Longer waiting times for GP appointments predicted as concerned GPs raise fears about the impact of cuts for patient care, UK

Main Category: Primary Care / General Practice
Also Included In: Public Health
Article Date: 20 Aug 2013 - 1:00 PDT Current ratings for:
Longer waiting times for GP appointments predicted as concerned GPs raise fears about the impact of cuts for patient care, UK

Over 70% of GPs are forecasting longer waiting times for GP appointments within the next two years - as nearly half (47%) reveal that they have cut back on the range of services they provide for their patients.

In the latest survey by the Royal College of General Practitioners (RCGP) highlighting the growing crisis in general practice, more than 80% of respondents said that they now have insufficient resources to provide high quality patient care.

As well as the reduction in patient services, 39% of respondents to the ComRes poll also said they had cut practice staff and over half had experienced difficulty recruiting and retaining GPs.

Worryingly, four in five GPs were concerned that it will become increasingly difficult to deliver continuity of care to vulnerable elderly people - which has been highlighted as a priority by the English Health Secretary Jeremy Hunt. And 72% of GPs in England said that the amount of time they are able to spend on frontline patient care has been reduced as a result of the new clinical commissioning responsibilities they have been given.

The RCGP is now calling on all four Governments across the UK for an emergency package of additional investment for general practice - before there are disastrous consequences for patients.

Dr Clare Gerada, Chair of the RCGP, said: "The results of our survey paint a bleak picture for patients, the profession and the future of general practice. GPs are grappling with a 'double whammy' of spiralling workloads and dwindling resources, and big cracks are now starting to appear in the care and services that we can deliver for our patients.

"We are particularly concerned about the effect this is having, and will continue to have, on waiting times for GP appointments. We fully understand that patients are already frustrated - and GPs are doing their best to improve access to appointments - but the profession is now at breaking point and we do not have the capacity to take on any more work, without the extra funding and resources to back it up.

"GPs currently make 90% of patient contacts for only 9% of the NHS budget in England. Some GPs are making up to 60 patient contacts in a single day, which is not safe, for patients or GPs.

"We are working our hardest to make sure that patients are not affected but the status quo is no longer an option. We must have an emergency package of additional investment for general practice to protect GP services and protect our patients from even deeper cuts to their care and longer waiting times."

The RCGP survey is the latest in a series highlighting the growing crisis in general practice. The College is concerned that the current situation in A&E departments is overshadowing the very serious problems in general practice. A previous College poll by Research Now revealed that 85% of GPs now consider the profession to be 'in crisis' and half of GPs are no longer able to guarantee safe patient care.

Dr Gerada added: "General practice is the most cost-effective and efficient arm of the health service - GPs keep the rest of the NHS stable and secure. Once general practice starts to crumble, the entire NHS will follow with disastrous consequences for our patients.

"Last week the English Government announced an additional £500 million for A&E departments. What we need is our fair share of funding so that GPs can do more for our patients in their communities."

ComRes interviewed 206 General Practitioners online - 170 from England; 21 from Scotland; nine from Wales; and six from Northern Ireland - between the 7th August and 9th August 2013. Data are regionally representative by NHS Strategic Health Authority (SHA). ComRes is a member of the British Polling Council and abides by its rules. Full data tables are available on the ComRes website, www.comres.co.uk

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Royal College of General Practitioners. "Longer waiting times for GP appointments predicted as concerned GPs raise fears about the impact of cuts for patient care, UK." Medical News Today. MediLexicon, Intl., 20 Aug. 2013. Web.
20 Aug. 2013. APA
Royal College of General Practitioners. (2013, August 20). "Longer waiting times for GP appointments predicted as concerned GPs raise fears about the impact of cuts for patient care, UK." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/265004.php.

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Obesity's impact on mortality risk increases with age

Main Category: Obesity / Weight Loss / Fitness
Article Date: 15 Aug 2013 - 13:00 PDT Current ratings for:
Obesity's impact on mortality risk increases with age

Researchers reviewed data from the National Health Interview Survey linked to the National Death Index to understand the association between obesity and early adult mortality. The sample included survey respondents between the ages of 40 and 84.9. The study uniquely accounted for not only the age of the respondent, but also the period in which they were observed and the birth cohort that they were a member of.

Results indicated that obesity accounts for more U.S. deaths in recent birth cohorts than for earlier ones. Furthermore, the impact of high body mass index on mortality risk was found to increase as individuals grew older.

"The large mortality burden we document suggests that current projections of U.S. life expectancy should be modified to account for the impact of rising obesity prevalence, especially among more recent birth cohorts. We believe that it is imperative for the U.S. public and those who construct policy for that public to recognize that population health and more than a century of steady gains in life expectancy are being jeopardized by the obesity epidemic," the study's authors conclude.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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“The Impact of Obesity on U.S. Mortality Levels: The Importance of Age and Cohort Factors in Population Estimates.”

Ryan K. Masters

American Journal of Public Health

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New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals

Main Category: Biology / Biochemistry
Also Included In: Pharma Industry / Biotech Industry
Article Date: 30 Jul 2013 - 0:00 PDT Current ratings for:
New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals

Just 12 molecules of water cause the long post-activation recovery period required by potassium ion channels before they can function again. Using molecular simulations that modeled a potassium channel and its immediate cellular environment, atom for atom, University of Chicago scientists have revealed this new mechanism in the function of a nearly universal biological structure, with implications ranging from fundamental biology to the design of pharmaceuticals. Their findings were published online in Nature.

"Our research clarifies the nature of this previously mysterious inactivation state. This gives us better understanding of fundamental biology and should improve the rational design of drugs, which often target the inactivated state of channels" said Benoît Roux, PhD, professor of biochemistry and molecular biology at the University of Chicago.

Potassium channels, present in the cells of virtually living organisms, are core components in bioelectricity generation and cellular communication. Required for functions such as neural firing and muscle contraction, they serve as common targets in pharmaceutical development.

These proteins act as a gated tunnel through the cell membrane, controlling the flow of small ions into and out of cells. After being activated by an external signal, potassium channels open to allow ions through. Soon after, however, they close, entering an inactive state and are unable to respond to stimuli for 10 to up to 20 seconds.

The cause of this long recovery period, which is enormously slow by molecular standards, has remained a mystery, as structural changes in the protein are known to be almost negligible between the active and inactivated states - differing by a distance equivalent to the diameter of a single carbon atom.

To shed light on this phenomenon, Roux and his team used supercomputers to simulate the movement and behavior of every individual atom in the potassium channel and its immediate environment. After computations corresponding to millions of core-hours, the team discovered that just 12 water molecules were responsible for the slow recovery of these channels.

They found that when the potassium channel is open, water molecules quickly bind to tiny cavities within the protein structure, where they block the channel in a state that prevents the passage of ions. The water molecules are released slowly only after the external stimulus has been removed, allowing the channel to be ready for activation again. This computer simulation-based finding was then confirmed through osmolarity experiments in the laboratory.

"Observing this was a complete surprise, but it made a lot of sense in retrospect," Roux said. "Better understanding of this ubiquitous biological system will change how people think about inactivation and recovery of these channels, and has the potential to someday impact human health."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our biology / biochemistry section for the latest news on this subject.

The work was supported by grants from the National Institutes of Health. Computation resources were provided by Oak Ridge National Laboratory, the National Resource for Biomedical Supercomputing and the Pittsburgh Supercomputing Center.

University of Chicago Medical Center

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New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals

Main Category: Biology / Biochemistry
Also Included In: Pharma Industry / Biotech Industry
Article Date: 30 Jul 2013 - 0:00 PDT Current ratings for:
New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals

Just 12 molecules of water cause the long post-activation recovery period required by potassium ion channels before they can function again. Using molecular simulations that modeled a potassium channel and its immediate cellular environment, atom for atom, University of Chicago scientists have revealed this new mechanism in the function of a nearly universal biological structure, with implications ranging from fundamental biology to the design of pharmaceuticals. Their findings were published online in Nature.

"Our research clarifies the nature of this previously mysterious inactivation state. This gives us better understanding of fundamental biology and should improve the rational design of drugs, which often target the inactivated state of channels" said Benoît Roux, PhD, professor of biochemistry and molecular biology at the University of Chicago.

Potassium channels, present in the cells of virtually living organisms, are core components in bioelectricity generation and cellular communication. Required for functions such as neural firing and muscle contraction, they serve as common targets in pharmaceutical development.

These proteins act as a gated tunnel through the cell membrane, controlling the flow of small ions into and out of cells. After being activated by an external signal, potassium channels open to allow ions through. Soon after, however, they close, entering an inactive state and are unable to respond to stimuli for 10 to up to 20 seconds.

The cause of this long recovery period, which is enormously slow by molecular standards, has remained a mystery, as structural changes in the protein are known to be almost negligible between the active and inactivated states - differing by a distance equivalent to the diameter of a single carbon atom.

To shed light on this phenomenon, Roux and his team used supercomputers to simulate the movement and behavior of every individual atom in the potassium channel and its immediate environment. After computations corresponding to millions of core-hours, the team discovered that just 12 water molecules were responsible for the slow recovery of these channels.

They found that when the potassium channel is open, water molecules quickly bind to tiny cavities within the protein structure, where they block the channel in a state that prevents the passage of ions. The water molecules are released slowly only after the external stimulus has been removed, allowing the channel to be ready for activation again. This computer simulation-based finding was then confirmed through osmolarity experiments in the laboratory.

"Observing this was a complete surprise, but it made a lot of sense in retrospect," Roux said. "Better understanding of this ubiquitous biological system will change how people think about inactivation and recovery of these channels, and has the potential to someday impact human health."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our biology / biochemistry section for the latest news on this subject.

The work was supported by grants from the National Institutes of Health. Computation resources were provided by Oak Ridge National Laboratory, the National Resource for Biomedical Supercomputing and the Pittsburgh Supercomputing Center.

University of Chicago Medical Center

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University of Chicago Medical Center. "New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals." Medical News Today. MediLexicon, Intl., 30 Jul. 2013. Web.
30 Jul. 2013. APA
University of Chicago Medical Center. (2013, July 30). "New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals." Medical News Today. Retrieved from
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'New mechanism in the function of a nearly universal biological structure will impact fundamental biology, design of pharmaceuticals'

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Ventilation in OR may be affected by patient warming systems, with possible impact on infection risk

Main Category: Public Health
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 28 Jul 2013 - 0:00 PDT Current ratings for:
Ventilation in OR may be affected by patient warming systems, with possible impact on infection risk

Forced-air systems used to keep patients warm during surgery may affect the performance of operating room (OR) ventilation systems - potentially increasing exposure to airborne contaminants, reports a study in the August issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

By comparison, conductive warming systems don't disrupt ventilation airflows over the surgical site, according to the report by Dr Kumar G. Belani of University of Minnesota and colleagues. But an accompanying editorial notes that there's not yet enough evidence to change current practice with regard to patient warming in the OR.

Patient Warming Affects OR Ventilation Airflow The researchers compared the effects of two different types of patient warming systems on airflow in the OR. Modern ORs use "sophisticated ventilation systems to create localized zones of highly filtered air over the surgical site," according to Dr Belani and coauthors.

For the experimental study, the researchers set up an OR as for knee replacement surgery, using a mannequin. They then assessed the performance of the OR ventilation system using "neutrally buoyant detergent bubbles," which made it possible to visualize airflow patterns under different conditions.

Airflow was compared using a forced-air warming system, which distributes heated air under the surgical drapes and over the patient; and a conductive warming system (such as heated water blankets), which applies direct heat to the patient's skin.

Forced-air warming "generated hot air convection currents that mobilized bubbles over the anesthesia site and into the surgical site," Dr Belani and colleagues write. The average "bubble count" in the simulated surgical field was more than 100 with the forced-air warmer, compared to about 0.50 with a conductive warming system.

The convection currents created by the forced-air system drew air from under the surgical drapes and into the surgical site. The concern is that this could mobilize bacteria or other contaminants from nonsterile areas, or interfere with the ventilation system's ability to clear contaminants from the surgical site.

Too Early to Assume Increased Infection Risk? The use of " downward displacement" OR ventilation systems had previously been shown to reduce exposure to microbes and infection rates during certain types of surgery. But more recent studies have found no reduction in infection rates. The new study was designed to test whether forced-air warming systems - a relatively recent introduction to ORs - could be affecting ventilation performance.

The results suggest that forced-air patient warming systems may indeed affect airflows in the OR, potentially increasing exposure to bacteria and other contaminants during surgery. Dr Belani and coauthors conclude, "These findings warrant future research into the effects of forced air warming excess heat on clinical outcomes during contamination-sensitive surgery."

In the editorial, Drs Charles Weissman and W. Bosseau Murray note that the findings provide only indirect evidence of potential infection risk, in a simulated setting. That's in contrast to the known benefits of preventing drops in body temperature during surgery. Pending further research, Drs Weissman and Murray write, "[T]he prudent course...might be to continue with the presently proven successful warming therapies, but keep an open mind about the possible future need to change practice."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Read the article in Anesthesia & Analgesia: http://www.anesthesia-analgesia.org/content/117/2/406.full?. The journal is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

Wolters Kluwer Health

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