Source:https://www.pennmedicine.org/news/news-releases/2018/november/yelp-reviews-reveal-strengths-and-weaknesses-of-emergency-departments-and-urgent-care-clinics Reviewed by James Ives, M.Psych. (Editor)Nov 12 2018Yelp reviews reveal that emergency departments are viewed as being higher quality but lacking in service as compared to urgent care centers, which patients rate the opposite, according to a new study from researchers in the Perelman School of Medicine at the University of Pennsylvania. The study results, published this month in the Annals of Emergency Medicine, provide a unique opportunity for researchers and clinicians to learn from online reviews, which provide a raw narrative from consumers.”Today’s world is very digital, and it’s very common for consumers to rate a restaurant, hotel or service online, a practice that is spilling over into health care,” said the study’s lead author, Anish Agarwal, MD, a National Clinician Scholars fellow and Emergency Medicine physician at Penn Medicine. “As an emergency department physician, patients often tell me that the internet is the first place they go for information about medical conditions and to research providers. Health systems and clinicians can learn a lot about the communities they treat and how people experience the services they provide by looking to online ratings and reviews.”In this new study, researchers, with the help of an automated system, analyzed high (five-star) and low (one-star) Yelp reviews for both emergency departments and urgent care centers, two venues that patients can select from when in need of acute care.Researchers identified key themes in the five-star reviews of emergency departments, including bedside manner, treatment of family members, and access to care on nights and weekends. Urgent care centers were unique in receiving five-star reviews more often for factors including ease of refilling prescriptions and being positively recommended by others.On the other side, emergency departments received negative remarks for speed of care, while urgent care centers received one-star reviews as a result of poor reception experiences and patients lacking confidence in the care received.”We are seeing more and more that patients are sharing their experiences online, and they’re looking to social media platforms and online communities to help inform their decision-making,” said Kevin B. Mahoney, executive vice president and chief administrative officer of the University of Pennsylvania Health System. “Within these review and rating websites lies a trove of decision-making data that we can and should be culling through to help inform how care is delivered, and what matters most to our patients in emergency situations.”Related StoriesIt is okay for women with lupus to get pregnant with proper care, says new studyAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyOlympus Europe and Cytosurge join hands to accelerate drug development, single cell researchUrgent care centers have proliferated widely across the country in the past 15 years. Between 2007 and 2016, visits increased by more than 1,700 percent. But while emergency departments have established surveys for patients and their families to report their experiences, there is not a clear equivalent for gathering direct feedback from patients who visit urgent care centers.The study’s senior author, Raina Merchant, MD, director of the Penn Medicine Center for Digital Health and an associate professor in Emergency Medicine, believes Yelp reviews could fill a knowledge gap.”Online reviews provide a rapid way of taking the pulse of how this acute care market is emerging and what consumers look for in these settings” said Merchant. “These platforms can also help us identify new focus areas, in an effort to provide better, more efficient care to patients based on their expressed needs.”The researchers analyzed more than 100,000 Yelp reviews, posted between 2005 and 2017–in the midst of the urgent care boom–tied to 1,566 emergency departments and 5,601 from urgent care centers. During the study period, an average of one new review for an emergency department or an urgent care center appeared every hour of every day.The reviews fell largely on one end of the spectrum or the other: five stars or one star. Roughly 47 percent of emergency department and 30 percent of urgent care center reviews fell in the one-star category. The disproportionate amount of negative reviews for acute care facilities, compared to other entities reviewed online, like hotels or restaurants, could be a result of what is at stake for the consumer.”If a restaurant provides you with a quick meal exactly as advertised, they meet your expectations,” Merchant said. “With healthcare, things are different. People are often critically ill, the outcomes are uncertain, and the wait can be long–which are all things that sometimes can’t be controlled.”The research team found that each type of facility received similar five-star reviews for comfort, cleanliness of facilities, pediatric care, and professionalism. One-star reviews for poor phone experiences, long wait times, billing difficulties, and pain management were tied to both emergency departments and urgent care centers.Moving forward, the researchers hope to find more nontraditional sources to provide clues about patient experiences and use them to enhance care quality.
By Dr. Ananya Mandal, MDMar 13 2019Reviewed by Kate Anderton, B.Sc. (Editor)Wireless earphones could be releasing potentially carcinogenic radiation into the heads of the users, finds a new study. Mohd Syis Zulkipl | ShutterstockA group of 250 experts and researchers have signed a petition to the United Nations and World Health Organisation to stop the use of these and other wireless devices.The researchers explain that these wireless ear pieces use a type of electromagnetic frequency (EMF) radiowave via Bluetooth technology to transmit data. The closeness of this radiation to the brains of the users is cause for concern, say the researchers.Related StoriesTrends in colonoscopy rates not aligned with increase in early onset colorectal cancerSugary drinks linked to cancer finds studyCancer killing capability of lesser-known immune cells identifiedJerry Phillips, a professor of biochemistry at the University of Colorado said, “My concern for AirPods is that their placement in the ear canal exposes tissues in the head to relatively high levels of radio-frequency radiation.” Phillips is one of the many scientists who have called for a restriction on use of such devices.The petition reads, “Based upon peer-reviewed, published research, we have serious concerns regarding the ubiquitous and increasing exposure to EMF generated by electric and wireless devices.” It goes on to say that the risk of cancer, neurological disorders, and DNA damage that have been associated with EMF exposure cannot be ignored.The International Agency for Research on Cancer too recently agreed that these EMF waves could be “possibly carcinogenic” to humans. These waves are similar to UV rays or X raysbut are not as powerful. They can cause burns at high concentration but are generally of less impact. The debate about whether they are carcinogenic is still ongoing.The World Health Organisation developed guidelines that regulate the amount of EMF the devices are allowed to emit. The petition adds, “The various agencies setting safety standards have failed to impose sufficient guidelines to protect the general public, particularly children who are more vulnerable to the effects of EMF. By not taking action, the WHO is failing to fulfil its role as the preeminent international public health agency.”The guidelines insist that phones should be kept away from the body when not in use. Sleeping with the phone is not a good practice and usage of headsets or headphones to conduct phone calls is suggested as a good option. Sources:Original editorial article: “Are AirPods and Other Bluetooth Headphones Safe?”.IARC classifies radiofrequency electromagnetic fields as possibly carcinogenic to humans. WHO. read more
Reviewed by James Ives, M.Psych. (Editor)Apr 17 2019The commonly used diabetes drug metformin could reverse the harmful thickening of heart muscle that leads to cardiovascular disease, according to a study at the University of Dundee.Scientists led by Professor Chim Lang, Head of the Division of Molecular and Clinical Medicine at Dundee, discovered that metformin has the potential to be repurposed as a heart disease treatment in non-diabetic patients.The MET-REMODEL Trial, published today in the prestigious European Heart Journal, showed that metformin, used to treat type 2 diabetes safely for the last six decades, reduced left ventricular hypertrophy (LVH) in patients with prediabetes and pre-existing heart disease. LVH is the thickening of the muscle wall in the heart’s left pumping chamber and is a serious risk factor for future heart attack, stroke and heart failure.LVH is often a silent symptom and most people do not know they have it prior to experiencing a heart attack or stroke. Large studies have previously shown that patients with LVH are at higher risk of adverse cardiovascular events and reducing LVH can substantially reduce mortality rates.Professor Lang said, “Cardiovascular diseases are the leading cause of global mortality. We have previously shown that metformin can have beneficial effects in patients with cardiovascular diseases. But this is the first time anyone has looked specifically at the effects of metformin on LVH in nondiabetic patients with coronary artery disease in a clinical trial.”The study involved treating prediabetic people with coronary artery disease with metformin or a placebo over a period of 12 months to see how the drug affected the heart muscle wall, using state-of-the-art MRI technology.”The major causes of LVH are high blood pressure, obesity and insulin resistance, which are also thought to be key contributors of coronary artery disease. The dangerous thickening of the left ventricle was reduced by twice as much in those taking metformin compared to the placebo.Related StoriesHeart disease is still the number 1 killer in Australia, according the latest figuresTeam approach to care increases likelihood of surviving refractory cardiogenic shockRNA-binding protein SRSF3 appears to be key factor for proper heart contraction, survival”We also found that metformin reduced blood pressure, oxidative stress and lost body weight – an average of 3.6 kg, compared to no changes in the placebo group. If the findings from this study are substantiated in a larger-scale study, metformin could offer hope for millions of patients across the globe.”The MET-REMODEL trial, funded by the British Heart Foundation (BHF), is the first clinical trial in the world to show that metformin could reverse harmful thickening heart muscle wall in a clinical trial. Repurposing cheap and readily available drugs, such as metformin, to treat other health conditions could potentially save the NHS billions of pounds every year.Mohapradeep Mohan, lead author and principal investigator of the MET-REMODEL trial, said blood pressure medications were the standard treatment modalities for LVH but that this approach was not particularly effective as LVH can also be present in patients who have well-controlled blood pressure. This highlighted the need for new treatment strategies in these patients.”In this context, we need non-blood pressure medication and we had good reason to suppose that metformin should help to reduce thickening of heart muscle wall,” he said.”The findings from our study reinforce the notion that metformin has the potential to improve cardiovascular health, offering the possibility of improving life expectancy of patients. From the standpoint of clinical practice, this drug is already approved and well tolerated with minimal side effects.”If our findings are backed up by bigger studies, using metformin to target LVH presents a novel treatment option and unique opportunity for a quicker translation to the clinic. We are thankful to BHF for funding this study and extremely grateful to all the participants of this study.” Source:https://www.dundee.ac.uk/ read more
Reviewed by Kate Anderton, B.Sc. (Editor)Jun 26 2019With summer in full swing, many people are cooling off in swimming pools. However, some of the substances that are made when chlorine in the water reacts with compounds in human sweat, urine or dirt aren’t so refreshing. Now, researchers have compared the effectiveness of different water treatment processes in mitigating these so-called disinfection byproducts (DBPs). They report their results in ACS’ journal Environmental Science & Technology.Chlorine is usually added to pool water to kill harmful microbes. However, this disinfectant can react with substances in the pool water — many of which are introduced by swimmers themselves — to form DBPs, which can irritate the eyes, skin and lungs. Most pool systems continuously recirculate water through various treatment steps to both disinfect the water and reduce DBPs and their precursors. But because of the difficulty of comparing swimming pools with different conditions, such as number of swimmers, chlorine dosing or filling-water quality, scientists don’t currently know which strategy is the best. So, Bertram Skibinski, Wolfgang Uhl and colleagues wanted to compare several water treatment strategies under the controlled and reproducible conditions of a pilot-scale swimming pool system.Related StoriesSummertime safety guidelines for childrenComplement system shown to remove dead cells in retinitis pigmentosa, contradicting previous researchCurved shape of bacteria can make it easier to find foodThe researchers continuously added compounds to their model swimming pool that simulated dirt and body fluids and added chlorine according to regulations for full-scale pools. Then, they treated the water with one of seven water treatment strategies. They found that the treatment using coagulation and sand filtration combined with granular activated carbon filtration was the most effective at lowering DBP concentrations. But even this treatment did not completely remove the contaminants because new DBPs were made more quickly than the old ones could be removed. When UV irradiation was used as a treatment step, the levels of some DBPs increased because the UV light elevated the reactivity of organic matter toward chlorine. New strategies need to be explored to more effectively remove DBPs and prevent new ones from forming, the researchers say. Source:American Chemical SocietyJournal reference:Skibinski, B. et al. (2019) Impact of Different Combinations of Water Treatment Processes on the Concentration of Disinfection Byproducts and Their Precursors in Swimming Pool Water. Environmental Science & Technology. doi.org/10.1021/acs.est.9b00491. read more
Press Trust of India New DelhiJuly 12, 2019UPDATED: July 12, 2019 16:25 IST Shashi Tharoor with Rahul Gandhi.Parliamentarians who have a slightly different relationship with their constituencies and are less frequently seen there have a rough time, according to Congress MP Shashi Tharoor.Speaking at a conclave in Delhi on Thursday, Tharoor, who has been elected to the Lok Sabha from Thiruvananthapuram in Kerala thrice in a row since 2009, said he believes he has done his job properly and that is the reason why people have reposed faith in him.After the recent Lok Sabha elections results, critics attributed the loss of Congress leader Rahul Gandhi from his family’s pocket borough Amethi to his disconnect with the voters of that constituency.Tharoor, though, pointed towards only MPs from the BJP and those from northern India in support of his contention.”MPs, particularly those from the north, who have a slightly different relationship with their constituencies and are less frequently seen there have a rough time,” he said.”They are the ones who can perhaps win only in Narendra Modi’s name and they do, like this time. But for most of us what differentiates us is precisely the work we do in our constituencies,” he said.He said people re-elected him as they believe that he has done his job properly.”People have seen me, seen me attending to their needs and that’s why they have trusted and voted for me.”Tharoor was speaking on the topic “Clients and Constituents: Political Responsiveness in Patronage Democracies” which is also the title of a book by academician Jennifer Bussell.The third edition of the South Asia Conclave organised by Oxford University Press witnessed researchers, policymakers, bureaucrats, academicians, and journalists from debating contemporary ideas that define modern South Asia.The conclave closely examined the key issues impacting the region, such as political challenges related to ethnic and religious diversity, identity politics, ethnic violence, terrorism, separatism, governance, economic growth, gender consciousness, national security, changes in culture and social structure as well as the significance of diaspora.Also Read | Shashi Tharoor uses cricket analogy to criticise Union BudgetAlso Watch | Congress altered ground reality while in power, Shashi Tharoor hits back at PM ModiFor the latest World Cup news, live scores and fixtures for World Cup 2019, log on to indiatoday.in/sports. Like us on Facebook or follow us on Twitter for World Cup news, scores and updates.Get real-time alerts and all the news on your phone with the all-new India Today app. Download from Post your comment Do You Like This Story? Awesome! Now share the story Too bad. Tell us what you didn’t like in the comments Posted bySanchari Chatterjee Next MPs not frequenting their constituencies have rough time: Shashi TharoorCongress MP Shashi Tharoor has said MPs who do not visit their constituencies often have a tough time.advertisement read more