Tuesday, April 3, 2012

Patients want immediate access to radiology test results

Patients want immediate access to radiology test results [ Back to EurekAlert! ] Public release date: 2-Apr-2012
[ | E-mail | Share Share ]

Contact: Marguerite Beck
marbeck@wakehealth.edu
336-716-2415
Wake Forest Baptist Medical Center

WINSTON-SALEM, N.C. -- You've been experiencing severe back pain and weakness in your right leg. Your doctor orders a spinal MRI to help determine the cause. The radiology report diagnoses cancer.

Would you rather read the detailed medical report right away at home or wait until your doctor was available to explain the test results, diagnosis and treatment options?

This scenario was part of a study at Wake Forest Baptist Medical Center designed to determine if patients wanted online access to radiology test results and, if so, how quickly.

The pilot study, published in the April 2 issue of the Journal of the American College of Radiology, showed that about half the participants preferred immediate access and about a third preferred access within three days, even in the face of very serious findings written in complex medical language and the knowledge that their doctor might not be available to discuss the results with them right away.

"Our study showed that even though the participants didn't completely understand the medical terminology, they wanted to be able to read the detailed report as soon as possible," said Annette Johnson, M.D., associate professor of radiology at Wake Forest Baptist and principal investigator of the study.

"One of the primary tenets in the drive to improve the quality of medical care is that services need to be delivered in ways that directly meet patients' needs and preferences," she said. "While current medical practice requires that radiologic test results go to the patient indirectly, usually verbally via the referring physician, this practice can potentially create delays, increase patient anxiety and compromise communications between patients and doctors."

An emerging trend in health care is establishing secure online systems that allow patients to access electronic health records. Multiple studies suggest that patients increasingly want to obtain information directly and be involved in making medical decisions. And research shows that this type of increased patient engagement has been associated with improved health outcomes and patient well-being.

In the Wake Forest Baptist study, 53 adult outpatients from the hospital's imaging center completed researcher-administered electronic questionnaires. Participants were presented with three simulated clinical scenarios and asked to answer questions based on what they thought they would do in each case.

The three scenarios were: a patient suffering from headaches whose head CT showed a normal-appearing brain but some sinusitis; a patient experiencing double vision whose brain MRI showed multiple brain lesions from an unknown cause, possibly multiple sclerosis or vasculitis; and the patient with back pain and right leg weakness whose MRI showed cancer compressing spinal nerves. In addition, the participants were asked about their preferred timing for online access to reports, communication methods, educational resources and alternative formats.

Eighty-one percent of the participants said they likely would use an online portal to access radiologic test results if such a system were available. Forty-three percent said they preferred the online portal over any other method of notification, including a phone call from a nurse or a physician, a mailed letter explaining the results, an email explaining the results or a return visit with their doctor.

For each of the three scenarios, immediate access was the most preferred option, and more than 80 percent of the participants wanted online access within three days. Preferences for timing did not vary significantly across the three scenarios or by participant's age or gender, according to the study findings.

Although the participants strongly preferred the online approach, doctors do have concerns about patients being able to understand test results, which could lead to increased anxiety, Johnson said.

"Doctors have been trained to be protective of their patients and don't want to hurt them in any way," Johnson said. "However, many patients want their detailed medical information and as doctors we can't be overly fearful of what will happen if we provide it for them."

Very few hospitals in the United States currently offer their patients online access to radiology reports and the "wait" time is typically a week or more, Johnson said. Wake Forest Baptist is in the process of developing a secure patient-access web portal that will have a three-day turnaround time when it is launched this fall.

###

Co-authors of the study are: Doug Easterling, Ph.D., Michael Chen, M.D., of Wake Forest Baptist, Roman Nelson, a student at Wake Forest University, and Richard Frankel, Ph.D., of Indiana University-Purdue University Indianapolis.



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Patients want immediate access to radiology test results [ Back to EurekAlert! ] Public release date: 2-Apr-2012
[ | E-mail | Share Share ]

Contact: Marguerite Beck
marbeck@wakehealth.edu
336-716-2415
Wake Forest Baptist Medical Center

WINSTON-SALEM, N.C. -- You've been experiencing severe back pain and weakness in your right leg. Your doctor orders a spinal MRI to help determine the cause. The radiology report diagnoses cancer.

Would you rather read the detailed medical report right away at home or wait until your doctor was available to explain the test results, diagnosis and treatment options?

This scenario was part of a study at Wake Forest Baptist Medical Center designed to determine if patients wanted online access to radiology test results and, if so, how quickly.

The pilot study, published in the April 2 issue of the Journal of the American College of Radiology, showed that about half the participants preferred immediate access and about a third preferred access within three days, even in the face of very serious findings written in complex medical language and the knowledge that their doctor might not be available to discuss the results with them right away.

"Our study showed that even though the participants didn't completely understand the medical terminology, they wanted to be able to read the detailed report as soon as possible," said Annette Johnson, M.D., associate professor of radiology at Wake Forest Baptist and principal investigator of the study.

"One of the primary tenets in the drive to improve the quality of medical care is that services need to be delivered in ways that directly meet patients' needs and preferences," she said. "While current medical practice requires that radiologic test results go to the patient indirectly, usually verbally via the referring physician, this practice can potentially create delays, increase patient anxiety and compromise communications between patients and doctors."

An emerging trend in health care is establishing secure online systems that allow patients to access electronic health records. Multiple studies suggest that patients increasingly want to obtain information directly and be involved in making medical decisions. And research shows that this type of increased patient engagement has been associated with improved health outcomes and patient well-being.

In the Wake Forest Baptist study, 53 adult outpatients from the hospital's imaging center completed researcher-administered electronic questionnaires. Participants were presented with three simulated clinical scenarios and asked to answer questions based on what they thought they would do in each case.

The three scenarios were: a patient suffering from headaches whose head CT showed a normal-appearing brain but some sinusitis; a patient experiencing double vision whose brain MRI showed multiple brain lesions from an unknown cause, possibly multiple sclerosis or vasculitis; and the patient with back pain and right leg weakness whose MRI showed cancer compressing spinal nerves. In addition, the participants were asked about their preferred timing for online access to reports, communication methods, educational resources and alternative formats.

Eighty-one percent of the participants said they likely would use an online portal to access radiologic test results if such a system were available. Forty-three percent said they preferred the online portal over any other method of notification, including a phone call from a nurse or a physician, a mailed letter explaining the results, an email explaining the results or a return visit with their doctor.

For each of the three scenarios, immediate access was the most preferred option, and more than 80 percent of the participants wanted online access within three days. Preferences for timing did not vary significantly across the three scenarios or by participant's age or gender, according to the study findings.

Although the participants strongly preferred the online approach, doctors do have concerns about patients being able to understand test results, which could lead to increased anxiety, Johnson said.

"Doctors have been trained to be protective of their patients and don't want to hurt them in any way," Johnson said. "However, many patients want their detailed medical information and as doctors we can't be overly fearful of what will happen if we provide it for them."

Very few hospitals in the United States currently offer their patients online access to radiology reports and the "wait" time is typically a week or more, Johnson said. Wake Forest Baptist is in the process of developing a secure patient-access web portal that will have a three-day turnaround time when it is launched this fall.

###

Co-authors of the study are: Doug Easterling, Ph.D., Michael Chen, M.D., of Wake Forest Baptist, Roman Nelson, a student at Wake Forest University, and Richard Frankel, Ph.D., of Indiana University-Purdue University Indianapolis.



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Monday, April 2, 2012

Top Marriage Advice Blog, RockinMarriage.com, Announces ...

rockinmarriage.com-save-marriage

rockinmarriage.com-save-marriage

Marriage can be awfully entertaining, but it isn?t entertainment.

San Diego, CA (PRWEB) April 02, 2012

RockinMarriage.com is quickly becoming one of the world?s most read marriage advice blogs. Offering daily tips and advice for married couples across the globe, information can be read directly from their blog, or via a daily digest email.

In their latest blog post, Ed and Cathy Lorient discuss the influx of relationship-based television. The new blog post is titled, ?What does the Kardashian Divorce say about the Value of Marriage??

The blog post can be accessed here:

http://rockinmarriage.com/what-does-the-kardashian-divorce-say-about-the-value-of-marriage/

Kicking off their latest blog post, Cathy touches on the recent news that Kim Kardashian has filed for divorce just 72 hours after getting married. A new Huffington Post article says that the Kardashian divorce, like their marriage, may become a televised event.

?Kardashian has gotten a great deal of backlash from the public, the media and other celebrities because of her supposed attempts to sell her brand by building up to a wedding and then filing for divorce 72 hours later? says Cathy.

Cathy then claims that some people may believe that divorce is ?just a publicity stunt?.

The blog post then proceeds to note concern that a lot of television these days has turned romance into drama, detracting from the true value of marriage, love and relationships.

?If the people growing up on these shows grow up feeling that marriage is a temporary situation and one that can be entered into on a whim, then we?ll certainly see those divorce statistics rise? Cathy adds.

Following this, Cathy makes a point that if people watch reality shows, they should also keep themselves in check. She makes the point that, if shows like this continue, will it make everyone believe that it is okay to marry two, three or more times on a whim?

?We also need to talk to our kids about the way marriage and divorce is portrayed on TV and in the movies today. Kids don?t start out thinking divorce is an accepted solution to boredom or differences, they learn that it is? Cathy concludes.

Where can married couples learn more? Learn how to save marriage by subscribing to Rockin Marriage for free. Visit their daily tips website at RockinMarriage.com.

RockinMarriage (?) thinks this is important information for married couples and asks them to Like our Page on Facebook to learn exclusive daily marriage tips, strategies and new, all with the aim of preserving life?s most precious bond. "We?d appreciate your help in spreading the word amongst married couples," says Ed and Cathy.

Like this? Check out RockinMarriage?s last article: Top Marriage Advice Blog, RockinMarriage.com, Announces Challenge to Readers: Will their Marriage Work Once they?re Parents?


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Article source: http://www.prweb.com/releases/rockinmarriage/savemarriage/prweb9357013.htm

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Sunday, April 1, 2012

Security Systems ? Secure You And Your Family ? A Green ...

[unable to retrieve full-text content]Security Systems ? Secure You And Your Family. A security alarm alarm is probably the most worthwhile money for ensuring the safety of your house and family. That behavioral instinct to secure one's life gets to be a drive for ...

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Caregiver For Elderly Parents | Parent Caregiving

PDF fileTaking Care Of The Caregiver
Taking Care of the Caregiver Written by Chris Cooper, CFP® absences to care for their elderly loved ones. Absenteeism is also noted, especially, in workers can be demanding, but it also has special rewards, such as returning the care that one?s parents gave ? Visit Document

PDF fileNew York State Policy Agenda For Family Caregivers
Are themselves old, provide between 75-80% oflong-term-, home-, and community-based care for elderly Among the members ofthe Family Caregiving Council should be representatives ofvarious caregiver populations, including spouses and adult children, partners, parents ofchildren with special health care ? Retrieve Content

PDF fileState Of The States In Family Caregiver Support
Law to facilitate extended family members who are caring for related children and allows parents to Family Caregivers Yes State Program Information ??? Administrative Structure ??? Program Name Family Caregiver Support Program (FCSP) (FC) Home and Community-Based Long-Term Care for Non-Medicaid Elderly and ? Read Here

PDF fileIn-home care for Elderly And Disabled
My parents have been married 60 years. They live in the house they moved into 40 years ago. can be temporary and tailored to meet the needs both of the care receiver and the caregiver In-home care TIRED OF MINIMUM WAGES? $10.00/hr. Need nonsmoking home-care aide to assist elderly woman with personal care and ? Read Document

PDF fileHow To Create Your Own Caregiver
How to Create Your Own Caregiver Handbook : Thinking Nationally, Acting Locally pbs.org/caringforyourparents Why Create a Caregiver Handbook ? Anyone who has been through a crisis with an elderly relative or friend can tell you how difficult it is to find services, or even to grasp the range of ? Visit Document

WikipediaLong-term care ? Wikipedia, The Free Encyclopedia
Long-term care provided formally in the home, also known as home health care, can incorporate a will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. The country?s LTC fund may also make pension contributions if an informal caregiver works more than 14 ? Read Article

WikipediaAssisted Living ? Wikipedia, The Free Encyclopedia
Other licensure terms used for this philosophy of care include residential care home, assisted care living facilities, and personal care homes. This greatly reduces the isolation that elderly, disabled people may suffer when living alone and who are afraid (usually for physical reasons) to leave ? Read Article

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Oxygen in tumors predicts prostate cancer recurrence

Oxygen in tumors predicts prostate cancer recurrence [ Back to EurekAlert! ] Public release date: 31-Mar-2012
[ | E-mail | Share Share ]

Contact: Geoff Koehler
geoff.koehler@uhn.ca
416-340-4011
University Health Network

TORONTO -- Low oxygen levels in tumors can be used to predict cancer recurrence in men with intermediate-risk prostate cancer even before they receive radiation therapy.

The clinical research, led by radiation oncologists at the Princess Margaret Hospital (PMH) Cancer Program, University Health Network (UHN) is published online today in Clinical Cancer Research, a journal of the American Association for Cancer Research (doi: 10.1158/1078-0432.CCR-11-2711).

"We've not only shown that men do worse if they have low oxygen levels (hypoxia) in their prostate cancer, but that they also do worse over a shorter period of time," says Dr. Michael Milosevic, radiation oncologist in the PMH Cancer Program, UHN. "These patients seem to develop cancer recurrence within only a few years of completing treatment."

"This information could change the way prostate cancer is treated and goes a long way to ensuring that all patients receive the right treatment from the outset based on their individual tumour," says Dr. Milosevic, who is also a professor of radiation oncology at the University of Toronto. "At the heart of it, this is what personalized medicine is all about."

Prostate cancer is commonly treated with surgery or radiation therapy, and yet cancer recurs or spreads in about 25% of treated men. The discovery of indicators, such as low oxygen in tumours, enables doctors to better select the most appropriate and effective treatments for each patient even before radiation therapy is delivered.

Dr. Milosevic and colleagues measured oxygen levels in 247 men with localized prostate cancer prior to radiation therapy and followed them for a median of 6.6 years. Low oxygen in the tumors predicted early relapse after radiation treatment. It was also the only identified factor that predicted local recurrence during follow-up.

"We believe that a tumour's genetic signature will be another promising predictor of recurrence," says Dr. Robert Bristow, radiation oncologist in the PMH Cancer Program, UHN, and professor in the departments of radiation oncology and medical biophysics at the University of Toronto. "Combined, these indicators may signal that the cancer has spread at a previously-undetectable level."

Dr. Milosevic and colleagues hope that identifying the factors that influence prostate cancer behavior will lead to the exploration of new drugs to target hypoxia in tumors. The findings may also accelerate the development of new treatment strategies informing physicians when complementary treatment may be more effective. .

"Knowing what works for which patient will make treatment more effective and improve outcomes for patients," says Dr. Milosevic.

###

The research was funded by United States Army Prostate Cancer Research Program, Terry Fox Program Project Grant through the National Cancer Institute of Canada and Terry Fox Foundation New Frontiers Program Project Grant through the Canadian Cancer Society Research Institute. Dr. Milosevic's research is also supported by The Princess Margaret Hospital Foundation.

About Princess Margaret Hospital

Princess Margaret Hospital and its research arm, Ontario Cancer Institute, have achieved an international reputation as global leaders in the fight against cancer and delivering personalized cancer medicine. Princess Margaret Hospital, one of the top five international cancer research centres, is a member of the University Health Network, which also includes Toronto General Hospital, Toronto Western Hospital and Toronto Rehabilitation Institute. All are research hospitals affiliated with the University of Toronto. For more information, go to www.uhn.ca

Media contact:

Geoff Koehler,
Public Affairs, Princess Margaret Hospital,
University Health Network
416-340-4011
geoff.koehler@uhn.ca



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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Oxygen in tumors predicts prostate cancer recurrence [ Back to EurekAlert! ] Public release date: 31-Mar-2012
[ | E-mail | Share Share ]

Contact: Geoff Koehler
geoff.koehler@uhn.ca
416-340-4011
University Health Network

TORONTO -- Low oxygen levels in tumors can be used to predict cancer recurrence in men with intermediate-risk prostate cancer even before they receive radiation therapy.

The clinical research, led by radiation oncologists at the Princess Margaret Hospital (PMH) Cancer Program, University Health Network (UHN) is published online today in Clinical Cancer Research, a journal of the American Association for Cancer Research (doi: 10.1158/1078-0432.CCR-11-2711).

"We've not only shown that men do worse if they have low oxygen levels (hypoxia) in their prostate cancer, but that they also do worse over a shorter period of time," says Dr. Michael Milosevic, radiation oncologist in the PMH Cancer Program, UHN. "These patients seem to develop cancer recurrence within only a few years of completing treatment."

"This information could change the way prostate cancer is treated and goes a long way to ensuring that all patients receive the right treatment from the outset based on their individual tumour," says Dr. Milosevic, who is also a professor of radiation oncology at the University of Toronto. "At the heart of it, this is what personalized medicine is all about."

Prostate cancer is commonly treated with surgery or radiation therapy, and yet cancer recurs or spreads in about 25% of treated men. The discovery of indicators, such as low oxygen in tumours, enables doctors to better select the most appropriate and effective treatments for each patient even before radiation therapy is delivered.

Dr. Milosevic and colleagues measured oxygen levels in 247 men with localized prostate cancer prior to radiation therapy and followed them for a median of 6.6 years. Low oxygen in the tumors predicted early relapse after radiation treatment. It was also the only identified factor that predicted local recurrence during follow-up.

"We believe that a tumour's genetic signature will be another promising predictor of recurrence," says Dr. Robert Bristow, radiation oncologist in the PMH Cancer Program, UHN, and professor in the departments of radiation oncology and medical biophysics at the University of Toronto. "Combined, these indicators may signal that the cancer has spread at a previously-undetectable level."

Dr. Milosevic and colleagues hope that identifying the factors that influence prostate cancer behavior will lead to the exploration of new drugs to target hypoxia in tumors. The findings may also accelerate the development of new treatment strategies informing physicians when complementary treatment may be more effective. .

"Knowing what works for which patient will make treatment more effective and improve outcomes for patients," says Dr. Milosevic.

###

The research was funded by United States Army Prostate Cancer Research Program, Terry Fox Program Project Grant through the National Cancer Institute of Canada and Terry Fox Foundation New Frontiers Program Project Grant through the Canadian Cancer Society Research Institute. Dr. Milosevic's research is also supported by The Princess Margaret Hospital Foundation.

About Princess Margaret Hospital

Princess Margaret Hospital and its research arm, Ontario Cancer Institute, have achieved an international reputation as global leaders in the fight against cancer and delivering personalized cancer medicine. Princess Margaret Hospital, one of the top five international cancer research centres, is a member of the University Health Network, which also includes Toronto General Hospital, Toronto Western Hospital and Toronto Rehabilitation Institute. All are research hospitals affiliated with the University of Toronto. For more information, go to www.uhn.ca

Media contact:

Geoff Koehler,
Public Affairs, Princess Margaret Hospital,
University Health Network
416-340-4011
geoff.koehler@uhn.ca



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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


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Newman wins wild finish at Martinsville Speedway

Ryan Newman crosses the finish line to win the NASCAR Sprint Cup Series auto race Sunday, April 1, 2012, in Martinsville, Va. (AP Photo/Don Petersen)

Ryan Newman crosses the finish line to win the NASCAR Sprint Cup Series auto race Sunday, April 1, 2012, in Martinsville, Va. (AP Photo/Don Petersen)

Ryan Newman celebrates in victory lane after winning the NASCAR Sprint Cup Series auto race Sunday, April 1, 2012, in Martinsville, Va. (AP Photo/Don Petersen)

Clint Bowyer (15), Jeff Gordon (24) and Jimmie Johnson (48) get sideways during the closing laps of the NASCAR Sprint Cup Series auto race at Martinsville Speedway in Martinsville, Va., Sunday, April 1, 2012. (AP Photo/LAT, Scott LePage)

Jimmie Johnson (48) ends up backward against the wall after an incident involving Clint Bowyer (15) and Jeff Gordon (24), as Ryan Newman (39) takes the lead during the closing laps of the NASCAR Sprint Cup Series auto race at Martinsville Speedway in Martinsville, Va., Sunday, April 1, 2012. Newman won the race. (AP Photo/LAT, Scott LePage)

Clint Bowyer (15), Jeff Gordon (24) and Jimmie Johnson (48) get sideways while racing for the lead with just laps to go in the NASCAR Sprint Cup Series auto race at Martinsville Speedway on Sunday, April 1, 2012, in Martinsville, Va. Ryan Newman (39) won the race. (AP Photo/Steve Sheppard)

(AP) ? Ryan Newman ended a 22-race winless streak by holding on for the victory at Martinsville Speedway on Sunday, grabbing the lead when a three-wide accident took out leading teammates Jeff Gordon and Jimmie Johnson with two laps to go.

Gordon, who dominated all day, and Johnson seemed poised for a showdown in a green-white-checker finish, each eager to give Hendrick Motorsports its 200th victory.

But as the green flag flew on lap 503, Clint Bowyer sneaked inside Gordon's car heading into the first turn, and the three cars slid up the track as Newman zipped past.

A.J. Allmendinger finished second, followed by Dale Earnhardt Jr., Matt Kenseth and Martin Truex Jr. Johnson wound up 12th and Gordon, who led for 328 laps, finished 14th.

The finish overshadowed what had been a stirring duel between Gordon, a seven-time winner on the 0.526-mile oval, and Johnson, a six-time winner. It seemed certain to end with one of them giving owner Rick Hendrick a landmark Sprint Cup victory.

Johnson first took the lead when he passed Gordon on the 356th lap. He lost it on pit road, then passed Denny Hamlin on lap 393. He held off a modest challenge by Gordon with about 30 laps to go and then dueled side-by-side with Gordon until the caution, which came when David Reutimann ran out of gas near the entrance to turn one.

Gordon, who had just nudged in front of Johnson before the yellow flew, was the leader, with Johnson second and everyone behind them heading to pit road for tires.

What had been an atypically clean raced turned into mayhem on the restart.

"We were not a dominate race car," Newman said. "Clint kind of cleared out Turn One for us and we were fortunate enough to be in the right place at the right time."

Earnhardt, who was in position to give Hendrick a sweep of the top three spots before the caution, said everyone being on fresh tires played a factor in the crash.

"We all took off and ran into the back of the leaders, all of us," he said.

Earnhardt didn't blame Bowyer for trying to take the inside line, but was at a loss to explain what Reutimann was thinking.

"I would like an explanation on why that happened," he said of Reutimann stopping where he did after having made several laps with trouble without going to the pits. "There doesn't seem like there could be a logical reason for him to have to stop on the track."

Reutimann said his motor just died.

"I would not have stopped on the freaking racetrack. I would have limped it around there and come to pit road, which is what I was trying to do," he said. "The thing quit going down the back straightaway, and it shut off. I just didn't stop there intentionally."

Associated Press

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nibusinessinfo.co.uk: Farm Business Data 2012

The Department of Agriculture and Rural Development (DARD) has announced publication of the 'Farm Business Data 2012' farm planning handbook.

'Farm Business Data 2012' is a valuable source of information for farmers, their professional advisors, those undertaking formal training in agriculture or anyone who requires planning and budgetary data relating to farming in Northern Ireland.

Click here to read more about the Farm Business Data 2012 on nibusinessinfo.co.uk

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