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Study Finds That Tobacco Companies Changed Design Of Cigarettes Without Alerting Smokers
As President Obama prepares to sign a bill giving the Food and Drug Administration (FDA) oversight of the tobacco industry, a new study from Harvard School of Public Health (HSPH) researchers shows that tobacco manufacturers have continually changed the ingredients and the design of their cigarettes over time, even if those changes have exceeded acceptable product variance guidelines. The result, say the researchers, is that consumers who buy the same brand of product are not made aware of how that product has been altered and what effect those alterations might have on their levels of addiction or harm.
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Risk For Sleep Apnea In Musicians May Be Reduced By Playing A High Resistance Wind Instrument
The naturalistic respiratory muscle training with high resistance wind instruments may potentially reduce musicians" risk for obstructive sleep apnea (OSA), according to a research abstract presented at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies.
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Questioning The Use Of Muscle Rubs
There is not enough evidence to support using gels and creams containing rubefacients for chronic and acute pain, according to a systematic review by Cochrane Researchers. Rubefacients cause irritation and reddening of the skin, due to increased blood flow. The review focused on formulations containing salicylates, which are widely prescribed or sold over the counter as topical treatments for sports injuries and muscle pain.
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Under-Use Of Hospice Care By Many Terminally Ill Patients: Study

Hospice, a well-established approach to palliative care, has enabled countless people worldwide to die with dignity. Through focusing on the patient rather than the disease, individuals can spend the last weeks of their lives in an environment where hospice caregivers minimize their pain, maximize their comfort, and provide bereavement services for loved ones and family members. A new study led by researchers at Harvard Medical School, however, found that only about half the patients diagnosed with metastatic lung cancer discuss hospice with their physician within 4 to 7 months of their diagnosis. "Many terminally-ill patients who might benefit from hospice aren"t discussing it with their physicians and may not be aware of the services hospice could offer," says Haiden Huskamp, lead author on the study and HMS associate professor of health care policy. Findings were published in the May 25 Archives of Internal Medicine. Through the Cancer Care Outcomes Research and Surveillance Consortium, the researchers surveyed 1,517 patients diagnosed with metastatic lung cancer. For reasons not clear, blacks and Hispanics were less likely to discuss hospice than whites and Asians. Forty-nine percent of blacks and 43 percent of Hispanics discussed hospice with their doctors; for whites and Asians the percentages were 53 and 57, respectively. Married people were also less likely than unmarried people to have this discussion (51 percent compared with 57 percent, respectively). In general, the longer patients expected to live after their diagnosis, the less likely they were to have explored hospice care with their doctor. However, the researchers also found that patients tended to overestimate how long they had to live. For example, about 30 percent of the patients thought that they would live up to two years. In reality though, only about 6 percent of patients with metastatic lung cancer will survive that long. What"s more, patients who preferred care that eased their pain and suffering at the end of life over care that extended life (roughly 50 percent of patients) were no more likely to have discussed hospice than patients who had the opposite preference. "These conversations can be difficult for everyone involved - patients, families, and physicians," says Huskamp. "But discussing prognosis and end-of-life care options in advance is essential to make sure that patients receive care that reflects their wishes." "Patients with advanced lung cancer understandably hope that cancer treatments can extend their lives," notes John Ayanian, senior author on the study and HMS professor of medicine and health care policy. "When these treatments are no longer working, their doctors have an important role to play in offering them hospice care that will ease their symptoms as they approach the end of life." This study was funded by the National Cancer Institute. Written by David Cameron Full citation Archives of Internal Medicine, May 25, Vol 169, number 10 "Discussions with Physicians about Hospice among Patients with Metastatic Lung Cancer" Haiden A. Huskamp, Ph.D., Nancy L. Keating, M.D., M.P.H., Jennifer L. Malin, M.D., Ph.D., Alan M. Zaslavsky, Ph.D., Jane C. Weeks, M.D., M.Sc., Craig C. Earle, M.D., Joan M. Teno, M.D., M.S., Beth A. Virnig, Ph.D., M.P.H., Katherine L. Kahn, M.D., Yulei He, Ph.D., and John Z. Ayanian, M.D., M.P.P. From the Department of Health Care Policy, Harvard Medical School (HAH, NLK, AMZ, YH, JZA), Division of General Internal Medicine, Brigham and Women"s Hospital (NLK, JZA) and Division of Population Sciences, Dana-Farber Cancer Institute (JCW) in Boston, MA; Department of Medicine (JLM) and Division of General Internal Medicine (KLK), David Geffen School of Medicine, University of California, Los Angeles in Los Angeles, CA; Veterans Affairs Health Care System, Greater Los Angeles (JLM), in Los Angeles, CA; RAND Corporation in Santa Monica, CA (JLM, KLK); Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Center (CCE) in Toronto, Canada; Center for Gerontology and Health Care Research, Department of Community Health, Warren Alpert Medical School, Brown University (JMT) in Providence, RI; Department of Health Policy and Management, University of Minnesota (BAV) in Minneapolis, MN. David Cameron Harvard Medical School


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