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Discoveries
Research Briefs
Of place and race
To better understand the interaction of race
and place in cancer care, DMS researchers
mined U.S. Census and Medicare data. Urban
African Americans have better access to
specialized cancer care than urban Caucasians
and are 70% more likely to
use National Cancer Institute-designated
centers, they determined.
But in rural locales, the opposite was
true, with African Americans 58% less likely
to go to an NCI-designated center. "Efforts
to understand and redress racial disparities
should take into account interacting demographic
and residential influences," concluded
the authors in the Journal of Rural Health.
Paging all nurses
In a study conducted in DHMC's 36-bed orthopaedic
unit, researchers found they could
significantly reduce the number of rescues
and transfers to the ICU by continually monitoring
patients' blood-oxygen levels. Nurses
were automatically notified via pager
when patients' oxygen saturation level
dropped or heart rate was too fast or too
slow. But, warned the authors in Anesthesiology,
"a high frequency of alarms
will desensitize staff, leading to delayed
responses." So it is necessary to limit "the
nuisance alarms generated by self-correcting
changes or false readings," they observed.
DMS nutrition researcher Lisa Sutherland, Ph.D., led an analysis of 200 top movies; 69% had at least one food brand placement, with sweet (26%) and salty (21%) snacks most prevalent.
Port authority
If you need a chest port—for chemotherapy
or blood draws—it doesn't matter if a radiologist,
a resident, or a nurse practitioner puts
it in; whoever does it just needs to be welltrained
in the procedure. That's what
several DMS radiologists found on reviewing
the records of 536 patients who
received a totally implanted subcutaneous
central venous access device (a.k.a. chest
port). "There was no statistically significant
difference in overall complication rates, including
infection rates, among operator
groups," they wrote in Academic Radiology.
Balancing act
In the process of investigating a gene-regulating
protein called Chd6, DMS scientists
may have pinpointed the cause of some forms
of human ataxia, a rare neurological disease.
When they created a mouse model with a
Chd6 mutation, they found that the animals
had "coordination defects most consistent
with a cerebellar neuron disorder," according
to a paper in Mammalian
Genome. "Behavioral testing indicated
that only coordination and balance
are impaired in [the] mice," wrote the
researchers. "Although Chd6 is expressed
ubiquitously, the only consistent phenotype
[of the mutation] appears to be the impairment
in sensorimotor performance."
A study in the Journal of the American Medical Association by Dartmouth economist Douglas Staiger showed that the average hours worked by physicians dropped 7% from 1996 to 2008.
Primary numbers
A popular health-care reform idea is to pay
doctors based on how well they care for patients
rather than the number of procedures
they perform. But most primary-care physicians
don't see enough patients "to produce
statistically reliable performance measurements
on common quality and cost
measures," according to a paper in the
Journal of the American Medical Association by
research ers at Dartmouth and the Centers for
Medicare and Medicaid. Few primary-care
practices are big enough to reliably measure
performance in blood-sugar testing, for example.
"Novel measurement approaches appear
to be needed," the authors wrote.
Sick of smoke
Smoking can make one more susceptible to
infectious diseases, such as influenza and
pneumonia. Exactly how it does that was the
focus of a recent study conducted at DMS. In
cell cultures of human airways, the researchers
found that cigarette smoke
thwarts the body's own innate antimicrobial
properties. "Cigarette smoke is a
complex mixture and has many biological activities,"
they wrote in the Open Immunology
Journal. "Additional studies are needed to
better understand the effects of this and other
environmental pollutants on functions of
the innate immune system."
At last count, DMS had received more than $32 million in research funding through the American Recovery and Reinvestment Act, advancing research (and securing jobs).
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