Today's Opinions: Haiti's Lesson For The U.S.; Ending 'Pay For Delay;' Getting The CLASS Act Off The Ground
In Haiti, A Lesson For U.S. Health Care The New York Times In February, a month after Haiti's earthquake, I went down to Port-au-Prince as part of a team that was helping to reactivate cardiac care in the city's public hospital. For several months since, I have observed how the earthquake and its aftermath profoundly changed Haiti's health care system...
http://mnt.to/f/3GMV
Also In Global Health News: Child Marriages; USAID In Afghanistan; Respiratory Diseases In El Salvador; Food Security Improving In Zimbabwe
Epoch Times Examines Child Marriage Hearing An Epoch Times article discusses a recent congressional hearing held by the Tom Lantos Human Rights Commission on child marriage...
http://mnt.to/f/3GN6
Health Experts Express Concern About U.S. Funding For International AIDS Treatment
Health experts at last week's International AIDS Conference in Vienna expressed anger and concern about future U.S. funding for HIV treatment in developing nations and the knowledge that due to funding constraints, some African nations already are turning away patients who need treatment, the Washington Post reports. According to the Post, current funding levels barely cover the 5...
http://mnt.to/f/3GMt
Usability Testing of an Online Self-management Program for Adolescents With Juvenile Idiopathic Arthritis
Background: A new bilingual (English and French) Internet-based self-management program, Teens Taking Charge: Managing Arthritis Online, for adolescents with arthritis and their parents was developed following a needs assessment. Objective: This study explored the usability (user performance and satisfaction) of the self-management program for youth with juvenile idiopathic arthritis (JIA) and their parents to refine the health portal prototype. Methods: A qualitative study design with semi-structured, audio taped interviews and observation by a trained observer was undertaken with two iterative cycles to determine the usability (ease of use, efficiency, errors, and user satisfaction) of the user interface and content areas of the intervention. A purposive sample of English-speaking (n = 11; mean age = 15.4, standard deviation [SD] 1.7) and French-speaking (n = 8; mean age = 16.0, SD 1.2) adolescents with JIA and one of their respective parents/caregivers were recruited from 2 Canadian tertiary care centers. Descriptive statistics and simple content analyses were used to organize data into categories that reflected the emerging usability themes. Results: All of the participants had access to a computer/Internet at home; however, adolescents were more comfortable using the computer/Internet than their parents. Adolescents and parents provided similar as well as differing suggestions on how the website user-interface could be improved in terms of its usability (navigation, presentation and control usage errors; format and layout; as well as areas for further content development). There were no major differences in usability issues between English- and French-speaking participants. Minor changes to the website user interface were made and tested in a second cycle of participants. No further usability problems were identified in the second iterative cycle of testing. Teens and parents responded positively to the appearance and theme of the website (ie, promoting self-management) and felt that it was easy to navigate, use, and understand. Participants felt that the content was appropriate and geared to meet the unique needs of adolescents with JIA and their parents as well as English- and French-speaking families. Many participants responded that the interactive features (discussion board, stories of hope, and video clips of youth with JIA) made them feel supported and “not alone” in their illness. Conclusions: We describe the usability testing of a self-management health portal designed for English- and French-speaking youth with arthritis and their parents, which uncovered several usability issues. Usability testing is a crucial step in the development of self-management health portals to ensure that the various end users (youth and parents) have the ability to access, understand, and use health-related information and services that are delivered via the Internet and that they are delivered in an efficient, effective, satisfying, and culturally competent manner.
http://www.jmir.org/2010/3/e30
Information-Seeking at a Caregiving Website: A Qualitative Analysis
Background: The Internet is widely used for health information, yet little is known about the online activity of family caregivers of elders, a rapidly growing group. In order to better understand the online information-seeking activity of “e-caregivers” and other visitors at a caregiving website, we undertook a qualitative analysis of survey data from a website marketed as a comprehensive resource for adults caring for aging parents. Objective: The objectives were to better understand what types of information are sought by those visiting a website focused on elder-care issues and to identify overarching themes that might inform future development of Internet resources related to caregiving and aging. Methods: From March 2008 to MarcFrom March 2008 to March 2009, a 5-question pop-up survey was offered 9662 times and completed 2161 times. For 1838 respondents, included was a free text answer to the question "What were you looking for?” and 1467 offered relevant and detailed responses. The survey also asked about satisfaction with the site, gender of the respondent, and relationship to the individual being cared for. Content analysis was used to develop a coding dictionary, to code responses into information-seeking categories, and to identify overarching themes. Results: Of the respondents (76% of whom were female), 50% indicated they were caring for parents, 17% for themselves only, and 31% for others. Over half (57%) reported finding what they were looking for, and 46% stated they were extremely likely to recommend the website. Frequently mentioned information-seeking categories included “health information,” “practical caregiving,” and “support.” Respondents also requested information related to housing, legal, insurance, and financial issues. Many responses referred to multiple comorbid conditions and complex caregiving situations. Overarching themes included (1) a desire for assistance with a wide range of practical skills and information and (2) help interpreting symptoms and behavior, such as knowing what life impacts to expect over the course of a health condition or treatment. Conclusions: Visitors to a website targeting adults caring for aging parents reported seeking both general information on caregiving and specific assistance with the complex custodial, medical, emotional, and financial aspects of caregiving. Visitors requested both information to build caregiving skills as well as assistance in interpreting and knowing what to expect from symptoms, health conditions, and changes in behavior and relationships. Many desired communication with and support from other caregivers. Health care providers and eHealth developers should expect that many caregivers of elders are using the Internet as a resource. Further research and development is needed to fully realize the Internet’s potential for education and support of caregivers.
http://www.jmir.org/2010/3/e31
Associations of Internet Website Use With Weight Change in a Long-term Weight Loss Maintenance Program
Background: The Weight Loss Maintenance Trial (WLM) compared two long-term weight-maintenance interventions, a personal contact arm and an Internet arm, with a no-treatment control after an initial six-month Phase I weight loss program. The Internet arm focused on use of an interactive website for support of long-term weight maintenance. There is limited information about patterns of website use and specific components of an interactive website that might help promote maintenance of weight loss. Objective: This paper presents a secondary analysis of the subset of participants in the Internet arm and focuses on website use patterns and features associated with long-term weight maintenance. Methods: Adults at risk for cardiovascular disease (CVD) who lost at least 4 kilograms in an initial 20-week group-based, behavioral weight-loss program were trained to use an interactive website for weight loss maintenance. Of the 348 participants, 37% were male and 38% were African American. Mean weight loss was 8.6 kilograms. Participants were encouraged to log in at least weekly and enter a current weight for the 30-month study period. The website contained features that encouraged setting short-term goals, creating action plans, and reinforcing self-management habits. The website also included motivational modules, daily tips, and tailored messages. Based on log-in and weight-entry frequency, we divided participants into three website use categories: consistent, some, and minimal. Results: Participants in the consistent user group (n = 212) were more likely to be older (P = .002), other than African American (P = .02), and more educated (P = .01). While there was no significant difference between website use categories in the amount of Phase I change in body weight (P = .45) or income (P = .78), minimal website users (n = 75) were significantly more likely to have attended fewer Phase I sessions (P = .001) and had a higher initial body mass index (BMI) (P < .001). After adjusting for baseline characteristics including initial BMI, variables most associated with less weight regain included: number of log-ins (P = .001), minutes on the website (P < .001), number of weight entries (P = .002), number of exercise entries (P < .001), and sessions with additional use of website features after weight entry (P = .002). Conclusion: Participants defined as consistent website users of an interactive behavioral website designed to promote maintenance of weight loss were more successful at maintaining long-term weight loss. Trial Registration: NCT00054925; http://clinicaltrials.gov/ct2/show/NCT00054925 (Archived by WebCite at http://www.webcitation.org/5rC7523ue)
http://www.jmir.org/2010/3/e29
Thirty Million Women Will Gain From Health Reform Law, Including About 15 Million Uninsured
Approximately thirty million American women will gain from the new health reform law over the next ten years, according to a new report from The Commonwealth Fund, a private foundation based in New York. The authors state that the law will stabilize women's growing exposure to ever-increasing health costs, and even reverse it, by subsidizing health insurance for approximately 15 million women who currently have to no health insurance cover, while at the same time strengthening existing coverage for another 14.5 million women deemed underinsured...


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Seven Influenza Vaccines For Coming Season Approved By FDA
The US FDA (Food and Drug Administration) has approved vaccines for the 2010-2011 USA influenza season, protecting against three strains of influenza, including the H1N1 virus which caused the 2009 pandemic. In 2009, because the H1N1 virus appeared after seasonal vaccine production commenced, two separate vaccines were required to protect against the seasonal flu and the 2009 H1N1 pandemic flu virus. The FDA says that only one vaccine is needed for this year...


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Why Are UK Stroke Patients Still Not Getting Prompt Treatment?
The Lancet this week featured an Editorial discussing a recent report from the UK Vascular Society and Royal College of Physicians showing that the waiting time for vascular surgery after symptoms of stroke or transient ischemic attack is far too long. Guidelines set by the UK National Institute for Health and Clinical Excellence (NICE) suggest no more than a 14 day wait between symptoms and operation. The 2007 National Stroke Strategy is targeting for there to be a 48 hour wait by 2017...


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FDA Approves Embryonic Stem Cell-Based Therapy For Patients With Acute Spinal Cord Injury
The US FDA (Food and Drug Administration) has lifted a clinical hold on Geron's Investigational New Drug (IND) application - the Phase I clinical trial of GRNOPC1 in patients with acute spinal cord injury may now go ahead. GRNOPC1 is the first ever clinical trial of a human embryonic stem cell based therapy in humans...
http://mnt.to/f/3GPt
Biogen Idec And Swedish Orphan Biovitrum Present Data On Long-Lasting Hemophilia B Therapy At The World Federation Of Hemophilia Congress
Biogen Idec (NASDAQ: BIIB) and Swedish Orphan Biovitrum AB (STO: SOBI) announced results from a Phase 1/2a open-label, dose-escalation, safety and pharmacokinetic study of the companies' long-lasting, fully-recombinant factor IX Fc fusion protein (rFIXFc) in hemophilia B patients...
http://mnt.to/f/3GPn
Orexigen® Therapeutics Announces Publication Of COR-I Phase 3 Study Of Contrave In Lancet
Orexigen® Therapeutics, Inc. (Nasdaq: OREX) announced that results from its COR-I trial of Contrave® were published online in the journal Lancet. COR-I was the largest of the four, 56-week, Phase 3 trials supporting the New Drug Application for Contrave, currently under review by the U.S. Food and Drug Administration...
http://mnt.to/f/3GLZ
The Mystery Of Healthy Fat People
Why some obese people go on to become diabetic while others do not. It is common to find obese people even morbidly obese people who are healthier than their condition would normally allow...
http://mnt.to/f/3GPd
Rising Obesity In Pregnancy Causes Concern For Gestational Diabetes
A NHS watchdog revealed concerns about the rising level of obesity among pregnant women yesterday in order to raise awareness of the associated complications, which includes gestational diabetes...
http://mnt.to/f/3GNg
Just Drop It: The One-Size-Fits-All Approach To Blood Sugar Control, That Is
Aggressive blood sugar control does not improve survival in diabetic patients with kidney failure, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The results suggest that physicians should individualize blood sugar targets for these patients and not rely on recommendations based on studies in the general population...
http://mnt.to/f/3GM8