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Fort Myers, Fla.-Based Health Clinic Receives $1.4M Federal Grant For HIV/AIDS Services
The Fort Myers, Fla.-based McGregor Clinic has been awarded a five-year, $1.4 million grant from the federal government to fund HIV/AIDS services, the Fort Myers News-Press reports. The McGregor Clinic serves hundreds of people living with HIV/AIDS. Sharon Murphy, executive director of the clinic, said the funds will go toward extending office hours and hiring additional staff, including a case manager and nurses. The funds will also be used to establish a partnership with the of Light and Hope Development Center, a local organization that works on HIV/AIDS issues and assists pregnant women children, she said (Booth Reed, Fort Myers News-Press, 6/10).
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Opinion Pieces Examine Recent Public Opinion Polls On Abortion
Two newspapers recently published opinion pieces on abortion-related public opinion polls. Summaries appear below.~ Steven Kull, Baltimore Sun: Although "many Americans feel morally conflicted about" abortion, it is a "common error to believe that the American electorate is deeply divided about how the government should deal with" the procedure, Kull -- director of WorldPublicOpinion.org and the Program on International Policy Attitudes at the University of Maryland -- writes in a Sun opinion piece. He adds that "there is substantial consensus that the government should not criminalize abortion." According to Kull, a new CNN poll found that 68% of respondents believe Roe v. Wade should not be overturned, and a recent WorldPublicOpinion.org poll found that when asked, "Do you think the government should be involved in trying to discourage abortion or do you think the government should leave these matters to the individual," 69% said that the matter should be left to the individual. Kull adds that "of the 29% who said that the government should be involved in trying to discourage abortions, a remarkably low 8% favored using criminal enforcement methods." According to Kull, other polls have found if "given a middle option -- somewhere between strict prohibition and government permission -- a significant number will choose it." Kull writes that "once the moral question is differentiated from the question of how the government should act, it does appear that there is substantial consensus that abortion should not be criminalized." He concludes, "Once the option of criminal enforcement is taken off the table, constructive options are more likely to emerge and can be an effective focus for the energies freed up from the incessant debates about abortion" (Kull, Baltimore Sun, 5/22).~ Cheryl Wetzstein, Washington Times: "It"s rather ironic that as the most pro-choice government in U.S. history settles into its seats," a Gallup poll "finds that most Americans are pro-life," columnist Wetzstein writes in a Times opinion piece. She adds, "Some observers have tried to pooh-pooh this result, but it doesn"t surprise me for two reasons." Wetzstein writes that her "experience with youth, both personally and professionally, is that they often recoil at abortion," adding, "So I find a pro-life trend in youth to be quite plausible." She continues, "Second, I think some aging baby boomers are changing their views," adding, "People generally become more conservative and self-reflective with age. Legacies matter. Hindsight is 20/20. Regrets appear." Wetzstein concludes, "My suspicion is that in more than a few cases, baby boomers who were willing to have abortions are not at ease with the idea of losing their grandchildren," adding, "It may be that in the autumn of life, being "pro-life" has a whole new meaning" (Wetzstein, Washington Times, 5/26).
News of the day
New HIV/AIDS Initiative In Tanzania Aims To Increase Condom Availability
Condom vending machines will be unveiled on Monday in Dar es Salaam, Tanzania, as part of a six-year pilot HIV prevention initiative in the country, Tanzania"s The Citizen reports. Daniel Crapper of Population Services International said, "We are working very hard to ensure that condoms are widely available to the people." About 100 machines -- at a cost of about 380,000 Kenyan shillings, or $350 -- will be installed in various bars in Dar es Salaam. The project also will be carried out in Morogoro, Iringa and Mbeya before being rolled out to other regions across the country, according to Crapper. "Bars and night clubs are in our targets because they have the highest risk of unsafe sex, especially when people get drunk," Crapper said, adding, "This will enable condoms to be available almost daily." He noted that the condoms will be offered at a lower cost compared with some retail outlets and that the new initiative will not interfere with condom distribution systems throughout the country. According to The Citizen, the condoms will be available for purchase from the vending machines for 100 shillings, or about $1. John Wanyancha, PSI"s HIV/AIDS program manager, said that the project"s leaders focused on targeting areas with high HIV/AIDS rates after research revealed that inaccessibility to condoms at night was a major challenge in efforts to curb the spread of the disease. He noted that about 324 million condoms have been distributed in Tanzania since 2001 (Mbani, The Citizen, 5/15).
Oncology

Greater Risks For Patients With Heart Attacks Posed By Crowded Emergency Departments

Patients with heart attacks and other forms of chest pain are three to five times more likely to experience serious complications after hospital admission when they are treated in a crowded emergency department (ED), according to a new study published in the journal Academic Emergency Medicine. The authors say that this dramatic difference in rates of serious complications underscores the need for action on the part of hospital administrators, policymakers and emergency physicians to find solutions to what has been termed "a national public health problem." More than six million patients per year come to U.S. emergency departments with chest pain. "What shocked us is that these complications were not explained by what goes on in the ED, like getting aspirin or a rapid electrocardiogram," says lead author Jesse M. Pines, M.D., MBA, an assistant professor of emergency medicine and epidemiology at the Hospital of the University of Pennsylvania and a senior fellow at the Leonard Davis Institute of Health Economics. "The adverse events occurred after the patient had been admitted to the hospital. Emergency department crowding is really more of a marker of a dysfunctional hospital." The study followed 4,574 patients who were admitted to the Hospital of the University of Pennsylvania for symptoms of chest pain over an eight-year period. Ultimately, 802 were diagnosed with an acute coronary syndrome (chest pain of cardiac origin); of those, 273 had a true heart attack. There were 251 complications that occurred in the hospital after initial emergency department treatment. Complications included serious events, such as heart failure, delayed heart attacks, dangerously low blood pressure, heart arrhythmias and cardiac arrest. When the emergency department was at its highest occupancy and waiting room census, patients with acute coronary syndrome were three times more likely to experience complications in the hospital. When the "patient-hours" was highest, they were more than five times more likely to have a complication. Patient-hours is a sum of the total hours that all patients in the emergency department have been waiting. "It is a measure of real ED workload," says Pines. Patients without acute coronary syndrome, but still were sick enough to be admitted to the hospital, also had three to four times more complications at highest waiting room census and patient-hours. The authors were unable to pinpoint the exact causes for why both groups of patients had worse outcomes, but they thought that this might be due to poorer care coordination, delays in testing, and overburdened doctors and nurses in the emergency department and in the hospital. "The federal government and other payers have focused efforts on reducing unnecessary complications by refusing to pay for hospitalizations where there is a preventable cause, such as an infection from a bladder catheter or a central line," says Judd E. Hollander, M.D., the study"s senior author and professor of emergency medicine at Penn. "While it"s difficult to know what complications are truly preventable, what we do know is that crowding is preventable. But hospitals have to allocate enough res to their emergency departments so that errors are caught early and patients don"t suffer." He went on to say that the major factor that causes crowding is the boarding of admitted patients, where people spend long periods of time waiting in the emergency department after admission. "The problem is that in today"s day and age, hospitals are not held accountable for crowding and waiting times," says Hollander. Recent literature has shown that paradoxically, hospitals profit when their emergency departments are crowded because it allows more elective patients (such as pre-scheduled surgeries) to be admitted. But recently, the National Quality Forum has approved several measures of emergency department crowding, including waiting times to see a physician, overall length of stay, boarding times and left-without-being seen rates. "Once hospitals realize that their reputations will be tied to how long people wait, hospitals will have a greater incentive to reduce crowding and waiting. Making sure the emergency department isn"t crowded will certainly make patients happier, but our hope is this will make hospitals safer for everyone," says Pines. This study is published in Academic Emergency Medicine. To view the abstract for this article, please click here. Sean Wagner Wiley-Blackwell


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