May 4th, 2011 by Dinah Miller, M.D. in Research
Tags: Happiness, Mental Health, NYT, Poverty, Psychiatry, Suicide, Suicide Rates
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On Tara Parker-Pope’s NY Time Well Blog, she tells us that in places where people are the happiest, for example Denmark & Sweden, for example, have the highest happiness ranks, and the highest suicide rates. This is perplexing.
And apparently, the various United States are also ranked. New Jersey, where I grew up, is the 47th happiest state– surprising given Full Serve gasoline, good pizza, and beaches. You were looking for something more out of life? Also it has the 47th suicide rate, so the miserable apparently tough it out.
Ms. Parker-Pope writes:
After analyzing the data, the researchers found a relationship between overall happiness and risk of suicide. In general, states with high levels of life satisfaction had higher suicide rates, according to the report, which has been accepted for publication in The Journal of Economic Behavior and Organization.
“Perhaps for those at the bottom end, in a way their situation may seem worse in relative terms, when compared with people who are close to them or their neighbors,’’ said Stephen Wu, associate professor of economics at Hamilton College. “For someone who is quite unhappy, the relative comparison may lead to more unhappiness and depression.”
Dr. Wu noted that other studies have found that people react differently to low income or unemployment depending on how common it is in their community. “If a lot more other people around them are unemployed, it doesn’t seem so devastating,’’ he said.
I’m not sure one idea leads to another. Could there be another factor here? How do suicide rates correlate with the availability of mental health professionals, for example? Or with the price of chocolate in a give region? And how happy is my state?
*This blog post was originally published at Shrink Rap*
May 4th, 2011 by Peggy Polaneczky, M.D. in Health Tips, Research
Tags: Birth Control Pills, Blood Clots, British Medical Journal, Drosperinone, DVT, Family Planning, OB/GYN, Obstetrics And Gynecology, Oral Contraceptives, Research, Risks, Women's Health, Yasmin, Yaz
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Two studies published in this weeks’ British Medical Journal, one from the US and the other from the UK, report that users of drosperinone containing oral contraceptives (Yaz, Yasmin and their generics) have increased relative risks for non-fatal blood clots compared with users of pills containing levonorgestrel.
While neither study is perfect, and indeed have some very major limitations, they add to a growing body of evidence that pills containing drosperinone may impart higher risks for blood clots than older pills. Yaz is not alone in this regard – other studies have suggested that pills containing the newer progestins gestodene and desogestrel also impart slightly high clot risks than the so-called first and second generation pills containing the older progestins norethindrone and levonorgestrel.
I won’t go into the studies’ limitations here, but will say that trying to get our hands around comparative data on clot risks between various pills is an extraordinarily difficult process given that the diagnosis of blood clots is not always straightforward (or correct), pill choices are not randomized and fraught with prescribing bias, and confounding risk factors for clotting are numerous and difficult to control for. I wish folks would stop trying to answer these questions on the quick and cheap using claims and pharmacy databases without requiring chart review and strict diagnostic criteria. But that’s the way these studies are being done, and that’s the data I am being forced to contend with in my practice, so let’s talk about it. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
May 2nd, 2011 by RyanDuBosar in Humor, Research
Tags: Anesthesiology, Curse Words, Foul Language, Internal Medicine, Pain Management, Pain Reduction, Physical Medicine And Rehabilitation, Swearing
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Swearing really can relieve pain, but only if one doesn’t do it daily.
Researchers at Keele University in England have considered this topic before, and most recently, they studied whether people who swear more often in everyday life get as much pain relief from cursing as those who swear less frequently.
Researchers recruited 71 participants who completed a questionnaire that assessed how often they swore. Pain tolerance was assessed by how long participants could keep their unclenched hand in icy water (5° C, capped at 5 minutes) while repeating a chosen word. The word was either a swear word (self-selected from a list of five words the person might use after hitting their thumb with a hammer) or a control word (one of five they might use to describe a table). Interestingly, one person was excluded from the study because they did not list a swear word among their five choices.
Results appeared in NeuroReport.
Swearing increased pain tolerance and heart rate, and decreased perceived pain compared with not swearing. But, the more often people swear in daily life, the less time they were able to hold their hand in the icy water when swearing compared with when not swearing. Read more »
*This blog post was originally published at ACP Internist*
May 2nd, 2011 by John Mandrola, M.D. in Research
Tags: ACO, AF Ablation, Atrial Fibrillation, Cardiologists, Cardiology, Education, Health Care Reform, Nursing, Outcomes, Patient Care
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Wait…
Before reading any further, I would like to issue a warning. If your ideas about healthcare delivery are of an older ilk; if you cling white-knuckled to past dogma, please stop reading now. What follows may cause your atria to fibrillate.
Last month I wrote that the best tool for treating atrial fibrillation (AF) was to give patients information—to teach them about their AF, its complications, role of lifestyle factors and the many treatment options. I didn’t say this was easy. In fact, thoroughly explaining AF takes nearly the same time it takes me to isolate the pulmonary veins–a lot longer than the 10 minutes allotted for a typical office visit. (Remember: of a 30 minute office visit, I have to review your chart, listen attentively to your story, examine you, and complete the e-record. That doesn’t leave much time for teaching.)
I was serious about the role of education in AF therapy, but I didn’t have any hard data to support such a bold claim. All I could offer was 15 years of experience on the front lines of treating AF—cardiology’s most expensive and prevalent disease.
But now I have found some real-world data to support the thesis that good teaching translates to better AF outcomes. Read more »
*This blog post was originally published at Dr John M*
April 28th, 2011 by American Journal of Neuroradiology in News, Research
Tags: A Third Cerebellar Hemisphere, Anomaly, Brain Deformity, Case Report, Cerebellum, Congenital Malformation, CT Scan, India, Radiology
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Improved visualization of the posterior fossa structures has led to an increased recognition of cerebellar malformations, including the Dandy-Walker malformation, Joubert syndrome, rhombencephalosynapsis, tectocerebellar dysrhaphia, and so forth. New anomalies continue to be discovered, highlighting the fact that cerebellar anomalies are poorly understood and have largely been ignored in the literature. We present a structural anomaly of the cerebellum, which we believe has not been previously reported.
A 16-month-old girl presented to the pediatric outpatient department with some delayed developmental milestones. She was full-term with a normal vaginal delivery and no history suggestive of perinatal asphyxia. The motor milestones were delayed, and the child could not stand. The other milestones, including language and socialization, were normal. Examination revealed a bony hard swelling in the occipital region, which, according to the mother, was noticed soon after birth. The occipitofrontal circumference was 52 cm, and the anterior fontanelle was open. There was generalized hypotonia, and the deep tendon reflexes were depressed. Mild truncal ataxia was observed, but there was no nystagmus. Read more »
*This blog post was originally published at AJNR Blog*
