Financial incentives (pay for performance) schemes for health professionals "can undermine motivation and worsen performance" warn US experts in an editorial published on bmj.com today. They also say that gaming of the system is rife. Their views are published alongside an analysis of the positive and negative effects of financial incentives led by Professor Paul Glasziou of Bond University in Australia. Glasziou and colleagues describe the current evidence on the effectiveness of financial incentives as "modest and inconsistent" and say that, although reward schemes ...

Certain medical students may be more likely to stay in their own countries or work in rural areas of their own countries when they qualify as doctors, suggests a study published on bmj.com today. Given that many low income countries have insufficient doctors to meet their needs, particularly in rural areas, the authors suggest that policy makers could use this evidence to adjust entrance criteria for medical schools that favour subsequent practice in less well served areas of their country. Previous studies have shown that, in high income countries, doctors with rural ...

A paper published on bmj.com today suggests that over 1000 people have committed suicide due to the 2008-2010 economic recession in the UK (846 men and 155 women). Suicides began to rise in the UK in 2008 following 20 years of decline - suicides rose 8% among men and 9% among women in 2008, compared to 2007. And even though suicides did begin to fall in 2010 figures were still above the 2007 averages. Previous studies have concluded that unemployment does increase the risk of suicide and non-fatal self-harm but while suicides tend to increase during economic downturns, ...

In a cautionary editorial alongside a related article in today's issue of the British medical journal BMJ, leading experts in health policy and behavioral economics argue that pay-for-performance (P4P) schemes – which financially reward doctors and hospitals for hitting specific, numerical targets in such matters as preventing hospital readmissions or prescribing certain drugs – are likely to do more harm than good. Such schemes are being adopted as a key component of the Accountable Care Organization strategy mandated by the 2010 health reform and are now part of the ...

In a major breakthrough, an international team of scientists has proven that addiction to morphine and heroin can be blocked, while at the same time increasing pain relief. The team from the University of Adelaide and University of Colorado has discovered the key mechanism in the body's immune system that amplifies addiction to opioid drugs. Laboratory studies have shown that the drug (+)-naloxone (pronounced: PLUS nal-OX-own) will selectively block the immune-addiction response. The results – which could eventually lead to new co-formulated drugs that assist patients ...

When a carnivore becomes extinct, other predatory species could soon follow, according to new research. Scientists have previously put forward this theory, but a University of Exeter team has now carried out the first experiment to prove it. Published today (15 August 2012) in the Royal Society journal Biology Letters, the study shows how the demise of one carnivore species can indirectly cause another to become extinct. The University of Exeter team believes any extinction can create a ripple effect across a food web, with far-reaching consequences for many other animals. ...

CAMBRIDGE, MA -- From an engineer's perspective, plants such as palm trees, bamboo, maples and even potatoes are examples of precise engineering on a microscopic scale. Like wooden beams reinforcing a house, cell walls make up the structural supports of all plants. Depending on how the cell walls are arranged, and what they are made of, a plant can be as flimsy as a reed, or as sturdy as an oak. An MIT researcher has compiled data on the microstructures of a number of different plants, from apples and potatoes to willow and spruce trees, and has found that plants exhibit ...

It's become a sport of sorts, predicting the low point of Arctic sea ice each year. Expert scientists with decades of experience do it but so do enthusiasts, whose guesses are gamely included in a monthly predictions roundup collected by Sea Ice Outlook, an effort supported by the U.S. government. When averaged, the predictions have come in remarkably close to the mark in the past two years. But the low and high predictions are off by hundreds of thousands of square kilometers. Researchers are working hard to improve their ability to more accurately predict how much ...

Girls with Attention Deficit Hyperactivity Disorder (ADHD) – and their families – often look forward to the likely decline in visible symptoms such as fidgety or disruptive behavior as they mature into young women. However, new findings from UC Berkeley caution that, as they enter adulthood, girls with histories of ADHD are more prone to internalize their struggles and feelings of failure – a development that can manifest itself in self-injury and even attempted suicide. "Like boys with ADHD, girls continue to have problems with academic achievement and relationships, ...

An intensifying Tropical storm called Kai-Tak (locally known as Helen) is causing more rain in the Philippines as it passes over northern Luzon. The Philippines have had a very wet month with the capital of Manila experiencing massive flooding earlier this month. NASA's TRMM satellite identified where the heavy rain was falling. Kai-tak has caused another day of warnings in the Philippines. On August 14, Public storm warning signal #1 is in effect for these provinces in Luzon: La Union, Nueva Ecija, Pangasinan, Rest of Aurora, and Tarlac. In addition, Public storm warning ...

Tropical Storm Hector is battling wind shear over the open waters of the Eastern Pacific Ocean, and NASA satellite data shows that has been affecting its organization and rainfall rates. The Tropical Rainfall Measuring Mission satellite known as TRMM is managed by both NASA and the Japanese Space Agency. From its orbit in space, TRMM's instruments can estimate rainfall from tropical cyclones. The TRMM satellite captured rainfall rates from Tropical Storm Hector on August 14, 2012 1:28 a.m. EDT. TRMM data showed that Hector had a small area of moderate to heavy rainfall ...

VIDEO: Filmed at 10,000 frames per second by Japan's NHK television, movies like this of electromagnetic bursts called "sprites " will help scientists better understand how weather high in the atmosphere relates... Click here for more information. High above the clouds during thunderstorms, some 50 miles above Earth a different kind of lightning dances. Bursts of red and blue light, known as "sprites," flash for a scant one thousandth of a second. They are often ...

Many elderly people spend their last years alone. Spouses pass and children scatter. But being lonely is much more than a silent house and a lack of companionship. Over time, loneliness not only takes a toll on the psyche but can have a serious physical impact as well. Feeling lonely has been linked to an increased risk of heart disease, Alzheimer's disease, depression and even premature death. Developing effective treatments to reduce loneliness in older adults is essential, but previous treatment efforts have had limited success. What to do? Researchers at UCLA ...

In 1714, the British government held a contest. They offered a large cash prize to anyone who could solve the vexing "longitude problem" — how to determine a ship's east/west position on the open ocean — since none of their naval experts had been able to do so. Lots of people gave it a try. One of them, a self-educated carpenter named John Harrison, invented the marine chronometer — a rugged and highly precise clock — that did the trick. For the first time, sailors could accurately determine their location at sea. A centuries-old problem was solved. And, arguably, crowdsourcing ...

Two researchers at Weill Cornell Medical College have deciphered a mouse's retina's neural code and coupled this information to a novel prosthetic device to restore sight to blind mice. The researchers say they have also cracked the code for a monkey retina — which is essentially identical to that of a human —and hope to quickly design and test a device that blind humans can use. The breakthrough, reported in the Proceedings of the National Academy of Sciences (PNAS), signals a remarkable advance in longstanding efforts to restore vision. Current prosthetics provide blind ...

Tiny space age probes — those that can see inside single living cells — are increasingly being used to diagnose illness in hard-to-reach areas of the body. NewYork-Presbyterian Hospital/Weill Cornell Medical Center's Dr. Michel Kahaleh often threads a tiny microscope into the narrow bile ducts that connect the liver to the small intestine to hunt for cancer. He also uses the device to minutely explore the pancreatic duct as one of a few doctors in the country to use such technology in this way. But because these devices are comparatively new, Dr. Kahaleh, chief of ...

SEATTLE – Yo-yo dieting – the repetitive loss and regain of body weight, also called weight cycling – is prevalent in the Western world, affecting an estimated 10 percent to 40 percent of the population. The degree to which weight cycling may impact metabolism or thwart a person's ability to lose weight in the long run has been unclear – until now. A new study by researchers at Fred Hutchinson Cancer Research Center, published online in the journal Metabolism, for the first time has shown that a history of yo-yo dieting does not negatively affect metabolism or the ability ...

ROCHESTER, Minn. -- Strawberry-shaped birthmarks called infantile hemangiomas (http://www.mayoclinic.com/health/hemangioma/DS00848) grow rapidly in infants much earlier than previously thought, Mayo Clinic and University of California, San Francisco, researchers found. Their study, published online in the journal Pediatrics (http://pediatrics.aappublications.org/), suggests that babies with complication-causing hemangiomas should be immediately referred to dermatologists for further evaluation. MULTIMEDIA ALERT: For multimedia resources and video of Dr. Tollefson, ...

SAN FRANCISCO -- Symmetrical looks are highly prized in the animal kingdom, but according to a new report by San Francisco State University biologists on an insect called the maritime earwig, asymmetry might come with its own perks. Animals—including humans—seem to use symmetry as a shortcut for evaluating potential mates. Symmetrical features usually indicate normal development, while asymmetry could point to an underlying developmental defect that would render a mate less fit. "The evolutionary theory that underpins symmetry in mate choice is very straightforward," ...

Though no systemic studies have been performed, it is generally believed that genes are the most sensitive toxicological endpoints for pollutants, and are thus desirable early warning indicators of environmental risks. A recent study, however, unexpectedly found that the sensitivity of the gene expression effect for cadmium was significantly lower than the individual level chronic toxicity indicators (such as the no observed effect concentration, NOEC). Therefore, the gene expression effect may not be the most sensitive toxicological endpoint. Dr Yan Zhenguang, Prof. Liu ...

PHILADELPHIA — The presence of multiple ovarian cancer genomes in an individual patient and the absence or downregulation of the gene LRP1B are associated with the development of chemoresistance in women with the high-grade serous cancer subtype of ovarian cancer whose disease recurs after primary treatment. These study results are published in Cancer Research, a journal of the American Association for Cancer Research. David Bowtell, Ph.D., head of the Cancer Genomics and Genetic Program at the Peter MacCallum Cancer Centre in Melbourne, Australia, and colleagues generated ...

Children who spend more than three-quarters of their time engaging in sedentary behaviour, such as watching TV and sitting at computers, have up to nine times poorer motor coordination than their more active peers, reveals a study published in the American Journal of Human Biology. The study, involving Portuguese children, found that physical activity alone was not enough to overcome the negative effect of sedentary behaviour on basic motor coordination skills such as walking, throwing or catching, which are considered the building blocks of more complex movements. "Childhood ...

Chevy Chase, MD—A study to be published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM) suggests that physical activity for premenopausal women is very effective in reducing sclerostin—a known inhibitor of bone formation. In addition, physical training enhances IGF-1levels, which have a very positive effect on bone formation. Bone is a tissue that is always changing due to hormonal changes and physical activity, or lack thereof. Sclerostin is a glycoprotein produced almost exclusively by osteocytes, the most abundant cells found ...

Chevy Chase, MD—A study to be published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM) shows consumption of a Mediterranean diet enriched with olive oil for two years is associated with increased serum osteocalcin concentrations, suggesting a protective effect on bone. Age-related bone mass loss and decreased bone strength affects women and men alike are an important determinant of osteoporosis and fracture risk. Studies have shown that the incidence of osteoporosis in Europe is lower in the Mediterranean basin. The traditional Mediterranean ...

Researchers at Moffitt Cancer Center have found that when breast cancer patients are offered pre-test genetic counseling before definitive breast cancer surgery, patients exhibited decreases in distress. Those offered pre-test genetic counseling after surgery improved their informed decision-making. Patients in both groups showed increases in their cancer knowledge with pre-test genetic counseling. The study, funded by the American Cancer Society, appeared in a recent issue of the Annals of Surgical Oncology. Given the role of breast cancer gene status in treatment ...