Since August 2009 all UK trainee doctors have been restricted to a 48 hour week, but some say this has had negative effects on the quantity and quality of medical training. Is there any evidence to substantiate these fears? Doctors discuss the issue in The BMJ this week. Andrew Hartle and Sarah Gibb of the Association of Anaesthetists of Great Britain and Ireland find no evidence that implementation of the European Working Time Directive has led to a decline in the quality of training. They point out that several reviews on the impact of restricting working time have ...

Poor professional performance is an unlikely cause of delays in referral for suspected cancer, argue researchers in The BMJ this week. Instead, such delays largely reflect "limitations in scientific knowledge and in the organisation and delivery of healthcare." And they question government plans to rank general practices according to how promptly patients are referred to specialist services for suspected cancer. Most patients who have cancer diagnosed after the onset of symptoms are referred after one or two GP consultations (80%), but a substantial minority (20%) ...

Most exaggeration in health related science news is already present in academic press releases, finds a study published in The BMJ this week. The researchers suggest that improving the accuracy of academic press releases "could represent a key opportunity for reducing misleading health related news." Health related news has widespread potential to influence health related behaviour but often misreports the science. It is not known whether exaggerations - claims going beyond those made in the research paper - originate in the news stories themselves or in press releases ...

The analysis of 3,494 contracts awarded by 182 Clinical Commissioning Groups (CCGs) in England between April 2013 and August 2014 - disclosed to the BMJ under the Freedom of Information (FOI) Act - showed that in total, non NHS providers have secured 45% of contracts awarded since April 2013. A total of 1,149 contracts (33%) were awarded to private sector providers, 335 contracts (10%) were awarded to voluntary and social enterprise sector providers, while 100 contracts (2%) were awarded to other providers, such as joint ventures or local authorities. A further 1,910 ...

WASHINGTON, DC (December 9, 2014)--A study published today in the Journal of the American Medical Association (JAMA) shows that physicians who do residency training in regions of the country with higher health care spending patterns continue to practice in a more costly manner - even when they move to a geographic area where health care spending is lower. Immediately following residency, physicians whose residencies were in higher-spending regions spent 29 percent more on average than their peers who had trained in lower-spending areas of the country, according to the ...

The cognitive effects of poverty can be mitigated during middle school with a targeted intervention, according to researchers at the Center for BrainHealth at The University of Texas at Dallas. In a paper published today in the open-access journal Frontiers in Human Neuroscience, researchers for the first time examine the efficacy of cognitive training in a large and diverse group of 7th and 8th grade public middle school students as compared to typically developing students who received no specific training. "Previous research has shown that growing up in poverty ...

Rules don't reduce death, morbidity or adverse effects Surgeon who best knows patient should continue with critical care Restrictions may hurt patient safety CHICAGO --- Controversial restrictions on hospital residents' duty hours imposed in 2011 did not improve surgery patients' outcomes, reports a large new Northwestern Medicine study of U.S. hospitals, one of the first national evaluations of the results of the restrictions. The restrictions also did not result in any differences in surgical residents' performance on exams. "Our study suggests that these ...

An examination of the effect of resident duty hour reforms in 2011 finds no significant change in mortality or readmission rates for hospitalized patients, according to a study in the December 10 issue of JAMA, a theme issue on medical education. In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new duty hour reforms for all ACGME-accredited residency programs. The revisions maintain the weekly limit of 80 hours set forth by the 2003 duty hour reforms but reduced the work hour limit from 30 consecutive hours to 16 hours for first­year ...

An examination of the effect of resident duty hour reforms in 2011 finds no significant change in outcomes for general surgery patients, according to a study in the December 10 issue of JAMA, a theme issue on medical education. Ravi Rajaram, M.D., of the American College of Surgeons, Chicago, and colleagues conducted a study to determine if the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. The study examined general surgery patient ...

Among primary care physicians, the spending patterns in the regions in which their residency program was located were associated with expenditures for subsequent care they provided as practicing physicians, with those trained in lower-spending regions continuing to practice in a less costly manner, even when they moved to higher-spending regions, and vice versa, according to a study in the December 10 issue of JAMA, a theme issue on medical education. Regional and system-level variations in Medicare spending and overall intensity of medical services delivered to patients ...

An analysis of the non-English-language skills of U.S. medical residency applicants finds that although they are linguistically diverse, most of their languages do not match the languages spoken by the U.S. population with limited English proficiency, according to a study in the December 10 issue of JAMA, a theme issue on medical education. More than 25 million U.S. residents have limited English proficiency, an 80 percent increase from 1990 to 2010. Limited English proficiency (LEP) may impede participation in the English­language-dominant health care system. Little ...

There has been a doubling during the last decade in the number of U.S. medical schools that have student-run free clinics, with more than half of medical students involved with these clinics, according to a study in the December 10 issue of JAMA, a theme issue on medical education. Sunny Smith, M.D., of the University of California, San Diego, and colleagues conducted a study to assess whether there has been growth of student-run free clinics (SRFCs) in medical schools and describe the characteristics of these clinics. The first national study of SRFCs conducted in 2005 ...

In a sample of U.S. emergency departments, compared to attending physicians alone, supervised visits (involving both resident and attending physicians) were associated with a greater likelihood of hospital admission and use of advanced imaging and with longer emergency department stays, according to a study in the December 10 issue of JAMA, a theme issue on medical education. A common assumption is that care at academic medical centers costs more than care at nonteaching hospitals in part because of a higher frequency of testing and other resource use in teaching settings. ...

PHILADELPHIA - In the first year after the Accreditation Council for Graduate Medical Education (ACGME) reduced the number of continuous hours that residents can work, there was no change in the rate of death or readmission among hospitalized Medicare patients, according to a new study published in JAMA. The study was led by researchers at the Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia. "There has been a lot of speculation about the effect of the 2011 ACGME duty hour reforms on patient outcomes, so we looked ...

ROCHESTER, Minn. -- Clinical recommendations discouraging the use of CYP2D6 gene testing to guide tamoxifen therapy in breast cancer patients are based on studies with flawed methodology and should be reconsidered, according to the results of a Mayo Clinic study published in the Journal of the National Cancer Institute. For years, controversy has surrounded the CYP2D6 gene test for breast cancer. Women with certain inherited genetic deficiencies in the CYP2D6 gene metabolize tamoxifen less efficiently, and thus have lower levels of tamoxifen's active cancer-fighting metabolite ...

Yeast cells can sometimes reverse the protein misfolding and clumping associated with diseases such as Alzheimer's, according to new research from the University of Arizona. The new finding contradicts the idea that once prion proteins have changed into the shape that aggregates, the change is irreversible. "It's believed that when these aggregates arise that cells cannot get rid of them," said Tricia Serio, UA professor and head of the department of molecular and cellular biology. "We've shown that's not the case. Cells can clear themselves of these aggregates." Prions ...

COLUMBUS, Ohio - Thinking you're good at math and actually being good at it are not the same thing, new research has found. About one in five people who say they are bad at math in fact score in the top half of those taking an objective math test. But one-third of people who say they are good at math actually score in the bottom half. "Some people mis-categorize themselves. They really don't know how good they are when faced with a traditional math test," said Ellen Peters, co-author of the study and professor of psychology at The Ohio State University. The results ...

GAINESVILLE, Fla. --- Mathematical models predicted it, and now a University of Florida study confirms it: Immunizing school-aged children from flu can protect other segments of the population, as well. When half of 5- to 17-year-old children in Alachua County were vaccinated through a school-based program, the entire age group's flu rates decreased by 79 percent. Strikingly, the rate of influenza-like illness among 0-4 year olds went down 89 percent, despite the fact that this group was not included in the school-based vaccinations. Among all non-school-aged residents, ...

Supplemental ultrasound screening for all U.S. women with dense breasts would substantially increase healthcare costs with little improvement in overall health, according to senior author Anna Tosteson, ScD, at Dartmouth Hitchcock's Norris Cotton Cancer Center and The Dartmouth Institute for Health Policy and Clinical Practice. In a study released Monday in the Annals of Internal Medicine, Tosteson and colleagues, including lead author Brian Sprague, MD, provide evidence on the benefits and harms of adding ultrasound to breast cancer screening for women who have had a ...

CHAMPAIGN, Ill. -- When a large protein unfolds in transit through a cell, it slows down and can get stuck in traffic. Using a specialized microscope -- a sort of cellular traffic camera -- University of Illinois chemists now can watch the way the unfolded protein diffuses. Studying the relationship between protein folding and transport could provide great insight into protein-misfolding diseases such as Alzheimer's and Huntington's. Chemistry professor Martin Gruebele and graduate students Minghao Guo and Hannah Gelman published their findings in the journal PLOS ONE. "We're ...

Irvine, Calif., Dec. 9, 2014 -- A learning technique that maximizes the brain's ability to make and store memories may help overcome cognitive issues seen in fragile X syndrome, a leading form of intellectual disability, according to UC Irvine neurobiologists. Christine Gall, Gary Lynch and colleagues found that fragile X model mice trained in three short, repetitious episodes spaced one hour apart performed as well on memory tests as normal mice. These same fragile X rodents performed poorly on memory tests when trained in a single, prolonged session - which is a standard ...

A new study links ADHD and conduct disorder in young adolescents with increased alcohol and tobacco use. The Cincinnati Children's Hospital Medical Center study is among the first to assess such an association in this age group. Conduct disorder is a behavioral and emotional disorder marked by aggressive, destructive or deceitful behavior. The study is published in the journal Drug and Alcohol Dependence. "Early onset of substance abuse is a significant public health concern," says William Brinkman, MD, a pediatrician at Cincinnati Children's Hospital Medical Center ...

INDIANAPOLIS -- As hospice for nursing home patients grows dramatically, a new study from the Regenstrief Institute and the Indiana University Center for Aging Research compares the characteristics of hospice patients in nursing homes with hospice patients living in the community. The study also provides details on how hospice patients move in and out of these two settings. Longer lengths of hospice care, rising costs and concerns over possible duplication of services have led to increased scrutiny by policymakers of hospice patients living in nursing homes. Nursing ...

E-cigarettes appear to be less addictive than cigarettes for former smokers and this could help improve understanding of how various nicotine delivery devices lead to dependence, according to researchers. "We found that e-cigarettes appear to be less addictive than tobacco cigarettes in a large sample of long-term users," said Jonathan Foulds, professor of public health sciences and psychiatry, Penn State College of Medicine. The popularity of e-cigarettes, which typically deliver nicotine, propylene glycol, glycerin and flavorings through inhaled vapor, has increased ...

PHILADELPHIA -Researchers at Penn Medicine, in collaboration with a multi-center international team, have shown that a protease inhibitor, simeprevir, a once a day pill, along with interferon and ribavirin has proven as effective in treating chronic Hepatitis C virus infection (HCV) as telaprevir with interferon and ribavirin, the standard of care in developing countries. Further, simeprevir proved to be simpler for patients and had fewer adverse events. The complete study is now available online and is scheduled to publish in January 2015 in The Lancet Infectious Diseases. ...