Use prescription painkillers only as directed by a health care provider
Get help for substance abuse problems if needed (1-800-662-HELP)
Where You Live Makes a Difference
Health issues that cause people pain don’t vary much from place to place—not enough to explain why, in 2012, health care providers in the highest-prescribing state wrote almost 3 times as many opioid painkiller prescriptions – opioid or narcotic pain relievers, including drugs such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana (oxymorphone), and methadone – per person as those in the lowest prescribing state in the US. Or why there are twice as many painkiller prescriptions per person in the US as in Canada. Data suggest that where health care providers practice influences how they prescribe. Higher prescribing of painkillers is associated with more overdose deaths. More can be done at every level to prevent overprescribing while ensuring patients’ access to safe, effective pain treatment. Changes at the state level show particular promise.
We need to know how to deal with risk and uncertainty. You have to think yourself. And that’s the key message
What Does a 30% chance of rain mean? Understanding Risk, with Gerd Gigerenzer.
In the good old times people learned how to read and to write. That’s no longer sufficient in the high tech twenty-first century. We also need to know how to deal with risk and uncertainty. And that is what I mean with risk savvy.
Here is a simple example. You hear on the weather report that there is a 30 percent chance of rain tomorrow. Thirty percent chance of what? Now I live in Berlin and most Berliners believe that it means that it will rain in 30 percent of the time, that is seven to eight hours. Others think it will rain in 30 percent of the region. Most New Yorkers believe that’s all nonsense. It means it will rain on 30 percent of the days for which this prediction has been made, that is, most likely not at all. Many psychologists think that people can’t learn how to deal with risk but in this case it’s the experts, the meteorologists who have not learned how to communicate risk in an instinctive way that is to say to what class 30 percent refers. Time or region or days? And if you have some imagination you can think about other classes. For instance, one woman in New York said I know what 30 percent means. Three meteorologists think it rains and seven not.
Now getting soaked is a minor risk. But are we risk savvy when it comes to more important things. For instance, 20 year olds drive with their cell phone glued to their ears not realizing that they decrease their reaction time to that of a 70 year old. Or many Americans, about 20 percent, believe that they are in the top one percent income group. And as many believe they will soon be there. Or take health. So about an estimated one million children get every year unnecessary computer tomography CT scans. And that’s really because they’re not really clinically indicated. Which is not just a waste of time but also danger to the kids because a CT scan can have the radiation of a hundred chest x-rays and may lead in a small number of these kids later to cancer.
We deal everyday with risks but we haven’t learned how to understand them. And the problem is not simply in the human mind but also in experts who really don’t know what the risks are or don’t know how to communicate. Or in other areas like if it’s about finance or health have interests other than yours. So the key message is this. Everyone can learn to deal with risk. In that case everyone can learn to ask the question probability of what. And second, if you believe that you’re safe by your delegating the responsibility of your wellness and health to experts then you may be disappointed because many experts do not know how to communicate probabilities or try to protect themselves against you as in health care as a potential plaintiff. So you have to think yourself. And that’s the key message.
Be aware that BPA can also be found in boxed wine, canned goods, cash register receipts, compact discs, dental sealants, toilet paper, toys…
Okay, we know that by far, the best way to stay “safe” – regarding Bisphenol-A(BPA) exposure – is to not eat or drink anything that’s in a plastic bottle (and/or can)… but be aware that BPA can also be found in:
Approximately 40 per cent of the 48,000 children born in the UK to mothers taking Epilim since it was introduced in 1973 have developed either mental or physical disorders, with many suffering both
Approximately 40 per cent of the 48,000 children born in the UK to mothers taking Epilim since it was introduced in 1973 have developed either mental or physical disorders, with many suffering both.
That is according to the Daily Mail, which states that drug is now being blamed for causing more harm to children than Thalidomide.
Epilim is one of the registered trade names for sodium valproate, which has been at the centre of a media storm in recent weeks following the publication of new research into its effects on unborn children and a special BBC documentary.
The anti-epileptic drug controls electrical activity in the brain and is one of the most effective means of halting seizures.
However, Emma Murphy, founder of the Independent Fetal Anti-Cunvulsant Trust, told the news provider: “This is bigger than Thalidomide and it will not just be epileptic mothers whose babies are harmed. Epilim is prescribed to pregnant mothers with depression, bi-polar disorders and even for pain relief.”
Nearly 20,000 Children Harmed By Epilim (Sodium Valproate), EpilepsyResearchUK, News, Feb 26 2013.
The drug that’s harmed more children than Thalidomide, DailyMail, article-2284425, 26 February 2013.
Associations between palliative chemotherapy and adult cancer patients’ end of life care and place of death
To determine whether the receipt of chemotherapy among terminally ill cancer patients months before death was associated with patients’ subsequent intensive medical care and place of death.
Secondary analysis of a prospective, multi-institution, longitudinal study of patients with advanced cancer.
Eight outpatient oncology clinics in the United States.
386 adult patients with metastatic cancers refractory to at least one chemotherapy regimen, whom physicians identified as terminally ill at study enrollment and who subsequently died.
Main outcome measures
Primary outcomes: intensive medical care (cardiopulmonary resuscitation, mechanical ventilation, or both) in the last week of life and patients’ place of death (for example, intensive care unit). Secondary outcomes: survival, late hospice referrals (≤1 week before death), and dying in preferred place of death.
216 (56%) of 386 terminally ill cancer patients were receiving palliative chemotherapy at study enrollment, a median of 4.0 months before death. After propensity score weighted adjustment, use of chemotherapy at enrollment was associated with higher rates of cardiopulmonary resuscitation, mechanical ventilation, or both in the last week of life (14% v 2%; adjusted risk difference 10.5%, 95% confidence interval 5.0% to 15.5%) and late hospice referrals (54% v 37%; 13.6%, 3.6% to 23.6%) but no difference in survival (hazard ratio 1.11, 95% confidence interval 0.90 to 1.38). Patients receiving palliative chemotherapy were more likely to die in an intensive care unit (11% v 2%; adjusted risk difference 6.1%, 1.1% to 11.1%) and less likely to die at home (47% v 66%; −10.8%, −1.0% to −20.6%), compared with those who were not. Patients receiving palliative chemotherapy were also less likely to die in their preferred place, compared with those who were not (65% v 80%; adjusted risk difference −9.4%, −0.8% to −18.1%).
The use of chemotherapy in terminally ill cancer patients in the last months of life was associated with an increased risk of undergoing cardiopulmonary resuscitation, mechanical ventilation or both and of dying in an intensive care unit. Future research should determine the mechanisms by which palliative chemotherapy affects end of life outcomes and patients’ attainment of their goals.
Associations between palliative chemotherapy and adult cancer patients’ end of life care and place of death: prospective cohort study, BMJ 2014; 348:g1219, 04 March 2014.
A Garches, le service d’oncologie pédiatrique de Nicole Delépine est menacé de fermeture. Pour de nombreux enfants, il est la seule possibilité d’être soigné
Objet : Pétition à Mme La Ministre de la santé pour la pérennité de l’unité d’oncologie pédiatrique de Lenny, Beatrice, James et les autres
” Madame la Ministre,
Nous nous mobilisons une nouvelle fois contre la mort programmée de l’Unité spécifique d’Oncologie Pédiatrique individualisée de l’hôpital Raymond Poincaré de Garches (92380) APHP.
Depuis plus de trente années, le Docteur Nicole Delèpine et son équipe pratiquent une médecine individualisée et humaine, pointue utilisant les traitements éprouvés efficaces, quand ils existent, sans les délaisser pour des essais thérapeutiques dont les résultats à long terme ne seront connus que plus tard et donc incertains.
Nous avons le droit de profiter des progrès de la médecine de ces trente dernières années et pas seulement d être le cobaye pour les prochaines décennies. Nous acceptons les essais lorsqu’aucune solution sérieuse n’existe pour nos cancers.
Nous ne sommes pas un simple numéro, mais un patient que l’on écoute et auquel on donne les moyens de vaincre le Cancer en connaissance de cause, c’est-à-dire des possibilités fournies par les schémas de traitement connus ou par les essais cliniques proposés. C’est à nous de choisir !
Le 6 novembre 2006, l’unité a été transférée de l’hôpital Avicenne de Bobigny à l’hôpital Poincaré à Garches, suite à la signature en 2004 d’un protocole d’accord entre l’AP HP, le Ministère de la Santé et l’Unité du Docteur Delèpine, affirmant sa pérennité.
Malheureusement à ce jour le protocole n’est plus respecté, les locaux, moyens matériels et même humains sont petit à petit grignotés. Sa fermeture régulièrement annoncée déstabilise le personnel harcelé par l’encadrement pour pallier aux restrictions de postes.
Pour que nos enfants puissent continuer à être suivis par cette unité qui n’existe “nulle part ailleurs” nous vous interpellons une nouvelle fois. Que d’autres puissent profiter des chimiothérapies adaptées à ‘âge évitant des amputations comme cela a encore été le cas pour trois patients le mois écoulé.
Ou iront-ils ?
Mme la Ministre, nous sommes sûrs que le sort d’enfants cancéreux ne vous laissera pas indifférente.
Nous espérons vous rencontrer en personne rapidement. Respectueusement. “
Signez la pétition !
” A tous ! Si vous ne voulez pas qu’un jour cette unité exemplaire disparaisse, il faut tous nous mobiliser et obtenir en peu de temps un grand nombre de signatures qui seront transmise à la Ministre de la Santé. Envoyer vos témoignages personnels aux associations Amétist et Regarde la vie ou au Docteur Delèpine via leurs sites qui seront joints à la pétition au ministre. C’est plus largement la liberté de choix thérapeutique que nous devons défendre ! Merci pour eux, pour nous, pour tous ! Christelle Mathillon, Céline Servant, les associations Regarde la Vie et Amétist. ”
Cliquez pour Signer sur AVAAZ.org Pétitions Citoyennes.
Friday 11th of July : join our #SocialMedia event taking place at each Full Moon – via #EAv – and give a boost to your social networking! #FullMoonEngageMe #SocialNetworking
The Buck Moon
There are native American names for the full moons that you can find here, here or here. July Month full moon is called Blood Moon, or Thunder Moon because thunderstorms are so frequent during this month, or the Buck Moon.
Male deer, which shed their antlers every year, begin to regrow them in July, hence the Native American name for this month’s full moon.
#FullMoonEngageMe Social Media Event N°3 Schedule
The event will start on Friday 11th of July at 12:00 noon UTC and last until Monday the 14th in HERE.
Please use the comment section to ask any question about the event.
You can join – for FREE – Empire Avenue at anytime – before and after any FullMoon EngageMe Social Media Event.
You can use this link – with no strings attached – to get some extra “eaves” at start !
See you soon 🙂
Use prescription painkillers only as directed by a health care provider
Get help for substance abuse problems if needed (1-800-662-HELP)
Prescription Painkiller Overdoses,
A growing epidemic, especially among women
About 18 women die every day of a prescription painkiller overdose in the US, more than 6,600 deaths in 2010. Prescription painkiller overdoses – opioid or narcotic pain relievers, including drugs such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana (oxymorphone), and methadone – are an under-recognized and growing problem for women.
Although men are still more likely to die of prescription painkiller overdoses (more than 10,000 deaths in 2010), the gap between men and women is closing. Deaths from prescription painkiller overdose among women have risen more sharply than among men; since 1999 the percentage increase in deaths was more than 400% among women compared to 265% in men. This rise relates closely to increased prescribing of these drugs during the past decade. Health care providers can help improve the way painkillers are prescribed while making sure women have access to safe, effective pain treatment.
A new book – Risk Savvy: How to Make Good Decisions – by Gerd Gigerenzer – one prominent statistician, expert in uncertainty and decision-making – says they have a poor, imperfect grasp of statistics… and that this makes it hard for patients to make informed decisions about treatment…
Read Do doctors understand test results? by William Kremer, BBC World Service, news/magazine-28166019, 7 July 2014.
A heated dispute about science communication regarding endocrine-disrupting chemicals…
A Dispute about Science Communication
Opposing groups of scientists have recently engaged in a heated dispute over a preliminary European Commission (EC) report on its regulatory policy for endocrine-disrupting chemicals. In addition to the scientific issues at stake, a central question has been how scientists can maintain their objectivity when informing policy makers.
Drawing from current ethical, conceptual, and empirical studies of objectivity and conflicts of interest in scientific research, we propose guiding principles for communicating scientific findings in a manner that promotes objectivity, public trust, and policy relevance.
Both conceptual and empirical studies of scientific reasoning have shown that it is unrealistic to prevent policy-relevant scientific research from being influenced by value judgments. Conceptually, the current dispute over the EC report illustrates how scientists are forced to make value judgments about appropriate standards of evidence when informing public policy. Empirical studies provide further evidence that scientists are unavoidably influenced by a variety of potentially subconscious financial, social, political, and personal interests and values.
When scientific evidence is inconclusive and major regulatory decisions are at stake, it is unrealistic to think that values can be excluded from scientific reasoning. Thus, efforts to suppress or hide interests or values may actually damage scientific objectivity and public trust, whereas a willingness to bring implicit interests and values into the open may be the best path to promoting good science and policy.
Read the full article: Science, Policy, and the Transparency of Values, Environ Health Perspect; DOI:10.1289/ehp.1408107,
1 July 2014 – PDF.