Consumers concerned about the recent withdrawal of certain infant multi-symptom cough and cold over-the-counter (OTC) products can seek guidance from their pharmacist and physician about treatment options. This voluntary product withdrawal by the manufacturers does not reflect product safety concerns but rather concerns with patterns of misuse leading to overdosing, particularly in infants less than two years of age.

“The American Pharmacists Association (APhA) strongly encourages parents to discuss the treatment needs of their children with their medication use specialist – their pharmacist,” said Winnie Landis, APhA President and community pharmacist. “Pharmacists can assist consumers in selecting among available treatment options and determining when the child needs to be referred to a physician.”

APhA issues the following guidance to consumers:

– Patients with questions are encouraged to talk to their pharmacist about their medication needs.

– This voluntary recall does not relate to the medications for children two years of age and older.

– Some manufacturers, recognizing the inconvenience this recall may create, are providing coupons for consumers to use on other products. To obtain these coupons or answers about specific products, consumers should contact the product’s manufacturer.

If disposing unused medications:

– DO NOT FLUSH unused medications, except when expressly instructed by the label.

– To ensure children and pet protection, crush or dissolve medications in water (also applies to liquids) and mix with kitty litter or a solid kitchen substance (such as coffee grinds), then place in a sealed plastic bag and dispose.

– To ensure protection of your privacy, remove and destroy all identifying personal information (such as the prescription label) from the medication container.

When selecting over-the-counter medication for your child:

– Provide the age and weight of the patient to your pharmacist.

– Discuss with your pharmacist the symptoms you are trying to treat and the duration of those symptoms.

– Provide a list of the types of products you have already used and the results achieved.

– Read product labeling, take the medication as directed, learn of possible side effects, and know what to avoid while taking the medication (such as to prevent duplication of active ingredients).
– Obtain appropriate medication administration aids (i.e. droppers, syringes, etc.) and ask the pharmacist how to use them properly.

This voluntary action does not affect non-infant cough and cold OTC products, single-ingredient analgesics, nasal spray/drops, or rubs expressly labeled for infants. The products affected in this withdrawal are:

– Dimetapp® Decongestant Plus Cough Infant Drops – 3-0031-2242-01-4

– Dimetapp® Decongestant Infant Drops – 3-0031-2283-78-9

– Little Colds® Decongestant Plus Cough – 7-56184-14021

– Little Colds® Multi-Symptom Cold Formula – 7-56184-14041

– PEDIACARE® Infant Drops Decongestant (containing pseudoephedrine) – 7140105

– PEDIACARE® Infant Drops Decongestant & Cough (containing pseudoephedrine) – 7150108

– PEDIACARE® Infant Dropper Decongestant (containing phenylephrine) – 6003600

– PEDIACARE® Infant Dropper Long-Acting Cough – 7527808

– PEDIACARE® Infant Dropper Decongestant & Cough (containing phenylephrine) – 6003400

– Robitussin® Infant Cough DM Drops – 3-0031-8681-01-5

– Triaminic® Infant & Toddler Thin Strips® Decongestant – 3-0043-0318-16-5

– Triaminic® Infant & Toddler Thin Strips® Decongestant Plus Cough – 3-0043-0319-16-2

– TYLENOL® Concentrated Infants’ Drops Plus Cold – 3931500

– TYLENOL® Concentrated Infants’ Drops Plus Cold & Cough – 3921500

About the American Pharmacists Association (APhA)

The American Pharmacists Association, founded in 1852 as the American Pharmaceutical Association, represents more than 60,000 practicing pharmacists, pharmaceutical scientists, student pharmacists, pharmacy technicians, and others interested in advancing the profession. APhA, dedicated to helping all pharmacists improve medication use and advance patient care, is the first-established and largest association of pharmacists in the United States. APhA members provide care in all practice settings, including community pharmacies, hospitals, long-term care facilities, managed care organizations, hospice settings, and the military.

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Two years after the implementation of a health care reform law aimed at providing health coverage for nearly all Massachusetts residents, public support for the law remains high. According to a new poll by the Harvard School of Public Health and the Blue Cross Blue Shield of Massachusetts Foundation, over two-thirds (69%) of Massachusetts residents support the law. Just over one in five (22%) oppose the law and approximately one in ten (9%) say they do not know enough about it to give an opinion. Since the law’s passage in 2006, public support has increased slightly (69% in 2008 compared to 67% in 2007 and 61% in 2006). The poll was conducted June 10-23, 2008.

Other signs of public support for the law include the following:
77% support providing subsidized coverage

58% support requiring individuals to have insurance

71% say the law has been successful at reducing the number of uninsured in Massachusetts

“The poll was taken during a time of much public discussion by legislators and policymakers about the high costs of the plan due to greater-than-expected enrollment numbers,” said Jarrett T. Barrios, president of the Blue Cross Blue Cross Blue Shield of Massachusetts Foundation. “We think this shows the public’s strong support for the law.”

In the two years since the law’s passage, approximately 350,000 Massachusetts residents have gained health insurance coverage.

A key component of the law is a mandate requiring all Massachusetts residents to have health insurance or pay a fine. A majority of the public support this individual mandate (58%) while slightly over one-third oppose it (35%). Support for the mandate has also increased slightly since the law was passed (58% in 2008 compared to 57% in 2007 and 52% in 2006).

The law requires businesses that employ more than 10 people to provide health insurance for their employees or pay a fine of up to $295 per employee per year. The public is highly supportive of this provision with three out of four expressing support (75%) and one in five opposition (21%). Support for this business requirement has also risen slightly since 2006 (75% support in 2008 compared to 70% in 2006).

Another key component of the law is providing free or subsidized coverage for Massachusetts residents whose incomes fall below 300% of the Federal Poverty Level ($63,600 for a family of four or $31,200 for an individual). Over three-quarters (77%) of the public support this subsidized insurance program while 18% oppose it.

Perceptions of Success of the Law

The poll finds that the public is aware of the law’s success at reducing the number of uninsured in the state with 14% saying the law has been very successful and 57% somewhat successful. Fifteen percent say the law has been not very successful at reducing the number of uninsured while 4% say it has been not successful at all. Nine percent say they did not know enough to give an answer.

“These findings have implications for the national debate on guaranteeing health insurance for all Americans,” said Robert J. Blendon, Professor of Health Policy and Political Analysis at the Harvard School of Public Health. “The poll shows that it is possible to cover most citizens and maintain public support. In most past cases of health reform, the public has become less supportive as it gained understanding of the trade offs involved. Massachusetts shows that this may no longer be true.”

Perceptions of Who the Law is Helping and Hurting

The public is divided on whether the law is helping the uninsured. A little less than half feel the law is helping the uninsured (45%) while one-third (33%) feel the law is hurting them. Fourteen percent say the law is not having much impact on the uninsured. The poll finds a similar split between those who feel that poor people are being helped by the law (44%) versus those who believe the poor are being hurt (31%) or not being affected (14%).

The poll also asked about the impact of the law on other groups such as the middle class, young adults and large corporations. A majority of the public feel that these groups are not being affected by the law or are being helped. Small businesses are the only group that a majority of Massachusetts residents feel are being hurt (56%). This compares to 13% who feel small businesses are being helped or not impacted (19%).

Many Massachusetts residents report that the law has had a limited impact on them personally. Just over two-thirds (67%) say the law is not having much impact on them personally compared to 14% who feel they are being helped and 18% being hurt. In addition, most people do not believe that the law has caused their health care costs to increase. Just over a majority (54%) say that the law has not had an impact on what they pay for health care while 6% say their costs have gone down. One in three (33%) say their costs have gone up as a result of the law.

Perceptions of the Law Among Those Affected

The law is most likely to have directly affected people who lacked health insurance at some point during the past 12 months and those who have gotten insurance or changed their insurance due to the law. Among this group, the law in general and the mandate in particular receive less support (52% law, 37% mandate) compared to the total population (69% law, 58% mandate). Respondents directly affected by the law are also more likely to say the uninsured and themselves personally are being hurt by the law (50% uninsured, 44% you personally) compared to the total population (33% uninsured, 18% you personally).

Challenges for the Future

The success of the law at reducing the number of uninsured in Massachusetts has created financial challenges. More people than projected signed up for subsidized coverage through the state causing the program to be over budget. When asked about a number of ways to cover this budget shortfall, several funding options receive support from a majority of Massachusetts residents. Nearly three of four (74%) favor charging businesses that have numerous part-time employees receiving subsidized coverage. Seventy percent favor increasing the cigarette tax, while 61% favor requiring insurers to contribute to a fund for subsidized coverage. Just over a majority (53%) favor increasing the $295 penalty for businesses with more than 10 employees that do not provide insurance.

Several policy options for covering the budget shortfall would face strong public opposition including increasing the state sales tax (75% oppose). Two out of three Massachusetts residents (66%) are opposed to limiting the number of people who qualify for subsidized insurance and creating a waiting list. Just over a majority (56%) are opposed to cutting other government programs as well. A majority of the public (55%, with 33% strongly opposing and 22% somewhat opposing) oppose increasing premiums, co-pays, and deductibles for subsidized care. Forty percent (16% strongly favor and 24% somewhat favor) support such increases on consumers.

Despite these financing challenges, the poll finds that Massachusetts residents want the law to continue. When asked if they would like the law to be repealed, continued as it currently stands or continued but with changes made, almost three-quarters want the law to continue though most want changes made (70% continued with changes, 14% continued as is). The poll did not ask about how the public would like to see the law changed. Only 12% want the law repealed. This is true even among the 22% of Massachusetts residents who say they do not support the law (56% continued with changes, 39% repealed, and 4% continued as is).

Methodology

The Massachusetts Health Reform Survey was conducted by the Harvard School of Public Health and the Blue Cross Blue Shield of Massachusetts Foundation. The survey was designed and analyzed by a team of researchers at the Harvard School of Public Health with input and review from the Foundation. This is the third survey in a series of surveys designed to measure the attitudes of Massachusetts residents towards the health reform law passed in 2006. The second survey also included the Kaiser Family Foundation as a research partner.

The instrument was approximately 15 minutes in length. Interviews were conducted with 1,015 randomly selected Massachusetts state residents, age 18 and older, via telephone by International Communications Research of Media, Pennsylvania. The interviewing period was June 10 to 23, 2008. The data were weighted to accurately reflect the demographics of the state’s adult population as described by the U.S. Census.

When interpreting these findings, one should recognize that all surveys are subject to sampling error. Results may differ from what would be obtained if the whole Massachusetts adult population had been interviewed. The size of this error varies with the number of persons surveyed and the magnitude of difference in responses to each question. The sampling error is ?±3.93 percentage points at the 95% confidence level.

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About the Harvard School of Public Health

Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: hsph.harvard.edu/.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care. Through grants and policy initiatives, the Foundation works with public and private organizations to broaden health coverage and reduce barriers to care. It focuses on developing measurable and sustainable solutions that benefit uninsured, vulnerable and low-income individuals and families in the Commonwealth, and served as a catalyst for the pioneering Massachusetts health care reform law passed in 2006. The Foundation was founded in 2001 with an initial endowment of $55 million from Blue Cross Blue Shield of Massachusetts; the endowment has since grown to $108 million. The Foundation operates separately from the company and is governed by its own 18-member Board of Directors. It is one of the largest private health philanthropies in New England and in 2007 was awarded the Paul Ylvisaker Award for Public Policy Engagement by the Council on Foundations.

Source: Robin Herman

Harvard School of Public Health Continue reading →

New licensing rules in New Jersey have led to the creation of long-term acute care hospitals in the state, the Bergen Record reports. The hospitals, which mostly treat elderly patients, “help fill the niche between general hospitals and nursing homes,” according to the Record. New Jersey officials changed the state hospital licensing rules to allow long-term acute care facilities after hospital executives raised concerns that there were too few options for patients who needed posthospital care, the Record reports. The long-term acute care hospitals typically have between 25 and 60 beds and usually rent space within larger medical centers. The patients — many of whom are on ventilators or have multiple medical conditions — require more nursing care than would be offered on a typical medical-surgical floor but do not need the monitoring of an intensive care unit. Treatment at the hospitals focuses on rehabilitation, with staff working to wean patients off ventilators or helping them to regain other functions. Nine long-term acute care hospitals are in operation or about to open in New Jersey, and 18 more have been approved. The use of such hospitals in 2006 is projected to grow about 50% compared with 2005, according to the state Department of Health and Senior Services. Patients at the center on average are admitted for 25 days. In New Jersey, Medicare pays about 85% of the bills for long-term acute facility patients, most beneficiaries receive coverage through Medicare Part A. Later this year, Medicare is expected to issue new rules on long-term acute care hospitals, including regulations designed to “make sure that the patients admitted are sick enough to belong there,” the Record reports (Washburn, Bergen Record, 10/31).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Pathologists and laboratory professionals at Henry Ford Health System in Detroit, MI have adopted an innovative and highly successful process improvement system that is changing the way laboratories deliver test results to doctors and patients.

As the 15th largest lab in the United States, processing more than 6.5 million specimens annually, Henry Ford’s labs had many of the same process issues endemic to labs everywhere. Researchers there decided to take the advice of their founder, automotive pioneer Henry Ford, and adopted his underlying production principles to maximize the efficiencies and qualities in the labs.

Their research findings, which describe their method to reduce errors and improve lab quality, will be published in the September 2007 issue of the American Journal of Clinical Pathology (AJCP). In the publication, researchers share simple yet novel approaches to data collection that led to worker-identified sources of waste, defects, and misidentifications that result in lost time and rework.

Researchers found that through deep and honest self analysis and the concerted effort of all workers, they could identify inefficiencies in their process. This knowledge formed the structure for effective changes to strive toward a zero-defect performance goal. Data were collected during two weeks of routine service by 57 personnel in surgical pathology for 1,690 surgical pathology cases. (Surgical pathology involves the examination of surgical tissue specimens, as well as biopsies for definitive diagnosis of disease.)

The new system has resulted in more than 100 improvements, each making a small but effective enhancement to the quality and timeliness of care. For instance, they have implemented the use of bar code-specified work processes to reduce specimen identification and work product defects, and results for routine biopsies have improved from 73 percent being completed in one day to 92 percent being completed in one day.

“The Henry Ford Production System is not just about waste reduction but adopts the best of the Toyota Production System’s approach to people,” said co-lead researcher Richard J. Zarbo, MD, DMD. “To be successful in using manufacturing-based approaches to quality requires nothing less than a complete cultural shift in the American workplace that gives every worker and manager a way to design their work in a blame-free and cooperative environment thereby unleashing their profound creative potential.”

Zarbo and co-author Rita D’Angelo, MS, ASQ CQE, SSBB found most helpful the use of a mounted visual data display poster to enter defects, rate their importance and their root causes. Six Sigma performance metrics were then utilized to make choices to improve quality.

The team redesigned specimen sorting to eliminate redundant steps, standardized tissue size to eliminate cassette opening during processing, and implemented action alerts to flag cases for critical values.

To read the full research study article that appears in AJCP, please click here or visit this link.

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Global issues such as intellectual property protections, follow-on biologics/biosimilars, international networking for research and development of neglected diseases and sustainable agriculture in developing countries will all be primary focus areas of the 2008 BIO International Convention.

Hosted by the Biotechnology Industry Organization (BIO), the 2008 BIO International Convention will take place Tuesday, June 17 through Friday, June 20, 2008 at the San Diego Convention Center in San Diego, Calif. Wednesday, June 18th is International Day, which will feature the international marketplace reception; a “Think & Drink” discussion forum on the global landscape for innovation, economics and policy; among other activities.

Biotechnology leaders from around the globe will be descending upon San Diego, one of the leading biotech hubs in the world, to discuss the most pressing issues and share their unique perspectives. In addition, there will be a total of 36 regional and country pavilions within the BIO Exhibition with several new pavilions, including Argentina, Brazil, Chile, Dubai, and South Africa.

This year’s convention will focus on the promise of biotech innovation to heal, fuel and feed the world. International case studies on biofuels, biomanufacturing, research funding, and international collaborations will focus on examples from Brazil, China, France, Germany, India, Japan, Korea, North America, Singapore, and Sweden. Two additional breakout session tracks will focus on doing business globally and global health. A Super Session entitled, “The Dynamics of a Globalized World and the Future of the Biotechnology Industry,” will feature several international public officials sharing insights on the evolving business landscape. Keynote speakers will capture the importance of innovation and leadership to the overall industry.

This year’s keynote speakers include:

Gen. Colin Powell will discuss leadership, drawing from his experience as both an international leader and as eyewitness to leadership in action to illustrate what it takes to be a leader in industry.

J. Craig Venter, Ph.D., will highlight the ways in which his early successes in genomics are now being used to lead the way toward breakthroughs in advanced biofuels through his cutting edge use of tools and techniques in synthetic genomic research in his presentation entitled, “From Reading to Writing the Genetic Code.” In 1998, Dr. Venter founded Celera Genomics to sequence the human genome, using the whole-genome shotgun technique, new mathematical algorithms, and automated DNA-sequencing machines. The successful completion of this research culminated in the publication of the human genome in February 2001.

Gov. Arnold Schwarzenegger will discuss the importance of innovation to the biotech industry.

Additionally, numerous international public officials are expected to attend, including Jos?© Lino Salvador Bara?±ao, Minister of Science, Technology and Productive Innovation, Argentina; Ewa Bjorling, Minister of Trade, Ministry of Foreign Affairs, Sweden; Suwit Khunkitti, Deputy Prime Minister and Minister of Industry, Chairman of the APEC Life Sciences Innovation Forum, Thailand; and Kapil Sibal, Minister of Science and Technology, India.

Since 2006, the international attendance has grown by more than 24% and now makes up more than 30% of the audience. The 2007 BIO International Convention in Boston saw double-digit percentage growth from Spain, Malaysia, Canada, German, India, and the United Kingdom. In 2008, more growth is expected from Asia and Latin America.

For more information on the 2008 BIO International Convention and its program, visit bio2008.

Registration is complimentary for credentialed members of the media. To register, visit bio2008/mediaregistration. Reporters and editors working full-time for print, broadcast, and online news organizations may register onsite with valid credentials. All freelancers, college and online publications are strongly encouraged to register in advance by Wednesday, June 4, 2008.

Registration for attendees is offered at an early-bird discounted rate of nearly 40 percent off the regular rate until May 8, 2008. Online registration is open at bio2008/registration.

The BIO International Convention helps to support BIO programs and initiatives. BIO works throughout the year to create a policy environment that enables the industry to continue to fulfill its vision of bettering the world through biotechnology innovation. For more information on the global event for biotechnology, including program and housing information, please visit bio2008. Also, be sure to check out our blog, bioontheroad for up to date information on all BIO events.

Upcoming BIO Events

– World Congress on Industrial Biotechnology & Bioprocessing
April 27-30, 2008
Chicago, Ill.

– 2008 BIO International Convention
June 17-20, 2008
San Diego, Calif.

– Pacific Rim Summit on Industrial Biotechnology and Bioenergy
Sept. 10-12, 2008
Vancouver, B.C., Canada

About BIO

BIO represents more than 1,200 biotechnology companies, academic institutions, state biotechnology centers and related organizations across the United States and in more than 30 other nations. BIO members are involved in the research and development of innovative healthcare, agricultural, industrial and environmental biotechnology products. BIO also produces the annual BIO International Convention, the world’s largest gathering of the biotechnology industry, along with industry-leading investor and partnering meetings held around the world.

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A study published in the Archives of Internal Medicine, finds that when physicians in hospitals use health information technology (health IT) to its full potential there are fewer deaths, fewer complications, and lower health care costs. The study, supported by The Commonwealth Fund and led by Ruben Amarasingham M.D., M.B.A., Associate Chief of Medicine at Parkland Health & Hospital System and Assistant Professor of Medicine at UT Southwestern Medical School and Neil Powe, M.D., M.P.H., M.B.A., Professor of Medicine at the Johns Hopkins University School of Medicine, surveyed physicians from 41 hospitals in Texas treating a diverse group of patients across a variety of conditions including heart attack, heart failure, and pneumonia.

The survey directly measures physicians using health IT in a hospital setting. Respondents were asked about their use of several different types of health IT including electronic notes and records, order entry, and clinical decision support. Researchers found that relatively modest increases in technology use had dramatic results – a 10 point increase in the use of electronic notes and medical records was associated with a 15 percent reduction in the likelihood of patient death. And, when physicians electronically entered their instructions for patient care, there was a 55 percent reduction in the likelihood of death for some procedures. Increased use of health IT was also linked to lower costs: hospitals with automated test results, order entry, and decision support experienced lower costs for all hospital admissions (-$110, -$132, and -$538, respectively per admission).

“These findings tell us, straight from the physicians using it, that this technology works to improve quality of care for patients – the first priority of health information technology,” said Commonwealth Fund Vice President for Quality Improvement and Efficiency Anne-Marie Audet, M.D. “But, in order to save lives and keep costs downs, health information technology has to be used to its fullest extent. As President Obama and his health care team consider investing in this technology for the nation, it would make sense to factor in on-going support and training for health care providers so that the technology can live up to its potential.”

Two additional Commonwealth Fund publications, also released today and available at commonwealthfund, expand on how health IT can be successfully integrated to help the U.S. create a truly high performing health care system:
In her new column, Commonwealth Fund President Karen Davis calls health IT a critical component of efforts to reform the U.S. health care system, when implemented alongside other key strategies such as payment reform and an overall commitment to performance improvement. “Just as investment in railroads, air traffic control, and interstate highways facilitated economic development and national prosperity in the 20th century, so too will the spread of health IT and the development of a national health information network bring long-run benefits and gains to the nation in the 21st century,” writes Davis. “It is crucial that our federal leadership move now to harness the power of information technology and put the nation on a path to high performance.”

In a new “Perspectives on Health Reform” brief also published today on The Commonwealth Fund Web site, David Blumenthal, M.D., director of the Institute for Health Policy at Massachusetts General Hospital/Partners HealthCare System and professor of medicine at Harvard Medical School, outlines federal policy options for overcoming the financial, technical, and logistical obstacles to getting hospitals and doctors to adopt health IT. “The Federal Role in Promoting Health Information Technology,” recommends offering assistance for purchase and implementation of health IT to providers that lack financial means; financial support for information exchange in local communities; support for research to improve health IT capabilities; payment reform to hasten use of health IT; and creating national regulations and standards for data security and patient privacy.

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The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high performance health system.

Source: Mary Mahon

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AstraZeneca today announced that the European Patent Office (EPO) has ruled that the European patent for Symbicort(R) in
the treatment of Chronic Obstructive Pulmonary Disease (COPD) is still valid, despite a challenge by generic manufacturers.

This positive decision means that this patent for Symbicort is still valid, covering its use in Austria, Belgium, Cyprus,
Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Monaco, the
Netherlands, Portugal, Romania, Slovenia, Spain, Sweden, Switzerland, the United Kingdom and former Yugoslav Republic of
Macedonia, in COPD. The patent, which expires in 2018, was challenged by generic manufacturers, Chiesi Farmaceutici S.p.A.,
Norton Healthcare Ltd and Generics [UK] Limited.

AstraZeneca has a comprehensive intellectual property portfolio for Symbicort including patents and data exclusivity.

In March, the EPO ruled that another European patent covering the combination of formoterol and budesonide in Symbicort(R) was
still valid, despite a separate challenge by several generic manufacturers.

Symbicort is a treatment for asthma and Chronic Obstructive Pulmonary Disease (COPD). The worldwide sales reached $797
million in 2004. Europe accounted for $701 million.

Media Enquiries:
Steve Brown, +44 207 304 5033
Edel McCaffrey, +44 207 304 5034

Investor Enquiries:
Jonathan Hunt, +44 207 304 5087
Mina Blair, +44 20 7304 5084

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The lack of a fall in the maternal death rate in the latest report by the Confidential Enquiry into Maternal and Child Health (CEMACH) has been partly attributed to the increasing percentage of births from immigrant women.

Women from ethnic minority groups (defined as those other than white British women), immigrants, refugees, asylum seekers and those from the gypsy population have been identified as being significantly more at risk of maternal mortality. Many of these women experience a range of complex medical and personal problems. A new paper to be published in The Obstetrician & Gynaecologist (TOG) examines why the maternal death rate is higher in these sections of UK society.

Researchers looked at the evidence from previous CEMACH reports and 34 relevant published papers. They examined the particular obstetric risks which such women are prone to, their access to care, the quality of care received and their perceptions of the maternity care received.

Several organisational issues were detected as risk factors:

- Communication problems – there are inadequate translation services for non-English speaking women and the written information provided to them is usually poor.

- Poor access to care – many were unlikely to attend antenatal classes or were more likely to present late when compared to white British women.

- Substandard care provision – the expectations of many of these women were not met. This was a result of systemic failures within maternity services to cater to these women’s special needs and also down to the women themselves and their poor understanding of the services available to them.

Levels of healthcare for these women vary from trust to trust. The authors of the paper suggest better monitoring and evaluation of the strategies implemented and for more research to be conducted into the healthcare needs of this particular group of women.

Nynke van den Broek, Senior Clinical Lecturer in Sexual and Reproductive Health at the Liverpool School of Tropical Medicine who co-authored the paper said, “Women belonging to an ethnic minority group, in particular asylum seekers and refugees, have an increased risk of maternal mortality. The women most affected are those who are newly arrived in the UK.

“There is evidence to suggest that care received by these women is substandard and that these women experience barriers to accessing maternal health care.”

Professor Neil McClure, TOG editor-in-chief said, “Caring for women from ethnic backgrounds is a complex issue facing all NHS staff working in maternity services. Although we would seek to individualise care for all patients, we must be particularly aware of the need to be sensitive to different cultural attitudes towards pregnancy and childbirth and to the often frightening experience of attending hospital. Many new immigrants see hospitals as a place of last resort and not for routine obstetric care.
“Ultimately, we must offer high quality safe care, for all mothers, regardless of their nationality and circumstances.”

Notes

The Obstetrician & Gynaecologist (TOG) is published quarterly and is the Royal College of Obstetricans and Gynaecologists’ (RCOG) medical journal for continuing professional development. TOG is an editorially independent, peer reviewed journal aimed at providing health professions with updated information about scientific, medical and clinical developments in the specialty of obstetrics and gynaecology.

Reference

Increased risk of maternal death among ethnic minority women in the UK.
Ameh CA, van den Broek N.
The Obstetrician & Gynaecologist 2008;10:177-182.

Royal College of Obstetricans and Gynaecologists Continue reading →

It has been a long debate in the United States as to whether or not vaccines used to battle the H1N1 outbreaks of recent lead to the development of Guillain-Barre syndrome, a rare disorder that causes the body’s immune system to turn against itself, resulting in muscle weakness and even paralysis. A new study says no such chance.

In 1976, a vaccine used during a U.S. flu outbreak was linked to the disease, and the government halted vaccination, but in a study published July 13 in the British Medical Journal, a renowned group of researchers reported that the H1N1 vaccine posed little, if any, increased risk for the disease.

The researchers state:

“This study provides reassurance that adjuvanted pandemic influenza A (H1N1) 2009 vaccines did not increase the risk of Guillain-Barre syndrome substantially, if at all.”

Guillain-Barr?© syndrome is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until the muscles cannot be used at all and the patient is almost totally paralyzed. In these cases, the disorder is life-threatening and is considered a medical emergency.

The patient is often put on a ventilator to assist with breathing. Most patients, however, recover from even the most severe cases of Guillain-Barr?© syndrome GBS), although some continue to have some degree of weakness.

Usually Guillain-Barr?© occurs a few days or weeks after the patient has had symptoms of a respiratory or gastrointestinal viral infection. Occasionally, surgery will trigger the syndrome. In rare instances, vaccinations may increase the risk of GBS. The disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks.

No one yet knows why Guillain-Barr?© strikes some people and not others or what sets the disease in motion. What scientists do know is that the body’s immune system begins to attack the body itself, causing what is known as an autoimmune disease.

The research was spawned from an analysis of 50 million people in five European countries that vaccinated people against H1N1 in 2009. The researchers compared 104 people with Guillain-Barre syndrome or a related condition to other people without the diseases.

The researchers adjusted their statistics to account for other risk factors for the diseases and found no link between flu vaccination and Guillain-Barre syndrome. Still, noting that it’s possible a small risk might remain, they estimated there may be less than three extra cases of Guillain-Barre syndrome for each one million people who get protected by a flu vaccination.

Larger studies already in progress should provide even more definitive information, the study authors added.

The flu is a serious disease, and while most cases are mild, some can be deadly. So far this flu season, most flu activity has been caused by the 2009 H1N1 virus, which was first identified in April 2009 and caused the first flu pandemic in 40 years.

Because many people with influenza illness are not tested for flu or are tested late in their illness, methods have been developed to estimate the numbers of people with influenza illness and with influenza-related complications, including hospitalizations and deaths. CDC estimates that from April to January 16, 2010, approximately 57 million cases of 2009 H1N1 occurred in the United States, including 257,000 H1N1-related hospitalizations and about 11,690 deaths.

Sources: The British Medical Journal and The U.S. Centers for Disease Control and Prevention

Sy Kraft

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The American Academy of Pediatric Dentistry (AAPD), the recognized leader in children’s dental and oral health, is one of only 21 organizations nationally to receive an Award of Excellence in the second round of the 2010 Associations Advance America (AAA) Awards program, a national competition sponsored by the American Society of Association Executives (ASAE) and The Center for Association Leadership, Washington, D.C.

AAPD received the award for its AAPD Head Start Dental Home Initiative. This program is now in the running to receive a Summit Award, ASAE & The Center’s top recognition for association programs, to be presented in ceremonies at ASAE’s 11th Annual Summit Awards Dinner at the National Building Museum in Washington, D.C., on September 29, 2010.

AAPD and Head Start (HS) are partnering at national, regional, state and local levels to develop a national network of dentists to link Head Start children with dental homes. A dental home means that each child’s oral health care is delivered in a comprehensive, ongoing, accessible, coordinated, family-centered way by a dentist.

This partnership also provides parents, caregivers and HS staff with the latest evidence-based information on how they can help prevent tooth decay and establish a foundation for a lifetime of oral health.

The AAPD Head Start Dental Home Initiative, which is in its third year of a five-year contract, will establish dental homes for the approximately 1 million children enrolled annually in Head Start across the United States. The five-year plan relies on five key components:

- Providing project leadership, administration and organizational support;
- Providing oral health expertise and technical assistance;
- Developing networks of dentists to provide access to dental homes;
- Training dentists to enhance their capability to meet the oral health needs of young children and their understanding of HS programs; and
- Enhancing HS oral health staff training and parent education programs.

Now in its 20th year, the prestigious Associations Advance America Awards program recognizes associations that propel America forward – with innovative projects in education, skills training, standards-setting, business and social innovation, knowledge creation,

citizenship and community service. Although association activities have been a powerful impact on everyday life, they often go unnoticed by the general public.

“AAPD’s program truly embodies the spirit of the Associations Advance America campaign. It is an honor and an inspiration to showcase this activity as an example of the many contributions associations are making to advance American society,” said the 2009-2010 Associations Advance America (AAA) Committee Chair Ping Wei, director of educational opportunities for the American Society of Civil Engineers.

“AAPD is deeply honored to receive this award on behalf of our members, professional partners and Head Start programs throughout America. Through this initiative we are combining their professional and creative talents, and developing the infrastructure necessary to provide Head Start children with the foundation for a lifetime of optimal oral health,” noted Project Director Dr. Jim Crall.

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