PE Focus on exercise not team sports
Tue, 15 Jan 2008 01:26:03 GMTBy JAMIE STENGLE, Associated Press Writer
RICHARDSON, Texas - With music pumping in the background, the kids in Terry Wade's physical education class are in constant motion, going from sit-ups to jumping jacks to curls with light weights.
After their 45-minute session, the sixth-graders who are sweating the most, or as Wade calls it, "burning butter," get stickers.
"My main goal and emphasis is getting these kids up and moving," said Wade, who teaches at Northrich Elementary in the Richardson school district in suburban Dallas. "It's 'Can this kid do this for a lifetime?' I don't care how good they are. I care if they're having fun."
Instead of team sports, Wade and other physical education teachers across the country are focusing more on individual activities that students can incorporate into their lives long after their school days are over.
Experts say the shift also helps gym teachers include children who are struggling with their weight. With individual activities, overweight students can work at their own pace, and not be left on the sidelines. And they can take part in lower impact activities like weightlifting, yoga or martial arts.
"Now we organize our classes in such a way where no kids are sitting," said Susan Henderson, coordinator for physical education and health for the Dallas-area Mesquite school district.
She said that even if the lesson is about a team sport like football, they focus on skills like passing the ball.
"Nobody is waiting their turn," Henderson said.
Steve Jefferies, head of the department of health, human performance and nutrition at Central Washington University in Ellensburg, Wash., is a fan of treasure hunts and other activities that students can do without realizing they are getting exercise. That shifts the focus to finding things, not the half-mile walk to get there, he said.
Jefferies suggests teachers wear a weight belt to get an idea of what an overweight student experiences.
"You've got to find something that each individual person enjoys," said Jefferies, who also runs a Web site to help physical education teachers keep up with the latest developments.
Gym teachers also are placing a greater emphasis on general health and nutrition, said Craig Buschner, president of the National Association for Sport and Physical Education.
"This field had to make changes. It's not about dodge ball and it's not about duck-duck-goose," said Buschner. He added that the obesity epidemic has helped educators make a case that students need more physical education time.
How to deal with overweight children in class is something that's on the minds of future gym teachers, too.
"My undergraduates are asking 'What do I do?'" said Josh Trout, of California State University, Chico, who has written a book set to be released in February called "Supersized PE: A Comprehensive Guidebook for Teaching Overweight Students."
Wade said she walks a fine line when instructing her students: "I don't want to push anyone past what they're capable of doing, but I don't want them to take it too easy."
As the morning light poured in from the windows in her gym, she asked her sixth-graders: "How are you graded in this class?"
A chorus of replies comes quickly: "Effort."
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On the Net:
National Association for Sport and Physical Education: http://www.naspeinfo.org
PELinks4U: http://www.pelinks4u.org
FDA OKs Tysabri to fight Crohns disease
Mon, 14 Jan 2008 23:44:46 GMTBy MATTHEW PERRONE, AP Business Writer
WASHINGTON - Tysabri, a treatment for multiple sclerosis made by Biogen Idec Inc. and Elan Corp., received regulatory approval on Monday for use among patients with a severe intestinal disorder.
The Food and Drug Administration approved Tysabri for use in patients with moderate to severe Crohn's disease who don't respond to more conventional drugs, such as Abbott Laboratories' Humira.
The approval represents a comeback for Tysabri, which was temporarily pulled from the market in 2005 after three patients using the drug developed a rare nervous system disorder called multifocal leukoencephalopathy, or PML.
FDA allowed the drug back on the market the following year, but only under a restricted distribution program. The drug is used by more than 12,000 multiple sclerosis patients in the U.S., according to Biogen, with no new reports of the fatal disorder.
Government officials said Tuesday Crohn's disease patients would have to enroll in a similar distribution program for Tysabri. Patients must undergo an educational program on the drug's risks and can only receive the injectable drug from a select number of registered physicians.
About 500,000 people in the U.S. have Crohn's, which usually causes diarrhea, fever and internal bleeding. There is no known cure.
Cambridge, Massachusetts-based Biogen said distribution of Tysabri for Crohn's patients will begin by the end of next month. Company representatives said a year's supply of drug will likely be priced at $29,000 .
Last week, Biogen management said it hoped to expand Tysabri's market to 100,000 patients by 2010. But some analysts, including BMO Capital Markets Jason Zhang, note the drug's safety risks could limit its distribution.
The drug is expected to compete with Remicade in the U.S., the leading Crohn's treatment made by Johnson and Johnson.
UK criticized for deporting dying woman
Tue, 15 Jan 2008 00:45:04 GMTLONDON - Britain has committed an act of "atrocious barbarism" by deporting a Ghanaian woman who is dying of cancer, a leading British medical journal said Tuesday.
In an editorial, The Lancet criticized the British government for removing Ama Sumani, 39, from the country last week, thereby denying her access to life-prolonging dialysis treatment. Sumani had applied for asylum, but was rejected.
In the same issue, 275 doctors signed a letter urging the government to abandon plans to abolish failed asylum seekers' rights to basic health care.
The editorial criticizes doctors' leaders for not speaking out on the issue.
"Sumani is not the only migrant who has fallen seriously ill in the U.K., begun treatment, and then been removed or deported to a country where treatment is unaffordable or inaccessible," the editorial said.
"To stop treating patients in the knowledge that they are being sent home to die is an unacceptable breach of the duties of any health professional. The U.K. has committed an atrocious barbarism," it concludes. "It is time for doctors leaders to say so — forcefully and uncompromisingly."
The doctors who signed the letter vowed to continue to give asylum seekers medical advice, regardless of their immigration status, and to campaign against the government proposal.
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On the Net:
http://www.lancet.com
New Orleans nurses turn home into clinic
Mon, 14 Jan 2008 23:53:05 GMTBy PAULINE ARRILLAGA, AP National Writer
NEW ORLEANS - The sign on the gate in front of the pretty blue house announced the good news to a neighborhood that has had little since Hurricane Katrina: "There's a doctor in the house. Make your appointment NOW!"
Earl Davis paused to take in the words, then headed up the ramp and through the door — destined for his first doctor visit since returning to the city five months earlier. The family practitioner who treated him as a boy, and then saw his own kids, left after the storm and isn't coming back. Hundreds of other doctors have gone the same route.
Medical centers devastated by floodwaters remain closed, with the number of beds available to the sick cut in half.
Charity Hospital, which for generations provided care to the poor and uninsured, sits like a darkened tomb on a downtown street, plywood blocking the main entryway, window shades twisted and broken.
But the blue house at the corner of St. Claude Avenue and Egania Street is open for business, dispensing free health care to anyone in need.
The Lower 9th Ward Health Clinic is its official name now.
"A medical home," Patricia Berryhill calls the facility offering primary care.
Before Katrina, this was Berryhill's own home. The living room where her kids congregated after school serves as a waiting area now, its walls painted a peaceful powder blue. The bedrooms are exam cubicles, the kitchen a file room and office.
Berryhill, a registered nurse, still spends almost every day at 5228 St. Claude, working as medical director of the clinic, lording over it as she once did her household.
Another registered nurse, Alice Craft-Kerney, runs the business side as the clinic's executive director. She grew up in the Ninth Ward, and rode out Katrina in her brother's house a mere three blocks away.
The story of how these neighborhood women and nurses gave a home — and themselves — to help a community they cherish is one of faith and perseverance but, most of all, friendship.
It is also the story of health-care delivery in post-Katrina New Orleans, where clinics have cropped up in corner groceries and old department stores, and Good Samaritans are stepping in to mend broken bodies and souls.
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They met on the night shift at Charity Hospital. Berryhill, 57, was a veteran with more than three decades of nursing experience, and Kerney, seven years her junior, often sought her out for guidance. They shared laughs and advice, and came to lean on each other. If one had trouble starting an intravenous line she would call the other for help.
Their professional relationship blossomed into a personal friendship. Even after Berryhill transferred to University Hospital, Charity's sister facility, Kerney would stop by her home in the Ninth Ward just to say hello. When Berryhill remarried, Kerney helped her plan the wedding.
In 2005, when Katrina struck, Berryhill was managing the high-risk obstetrics and gynecology unit at University Hospital while Kerney was a supervisor for trauma, surgery and the prison ward at Charity. Berryhill was assigned to the medical team that stayed behind during the storm; Kerney was delegated to another group that was to relieve the first.
Eventually, both wound up evacuated from the city — and they returned to a health care system in shambles. Charity, its basement flooded, was closed. University was shuttered for more than a year, though doctors temporarily offered care from a tent. In some neighborhoods, medical workers took to bicycles in search of patients.
"Pre-Katrina there was an inadequate number of beds," says Kerney. "Charity Hospital was the safety net that would take all of the medically indigent. With Charity being closed and so many of the private sector hospitals closed, it put a tremendous strain on the health care system."
Berryhill put in for retirement and considered teaching. Meanwhile, she had to look for a new place to live. Her home on St. Claude Avenue, where she'd lived 28 years and raised four children, was structurally sound on the outside but wrecked inside. She rented a townhouse and considered refurbishing and renting her home below the going rate, to try to help another family.
Kerney was furloughed but found work for an agency doing per-diem nursing wherever she could. She reconnected with Berryhill, who offered a room while Kerney's house was repaired. Kerney declined, but would soon turn to her friend with an offer of her own.
At the beginning of 2006, Kerney met some folks working with Common Ground, a volunteer organization established in the aftermath of Katrina that has provided an array of services to people returning home, everything from first aid and legal assistance to shovels, hammers and manpower to help rebuild homes.
Michelle Shin, the coordinator of services in the Lower Ninth Ward, told Kerney about a group that wanted to donate as much as $35,000 to help rebuild a family's home, but Shin and Kerney envisioned some type of project that would instead benefit the entire community. Shin suggested a clinic, immediately asking Kerney: "What do you think about spearheading it?"
"I wouldn't want to do it without my friend Pat," the nurse replied.
Kerney called up her old comrade to get her on board, and when Shin learned that Berryhill's home was sitting empty, the idea was hatched for renovating it to accommodate the clinic.
"I prayed on it," says Berryhill, who then asked her children what they wanted her to do with the house.
"`Do what the Lord calls you to do,'" they told their mom.
The renovations got under way the summer of 2006, with volunteers from Common Ground hoisting crowbars and hammers to tear out walls and erect new ones. Kind souls came out of the woodwork to help: an air conditioning business donated duct work and units and provided free labor, a New Orleans-trained doctor who heard of the project asked for donations to be sent to the clinic in lieu of wedding gifts.
But the project was not without hiccups as the two nurses suddenly had to learn contracting and management on the fly. On the day of the clinic's grand opening — Aug. 30, 2006, a year after Katrina struck — city building inspectors shut down the operation because the home had been renovated using a residential permit rather than commercial.
New paperwork was filed and additional accommodations made for the handicapped, and last March 1, the clinic reopened.
Kerney and Berryhill vividly recall the first patient who came through the doors: A woman so ill that she passed out and lost control of her bodily functions. The nurses suspected the woman was suffering from severe respiratory problems due to the mold and mildew, but her condition was too dire for their small shop. They called 911.
The incident only proved to Kerney, "We were sorely needed here. Every day."
___
"Fill all this out. Sign it for me. And I'm gonna need a picture ID," the woman at the reception desk tells Earl Davis.
Clipboard in hand, Davis finds a seat while his wife, Jessica, scans the waiting room, admiring the shelves stacked with children's books and a plastic bin filled with Ziploc bags, each one stuffed with notepads, glue and erasers. She reads a sign: "Kids Please Take One."
"That's neat," she says. "This is one of the good things, apparently, that's derived from Katrina. To go ahead and give this piece of property to help put back into the community ..."
A former medical lab employee, Earl Davis was in a car accident years ago and injured his back and hand. After learning that his family doctor would not return to the city, he began searching for a new primary care physician for himself and his family.
The couple live in Arabi, about a mile east of the clinic, and after passing by on several occasions they decided to drop in.
"They should be commended for what they're doing," he says. "It's definitely needed."
Today, the clinic is one of several dozen scattered across the city but one of the few offering free care. Another is the Common Ground Health Clinic in nearby Algiers, where patients begin lining up long before the doors open. Hypertension, uncontrolled diabetes, asthma, depression and anxiety are the biggest problems among patients at both clinics.
Noah Morris, a 24-year-old street medic who helped start the Common Ground clinic in the days after Katrina, still puts in 12 hours a week without pay at the facility, housed in an old grocery store. Dr. Michelle Carley, a family practitioner who lives in Baton Rouge with her six children, commutes one day a week to the clinic to volunteer.
"When you drive past Charity Hospital ... and you see that it's gone, and then you drive to a corner grocery store in Algiers and you see what's left, the enormity of what's been lost in this city, it's just overwhelming," Carley says. "What we've been reduced to is just trying to help people willy-nilly."
There are plans for new hospitals, but no one expects a system as extensive as the one pre-Katrina. Folks like Morris, Carley, Kerney and Berryhill believe neighborhood clinics like theirs will be the future of health care — in New Orleans and, possibly, other American cities.
Kerney and Berryhill are already scouting for a larger site, but staffing has been a problem, as it is for public and private hospitals and the other clinics around town. Their nurse practitioner found a better-paying job. During a recent week, a volunteer doctor from Pennsylvania arrived with his sister, a registered nurse in Maine, to pitch in.
Still Kerney and Berryhill, who share a devout faith in God, believe they will find a way to sustain their endeavor.
"You have to walk by faith," says Berryhill. "It's only faith that's brought us this far, and faith will certainly lead us on."
"It's not perfect," she adds, and then Kerney interjects: "But we're doing the best we can."
The project has, at times, put their friendship to the test, as any venture that brings together strong wills and strong minds can. But a true friend, says Berryhill, "is a lasting thing ... someone that's there in good times and bad times."
"We are two different human beings, but we have the same vision," she says. "We have a heart for people."
Depression Obesity Coexist in Many MiddleAged Women
Tue, 15 Jan 2008 04:47:34 GMTMONDAY, Jan. 14 -- Obesity and depression often go hand-in-hand in middle-aged women, a new U.S. study found.
The research collected information on the height, weight, dietary and exercise habits, and body image of 4,641 women, ages 40 to 65, enrolled in a health plan. The women also completed a questionnaire used to measure depression symptoms.
Women with clinical depression were more than twice as likely to be obese , and obese women were more than twice as likely to be depressed, the study found.
It also found that women with BMIs of 30 or higher exercised the least, had the poorest body image, and consumed 20 percent more calories than women with lower BMIs.
The link between obesity and depression remained intact even when the researchers factored in marital status, education, tobacco use and antidepressant use.
The study was published in the January/February issue of the journal General Hospital Psychiatry.
It's likely that depression and obesity fuel one another, said lead author Dr. Gregory Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle.
"When people gain weight, they're more likely to become depressed, and when they get depressed, they have more trouble losing weight," he said in a prepared statement.
The stigma of being overweight can damage self-esteem and efforts to lose weight.
"It's not that these women are clueless. It's that they're hopeless," said Simon, who suggested that if obese women focus on rebuilding their self esteem, it may help them lose weight.
More information
The American Academy of Family Physicians has more about women and depression.
Health Tip Use a ChildSafety Gate
Tue, 15 Jan 2008 04:47:38 GMT- Safety gates are an important way to prevent injuries among children in the home.
Here are guidelines for how to choose a safety gate, courtesy of the Nemours Foundation:
- Choose a gate that is securely mounted to the door frame with hardware, and that doesn't leave any openings to pinch little fingers.
- Be careful with gates that use pressure or tension to keep them secured in a doorway. Never place this type of gate in front of stairs, as it may be more easily removed by children.
- Make sure that the bar on pressure gates is on the side away from the child's access.
- Leave no more than 2 inches at the bottom of the gate to prevent a child from trying to slide underneath.
- Choose a gate that is difficult to climb on or over.
- Only use gates that are safety approved and certified, and have no sharp or dangerous parts that could hurt a child.
Older patients found to need less chemo with MabThera
Tue, 15 Jan 2008 00:15:45 GMTZURICH - Shorter courses of chemotherapy taken with Roche Holding AG's cancer drug MabThera are as effective as longer courses in elderly patients with aggressive lymphoma, a study in The Lancet Oncology showed.
Six cycles of chemotherapy plus MabThera worked as well as eight cycles and should be the preferred treatment for elderly patients, according to the study of 1,222 patients, to be published in the February issue.
"Importantly for this elderly population, patients can be spared the toxicity and side-effects of an additional two cycles of chemotherapy," The Lancet Oncology said in a statement.
The three-year event-free survival rate was 66.5 percent after six cycles, and 63.1 percent after eight cycles, the study found.
MabThera -- known as Rituxan in the United States, where it is sold by Roche's partners Genentech Inc and Biogen Idec -- is the Swiss company's biggest seller, raking in 4.8 billion Swiss francs in 2006.
quotNaturalquot supplements caused cancer in 2 men study
Tue, 15 Jan 2008 06:20:37 GMTBy Maggie Fox, Health and Science Editor
WASHINGTON - Two men seeking to boost sexual performance and grow bigger muscles instead ended up with advanced prostate cancer after taking "herbal" supplements, U.S. doctors reported on Tuesday.
They said many supplements marketed as "safe" and "natural" could contain unknown and potentially dangerous ingredients, and noted that the U.S. Food and Drug Administration has little authority to regulate them.
"Physicians need to ask their patients not only about the prescription drugs they may be taking, but -- perhaps even more importantly -- about the over-the-counter drugs and supplements, which may have a profound impact on certain health conditions," Dr. Claus Roehrborn, chairman of urology at the University of Texas Southwestern medical school, said in a statement.
Roehrborn's team became concerned about what they call herbal/hormonal dietary supplements, or HHDSs, after two men developed aggressive and incurable prostate cancer within months of taking the same supplement.
They analyzed the product, which they did not name for legal reasons, and found it contained two hormones -- testosterone and estradiol. When they tested it on tumor cells in the lab, they found it fueled the growth of prostate cancer cells more potently than testosterone alone, they reported in the journal Clinical Cancer Research.
"We filed an adverse event report with the FDA who issued a warning letter. The manufacturer responded by removing this HHDS product from the market," the researchers wrote.
"Individuals use HHDS for self-improvement, failure or distrust of conventional medicine, and because they believe that, these natural products are safe and drug-free," they wrote.
The researchers searched Web sites promoting such products and found they promised "'fountain of youth,' maintenance of a 'youthful' heart, relief of stress, and improvements in mood disturbances, stamina, energy, strength and virility."
The patients, a 67-year-old white man and a 51-year-old black man, have both survived but have extensive cancer that has spread throughout their bodies.
"Unlike prescription and over-the-counter drugs, the law does not require nutritional supplements to undergo pre-market approval for safety and efficacy," the researchers wrote.
"The Dietary Supplement Health and Education Act in 1994 allows HHDS manufacturers to assume the sole responsibility for ensuring the effectiveness and safety of their products. Thus, the current Food Drug Administration regulatory system provides little oversight or assurance that HHDS will have predictable pharmacological effects or even that product labels provide accurate information to consumers."
