This year's Common Book, The Omnivore's Dilemma: A Natural History of Four Meals, by Michael Pollan is an exploration of the different methods of food production found in the United States today. The author takes us behind the scenes of today's industrial monoculture and shows us how the crops and animals raised by today's farmers and agricultural corporations ends up as food on our dinner tables. Especially enlightening is his description of the consequences of the agricultural subsidies promoting the growing of corn. This corn is found in the majority of the food products we consume each day. It turns out that Americans, not Mexicans, are the true "people of the corn."
Copies of the Common Book are available for 3 day loan at Atherton and Meader Libraries. Go to the Circulation Desk to check it out.
Wednesday, September 24, 2008
Tuesday, September 23, 2008
The Doctor’s Hands Are Germ-Free. The Scrubs Too?
By TARA PARKER-POPE
Published: September 22, 2008
Many hospitals have stepped up efforts to encourage regular hand washing by doctors. But what about their clothes?
Amid growing concerns about hospital infections and a rise in drug-resistant bacteria, the attire of doctors, nurses and other health care workers — worn both inside and outside the hospital — is getting more attention. While infection control experts have published extensive research on the benefits of hand washing and equipment sterilization in hospitals, little is known about the role that ties, white coats, long sleeves and soiled scrubs play in the spread of bacteria.
The discussion was reignited this year when the British National Health Service imposed a “bare below the elbows” rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient.
(In the United States, hospitals generally require doctors to wear “professional” dress but have no specific edicts about ties and long sleeves.)
But while some data suggest that doctors’ garments are crawling with germs, there’s no evidence that clothing plays a role in the spread of hospital infections. And some researchers report that patients have less confidence in a doctor whose attire is casual. This month, the medical journal BJU International cited the lack of data in questioning the validity of the new British dress code.
Still, experts say the absence of evidence doesn’t mean there is no risk — it just means there is no good research. A handful of reports do suggest that the clothing of health workers can be a reservoir for risky germs.
In 2004, a study from the New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.
Another study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus, or MRSA. The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the worker’s clothes about 70 percent of the time, even if the person never actually touched the patient.
“We know it can live for long periods of time on fabrics,” said Marcia Patrick, an infection control expert in Tacoma, Wash., and co-author of the Association of Professionals in Infection Control and Epidemiology guidelines for eliminating MRSA in hospitals.
Hospital rules typically encourage workers to change out of soiled scrubs before leaving, but infection control experts say enforcement can be lax. Doctors and nurses can often be seen wearing scrubs on subways and in grocery stores.
Ms. Patrick, who is director of infection prevention and control for the MultiCareHealth System in Tacoma, says it’s unlikely that brief contact with a scrub-wearing health care worker on the subway would lead to infection. “The likelihood is that the risk is low, but it’s also probably not zero,” she said.
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.
The focus on hand washing, sterilization, screening and clothing control appears to have worked: in Denmark, fewer than 1 percent of staph infections involve resistant strains of the bacteria, while in the United States, the numbers have surged to 50 percent in some hospitals.
But American hospitals operate on tight budgets and can’t afford to provide clothes and shoes to every worker. In addition, many hospitals don’t have the extra space for laundry facilities.
Ann Marie Pettis, director of infection prevention for the University of Rochester Medical Center, says most hospitals are focusing on hand washing and equipment sterilization, which are proven methods known to reduce the spread of infection. But she adds that her hospital, like many others, has a policy against wearing scrub attire to and from work, even though there is no real evidence that dirty scrubs pose a risk to people in the community.
“Common sense tells us that the things we are wearing as health care providers should be freshly laundered,” Ms. Pettis said. After all, she went on, the wearing of scrubs in public “raises fear” among consumers.
“I don’t think we should feed into that,” she said. “Scrubs shouldn’t be worn out and about.”
well@nytimes.com
More Articles in Health » A version of this article appeared in print on September 23, 2008, on page F5 of the New York edition.
Published: September 22, 2008
Many hospitals have stepped up efforts to encourage regular hand washing by doctors. But what about their clothes?
Amid growing concerns about hospital infections and a rise in drug-resistant bacteria, the attire of doctors, nurses and other health care workers — worn both inside and outside the hospital — is getting more attention. While infection control experts have published extensive research on the benefits of hand washing and equipment sterilization in hospitals, little is known about the role that ties, white coats, long sleeves and soiled scrubs play in the spread of bacteria.
The discussion was reignited this year when the British National Health Service imposed a “bare below the elbows” rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient.
(In the United States, hospitals generally require doctors to wear “professional” dress but have no specific edicts about ties and long sleeves.)
But while some data suggest that doctors’ garments are crawling with germs, there’s no evidence that clothing plays a role in the spread of hospital infections. And some researchers report that patients have less confidence in a doctor whose attire is casual. This month, the medical journal BJU International cited the lack of data in questioning the validity of the new British dress code.
Still, experts say the absence of evidence doesn’t mean there is no risk — it just means there is no good research. A handful of reports do suggest that the clothing of health workers can be a reservoir for risky germs.
In 2004, a study from the New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.
Another study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus, or MRSA. The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the worker’s clothes about 70 percent of the time, even if the person never actually touched the patient.
“We know it can live for long periods of time on fabrics,” said Marcia Patrick, an infection control expert in Tacoma, Wash., and co-author of the Association of Professionals in Infection Control and Epidemiology guidelines for eliminating MRSA in hospitals.
Hospital rules typically encourage workers to change out of soiled scrubs before leaving, but infection control experts say enforcement can be lax. Doctors and nurses can often be seen wearing scrubs on subways and in grocery stores.
Ms. Patrick, who is director of infection prevention and control for the MultiCareHealth System in Tacoma, says it’s unlikely that brief contact with a scrub-wearing health care worker on the subway would lead to infection. “The likelihood is that the risk is low, but it’s also probably not zero,” she said.
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.
The focus on hand washing, sterilization, screening and clothing control appears to have worked: in Denmark, fewer than 1 percent of staph infections involve resistant strains of the bacteria, while in the United States, the numbers have surged to 50 percent in some hospitals.
But American hospitals operate on tight budgets and can’t afford to provide clothes and shoes to every worker. In addition, many hospitals don’t have the extra space for laundry facilities.
Ann Marie Pettis, director of infection prevention for the University of Rochester Medical Center, says most hospitals are focusing on hand washing and equipment sterilization, which are proven methods known to reduce the spread of infection. But she adds that her hospital, like many others, has a policy against wearing scrub attire to and from work, even though there is no real evidence that dirty scrubs pose a risk to people in the community.
“Common sense tells us that the things we are wearing as health care providers should be freshly laundered,” Ms. Pettis said. After all, she went on, the wearing of scrubs in public “raises fear” among consumers.
“I don’t think we should feed into that,” she said. “Scrubs shouldn’t be worn out and about.”
well@nytimes.com
More Articles in Health » A version of this article appeared in print on September 23, 2008, on page F5 of the New York edition.
Tuesday, September 16, 2008
Stem Cells Ease Stroke-Like Brain Damage in Mice
The strategy might someday help humans recover from similar events, scientists say
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Human stem cells derived from bone marrow can cut the brain damage caused by an interruption in blood supply, such as what happens after a heart attack, scientists report.
Although these initial results were seen in mice, researchers are hopeful the breakthrough will one day help humans struck by cardiac arrest or stroke.
The human cells did not trigger the development of new brain cells, as previously believed. Instead, they switched on and off different genes, essentially turning down inflammation and immune system reactions that were harmful to the brain.
"This is the first time that interactions between the two kinds of cells [injected cells and host cells] worked out," said Dr. Darwin Prockop, senior author of the study, which appears in this weeks issue of the Proceedings of the National Academy of Sciences.
The study was completed while Prockop was with Tulane University's Center for Gene Therapy. He recently accepted a post as Stearman Chair in Genomic Medicine at Texas A&M Health Science Center College of Medicine and is director of the Institute for Regenerative Medicine at Scott & White.
"The big thing was finding out how these cells were helping," Prockop elaborated. "This dramatic crosstalk was very surprising. The human cells specifically turned down immune and inflammatory reactions."
The finding "goes along with the argument that something here could be used in human therapy. Even though this is a short-term fix, it might be sufficient to have a reparative function," added Dr. Robert Schwartz, director of the Texas A&M Health Science Center Institute of Biosciences and Technology, in Houston.
For this study, Prockop's team at Tulane injected human mesenchymal stromal cells (hMSCs) into the brains of adult mice one day after blood flow to the rodents' brains had been temporarily blocked.
"The blood supply was tied off for just 15 minutes and then restored," Prockop explained. "That causes massive damage to the brain. It's the sort of thing that happens when you have a cardiac arrest ... It's not quite a stroke because you're cutting off the blood supply then returning it."
Although the human cells disappeared within about a week, they nevertheless exerted dramatic effects upon the brain. "The number of dead neurons dropped off about 60 percent. It was quite amazing," Prockop said. "And the motor responses of mice improved dramatically."
Further analysis revealed that the human and mouse cells were actually signaling to each other, with the human cells changing the way certain genes were expressed. This meant that certain harmful immune and inflammatory responses were considerably suppressed, the researchers said.
"These hMSCs are really blood cells and they have effects on vascular formation and angiogenesis [new blood vessel growth] and they also produce a fair number of growth factors and signaling factors that seem to ameliorate the disease process," Schwartz explained.
Ideally, the results would one day be translated into stroke and other therapies for humans, an area which is sadly lacking in options.
"This could be a therapy for patients who have had cardiac arrest either by itself or after surgery," Prockop said. "But the next step is to find out what human cells are producing to make all these effects."
"This is a really good study," Schwartz added. "It has a lot of value. Now the question is, can you move it eventually into the clinic and how do you go forward with the next set of studies involving large mammals and getting it generally approved by the FDA [U.S. Food and Drug Administration] as a methodology and treatment?"
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Human stem cells derived from bone marrow can cut the brain damage caused by an interruption in blood supply, such as what happens after a heart attack, scientists report.
Although these initial results were seen in mice, researchers are hopeful the breakthrough will one day help humans struck by cardiac arrest or stroke.
The human cells did not trigger the development of new brain cells, as previously believed. Instead, they switched on and off different genes, essentially turning down inflammation and immune system reactions that were harmful to the brain.
"This is the first time that interactions between the two kinds of cells [injected cells and host cells] worked out," said Dr. Darwin Prockop, senior author of the study, which appears in this weeks issue of the Proceedings of the National Academy of Sciences.
The study was completed while Prockop was with Tulane University's Center for Gene Therapy. He recently accepted a post as Stearman Chair in Genomic Medicine at Texas A&M Health Science Center College of Medicine and is director of the Institute for Regenerative Medicine at Scott & White.
"The big thing was finding out how these cells were helping," Prockop elaborated. "This dramatic crosstalk was very surprising. The human cells specifically turned down immune and inflammatory reactions."
The finding "goes along with the argument that something here could be used in human therapy. Even though this is a short-term fix, it might be sufficient to have a reparative function," added Dr. Robert Schwartz, director of the Texas A&M Health Science Center Institute of Biosciences and Technology, in Houston.
For this study, Prockop's team at Tulane injected human mesenchymal stromal cells (hMSCs) into the brains of adult mice one day after blood flow to the rodents' brains had been temporarily blocked.
"The blood supply was tied off for just 15 minutes and then restored," Prockop explained. "That causes massive damage to the brain. It's the sort of thing that happens when you have a cardiac arrest ... It's not quite a stroke because you're cutting off the blood supply then returning it."
Although the human cells disappeared within about a week, they nevertheless exerted dramatic effects upon the brain. "The number of dead neurons dropped off about 60 percent. It was quite amazing," Prockop said. "And the motor responses of mice improved dramatically."
Further analysis revealed that the human and mouse cells were actually signaling to each other, with the human cells changing the way certain genes were expressed. This meant that certain harmful immune and inflammatory responses were considerably suppressed, the researchers said.
"These hMSCs are really blood cells and they have effects on vascular formation and angiogenesis [new blood vessel growth] and they also produce a fair number of growth factors and signaling factors that seem to ameliorate the disease process," Schwartz explained.
Ideally, the results would one day be translated into stroke and other therapies for humans, an area which is sadly lacking in options.
"This could be a therapy for patients who have had cardiac arrest either by itself or after surgery," Prockop said. "But the next step is to find out what human cells are producing to make all these effects."
"This is a really good study," Schwartz added. "It has a lot of value. Now the question is, can you move it eventually into the clinic and how do you go forward with the next set of studies involving large mammals and getting it generally approved by the FDA [U.S. Food and Drug Administration] as a methodology and treatment?"
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Thumbs Down on Beta Blockers for High Blood Pressure
No more effective than other drugs, increased stroke risk, study finds
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for the condition, an analysis of studies indicates.
"For heart failure, beta blockers clearly are an integral therapy," said Dr. Marrick Kukin, a professor of clinical medicine at Columbia University's College of Physicians and Surgeons, and a member of the team reporting the results in the Sept. 16 issue of the Journal of the American College of Cardiology. "But it has never been proven that they have a role for hypertension in preventing heart failure," Kukin said.
Hypertension is the medical term for high blood pressure. One major goal in treating hypertension is to prevent heart failure, the progressive loss of the heart's ability to pump blood, which can be fatal. Kukin was one of a group led by Dr. Franz H. Messerli, a Columbia cardiologist, that analyzed the results of 12 controlled trials in which 112,177 people were treated for high blood pressure.
"Our meta-analysis showed that compared to placebo, beta blockers offered a benefit," Kukin said. "But when compared to other medications, such as ACE inhibitors, there was no difference. Also, there was an increased risk of stroke with beta blockers in older patients, which has been shown in other trials."
The risk of stroke in elderly people was increased by 19 percent in those taking beta blockers.
Beta blockers help the heart by limiting the effect of adrenaline. Diuretics lower blood pressure by draining fluid from the body, while ACE inhibitors block production of an enzyme that constricts blood vessels.
This is one of a series of studies that have cast doubt on the use of beta blockers as the first line of treatment of high blood pressure. Studies done in Europe led British authorities to issue guidelines recommending against use of beta blockers as first-line hypertension therapy two years ago.
But Kukin, who described himself as "the heart failure person" in the group that produced the report, said that beta blockers "unequivocally are part of the therapy for someone with heart failure." They also are essential in treatment of heart attacks, he said. The new report simply emphasizes that they have no benefit over other blood pressure medications but do carry the extra risk of stroke, he said.
Another report in the same issue of the journal is the latest to describe an advantage of drug-coated stents over the bare-metal kind inserted to keep arteries open. Physicians at the Cleveland Clinic compared 6,053 patients who received drug-coated stents with 1,983 who were given bare-metal stents.
The death rate from all causes was about a third lower in the coated stent group, the report said. Adjustments for other accompanying conditions such as anemia, depression and socioeconomic status found the death rate for the coated stent group was almost 50 percent lower than for the bare-metal stent recipients.
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Monday, September 15, 2008
MONDAY, Sept. 15 (HealthDay News) -- Beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for the condition, an analysis of studies indicates.
"For heart failure, beta blockers clearly are an integral therapy," said Dr. Marrick Kukin, a professor of clinical medicine at Columbia University's College of Physicians and Surgeons, and a member of the team reporting the results in the Sept. 16 issue of the Journal of the American College of Cardiology. "But it has never been proven that they have a role for hypertension in preventing heart failure," Kukin said.
Hypertension is the medical term for high blood pressure. One major goal in treating hypertension is to prevent heart failure, the progressive loss of the heart's ability to pump blood, which can be fatal. Kukin was one of a group led by Dr. Franz H. Messerli, a Columbia cardiologist, that analyzed the results of 12 controlled trials in which 112,177 people were treated for high blood pressure.
"Our meta-analysis showed that compared to placebo, beta blockers offered a benefit," Kukin said. "But when compared to other medications, such as ACE inhibitors, there was no difference. Also, there was an increased risk of stroke with beta blockers in older patients, which has been shown in other trials."
The risk of stroke in elderly people was increased by 19 percent in those taking beta blockers.
Beta blockers help the heart by limiting the effect of adrenaline. Diuretics lower blood pressure by draining fluid from the body, while ACE inhibitors block production of an enzyme that constricts blood vessels.
This is one of a series of studies that have cast doubt on the use of beta blockers as the first line of treatment of high blood pressure. Studies done in Europe led British authorities to issue guidelines recommending against use of beta blockers as first-line hypertension therapy two years ago.
But Kukin, who described himself as "the heart failure person" in the group that produced the report, said that beta blockers "unequivocally are part of the therapy for someone with heart failure." They also are essential in treatment of heart attacks, he said. The new report simply emphasizes that they have no benefit over other blood pressure medications but do carry the extra risk of stroke, he said.
Another report in the same issue of the journal is the latest to describe an advantage of drug-coated stents over the bare-metal kind inserted to keep arteries open. Physicians at the Cleveland Clinic compared 6,053 patients who received drug-coated stents with 1,983 who were given bare-metal stents.
The death rate from all causes was about a third lower in the coated stent group, the report said. Adjustments for other accompanying conditions such as anemia, depression and socioeconomic status found the death rate for the coated stent group was almost 50 percent lower than for the bare-metal stent recipients.
HealthDay
Copyright (c) 2008 ScoutNews, LLC. All rights reserved.
Friday, September 12, 2008
Atherton Library Fall 2008 Hours
~ Fall 2008 Library Hours ~
September 2 - December 14, 2008
Sunday 12:00 p.m. - 7:00 p.m.
Monday - Thursday 8:00 a.m. - 9:00 p.m.
Friday 8:00 a.m. - 7:00 p.m.
Saturday 9:00 a.m. - 5:00 p.m.
Library Closings / Special Hours
Veteran's Day Tuesday, November 11, 2008
Thanksgiving Holiday Thursday - Friday, November 27 - 28, 2008
Last Day of Finals Sunday, December 14, 2008: closed 6:00 p.m.
FALL 2008
ATHERTON LIBRARY
September 2 - December 14, 2008
Sunday 12:00 p.m. - 7:00 p.m.
Monday - Thursday 8:00 a.m. - 9:00 p.m.
Friday 8:00 a.m. - 7:00 p.m.
Saturday 9:00 a.m. - 5:00 p.m.
Library Closings / Special Hours
Veteran's Day Tuesday, November 11, 2008
Thanksgiving Holiday Thursday - Friday, November 27 - 28, 2008
Last Day of Finals Sunday, December 14, 2008: closed 6:00 p.m.
FALL 2008
ATHERTON LIBRARY
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