their Internet health inquiry using a search engine, it is no wonder that Wikipedia has become a common medical resource for patients. More than half, according to the Pew Internet & American Life Project, reported that their most recent Web session influenced how they took care of themselves or for someone else, illustrating how critical online health information has become.
But Wikipedia’s medical entries — as has been reported with other entries on other issues — are not reliable for the simple fact that they are prone to manipulation, as is all Wikipedia content.Anyone can write and edit its topics, which means millions of non-doctors can essentially dispense medical advice. In several instances, pharmaceutical companies intentionally tried to delete or modify Wikipedia entries that mentioned adverse effects associated with their drugs.For example, in 2007, a claim that the psychiatric medication Seroquel made teenagers “more likely to think about harming or killing themselves” was deleted from the Wikipedia entry by a computer registered to AstraZeneca, the drug’s manufacturer.
Even more troubling is that doctors, too, appear to be increasingly reliant on Wikipedia. According to a survey of 1,900 physicians by Manhattan Research, a health care market research firm, nearly half of doctors going online for professional purposes reported using Wikipedia as a source of medical information. That number has doubled in the past year alone.
The threat is obvious. Can you imagine your doctor stepping out from the exam room, tapping away at his or her computer seeking the advice of Wikipedia? Research has documented the danger. A study from The Annals of Pharmacotherapy compared drug information from Wikipedia with the Medscape Drug Reference, a resource whose information is reviewed by pharmacists. Researchers found that Wikipedia omitted important information, including drug side effects. Another entry overlooked a commonly prescribed pain medication’s association with miscarriages.
This isn’t to say patients shouldn’t research their medical conditions to become better informed. But it’s imperative that patients not rely on Wikipedia as the primary source of their health research. Websites sponsored by the government, academic medical centers, or professional medical societies all have more authoritative information that can be relied upon.
Jay Walsh, head of communications at the Wikimedia Foundation, says: “Wikipedia shouldn’t be taken as a 100% reliable source of medical information. … But Wikipedia always strives for a degree of improvement.
”And as for physicians, there’s no excuse turning to Wikipedia as a source when reputable medical resources are a few more keystrokes away. Although these other sites might require more time for a busy clinician, doctors need to eschew convenience to ensure their decisions are based on sound medical information.
Quality patient care demands no less.

published on July 15th, 2009 in the USA Today.

Ultrasound effective in screening for endometrial cancer

Transvaginal ultrasound screening can detect endometrial cancer before symptoms appear in postmenopausal women, according to research from the U.K.

In a large-scale study to assess the performance of transvaginal ultrasound screening for endometrial cancer, a research team led by Ian Jacobs, of University College London, found that the modality yielded 81% sensitivity and 86% specificity.
The researchers analyzed data from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), in which transvaginal ultrasound screening was performed on 37,038 women (Lancet Oncology, December 13, 2010).
Performance characteristics of endometrial thickness and endometrial abnormalities at detecting endometrial cancer within one year of transvaginal ultrasound screening were calculated. The researchers then evaluated the method's sensitivity and specificity for different risk groups, and the group performed modeling using epidemiological variables to assess a screening strategy for women at higher risk.
Of the 133 women diagnosed with endometrial cancer or atypical endometrial hyperplasia within one year of screening, 107 (81%) had an endometrial thickness of 5 mm or more. Most of the 36,731 women who did not have cancer had an endometrial thickness of less than 5 mm, according to the researchers.
At the optimum cutoff of 5.15 mm, transvaginal ultrasound would detect 80.5% of cancer cases, with a false-positive rate of 14.3% (85.7% specificity), they found. With this screening threshold, one case of endometrial cancer would be detected for every 47.7 women screened, according to the researchers.
The authors noted, however, that further studies are needed to examine transvaginal ultrasound screening's acceptability, health economics, and risk before routine population screening or targeted screening can be advocated.


by : Erik L. Ridely
published online in the Lancet Oncology.

UCP update: Young Benefactors Visit Delrey School

I'm a member of UCP since 2006 and i'm so proud.This month i tried to follow the activities more closely and rejuvenate my communication with the whole team .I've got some fresh ideas in line with the NGO main trgets, therefore i try to pursue and build a firm connection . Pedram/

UCP's Young Benefactors may be a new group of supporters and advocates for UCP, but their presence is already being felt across UCP’s affiliate network. Last month the group had the opportunity to tour the Delrey School in Baltimore, Md. Founded in 1964, the school recently moved into a new state-of-the-art facility that houses the children’s services division of UCP Central Maryland.
For many in our group this was the first chance to interact with a few of the thousands of people that are directly impacted by the collective work of the UCP family. It was a humbling and energizing experience to say the least. We were able to see children learning to read, walk and communicate using a customized approach specific to each individual student. We heard success stories of former students who are now leading productive independent lives as a direct result of attending the Delrey School. Just as touching and inspiring as the children enrolled in the school and their families was the staff at the Delrey School. Their tireless and steadfast dedication to these children has had, and continues to have, a positive life-altering effect on people with disabilities.
Our function, as Young Benefactors, is to serve as a vehicle for continued and expanded support for UCP and specifically to have an impact on the lives of disabled individuals within our local communities. Through this experience we are reminded that much work remains to be done to ensure that everyone has access to opportunity and the proper support that will serve as the foundation for a life without limits for people with disabilities. Our heartfelt thanks goes out to Mimi Wang, principal of the Delrey School, and Debbie Daskaloff, chief development officer of UCP Central Maryland, for providing us with this experience.