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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People Lie More When Texting

Wichita State University professor David Xu said people are less likely to lie via video chat than when in person.

Newswise — Sending a text message leads people to lie more often than in other forms of communication, according to new research by David Xu, assistant professor in the W. Frank Barton School of Business at Wichita State University.

Xu is lead author of the paper, which compares the level of deceit people will use in a variety of media, from text messages to face-to-face interactions.

The study will appear in the March edition of the Journal of Business Ethics. The other co-authors are professor Karl Aquino and associate professor Ronald Cenfetelli with the Sauder School of Business at the University of British Columbia.

How the study worked

The study involved 170 students from the Sauder School performing mock stock transactions in one of four ways: face-to-face, or by video, audio or text chatting.

Researchers promised cash awards of up to $50 to increase participants’ involvement in the role play. “Brokers” were promised increased cash rewards for more stock sales, while “buyers” were told their cash reward would depend on the yet-to-be-determined value of the stock.

The brokers were given inside knowledge that the stock was rigged to lose half of its value. Buyers were only informed of this fact after the mock sales transaction and were asked to report whether the brokers had employed deceit to sell their stock.

The authors then analyzed which forms of communication led to more deception. They found that buyers who received information via text messages were 95 percent more likely to report deception than if they had interacted via video, 31 percent more likely to report deception when compared to face-to-face, and 18 percent more likely if the interaction was via audio chat.

The fact that people were less likely to lie via video than in person was surprising, Xu said, but makes sense given the so-called “spotlight” effect, where a person feels they’re being watched more closely on video than face-to-face.

Xu said this kind of research has implications for consumers to avoid problems such as online fraud, and for businesses looking to promote trust and build a good image, Xu said.

Released: 1/25/2012

Source: Wichita State University

Related Link:

http://www.newswise.com/articles/people-lie-more-when-texting

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

We May Be Less Happy, but Our English Language Isn’t

Newswise — “If it bleeds, it leads,” goes the cynical saying with television and newspaper editors. In other words, most news is bad news and the worst news gets the big story on the front page.

So one might expect the New York Times to contain, on average, more negative and unhappy types of words — like “war,” ” funeral,” “cancer,” “murder” — than positive, happy ones — like “love,” “peace” and “hero.”

Or take Twitter. A popular image of what people tweet about may contain a lot of complaints about bad days, worse coffee, busted relationships and lousy sitcoms. Again, it might be reasonable to guess that a giant bag containing all the words from the world’s tweets — on average — would be more negative and unhappy than positive and happy.

But new research shows just the opposite.

“English, it turns out, is strongly biased toward being positive,” said Peter Dodds, an applied mathematician at the University of Vermont.

The UVM team’s study “Positivity of the English Language,” is presented in the Jan. 11 issue of the journal PLoS ONE.

This new study complements another study the same Vermont scientists presented in the Dec. 7 issue of PLoS ONE, “Temporal Patterns of Happiness and Information in a Global Social Network.”

That work attracted wide media attention showing that average global happiness, based on Twitter data, has been dropping for the past two years.

Combined, the two studies show that short-term average happiness has dropped — against the backdrop of the long-term fundamental positivity of the English language.

In the new study, Dodds and his colleagues gathered billions of words from four sources: twenty years of the New York Times, the Google Books Project (with millions of titles going back to 1520), Twitter and a half-century of music lyrics.

“The big surprise is that in each of these four sources it’s the same,” says Dodds. “We looked at the top 5,000 words in each, in terms of frequency, and in all of those words you see a preponderance of happier words.”

Or, as they write in their study, “a positivity bias is universal,” both for very common words and less common ones and across sources as diverse as tweets, lyrics and British literature.

Why is this? “It’s not to say that everything is fine and happy,” Dodds says. “It’s just that language is social.”

In contrast to traditional economic theory, which suggests people are inherently and rationally selfish, a wave of new social science and neuroscience data shows something quite different: that we are a pro-social storytelling species. As language emerged and evolved over the last million years, positive words, it seems, have been more widely and deeply engrained into our communications than negative ones.

“If you want to remain in a social contract with other people, you can’t be a…,” well, Dodds here used a word that is rather too negative to be fit to print — which makes the point.

This new work adds depth to the Twitter study that the Vermont scientists published in December that attracted attention from NPR, Time magazine and other media outlets.

“After that mild downer story, we can say, ‘But wait — there’s still happiness in the bank,” Dodds notes. “On average, there’s always a net happiness to language.”

Both studies drew on a service from Amazon called Mechanical Turk. On this website, the UVM researchers paid a group of volunteers to rate, from one to nine, their sense of the “happiness” — the emotional temperature — of the 10,222 most common words gathered from the four sources. Averaging their scores, the volunteers rated, for example, “laughter” at 8.50, “food” 7.44, “truck” 5.48, “greed” 3.06 and “terrorist” 1.30.

The Vermont team — including Dodds, Isabel Kloumann, Chris Danforth, Kameron Harris, and Catherine Bliss — then took these scores and applied them to the huge pools of words they collected. Unlike some other studies — with smaller samples or that elicited strong emotional words from volunteers — the new UVM study, based solely on frequency of use, found that “positive words strongly outnumber negative words overall.”

This seems to lend support to the so-called Pollyanna Principle, put forth in 1969, that argues for a universal human tendency to use positive words more often, easily and in more ways than negative words.

Of course, most people would rank some words, like “the,” with the same score: a neutral 5. Other words, like “pregnancy,” have a wide spread, with some people ranking it high and others low. At the top of this list of words that elicited strongly divergent feelings: “profanities, alcohol and tobacco, religion, both capitalism and socialism, sex, marriage, fast foods, climate, and cultural phenomena such as the Beatles, the iPhone, and zombies,” the researchers write.

“A lot of these words — the neutral words or ones that have big standard deviations — get washed out when we use them as a measure,” Dodds notes. Instead, the trends he and his team have observed are driven by the bulk of English words tending to be happy.

If we think of words as atoms and sentences as molecules that combine to form a whole text, “we’re looking at atoms,” says Dodds. “A lot of news is bad,” he says, and short-term happiness may rise and and fall like the cycles of the economy, “but the atoms of the story — of language — are, overall, on the positive side.”

Released: 1/12/2012

Source: University of Vermont

Related Link:

http://www.newswise.com/articles/we-may-be-less-happy-but-our-language-isn-t

Pick Up the Cell Phone, Drop the Pounds!

Photo Credit: UC San Diego School of Medicine Pictured: The team from CalIT2's Center for Wireless and Population Health Systems.

Newswise — Cell phones aren’t just for talking any more. Surfing the web, storing music and posting to Facebook have all contributed to the near-mandatory use of a cell phone. How about using that cell phone to lose weight? Researchers with Calit2’s Center for Wireless and Population Health Systems (CWPHS) and the Department of Family and Preventive Medicine, at University of California, San Diego are expanding a previous study aimed at finding out if cell phone technology can help with weight loss.

For one year, researchers with the “ConTxt” study will evaluate the use of cell phone text messages to remind participants to make wise nutritional choices throughout the day. Participants randomized to the intervention conditions will also be given tailored messages for weight loss and lifestyle changes as well as a pedometer to monitor their daily activity.

“ConTxt is an innovative, yet straightforward approach to getting people to monitor their diet and physical activity,” says CWPHS project principal investigator Kevin Patrick, MD, MS, professor of Family and Preventive Medicine, UC San Diego School of Medicine. “We are trying to make this as pain free as possible. People won’t stick to something that’s too difficult and they’re all multi-tasking anyway. We’re doing this study to increase what we know about using the cell phone to get messages to busy people on the go.”

Who Can Participate?

ConTxt is recruiting more than 300 participants who meet these criteria:

*Men and women
*21 to 60 years of age
*Overweight or moderately obese with Body Mass Index (BMI) of 27-39.9
*Own a cell phone capable of sending and receiving picture and text messages
*English and Spanish speaking participants that reside in San Diego county

Strategy

As a part of tailoring of the program, surveys completed during baseline visit will help assess the participant’s lifestyle, for example, assessing nearby grocery stores, finding opportunities for physical activity and possibly enlisting the support of friends or family.

The intervention is designed to send “prompts,” text or picture messages, with specific suggestions or tips regarding diet and improving lifestyle habits. “It seems like everybody has a cell phone. Those who do usually carry it with them at all times,” explained ConTxt study coordinator Lindsay W. Dillon, MPH, CHES. “We want to see if we can use that same technology to get people to think differently.”

About CWPHS

CWPHS research focuses on how the health of individuals, families, communities, social networks, and populations can be improved through the creative use of wireless and networked technologies. CWPHS is Housed within the UCSD Division of Calit2: The California Institute for Telecommunications and Information Technology.

Collaborators include physicians and scientists with backgrounds in clinical and preventive medicine, computer science and engineering, social networks, political science, clinical and experimental psychology, electrical engineering, health behavior, behavioral exercise and nutrition science and public health. Center research is supported through public and private sources, including the National Institutes of Health, the U.S. Centers for Disease Control and Prevention, the National Science Foundation, the Robert Wood Johnson Foundation, the American Cancer Society, and Nokia Research.

To learn more about enrolling in the ConTxt study, call in USA        858-534-8412       or email us at contxtcoach@ucsd.edu.

Via Newswise

Source: University of California, San Diego Health Sciences

Related Link:

http://newswise.com/articles/pick-up-the-cell-phone-drop-the-pounds2

Time for a Change? Johns Hopkins Scholars Say Calendar Needs Serious Overhaul

Newswise — Researchers at The Johns Hopkins University have discovered a way to make time stand still — at least when it comes to the yearly calendar.

Using computer programs and mathematical formulas, Richard Conn Henry, an astrophysicist in the Krieger School of Arts and Sciences, and Steve H. Hanke, an applied economist in the Whiting School of Engineering, have created a new calendar in which each new 12-month period is identical to the one which came before, and remains that way from one year to the next in perpetuity.

Under the Hanke-Henry Permanent Calendar, for instance, if Christmas fell on a Sunday in 2012 (and it would), it would also fall on a Sunday in 2013, 2014 and beyond. In addition, under the new calendar, the rhyme “30 days hath September, April, June and November,” would no longer apply, because September would have 31 days, as would March, June and December. All the rest would have 30. (Try creating a rhyme using that.)

“Our plan offers a stable calendar that is absolutely identical from year to year and which allows the permanent, rational planning of annual activities, from school to work holidays,” says Henry, who is also director of the Maryland Space Grant Consortium. “Think about how much time and effort are expended each year in redesigning the calendar of every single organization in the world and it becomes obvious that our calendar would make life much simpler and would have noteworthy benefits.”

Among the practical advantages would be the convenience afforded by birthdays and holidays (as well as work holidays) falling on the same day of the week every year. But the economic benefits are even more profound, according to Hanke, an expert in international economics, including monetary policy.

“Our calendar would simplify financial calculations and eliminate what we call the ‘rip off’ factor,’” explains Hanke. “Determining how much interest accrues on mortgages, bonds, forward rate agreements, swaps and others, day counts are required. Our current calendar is full of anomalies that have led to the establishment of a wide range of conventions that attempt to simplify interest calculations. Our proposed permanent calendar has a predictable 91-day quarterly pattern of two months of 30 days and a third month of 31 days, which does away with the need for artificial day count conventions.”

According to Hanke and Henry, their calendar is an improvement on the dozens of rival reform calendars proffered by individuals and institutions over the last century.

“Attempts at reform have failed in the past because all of the major ones have involved breaking the seven-day cycle of the week, which is not acceptable to many people because it violates the Fourth Commandment about keeping the Sabbath Day,” Henry explains. “Our version never breaks that cycle.”

Henry posits that his team’s version is far more convenient, sensible and easier to use than the current Gregorian calendar, which has been in place for four centuries – ever since 1582, when Pope Gregory altered a calendar that was instituted in 46 BC by Julius Caesar.

In an effort to bring Caesar’s calendar in synch with the seasons, the pope’s team removed 11 days from the calendar in October, so that Oct. 4 was followed immediately by Oct. 15. This adjustment was necessary in order to deal with the same knotty problem that makes designing an effective and practical new calendar such a challenge: the fact that each Earth year is 365.2422 days long.

Hanke and Henry deal with those extra “pieces” of days by dropping leap years entirely in favor of an extra week added at the end of December every five or six years. This brings the calendar in sync with the seasonal changes as the Earth circles the sun.

In addition to advocating the adoption of this new calendar, Hanke and Henry encourage the abolition of world time zones and the adoption of “Universal Time” (formerly known as Greenwich Mean Time) in order to synchronize dates and times worldwide, streamlining international business.

“One time throughout the world, one date throughout the world,” they write in a January 2012 Global Asia article about their proposals. “Business meetings, sports schedules and school calendars would be identical every year. Today’s cacophony of time zones, daylight savings times and calendar fluctuations, year after year, would be over. The economy — that’s all of us — would receive a permanent ‘harmonization’ dividend.”

View a website about the Hanke-Henry Permanent Calendar here:
http://henry.pha.jhu.edu/calendar.html

Read Hanke and Henry’s January 2012 Global Asia article about calendar reform here:
http://www.cato.org/pub_display.php?pub_id=13940

Released: Released: 12/27/2011

Source: Johns Hopkins

Related Link:

http://newswise.com/articles/time-for-a-change-johns-hopkins-scholars-say-calendar-needs-serious-overhaul

Looking Ahead to the New Year…..Top Tech of 2012

Newswise — Retinal Prostheses: Implantable chips will apply a grid of photosensors to the optic nerve, giving blind people a form of vision.

LED Lighting: Super-efficient, affordable bulbs based on the Philips L Prize winner and other designs will replace incandescents and, in many cases, compact fluorescent lamps.

Windows 8: Microsoft has so far been sidelined by the industry-wide move to mobile platforms, such as smart phones and tablets. This new operating system is the Redmond, Wash., company’s last, best hope to turn things around.

Chinese Supercomputers: For the first time China is building world-class supercomputers based on home-grown processor chips, and experts say this could be the beginning of that country’s push into the highest-tech regions of high tech.

3-D Printing: This idea, which began as a tool for designers and evolved into a toy for hobbyists, is now maturing into a new, one-off kind of fabrication, one that will find its way into routine manufacturing as well as the production of spare parts.

Plug-ins Proliferate: This will be the year in which plug-in gas-electric hybrid cars go from curiosity to mainstay, as the number of manufacturers offering models rises and the market for their wares matures.

EV Charging Stations: A fast-charging infrastructure, partly based on super-powerful direct current, will begin to service pure-electric vehicles, thus allaying drivers’ “range anxiety.”

3-D Chips: A long-anticipated foray into the third dimension will turn flat chips into thick cubes, increasing the density of elements in integrated circuits in an entirely new way and thus giving Moore’s Law a new lease on life.

Extreme UV Lithography: This is the year of decision for an expensive chip-fabrication technology that uses hard-to-handle extreme ultraviolet light to draw finer-than-ever features on silicon chips. Whether EUV lithography succeeds or fails, the result will be of critical importance to the industry.

Private Spacecraft: Millionaires are doing what government cannot–they are creating companies that will take people and cargo into space at a fraction of the cost of NASA launches.

Exoskeletons for Paraplegics: People who have suffered from spinal-cord injuries will for the first time strap themselves into robotic exoskeletons. Initially, these machines will help rehabilitate patients; later, the exoskeletons will take them where their own legs cannot.

4G Networks: Smart phones and other mobile platforms will carry real-time video and do other network duties with a zip never before seen, thanks to this new and very capacious wireless standard.

Grid-level Batteries: As the electric power distribution system–the grid–comes to depend on variable sources of energy, such as the wind and the sun, it will increasingly smooth out the power by using enormous battery stations.

Another Earth: New telescopes and instrumentation will guide astronomers to hundreds of planets orbiting foreign stars and will reveal candidate planets of a size, composition, and temperature suitable for life as we know it.

Released: 12/22/2011

Source: IEEE Spectrum Magazine

Related Link:

http://newswise.com/articles/top-tech-of-2012

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