Stroke rate 25 percent higher for Metis

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• Stroke rate 25 percent higher for Metis
• Telestroke the next best thing
• Undetected strokes increase risk
• Panama REDD: Getting what you pay for
• Prison education programs reduce inmate prison return rate, University of Missouri study shows
• Advance directives related to use of palliative care, lower Medicare end-of-life spending
• Secretary Chu congratulates DOE supported researcher on 2011 Nobel Prize in physics
• Remitting multiple sclerosis: Natalizumab reduces relapses and disability
• Regular exercise improves health of people with long-term kidney disease
• Frequently used weight-loss method is light on evidence

Stroke rate 25 percent higher for Metis Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) OTTAWA, Oct. 4, 2011 -- The stroke rate among Manitoba Metis is nearly 25 percent higher than for other Manitobans, according to a study by the University of Manitoba and the Manitoba Metis Federation (MMF) presented today at the Canadian Stroke Congress. The higher stroke rate is driven by a 53 percent higher smoking rate, 34 percent higher rate of diabetes, and 13 percent higher rate of high blood pressure among Metis aged 40 years and older, compared to all other Manitobans. High blood pressure, smoking and diabetes are leading risk factors for stroke. Being historically of both First Nation and European ancestries, but not really identifying as either one, Metis are a very unique people, but little research has been done on this population, says Dr. Judith Bartlett of the University of Manitoba and the MMF. It's really difficult for a health system to put in place Metis-specific programs if they don't understand what that means. Our job through this study is to link the health authorities with the Metis to bridge that knowledge gap. The study linked the MMF membership list and several Canadian Community Health Survey cycles with Manitoba Health's hospital records throughout the province to create the Metis Population Data-Base, a one-of-a-kind registry of the 73,000 Metis in the province. Despite universal health care, it is clear that stroke and related conditions are even more significant issues for Manitoba Metis than for all other residents in the province, the study says. What are called knowledge networks of Metis and provincial Regional Health Authority (RHA) staff have now been established in each of the Manitoba Metis Federation's seven regions to look at the information from the study and interpret it within a local context, says Julianne Sanguins, Ph.D, of the Faculty of Medicine at the University of Manitoba and the MMF. During the first few meetings of these knowledge networks, Metis Regions learned about... http://www.rxpgnews.com

Telestroke the next best thing Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) OTTAWA, Oct. 4, 2011 -- The use of long-distance video and data hookups to link remote community hospitals with stroke neurologists in large centres provides the same level of care as having everyone in the same room, according to a new study presented today at the Canadian Stroke Congress. The study found that rural patients examined with the aid of a technology called Telestroke received an important stroke drug, tPA, at the same rate as patients treated in specialized urban centres, says Dr. Thomas Jeerakathil, a neurologist at the University of Alberta Hospital. The drug tPA (tissue plasminogen activator) is used to break up blood clots. It can help reverse stroke damage if administered within 4.5 hours of the onset of symptoms. Besides providing better care to remote communities, early projections show that Telestroke resulted in more than $1 million in health-care savings over four years, Dr. Jeerakathil says. Telestroke is a way to bring the expert out to the rural centre to provide treatment that wouldn't otherwise be available, Dr. Jeerakathil says. And there is no delay in treatment despite the time required to set up video conferencing equipment and examine CT scans and blood work. In the study, an initiative of the Alberta Provincial Stroke Strategy, University of Alberta Hospital neurologists observed the use of Telestroke in 10 primary stroke centres throughout remote parts of Northern Alberta over a four-year period. During this time, tPA was administered to more than 500 people and, of those, 119 patients were treated with the help of Telestroke. Without access to the technology, these patients would have gone without treatment or been transferred to a bigger hospital and faced delays, says Dr. Jeerakathil. Effective Telestroke treatment in remote areas contributed to a 50-per-cent decrease in emergency room transfers from rural areas to the University Hospital in Edmonton, says Dr. Jeerakathil. Some remote... http://www.rxpgnews.com

Undetected strokes increase risk Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) OTTAWA, Oct. 4, 2011 -- Everyday, 1,000 people in Canada turn 65, entering a stage of life that has increasing risk of stroke and Alzheimer's disease. Recent national and international imaging studies on the brains of people aged 65 and older show that 95 per cent have brain small vessel disease seen as white spots and patches on magnetic resonance images, says Dr. Sandra Black, director of the Brain Sciences Research Program at Sunnybrook Research Institute at the University of Toronto. These studies also show that a quarter of healthy senior volunteers, average age 70, living in the community, have evidence of small silent strokes. Even in younger people (average age 60), this number may be as high as 14 per cent, according to preliminary results of the Canadian PURE MIND study, presented at the Canadian Stroke Congress in Ottawa, where Dr. Black addressed more than 900 researchers and clinicians. Microbleeds, another type of small vessel disease, are associated with high blood pressure and with Alzheimer's disease, she says. Unlike major stroke events, these types of small vessel disease gradually build up and increase the risk of clinical stroke events, depression, falls and Alzheimer's dementia. Alzheimer's and small vessel disease often live together in the brains of the elderly in a way that is very disabling, says Dr. Black. People become depressed, off balance when walking, have trouble thinking and often cannot live on their own. Unfortunately, so far there is no cure for either disease but there are actions we can all take to delay onset or progression. The time is now for the brain to be the top priority for Canada's health research community, says Dr. Black. In the next 20 years the number of people with dementia and Alzheimer's disease is expected to reach more than one million in Canada alone, increasing ten-fold the current health care costs of$15 billion/year, she says. Stroke is adding to the... http://www.rxpgnews.com

Panama REDD: Getting what you pay for Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) A new report by researchers from the Smithsonian Tropical Research Institute in Panama and Canada's McGill University identifies gaps in forest monitoring and ways to improve data collection. This will produce reliable estimates of greenhouse gas emission reductions from activities aimed at reducing deforestation. Under a United Nations proposal to Reduce Emissions from Deforestation and Forest Degradation, called REDD+, developing countries would be compensated according to their success in reducing greenhouse gas emissions. The importance of the REDD+ proposal is that it addresses the approximately 10-15 percent of all greenhouse gas emissions created by deforestation. Panama's abundant tropical biodiversity and the fact that more than 40 percent of the country is still forested makes Panama an ideal testing ground for conservation strategies that would reduce carbon dioxide emissions. In fact, Panama was one of the first countries selected by the World Bank and the United Nations REDD+ initiative to receive funding. We wanted to know if readily available in-country monitoring techniques would be enough to demonstrate that emissions could be reduced by the REDD+ plans that United Nations delegates have been discussing since 2005, said Johanne Pelletier, doctoral candidate at McGill University and first author of the study. We made a model for Panama to simulate land-cover change from 2000-2030 based on two maps and the available carbon stock information, and found that better monitoring will be needed to show that emission reductions are really taking place. The best land-use maps available to the public from Panama's National Environmental Authority were maps produced in 1992 and 2000 using information about forest cover from Landsat satellites. Cloud cover often blocks the view of satellites. The STRI-McGill team found that the 1992 map was a composite of images from 1988 to 1992 and the 2000 map was based on images... http://www.rxpgnews.com

Prison education programs reduce inmate prison return rate, University of Missouri study shows Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) COLUMBIA, Mo. -- According to the Pew Research Center, one in one hundred American adults is currently in prison. U.S. Department of Justice statistics show that 67 percent of those inmates will recidivate, or re-offend and return to prison after they are released. Now, a University of Missouri researcher has found that educating inmates and preparing them to find jobs upon their release from prison greatly reduces their recidivism rate. Jake Cronin, a policy analyst with the Institute of Public Policy in the Truman School of Public Affairs at the University of Missouri, studied Missouri Department of Corrections data and found that inmates who earned their GED in Missouri prisons were significantly more likely to find a job after prison and less likely to recidivate than inmates who did not. Cronin found the biggest jump in reduced recidivism rates, more than 33 percent, when he looked at inmates who earned a GED and acquired a full-time job after their release. Employment proves to be the strongest predictor of not returning to prison that we found, Cronin said. Those who have a full-time job are much less likely to return to prison than similar inmates who are unemployed. Recidivism rates were nearly cut in half for former inmates with a full-time job compared to similar inmates who are unemployed. Inmates who take advantage of the educational opportunities available to them in prison are more likely to find a job than those who do not. Cronin says these reduced recidivism rates can save the state a substantial amount of money in reduced incarceration costs. He points to a similar study which found that educational programs that reduced recidivism rates saved the state of Maryland $24 million a year, which is twice the amount of money spent on the program. Cronin believes this shows that correctional facility educational programs are a good investment for the state of Missouri. If similar results occur in Missouri, which... http://www.rxpgnews.com

Advance directives related to use of palliative care, lower Medicare end-of-life spending Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) ANN ARBOR, Mich.--- Advance directives do have an impact on health care at the end of life, especially in regions of the country with high spending on end-of-life care, according to a University of Michigan study. People who had completed advance directives stating their preferences for care were less likely to die in a hospital and more likely to receive palliative hospice care than similar decedents without advance directives. Advance directives may help patients get the care they want if they prefer less aggressive care at the end of life, while also providing cost savings to the Medicare program, particularly in higher-spending regions of the country, said Lauren Hersch Nicholas, a U-M health economist who is the lead author of the study. The study is in the current (Oct. 5, 2011) issue of the Journal of the American Medical Association. Accompanying greater use of palliative care, we found that Medicare expenditures for those with advance directives were significantly lower than for those without, but only in those regions that spent more than average per person on end-of-life care, she said. In contrast, advance directives seemed to have little effect on care received by people living in regions of the country that have lower levels of medical spending at the end of life. The study, which is among the first to have national data linking end-of-life spending, treatments, and patients' advance directives, is based on a sample of 3,302 Medicare beneficiaries from the Health and Retirement Study, a nationally representative longitudinal study of more than 30,000 older Americans conducted by the U-M Institute for Social Research (ISR). The study is funded by the National Institute on Aging (NIA), part of the National Institutes of Health, and by the Social Security Administration. The U-M research team analyzed data on Health and Retirement Study participants who died between 1998 and 2007. Their records were linked to... http://www.rxpgnews.com

Secretary Chu congratulates DOE supported researcher on 2011 Nobel Prize in physics Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) WASHINGTON, DC -- Secretary of Energy Steven Chu today congratulated Saul Perlmutter, a physicist at DOE's Lawrence Berkeley National Laboratory (LBNL) and a professor of physics at the University of California at Berkeley, for winning the 2011 Nobel Prize in Physics for the discovery of the accelerating expansion of the Universe through observations of distant supernovae. I offer my congratulations to Dr. Perlmutter and the entire Berkeley Lab team for their extraordinary contributions to science, which are being recognized with the 2011 Nobel Prize in Physics, said Secretary Chu, who was a 1997 Nobel Prize winner in Physics and former director at LBNL. His groundbreaking work showed us that the expansion of the universe is actually speeding up, rather than slowing down. Dr. Perlmutter's award is another reminder of the incredible talent and world leading expertise America has at our National Laboratories. On a more personal note, I am delighted about this well-deserved recognition and to have worked with Saul during the time I spent at the Berkeley Lab. Perlmutter shares the prize with Brian Schmidt of the Australian National University and Adam Riess of Johns Hopkins University and Space Telescope Science Institute. The discovery that the expansion of the universe is accelerating came after ten years of work by the Supernova Cosmology Project, an international collaboration of physicists and astronomers led by Perlmutter. The group measured the expansion rate of the universe by observing distant supernovae. Schmidt was the leader and Riess was a key member of another group of scientists called the High-Z Supernova Search Team, which began a similar study in the 1990s. The two independent groups reached identical conclusions at nearly the same time, and their joint discovery was named breakthrough of the year for 1998 by the journal Science. It has been known since 1929 that the universe was expanding, but the... http://www.rxpgnews.com

Remitting multiple sclerosis: Natalizumab reduces relapses and disability Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) Taking the new generation anti-inflammatory drug natalizumab for two years lowers the number of remitting multiple sclerosis patients who experience relapses and progression of disability. This is the main finding of a systematic review published in the latest edition of The Cochrane Library. Multiple sclerosis (MS) is a disease that damages a person's nervous system. The symptoms vary considerably from person to person, but many have a form of the disease in which they feel healthy for a time, and then relapse into periods of ill health. Over time, the disease tends to develop into a permanent disability. The aim of many treatments is to increase the period of remission that MS patients have between each relapse, and to delay the progression to the full disease for as long as possible. Part of the body's defensive immune system involves a type of white blood cell that actively moves to areas where there is disease or damage. This movement causes the swelling associated with inflammation. Natalizumab, normally abbreviated as NTZ, is an advanced form of medicine that prevents some of these white blood cells passing from blood vessels into the brain. As MS is closely linked to inflammation, the theory is that blocking this passage of cells might help reduce the symptoms. By searching through the medical literature a team of researchers working in Italy and the UK found three trials that met their inclusion criteria. Together these trials involved over two thousand patients, and showed that after two years of treatment, NTZ reduced the risk of experiencing at least one new bout of disease at two years by about 40%, and the number who had disability progression over the two years was reduced by 25%. MRI brain scans also showed evidence that NTZ had reduced disease activity. Our analysis indicated that NTZ is well tolerated and safe over a period of up to two years, says study leader Eugenio Pucci, who works at the neurological unit... http://www.rxpgnews.com

Regular exercise improves health of people with long-term kidney disease Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) There are many reasons why people with chronic kidney disease (CKD) often lose fitness and have increasing difficulty performing normal daily tasks, but new research shows scientific evidence for the benefits of regular exercise for people with CKD, including those with a kidney transplant. They can improve their physical fitness, walk further, have healthier blood pressures, healthier heart rates, higher health-related quality of life scores and better nutritional characteristics compared to those who don't exercise. So concludes a systematic review published in The Cochrane Library. CKD is a worldwide public health problem and a person is said to have CKD if they have damaged or poorly performing kidneys where the effects last for more than three months. There are many causes of damage, including high blood pressure, diabetes and rheumatic diseases. Their muscles tend to tire quickly, which reduces the amount of exercise they do, but this then further reduces their fitness, explains Susanne Heiwe from the Karolinska Institute in Stockholm, Sweden. During the last 30 years there have been many studies into the way that exercise affects people with CKD, but very few evidence-based guidelines have been drawn up. To fill this gap Heiwe and her colleague, Stefan Jacobson, studied the data and results in forty-five studies that met specific inclusion criteria. Together these involved a total of 1,863 participants. Heiwe's team discovered adults with CKD but who do not yet need dialysis, patients on dialysis and kidney transplant recipients all benefitted from exercise, but different types of exercise produced different types of benefit. For example, when compared with controls, people who performed supervised, high intensity, cardiovascular training for four to six months had significantly improved aerobic capacity Other studies showed that three months of regular, high intensity resistance training or yoga, whether supervised or... http://www.rxpgnews.com

Frequently used weight-loss method is light on evidence Posted: 04 Oct 2011 05:00 AM PDT ( From http://www.rxpgnews.com ) Although the transtheoretical model stages of change (TTM SOC) method is frequently used to help obese and overweight people lose weight, a newly published Cochrane systematic review indicates there is little evidence that it is effective. The use of TTM SOC only resulted in 2kg or less weight loss, and there was no conclusive evidence that this loss was sustained, says study leader Nik Tuah, who works at Imperial College London. The transtheoretical model describes a step-by-step way in which individuals move from unhealthy behaviours to healthy ones. The model helps clinicians and patients by showing the sorts of benefits that can be expected for each step in the sequence. The five stages of change that the model anticipates are pre-contemplation, contemplation, preparation, action and maintenance. A key assumption underlying this model is that people do not start off by being ready to change their behaviours, so any intervention that starts by asking for change is unlikely to be taken up, says Tuah. TTM SOC tries to overcome this by introducing stages that lead people to the place where they can see the need to change their behaviour and are willing to give it a go. Only then do you introduce the active interventions. Leading a team of researchers, Tuah looked for studies that had investigated the effectiveness of TTM SOC. They identified five appropriate studies involving 1834 people who received an intervention and 2076 people who were placed in control groups. The trials varied in length from six weeks to 2 years. Drawing all the findings together showed that there was no convincing evidence that the intervention produced any significant sustainable weight loss. There was, however, some indication that when TTM SOC was combined with exercise and dieting, people's physical activity or eating habits did change a little. One of the adverse outcomes noted by a single trial was that some people gained weight while using TTM... http://www.rxpgnews.com

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