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.
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.
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.
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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