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Advanced physical therapy is the medical practice of treating, healing, and preventing injuries. While this isn?t the sole purpose of physical therapy, it does encompass the majority of care that patients receive. Many patients also engage in therapy to prevent deterioration of muscle and tissue important for basic mobility, such as walking and lifting. Athletes take advantage of sports training that helps increase speed, agility, and endurance. The field of advanced physical therapy prides itself on providing adequate education so that patients learn and understand how to prevent future injuries by performing exercises at home and understanding how the body works.Geriatric Physical Therapy BenefitsAs bone mass and muscle deteriorate with age, the elderly are at a high risk for falls and bone fractures. Osteoporosis is a leading cause of lost bone mass, especially in women. Treatment to help build bone mass includes strength training, because the increased blood flow to the bones helps strengthen them. Physical therapists can assist the elderly at home, in assisted living centers, skilled nursing facilities, and at outpatient facilities. Medicare will usually cover physical therapy costs associated with rehabilitation and pain management.One benefit many elderly patients receive from therapy is the ability to regain independent mobility without the need for walkers or canes. Musculoskeletal problems of the spine are one reason many older people need assistance when walking. Not only is the spine deteriorating because of age, but there may be a considerable amount of pain caused by slipped discs or swollen nerves. By helping elderly patients improve posture and strengthen the back and core, therapists improve an older patients balance, strength, and coordination. This leads to a better quality of life in the later years.Prenatal Physical Therapy BenefitsOne area of advanced physical therapy that many people don?t consider is prenatal therapy. Women are told to exercise while pregnant to prevent weight gain and have an easier labor, but magazines and television programs don?t educate women on the best way to exercise that benefits the entire body. During the last trimester, much more stress and weight is put onto the lower back, and the lower back is expected to support all of this stress and weight. That is why many pregnant women experience pain in the sciatica and have pain when sitting or walking.A prenatal therapist will work with an expectant mother, taking into consideration any restrictions set forth by her OB/GYN, to help her reduce weight gain and pregnancy pain. A physio trainer will work on exercises, both cardio and strength training, so that an expectant mother has an easier pregnancy and delivery. The major benefit of receiving therapy services while pregnant is that any new aches and pains can be brought up immediately and the therapist can plan and manage the new pains with exercise.Sports Physical Therapy BenefitsThe American Physical Therapy Association offers its members the opportunity to expand their education by taking online and home study courses in sports therapy. Physical therapy centers have trained therapists who focus on working with high school and college athletes. This aspect of therapy is popular as many younger people need help rehabilitating from sports-related injuries.Therapists work one-on-one with athletes to help them gain agility and strength. Patients can also recover quickly when using advanced physical therapy techniques customized for their specific sport. Thanks to the wide variety of specialties studied in physical therapy, anyone can benefit from a therapy program that takes into consideration their specific ailment.
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SEOUL/LONDON (Reuters) - Samsung Electronics launched its top-of-the-range Galaxy S3 smartphone in Europe on Tuesday, aiming to outsell its previous model that helped the South Korean company topple Apple as the world's largest smartphone maker.
The Galaxy S3, which tracks the user's eye movements to keep the screen from dimming or turning off while in use, hits stores in 28 European and Middle East countries, including Germany, as Samsung aims to increase its lead over Apple months ahead of its new iPhone, expected in the third quarter.
Samsung has tried to create the kind of frenzy around the launch that has become the norm for Apple's new gadgets. But some customers will have to wait a couple of weeks to get their phone because of delays in making it in a newly-invented "Pebble Blue" color.
In Berlin, about 50 customers queued outside the BASE mobile phone shop on Monday night eager to be the first to lay their hands on the S3.
Also in Frankfurt some 100 people were in the queue this morning when the Deutsche Telekom shop on the city's busiest shopping street The Zeil opened.
"That's about the same as when the latest iPhone went on sale," said 21-year old Steven Barth, who was taking orders at the shop. "I think our publicity campaign also helps. We are giving away about a hundred Galaxys today, in this shop."
Robert, a student from Frankfurt, who declined to give his last name as he should have been studying, said he had already ordered his Galaxy S3.
"I didn't really like it when Apple was selling the iPhone only via Deutsche Telekom. That's when I decided to buy a Samsung and never left," the 28-year old said.
Other Frankfurt cellphone stores were not so busy.
And in Paris, several cellphone stores did not have the S3 and sales assistants said they did not know when they would get it.
"Consumers have been waiting for the Galaxy S3. It's one of the few emblematic smartphone launches this year," said Laurent Lame, marketing director of devices for French operator SFR.
He said Samsung was aiming for a similar buzz as with iPhone launches.
"Samsung has closely guarded the details of the phone to create a sense of secrets and confidentiality that then makes the launch into an event. They do 'teasing' like Apple does now," Lame said.
A spokesman for Vodafone in Britain said the device had been the most pre-ordered Android device in its line-up ever.
MASSIVE MARKETING
The smartphone, running on Google's Android operating system, boasts a 4.8-inch screen, one of the largest on smartphones ever, and much bigger than the 3.5-inch display on the iPhone 4S.
Top global carriers - from Britain's Vodafone to Singapore's SingTel - have started to promote the S3 aggressively, fuelling speculation the smartphone could top its predecessor, the Galaxy S2's 20 million sales worldwide.
Samsung itself has said it expects the new flagship model to outsell its predecessor.
Samsung introduced its first Galaxy in 2010, three years after the iPhone's debut, to counter Apple's roaring success in smartphones when the troubles of bigger rivals Nokia and BlackBerry maker Research In Motion had started.
Samsung sold 44.5 million smartphones in January-March - equal to nearly 21,000 every hour - giving it 30.6 percent market share. Apple sold 35.1 million iPhones, taking 24.1 percent market share.
"The Galaxy S3 is a real challenger to the upcoming iPhone," said Francisco Jeronimo, an IDC analyst based in London. "This is likely be one of the most sold smartphones this year, though the real test will come when the next iPhone is launched."
In the race for global smartphone supremacy, Apple has accused Samsung of copying some of its products. The South Korean company counter-claims that Apple has infringed its patents. Both have denied the allegations, and a long-running court saga continues.
Apple plans to use a larger screen on the next iPhone, according to people familiar with the situation. The current iPhone 4S model was introduced last October.
Samsung has launched its own music service on the Galaxy S3, putting itself head-to-head with Apple. It has previously rebranded existing music and video services.
"Samsung is not known for our content services; we make good hardware products but we haven't done much in the content space but that's changing," T.J. Kang, senior vice president of Samsung Electronics' Media Solution Center, said.
"We are doing it to create a better experience for our users. There are things we could do better if we have complete control over all of the service."
MORE ROUNDED
In a departure from its predecessor, whose look and feel became the main subject of the legal dispute with Apple, the latest Galaxy has a more rounded outline. It also has voice recognition, dubbed S Voice, which will inevitably be compared with Apple's Siri, and image recognition software that can tag and share photographs.
Prices vary depending on the contract. A model with 16 gigabytes of memory costs up to 189 pounds ($300) under a 12-month contract with Vodafone. A similar package for the iPhone 4s costs 159 pounds, but comes with a more expensive monthly data plan.
Samsung said it will release the S3 via 296 carriers in 145 countries by July.
Profit from Samsung's mobile division nearly tripled in January-March to $3.6 billion, accounting for 73 percent of operating profit.
Analysts estimate its global marketing campaign for the S3 will likely have cost several hundred million dollars.
Samsung - whose shares have gained 82 percent since late-August, beating Apple's 58 percent rise - is now banking on an aggressive marketing campaign ahead of the summer London Olympics to further drive sales. It has said its mobile market share in China doubled after the 2008 Beijing Olympics.
"The S3 is supported by an unprecedented promotional campaign," said Geoff Blaber, an analyst at CCS Insight in London. "Samsung's timing with the Galaxy S3 is perfect."
($1 = 0.6396 British pounds)
($1 = 1185.3500 Korean won)
(Additional reporting by Fabrizio Bensch in BERLIN, Leila Abboud in PARIS, Harro ten Wolde in FRANKFURT and Tarmo Virki in HELSINKI; Editing by Ian Geoghegan, Erica Billingham and Jane Merriman)
(This story was refiled to remove extraneous apostrophe in paragraph six)
Facebook founder Mark Zuckerberg. (Paul Sakuma / Associated Press / May 27, 2012)
By Stuart Pfeifer
May 27, 2012, 5:30 a.m.
Here is a roundup of alleged cons, frauds and schemes to watch out for.
Facebook "cancellation" ? Facebook users should be cautious if they receive an email that claims they need to take action to prevent their Facebook accounts from being canceled, according to the Internet security blog Naked Security. Users who follow a link on the email can end up downloading code that allows hackers to spy on their activities and take over their computers. Instead of following links in the emails, users should sign into their Facebook accounts and communicate with Facebook staff directly.
Ponzi scheme ? An Irvine attorney has been sentenced to more than seven years in federal prison for her role in an investment scheme that caused victims to lose about $20 million. Jeanne Rowzee, 53, and her partner, James Halstead, attracted investors by promising returns of between 25% and 35% every three to four months. Victims were told that their money would be used to make short-term loans to businesses and that there was a chance they would lose money. In reality, the victims' money was never invested. Rowzee and Halstead instead used the money to make Ponzi payments to some investors and to support their lavish lifestyles. According to court documents, Halstead used $191,005 of victim-investors' money to buy a Ferrari, more than $1 million to purchase a home for himself in the Las Vegas area and $162,350 to buy a Porsche. Halstead was previously sentenced to 10 years in prison.
Own-your-own website ? A federal judge in Arizona has temporarily stopped a business that offered consumers the chance to start their own websites with promises of big advertising revenue. The Federal Trade Commission had alleged in a lawsuit that North America Marketing and Associates charged consumers between $100 and $400 to build and host websites, which generated little or no revenue. In addition, the FTC said, the company tried to sell customers more expensive plans. When customers started to complain, the FTC said, the company shut down and opened under a different name.
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Members of Rolling Thunder salute during the presentation of colors during the annual Rolling Thunder rally on the National Mall ahead of Memorial Day in Washington, Sunday, May 27, 2012. (AP Photo/Charles Dharapak)
Members of Rolling Thunder salute during the presentation of colors during the annual Rolling Thunder rally on the National Mall ahead of Memorial Day in Washington, Sunday, May 27, 2012. (AP Photo/Charles Dharapak)
WASHINGTON (AP) ? President Barack Obama is paying tribute to the nation's fallen warriors on Memorial Day, attending a ceremony at Arlington National Cemetery and honoring those who died during the Vietnam War.
The president was to participate in a wreath-laying ceremony at the Tomb of the Unknowns at Arlington National Cemetery near Washington, and then marking the 50th anniversary of the Vietnam War at the Vietnam Veterans Memorial.
In an election year, Obama has touted his work to bring U.S. combat troops home from Iraq and wind down the conflict in Afghanistan. Before military audiences and in a campaign ad released last week, he credits U.S. servicemen who helped in the raid that killed Osama bin Laden.
With so many troops returning home from their service, Obama says the U.S. needs to return the favor.
"We have to serve them and their families as well as they have served us," Obama said in his weekly radio and Internet address. "By making sure that they get the health care and benefits they need; by caring for our wounded warriors and supporting our military families; and by giving veterans the chance to go to college, find a good job and enjoy the freedom that they risked everything to protect."
Veterans could play a significant role in the 2012 election. Exit polls in 2008 showed that Obama was supported by about 44 percent of voters who said they served in the military, while 54 percent voted for John McCain, a former Navy pilot who was a prisoner of war for more than five years during the Vietnam War.
Republican Mitt Romney was scheduled to appear Monday with McCain in San Diego, home to a large number of military personnel and veterans. Romney has made the case that too many veterans are returning home to poor job prospects, casting blame on Obama's economic policies.
A Bureau of Labor Statistics report in March found that 12.1 percent of U.S. Armed Forces veterans who served on active duty after September 2001 were unemployed in 2011. The unemployment rate for all veterans was 8.3 percent.
Several closely watched states in the election have large blocs of military voters. Florida, home to several military installations, has more than 1.6 million veterans, according to the Veterans Administration. Pennsylvania has nearly 1 million veterans, while Virginia and North Carolina each have about 800,000 veterans living in their states.
The president and first lady Michelle Obama were starting the day with a breakfast at the White House for families who have lost loved ones in combat.
Mice and monkeys don't develop diseases in the same way that humans do. Nevertheless, after medical researchers have studied human cells in a Petri dish, they have little choice but to move on to study mice and primates.
University of Washington bioengineers have developed the first structure to grow small human blood vessels, creating a 3-D test bed that offers a better way to study disease, test drugs and perhaps someday grow human tissues for transplant.
The findings are published this week in the Proceedings of the National Academy of Sciences.
"In clinical research you just draw a blood sample," said first author Ying Zheng, a UW research assistant professor of bioengineering. "But with this, we can really dissect what happens at the interface between the blood and the tissue. We can start to look at how these diseases start to progress and develop efficient therapies."
Zheng first built the structure out of the body's most abundant protein, collagen, while working as a postdoctoral researcher at Cornell University. She created tiny channels and injected this honeycomb with human endothelial cells, which line human blood vessels.
During a period of two weeks, the endothelial cells grew throughout the structure and formed tubes through the mold's rectangular channels, just as they do in the human body.
When brain cells were injected into the surrounding gel, the cells released chemicals that prompted the engineered vessels to sprout new branches, extending the network. A similar system could supply blood to engineered tissue before transplant into the body.
After joining the UW last year, Zheng collaborated with the Puget Sound Blood Center to see how this research platform would work to transport real blood.
The engineered vessels could transport human blood smoothly, even around corners. And when treated with an inflammatory compound the vessels developed clots, similar to what real vessels do when they become inflamed.
The system also shows promise as a model for tumor progression. Cancer begins as a hard tumor but secretes chemicals that cause nearby vessels to bulge and then sprout. Eventually tumor cells use these blood vessels to penetrate the bloodstream and colonize new parts of the body.
When the researchers added to their system a signaling protein for vessel growth that's overabundant in cancer and other diseases, new blood vessels sprouted from the originals. These new vessels were leaky, just as they are in human cancers.
"With this system we can dissect out each component or we can put them together to look at a complex problem. That's a nice thing?we can isolate the biophysical, biochemical or cellular components. How do endothelial cells respond to blood flow or to different chemicals, how do the endothelial cells interact with their surroundings, and how do these interactions affect the vessels' barrier function? We have a lot of degrees of freedom," Zheng said.
This video shows blood pumping through an engineered microvessel stimulated with an agent that causes inflammation. Over time green clots form in the vessel, like they do in the human body.Credit: Y. Zheng, U. of Washington
The system could also be used to study malaria, which becomes fatal when diseased blood cells stick to the vessel walls and block small openings, cutting off blood supply to the brain, placenta or other vital organs.
"I think this is a tremendous system for studying how blood clots form on vessels walls, how the vessel responds to shear stress and other mechanical and chemical factors, and for studying the many diseases that affect small blood vessels," said co-author Dr. Jos? L?pez, a professor of biochemistry and hematology at UW Medicine and chief scientific officer at the Puget Sound Blood Center.
Future work will use the system to further explore blood vessel interactions that involve inflammation and clotting. Zheng is also pursuing tissue engineering as a member of the UW's Center for Cardiovascular Biology and the Institute for Stem Cell and Regenerative Medicine.
###
University of Washington: http://www.uwnews.org
Thanks to University of Washington for this article.
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Genius networks: Link to a more creative social circle by Zella King? May 29, 2012
The greatest artists and scientists have been inspired by brilliant peers. Now technology can help you maximise creativity by fine-tuning your social circles?The social circles in which these artists and scientists moved seemed to foster the free-flowing ideas from which great movements and discoveries sprang.
[Creativity] ? The constant tension between alien perspectives and familiar faces seems to be key. Take Johannes Gutenberg?s invention of the printing press. He was a goldsmith, but his connections to wine-makers enabled him to see the potential of the screw press for printing.
if you belong to several unrelated social groups you are in a good position to uproot ideas from one and use them in anotherWhere many unrelated groups are connected by a few people, a network can begin to develop ?small world? properties. This kind of structure is repeated across a surprising range of systems ? including scientific collaboration, film-making, power grids, worms? brains, and even memory itselfA small-world network allows information to travel quickly between any two unconnected people by way of a very short chain of intermediaries.
As the game shows, a few hubs can profoundly affect how far and fast information can travel in a small-world network. But a small-world network isn?t just about strangers. Our friends matter, too.
Most people?s social networks are composed primarily of dense clusters of these close acquaintances. We trust them to act both as fans and critics of our new ideas, reinforcing and developing some aspects and dismantling others. The conformity of a close-knit group helps batter an idea into coherent shape. But they don?t often introduce us to new ideas.
[There is a] ?Goldilocks zone? for social networks. Brian Uzzi, a sociologist at Northwestern University in Evanston, Illinois, looked at how the relationships between artists involved in Broadway musicals between 1877 and 1989 affected box office sales (Science vol 308 p 697).
too many strangers dampened the free exchange of ideasBut too many close friends created an atmosphere in which ideas were born of inside references and so only appealed to a limited audience.
That had consequences. In the 1920s, for example, Uzzi found that the people working on Broadway came from an unusually small and interconnected pool, so most productions only involved close friends. Musical theatre hit a low point with a ?flop? rate of 87 per centBut Uzzi and Spiro showed that when the mix was right, the links between different social clusters served to spark radically new conventions that resonated with audiences. A good ratio resulted in some of the 20th century?s most critically successful musicals, such as West Side StoryThe ratio was a quantity called Q.
Although they called it the ?familiarity index?,
Q isn?t just a straightforward percentage of friends and strangers. Instead, it?s a measure of just how clustered a group is, or the extent to which any two people connected to the same person are also likely to be connected to each otherWhen the Q score was too high, it meant that people had been working together on one musical after another, cloistered with others who had also worked together before, reducing their openness to fresh ideasBut when the Q was too low, teams weren?t sufficiently connected to let ideas flow.
By itself, the act of signing up for Facebook, Twitter or a Google + account does little to improve anyone?s creativity. Take a scattergun approach to eavesdropping on strangers, and you might drown in the tide of disorganised information. Most of us react to this information overload by focusing only on what is already familiar. We find it easier to interact with people who are familiar, especially in situations that give us plenty of choices (Group Processes and Intergroup Relations, vol 15, p 119). This leads to the clustered shape that characterised so many of our social networks (see diagram).
To help you understand whether you?re embedded in an echo chamber of people who all know each other, visualisations can give you a rough sense of your Q score. Apps such as TouchGraph and InMaps provide a ?map? of your Facebook or LinkedIn connections.
One way to pepper your social network with the right strangers is by finding the right superconnectors. To find them, you might start by focusing on the problem you?re trying to solve, and then seek out the people who share that interest. On Twitter, for example, the hash tag #creativity will turn up other people who are interested in the topic. The links and connections in their tweets will lead you to second-order strangers who might introduce you to magazines, journals and blogs you would never have known about.
Theoretically, the internet can give you access to a limitless number of interesting strangers. But how many should you be listening to? Anthropologist Robin Dunbar of the University of Oxford has placed the upper limit on this number at a puny 150. And in practice, the ones you actually have the time to get ideas from is probably closer to 50.
If you can keep your universe from collapsing to those 50 people, you?ll avoid falling into the insider trap that characterises social circles with a high Q. The best way to do this is by periodically replacing 25 per cent of your usual news sites, blogs or Twitter feeds. Replacing is key: our limited attention span requires a revolving-door approach.
After all that, don?t forget about your local social network. The internet lets you gather novel snippets in unknown social territory. But it is the people around you ? in your office, lab or school ? who will help you translate these snippets into the real world. Their input will develop the strengths and iron out the weaknesses in your ideas.
Of course, there are those who will groan at the prospect of co-opting their social circles in the joyless pursuit of self-improvement.
They can take comfort in the knowledge that creativity research has done nothing to puncture the notion of the role of individual genius. It has simply proposed that, like Kevin Bacon, few who accomplished great things did so entirely alone.
Zella King is an associate professor at Henley Business School at the University of Reading, UK After all that, don?t forget about your local social network. The internet lets you gather novel snippets in unknown social territory. But it is the people around you ? in your office, lab or school ? who will help you translate these snippets into the real world. Their input will develop the strengths and iron out the weaknesses in your ideas.
Of course, there are those who will groan at the prospect of co-opting their social circles in the joyless pursuit of self-improvement.
They can take comfort in the knowledge that creativity research has done nothing to puncture the notion of the role of individual genius. It has simply proposed that, like Kevin Bacon, few who accomplished great things did so entirely alone.
Zella King is an associate professor at Henley Business School at the University of Reading, UK
Legalising same-sex marriage would "legitimise and encourage" the existence of fatherless or motherless children, according to a report.
A Free Church of Scotland study panel examined the issues surrounding marriage, divorce and remarriage.
The study comes as responses to the Scottish Government's consultation on gay marriage are evaluated.
Referring to same-sex couples, the Free Church report said: "By getting the right to marry, they get more respectability for bringing up children (they already have the right to foster and adopt).
"This is a huge social experiment in which the guinea pigs are children. That is not fair or just to children and does not safeguard their rights. It is really being pushed in a doctrinaire way by the gay lobby without any consideration of the harm that it will do."
The church said that civil partnerships already give same-sex couples the same legal rights as marriage, and therefore there is no need to introduce same-sex marriage.
1 size doesn't fit all when treating blood pressure in people with diabetes, VA/U-M study suggestsPublic release date: 28-May-2012 [ | E-mail | Share ]
Contact: Kara Gavin kegavin@umich.edu 734-764-2220 University of Michigan Health System
Aiming for & incentivizing strict BP control for all patients means some are being over-treated -- but an individualized approach could help
ANN ARBOR, Mich. Aggressive efforts to lower blood pressure in people with diabetes are paying off perhaps too well, according to a new study
The research shows that there have been dramatic improvements in blood pressure control among patients with diabetes in the U.S. Department of Veterans Affairs, with as many as 82 percent of patients having blood pressure controlled and 94 percent getting appropriate BP treatment.
However, given the dramatic rise in control, as many people now may be getting over-treated with blood pressure medications as are being under-treated.
That suggests it might be time to reconsider the current one-size-fits-all approach to blood pressure control, and turn to a new model that adjusts the blood pressure goal according to the individual, say a team of researchers from the VA Ann Arbor Healthcare System and the University of Michigan Health System.
Modern healthcare electronic record systems should help make this possible, they say, because blood pressure, prescription and other health data on individual risks such as heart disease or balance problems can all be combined.
In a paper being published online in the Archives of Internal Medicine, the team finds that over 8 percent of the 977,000 VA patients nationwide with diabetes are possibly being over-treated. Meanwhile, 6 percent were not being treated as aggressively as they could be.
"Appropriately treating blood pressure in people with diabetes is extremely important, and good blood pressure control should still be the goal to reduce risk of heart attack, stroke and other conditions," says first author Eve Kerr, M.D., director of the Center for Clinical Management Research at the VAAAHS and professor of internal medicine at the U-M Medical School.
"But just treating to a BP target in all patients may result in over-treating and harming some patients because their blood pressures actually fall too low," she adds. "We need to find better ways to measure and incentivize appropriate BP management to make sure that patients who need aggressive treatment are getting it, and to decrease the rate of inappropriate overtreatment."
The team looked back at electronic records from people with diabetes and high blood pressure who were treated at any of 879 VA hospitals and clinics in 2009 and 2010. Almost 714,000 of them were between the ages of 18 and 75. Drawing on the expertise of dozens of VA clinical and measurement experts, they developed a "clinical action measure", or way of assessing the appropriateness of a patient's care by looking at treatment factors and contraindications, not just the target blood pressure. They also defined a monitor of potential overtreatment, to signal that some patients could be receiving overly aggressive treatment.
Appropriate BP management was defined by the clinical action measure having a BP either less than 140/90 or less than 150/65; or having appropriate management of elevated blood pressure (medication intensification or being on 3 or more BP medications). Potential overtreatment was defined as having blood pressure that was less than 130/65 while also receiving three or more BP medicines or having recent medication increases. They focused on the patients under the age of 75 when assessing under-treatment, and all patients when looking for overtreatment.
Recent research has found that patients with diabetes don't have better cardiovascular outcomes, but experience more side effects, if they get aggressive treatment to lower their blood pressure under 130/80. At the same time, some people experience side effects caused by "polypharmacy", or the impact of taking multiple drugs at the same time for the same condition. In addition, diastolic blood pressure under 65 is associated with worse cardiovascular health, and low blood pressure could also cause dizziness that can lead to dangerous falls.
Interestingly, the rate of overtreatment varied considerably between VA facilities ranging as high as 20 percent at some and as low as 3 percent at others. The hospitals and clinics with the highest overall rates of diabetes patients with blood pressure at or below the target of 140/90 also had the highest rates of overtreatment, they found.
This is likely a result of focusing on a target than on an individualized approach a phenomenon that might be tied to performance incentives and public reporting practices currently in place, says Kerr, a member of the U-M Institute for Healthcare Policy and Innovation and the Michigan Diabetes Research and Training Center.
Such one-goal-for-all benchmarks were set years ago when blood pressure control for people with diabetes was poor across the board. But now, when 82 percent of VA patients with diabetes have their blood pressure under 140/90, a more sophisticated approach is likely needed, Kerr notes.
"We need to have performance measures that focus on appropriate treatment, and if patients are being treated aggressively but still don't quite get to a target control value we need to allow that to count as appropriate care," she says. As a first step, the VA system will adopt the BP clinical action measure to motivate appropriate BP management for patients based on their risks and treatment characteristics. But the same could be done in non-VA settings, especially those that have reached as high levels of BP control as has the VA healthcare system.
In the meantime, people who have diabetes should talk with their doctors about their blood pressure treatment and the lifestyle steps and medicines they are taking to keep it under control, Kerr says. "It is essential that we continue to monitor and focus on BP control among patients with diabetes, but we also have to realize that when BP starts to dip too low, it may be time to decrease treatment."
###
The research was funded by VA grant QUERI RRP 09-111. In addition to Kerr, the study's authors include Timothy Hofer, M.D., of both VA and U-M, and VA colleagues
Reference: Archives of Internal Medicine, online publication May 28, 2012 DOI:10.1001/archinternmed.2012.2253
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1 size doesn't fit all when treating blood pressure in people with diabetes, VA/U-M study suggestsPublic release date: 28-May-2012 [ | E-mail | Share ]
Contact: Kara Gavin kegavin@umich.edu 734-764-2220 University of Michigan Health System
Aiming for & incentivizing strict BP control for all patients means some are being over-treated -- but an individualized approach could help
ANN ARBOR, Mich. Aggressive efforts to lower blood pressure in people with diabetes are paying off perhaps too well, according to a new study
The research shows that there have been dramatic improvements in blood pressure control among patients with diabetes in the U.S. Department of Veterans Affairs, with as many as 82 percent of patients having blood pressure controlled and 94 percent getting appropriate BP treatment.
However, given the dramatic rise in control, as many people now may be getting over-treated with blood pressure medications as are being under-treated.
That suggests it might be time to reconsider the current one-size-fits-all approach to blood pressure control, and turn to a new model that adjusts the blood pressure goal according to the individual, say a team of researchers from the VA Ann Arbor Healthcare System and the University of Michigan Health System.
Modern healthcare electronic record systems should help make this possible, they say, because blood pressure, prescription and other health data on individual risks such as heart disease or balance problems can all be combined.
In a paper being published online in the Archives of Internal Medicine, the team finds that over 8 percent of the 977,000 VA patients nationwide with diabetes are possibly being over-treated. Meanwhile, 6 percent were not being treated as aggressively as they could be.
"Appropriately treating blood pressure in people with diabetes is extremely important, and good blood pressure control should still be the goal to reduce risk of heart attack, stroke and other conditions," says first author Eve Kerr, M.D., director of the Center for Clinical Management Research at the VAAAHS and professor of internal medicine at the U-M Medical School.
"But just treating to a BP target in all patients may result in over-treating and harming some patients because their blood pressures actually fall too low," she adds. "We need to find better ways to measure and incentivize appropriate BP management to make sure that patients who need aggressive treatment are getting it, and to decrease the rate of inappropriate overtreatment."
The team looked back at electronic records from people with diabetes and high blood pressure who were treated at any of 879 VA hospitals and clinics in 2009 and 2010. Almost 714,000 of them were between the ages of 18 and 75. Drawing on the expertise of dozens of VA clinical and measurement experts, they developed a "clinical action measure", or way of assessing the appropriateness of a patient's care by looking at treatment factors and contraindications, not just the target blood pressure. They also defined a monitor of potential overtreatment, to signal that some patients could be receiving overly aggressive treatment.
Appropriate BP management was defined by the clinical action measure having a BP either less than 140/90 or less than 150/65; or having appropriate management of elevated blood pressure (medication intensification or being on 3 or more BP medications). Potential overtreatment was defined as having blood pressure that was less than 130/65 while also receiving three or more BP medicines or having recent medication increases. They focused on the patients under the age of 75 when assessing under-treatment, and all patients when looking for overtreatment.
Recent research has found that patients with diabetes don't have better cardiovascular outcomes, but experience more side effects, if they get aggressive treatment to lower their blood pressure under 130/80. At the same time, some people experience side effects caused by "polypharmacy", or the impact of taking multiple drugs at the same time for the same condition. In addition, diastolic blood pressure under 65 is associated with worse cardiovascular health, and low blood pressure could also cause dizziness that can lead to dangerous falls.
Interestingly, the rate of overtreatment varied considerably between VA facilities ranging as high as 20 percent at some and as low as 3 percent at others. The hospitals and clinics with the highest overall rates of diabetes patients with blood pressure at or below the target of 140/90 also had the highest rates of overtreatment, they found.
This is likely a result of focusing on a target than on an individualized approach a phenomenon that might be tied to performance incentives and public reporting practices currently in place, says Kerr, a member of the U-M Institute for Healthcare Policy and Innovation and the Michigan Diabetes Research and Training Center.
Such one-goal-for-all benchmarks were set years ago when blood pressure control for people with diabetes was poor across the board. But now, when 82 percent of VA patients with diabetes have their blood pressure under 140/90, a more sophisticated approach is likely needed, Kerr notes.
"We need to have performance measures that focus on appropriate treatment, and if patients are being treated aggressively but still don't quite get to a target control value we need to allow that to count as appropriate care," she says. As a first step, the VA system will adopt the BP clinical action measure to motivate appropriate BP management for patients based on their risks and treatment characteristics. But the same could be done in non-VA settings, especially those that have reached as high levels of BP control as has the VA healthcare system.
In the meantime, people who have diabetes should talk with their doctors about their blood pressure treatment and the lifestyle steps and medicines they are taking to keep it under control, Kerr says. "It is essential that we continue to monitor and focus on BP control among patients with diabetes, but we also have to realize that when BP starts to dip too low, it may be time to decrease treatment."
###
The research was funded by VA grant QUERI RRP 09-111. In addition to Kerr, the study's authors include Timothy Hofer, M.D., of both VA and U-M, and VA colleagues
Reference: Archives of Internal Medicine, online publication May 28, 2012 DOI:10.1001/archinternmed.2012.2253
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Loaded with phytonutrients, this triple pepper kale dip may play a role in skin cancer prevention.
I?ve been celebrating Celiac Awareness all month long, but there is another important celebration going on in May that is near and dear to my heart, and that is Skin Cancer Awareness Month.? I hope you will celebrate with me by trying some of my favorite antioxidant and phytonutrient rich recipes, that are not only delicious, but may also play a role in skin cancer prevention.
As a blue-eyed blonde {ahem?with a little help from my hairdresser these days}, with a history of tanning in my late teens/early 20?s, several dysplastic moles and one basal cell skin cancer in my not so distant past, skin cancer prevention is always on my mind.
With this said, I urge everyone to see your physician or dermatologist for an annual skin cancer check, since both basal cell and squamous cell carcinomas are almost always curable with early detection, and even localized {non-spreading} melanoma, a more serious form of skin cancer, has a 98 % cure rate when treated early.
So, PLEASE, be sure and get your skin checked! And be sure to review The Skin Cancer Foundation website for more important information on risk factors, detection, and prevention of both non-melanoma and melanoma skin cancers.
While the research regarding nutrition, and skin cancer prevention is far from conclusive, there is some evidence that foods high in antioxidants and phytonutrients, including luetin, lycopene, carotenoids, epicatechin, quercetin, and Vitamin E, have shown promise as photoprotectants in clinical, animal and cell culture studies. In addition, two very interesting recent studies, one human and one animal, showed the potential for caffeine {or caffeine combined with exercise} to play a role in skin cancer prevention.? As a coffee and tea junkie lover, all I can say is more good news!
Foe more reading/research links:
And, now on to the recipes?
Foods that may help prevent skin cancer: A Full Day?s Worth of {Delicious} Cancer Fighting Recipes
Cilantro, Tomato, and Green Onion Baked Eggs {Breakfast}
Key nutrients: Vitamin A, Vitamin C, lutein, lycopene, quercetin, zeaxanthin
Note:? If you are sensitive to caffeine later in the day {like me}, you?ll definitely want to consume the caffeinated version earlier in the day, as I don?t want to be held accountable for keeping you up all night
For more good information on nutrition and cancer research in general, please check out The American Institute for Cancer Research {AICR}.
Were you aware that May is Skin Cancer Awareness Month?? Do you know your risk factors for skin cancer? Do you eat a diet high in phytochemicals and antioxidants? Are you a coffee and tea lover like me???
I love hearing from you! Please click?here?to leave a comment or ask a question, or leave a suggestion. And, if you enjoyed the post, please stumble, tweet, pin, or share this post to spread the word that healthy eating and delicious eating happily co-exist! Oh, and to make sure you don?t miss any Spicy food, fun, and adventure, please sign up for new post notifications via e-mail or feedburner. Cheers!
A popular way to mount a flat screen television is on a wall. People like the minimal impact that it makes in a room as far as its footprint, but it adds a certain style that looks cool and impressive. That is why people like to hang them on the wall and not use a traditional television stand. You can mount them almost anywhere, as long as you have the right mounting hardware and a wall that is sturdy enough to handle the extra weight.
Mounting them the wrong way or not using real hardware, rigging something up on your own, is dangerous. It can fall and damage the television, the wall and anything that happens to be sitting under the television at the time. Another thing to think about is the wires needed to connect the television to the other components and to a power outlet. Many times the builder will take this into account in newer homes and has hidden a way to supply the power and a way to hook up everything.
Yet in older homes this is usually not an option without doing a little bit of remodeling. Another option besides mounting directly on the wall is to put the television on a shelf. This way it can be very close to the wall, take up less floor space and looks like it is hanging on the wall. This can work on a mantle over a fireplace or on a shelf specially built for the television. But once again, the shelf needs to be able to hold the weight of the television as well as have access to electricity.
This is often more trouble than it's worth for most people. It really comes down to a personal choice and preference and how much work and money you want to throw at the project. But remember, if you aren't going to hang the television on the wall, you still need some sort of stand to place it on. Most stands, even old ones for conventional tube televisions, will work. But they take up almost as much floor space as the big old televisions used to take up.
That's the great thing about these new flat screen televisions. They not only have better picture quality, but they also take up much less area. This is great, especially if you have a small room without a lot of extra room for bulky furniture. But everything has concerns to go along with the positives; you just have to decide which ones are most significant to you.
Lots of people like to do small projects around their house and they need the right tools for those projects. Going to toolhq.com.au today will help you find the right tools. Tool HQ will give you a huge choice to choose from, and their are specialists if you need help.
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The appeal of Pinterest is hard to understand for those who have yet to post anything to that great pinboard in the cloud. And then once your pin addiction is in full effect, it can be even harder to figure out exactly why you are sinking so much time into the endless stream of neat-looking stuff.
While there?s nothing wrong with simply sharpening your eye and taste by clicking the "Pin It" bookmarklet?? we all need a break sometimes?? Pinterest can also be used in productive, focused ways. It?s all about having an end goal in mind when you create those pinboards. So if you want to harness Pinterest?s strengths and habit-forming powers, try these exercises.
Love Pinterest? Follow TODAY's boards here.
Plan a vacation with friends Pretty much everywhere you want to visit, eat, drink, stay or relax on a vacation has a website, and most of them have illustrative pictures. Isn't that convenient? Capitalize on the web's travel-friendly nature by creating a separate pinboard for every city or destination you want to hit up. If you're traveling with other people, nag them to create a Pinterest account if they haven't already, then follow them. Now, head to the board for the city you're visiting, click "Edit Board," then type in their name under the "Who can pin?" section.
Now you can both throw restaurants, hotels, attractions, events, coffee shops, dive bars or whatever catches your eye onto the board, and you and your travel buddies can see what common themes crop up. It's a lot easier to make sense of than a spreadsheet, and you're always just one click away from getting to a phone number or online booking form. My wife and I are planning a three-city jaunt through Pinterest, and it's helped us realize that, at the least, we should plan to enact a strict diet a few weeks before we leave.
Window-shop Speaking of vacations, maybe you?ve thought about crashing on a couch in another city for a quick, cheap weekend trip. But the idea of browsing Airbnb for a distant city, with unfamiliar neighborhoods and unknown renters, kills the impulse. Then check out Airbnb?s pinboards, where you?ll find the Best of Austin, Unique New York, Brazilian Bests and other boards with big, clear pictures of where you?d stay, arranged by city.
There are, in fact, quite a few brands that offer what amounts to a prettier, easier to browse version of their own websites on Pinterest. Etsy, Threadless Tees, Whole Foods, Travel Channel?? the list goes on. Searching Google with ?Pinterest? before the name of the brand gives you something more akin to a window-shopping experience than almost anything else on the web.
Mood board Pinterest pushes you to use its site in a social, casual, fun way. But that?s their branding, not a rule. Single-purpose pinboards can be used for work, or just to explain one concept to one person. Create a nondescript account under an assumed name if you must, or just delete the board once its job is done.
If you?re looking for a certain look from a designer, pin some examples ? it's known as a mood board ? and send them over. Create a board to brainstorm gift ideas with relatives of your significant other. Pin a batch of articles to illustrate the ideas you?re trying to incorporate into a pitch, statement, or campaign. In short, whenever you?ve created a list of blue links separated by carriage returns, consider whether they?d work better with thumbnail images and much more whitespace.
Read it later A lot of apps and services compete for your off-board memory, or what you might call time-shifted consideration. Evernote and Springpad aim for universal capture and productivity, while Instapaper, Pocket (formerly Read It Later) and Readability want to hold your longer articles for when you?ve got time to read.
But consider again the value of a pinboard where you stash the things you want to check out later, no matter if they?re articles, videos, shopping items or recipes. Other apps can capture and tag nearly anything, sure, but Pinterest often feels lighter, less like work, and looks more inviting when you return to browse through all the stuff you?ve captured. Plus, there?s always the reward of friends and complete strangers repinning and dealing out kudos on your great taste.
New Business Sales Executive (B2B) Location: Welwyn Garden City Salary: ?25,000 plus benefits
Omni are recruiting for an energetic, self-motivated and consultative individual to join our clients' New Business team in Welwyn Garden City. My client is a well-recognised global brand who specialise in offering new mothers specialist advice. They offer specialist services in child development, health and well being, baby care, financial advice, food and nutrition and sound parenting advice.
You will be calling small businesses across all sectors selling advertising space and data for use in various targeted marketing campaigns. You will be provided with extensive training, giving you the best tools for the job. It is key that applicants are highly driven in their enthusiasm and approach, with a thirst for sales and to be the best.
We will welcome anybody from a telesales, B2B, B2C, Account Management, Sales, Advertising Sales, Data Sales, Online Sales, Consumer Sales background.
For more information, please send your CV via the apply button below for an immediate interview!.
If you're established to get engaged with foreclosed investing, you're on the right monitor. House foreclosures are at an all-time high due to the latest downturn in the international economic system, and the chance of huge profits has never before been quite what it is in this present economical environment. The concern is, what street will you take - buying houses for back taxes, or by investing your money in mortgage foreclosures?
The obvious response is buying houses for back taxes, and here's why.
While getting mortgage foreclosed used to be a profitable business, present periods are displaying more and more property owners upside-down in their house mortgages. The value these people had in components decreased along with their ideals. Discovering your home foreclosed with any value still remaining in the bag is almost difficult presently.
Buying houses for back taxes, however, indicates usually never have your home and still have a ton of value remaining in them.
Why? Because at tax foreclosed revenue, home mortgages are removed - mortgage organizations make sure the transaction of past due taxes on a residence before it ever creates it to tax buy, making qualities that have no mortgage on them by time the buy comes around. Also, often periods the rear taxes due are the only economical debt on these houses; qualities without your home are most likely without any other liens. So what do we do now? How do we get this property?
Most will likely have very little achievements at the tax deed/lien buy itself. A coordinator of huge tax residence economical commitment organizations will have long done their due persistence and investigated the top qualities to get. They would be willing to create a lesser roi than you are - in other terms, would likely be outbid. This shouldn't quit you from seeking to get tax property-- you basically have to be a little more innovative.
Why not try something along these collections. Find the property immediately from the proprietor - but delay until after the tax buy. This way, you avoid the need for aggressive market bidding process. And by time their residence has already been "sold" at tax buy, these property owners are more than willing to rid themselves of their tax responsibility and would rather see you with the residence instead of dropping it to the govt.
You will often observe that most these entrepreneurs have already approved the loss of components and basically want to put the bad reminiscences behind them. They are inspired to offer, and to offer for inexpensive. Not only do you help someone in need, but you also create a sensible economical commitment shift.
The present foreclosed amount won't last permanently - take benefits of it now.
NEW YORK (AP) ? What defines sugar? It's getting to be a stickier question.
The Sugar Association is accusing the makers of high fructose corn syrup of trying to candy-coat their image by calling their product a "sugar." The Corn Refiners Association is firing back by calling the accusations another attempt to censor its efforts to explain to the public that high fructose corn syrup is, well, a form of sugar.
The latest twist in the spat came after a recent medical study prompted headlines such as "Sugar can make you dumb." The Sugar Association issued a release this week noting the substance used in the study was actually fructose, not its sugar. The group blamed a "multimillion-dollar advertising campaign" by the Corn Refiners Association for generating the confusion.
Audrae Erickson, president of Corn Refiners Association, says the Sugar Association's press release this week "seems to be an effort to silence the campaign" to educate consumers.
The two sides have been at odds for some time now.
Given the negative image of high fructose corn syrup in recent years, the Corn Refiners Association in 2010 submitted an application to the federal government to have the sweetening agent renamed "corn sugar" on nutrition labels. That decision is still pending.
The group has also been running a marketing campaign to explain that its syrup is actually a form of sugar and has the same nutritional value as the white, granular table sugar consumers are familiar with.
That prompted a lawsuit from the Sugar Association last year claiming the campaign was misleading. An attorney for the group, John Burlingame, says it's not trying to stifle free speech with its lawsuit or latest statement. It just wants to point out that high fructose corn syrup is chemically distinct and derived from a different source than sugar.
High fructose corn syrup came into the U.S. market in the late 1970s and 1980s. The product is used widely in cereals, sodas and other processed food and drinks because it's cheaper and mixes easily into recipes. Despite the name, the Corn Refiners Association says the most common forms of it are about half fructose and half glucose.
The American Medical Association has said there's not enough evidence to restrict the use of high fructose corn syrup, although it wants more research. The Center for Science in the Public Interest has said that there was no evidence that the sweetener is any worse for the body than sugar ? and that Americans eat too much of both of them.
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Follow Candice Choi at www.twitter.com/candicechoi
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Public release date: 28-May-2012
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Loaded with phytonutrients, this triple pepper kale dip may play a role in skin cancer prevention.
Pumpkin Pesto Bruschetta {Appetizer}
Lemony Kale Pasta and Pistachio Salad {Lunch/Dinner}
Cinnamon Almond Mocha {Dessert}
