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Never say “pain meds”

23 Feb

Never say “pain meds” on the phone in an Emergency Call for a on call Physician in California.

It's a Emergency Call Device Sign

It's a Emergency Call Device Sign (Photo credit: Rantz)

I underwent the same back pain emergency in Marseille, France I related here.

godlessnurse

As last night unfolded, I knew I would eventually blog about it.

After a long holiday weekend, James and I were doing a bit of leisurely shore line fishing. While we were packing up, James exited his truck and BAM! He immediately felt a sharp pain in his back. This isn’t the first time, but it had been a little while since such a severe flare-up. With this, we promptly went home and applied all the home remedies we knew. Heat, rest, ibuprofen.

James’ back was no better in the morning. After dealing with it for the majority of the day, he made the decision to call his doctor.

It was 6:15 p.m.

After hours.

With the on-call physician answering service phone number safely in hand, he dialed.

“Hi, my name is James, and I’d like to speak to the doctor on call regarding possible pain meds for some pretty…

View original post 634 more words

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16 Feb

Although I do not share the same ideas of this right-wing American party, I found interesting their analysis of the Greek’s debt default in payment. This financial crisis entails the loss of the sovereignty of the Greek people and hence is endangering their democracy. The author of this text, Judson Phillips is the leader of the Tea Party Nation. With regard to the American political landscape, the Tea Party Nation is a USA ultra reformist party believing in the return to the fundamental values of their Constitution especially the second Amendment which allows all citizen to bear and possess weapons in the aim to defend the democracy in case of governmental abuse. Their point of view does not reflect my own personal position but contributes to bring some arguments in the discussion with regard to the topic of the European debt problem.

Gds44's Blog

The death rattle of Democracy – Tea Party Nation.

Posted by Judson Phillips

Watching a Democracy die is not a pleasant experience.  The only thing worse is watching one die and having most people not even realize a Democracy just died.

 Which Democracy died?

 Greece, of course.

 Greece is a cautionary tale for America and every other nation in the world.  Perhaps the question we have to ask, is Greece even a nation any more?

 The obvious reaction to that question is, of course it is.  The Greek flag still flies.  There are Greek borders.  The Greek government and Parliament are still there.

 All true.

 But for all intents and purposes, Greece is now a state in receivership. 

 The defining characteristic of a nation state is sovereignty.  The people of the nation state, through their government make the decisions for that state. 

 Greece has lost that.

 Greece…

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The pros and the cons of CER

27 Jan

CER or Comparative Effectiveness Research has its defenders and its contradictors.

But first of all, what is the CER?

CER typically products guidelines issued from the comparison of respective harms and benefits of medicines or techniques of cure already marketed and used routinely by health care providers.

Defenders argue that this is the core of an evidence based medicine. Guidelines will save a lot of money by showing the best way to cure efficiently.

Contradictors estimate that this is the best way to sterilise the research and the development of new molecules and new procedures of treatment given that guidelines strictly forbid practitioners to welcome new therapies. Since guidelines decide the best state of the art, why care givers should worry and take the risk to try new therapies?

Beside there is the question of the quality of CER and of its independence with regard of the pharmaceutical industry. We have to keep in mind that independence with regard of industry is not automatically a warrant of quality because industry possesses a real research and development capacity.

If you want to read more on the topic of CER:

http://campaign.r20.constantcontact.com/render?llr=nnvp8ocab&v=001lnBTEkB9iIGf1-holfshJ2uO5HHt7bv_cfN7P8B5xhN30LlXJlH5N2zqH28OPX_CLTPZOrH5z5cTwbX7_t2TlQSh-5Y3665YqHu_UxXBaLuY94o52vSG8jlBhL80FJfNkVwNOJPBgvY%3D

 

http://blog.ehesp.fr/blog/tag/comparative-effectiveness-research/

 

http://www.nlm.nih.gov/nichsr/htawebinars/index.html

 

http://www.policymed.com/2011/11/ahrq-national-resource-center-for-academic-detailing.html

 

http://www.policymed.com/2011/03/iom-clinical-practice-guidelines-we-can-trust-but-what-about-the-iom.html

Research Works Act

7 Jan

Free access to publicly funded research

English: This is the first issue of California...

Image via Wikipedia

How can people access freely to publicly funded research results?
From two things one: – either the government agencies buy the copyrights of privates scholarly publishers and then make available articles on governmental web sites
– or it publish himself the final reports or the intermediate or progress reports that the publicly funded researchers have produced.
But one thing for sure, since the recent “research works act” bill, the government or the federal agencies have no more the possibility to force or to mandate for free, by rule, the dissemination of the private scholarly publications issued from the peer reviewed journals.

A third possibility should be the government using the open access journals, but in that case instead of buying the copyrights afterward, federal agencies will be charged before the publication procedure.

Nevertheless, we have to keep in mind that the fundamental difference between a final report of a research work and a peer reviewed article issued from the same research work are: – the length (average length for a report: 60 pages vs 20 for an article), – the use of technical and complex words in the writing (because the articles are peer reviewed and aimed at the intention of a wider number of readers, mostly outside the institution, technical words and context have to be explained), – the transfer of responsibility in case of mistake or falsification of data (private publisher are eager to retract the article if a falsification or a conflict of interest is disclosed but will a federal agencies do the same?) and last but not least – scholarly publications are the products of multinational, world-wide expanded, globalised enterprises that are independent from the policy of a single state. And this must be seen as a guarantee of the independence of science from political pressure like, for example, the recent attempt by the US government to stop the publication by a Netherlander searchers team of their findings on the H5N1 flu virus mutation capacity (see here and here for more information).

Below are three references if you want to read more on the topic of the dissemination of research works:

1)My Argument for Public Access to Research Reports

http://scholarlykitchen.sspnet.org/2012/01/06/my-argument-for-public-access-to-research-reports/

2)Publishers Applaud “Research Works Act,”Bipartisan Legislation To End

Government Mandates on Private-Sector Scholarly Publishing

http://www.publishers.org/press/56/

3)A BILLTo ensure the continued publication and integrity of peer-

reviewed research works by the private sector.

http://www.gpo.gov/fdsys/pkg/BILLS-112hr3699ih/pdf/BILLS-112hr3699ih.pdf

Publish or not publish?

23 Dec

Terror risk linked to flu study

Cover of the first issue of Nature, 4 November...

Image via Wikipedia

Searchers have recently discovered in Netherlands and United States the method to transform the H5N1 virus in a mass destruction weapon. They were just on the way to publish the ingredients of the experiment on Nature and Science (the two world-wide best known scientific journals) when an US advisory board said: ”hello guys, wait a minute please, have you think to the consequences if terrorists buy the journal?”.

The scholarly kitchen blog analyse the issue. Now that the new has already been broadcasted it is useless to censor scientists. The better way, according to scholarly kitchen, to manage the thing is to widen open the access to information, thus hoping that the good guys will discover the vaccine before that the bad ones discovers the genetically modified virus. Indeed the scientific knowledge discovered by the two teams of searchers in Netherlands and United States can lead to both, the better and the worst. If hidden or censored, the information will more rapidly fall into terrorist’s hands than in philanthropic hands because the former possess more means to access secrecy than the latter.

The editor in chief of  Science stated that his journal may comply with the request if the NIH can create systems to provide the data to legitimate scientists around the world

We thank the Scholarly Kitchen for having revealed this frightening issue.

Prison valley

27 Nov

Vodpod videos no longer available.

Prison valley, posted with vodpod

Professor Patrick Morvan tell us in his blog that in the State of California, there are 50 death per year motivated by a lack of health care and that up to 700 prisoners are enlisted in a waiting list to attend a Doctor visit.
In France an author, Dr Véronique Vasseur,had published a book, on the subject that is very similar with the problem faced in California.
The prison industry is not exposed to unemployment during times of economic crisis but prisoner’s access to health care is a real public health issue!

You can access to the entire free movie entitled Prison Valley by clicking here.

Walmart

22 Nov
A typical Wal-Mart discount department store i...

Image via Wikipedia

According to a Kaiser Health News  report Wal-Mart is questioning the possibility to enter in primary health care by the mean of opening retail clinics in its stores.

A document written by the company contains the following statement: “Walmart intends to build a national, integrated, low-cost primary care healthcare platform that will provide preventative and chronic care services that are currently out of reach for millions of Americans.”

Retail clinics provide primary cares and preventive cares within a retail store. Are they an opportunity to reach the poorest patients or a risk of bad quality cares? A study published in the anal of internal medicine try to respond to the question. If Walmart enter in the primary care health market they will bring in their efficacy in reaching each American with 138 millions of them visiting their store every week. Some thinks it is a unique opportunity to enhance the productivity of the primary cares and to lower health care costs. More studies are needed to evaluate the quality of cares provided in retail clinics.

Two studies address the location of and the prices practiced by retail clinics and compare their efficacy with other primary cares providers.

Health coach

2 Nov

Your knee has to be replaced? You should need a health coach before taking a decision. A Kansas city medical center organizes the meeting for you. It promotes a share decision-making enabling you to choice between surgery or rehab.

Vodpod videos no longer available.

thanks to Gary Schwitzer for having signaled this interesting procedure which could reduce the discrepancy of surgery consumption across the different states in the US.

Heart Failure

20 Oct

A study including more tha 55 000 000 patients demonstrates

Acute Decompensated Heart Failure

Image via Wikipedia

that hospitalization motivated by heart failure declined steadily from 1998 to 2008 in the US.

According to the blog Policy and medicine this is the result of the collaboration between physicians and drug industry bringing an advance in heart failure treatment. The falling of hospital stays at a rate of 30%  saved  4,1 billion dollars the author of the study said to the journalist of USA Today.

Occupy Wall Street

11 Oct

Vodpod videos no longer available.

Wall Street

Image by b00nj via Flickr

Occupy Wall Street movement is spreading like wild-fire to all the big cities of the US (LA, Portland, Boston, Chicago, Seattle) Protesters are camping out like those of Madrid and Athens. They call themselves the 99 (like 99 percent of population compared to the 1 percent of the population that owns most of the country wealth). They are untill now peaceful and non violent. They search solutions for the financial crisis in a peaceful and respectful attitude. They are calling for a change in their country’s financial system.

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