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The Healthcare Engineering Blog is the place for conversation and discussion about Infrastructure, Healthcare Devices and Products, Information Management, and Patient Safety and Security. Here, you'll find everything from application ideas, to news and industry trends, to hot topics and cutting edge innovations.

Let's Take a Nap!

Posted January 14, 2017 12:00 AM by M-ReeD

I can distinctly remember nap time in kindergarten. While all of the other kids seemingly complied with the teacher, laying down on their mats and closing their eyes, I would feel a bolt of resistance course through my entire five-year-old body. I would remain electrified until we were offered milk and cookies as the drowsier kids started coming to. Countless decades later, I would do anything for someone to insist that I take a nap (or, better yet, to wake from said nap to a plate of cookies).

Lucky for those in the 65+ age bracket, that is exactly what is being recommended in a new study recently published in the Journal of the American Geriatrics Society, which found improved brain function among senior citizens who napped every day for one hour.

The study looked at over 3,000 participants with varying sleep schedules: some taking regular daily naps and others not napping at all. The study revealed that of the 3,000 tested, fewer than 60% took regular daily naps.

The value of those naps was measured in how the people performed on simple tests upon waking up. The researchers administered memorization tests and word recall exercises and also required participants to recreate simple geometric figures.

The results of the study showed that those participants who napped for an hour a day performed better on all of the simple tests administrated than those participants who did not nap.

Unexpectedly, two other categories of “napper” also demonstrated declining mental abilities. Those participants who napped for less than an hour and those participants who napped for over an hour showed a four to six times greater deficit in cognitive skills than those who napped for an hour.

Alarmingly, participants who took shorter, longer, or no naps at all also seemed to experience a decline in mental abilities that is typically characterized by a five-year age increase, according to researchers.

While the study applies to the 65+ age bracket, it is hardly a stretch to imagine that the benefits of napping wouldn’t be universal. In recent years, large, well-known companies have started to realize the value of rest and its direct benefits to the company (i.e., improved employee performance, satisfaction, safety, productivity, etc.) and have been offering its employees “nap times” in places designated for resting.

So, while this study has its detractors, with other researchers insisting that a nap could disrupt our circadian rhythms and increase the incidence of insomnia and other sleep disorders, I think most of us (save a few hyperactive five-year-olds) could use a nap.

Do you nap as an adult? If offered as an employee benefit, would you nap in the workplace?

20 comments; last comment on 01/17/2017
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The Science Behind SAD: Is It Real?

Posted January 09, 2017 12:11 PM by IronWoman

For many years, individuals and professionals alike have turned to seasonal affective disorder (SAD) as reason enough for mood changes with the fluctuating seasons. However, there has been controversy over whether SAD exists. Research has been conducted to prove the theory that people are simply over-exaggerating their symptoms; in addition, it is suggested that the studies supporting SAD resulted in inaccurate and problematic research.

As noted in a 2013 post from The Telegraph, researchers, led by Dr. David Kerr of Oregon State University, confirmed that SAD is far less common than people think. However, with its increased societal awareness — and simply the fact that people are unhappy about having to bundle up when the air gets chilly — the disorder in and of itself is being greatly overstated. David Kerr and his team reviewed past experiments and their inaccuracies in determining cases of SAD. In one study of around 800 people, ninety two percent of the group determined a lack of appetite and sleeplessness. Although the affected individuals reported seasonal changes in mood from depressive symptoms over a number of years, Kerr and his crew later discovered that these depressive symptoms occurred very little in the colder weather patterns. Kerr stresses the importance of not taking this disorder lightly; he is quick to state that there are varying degrees of SAD and patients can be clinically diagnosed with it. That being said, with increased reports and the significance of a majority of people reporting it, there is a high likelihood that the human psyche is putting undue stress on itself.

Earlier this year, Scientific American posted a similar article on the skewed studies behind SAD. Megan Traffanstedt and Dr. LoBello, in collaboration with Dr. Sheila Mehta, uncovered the questions asked in studies of SAD over the years and realized that those same questions are used to screen for major depression. The inevitably skewed data, in combination with confirmation biases of SAD in test subjects and its seeming popularity in society, create false expectations for patients when self-diagnosing. Additionally, a 1998 US survey of 8000 people suggested that seasonal depression is exceedingly rare and, therefore, hard to detect and pin-point at the population level. Moreover, genuine cases of SAD in the U.S. drastically decreased when comparing our colder months with the winters of countries across the globe. As an example, Traffanstedt, LoBello, and Mehta referenced winters in Norway. There, residents have severely shortened daylight and have yet to report higher rates of SAD over the years. Aside from the lack of evidence proving SAD’s prevalence, the researchers don’t deny that SAD exists. Traffanstedt, LoBello, and Mehta simply suggest that SAD may be a mood disorder, since the malady shares little symptoms with depression overall.

To counteract the negative attention that SAD has received, Time opened up about the severity of seasonal affective disorder and reasons for the change in mood. In it, Dr. Teodor Postolache and Dr. Alex Korb waste no time in acknowledging that SAD is real. They go on to say that people feel sad and helpless due to the absence of light (in other studies, rates of SAD vary by latitude), causing “dyssynchrony” in the body’s sleep-wake cycles and internal clocks. In turn, there are inevitable imbalances in serotonin, dopamine, and other neurotransmitter levels (i.e. appetite, energy, and trouble controlling mood). Not only this, but the modern, on-the-go lifestyles in which we inhabit further hinder people’s ability to cope with the seasonal changes. Korb and Postolache suggest that, like other creatures, we are meant to be much less active in winter in order to conserve energy for the coming months. That being said, Korb also suggests that lowered activity levels during winter months greatly affect our mood and stamina. The last — and possibly strongest — implication of SAD is the genetic and biological factors that follow the disease. Not only have researchers like Rosenthal found that seasonal affective disorder runs in families, but there is also a higher tendency for women to obtain it in their reproductive years.

If you began reading this believing—or now believe—that you may have SAD, there’s no need to worry. Korb and Rosenthal leave their readers with some tips to shake the blues away. Initially, try home remedies: light therapy helps more than people realize when it comes to depression of all forms (try sitting in front of a light or box fixture thirty minutes each morning). Overall, standing or sitting near windows with natural light greatly diffuses any stress that may be built up around you. Beyond the four walls, try exercising, socializing outdoors, or — if you can afford it — taking a vacation somewhere sunny. When worse comes to worst and your symptoms persist, do not hesitate to see a doctor, take a prescription, or attend cognitive behavioral therapy.

And now I turn to you, readers — do you believe SAD is real? Have you ever known anyone — or have you yourself — had to deal with seasonal affective disorder? Provide me with your insight and reasons in the comments below.

References

Scientific American: https://www.scientificamerican.com/article/study-finds-seasonal-affective-disorder-doesn-t-exist/

The Telegraph: http://www.telegraph.co.uk/news/science/10272346/Seasonal-affective-disorder-is-over-exaggerated.html

Time: http://time.com/4243319/seasonal-affective-disorder-sad-light-therapy/

64 comments; last comment on 02/07/2017
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Will Having a Female Doctor Save Your Life?

Posted December 31, 2016 12:00 AM by M-ReeD
Pathfinder Tags: doctors Gender illness

As a sick kid, I always preferred my mother’s approach to caregiving to my father’s approach. My father was no less loving of a parent than my mother, but his reaction to illness usually followed a dramatic template of gagging, visible disgust, and an eventual mirroring of our symptoms.

So, it came as no surprise to me that, according to a study published in JAMA Internal Medicine, female doctors had higher patient survival rates than male doctors in the United States.

The study analyzed the results from Medicare patients treated by 58,344 physicians between 2011 and 2014. The results: The risk of premature death for patients of female doctors (10.82%) was less than the risk for those of male doctors (11.49%). The risk of being readmitted into the hospital within thirty days of an initial admission was also lower for patients of female doctors (15.01%) than patients of male doctors (15.57%).

According to researchers, if this trend held for non-Medicare patients, the disparity would be even more significant, estimating that 32,000 fewer patients would die “if male physicians could achieve the same outcomes as female physicians every year.”

What is the explanation for the difference in numbers? While researchers couldn’t conclusively determine a reason for the disparity, they offered up a few possible explanations.

Ultimately, it was determined that women and men practice medicine differently, with women more likely adhering to clinical guidelines and counseling patients on preventive care and ordering preventive tests (pap smears, mammograms, etc.). Another theory is that overall, women are better communicators.

Another thought behind the findings includes a theory that healthier patients prefer female doctors.

While the study’s findings make intuitive sense (females being more nurturing, etc.), the study failed to take into account that, often, patients are treated by teams of doctors, both male and female.

Regardless of the findings, the researchers advise against oversimplifying the matter by going out and choosing a provider based solely on gender.

Do you have a gender preference when you are seeking medical treatment?

Image credit:

Day Donaldson / CC BY-SA 2.0

17 comments; last comment on 01/10/2017
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A New Weapon In the Zika Virus Fight

Posted February 18, 2016 7:00 AM by cheme_wordsmithy

You may have heard about the Zika virus in the news. It's the latest in a long line of mosquito-born illnesses that seems to be spreading in epidemic proportions across many countries in the Americas. While there are few immediate complications, health experts believe that Zika is responsible for microcephaly in babies of infected mothers. Microcephaly (abnormal smallness of the head) is a serious birth defect, and pregnant women are being urged not to travel to countries with known outbreaks.

The culprit is the Aedes aegypti mosquito, which has made its home in parts of Africa, Asia, the South Pacific, Australia, and the Americas. This mosquito has been responsible for the spread of yellow fever, dengue fever, and other dangerous viruses that have infected and killed thousands of people. And while efforts to reduce mosquito populations have been ongoing for many years, the emergence of the Zika virus has brought a renewed urgency to the fight.

Perhaps the most promising weapon against mosquitoes is the recent development of "gene drive" technology. A gene drive differs from an ordinary gene in an organism's DNA because its trait is passed to all of its offspring (rather than just 50%). A gene drive could thus be used to pass destructive genes to the Aedes aegypti mosquito, such as those that destroy female mosquito chromosomes, prevent female mosquitoes from flying, or cause a mosquito to be born male. By releasing genetically altered mosquitoes into the wild, female populations of the target species would be reduced with each generation, until the population is eradicated. Gene technology has already been used to help control the spread of malaria, however the approach is complicated by the fact that there are a number of diverse species that carry this disease. With dengue and Zika, the Aedes aegypti species is primary carrier.

One of the biggest advantages of the gene-drive-based approach is that it is species-specific. Traditional methods of control (insecticides and removing breeding sites) attack all mosquitoes, meaning the entire ecosystem is effected. Gene-drive technology would attack the Aedes aegypti while not affecting other (less harmful) mosquito species, potentially causing less damage to the environment and the surrounding ecosystem.

There are still concerns to this new approach, however. Most notably is whether the eradication of the Aedes aegypti could have any unintended consequences, like for example leaving room for some new or potentially more harmful species to emerge. And there have been looming fears about the broader impact of gene-editing technology and the possibility of its accidental or intentional misuse. But whether these fears will delay or prevent its use against the Zike mosquito remains to be seen.

Meanwhile, we will likely continue to see the spread and impact of Zika, and a vaccine against the virus looks to be at least a year away.

Source: MIT Technology Review

13 comments; last comment on 02/20/2016
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No Evidence that Cancer Screening Saves Lives

Posted January 13, 2016 1:00 PM by Quasar
Pathfinder Tags: cancer screening mortality

An article in the British Medical Journal argues that screening for cancer has never been shown to save lives. The authors focus on the difference between overall mortality (the death rate from any cause) and disease specific mortality (the death rate caused specifically by a disease). They say that while there is evidence to suggest that screenings reduce disease specific mortality, overall mortality is either unchanged or negatively affected.

The authors point to, among others, a review of meta-analyses of cancer screening trials in the International Journal of Epidemiology, which found that while some trials showed reductions in disease specific mortality, none showed reductions in overall mortality.

There are two main reasons mentioned for the discrepancy between disease specific mortality and overall mortality. The first is that studies might be underpowered to detect a small overall mortality benefit. (Underpowered studies are those that have a low probability of detecting an effect of practical importance.) The second is that disease specific mortality reductions may be offset by deaths due to the downstream effects of screening.

Given that the overall goal of a person considering a cancer screening is to reduce their risk of dying, the possible harmful effects of screening need to be considered in addition to potential benefits. Screenings can cause harm if they result in false positives (abnormal results that turn out to be normal) or overdiagnosis (harmless cancers that never cause symptoms). For instance, false positive results from prostate cancer screenings contribute to more than one million prostate biopsies a year, which are linked with serious harm, including admission to hospital and death. False positive results affect between 12-13% of all men who have undergone three or four screening rounds with PSA, and over 60% of women undergoing screening mammography for a decade or more.

Do you plan to get screened for cancers? Are you worried about false positives, overdiagnosis of non-harmful cancers, or detection of incidental findings leading to treatment that you don't need and could cause you harm?

13 comments; last comment on 01/15/2016
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