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Ensuring Adequate Care For Pregnant Women And Newborns During An Influenza Pandemic
Pregnant women and newborns are at greatest risk in a flu epidemic, but more planning must be done to ensure that they receive priority treatment should an outbreak occur, according to a University of Pittsburgh Medical Center (UPMC) and University of Pittsburgh study. The findings, published online in Emerging Health Threats Journal, raise concerns about the ability of hospitals to adequately treat this vulnerable population, particularly in light of the current H1N1 flu outbreak.

Some Small Businesses Must Cut Employee Health Benefits Or Lay Off Workers Amid Economic Recession
Small businesses increasingly are eliminating their employee health coverage plans because of rising health care premiums and declining revenue attributed to the current economic recession, the Wall Street Journal reports. About 10% of small companies are considering ending their employee health coverage plans over the next year, compared with 3% of small businesses in 2005, according to a recent survey by the National Small Business Association. In 2008, 38% of small companies offered health coverage, compared with 41% in 2007 and 61% in 1993, according to NSBA. According to a Hewitt Associates survey, 19% of all U.S. businesses plan to halt providing health care benefits to their employees in the next three to five years.A rise in health care coverage premiums has contributed to employers eliminating plans, according to the Journal. Premiums for single policies increased by 74% for small businesses from 2001 to 2008, according to the Kaiser Family Foundation. According to Scott Krienke, senior vice president of product lines for Assurant Health, health insurance premiums for small businesses increase by 8% to 16% annually on average, with smaller firms often having the highest increases. According to the Journal, many employers are choosing to eliminate health coverage instead of eliminating jobs or closing down their business. Some businesses have chosen instead to shift more health care costs to workers, change health insurers, switch prescription drug plans to encourage employees to purchase more generic drugs or offer employees wellness plans that encourage healthy habits as a strategy to reduce health care costs, the Journal reports (Mattioli, Wall Street Journal, 5/26).
News of the day
GPs Have Difficulty Separating Those With And Without Depression In Primary Care
A meta-analysis of more than 50,000 patients has shown that general practitioners (GPs) continue to have difficulty separating those with and without depression, with substantial numbers missed and misidentified. GPs looking for depression make more misidentifications (false positives of depression) than the number of depressions they correctly spot following an initial consultation but accuracy could improved by re-assessment of people suspected of having depression. These are the conclusions of an Article published Online First and in an upcoming edition of The Lancet, written by Dr Alex Mitchell, Dr Amol Vaze, and Dr Sanajay Rao of Leicester Partnership Trust and University of Leicester, Leicester, UK.
Mental Health

More Research Needed To Help Workers With Upper Limb Disorders

A severe lack of evidence is holding doctors back from providing the right treatment for workers suffering from Upper Limb Disorders, according to new research by the NHS Plus funded Occupational Health Clinical Effectiveness Unit (OHCEU) at the Royal College of Physicians. Upper Limb Disorders is an umbrella term for a number of common conditions of the shoulder, arm, wrist and hand, including carpal tunnel syndrome which is estimated to affect around 5% of UK adults The review by the OHCEU"s Guideline Development Group (GDG) looked for evidence on the best way to manage four specific conditions; carpal tunnel syndrome, non-specific arm pain, tenosynovitis and lateral epicondylitis. The GDG found only four papers of acceptable quality looking at how people with these conditions could be helped in their workplace. The group is now calling for researchers to build an evidence base to inform future management The group believe research is needed in the following areas: - Establishing clear and consistent definitions for the various disorders studied - Assessing outcomes such as job retention and sickness absence in relation to multi-disciplinary rehabilitation. - The effect of modern keyboard design on occupational outcomes in comparison with current standard workstation equipment. Despite the scarcity of evidence, the GDG was able to make a number of recommendations for occupational health practitioners and employers with employees suffering from these conditions. These include: - Allowing people with carpal tunnel syndrome to try out alternative computer keyboards - Offering or facilitating a multi-discipline rehabilitation to workers with non-specific arm pain who have been absent from work for more than four weeks. Commenting on the new guideline, Dr Sian Williams, Clinical Director of the OHCEU, said: "The major benefit of this review is that it has revealed the lack of high quality research on workplace management of Upper Limb Disorders. Our recommendations provide a starting point for clinicians and employers managing workers with Upper Limb Disorders and for researchers planning studies in this area." Dr Ira Madan, Director of Clinical Standards at NHS Plus, said: "For the first time all the evidence on the effectiveness of occupational health interventions in the management of upper limb pain in the workplace has been collated into one document. NHS Plus is concerned by the lack of research in this important area and we would encourage academic departments to fill the gaps in the evidence base. NHS Plus recognises that there is a need to identify and prioritise gaps in occupational health clinical effectiveness research and will be incorporating this aim into its future project plan." Professor David Coggon, President of the Faculty of Occupational Medicine, commented: "Upper Limb Disorders are a major cause of incapacity for work in the UK. The OHCEU Review is helpful in prioritising questions for research so that these conditions can be managed more effectively in the workplace." Notes 1. OHCEU is funded by NHS Plus, and operated in partnership by the Royal College of Physicians and the Faculty of Occupational Medicine. 2. The primary purpose of the OHCEU is to improve the quality of occupational health in the NHS. It will also make evidence-based guidelines and associated implementation strategies available for the wider delivery of occupational health care in the UK. The NHS Plus Project aims to improve the quality and delivery of occupational health services to NHS staff and in turn increase the availability of NHS Plus services to small and medium employers. 3. Clinical audit is about improving the quality of care. It is conventionally considered as a cycle with a number of key elements including: Determining what the standard is for practice; Measuring practice; Improving practice to approximate to the accepted standard; Re-measuring practice. Royal College of Physicians


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