Posts Tagged ‘danger’
With almost no experience, newly graduated medical students enter teaching hospitals around the country every July, beginning their careers as interns. At the same time, the last year’s interns and junior residents take a step up and assume new responsibilities.
In addition to developing their nascent clinical skills, each entering class of interns must grasp the many rules and standards for operating in this “new” hospital structure.
More experienced physicians share a joke about this changing of the guard: Don’t get sick in July…
“The good news for patients is that in most cases, it’s very difficult for a physician to make a mistake that results in a patient’s death,” said Anupam Jena, HMS assistant professor of health care policy and of medicine at Massachusetts General Hospital and lead author of the study. “But for severely ill patients, health can be very tenuous. A small error or a very slight delay in care is potentially devastating…”
Overall, they found that patients at teaching hospitals had a lower risk of dying than at non-teaching hospitals, but in July, the risk at teaching hospitals rose to the same level that patients at non-teaching hospitals faced. For high-risk patients who came to the teaching hospitals with heart attacks, the risk of death in hospital went from 20 percent to 25 percent. They also found that among teaching hospitals, the difference between outcomes in May and July is greatest in institutions with the highest percentages of trainees.
The researchers ruled out two potential factors that they suspected may have accounted for some of that difference — the prevalence of percutaneous coronary intervention (i.e. cardiac stents) and of complications from the use of blood thinners.
Without evidence for specific procedures or protocols that could prevent increased deaths, the researchers said that their findings suggest that, especially during the early months in the training cycle, oversight should be intensively focused on high-risk cases rather than across cases overall. In July, doctors with more experience should play a greater role in the care of high-risk patients than has typically been the case.
I never ran into this dicho before. Though it has been at least 40 years since I worked in a teaching hospital. And it was one of the very best.
Still – remind self not to have a stroke or heart attack in July. Especially since the only hospital in town is known as Saint Victims.
Anyone allowed to sue the Catholic Church because their prayers didn’t work?
A group of scientists are facing six years in jail for manslaughter after providing “an incomplete, inept, unsuitable and criminally mistaken” assessment of risks posed by the devastating L’Aquila earthquake that killed more than 300 people.
The landmark decision on Monday was welcomed by victims and their families but immediately prompted uproar from the scientific community, which contends that there is no reliable way of predicting earthquakes.
The six scientists and a former government official were all members of the Major Risks Committee which met in the central Italian city on March 31, 2009, after several small tremors had been recorded in the region. At the time, they ruled that it was impossible to determine whether the tremors would be followed by a large quake, in a judgment which reassured residents. One of the group famously advised them to relax with a glass of wine. Just six days later, a 6.3 magnitude quake devastated L’Aquila.
On Monday, Judge Marco Billi announced the manslaughter sentence to a packed courtroom in a temporary building erected to hear the case in the still devastated city. He also ruled that the defendants should pay 7.8 million euros in damages, with two million euros to be paid immediately.
The sentencing provoked strong criticism from the scientific community.
Richard Walters of Oxford University’s Department of Earth Sciences, said he was “saddened” about the verdict, warning that it set a “dangerous precedent”.
“The issue here is about miscommunication of science, and we should not be putting responsible scientists who gave measured, scientifically accurate information in prison. This sets a very dangerous precedent and I fear it will discourage other scientists from offering their advice on natural hazards and trying to help society in this way…”
Just to illustrate the politics of this jurisprudence, family members of some of those killed said the victims had won the case with “heavenly” intervention. Just as national politics in Italy can’t escape the Pope and the Vatican, parochial law is even worse.
Yes, there are a couple of obvious parallels. You can reach back to the bowels of the Inquisition when the Catholic Church was the ultimate arbiter of public good and evil. You can look around you at a gathering of Tea Party politicians and flinch at listening to proposals equally ignorant, determinedly anachronistic and filled with the same self-righteous bile.
Misrepresenting science in the eyes of the law is another part of anti-science, superstition. Worldwide.
The Belle Epoque, France’s golden era at the turn of the last century, bequeathed Paris elegant landmarks such as the Eiffel Tower, but also a more sinister legacy of radioactive floors and backyards which the capital is only now addressing.
When the Franco-Polish Nobel Prize winner Marie Curie discovered the radioactive element radium in 1898, she set off a craze for the luminescent metal among Parisians, who started using it for everything from alarm clock dials to lipsticks and even water fountains.
The companies that manufactured these slightly radioactive objects have long gone out of business, but they left small doses of radium between the cracks of some Parisian parquet floors. These doses, after prolonged exposure, could prove toxic though, officials say, they do not pose serious health risks.
“The history of radium started in Paris,” said Eric Lanes, head of radioactive decontamination at France’s national agency for radioactive waste, ANDRA. “Marie Curie never patented her discoveries so a lot of people rode the radium wave.”
After Curie showed that radium could be used to destroy cancerous cells, people assumed that the new element had miraculous healing properties and started putting it in everything from body lotions to cough syrups…
Curie herself died at 66 from her prolonged, unprotected exposure to radium…
ANDRA – in some case using addresses that were written on vintage advertising posters – has identified some 130 sites in France suspected of being at risk. Some 40 of them are set for decontamination, half of those in the Paris area.
Lanes said the clean-up was being undertaken as a precautionary measure under a recent French law requiring that preventative steps be taken in a case of a suspected health risk even in the absence of conclusive scientific evidence.
RTFA. Interesting anecdotal tales. Worth reflecting on.
I get a checkup every 10 years because of a nuclear fab I worked in 55 years ago. They certainly must have done a solid job of decontamination – unusual for the time – and I’ve been clean as a whistle every time.
Tens of thousands of ultra-Orthodox Jewish men attended a rally Sunday at the New York Mets’ Citi stadium on the dangers of the Internet and how to use modern technology in a religiously responsible way.
Women were not permitted to attend the meeting at Citi Field in Queens. However, it was broadcast live to audiences of women in schools and event halls in ultra-Orthodox neighborhoods…
Eytan Kobre…spokesman for the event’s organizers…cited online pornography and gambling as well as the risk of social media undermining “our ability to pray uninterruptedly, to focus and to concentrate…”
Shlomo Cohen of Toronto told The New York Times that he uses the Internet for shopping, business and staying in touch with friends, but that “desires are out there…we have to learn how to control ourselves…”
The rally was organized by a rabbinical group called Ichud Hakehillos Letohar Hamachane, which means Union of Communities for the Purity of the Camp. Published reports have put the cost at $1.5 million…
A group urging more support for the victims of child sexual abuse inside the close-knit community held a counter-protest outside the stadium.
Abuse of children, women, non-Orthodox Jews, non-whites are all persistent problems within this community. Anyone recall anytime they held a rally to deal with bigotry?
Inside Citi Field, two billboards for Cholula hot sauce were censored, with the female in the company’s ad campaigns covered up. Telling the press reporters would not be permitted inside because of Homeland Security was another Cloud Cuckooland touch.
The mass dementia of minds closed to science, reality, modern knowledge is an affront to all. I have to wonder if the owners of Mets’ Citi stadium would have rented the venue out for a non-Othordox rally with the purpose of relegating women to servility. If it’s religious I guess that’s sufficient excuse to profit from bigotry.
Kermit the Frog and Miss Piggy hit back at Fox News during a UK press conference following the London Premiere of their new film. Fox had publically criticized the film for supposedly pushing a ‘dangerous liberal agenda’ at kids.
America’s conservatives lead the world in paranoia. They may not get what they think they need; but, they surely sound like they get what they deserve.
Blood thinners and diabetes drugs cause most emergency hospital visits for drug reactions among people over 65 in the United States, a new study shows.
Just four medications or medication groups — used alone or together — were responsible for two-thirds of emergency hospitalizations among older Americans, according to the report. At the top of the list was warfarin, also known as Coumadin, a blood thinner. It accounted for 33 percent of emergency hospital visits. Insulin injections were next on the list, accounting for 14 percent of emergency visits.
Aspirin, clopidogrel and other antiplatelet drugs that help prevent blood clotting were involved in 13 percent of emergency visits. And just behind them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11 percent of hospitalizations.
All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. The sheer extent to which they are involved in hospitalizations among older people, though, was not expected, said Dr. Dan Budnitz, an author of the study…
As Americans live longer and take more medications — 40 percent of people over 65 take five to nine medications — hospitalizations for accidental overdoses and adverse side effects are likely to increase, experts say…
A common denominator among the drugs topping the list is that they can be difficult to use. Some require blood testing to adjust their doses, and a small dose can have a powerful effect. Blood sugar can be notoriously hard to control in people with diabetes, for example, and taking a slightly larger dose of insulin than needed can send a person into shock. Warfarin, meanwhile, is the classic example of a drug with a narrow margin between therapeutic and toxic doses, requiring regular blood monitoring, and it can interact with many other drugs and foods…
One thing that stood out in the data, the researchers noted, was that none of the four drugs identified as frequent culprits are typically among the types of drugs labeled “high risk” for older adults by major health care groups…
Dr. Budnitz said that the new findings should provide an opportunity to reduce the number of emergency hospitalizations in older adults by focusing on improving the safety of this small group of blood thinners and diabetes medications, rather than by trying to stop the use of drugs typically thought of as risky for this group.
Dr. Budnitz thinks it is critical that patients tell their physicians everything they’re taking. Well, presuming that the digitizing program put in place by President Obama is proceeding at least as quickly as anything else that hasn’t been roadblocked by the Party of NO – seems to me it soon should be practical for that physician to have someone on staff run a database check on his patients for exactly these conflicts and dangers.
Leaving the responsibility up to a patient who may not even be able to spell the crap he’s taking ain’t the most reliable approach. Involving doctor and pharmacy database records makes as much sense or more.
Forget jobs and spending cuts. Ask around online, and it seems Americans just want the right to get high.
Marijuana legalization has been the top issue on the White House’s new “We the People” petition site since it launched last month as a way for citizens to lobby for issues that matter most to them.
The marijuana petition already has more than 55,000 signatures — 20,000 more than any other issue on the site and much more than the 25,000-signature threshold administrators set to warrant an official response. The White House has not yet responded to the marijuana petition.
And so it has been each time the Obama administration engaged voters online: Marijuana legalization was among the most popular questions raised on Twitter, YouTube and Change.gov, the president’s transition site…
“The political mind is pretty simple: What can you do for me, what can you do to harm me. … We’re not effectively casting that in either direction,” said Allen St. Pierre, executive director for the National Organization for the Reform of Marijuana Laws, which started the White House petition…
“We are not nearly as organized [or wealthy enough] to put together the type of donations and PACs that arrest and immediately catch the attention of the elite body politic,” St. Pierre said.
Obama and all the other safe and secure ideologues need to realize that the majority of the American electorate know from experience that marijuana is no more of a public danger than beer – and probably less than a lot of other deleterious substances from cigarettes to PAC commercials.
What happens to transparency when the people speak and the president thinks its a joke?
Traditional playgrounds which teach children about risk and danger are being reintroduced after research found that they aid development.
Climbing frames, monkey bars, sand and water features have been replaced with sterile play areas in recent years amid overzealous health and safety fears.
Councils removed features such as paddling pools sand pits and fitted rubber mats in a bid to avoid costly litigation. But experts believe that the opportunity to assess potential danger and react to risk in the playground helps children make decisions in later life.
South Somerset district council has revised its play strategy and has granted approval for more traditional playgrounds which including stepping logs and wooden forts.
Adrian Moore, the council’s play and youth facilities officer, told the Sunday Times: “Playgrounds are the nursery slopes for real life. If we don’t help children differentiate between acceptable and unacceptable risk, we are failing them.
“Instead of eliminating it, let’s embrace it. In a playground, learning to judge speed, movement and distance stands you in good stead when you master other vital but dangerous skills, such as riding a bike or crossing the road.”
Ellen Sandseter, a professor of psychology at Queen Maud University in Norway, wrote in the journal Evolutionary Psychology: “Children must encounter risks and overcome playground fears, monkey bars and tall slides are great.
“They approach thrills and risks in a progressive manner. Let them encounter these challenges from an early age and they will master them through play over the years.”
Good grief. I don’t think the kids ever worry about danger.
Mommies and daddies are always ready to rush out in overprotective mode. The best thing they can do is ban parents from anywhere they can watch their children playing.
Women participating in a study of patients with breast cancer have been inadvertently left with hundreds of tiny particles of the heavy metal tungsten in their breast tissue and chest muscles. The particles came from a device used during surgery. The device has since been recalled.
It is not known if the metal is dangerous to health because relatively little research has been done on its long-term effects in the body. But it shows up on mammograms, and may make them difficult to read, an especially troubling effect for women who have already had breast cancer and worry about recurrences. (The particles resemble calcium deposits, which can indicate cancer.)
About 30 women have been affected, according to the manufacturer of the device that caused the problem, the Axxent FlexiShield Mini. The women are in a quandary. At least one, fearing that the tungsten could cause cancer or another illness, is trying to decide whether to get rid of the particles by having her breast and its underlying tissue removed in a radical and disfiguring operation…
The episode casts doubt on the safeguards for people who participate in medical research and on the Food and Drug Administration’s ability to protect the public from flawed medical devices…
Karen Riley, FDA spokeswoman, said the 510(k) process was used to avoid “reinventing the wheel” for products that were essentially the same as others that had already passed muster with the agency.
RTFA as a cautionary tale. An accepted procedure for passing medical devices as safe – and has a fine track record – failed a number of women. They are left with years of wondering just what medical issues may follow the tests of the Flexishield.