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Immunization rates improve with centralized reminder system

February 23, 2015 University of Colorado - Denver Childhood immunization rates would improve with a centralized notification system that reminded families when immunizations were due, according to a new study. The study found that a centralized notification system run in collaboration with public health departments and physician practices was more effective and cost-effective than a practice-based notification system, which few practices implemented. Childhood immunization rates would improve with a centralized notification system that reminded families when immunizations were due, according to a new study, published online by JAMA Pediatrics, developed by researchers at the University of Colorado School of Medicine at the Anschutz Medical Campus. The study found that a centralized notification system run in collaboration with public health departments and physician practices was more effective and cost-effective than a practice-based notification system, which few practices implemented. Reminder/recall notification systems for immunizations have been shown to be a way to help increase immunization rates. However, the use of such systems by primary care practices has been less than 20 percent nationally because of numerous barriers to implement a system that relies on phone calls and mailings, according to the study background. Allison Kempe, MD, MPH, professor of pediatrics and director of the Children's Outcomes Research Program, and her coauthors conducted a randomized trial using the Colorado Immunization Information System (CIIS) to measure the effectiveness of a collaborative centralized (CC) system compared with a practice-based (PB) reminder/recall system. Public health entities, most pediatric practices and many family medicine practices were enrolled in CIIS, which collects vaccination data. The study included 18,235 children (ages 19 to 35 months) in 15 Colorado counties. Patients in the CC group received autodial and mail reminders or mail reminders only. Practices in the PB group were invited to attend training on a notification system and they were offered reimbursement to help with mailing or generating phone calls. Study results indicate that 7,873 of 9,049 (87 percent) children in the CC group received at least one contact, while in the PB group the reach was just 75 of 9,189 (0.8 percent) children because only two practices conducted reminder/recall notifications. Documentation rates for at least one immunization were 26.9 percent for the CC group vs. 21.7 percent for the PB counties and 12.8 percent vs. 9.3 percent of patients, respectively, achieved up-to-date (UTD) status. The CC reminder/recall system was also more cost-effective. "Our findings and those of previous studies support consideration of a CC compared with a PB reminder/recall approach to increase immunization rates during the preschool years. Sustainable funding mechanisms will be needed to support such an approach and may involve a shared investment between practice organizations or accountable care organizations and the public sector. With minimal contributions from each, substantial cost savings should be realized from a societal perspective," the study concludes. Story Source: The above story is based on materials provided by University of Colorado Denver. Note: Materials may be edited for content and length. Journal Reference: Allison Kempe, Alison W. Saville, L. Miriam Dickinson, Brenda Beaty, Sheri Eisert, Dennis Gurfinkel, Sarah Brewer, Heather Shull, Diana Herrero, Rachel Herlihy. Collaborative Centralized Reminder/Recall Notification to Increase Immunization Rates Among Young Children. JAMA Pediatrics, 2015; DOI: 10.1001/jamapediatrics.2014.3670

'Walking Football' phenomenon has great health benefits

Walking Football participants. Aston University (UK) researchers have said that 'walking football' could have a multitude of health benefits. The new sporting craze of 'Walking Football' may enable people to continue playing football into their 60s and 70s while reaping a multitude of health benefits, according to Aston University researchers. The sport was created in 2011 to help keep older players involved in football for longer and from hanging up their boots before they need to. Games are played at a slower pace to reduce the threat of pain, discomfort and injury, with players briskly walking through matches. Across the country, new Walking Football clubs and groups are setting up every week as its popularity rockets. Although it is known that regular football, including 11-a-side and 5-a-side versions of the sport, has considerable health benefits such as reducing the risk of cardiovascular disease and improving blood pressure, little research has been done into the impact of Walking Football. Aston University researcher, Peter Reddy, felt compelled to conduct a study into the sport to discover just how healthy it is. The investigation will assess two groups of men and women over the age of 48 playing Walking Football once a week for 12 weeks. Participants will be regularly assessed to measure changes in their postural balance, blood pressure and resting heart rate, cholesterol, blood sugar and bone density -- all indicators of general good health. The study will also look into the psychological advantages of playing Walking Football. Recent research into older males exposed to lifelong football found they had high levels of 'flow' while playing football -- a state of psychological reward and satisfaction. They also reported low levels of stress and exertion while playing, despite working hard. Peter hopes to see similarly positive results in his investigation. Peter, a Reader in Psychology, said: "Football is a fantastically good way of staying fit and healthy. Studies have shown it can be effective in the treatment of mild to moderate hypertension and that it can produce high aerobic activity with marked improvements in fat oxidation and aerobic power. Most people who play the sport, at amateur and professional levels, give it up in their late 30s but there's no reason not to enjoy the beautiful game until well into your 60s and even 70s. "We hope this study will establish that Walking Football has health benefits on proportionally similar lines to regular football and that older adults can happily play every week without pain or discomfort. If the data is positive, it will form a basis for local and national charities and authorities to set up and support local Walking Football groups. We want to ensure people are healthy for longer -- and that they can enjoy a kickabout at any age." In the context of an aging society, rising levels of obesity and the growing incident of late onset diabetes, it is thought Walking Football has the potential to make a significant impact. In the UK around 22% of men die before the age of 65, compared to 13% of women. Although physically active men have a 20 -- 30% reduced risk of premature death and 50% less chronic disease, by the age of 55-64 only 32% of men say they take the recommended half hour of exercise five times a week.

Um nome complicado.

Do outro lado da linha, a funcionária da empresa de ônibus pediu uma informação básica para Lady, que queria comprar uma passagem de Bogotá para Santa Marta, na Colômbia: o nome completo da passageira. Ela, que havia se preparado para pronunciar seu novo nome, meditou por alguns segundos antes de responder. "A, B, C, D, E, F", começou a soletrar. A funcionária ficou confusa e achou que era piada. Mas Lady estava falando sério. Reflexão Desde fevereiro de 2013 seu nome e sobrenome são formados pelas 26 letras do alfabeto. "Sempre fui classificada com letras, como LGTB e BDSM. Então quis que meu nome significasse que sou tudo isso, mas também que sou nada", disse a BBC Mundo ABCDEFG, que antes da mudança de nome era conhecida como Ladyzunga. É um nome de fantasia, escolhido pela artista performática, DJ e desenhista. "Sempre senti que o nome que meus pais haviam me dado não me representava. Era parecido com todos os outros nomes." Com a mudança, ela cumpre um objetivo que sempre teve: seu nome não é de mulher nem de homem. Não há um gênero reconhecível. ABCDEFG nasceu na cidade montanheira de Popayán, no sudoeste da Colômbia, em 1978. Depois de concluir o curso de desenho industrial na Universidade de Cauca, foi para Bogotá e começou a realizar performances embaladas por música. "Com o tempo me dei conta de que queria mudar de nome. Refleti muito e decidi ir adiante", lembra. "Primeiro pensei em algo grosseiro, para chocar as pessoas. Mas me dei conta de que ninguém iria pronunciar meu nome assim. Foi por isso que pensei no alfabeto." Entraves Em dezembro de 2012, durante uma apresentação em Cali, que fica a apenas duas horas de Popayán, ABCDEFG decidiu ir a sua cidade natal fazer a mudança. "Disseram-me que era um procedimento que durava cinco dias e custava o equivalente a US$ 20." Giraldo Zuluaga Desde 2004, este homem se chama Deportivo Independiente Medellin Giraldo Zuluaga No caso dela, porém, foram necessários três meses e bem mais dinheiro. Uma lei de 1851 dá aos colombianos o direito de mudar nome e sobrenome. No Brasil, a Lei de Registros Públicos estabelece que a mudança apenas pode ser feita nos casos em que o nome provoque constrangimentos ou problemas. O caso colombiano mais famoso desde então era de um torcedor de futebol que adotou o nome de seu time e em 2004 passou a ser chamado Deportivo Independiente Medellín Giraldo Zuluaga. A mudança, porém, só pode ser feita uma única vez. Vida imita a arte Mas quando Ladyzunga chegou ao cartório em Popayán, foi informada de que a mudança de nome não seria aceita. "Eu sabia que tinha o direito (de mudar de nome). Eles (o cartório) diziam que precisavam consultar superiores, mas eu sabia que o cartório tinha autonomia para realizar a mudança." Durante meses o processo ficou parado. Até o dia em que a artista foi a um cartório de Bogotá e enfim resolveu o problema. "Não me fizeram perguntas. Simplesmente pediram documentos e o pagamento da taxa. Em cinco dias fui recolher tudo." ABCDEFG diz não se preocupar com os problemas práticos causados pela mudança, como o da compra da passagem pelo telefone. Isso porque ela vê sua vida atual como uma intensa sequência de performances. "Todas as vezes que interajo com alguém por causa de meu nome o momento se transforma em um happening ('acontecimento', em inglês), uma experiência artística diferente", explica. Seu novo nome também representa uma demonstração de rebeldia contra o sistema. "Não fiz isso para ficar famosa ou dar entrevistas. Fiz isso contra um sistema que quer ver todos nós clonados." Fonte : BBC Brasil

Minhas músicas preferidas –1– Let me call you sweetheart -

Acute use of cannabinoids depresses motor neuron activity

New research could explain the acute lack of coordination and difficulty speaking and breathing experienced by some people who use cannabis. Why do some habitual marijuana users have difficulties speaking, breathing or swallowing food? Is it true that people who use this substance may suffer acute lack of motor coordination? Does the use of cannabis cause muscular weakness? These questions have been addressed by researchers of the NeuroDegeneration and NeuroRepair Group of the University of Cadiz, directed by professor Bernardo Moreno, and who recently published a study related to this topic in the journal Neuropharmacology. This study reveals that synthetic analogues of the psychoactive compounds of marijuana significantly reduce the activity of motor neurons. To fully understand the importance of this discovery, it is necessary to bear in mind that up until now there were no studies focusing on this subject. All the work known to date related to cannabis and its effects had been based on the psychomotor mechanisms (the higher central nervous system) and there was no study focused on describing the direct impact of cannabinoids on the neurons that control the muscles, that is, the motor neurons. Therefore, at the University of Cadiz it was decided to work on this topic using the motor hypoglossal nucleus (that controls the movements of the tongue) as a model, given that "the tongue is an important muscle used in respiratory phenomena, in speech, it is necessary to swallow food, i.e., it has many functions that in cannabis users, appear to be disrupted," explains professor Bernardo Moreno. Thus, "during the investigation, we used an animal model in which we studied the alterations produced by synthetic cannabinoids on the activity of the motor neurons of the hypoglossal nucleus. In doing so, we discovered that these psychoactive compounds inhibit the information that reaches these neurons via the synapses (structures specialized in the communication of information between neurons). In other words, cannabinoids hinder the transmission of information between neurons." A consequence of this fact is, for example, that muscular weakness is produced as "the motor neuron, that is the one that gives the order to the muscle to contract, sees its activity reduced which, as a consequence, would weaken the strength of the muscle contraction," as doctor Moreno points out. All of this could lead to problems speaking, breathing and even swallowing food. Nevertheless, this action mechanism could also explain the beneficial therapeutic effects that marijuana has on motor disturbances in people suffering from neurodegenerative diseases such as multiple sclerosis for example, given that "in pathological processes associated with muscular hyperactivity phenomena, the reduction in motor neuron activity induced by cannabis could lead to a symptomatological improvement." This study, carried out as a consequence of the studies on synaptic mechanisms performed by this group at the University of Cadiz, opens a new avenue of research for the scientific community. In spite of this, "our work will be steered towards other territories. At this time we are in the middle of a study focusing on the effects of cannabinoids as possible mediators of synaptic plasticity (phenomenon involved in motor learning), although it must be made clear that these compounds are not the central theme of the work of our research group," concludes Bernardo Moreno. In order to carry out this study, the work of the researchers of the UCA, Victoria García Morales (pre-doctoral scholarship holder at the UCA) and Fernando Montero (postdoctoral contract from the Junta de Andalucía) has been fundamental and, directed by professor Bernardo Moreno, they have carried out all the experimental stages. Equally, we must mention that this discovery has been made thanks to the funding of two research projects, one by the Ministry of Science and Innovation, now the Ministry of Economy and Competitiveness, and the other by the Junta de Andalucía.

Scientists bring oxygen back to dead fjord

Deployment of scientific instrumentation for measuring microbial processes in the sediment is shown: Byfjord, Sweden. More and more of the world's waters are seriously lacking oxygen. Could we use pumps to bring oxygen and thus higher life back into these waters? A Danish/Swedish research team says yes. They installed pumps in a Swedish fjord that showed a strong oxygen deficit and now they report that all the right oxygen-loving organisms have come back to the fjord. Lack of oxygen is a major problem in many of the world's waters. Both big oceans and small fjords are affected, and climate models predict an increase of this phenomenon in the future. To bring oxygen and thus higher life back to these waters is a huge task. But maybe it is possible -- at least judging by a pilot project in a Swedish fjord. "Our Swedish colleagues got the idea to use a pump to mix oxygen-rich surface water into the deeper parts of the water column in the fjord which was lacking oxygen," says postdoc Michael Forth and Associate Professor Alexander Treusch from the Nordic Center for Earth Evolution, Institute of Biology at the University of Southern Denmark. Could also help the Baltic Sea The Swedish part of the team, Professor Anders Stigebrandt and Dr. Bengt Liljebladh from the Department of Earth Sciences, Oceanography, and Professor Per Hall from the Department of Chemistry and Molecular Biology, Marine Chemistry at the University of Gothenburg, were interested if pumps could support and enhance natural venting events, that bring oxygen-rich water into deeper parts of the water column. Ultimately such an approach could be used to increase water quality in the oxygen-lacking Baltic Sea, they believe. To test these ideas, a large-scale experiment was conducted in a Swedish fjord called Byfjord, which is located near the town of Uddevalla. Similarly to the Baltic, the four kilometer long and 1.5 m wide fjord has a shallow entrance with a deeper basin that, in the case of the fjord, is 51 m deep. The water in the fjord's deep basin doesn't get mixed as oxygen-rich water coming in from the Kattegat Ocean and the river Bävenå exchanges only the surface water. Therefore the bottom waters suffer from a long-term lack of oxygen. The pump was used during multiple periods between 2010 and 2013 to bring oxygen-rich water from the fjord's surface down to about 35 meters depth. The surface water then was naturally and instantly replaced with new water from the Kattegat Ocean, creating inflows of oxygen-rich water into the fjord. Two months of pumping Did the experiment work? After two months of pumping, higher oxygen concentrations became detectable in the bottom waters. Forth says "Already while the pumps were working we could see how some oxygen requiring bacteria returned into the deeper water of the fjord and some that don't like oxygen disappeared." Before the pumps were used, the anoxic bottom waters were home to certain groups of bacteria, e.g. the so-called SUP05 clade and Desulfocapsa bacteria. These microorganisms use nitrate or sulphate instead of oxygen for respiration. As part of this lifestyle the SUP05 and similar bacteria transform sulfur, carbon and nitrogen in such large quantities that it can change the chemical composition of an ocean and can contribute to the production of climate-active gases. "At the same time as we saw the SUP05 bacteria disappearing from the fjord's bottom waters, the oxygen-requiring SAR11 clade bacteria appeared. Until then they had only lived in the surface water," say Forth and Treusch and continue: "In the later phase of the experiment the entire water column began to look healthy. Many of the oxygen-needing bacterial species had returned and new bacterial communities similar to those in natural oxic fjords formed. This showed us that the idea worked." 50 pct of bottom water was replaced For obvious reasons the scientists do not know if the oxygen levels in the fjord will begin to fall again in the future, now that the pumps have stopped. But initially there was no sign of this happening. "It seems that the fjord "only" needs help from time to time to restore the oxygen levels and then can maintain them for a longer period of time on its own," the researchers said. Overall, 50 per cent of the Byfjords bottom water (below 15 meters) was replaced with fresh oxygen-rich water from the Kattegat Ocean in the frame of the experiment. The results from the Swedish fjord may have implications for the whole Baltic Sea. "The bacterial communities in the Baltic Sea are very similar to those in Byfjord before the fjord was aerated. So it is fair to imagine that the same change in the bacterial community will take place in the Baltic Sea if we start to pump oxygen-rich water down to the bottom waters of the Baltic Sea. This is an idea our Swedish colleagues are investigating further," say Forth and Treusch. Facts about lack of oxygen in world oceans Lack of oxygen in the oceans is an increasing problem. Climate models indicate that the large anoxic areas, called Oxygen Minimum Zones (OMZs), are growing. Growing OMZs may lead to an increase in the loss of organic nitrogen and affect the global carbon cycle. There are very large OMZs off the coast of Chile and in the Arabian Sea.

How a wound closes

Epithelial cells move collectively out of their original shape (left) into the environment (right). Localisation of Merlin is shown in green, the cell nuclei in red. For wounds to close, cells need to move collectively in one direction in a coordinated fashion. Until now the central molecular mechanism that allows cells to coordinate these movements over larger distances has been unclear. Now researchers from Heidelberg University and the Max Planck Institute for Intelligent Systems in Stuttgart have succeeded in decoding it. Collective cell migration is not only important in wound healing, but also in the development of the embryo and even of cancer. The results of their research, published in the journal "Nature Cell Biology," have tremendous implications for all three of these areas. "The collective migration of cells and biological systems is one of the most important natural phenomena and occurs in nature at different levels and length scales. We have now identified the key molecular player and the related mechanism that controls the collective migration of epithelial cells, that is the covering layer of skin cells," explains Prof. Dr. Joachim Spatz of the Institute for Physical Chemistry at Heidelberg University and the Max Planck Institute for Intelligent Systems. In their investigation, the researchers introduce a complete molecular mechanism that focuses on the protein called Merlin. The results link intercellular mechanical forces to collective cell movements and also demonstrate how local interactions give rise to collective dynamics at the multicellular level. "They create an analogy with what we already know about collective movements observable in both the biological and physical world," explains Prof. Spatz. The researcher compares the process of cell migration to running a marathon. "At the level of the organism, an individual in a collective consciously tries to align its movements with those of its neighbours, which involves orchestrated sensing and action." Within a cellular collective, these two processes are linked via signal transduction pathways. There is a lead cell in the collective, similar to the leader in a marathon. It is mechanically connected to its follower cells by cell-to-cell contacts. The forward motion of the lead cell puts mechanical tension on the follower cells, according to Spatz. The merlin protein senses this mechanical tension and initiates spatially polarised following movement. This transmits the mechanical tension among the follower cells from one cell to the next. The follower cells respond by forming 'leg-like' protrusions directed at the lead cell in order to move forward. "Until now it has been unclear what molecular link connects these two events, sensing and action," says Joachim Spatz. "Our study now shows how the mechanosensitive Merlin protein converts cellular forces to collective cell motions by acting as a mechanochemical transducer. What's truly astonishing is that Merlin is the only protein in the responsible signal network that conveys this property to cellular collectives -- that there are no replacement mechanisms. If Merlin fails, the cells lose their ability to move collectively and trigger the related medically relevant, pathophysiological properties in the organism." The major player in the study, Merlin, is also a known tumour suppressor that is responsible for several types of cancer. Merlin is also a regulator of the Hippo pathway, an important signal pathway in biology that controls cell proliferation and organ size. It has been preserved in evolution since the emergence of primitive multicellular organisms. "It's exciting to see a connection between these seemingly disparate fields, linked by a Merlin-mediated signalling mechanism," says the researcher. Story Source: The above story is based on materials provided by Heidelberg, Universität. Note: Materials may be edited for content and length. Journal Reference: Tamal Das, Kai Safferling, Sebastian Rausch, Niels Grabe, Heike Boehm, Joachim P. Spatz. A molecular mechanotransduction pathway regulates collective migration of epithelial cells. Nature Cell Biology, 2015; DOI: 10.1038/ncb3115 Cite This Page:

Your privacy online: Health information at serious risk of abuse, researchers warn

An analysis of over 80,000 such web pages shows that nine out of ten visits result in personal health information being leaked to third parties, including online advertisers and data brokers. There is a significant risk to your privacy whenever you visit a health-related web page. An analysis of over 80,000 such web pages shows that nine out of ten visits result in personal health information being leaked to third parties, including online advertisers and data brokers. This puts users are risk for two significant reasons: first, people's health interests may be publicly identified along with their names. This could happen because criminals get ahold of the information, it is accidentally leaked, or data brokers collect and sell the information. Second, many online marketers use algorithmic tools which automatically cluster people into groups with names like "target" and "waste." Predictably, those in the "target" category are extended favorable discounts at retailers and advance notice of sales. Given that 62 percent of bankruptcies are the result of medical expenses, it is possible anyone visiting medical websites may be grouped into the "waste" category and denied favorable offers. For individuals, this means profiles are built based on web page visits, potentially resulting in someone being labeled a commercial risk due to the fact that they have used a site like WebMD.com or CDC.gov to look up health information for themselves, a family member, or a friend. Given that data brokers are free to sell any information they collect regarding visits to health websites, those visiting such sites are potentially at risk of being discriminated against by potential employers, retailers, or anybody else with the money to buy the data. These findings are reported in the article "Privacy Implications of Health Information Seeking on the Web," appearing in the March 2015 issue of Communication of the ACM. Timothy Libert, a doctoral student at the University of Pennsylvania's Annenberg School for Communication wrote the article. He authored a software tool that investigates Hypertext Transfer Protocol (HTTP) requests initiated to third party advertisers and data brokers. He found that 91 percent of health-related web pages initiate HTTP requests to third-parties. Seventy percent of these requests include information about specific symptoms, treatment, or diseases (AIDS, Cancer, etc.). The vast majority of these requests go to a handful of online advertisers: Google collects user information from 78 percent of pages, comScore 38 percent, and Facebook 31 percent. Two data brokers, Experian and Acxiom, were also found on thousands of pages. "Google offers a number of services which collect detailed personal information such as a user's persona email (Gmail), work email (Apps for Business), and physical location (Google Maps)," Libert writes. "For those who use Google's social media offering, Google+, a real name is forcefully encouraged. By combining the many types of information held by Google services, it would be fairly trivial for the company to match real identities to "anonymous" web browsing data." Indeed, in 2014, the The Office of the Privacy Commissioner of Canada found Google to be violating privacy Canadian laws. "Advertisers promise their methods are wholly anonymous and therefore benign," Libert writes. "Yet identification is now always required for discriminatory behavior to occur." He cites a 2013 study where individuals' names were associated with web searches of a criminal record, simply based on whether someone had a "black name." "Personal health information -- historically protected by the Hippocratic Oath -- has suddenly become the property of private corporations who may sell it to the highest bidder or accidentally misuse it to discriminate against the ill," Libert said. "As health information seeking has moved online, the privacy of a doctor's office has been traded in for the silent intrusion of behavioral tracking." Online privacy has for some time been a concern. Studies conducted by Annenberg dating back to 1999 indicate wariness among Americans about how their personal information may be used. And slightly more than one in every three Americans even knows that private third-parties can track their visits to health-related websites. Libert points out that the Federal Health Insurance Portability and Accountability Act (HIPPA) is not meant to police business practices by third party commercial entities or data brokers. The field of regulation is widely nonexistent in the U.S., meaning that individuals looking up health information online are left exposed and vulnerable. According to Libert, "Proving privacy harms is always a difficult task. However, this study demonstrates that data on online health information seeking is being collected by entities not subject to regulation oversight. This information can be inadvertently misused, sold, or even stolen. Clearly there is a need for discussion with respect to legislation, policies, and oversight to address health privacy in the age of the internet."

O Professor Pardal ataca novamente–parte II

Na postagem  em que disserto sobre inventos e onde apresento a minha ideia para se aproveitar a força da gravidade, ao reler a postagem sobre as bóias que aproveitam a força das ondas para gerar eletricidade,  estas simplesmente sustentam o mecanismo principal que gera eletricidade e que fica ligado abaixo da bóia. O movimento das ondas do mar produzem um movimento linear no mecanismo e uma empresa sueca desenvolveu um sistema para transformar o mocimento linear em movimento rotatório. É esse movimento rotatório que irá efetivamente gerar eletricidade usando-se alguma tecnologia que não foi possível descobrir na postagem já que obviamente deve tratar-se de algo secreto. Então, na minha idéia do peso descendo sob a ação da gravidade, o movimento linear também poderia ser transformado em movimento rotativo. A diferença é que no lugar das ondas do mar como fonte de energia, usa-se a força da gravidade. E o alternador seria substituido pelo mesmo sistema usado no sistema das bóias.  (continua no próximo capítulo) Ia esquecendo de mencionar. Quem se aventurar no projeto que idealizei e se der bem, favor enviar para a conta 876-98675-r54t-6745 do Banco da Praça, 10% dos rendimentos obtidos com a venda das máquinas já que a ideia foi minha. Obrigado de antemão.