CT Scans for Dizziness in the ER: Worth the Cost?

Newswise — DETROIT – Performing CT scans in the emergency department for patients experiencing dizziness may not be worth the expense – an important finding from Henry Ford Hospital researchers as hospitals across the country look for ways to cut costs without sacrificing patient care.

According to the Henry Ford study, less than 1 percent of the CT scans performed in the emergency department revealed a more serious underlying cause for dizziness – intracranial bleeding or stroke – that required intervention.

The findings suggest that it may be more cost effective for hospitals to instead implement stricter guidelines for ordering in-emergency department CT scans of the brain and head for patients experiencing dizziness.

“When a patient comes into the emergency department experiencing dizziness, a physician’s first line of defense is often to order a CT scan to rule out more serious medical conditions. But in our experience it is extremely rare that brain and head imagining yields significant results,” says study author Syed F. Ahsan, M.D., a neuro-otologist in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

“It is our hope that our investigation into our own practices will shed light on avenues to run leaner practices within our institution, as well as serve as a model for other health systems.”

The study will be presented Jan. 26 in Miami Beach at the annual Triological Society’s Combined Sections Meeting.

The Henry Ford study was a retrospective review of 1,681 patients with dizziness or vertigo who came into a Detroit metropolitan emergency department between January 2008 and January 2011.

Of those patients, nearly half (810 patients) received a CT scan of the brain and head, but only 0.74 percent of those scans yielded clinically significant results that required intervention. In all, the total cost for the CT scans during the three-year period was $988,200.

The analysis also revealed that older patients and those with a lower income were more likely to receive a CT scan for dizziness when they came into the emergency department.

While dizziness may signal intracranial bleeding or stroke, it is more likely that the cause is due to dehydration, anemia, a drop in blood pressure with standing (orthostatic hypotension), problems or inflammation in the inner ear such as benign paroxysmal postional vertigo, labyrinthitis or meniere’s disease, or vestibular neuritis.

And, Dr. Ahsan notes, in previous studies it has been well documented that CT scans are not very effective in detecting stroke or intracranial bleeding in the acute (emergency room) setting.

Ultimately, the study shows that there is potential for cost savings by creating and implementing stronger guidelines to determine when it is medically necessary for patients with dizziness to undergo CT imaging in the emergency department.

Funding: Henry Ford Hospital

Along with Dr. Ahsan, Henry Ford study co-authors are Mausumi N. Syamal, M.D., and Kathleen Yaremchuk, M.D.

Released:  1/26/2012

Source: Henry Ford Health System

Related Link:

http://www.newswise.com/articles/ct-scans-for-dizziness-in-the-er-worth-the-cost

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Walking and Texting at the Same Time? Stony Brook Study Says Think Again!

A Stony Brook University study that tested cell phone use/texting while walking showed use of the mobile device often results in walking errors and interferes with memory recall.

Newswise — STONY BROOK, N.Y., January 18, 2012 – Talking on a cell phone or texting while walking may seem natural and easy, but it could be dangerous and result in walking errors and interfere with memory recall. Researchers at Stony Brook University found this to be the case in a study of young people walking and using their cell phones. The study is reported in the online edition of Gait & Posture.

Thirty-three men and women in their 20s, all of whom reported owning and using a cell phone and familiar with texting, participated in the study. To assess walking abilities, participants completed a baseline test. Each participant was shown a target on the floor eight meters away. Then, by obstructing vision of the target and floor, participants were instructed to walk at a comfortable pace to the target and stop. They repeated the same walk three times. After each walk, the amount of time it took and the position where each participant stopped was measured.

Participants returned one week later. With vision occluded except for the ability to see a cell phone, one-third completed the exact same task; one-third completed the task while talking on a cell phone; and one-third completed the task while texting.

“We were surprised to find that talking and texting on a cell phone were so disruptive to one’s gait and memory recall of the target location,” says Eric M. Lamberg, PT, EdD, co-author of the study and Clinical Associate Professor, Department of Physical Therapy, School of Health Technology and Management, Stony Brook University.

Dr. Lamberg summarized that the changes from the baseline blindfolded walk to testing indicated that participants who were using a cell phone to text while walking and those who used a cell phone to talk while walking were significantly slower, with 33 and 16 percent reductions in speed, respectively. Moreover, participants who were texting while walking veered off course demonstrating a 61 percent increase in lateral deviation and 13 percent increase in distance traveled.

Although walking seems automatic, areas in the brain controlling executive function and attention are necessary for walking. Dr. Lamberg says that the significant reductions in velocity and difficulty maintaining course indicates cell phone use and texting impacts working memory of these tasks.

“We are using the findings to help physical therapy patients improve true functional walking while making them aware that some tasks may affect their gait and/or certain aspects of memory recall,” said Dr. Lamberg. He emphasizes that using a cell phone while walking reflects a “real world” activity, one that recovering patients are likely to engage in sooner rather than later during their recovery process.

Lisa M. Muratori, PT, EdD, study co-author and Clinical Associate Professor in Stony Brook’s Department of Physical Therapy, points out that the study is also being used to help them further understand the underlying mechanism causing the difficulty in performing the dual-task of walking while using a cell phone.

Drs. Muratori and Lamberg believe that these results bring new and important insight into the effects of multi-tasking with mobile devices. Elucidating the cause of this disruption may allow for new physical therapy treatment interventions and modifications in technology – such as voice-activated texts – that may lessen the potential dangers of walking while using hand-held devices.

Both authors describe the results as preliminary, with the need for further studies with larger and more varied populations.

Released: 1/18/2012

Source: Stony Brook University Medical Center

Related Link:

http://newswise.com/articles/walking-and-texting-at-the-same-time-stony-brook-study-says-think-again

Some Like it Hot: Popular Yoga Style Cranks up the Heat

What You Need to Know to Prevent Injuries

Photo Credit, Hospital for Special Surgery. People practicing hot yoga should take certain precautions, said certified yoga instructor Diana Zotos of Hospital for Special Surgery.

Newswise — Yoga is one of the hottest fitness trends and a style known as “hot yoga” is gaining in popularity.

Hot yoga refers to yoga practiced in a heated environment, with the room temperature generally reaching 90 to 105 degrees. The theory behind it is that hot yoga helps the body to sweat out toxins while allowing the practitioner to safely achieve deeper poses. Bikram is a common form of hot yoga.

Almost 16 million Americans practice some form of yoga, according to a 2008 study in the Yoga Journal.

While the practice can offer health benefits and a sense of well-being, people practicing hot yoga, especially beginners, should take certain precautions, according to Diana Zotos, a certified yoga instructor and physical therapist in the Rehabilitation Department at Hospital for Special Surgery in Manhattan.

“Yoga of any type is physically challenging, and the heated environment of hot yoga makes the practice especially demanding,” Zotos says. “The heat makes people feel as if they can stretch deeper into poses and can give them a false sense of flexibility. This can lead to muscle strains or damage to the joint, including ligaments and cartilage.”

Zotos says people over 40 who have never done Bikram yoga may be at greater risk of injury, and she recommends they familiarize themselves with it prior to trying a class. “There are many books and videos that describe this style and can demonstrate the poses and techniques,” she says. “Since classes are constructed of the same 26 poses, people can become familiar with them beforehand.”

Beginners should keep in mind that poses will require a certain level of leg, core and upper body strength, as well as balance, according to Zotos. People should also have a tolerance for stretching and moderate flexibility in their legs and spine.

“The heat factor also puts more strain on the heart and challenges endurance. That being said, people should be of good cardiovascular health; have healthy hip, knee, spine and shoulder joints; shouldn’t have balance or neurological issues; and should have a general tolerance for excessive heat,” she advises.

Zotos has these additional tips:

• Be well-prepared. Bring a mat and towel, and
wear shorts and a tank top. If possible, bring a buddy. It can be more fun and less intimidating if you take your first class with a friend.
• Make sure you drink plenty of fluids well before class (but not coffee or soda). Don’t eat anything too heavy (more than 200 calories) two to three hours prior to class.
• Make sure the studio and teachers have a good reputation. Ask about their experience and credentials. The teacher should be certified in Bikram or another form of yoga.
• Try to arrive early. This way you can introduce yourself and speak with the instructor, pick a good spot in the studio to set up your mat and get comfortable with your surroundings and the heat.
• Start slowly and learn the basics. Never push yourself to the point of pain while stretching or assuming a position.
• Listen to your body. Stop at the first sign of discomfort. If you are extremely fatigued, take a break. Do not try yoga poses beyond your experience or comfort level.
• Don’t get discouraged if you can’t reach a pose. It’s not a competition.
• Ask questions if you’re not sure how to perform a pose.
• If you get dizzy, lightheaded, overheated or experience chest pain, STOP immediately. Seek medical assistance if necessary.

Anyone who questions whether hot yoga is safe for them should consult their physician, Zotos says. “If you have sensitivity to heat, if you’ve ever had heat stroke or tend to get fatigued, dizzy or dehydrated quickly, you should ask your doctor before starting hot yoga. Anyone with osteoarthritis, any rheumatologic arthritis, pain in muscles or a joint, or any kind of previous injury should check with their doctor.”

Zotos says it’s especially important that anyone who has hypertension, low blood pressure or heart disease check with their cardiologist before trying hot yoga.

For more tips concerning other forms of exercise and wellness advice, visit www.hss.edu/wellness.

Released: 1/16/2012

Source: Hospital for Special Surgery

Related Link:

http://newswise.com/articles/some-like-it-hot-popular-yoga-style-cranks-up-the-heat

Ring in a New Healthier You in 2012!

Newswise — BOSTON— With the start of a new year, Dana-Farber Cancer Institute experts are encouraging people to ring in new healthy habits and offer a number of free and low-cost strategies to help people maintain good health and possibly reduce various cancer risks.

Get moving!
Staying fit and healthy can be as simple as lacing up a pair of sneakers and going for a walk. Moderate to intensive aerobic exercise, according to studies, can reduce the risk of recurrence of several cancers, including colon and breast.

“You don’t have to be a marathon runner, but the more you exercise, typically the greater the beneficial effect,” says Jeffrey Meyerhardt, MD, MPH, a Dana-Farber gastrointestinal cancer specialist.

Here are some inexpensive ways to workout, but consult a doctor first.
– Using the stairs rather than an elevator.
– Walking or riding a bike rather than driving.
– Taking an exercise break or quick walk at work.
– Using a stationary bicycle or treadmill while watching TV.

Color Your World…and your shirt?
It doesn’t cost anything to walk by the cookie aisle and into a store’s produce section. And, taking that little detour can provide many health benefits. A diet low in processed sugars, red meat and calories, but high in fruits and vegetables and loaded with antioxidants is one of the simplest ways to help maintain a healthy weight and reduce the risk of certain cancer.
The overall key is to look for colorful produce like pomegranates, tomatoes, eggplant, grapes, cherries, and turnip. The brighter and richer the pigment, the higher the level of nutrients.
“In the nutrition world, we like to say if it comes from the ground and it stains your shirt, you want to be eating it,” says Stephanie Meyers, MS, RD/LDN, a nutritionist at Dana-Farber.

Skip that cocktail
Limiting alcohol consumption can save money and it may lower the risk of developing some cancers. Dana-Farber researchers found that women who consume one alcoholic drink a day may increase their risk for breast cancer. “Women need to consider the possible effects of alcohol on breast cancer risk when weighing the risks and benefits of alcohol consumption,” says Wendy Chen, MD, PhD, a breast cancer expert. “Our findings indicate that in some women, even modest levels of alcohol consumption may elevate their risk of breast cancer.”

Save money and lives – quit smoking
Buying cigarettes and other tobacco products can really take a bite out of a budget. Kicking the habit can result in both a healthier lifestyle and significant financial savings.
According to the American Cancer Society, smoking is the most preventable cause of death in the United States. It also causes more than 80 percent of all cases of lung cancer and increases the risk of oral, throat, pancreatic, uterine, bladder, and kidney cancers.

“Even though there have been many recent advances in lung cancer treatments, the most effective way to eradicate lung cancer is to prevent it from ever happening,” explains Bruce Johnson, MD, director of Dana-Farber’s Lowe Center for Thoracic Oncology. Johnson emphasizes that it is never too late to quit.

People who stop and remain nonsmokers for at least 10 to 20 years can cut their risk of developing lung cancer in half.
– Plan the quit day
– Follow the four D’s: Deep breaths, Drink lots of water, Do something to avoid focusing on cravings, Delay reaching for a cigarette – the urge will pass.
– Avoid triggers: Get rid of cigarettes, lighters, matches, and ashtrays.

Sunscreen ‘applies’ year round
Sunscreen shouldn’t be packed away after summer ends. Skin can be exposed to harmful rays all year long. Snow, ice and water can all reflect the ultraviolet (UV) radiation that causes sunburn, which, in turn increases the risk of developing skin cancer. Some experts say winter sports enthusiasts can face just as much risk of getting sunburn as summer sunbathers. Dana-Farber experts remind to protect year round.
– Wear sunscreen, lip balm and makeup with an SPF of 15 or higher.
– Use UV-blocking eye protection, especially for skiing.
– In a tropical setting, wear a broad brimmed hat and UV-blocking sunglasses.
– Avoid excessive exposure to the sun, especially between 10 a.m. and 4 p.m. when the sun is at its strongest.

Don’t forget your dentist
Visiting the dentist is not just about clean and healthy teeth. Dentists also are on the front lines of detecting cancer in the mouth. Research shows more than half of all smokeless tobacco users have non-cancerous or pre-cancerous lesions in their mouth. In addition to the increased risk of cancer, smoking and chewing tobacco erodes teeth and gums. “The treatment for this type of head and neck cancer can be a radical and deforming surgery,” warns Robert Haddad, MD, disease center leader of the head and neck oncology program at Dana-Farber. He stresses, “The changes in the cells never go away once they happen. So don’t start using tobacco and if you have, get help to stop.”

Released: Released: 12/28/2011

Source: Dana-Farber Cancer Institute

Related Link:

http://newswise.com/articles/ring-in-a-new-healthier-you-in-2012

New Trends…Convenience Stores To Focus on Food in 2012

Newswise — CHICAGO- Convenience stores (c-stores) are not typically recognized for their food selections, but as tobacco and gas prices rise, fewer people are spending money on these items and other c-store staples. In the January 2012 issue of Food Technology magazine, published by the Institute of Food Technologists (IFT), Digital Editor Kelly Hensel writes that c-stores are beginning to shift their attention to growing their food/beverage and foodservice segments in order to compete with quick service restaurant chains.

According to data from Symphony IRI Group, the c-store channel is expected to see a growth rate of about 3 percent between 2010 and 2012, and one of the key drivers of this expansion are foodservice items. Technomic Director Tim Powell says that recently convenience stores are increasingly falling into the same consideration set as fast food restaurants. As technology and food innovation continue, c-stores will continue to capitalize on the opportunity to present consumers with better quality products with do-it-yourself customization.

C-stores are well known for their coffee bars that offer customers a way to make their coffee the way they like it. Some chains switched to a thermal dispensing system last year in order to keep coffee fresh tasting. In addition some c-stores offer hot tea reaching the previously untapped demographic of female consumers and those 50 years and older. It’s the hope that by getting consumers in the door with beverages, they will also end up choosing one of their many new food items such as breakfast sandwiches, hot dogs, made-to-order sandwiches, soups, etc.

Snacking is also becoming a key driver for all c-stores. According to a survey by Snack Factory more Americans would prefer to reach for snacks throughout the day instead of having three solid meals. Pairing foods with beverages is also a popular way c-stores can drive profits. Also due to the shifting paradigm of what is considered a snack, for example a hot dog or pizza slice as a snack instead of a meal can increase traffic at c-stores throughout the day.

Released: 1/12/2012

Source: Institute of Food Technologists (IFT)

Related Link:

http://newswise.com/articles/convenience-stores-to-focus-on-food-in-2012

Looking For Love: Drexel Researchers Put Online Dating to the Test

Today, one-in-five Americans finds his or her spouse via online dating websites, but according to Drexel researchers, marriage isn’t the only measure of success among people looking for love in cyberspace.

Rachel Magee and Christopher Mascaro, both second-year Ph.D students in The iSchool at Drexel, College of Information Science and Technology, and their advisor Dr. Sean P. Goggins, completed a study that takes a closer look at the success stories of online daters. Their results point toward a more accurate interpretation of why people decide to use online dating technology, why they choose a specific site and what they consider a successful online dating experience.

“We each had used online dating sites, and were both fascinated with how and why people use these services,” Magee said “We started to look at the research out there, and realized that what was missing was research into what constitutes successful online dating experiences. This is an extremely important part of most people’s lives, and we wanted to look at the big picture.”

The Drexel study, entitled “Not Just a Wink and a Smile: An Analysis of User-Defined Success in Online Dating,” examined data gathered during a two-week sample period in the spring of 2011 from success stories listed on the dating sites Match.com, eHarmony and OkCupid. The researchers looked at a random sampling of 20 percent of the success stories from each site.

Their findings concluded that a vast majority, 84 percent, of users who reported “successful” experiences on eHarmony where referring to marriage. By contrast, 46.7 percent of the reported success stories from Match.com were marriage stories and only 23 percent of the success stories on OkCupid were about marriage.

“What we found in our research confirmed some of our experiences and anecdotal evidence, that certain dating sites fostered certain cultures and the range of success stories indicated as much,” Mascaro said. “Our findings also indicate that even with the proliferation of technologically and mediated social networking sites, real world social networks still play a significant role in technological adoption and mate selection.”

Each of the sites broke down their results into three categories of success: dating, engaged and married. An analysis of the data revealed that most users who had a successful experience on OkCupid, considered dating to be successful with slightly fewer stories of engagement and the fewest stories in the category of marriage.
The frequency of stories for both eHarmony and Match.com increased in each category from dating to marriage.

The researchers also examined geographic distribution of the people who logged on to write about their online dating success stories. Success stories followed population trends across the country. The region with the most respondents was the South Atlantic, while California boasted the most success stories as a state and Houston, Chicago and New York, respectively, were the top cities in generating online dating stories. The stories and locations of successful online daters indicate that in-person social networks may influence why individuals select online dating sites.

“Geography might not play a big role in dating site selection, but the people you know, especially if they are successful at online dating, might influence site adoption,” Magee said. “This has implications for the design of online dating sites, and for people using these sites or interested in participating in online dating. There are so many sites out there, and many different success stories.”

Via Newswise

Released: 1/5/2012

Source: Drexel University

Related Link:

http://www.newswise.com/articles/looking-for-love-drexel-researchers-put-online-dating-to-the-test

Marketing Trends in 2012: Traditional Expensive Advertising No Longer Effective, Says Expert

Newswise — Traditional product advertising — full-page magazine ads and 30-second television commercials — may be going the way of the rotary phone. Emerging concepts such as crowdsourcing, viral Internet campaigns, product placements and guerilla promotions will dominate the marketing and advertising landscape in 2012 and beyond, says a marketing expert at Washington University in St. Louis.

“Traditional expensive advertising is no longer effective given all the clutter, as well as the emergence of technologies, like digital video recorders, that block the ads from even being viewed, much less absorbed, by consumers,” says Seethu Seetharaman, PhD, the W. Patrick McGinnis Professor of Marketing at Olin Business School.

Seetharaman says the success of “ingeniously crafted” inexpensive viral ad campaigns, such as BlendTec’s “Will it Blend?” YouTube campaign for its blenders, indicates that such non-traditional, low-cost/high-impact promotional campaigns will be on the rise moving forward.

Product placements, though they’ve been around a long time, will continue to gain popularity as well in place of more traditional advertising, he says.

“The movie Transformers 3 created a record, even by Hollywood standards, in terms of the number of brands that were ‘product placed’ within the movie,” Seetharaman says. “This will catch on in the future, although the concept of product placements goes back to the times of the Marx Brothers.”

The reason for its reemergence, he says, is that there are very few opportunities these days to get consumers in a “captive” mode of having no choice but to take in the brand being advertised.

“One of those few opportunities is being stuck in a dark auditorium, consuming entertainment, having no choice of whitening out a brand on screen, or using a DVR to fast-forward,” Seetharaman says. “In fact, product placements are also on the rise in sitcoms, video games and other media for the same reason.

“In fact,” he says, “pre-movie advertising interspersed between movie trailers will increase as well.”

Social media will play a critical role in product development, as well as advertising.

“I think crowdsourcing is only going to increase,” Seetharaman says.

Crowdsourcing refers to the open innovation model, pioneered by sites like Threadless.com, where customers design and vote on new product designs.

This allows them to take active charge of the new product development process, rather than reacting to product concepts developed by firms, he says.

“This product development model has already moved to information markets like the Huffington Post, and is now moving to high-ticket products such as furniture and cars, albeit for limited target markets for now,” Seetharaman says.

Given the popularity of campaigns such as the T-Mobile Flash Mob, one is more likely to see non-traditional “grassroots” campaigns get more noticed than traditional billboard advertising in city streets.

“With the explosion of smartphones, these grassroots campaigns are swiftly recorded by people and then posted on YouTube in short order, which then makes these guerilla campaigns go viral in a big way,” Seetharaman says. “This ‘guerrilla promotion’ style of advertising will blossom in 2012 and beyond.”

Released: 12/21/2011

Source: Washington University in St. Louis

Related Link:

http://www.newswise.com/articles/marketing-trends-in-2012-traditional-expensive-advertising-no-longer-effective-says-wustl-expert

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