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Popular Articles

RCN Responds To Report On NHS Pay Modernisation In England
Responding to the publication of the Public Accounts Committee report, NHS pay modernisation in England: Agenda for Change, Dr Peter Carter, RCN Chief Executive & General Secretary, said:

Washington Post Interviews Atul Gawande
The Washington Post"s Ezra Klein spoke with surgeon and writer Atul Gawande. Klein writes: "Gawande"s New Yorker article comparing the medical systems of El Paso and McAllen, Tex., has been a definitional piece in the health reform conversation. President [Barack] Obama has repeatedly invoked it. Senators have talked about it. The media have embraced it. I spoke to Gawande this afternoon about the fallout from his article, the problem of revenue-driven medicine, and whether a public plan would make a difference."
News of the day
Do Prevention Programs Save Money? CBO Says 'No'
The Congressional Budget Office has so far "failed to attribute any savings to increased efforts to provide preventive efforts like stop-smoking programs," challenging the notion that preventive care saves money for the health care system, NPR reports. "Former CBO health analyst Joe Antos, now at the American Enterprise Institute, says preventive services often cost more than they save. In screening people for cancer, for example, he says, "you screen literally millions of people, sometimes at fairly high cost per screen. You"ll pick up some true positives, people who really have the disease. You"ll pick up some false positives." Then all those people have to be followed up by the medical system, which costs even more money."
Medical Devices

Widespead And On The Increase - Vitamin D Deficiency

A new report issued by the International Osteoporosis Foundation (IOF) and published in the scientific journal Osteoporosis International1, shows that populations across the globe are suffering from the impact of low levels of vitamin D. The problem is widespread and on the increase, with potentially severe repercussions for overall health and fracture rates. Compiled by IOF"s expert working group on nutrition, the report reviews the scope and causes of low vitamin D levels in six regions: Asia, Europe, Latin America, Middle East and Africa, North America and Oceania. Regional reports are available on the IOF website Vitamin D is mainly produced in the skin upon exposure to sunlight, and, to a lesser extent, is derived from nutritional s. It plays an important role, through its influence on calcium levels, in the maintenance of organ systems, and is needed for normal bone mineralization and growth. Suboptimal levels of vitamin D may lead to increased risk of osteoporosis and hip fracture and, in severe cases, to the development of rickets, a softening of bones in children that can lead to skeletal fractures and deformity. Although there is ongoing debate as to what constitutes the optimal level of vitamin D, the report shows that regardless of whether it is defined at 50nmol/L or 75nmol/L, vitamin D status is seriously inadequate in large proportions of the population across the globe. The main risk factors for low vitamin D levels include older age, female sex, lower latitudes, winter season, darker skin pigmentation, less sunlight exposure, dietary habits, and the absence of vitamin D fortification in common foods. Further factors include the increase in urbanization, where people tend to live and work indoors, as well as cultural practices that tend towards sun avoidance and the wearing of traditional clothing that covers the skin. The severity of the problem in Middle East and South Asia arises from the combination of several of these risk factors. These findings suggest that prevention strategies must be initiated at the national level - especially given the increasing ageing of populations in many regions of the world. National plans of action should encourage safe, limited exposure to sunlight and improved dietary intake of vitamin D, whilst considering fortification of foods as well. Notes: 1. A. Mithal, D.A. Wahl, J-P. Bonjour et al. on behalf of the IOF Committee of Scientific Advisors (CSA) Nutrition Working Group. Global vitamin D status and determinants of hypovitaminosis D (2009) Osteoporosis International, in press. 2. Regional reports for Asia, Europe, Latin America, Middle East and Africa, North America and Oceania may be downloaded free of charge from the IOF website. L. Misteli International Osteoporosis Foundation


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