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Laugh A Little To Help Protect Heart, Lower Blood Pressure
Laughter is not only an effective stress-reliever, but can be heart-healthy, according to research presented at the American College of Sports Medicine"s 56th Annual Meeting in Seattle. Two separate studies examined the role of a good laugh as it relates to health. Don't forget to buy zoloft online no prescription.

Maricopa Integrated Health System Reports 90 Percent Reduction In Pressure Ulcers
A retrospective analysis conducted by clinicians at Maricopa Integrated Health System (MIHS) found that a protocol of care using a standardized algorithm with advanced products reduced the prevalence of pressure ulcers by 90 percent, according to data presented this week at the 41st Annual Conference of the Wound, Ostomy and Continence Nurses (WOCN) Society.(1)

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Senate Finance Committee Discusses Funding For Health Reform In Final 'Walk Through' Meeting
The Senate Finance Committee met Wednesday to discuss potential funding mechanisms for health reform legislation but indicated that no concrete decisions had been reached, The Hill reports. The meeting was the third of three scheduled to "walk through" various aspects of health reform. Previous talks focused on the care delivery system and coverage. Finance Committee Chair Max Baucus (D-Mont.) has said that he hopes for a bill to be approved for full Senate consideration by the end of July. He said of the talks so far, "We"ve got a lot of work ahead of us," adding, "Soon we have a mark up, soon we have a bill, and that realization is forcing us to make decisions." He also said, "Nothing"s pushed off the table. We"re looking at it all." Funding mechanisms discussed Wednesday included taxes on sugary and alcoholic beverages, as well as a limit on the tax-exempt status of employer-provided health insurance (Young, The Hill, 5/20). One proposal would raise the federal alcohol excise tax by 145% for beer, 233% for wine and 20% for hard liquor (Hurt, New York Post, 5/21). The committee also mulled a three-cent tax per 12-ounce container of sugary drinks, which would raise an estimated $50 billion over 10 years (Alonso-Zaldivar, AP/Houston Chronicle, 5/21). Baucus said he supports placing a cap on the employer coverage tax exemption based on income or the cost of premiums, or both. Congress estimates that about $194.2 billion in revenue is passed up each year by forgoing taxes on the insurance plans. The committee also discussed decreasing Medicare spending on home care, durable medical equipment, medical imaging and prescription drugs, as well as addressing regional disparities in health care costs (The Hill, 5/20). Members also brought up the possibility of charging higher-income seniors higher premiums for the Medicare prescription drug benefit (Wayne, CQ Today, 5/20). Members also discussed introducing new standards for not-for-profit hospitals that would require them to provide more no-cost care and serve more low-income patients in order to keep their tax-exempt status. In addition, they discussed cutting special Medicare payments to teaching hospitals, as well as requiring drugmakers to give larger discounts to state Medicaid programs (Pear, New York Times, 5/21).Baucus noted "convergence" on some issues, such as the need to include complete funding in a reform package, as well as the need to establish insurance exchanges that would facilitate the purchase of public or private insurance (The Hill, 5/20). Committee ranking member Chuck Grassley (R-Iowa) said, "There was a greater understanding of the issues we have," but there are "a lot of members who still want some more understanding." Grassley also said, "There"s just a lot of questions; there are -- I wouldn"t say misunderstandings, but there"s got to be a lot of understanding about what you"re talking about" (CQ Today, 5/20). Chances of Bipartisan Bill
Public Health

Giving Early Physical And Occupational Therapy To Critically Ill Patients Leads To Better Outcomes

Long-term complications of critical illness include intensive care unit (ICU)-acquired weakness and neuropsychiatric disease - both of which could be related to the immobilisation caused by sedation. An Article published Online First and in an upcoming edition of The Lancet has found that interrupting sedation in the earliest days of treatment to give critically ill patients physical and occupational therapy leads to better outcomes than standard care. In this randomised controlled trial, Dr John Kress (University of Chicago, USA) and colleagues analysed sedated adults in the ICU who had been on mechanical ventilation for less than 72 h, and were expected to continue for at least 24 h. Patients were assigned to the early exercise and mobilisation* (49 patients-intervention group) or standard care of daily interruption of sedation and therapy at the discretion of the ICU team (55 patients-control group). The study calculated the proportion of patients from each group that had independent functional status (IFS) at hospital discharge - defined as ability to do six tasks of daily living** and walk unaided. The researchers found that 59% of patients in the intervention group achieved IFS, compared with 35% in the control group. Intervention patients also suffered from ICU delirium*** only half as long (2.0 days) as did control patients (4.0 days). Intervention patients also had more ventilator free days while in ICU in the 28 day follow-up (23.5 days vs 21.1 days for control). The authors conclude: "A strategy for whole-body rehabilitation-consisting of interruption of sedation and physical and occupational therapy in the earliest days of critical illness-was safe and well tolerated, and resulted in better functional outcomes at hospital discharge, a shorter duration of delirium, and more ventilator-free days compared with standard care." They add: "This study highlights the robust outcomes that can be achieved with the coordinated efforts of multiple disciplines dedicated to the survival and mental and physical recovery of critically ill patients receiving mechanical ventilation." In an accompanying Comment, Dr Stephan M Jakob and Dr Jukka Takala, University Hospital, Switzerland, say: "Exercise should have a central role in the treatment of critically ill patients... Although physiotherapy is commonly administered to patients in intensive care during recovery from critical illness in the USA, the frequency and type of physiotherapy greatly varies between the type of hospital and clinical scenarios." Link to article The Lancet


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