Gazette (Montreal, Canada)

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Washington Post

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Eagle (Reading, PA)

Napping With Your Boss's Blessing

It used to be that workers could get in trouble for nodding off at work. But now some progressive companies are incorporating naptime into workers' daily schedules, allowing them to slip away at designated times to sleep for a short period -- usually 40 or 45 minutes. According to the Washington Post, a company called 42 IS Consulting, a computer consulting firm based in Berkeley, Calif., encourages naps, believing that resting keeps employees "sane and healthy." The firm has even set up a napping loft with a queen-size bed.  

"There is a natural tendency, which is biologically driven, to get tired in a work atmosphere," David Dinges, Ph.D., associate professor of psychology in psychiatry and director of the experimental psychiatry unit at the University of Pennsylvania School of Medicine, told the Washington Post. "There is no question that workers would be better off if they're allowed to sleep for 25 minutes. Naps enhance morale, performance, production, and safety." Naps are especially beneficial for workers who work odd hours or shift work. Still, Dinges said, "companies have the right to expect workers to come into the office reasonably well rested."  

Nap policies are still not very popular among most mainstream companies, Dinges added. "Most offices don't accept naps as part of work. The reason it hasn't gone as far in the United States is because we're bogged down in the American view that sleep isn't productive."  

Reports began December 7.

Hospital and Healthcare News

Profiles in Healthcare Marketing

Health Care Information at the Click of a Mouse

The University of Pennsylvania Health System's health-information web site provides consumers with health tips, advice for managing chronic diseases, chat sessions with Penn physicians, listings of educational seminars, support groups, and special events, and listings of Penn primary care physicians and specialists. Users can even tap into maps that will direct them to physicians' offices. In September, 1997, the site encountered 381,625 hits, according to Profiles in Healthcare Marketing. And recently, UPHS joined forces with Digital City Philadelphia to provide an online health-information site to American Online members. UPHS will serve as the exclusive healthcare provider for the new site.  

"This relationship helps the University of Pennsylvania Health System maintain a committed connection with the on-line community, locally and globally," said William N. Kelley, M.D., CEO of Penn's Health System and dean of the School of Medicine. "This is an innovative venture that provides on-line users a gateway to credible health-related information from a national healthcare leader."  

The site can be accessed at http://health.upenn.edu. America Online subscribers can access the site with the keyword: Penn Health.  

Reports began in November.

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KYW-TV3

Parkinson's Patients Helped by Man's Best Friend

Kathy Koch, a director at SmithKline Beecham, volunteers her time at Independence Dogs, a training school in Chadds Ford, Pa., that provides service dogs for children and adults with mobility impairments such as muscular dystrophy, multiple sclerosis, polio, cerebral palsy, and spinal-cord injuries. According to Philadelphia Business Journal, it was her idea to pair the agency's dogs with people with Parkinson's disease as well. Because the debilitating neurological disorder causes tremors and impaired balance, people with Parkinson's who are out walking sometimes draw stares and whispers from strangers who think they are drunk or demented.  

When Koch approached Matthew B. Stern, M.D., director of the Parkinson's Disease and Movement Disorders Center at Pennsylvania Hospital, with her idea, he was intrigued. "We are constantly looking for ways to improve the care of Parkinson's patients." The dogs could be used to help patients keep from falling as much and help them get back up more easily and regain their balance.  

The dogs could also be trained to sense when the Parkinson's patients were about to "freeze," a phenomenon in which patients suddenly stop moving and freeze in place. The trained dogs can walk in front of the patient and tap him or her on the foot. Said Stern, "That breaks the cycle, and they can continue moving."  

SmithKline provided a grant of $50,000 to train the first five dogs and has agreed to provide funding to help the program continue for another year. Stern plans to develop objective measures to test how the animals help the quality of life for Parkinson's patients. According to the Journal, he hopes that data can be used to secure additional money to expand the program and train more dogs.  

Reports began November 20.

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KXAS-TV5

Birth of Septuplets Triggers Much Discussion

One of the biggest news stories of 1997 was the birth of septuplets to an Iowa couple, Kenny and Bobbi McCaughey. The four boys and the three girls are only the second set of septuplets known to be born alive. When it was revealed that Bobbi McCaughey had conceived after taking the fertility medication Pergonal, physicians and ethicists were called on to examine the business of treating infertility.  

Some questioned the judgement of Bobbi McCaughey's physician, after she let the couple proceed with treatment even though a pre-ovulation ultrasound showed that Bobbi would release a very high number of ova. Others discussed the extremely high cost of prenatal care and caring for the babies after birth.  

Arthur Caplan, Ph.D., director of the Center for Bioethics, spoke to USA Today about the pressure placed on competitive infertility clinics to produce high success rates, sometimes at any cost. "The pressure is on to have good numbers for making babies and people are not penalized for making multiple babies," Caplan said. "This is an extremely lucrative business. It's an absolute cash cow."  

Glenn McGee, Ph.D., assistant professor of bioethics for Penn's School of Medicine and senior fellow in health economics at Penn's Leonard Davis Institute, told NBC's Nightside, "There is more regulation for circus animal treatment than for infertility research in America."  

Another bioethicist, David Magnus, Ph.D., graduate studies director for the Center for Bioethics and associate professor of cellular and molecular engineering and philosophy, expressed his concerns on MSNBC. "There are several ways in which I think this is potentially dangerous. It is very costly, there are risks, and there are forty specialists involved in this care. We're spending an awful lot of money at a time when there are a lot of children who aren't getting any needed treatment."  

"It's great that these babies seem to be doing well and the mom is doing well," said Caplan in an appearance on ABC's This Week. But Caplan went on to talk about limits. "We've got no ground rules, not even minimal limits just to say, standardize the informed consent. . . . And, maybe, let's put some constrictions on who can use this technology. For example, do you have to be infertile to use it? What if I just wanted, as a woman, to make seven babies just because I want to be a celebrity? Right now, there is nothing to stop that."  

Reports began November 10.

Time

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KYW-TV3

Scientific Support for Acupuncture

Acupuncture has been used in China for at least 3,000 years to treat illness and pain. And while American physicians have traditionally been skeptical of the treatment, many now consider it a viable option.  

In early November, a federal panel convened to review acupuncture and concluded that, for some ailments, acupuncture is an effective treatment. Their decision was partially based on evidence that acupuncture appears to alleviate the nausea of pregnancy and chemotherapy and the pain of dental surgery. It may also work against drug addiction, headaches, and menstrual cramps. However, the panel concluded that there was not overwhelming evidence that acupuncture could help with lower back pain and asthma.  

"We did not find that acupuncture was a panacea," said Majorie Bowman, M.D., chair of the department of family practice and community medicine. "But we did find evidence that it worked for some areas."  

Michael Cirigliano, M.D., assistant professor of medicine, told KYW-TV3, "If someone wants to see an acupuncturist for a particular pain syndrome, as long as they've been fully evaluated and a proper diagnosis has been made, I think complementary medicine is wonderful."  

The panel urged broader coverage from private insurers and the government for the alternative treatment. Acupuncture treatments cost about $70 a session.  

Reports began November 5.

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Optimizing Working Memory

Short-term, or working, memory acts like a mental triage, of sorts. A small part of the brain in the prefrontal cortex is responsible for coordinating ephemeral sights, sounds, and smells before they are jettisoned or reserved for long-term keeping. Understanding the neurochemistry of how the brain's version of Post-It Notes (TM) works has long been the subject of intense research.  

Recent studies have demonstrated a role for the neurotransmitter dopamine in orchestrating aspects of short-term memory.  

Now, a team of neuroscientists from the University of Pennsylvania Medical Center have demonstrated -- for the first time -- that a dopamine-like drug called bromocriptine can improve higher-level cognitive functions. What's more, the effects of bromocriptine depend on a person's baseline short-term memory capacity.  

"Our a priori hypothesis was that the drug would improve performance in normal subjects," remarked Daniel Y. Kimberg, Ph.D., a post-doctoral fellow in the department of neurology, and lead author of the study. "After running a couple of pilot studies, we noticed that subjects who did better on a reading memory test scored worse when performing the test a few hours after taking bromocriptine, and the ones who didn't do so well on the test seemed to improve on the drug."  

When the subjects were divided into two groups based on their reading-memory-test scores, high-capacity subjects performed more poorly on four other tests that measure different aspects of working memory after taking bromocriptine; whereas, the scores of low-capacity subjects improved.  

The findings suggest that there is an optimal level of dopamine for short-term memory to function properly, and at high levels of working memory capacity and/or dopamine found naturally in the brain, adding more dopamine to the system impairs rather than enhances performance.  

Reports began November 26.

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Calming, Not Sedating, Aggressive Alzheimer's Patients

An unfortunate complication of Alzheimer's disease is aggression and dementia, and in many cases, this leads to attacks on loved ones or nursing-home workers. And while restraints and sedation are usually used to control the problem, scientists continue to look for ways to calm these patients without making them blurry-minded.  

Now, a recent study has found that the schizophrenia medicine risperidone is effective in treating Alzheimer's related dementia and aggression. Ira Katz, M.D., Ph.D., professor of psychiatry and lead investigator of the study of 625 patients in 40 United States nursing homes and hospitals, is hopeful. "With a safer agent, we can really begin more use of the medicine not just to keep the [nursing home] aide from being slugged, but to help the patient enjoy life more."  

One 83-year-old study participant was a stroke patient who had been extremely combative with the workers in his nursing home. When the patient was treated with risperidone, he was able to cheerfully live out his last months.  

Risperidone helped 36 percent of the study patients have a 60 percent reduction in psychotic symptoms. This was not substantially greater than the group receiving placebos, in which 22 percent experienced a reduction in symptoms, but still significant. Both groups received psychological counseling, which is known to reduce symptoms. Katz said that risperidone's great advantage is that is does not cause sedation, as most other treatments do.  

Reports began December 11.

United Press International

Chicago Tribune

Arizona Republic

3-D Technology Could Reduce Breast Biopsies

When a woman is told that her mammogram is "suspicious," she is almost always subjected to subsequent breast tissue biopsy. Now, a new computer imagery that gives doctors a three-dimensional view of abnormalities in breast tissue may reduce the need for the invasive procedure.  

At the Radiological Society of North America meeting in Chicago in December, Emily Conant, M.D., associate professor of radiology and chief of the breast-imaging division, and her co-researcher Andrew Maidment, MD, director of radiology imaging physics at Thomas Jefferson University Hospital, told attendees that computer technology can determine the status of half of all suspicious calcifications, preventing the need for thousands of biopsies.  

The technology works by manipulating digital images so that physicians can watch them rotate in three dimensions on a computer screen. The technology used in the study is currently in use to position needles that extract sample tissue from breasts, Conant said.  

In Maidment's study of 44 suspicious mammograms, researchers were able to correctly pinpoint 14 cancers, and were correct in ruling out 18 of 30 other suspicious lumps. All the women in the study were scheduled for biopsies, but they agreed to undergo the additional procedure as part of the study.  

"Breast biopsies are physically and emotionally traumatic for women," Conant said. "If we can improve the accuracy of our mammography diagnoses, we can reduce the number of unnecessary biopsies. We believe this new technology will allow this advance."  

Reports began December 2.