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Health and Life
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What doctors think they are telling hospital patients, and what those patients actually hear, may be very different, a small study suggests. The findings, from a study of 89 patients at one U.S. hospital, add to research showing that doctors and patients are often not on the same page when discussing diagnoses and treatment. In interviews with the patients on the day of their discharge, researchers found that only 18 percent even knew the name of the main physician in charge of their hospital care. Meanwhile, just 57 percent left the hospital knowing what their diagnosis was. In contrast, two-thirds of the 43 physicians interviewed thought their patients knew their name, and 77 percent believed their patients were aware of their diagnosis. Drs. Douglas P. Olson and Donna M. Windish of Yale University School of Medicine in New Haven, Connecticut, report the results in the Archives of Internal Medicine. The finding that many patients were unsure of their diagnosis or their doctor's name may sound surprising, but it is not new, according to Olson. Past studies have found that the majority of hospital patients cannot name their main physician, and frequently cannot name their medical problem. However, the current study also shows that many doctors mistakenly believe their patients know more than they do. "What's new here is the discrepancy between doctors and patients," Olson told Reuters Health. "Patients aren't really getting the take-home message." The communication gaps go beyond names and diagnoses, the study found. Of patients in this study who were prescribed a new medication during their hospital stay, one-quarter said their doctor never told them about it. And very few -- 10 percent -- said their doctor discussed the drug's potential side effects with them. In contrast, all physicians in the study said they at least sometimes told patients about any new prescriptions, and 81 percent said they described the possible side effects at least some of the time. In recent years, the medical community has increasingly focused on improving doctor-patient communication. In residency programs at academic hospitals, for instance, doctors-in-training are taught to include patients in discussions rather than talking amongst themselves in front of patients, Olson pointed out. "But there's still a disconnect," he said, adding that even when patients say they understand, that often turns out not to be the case. One explanation, according to Olson, may be that many hospitalized patients are elderly and have complex medical problems -- not just one diagnosis, but several co-existing health conditions -- and the information they receive during their stay "could understandably be overwhelming." And compared with 30 or 40 years ago, Olson noted, patients' hospital stays are now typically much shorter; that leaves them with less time to absorb and fully understand information about their condition and any treatment changes. One potential way to address the communication gaps would be to give patients and families written information, in addition to spoken explanations, during the hospital stay -- and not only at discharge, Olson said. "It's important for us to take a step back and see how some system changes might improve communication," he said. Steps patients and their family members can take include writing down any questions as they come up so they can raise them with the doctor later, according to Olson. Family involvement is important, he noted, particularly for older patients with more complex medical problems and multiple medications. "How is my life going to be different when I leave the hospital?" is a good general question that patients can ask their doctors, Olson recommends. It can help start a discussion about a range of concerns, including any lifestyle adjustments and medication changes that need to be made, he said. Olson also advised that patients lacking a primary care doctor get the number of someone at the hospital whom they can call with any questions after they are discharged. 2010-08-31
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Rochelle Thomas has gotten so fed up with her husband's snoring over the years that she's created a 'three strikes rule.' Each time he wakes her up with his snorts, honks or shudders -- shaking the mattress 'like a cheap motel-bed vibrator' -- she gives him a penalty.
Strike one: A nudge.
Strike two: A shove or kick.
Strike three: He's out -- of the bed and down the hall to the guest room.
'It prevents anger in the morning from lack of sleep,' says Ms. Thomas, a sales representative from La Mirada, Calif. 'And I think it just may have saved his life, because I am sure I would have killed him by now.'
Isn't sleeping together supposed to be fun?
Well, maybe in the beginning. But as soon as we start trying to get some actual rest, we quickly realize what the bed really is: another stage to play out the power struggles that occupy the rest of our waking hours.
Bedroom bickering goes beyond sex and snoring. Couples argue about everything from what time to turn out the lights to who hogs the covers. Should you keep the window open or closed? Watch TV while your partner sleeps? Let the kids climb into bed with you when they're scared? It's a wonder anyone gets any shut-eye at all.
Recently, I've listened to friends complain about wives who stuff used tissues under the pillow and partners who place grime-encrusted suitcases on the sheets when they pack.
One friend who goes to bed earlier than his boyfriend admits he's spent up to an hour at night knocking on -- and even throwing things at -- the wall that separates the bedroom from the living room, trying to get his partner to come to bed. (He stopped after he accidentally clocked the cat with a book.)
When 26-year-old Jackie Vertuccio and her boyfriend moved into their first apartment together a few months ago, she says they worried about how they'd adjust to actually sleeping together, night after night.
According to Ms. Vertuccio, her boyfriend likes to go to bed early and wake up late. (She's the opposite.) She likes to cuddle. (He says it's too hot in the summer to do that.) And then there's 'Pinky,' the terry cloth blanket that her boyfriend has had since he was a child. Ms. Vertuccio thinks it needs to go.
Now, Ms. Vertuccio says the Queens, N.Y., couple has struck a compromise: He tries to sleep less and she tries to sleep more, so they can go to bed and wake up at the same time. There's a summer ban on cuddling -- and, in return, a winter ban on 'Pinky.'
Remember when you used to rip the covers off your partner in lust, not anger? Early in a relationship, we marked the turning points by bedroom firsts: the first time we had sex, first time we spent the night together, first time we watched our sleeping partner and thought 'I don't want you to leave.'
So what went wrong? We moved in together. And although we've had to learn to compromise in many areas of our coupled lives, the bed may prove to be the hardest. It's a small area to share. And we're often tired and cranky -- or flat-out unconscious -- when we're in it.
Is it any wonder, then, that almost one in four couples sleeps in separate beds or bedrooms, according to the National Sleep Foundation.
Yet here's the dilemma: No matter how annoying we find the body next to us in bed, we miss it when it's not there.
So how can we get a good night's sleep? Here, some ideas: Wear a mask.Cliff Mugnier, a 66-year-old Baton Rouge civil engineering professor has one that conforms around the bridge of his nose with memory foam to block out the glare from the cable news shows his girlfriend insists on keeping on all night. Get your own sheets and blankets.Stacey Scaravelli, a 44-year-old Wheat Ridge, Colo., environmental consultant tried this after her boyfriend began using all the covers to wrap himself up 'like a burrito' on his side of the bed. Host bedroom 'visiting hours.'That's what financial adviser Greg Scherr and his wife, Valorie, did before he retired. She'd climb into bed with him at 8:30 p.m., then leave around 10 p.m., after he fell asleep. 'Both of us being in bed and awake and coherent at the same time was a major advantage to the physical part of our relationship,' says Mr. Scherr. Build another bedroom. Forty-year-old Belton, Texas, insurance salesman John Farwell and his wife plunked down $22,000 and converted their three-car garage to a two-car one to make room for another bedroom. Now, whether or not the sheets are tucked in and the number times Mr. Farwell gets up to use the bathroom are non-issues. 'People in the 1800s were considered rich if they had separate rooms as married couples,' says Mr. Farwell. 'That is what we keep reminding each other.' Use three beds. Pablo and Beverly Solomon have two -- both full-sized -- in their bedroom: One with a hard mattress and a light blanket for him and one with a soft mattress and an electric blanket for her. 'We took the easy way out,' says Mr. Solomon, 62, an artist.
So where's the third bed? In a guest room downstairs, which the Lampasas, Texas, couple uses for intimate moments.
'It's sexier that way,' says Ms. Solomon, 56, who does the sales and marketing of her husband's art. 'The bedroom is where you brush your teeth and go to bed. This is where we actually add some romance to the marriage -- to keep it rocking.' 2010-08-30
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Ovarian function of recession is the natural, normal ovarian function in 45 ~ 50-year-old is beginning to decline. In recent years, only to find that the ovaries ' premature ' has been a noticeable increase of patients in the out-patient often can see some 30 or so young white-collar signs of premature ovarian failure occurs. The exact cause of premature ovarian failure is not very clear, but at present there are more positive immunization, drugs, surgery, infection, destructive factors. 1. Immune diseasesMost autoimmune diseases such as thyroid inflammation can lead to premature ovarian failure. 2.Iatrogenic premature ovarian failure40 years ago with bilateral or unilateral ovarian tissue can cause ovarian insufficiency causes premature ovarian failure. Therefore, you should avoid invasive surgical operations, such as repeated abortions, etc.; 3.Idiopathic premature ovarian failureIs a clear risk of secondary amenorrhea, premature ovarian failure is the most important types. Many in the clinical incidence of child-bearing age, progressive or appears on the sexual menstrual scarce, and amenorrhea and accompanied by hot flashes, irritability, menopause symptoms, genital atrophy within a State. Some young girls amenorrheal menstruation or even a long time, do not go to the hospital for treatment until the infertility. Premature ovarian failure occurs if not timely treatment, amenorrhea, patients with osteoporosis, cardiovascular disease and disorder of lipid metabolism and other symptoms. 4.Virus infectionViruses such as herpes simplex virus, mumps virus can cause ovarian inflammatory autoimmune damage caused or ovarian premature ovarian failure. 5.Used to promote the ovulationModern human infertility rate increases, some women are forced to use the ovulation method to improve the chances of pregnancy, but this was excessive, lethal to the ovary is enormous. 6.Excessive weight lossExcessive weight loss, resulting in a dramatic reduction of body fat, fat ratio is too low it will affect the level of estrogen in the body, as the main raw materials of synthetic estrogen as fat, body fat, not enough estrogen into estrogen reduce menstrual disorders and even amenorrhea, irregular menstrual suppression will also inhibits ovarian stimulation, easily lead to premature ovarian failure, if the treatment is not timely, or even cause infertility. Premature ovarian failure and increasing menstrual disorders, and so on. 7.StressModern women are in fierce competition, due to stress, give rise to vegetative nerve dysfunction, endocrine regulation affecting the human body, resulting in premature ovarian failure, estrogen secretion of recession, menopause early arrival. 8.Bad habitsSmoking and drinking bad habits can also cause premature ovarian failure, because of nicotine in cigarettes and alcohol alcohol interferes with normal menstruation and menstrual disorders caused by. 2010-08-29
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You don't need to delay a second pregnancy if you've had a miscarriage, Scottish researchers said . In fact, women who got pregnant within six months of their miscarriage were more likely to go on to have a live birth than those who waited longer, the researchers' report shows. "Women are often advised to delay the second pregnancy," Dr. Sohinee Bhattacharya, who worked on the study, told Reuters Health. Since 2005, the World Health Organization (WHO) has recommended that women wait at least half a year before they try again. According to Bhattacharya, of Aberdeen Maternity Hospital, those guidelines are widely used, but based on very little evidence. "The sound advice to women is that there is no physical reason why you would delay your second pregnancy," she said. In developed countries, many women have their first child later in life, which ups the chances of miscarrying. Almost a third of 40-year-olds miscarry, for example, according to the researchers, whose findings are published in the journal BMJ. So Bhattacharya's advice is to try again as soon as possible. "But," she added, "there is no point in saying 'Yes, go for it now' if the woman is completely drained emotionally or physically." Other doctors say it's too early to change current practice. "We would need some additional data to really firmly direct patients," obstetrician Dr. Alison G. Cahill of Washington University in St. Louis told Reuters Health. "What I tell my patients is that there is some available data and that from that data the recommendation from the WHO is to wait 6 months," she said. "But when we take a step back, most women go on to have a successful pregnancy." The Scottish researchers examined hospital data for more than 30,000 women who had a miscarriage in their first recorded pregnancy. Of those who got pregnant within six months of the miscarriage, 85 percent gave birth to a live baby and 10 percent miscarried again. If more time went by, however, fewer than 80 percent of the women had live births and more than 12 percent miscarried. Those findings held even after accounting for the women's age and socioeconomic status, although adjusting for smoking tended to reduce the differences. Bhattacharya stressed the results might not hold in developing countries, where women tend to be much younger when they have kids. What makes the data difficult to interpret, said Cahill, is that there is no way of telling exactly how soon after their miscarriages women started trying to get pregnant again. The researchers only know when they became pregnant. The results also say nothing about the effects of the 2005 WHO guidelines because the hospital records examined were from 1981 to 2000. If most of the women were trying to get pregnant again right away, those who succeeded early on might have had a healthier reproductive system. That, in turn, might boost their chances of having a live birth. Whatever the explanation, said Cahill, "the most likely outcome is a successful pregnancy." 2010-08-29
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