Tele-health brings care into people's homes
Ethan Baron, The Province
Federal law mandates equal health care for all, but one in five Canadians receives unequal care because of where they live.
Twenty per cent of Canadians reside in rural areas, while medical specialists and services are concentrated in larger cities.
And with regard to heart disease in B.C., the patients receiving unequal care are often the most in need.
"In rural areas, smoking rates are higher, obesity rates are higher, and these are two risk factors for heart disease and other diseases as well," says Dr. Scott Lear.
Lear and a team of 17 researchers and six staff are working to level the field, to bring equal care to all British Columbians regardless of their location or medical condition. Members of the B.C. Alliance on Tele-health Policy and Research are identifying gaps in health-care service, and looking at ways to use the Internet to bridge them.
"Tele-health" is a mode of care delivery that uses phones, computers and the Internet to connect patients and health professionals.
"The whole idea of tele-health is to bring the services to where they're needed instead of having the individual patients or professionals go to where the services are," Lear says.
For cardiac care especially, ser-vices are found largely in big centres. At St. Paul's Hospital, about 40 per cent of cardiac patients come from outside the city.
Now, however, patients recovering from heart attacks can visit an interactive website. They upload data from their heart-rate monitor, enter information on their weight, diet and exercise, and for diabetics, blood-sugar and blood- pressure levels. Three to four times over four months, each patient has online meetings in a secure chat room with a nurse, dietitian and exercise specialist, one on one.
The health professionals access the patient's uploaded information and adjust treatment as necessary. For issues beyond the capacities of these care providers, the nurse will fax a letter to the patient's family doctor.
This proactive, interactive approach is designed to keep heart patients healthy and reduce the need for costly care in hospitals.
Base tan does not protect from skin cancer risk: studies
Lesley Ciarula Taylor, Toronto Star
There is no such thing as a safe tan regardless of how dark-skinned you are and tanning beds breed their own cancer, two comprehensive new studies report.
“One big misconception was that you could get a light tan, a base tan, and then feel protected. These are myths, they just aren’t real,” said Dr. Edward DeFabo of George Washington University in Washington, D.C.
The second study, by European cancer researchers, revealed 3,438 cases of skin cancer were caused specifically by sunbed use, with each exposure jacking up the risk to fully double if the tanner was under 35.
DeFabo and other scientists proved that UVA rays, which are particularly intense from tanning salon lamps, acting on skin pigment create a lethal combination that exploded into skin cancer.
“I didn’t believe it when I first saw it,” DeFabo told the Star. “We believed pigment protected us.”
And so scientists spent another year testing and verifying their results.
The findings, published in Nature Communications, reveal that skin pigment, melanin, is the key factor in triggering the genetic damage that leads to malignant melanoma when exposed to UVA rays.
“UVB is still the major player in melanoma. UVA plus melanin not far behind,” DeFabo said.
“There is an enormous amount of UVA coming out of tanning lamps.”
In fact, dark skin pigment produced spontaneous UVA melanomas that even rare albino skin did not, he said. Albino skin was still susceptible to UVB melanomas.
The European analysis of 27 skin cancers studies in 18 countries also found dark skin was not the absolute protection it was thought to be when using tanning beds.
Beating the Heat
As glad as most of us are to see the warm summer months take over after our long Canadian winter, it is important to be aware of the possible perils of too much sun and heat.
It isn’t just the risk of a bad sunburn that we need to be aware of. Each year, approximately 400 deaths in the United States are attributed to hyperthermia, or what is commonly referred to as heat stroke. Heat stroke can result from prolonged over-exposure to heat or sun and if untreated, can have deadly results.
Hyperthermia occurs when the body is unable to regulate its temperature and so cannot cool down. Ordinarily, the body cools itself by sweating but in cases of extreme heat, sweating is sometimes not enough to control the body’s core temperature. This can happen even if you are not outside jogging or doing other physical activity – your body can over-heat sitting still if it is hot enough or you become dehydrated. Those with heart conditions or taking certain medications are especially at risk when the temperatures rise.
The initial warning signals of hyperthermia often manifest themselves as heat exhaustion – dehydration, too much time in the sun or doing strenuous activity outside on a hot or humid day can lead to heat exhaustion. Symptoms of heat exhaustion include: lightheadedness, headaches, nausea, fatigue and overall weakness or dizziness. If you experience any of these symptoms get out of the sun and into a cool, or preferably, air conditioned place immediately and drink plenty of water – even if you don’t feel thirsty. If you still feel dizzy or nauseous, lie down.
If these symptoms persist, you are unable to drink or have a high temperature, seek medical attention immediately. You could be suffering from heat stroke.
If you don’t have air conditioning at home, on days where the temperature, or the temperature combined with humidity, is expected to be very high, try spending at least part of your day somewhere that has air conditioning. Libraries, community centres or even the shopping mall are some good options for places which you can likely find in your neighbourhood and which will be air conditioned. Listen to the news as “extreme weather alerts” will be issued on days when you should be particularly cautious and avoid excessive time or activity in the sun.
On the extremely hot and humid days we are experiencing this summer, it is especially important to check in on older friends and family members who are more vulnerable at this time of year. Make sure they are somewhere out of the heat and staying hydrated.
Access to care for B.C. seniors shrinking as their numbers grow
Elaine O'Connor, The Province
B.C. seniors’ access to home and community care has declined drastically in the past decade and must be improved or seniors will overwhelm our hospital system, warns a new Canadian Centre for Policy Alternatives report.
The study, Caring for B.C.’s Aging Population: Improving Health Care for All, released Wednesday, ties deficits in seniors’ home and community health care to chronic, expensive hospital overcrowding and long wait lists.
“A decade of underfunding and restructuring has led to a home and community care system that is fragmented, confusing to navigate, and unable to meet seniors’ needs,” the report states.
“Seniors often have to wait until they are in crisis and are admitted to hospital before they can access residential care services,” and “hospitals are increasingly the route through which seniors gain access to both residential and home health services” — an expensive, inefficient route.
Across B.C., as the number of seniors over 75 increased 28 per cent from 2001 to 2010, their access to residential care dropped 21 per cent and access to home support fell 30 per cent, with steep declines regionally, notably in Vancouver Coastal and Northern Health, the report says.
That’s due in part to slower funding growth — B.C.’s per-capita health spending has fallen to the second-lowest among provinces in 2011 from second-highest in 2001 — and also tighter eligibility criteria. (These reductions have been offset by a 14-per-cent increase in availability of community rehabilitation, while access to home nursing fell minimally by three per cent.)
Overall, access to home and community care in the province has fallen 14 per cent over the past decade, according to the report, which calculated its figures by comparing the volume of services to the number of seniors over 75.
Respect Matters More than Money for Happiness in Life
New research suggests that overall happiness in life is more related to how much you are respected and admired by those around you, not to the status that comes from how much money you have stashed in your bank account.
Psychological scientist Cameron Anderson of the Haas School of Business at the University of California, Berkeley, and his co-authors explore the relationship between different types of status and well-being in a new article published in Psychological Science, a journal of the Association for Psychological Science.
“We got interested in this idea because there is abundant evidence that higher socioeconomic status – higher income or wealth, higher education – does not boost subjective well-being (or happiness) much at all. Yet at the same time, many theories suggest that higher status should boost happiness,” said Anderson.
So if higher socioeconomic status doesn’t equate with a greater sense of well-being, then what does? Anderson and his colleagues hypothesized that higher sociometric status – respect and admiration in your face-to-face groups, such as your friendship network, your neighborhood, or your athletic team – might make a difference in your overall happiness. “Having high standing in your local ladder leads to receiving more respect, having more influence, and being more integrated into the group’s social fabric,” Anderson said.
Over a series of four studies, Anderson and his colleagues set out to test this hypothesis.
In the first study, they surveyed 80 college students who participated in 12 different campus groups, including sororities and ROTC. Each student’s sociometric status was calculated through a combination of peer ratings, self-report, and the number of leadership positions the student had held in his or her group. The students also reported their total household income and answered questions related to their social well-being. After accounting for gender and ethnicity, the researchers found that sociometric status, but not socioeconomic status, predicted students’ social well-being scores.
The researchers were able to replicate these findings in a second study that surveyed a larger and more diverse sample of participants and they found that the relationship between sociometric status and well-being could be explained, at least in part, by the sense of power and social acceptance that the students said they felt in their personal relationships. And in a third study, Anderson and his colleagues provided evidence that the relationship between sociometric status and well-being could actually be evoked and manipulated in an experimental setting.
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