Heavy consumption of hot dogs, sausages and luncheon meats, along with other forms of processed meat, was associated with
the greatest risk of pancreatic cancer in a large multiethnic study reported today at the 96th Annual Meeting of the American
Association for Cancer Research.

“The results suggest that carcinogenic substances related to meat preparation, rather than their inherent fat or cholesterol
content, might be responsible for the association,” said Ute NпїЅthlings, DrPH, MSE, the study’s lead investigator from the
Cancer Research Center at the University of Hawaii in Honolulu.

Meat consumption has been linked to pancreatic cancer in several case-control studies in the past, but the results have been
inconsistent and data from prospective studies has been lacking.

For this study, researchers from the Cancer Research Center and USC examined the relationship of diet to pancreatic cancer
among 190,545 men and women of African-American, Japanese-American, Caucasian, Latino and Native Hawaiian origin who were
part of the Multiethnic Cohort Study in Hawaii and Los Angeles. An average follow-up of seven years yielded 482 incident
cases of pancreatic cancer.

The researchers found that the heavy consumption of processed meats resulted in the highest risk for pancreatic cancer, after
adjusting for age, smoking status, history of diabetes, familial history of pancreatic cancer and ethnicity. Those who
consumed the greatest amount of processed meats had a 67 percent increase in risk over those participants with the lowest
intake of this food category. A diet rich in pork and red meat also increased pancreatic cancer risk by about 50 percent,
compared to their counterparts who ate less meat.

Consumption of poultry, fish, dairy products and eggs showed no link to pancreatic cancer risk, nor did overall intake of
total fat, saturated fat, or cholesterol.

“An analysis of fat and saturated fat intakes showed a significant increase in risk for fats from meat, but not from dairy
products, indicating that fat and saturated fat are not likely to contribute to the underlying carcinogenic mechanism,” said
NпїЅthlings.

In particular, the scientists suggest that chemical reactions that occur during the preparation of processed meats might be
responsible for the association. Such reactions can yield carcinogens including heterocyclic amines or polycyclic aromatic
hydrocarbons.

“Our study is the largest of its kind to demonstrate a link between high consumption of processed meats over long periods of
time and pancreatic cancer,” said NпїЅthlings. “The sample size allowed us to obtain statistically significant risk-estimates
that support this hypothesis.”

Founded in 1907, the American Association for Cancer Research is a professional society of more than 24,000 laboratory,
translational, and clinical scientists engaged in all areas of cancer research in the United States and in more than 60 other
countries. AACR’s mission is to accelerate the prevention and cure of cancer through research, education, communication, and
advocacy. Its principal activities include the publication of five major peer-reviewed scientific journals: Cancer Research;
Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers &
Prevention. AACR’s Annual Meetings attract more than 15,000 participants who share new and significant discoveries in the
cancer field. Specialty meetings, held throughout the year, focus on the latest developments in all areas of cancer research.

Contact: Warren R. Froelich
froelichaacr
215-440-9300
American Association for Cancer Research
aacr

The NHS Constitution promises a health service based on choice, information and respect – and beat welcomes this commitment. However – for people affected by eating disorders – their experience of the health service too often falls far short of this.

beat surveyed 1,500 people affected by an eating disorder about their experiences of visiting their GP. The vast majority encountered uninformed GPs and a widespread lack of understanding. Rather than ‘choice’, their recovery was entirely down to chance – with the odds stacked against them.

Chance: the ‘information lottery’

59% of people visit their GP about their eating disorder worries

beat always encourages people to speak to their GP about their eating disorder. Speaking out ends the silence and secrecy on which eating disorders thrive. It is a courageous step – and a great first move towards recovery.

But people need to have confidence and trust that their GP is informed about eating disorders and knows how to help them. beat knows that an understanding and supportive GP can be a gateway to effective treatment – and a signpost to recovery.

“My GP referred me straight away to the nearest mental health unit. The help I got was immeasurable. Not once did I feel a burden or that I wasn’t worth bothering about. I’m lucky to live near one of the best GPs.”

Yet – according to our survey:

Only 15% of people felt their GP understood eating disorders and knew how to help

“I felt as if my weight had to drop before the GP would take my worries seriously.”

“When I first went to see my GP they didn’t listen at all. They just told me it was a phase I was going through.”

Far too many people encounter a GP who is not up to date about eating disorders. We have heard from people whose GPs did not take eating disorders seriously, treating it as a phase or a diet gone wrong. GPs should be putting an end to these dangerous myths – not propagating them.

The majority of people told us their GP was unable to help them – GPs didn’t know about available treatment or how they could access it. People affected by eating disorders need support – provided without delay. If GPs aren’t informed about available treatment then their patients’ recovery can be endangered – with fatal consequences.

“I left the doctors feeling disheartened, patronised and as if I was making a big fuss about nothing.”

Ending the lottery: a campaign for choice

You have the right to choice about your NHS care and to information to support these choices.”

The NHS Constitution

beat is committed to bring about change, and improving the choices that everyone has about their health. The NHS has promised a service based on choice – not on chance. Our major campaigning issue for 2009 is to hold the NHS to their promise.

“People with eating disorders should be assessed and receive treatment at the earliest opportunity.”

The NICE guidelines on eating disorders

The NICE guidelines on eating disorders provide evidence-based recommendations of effective treatment. They state that recovery is possible, provided that GPs listen to their patients, act quickly and, in the case of young people, involve their families as much as possible.

The NHS Constitution grants patients a legal right to the treatment NICE recommends. GPs are crucial to this right becoming a reality. Our campaign will hold the health service to account. We will champion best practice and highlight where changes are needed. We call on the NHS to do away with the unacceptable variety in standards of primary care.

That only 15% of our survey felt their GPs to be informed and understanding is a shocking indictment of just how much needs to be done.

Choosing recovery

“My GP phoned me the next morning and told me he’d referred me to a specialist eating disorder service.”

“I was happy to open up to my GP. She made it feel as if I could – because she was there to help me.”

beat wants to see the NHS deliver their promise. We want anyone affected by an eating disorder to feel able to speak to their GP, confident they will reach someone who understands their condition and is willing to listen.

Right now, too few people receive the quality of service that should be theirs by right – rather than by luck or chance. It is only by ending this information lottery that everyone will have the best chance of beating their eating disorder.

“My GP discussed the different options for treatment – she told me about counselling and other services I could be referred to. She explained how long the referral would take. I left feeling relieved and comfortable – and optimistic about recovery.”

b-eat

Medtronic (NYSE: MDT) announced its commitment to voluntarily disclose payments to U.S. physicians. The company will begin capturing payment data for all of its businesses on January 1, 2010 and will publicly report this information annually. The first disclosure will occur in March of 2011 and will address payments made to physicians during calendar year 2010. The company will commission an annual third party audit to demonstrate its commitment to the accuracy of these postings, and will make a summary of the audit results public.

Medtronic will report the amount paid in consulting fees, royalties or honoraria for physicians who receive payments of $5,000 or more per year from Medtronic. Consulting agreements include counsel for areas such as education and training, clinical trial design and administration, and product design and safety. The company currently plans to report these data on its company website.

“Relationships between industry and doctors are essential to innovation, education and training in our industry.” said Bill Hawkins, chairman and CEO. “Through greater transparency about the nature of these relationships, we will help people better understand how important they are to developing life-saving and enhancing products for patients who need them.”

Medtronic initiated a first step toward greater transparency when it launched its online Donations Registry in August 2008 (available at medtronic). The donations registry makes public donations given by Medtronic to U.S. customers or organizations affiliated with customers, including patient groups and medical societies. In addition, the company has supported Senator Charles Grassley and Senator Herb Kohl’s proposed legislation, the Physician Payments Sunshine Act, which proposed that all medical device manufacturers publicly disclose payments made to physicians for their inventions and assistance in product development, research and training. The company continues to support appropriate legislation in this area. Finally, Medtronic, with the Advanced Medical Technology Association, led the creation of an industry code of ethics designed to guide industry day-to-day relationships with healthcare professionals.

“We will work hard with the bill sponsors to get this legislation passed,” said Hawkins. “These efforts will ensure a level playing field and consistency in reporting.”

About Medtronic

Medtronic, Inc., headquartered in Minneapolis, is the global leader in medical technology – alleviating pain, restoring health, and extending life for millions of people around the world.

Medtronic

Doctors who become addicted to alcohol and other drugs can be treated successfully and returned to medical practice with the help of special programs that couple referral to treatment and monitoring with rapid responses to noncompliance, University of Florida researchers report.

The study is the first national-level analysis of such Physician Health Programs, and confirms they are effective alternatives to simply punishing drug-addicted doctors. The findings are published in the March issue of the Journal of Substance Abuse Treatment.

More than three-quarters of doctors enrolled in state programs stayed drug-free over a five-year monitoring period. The results were the same regardless of whether the doctor’s drug of choice was alcohol, crack cocaine, prescription drugs or other substances.

“Treatment works,” said Dr. Mark Gold, psychiatry chairman at the UF College of Medicine and the McKnight Brain Institute. “It has been shown now to be safe and effective and cost-effective.”

But it’s not just for doctors, said Gold, who with UF colleagues pioneered evaluation and treatment for drug-addicted doctors. “It should be a model for treatment of anyone with these diagnoses.”

In general, rates of illicit drug use are lower among physicians than the general public, but rates of prescription misuse are five times higher among physicians, according to a 2008 review Gold co-authored in the Harvard Review of Psychiatry.

Gold and others conclude that drug problems in doctors are related to medical specialties that put them in regular contact with drugs of addiction, ease of access to drugs, stress and lack of early detection. Addiction also appears linked to physician-suicide.

Physician Health Programs are not addiction treatment programs, however. Instead, they provide intensive, long-term case management and monitoring. Fifty-five percent of doctors enrolled are mandated formally by a licensing board, hospital, malpractice insurance or other agency. The rest are informally “mandated” by others such as employers, families and colleagues. Doctors sign contracts agreeing to abstain from drugs or face intensified treatment, being reported to their medical licensing boards or losing their license.

The programs aim to save the lives and careers of addicted physicians, and to protect the public by addressing substance use among doctors. They are also are an effective way to remove noncompliant doctors from the practice of medicine.

“This isn’t to cover it up, it’s quite the opposite,” said Temple University psychiatry chairman Dr. David Baron, who oversees Pennsylvania’s program. “It allows for quality treatment and to make sure that we’re still ensuring the safety of the public.” Baron was not involved in the current study.

Program measures include group and individual therapy, residential and outpatient programs, surprise workplace visits from monitors, and links to 12-step programs of Alcoholics Anonymous and Narcotics Anonymous. Doctor-patients get care not just for drug problems, but also for accompanying medical or psychiatric disorders. They pay for their treatment, drug tests and follow-up care.

The research, funded by the Robert Wood Johnson Foundation, evaluated 904 physicians admitted to 16 state-run Physician Health Programs from 1995 to 2001. Collaborators included founding National Institute of Drug Abuse Director and former drug czar Dr. Robert Dupont, A. Thomas McLellan, of the University of Pennsylvania, and Lisa Merlo, of UF.

Previous studies have shown that in individual states, and on a small scale, the programs are effective. The current study, first reported at the Betty Ford Institute, has the largest sample of physicians ever followed, and over the longest period.

Doctors in the programs had to abstain from alcohol or other drugs, and were tested frequently at random for five or more years. If tests revealed they had returned to substance abuse, swift action was taken — doctors were reported to the medical board, which could lead to loss of their licenses.

“It’s the idea of a carrot and a stick,” said Dr. Scott Teitelbaum, director of the UF-run Florida Recovery Center, which treats addicted physicians referred from around the country. “There’s always a level of resistance — people never feel they need the level of care that’s recommended. Someone might not agree with you, but if they want to practice medicine they have to comply.”

Often, with the support of peers and growing realization that treatment is working, physician-patients’ motivations change from simply wanting to obey the rules to wanting to change their lives, Teitelbaum said.

One-fifth of doctors were reported to their board during treatment and monitoring — some more than once with multiple disciplinary actions taken.

But 78 percent of doctors in the programs had no positive drug tests during five years of intensive monitoring. And five to seven years after starting treatment, 72 percent were actively practicing medicine, without drug abuse or malpractice.

Eighteen percent left medical practice, while others relapsed into drug use. Three percent of those who didn’t complete their programs had substance-related deaths or committed suicide.

Although the programs employed a variety of approaches, the researchers found that success was not related to specific therapists or modes of therapy, but rather to the long-term nature of the treatment.

Still, there are some “essential ingredients” that successful programs have in common, Gold said. Those include treatment extended over years — not weeks or months — and unambiguous success markers such as urine testing and return to work and normal family activities.

###

Source: Czerne M. Reid

University of Florida

The UK Government’s extended hours initiative has deprived small GP practices, and those in the poorest areas of the country, of millions in funding according to a major Pulse investigation.

Smaller practices find it far more difficult to offer evening and weekend appointments compared to those with a large number of GPs, disadvantaging their patients and reducing their funding by thousands of pounds.

There is also evidence the extended hours policy is widening the gap between rich and poor. Only 61% of urban practices in the highest quartile for deprivation will qualify for the average ВЈ18,000 annual payment for providing extended hours, compared with 75% of those in the lowest quartile for deprivation.

Only 44% of one-GP practices and 60% of those with two or three partners are currently offering extended hours, compared to 83% of those with eight or more partners, shows our analysis of 200 randomly selected practices from more than 100 PCTs.

Payments were recycled from other parts of the contract, meaning practices that are not offering extended hours are receiving less funding compared to one year ago.

Official government figures show the proportion of practices not offering extended opening has stabilised at almost 30%.

Pulse’s investigation identifies for the first time specifically which practices are opening longer – based on calls to each practice to confirm extended opening, data on practice size from NHS Choices and indices of deprivation data from the Office for National Statistics.

The location of a practice is also a key factor, says the report. Some 68% of urban practices offer extended hours, compared with 59% in rural areas.

Dr Asad Mubarik, a GP in Rochdale, Greater Manchester, said his ‘semi-rural’ practice could not afford to open longer. “We would make a loss if we did,’ he said, adding practices in deprived urban areas also faced safety concerns. Opening in deprived urban areas can be very scary. I know a GP who was assaulted after work and ended up in intensive care. The number of staff you would have to have working in the evening would be significant.”

A spokesperson for the Department of Health said: “The issue is not the size of practice, their location or the patients they treat – it is whether GPs make the decision to provide extended hours for their patients. In some PCTs, nearly 100% of practices, from singlehanded to large surgeries and in both urban and rural areas, are delivering extended hours.”

Richard Hoey, deputy editor of Pulse, said: “The Government insists that whether a GP practice offers extended opening is purely a matter of choice, but our statistics show that it is much easier for some practices than others. That means some groups of patients miss out twice over, because they don’t get access to longer hours, and neither does their practice receive as much money for their healthcare. What’s worse is that it is often poorer patients who are missing out, and it is they who often find it hardest to take time off work to see a GP.”

About PulseToday

PulseToday is the GP’s website in the UK providing general practice news, clinical education and practice information to GPs and primary care staff.

www.pulsetoday

Medtronic on Tuesday announced plans to begin to disclose certain payments to physicians, the AP/Miami Herald reports. In a statement, Medtronic said that the company will begin to collect information on payments to physicians and make the first disclosures in March 2011 (AP/Miami Herald, 2/24). The disclosures will include consulting fees, royalties or honoraria for physicians who receive payments of $5,000 or more annually from Medtronic (Burton, Wall Street Journal, 2/24).

Steve Cragle, a Medtronic spokesperson, said that the company cannot begin to make the disclosures earlier because of the need to design a tracking system for payments to physicians to allow the practice. In addition, Medtronic must address confidentiality provisions in some contracts with physicians, Cragle said (Snowbeck, St. Paul Pioneer Press, 2/24).

According to Medtronic Chair and CEO Bill Hawkins, the company also supports a bill (S 301) sponsored by Sens. Herb Kohl (D-Wis.) and Chuck Grassley (R-Iowa) that would require pharmaceutical and medical device companies to publicly disclose any gifts and payments to physicians of $500 or more annually. Hawkins in a statement said, “Relationships between industry and doctors are essential to innovation, education and training in our industry,” adding, “Through greater transparency about the nature of these relationships, we will help people better understand how important they are to developing lifesaving and enhancing products for patients who need them” (AP/Miami Herald, 2/24).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Reps. Randy Forbes (R-Va.) and Patrick Kennedy (D-R.I.) recently introduced a bill (HR 855) that seeks to promote increased use of medical modeling and simulation technology to reduce health care costs and medical errors, CQ HealthBeat reports. M&S allows physicians to practice difficult medical procedures through virtual reality technology. The legislation would authorize $50 million for fiscal year 2010 to establish M&S “centers of excellence” to expand development of the field and fund grants for academic and professional organizations.

According to Forbes, M&S could reduce health care costs by as much $17 billion nationwide through a decrease in medical errors. In a statement, Forbes said, “The use of medical modeling and simulation provides doctors the ability to practice new and sophisticated techniques, with considerable cost benefits to patients and to our nation as a whole.” He added that the bill would help “bring our health care industry into the 21st century through the use of technology” and provide the “potential to increase doctor skill and proficiency, save money and most importantly, save lives.”

Kennedy said in a statement, “Medical errors can be extremely costly, and in the worst cases, fatal, with thousands of fatalities each year attributed to medical errors,” adding, “Enabling clinicians to train and practice these new techniques in ‘life-like’ scenarios can dramatically reduce clinical error rates and improve patient safety and outcomes” (Weyl, CQ HealthBeat, 2/23).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Royal Australian College of General Practitioners (RACGP) acknowledges the release of the Australian Government’s Report of the Maternity Services Review Improving Maternity Services in Australia.

“Australia currently leads the world in terms of the safety of our maternity services and the time has come to recognise that the greatest risk to our maternity services is lack of investment,” said Dr Chris Mitchell, RACGP President and GP in northern NSW.

“Women want to deliver their babies safely and preferably close to their home and local hospital. Fifty percent of all rural maternity units across Australia have been closed in the past 12 years; this is not acceptable,” said Dr Kathryn Kirkpatrick, Chair, RACGP National Rural Faculty and GP in southern Queensland.

“The closure of rural obstetric services by a succession of State Governments has meant women and their unborn and new born children are required to travel in order to receive maternity care. This travel disrupts the family unit and exposes families to increased costs and increased risks. After adjustments for risk, rural maternity units are Australia’s safest maternity option,” said Dr Kirkpatrick.

Australian general practice needs to be fully engaged in maternity care. GPs know the value of collaborative models of care, with GP obstetricians, specialist obstetricians and midwives all working together. We know that these models provide safe options for women to access maternity care closer to home.

Maternity teams need a shared understanding of roles and responsibilities; that is why the RACGP’s submission to the Maternity Services Review focused on teams and teamwork within maternity care.

“We need service delivery models that build on this teamwork, rather than fragment care by creating new silos of care delivery. The RACGP supports a team based approach to maternity care in Australia, with models of care that utilise the skills of all members of the team. These teams need to fully utilise general practice in antenatal, intrapartum and postnatal care when this is possible,” said Dr Kirkpatrick.

The RACGP, in its submission to the Maternity Services Review, made the following recommendations for any changes to the way care is delivered for women and babies:

- All roles support the safety of the woman and family
- Clarity over who leads in any particular case
- Watertight handover between care providers
- Training and ongoing education of those involved in the care of women and babies is accessible, relevant, feasible and affordable
- Care is aligned with training and experience of staff and back up is available in a timely manner
- Infrastructure is aligned with the level of care to be provided in that facility
- Indemnity covers all care provided by each team member
- Women agree with proposed strategies

The RACGP is concerned that many of these issues have not been addressed in the current review.

About the RACGP

The Royal Australian College of General Practitioners (RACGP) is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP represents the majority of Australia’s urban and rural general practitioners.

Royal Australian College of General Practitioners

An on-line training module for GP’s and healthcare professionals to increase awareness of Parkinson’s disease, has attracted over 3,000 participants from as far away as New Zealand.

Parkinsons’ Disease Society’s (PDS) 2007 membership survey showed that 50% of people with Parkinson’s believed there was a lack of understanding from GP’s and professionals about how to spot and treat the condition.

As a result the PDS commissioned BMJ Learning to produce an on-line module to help users increase their knowledge and skills in how to care for patients, and how to increase knowledge and skills to assess and refer people with suspected Parkinson’s Disease.

Daiga Heisters, PDS National Education Adviser, comments:

“We were delighted with the response to the training. The target of 400 participants to complete the module in the first 6 months was exceeded with over 3,000 completing in the first 5 months. This reflects the interest health care professionals have in increasing their knowledge on the management of Parkinson’s and the effectiveness of BMJ Learning’s marketing campaign”.

Alveena Igbal, from Derby City PCT who took the course, said:

“As our elderly population increases so does the challenge to deal with chronic disabling conditions like Parkinsonism. In this context I have found the BMJ Learning module very useful.”

Dr Amal Paul from Pudsey, Leeds, adds:

” As a G.P. I have to look after a few patients with Parkinson’s disease, and the need for further care management was more imperative for me when someone close to me was diagnosed. The module was very interesting, designed for adult learning, interactive, and educational. My knowledge and skills have definitely improved and the module was a big impetus for further study”.

This module complements the work of the PDS Education Training Officers currently working with GPs and other healthcare professionals throughout the UK at a local level.

Due to the success of the pilot, a second learning module is being launched, focusing on non- motor symptoms of Parkinson’s such as depression and sleep disorders.

For more information about Parkinson’s visit: parkinsons

For more information about BMJ Learning visit bmjlearning.

The Parkinson’s Disease Society (PDS) is the leading authority in the UK on the condition and a world leader in research. We campaign for a better quality of life for people with Parkinson’s wherever they live in the UK. We provide expert information on all aspects of Parkinson’s and a local support network for people with Parkinson’s, their carers, families and friends. We are the UK’s leading non-commercial funder of research into the cause, prevention and improved management of Parkinson’s and are confident that our work will help lead to a cure. We are totally dependent on voluntary donations.

Parkinson’s Disease Society

NPR’s “News and Notes” on Tuesday profiled two brothers, originally from a village in western Kenya, who returned to the village after attending medical school at Dartmouth College to build and operate a local health clinic to provide services such as HIV/AIDS, tuberculosis and malaria treatment. Milton Ochieng said that after seeing “the difficulties in people accessing health care” in their village while growing up and having both parents die from AIDS-related causes, he returned with his brother to open a clinic that provides “public health interventions,” including vaccinations and child immunizations. He reported that the clinic has seen more than 30,000 patients, 85% of whom have been treated at no cost. He said that the government plans to partner with the clinic to bolster community outreach efforts, adding, “We are hoping to break ground on the maternity wing and an HIV wing so that we can provide more comprehensive care to the community.”

According to Fred Ochieng, curbing the spread of HIV in Kenya will require “interventions on different levels.” He added that the clinic has used soccer, which has a large following in the country, to provide HIV/AIDS education through tournaments to “bring people together to talk about ways to raise HIV awareness” and “answer the questions that the young people do have about HIV.” Fred Ochieng said that he is excited about the “potential” of President Obama’s plans to support HIV/AIDS efforts in Africa. He added that there has been a “feminization of HIV/AIDS” and that support is needed for agriculture, sanitation and health care delivery (Cox, “News and Notes”, NPR, 2/24).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.