Helping find lost Alzheimers patients
Sun, 12 Aug 2007 16:27:07 GMT
By LAURAN NEERGAARD, AP Medical Writer
HAINESPORT, N.J. - It looks like a toy, but the bracelet locked around Bob Melnick's wrist gives his wife some peace of mind: If this Alzheimer's patient wanders off and gets lost, he's wearing a tracking beacon to help bring him home.
"I'm a marked man," joked Melnick, of Hainesport, N.J. "The police can pick me up anywhere."
Wandering is one of the most frightening symptoms of advancing dementia, and the Alzheimer's Association estimates it will happen to nearly 60 percent of patients.
A mini-industry of technologies promises to find lost Alzheimer's patients — from simple radio-wave beacons that cost $10 a month for batteries, to more-sophisticated GPS devices that can cost hundreds of dollars.
Little if any independent research has been done to help determine which systems work best in different environments, and therefore are best suited to different families.
"These technologies need to be evaluated," said Majd Alwan, director of the Center for Aging Services Technologies, a coalition of government, universities and high-tech companies.
Among considerations are where the patient lives, added Henry Kautz of the University of Rochester, who is helping develop next-generation systems. For example, the accuracy of GPS devices depends on access to satellites powering the navigation tool.
"You have to have a clear line of sight to the satellite," Kautz said, which can be difficult in a large city. Companies are working to boost signal strength.
Radiofrequency "tags" are a hot topic for assisted-living facilities. Patients wear a sensor read by receivers on doors that sound an alarm when someone strolls too far.
Then there's the more traditional beacon like Melnick's, which emits a radiofrequency signal for rescue workers to hunt.
"That kind of technology is the most flexible, because it doesn't require GPS or infrastructure. But it doesn't work if you don't notice the person is gone," Kautz said.
Whatever the transmitter, there's the question of how to ensure the patient doesn't wander off without it. Some systems require carrying cell phones; others come in hard-to-remove jewelry; one company sells sneakers implanted with a GPS chip.
For families, there's little guidance on how to find, or choose from, the devices.
Dolores Melnick learned almost by accident that her county sheriff's department offered the radio beacon through a program called Project Lifesaver, when a relative stumbled across an Internet site.
Melnick already was enrolled in the Alzheimer's Association's low-tech Safe Return program. For $20 a year, the hot line faxes photos and descriptions to law enforcement when a patient is reported missing. Patients also wear a stainless steel tag listing a number to call if they're found wandering.
But after getting briefly separated in an airport, Mrs. Melnick liked the idea of more active tracking, too. When she snapped the bracelet on her husband, "He said, 'Oh, this is so you don't lose me!'"
Stay tuned: Kautz says next-generation sensors promise to help dementia patients help themselves, guiding those with early-stage Alzheimer's on city buses or reminding later-stage patients how to wash their hands.
US slipping in life expectancy rankings
Sun, 12 Aug 2007 11:03:33 GMT
By STEPHEN OHLEMACHER, Associated Press Writer
WASHINGTON - Americans are living longer than ever, but not as long as people in 41 other countries.
For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and lifestyles.
Countries that surpass the U.S. include Japan and most of Europe, as well as Jordan, Guam and the Cayman Islands.
"Something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries," said Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington.
A baby born in the United States in 2004 will live an average of 77.9 years. That life expectancy ranks 42nd, down from 11th two decades earlier, according to international numbers provided by the Census Bureau and domestic numbers from the National Center for Health Statistics.
Andorra, a tiny country in the Pyrenees mountains between France and Spain, had the longest life expectancy, at 83.5 years, according to the Census Bureau. It was followed by Japan, Macau, San Marino and Singapore.
The shortest life expectancies were clustered in Sub-Saharan Africa, a region that has been hit hard by an epidemic of HIV and AIDS, as well as famine and civil strife. Swaziland has the shortest, at 34.1 years, followed by Zambia, Angola, Liberia and Zimbabwe.
Researchers said several factors have contributed to the United States falling behind other industrialized nations. A major one is that 45 million Americans lack health insurance, while Canada and many European countries have universal health care, they say.
But "it's not as simple as saying we don't have national health insurance," said Sam Harper, an epidemiologist at McGill University in Montreal. "It's not that easy."
Among the other factors:
• Adults in the United States have one of the highest obesity rates in the world. Nearly a third of U.S. adults 20 years and older are obese, while about two-thirds are overweight, according to the National Center for Health Statistics.
"The U.S. has the resources that allow people to get fat and lazy," said Paul Terry, an assistant professor of epidemiology at Emory University in Atlanta. "We have the luxury of choosing a bad lifestyle as opposed to having one imposed on us by hard times."
• Racial disparities. Black Americans have an average life expectancy of 73.3 years, five years shorter than white Americans.
Black American males have a life expectancy of 69.8 years, slightly longer than the averages for Iran and Syria and slightly shorter than in Nicaragua and Morocco.
• A relatively high percentage of babies born in the U.S. die before their first birthday, compared with other industrialized nations.
Forty countries, including Cuba, Taiwan and most of Europe had lower infant mortality rates than the U.S. in 2004. The U.S. rate was 6.8 deaths for every 1,000 live births. It was 13.7 for Black Americans, the same as Saudi Arabia.
"It really reflects the social conditions in which African American women grow up and have children," said Dr. Marie C. McCormick, professor of maternal and child health at the Harvard School of Public Health. "We haven't done anything to eliminate those disparities."
Another reason for the U.S. drop in the ranking is that the Census Bureau now tracks life expectancy for a lot more countries — 222 in 2004 — than it did in the 1980s. However, that does not explain why so many countries entered the rankings with longer life expectancies than the United States.
Murray, from the University of Washington, said improved access to health insurance could increase life expectancy. But, he predicted, the U.S. won't move up in the world rankings as long as the health care debate is limited to insurance.
Policymakers also should focus on ways to reduce cancer, heart disease and lung disease, said Murray. He advocates stepped-up efforts to reduce tobacco use, control blood pressure, reduce cholesterol and regulate blood sugar.
"Even if we focused only on those four things, we would go along way toward improving health care in the United States," Murray said. "The starting point is the recognition that the U.S. does not have the best health care system. There are still an awful lot of people who think it does."
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On The Net:
Census Bureau: http://www.census.gov/ipc/www/idb/
National Center for Health Statistics: http://www.cdc.gov/nchs/fastats/lifexpec.htm
Egyptian girl dies in circumcision
Sat, 11 Aug 2007 23:50:50 GMT
CAIRO, Egypt - A 13-year-old Egyptian girl has died during a circumcision operation, two months after the death of another girl prompted health officials to ban the widespread traditional procedure, local media said Saturday.
The latest death was uncovered when Karima Rahim Massoud's father applied for a death certificate Friday, insisting his daughter had died from natural causes, the independent daily Al-Masry Al-Youm reported Saturday. The father has been referred to the state prosecutor.
The doctor involved also has been referred to the prosecutor and his clinic in rural Gharbiyah province has been closed down, state-owned al-Gomhoria daily reported.
The reports could not be immediately confirmed as judicial authorities were not available for comment Saturday.
In June, the death of 12-year-old Badour Shaker during a circumcision operation in the southern town of Maghagh sparked a public outcry, prompting the government to officially ban hospitals from performing female circumcisions.
The Egyptian Health Ministry said violators would be punished, but did not specify the penalty. The ban is not as enforceable as a law, which requires passage in the national legislature.
The procedure, which many refer to as female genital mutilation, usually involves the removal of the clitoris and other parts of female genitalia. Advocates say it tames a girl's sexual desire and maintains her honor. Opponents say girls can bleed to death, suffer chronic urinary infections and have life-threatening complications in childbirth as a result.
It is practiced by Muslims and Christians alike and is deeply rooted in the Nile Valley region and parts of sub-Saharan Africa, Yemen and Oman.
While top clerics insist the practice has nothing to do with Islam, parents, especially in rural villages and Cairo slums, believe they are helping their daughters by protecting their virginity before marriage.
A 2003 survey by UNICEF said that 97 percent of married women in Egypt have undergone genital mutilation. A recent study by Egypt's Ministry of Health and Population found that only half of all girls between the age of 10-18 years have been circumcised.