World's largest cardiac arrest trial suggests longer initial paramedic CPR provides no benefit

ScienceDaily (Aug. 31, 2011) ? A study involving nearly 10,000 cardiac arrest patients from 10 North American regions has shown that extending the period of initial cardiopulmonary resuscitation (CPR) by paramedics and firefighters from one to three minutes provides no benefit. The study, led by Dr. Ian Stiell of the Ottawa Hospital Research Institute (OHRI), the University of Ottawa (uOttawa) and the Resuscitation Outcomes Consortium (ROC), resolves a worldwide controversy about cardiac arrest care.

It is the largest randomized cardiac arrest trial in the world, published in the New England Journal of Medicine.

Every year, more than 350,000 people in Canada and the U.S. suffer a sudden cardiac arrest, and less than 10 per cent survive. Prompt CPR can increase blood flow to the brain and keep the body alive for a short time, but for patients with certain heart rhythms, the heart can only be restarted by providing electrical shocks with a defibrillator. Traditionally, paramedics and firefighters have analyzed heart rhythm as soon as possible, and provided only brief CPR while preparing a defibrillator. However, several recent studies have suggested it may be better to provide a longer period of initial CPR (up to three minutes) before analyzing heart rhythm. Clinical guidelines have not been able to provide clear guidance on which approach is better, and standard practice has varied around the world.

In the current study, paramedics and firefighters across Canada and the U.S. were randomly divided into groups (called clusters) and instructed to provide 30 to 60 seconds of initial CPR or three minutes of initial CPR. Part way through the study, the groups were switched. The primary analysis of data from 9,933 patients showed no difference between the groups, with 5.9 per cent of patients in both groups surviving to hospital discharge with satisfactory health. However, when the actual length of CPR was analyzed more closely, it was found that survival tended to decrease as the length of initial paramedic CPR increased in patients who also received bystander CPR and had a heart rhythm amenable to defibrillation. This subgroup represents approximately 10 per cent of all patients in the study. There were no differences in other subgroups analyzed.

"Our study definitively shows that there is no advantage to a longer period of initial CPR," said Dr. Ian Stiell, a Senior Scientist at OHRI, Chair of Emergency Medicine at uOttawa and Physician in The Ottawa Hospital Emergency Department. "The data also suggest that patients who received bystander CPR may fare better with the shorter period of paramedic CPR. While there is some debate about the significance of this result, I think it is better to be on the safe side and stick with the traditional shorter initial CPR approach."

This study was conducted through ROC, a large Canada-U.S. research collaboration aimed at improving survival for patients who suffer cardiac arrest and severe trauma in the community. ROC is funded by the Canadian Institutes of Health Research, Defence Research and Development Canada, the Heart and Stroke Foundation of Canada, the U.S. National Heart, Lung, and Blood Institute, the U.S. National Institute of Neurological Disorders and Stroke, the U.S. Department of Defense and the American Heart Association.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Ottawa Hospital Research Institute.

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Journal Reference:

1. Ian G. Stiell et al. Early versus Later Rhythm Analysis in Patients with Out-of-Hospital Cardiac Arrest. New England Journal of Medicine, September 1, 2011 DOI: 10.1056/NEJMoa1010076

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/dYR7HfQtVmY/110831205934.htm

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Benefits of reading Online Women's Magazines | Best personal ...

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Loughner's lawyers fighting forced medication

A federal appeals court on Tuesday will consider how much authority prison officials have in forcibly medicating Jared Loughner, the Arizona man accused of killing six people and wounding 13 others, including Rep. Gabrielle Giffords, during a January shooting rampage.

Loughner has been held since late May at a federal prison hospital in Missouri. He was sent there for treatment after a judge concluded that Loughner was not mentally fit to stand trial for the shootings in a Tucson parking lot on Jan. 8.

His lawyers are fighting a decision by prison doctors to give him psychoactive medications against his will. Prosecutors argue that the drugs were administered because he was a danger to himself and others.

Story: Appeals court: No forced meds for Tucson shooting suspect

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For a three-judge panel of the Ninth Circuit Court of Appeals, the issue is a simple one: Who gets to decide? Can the doctors give Loughner the drugs based on their own medical opinion, or must they first get approval from a judge?

In June, prison doctors began giving Loughner anti-psychotic medications against his will, in the belief that they were medically necessary to treat his symptoms of schizophrenia. In response to a challenge from his lawyers, a federal appeals court in July ordered the treatments to stop, while it considered the legal issues.

But less than a week later, prison doctors resumed giving him the drugs for a different reason.? They said he had become violent, endangering himself, other inmates, and prison staff.

Video: Judge to rule on Jared Lougher?s mental fitness (on this page)

The U.S. Supreme Court has never spelled out the rules that apply in a case like this, involving an inmate who has not been convicted, who is being held in order to see whether his mental competency can be restored, and who refuses to take medication to treat his mental problems.

Prosecutors argue that the reason Loughner is in a prison hospital do not matter. "The legitimate interest of a prison to maintain safety and security is the same whether the inmate is a pretrial detainee or a convicted prisoner," they argue in court filings.

"A dangerous inmate is a danger regardless of the state of his criminal case," they say.

But Loughner's lawyers argue that different legal standards should apply to an inmate who is being held for medical reasons and whose ability to stand trial and play a role in his own defense could be affected.

Story: Filing says Tucson shooting suspect spit on lawyer

"General restrictions of liberty intended to maintain the safety and security of a prison are not the same as the forcible administration of drugs that are intended to alter the thinking of an individual, may cause permanent and debilitating side effects, and may deprive the detainee of his right to a fair trial," they argue in their legal briefs.

A prison doctor testified at a separate hearing last week that Loughner paces and rocks back and forth during discussion sessions. At other times, the doctor said, he stands in a corner holding his face in his hands. Attempts to videotape sessions with his doctors produce angry outbursts, the doctor testified.

Earlier court filings said that Loughner threw a chair and spat at his lawyers before he was declared mentally unfit for trial.

The federal judge presiding over the criminal case has set a deadline of Sept. 6 for prison doctors to file a report indicating whether or not the hospital treatments have rendered Loughner mentally competent for trial.

? 2010 msnbc.com? Reprints

Source: http://www.msnbc.msn.com/id/44319262/ns/us_news-crime_and_courts/

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orval - Health And Fitness | Acupuncture As an Alternative Health ...

Acupuncture is a way of regulating responses in the nerve tissue throughout the human body. Pioneered by Chinese doctors, it is a method which has shown to relieve stress and all kinds of ailments throughout these pressure points in the nervous tissue of men and women.

Acupuncture is done through the application of needles at different points throughout the body, stimulating muscles and nerves, changing the chemical reactions at these points in the body, and causing the nerves to release the proper hormones and chemicals in response to the treatment. This has been effectively used to relieve pain, certain types of paralysis, and even mental and emotional illnesses, which are all in one way or another related to or affected by the body.

The theory behind acupuncture is that body tissue has channels of energy or chemical activity going through it at all times, and acupuncture is a method by which the obstructions or dams causing blockage in the normal flow of these chemical reactions are removed to allow the body to function normally again. This has promoted better emotional health, better digestion, better reflexes, and it has relieved muscle tension, depression, migraines, and many other common ailments, including respiratory problems such as asthma and bronchitis.

Some have used acupuncture as a preventative measure against illness and infection. For those with certain medical problems, long term treatments including two sessions a week for several months have been used.

Unlike other branches of medicine, there are generally very few side effects to this treatment, and as such, there have been great strides in this particular field of medicine, even in the Western world. Like with some prescription medications, the changes in hormones and chemical activity induced by the acupuncture treatments can cause some unpleasant side effects for the first few days such as upset stomach, changes in mood or appetite, but this is a sign that the treatments are working, and with proper rest, these effects tend to go away.

For those who have been looking for an alternative to traditional medical treatments and prescription medications, acupuncture is being regarded more and more as a safe, effective alternative. It is a branch of medicine that has been practiced for many years, and as scientists discover more about the chemical activities which take place in the body and the brain, acupuncture treatment is likely to become even more effective and more common.

Because each person's body chemistry is different, the number of treatments required for each person to achieve the desired effect, depending on the illness, varies greatly. For a number of years, scientists regarded acupuncture treatment as an experimental or inferior method to treat patients, but with the advent of new technology and a track record of success, this is changing.

Much relief has been found through the careful and resourceful application of acupuncture therapy throughout much of the world, even in the United States. It is a branch of medicine which treats the whole person, not just certain symptoms or symptoms of symptoms which are related to a certain illness, and this is why this form of treatment is catching on.

Article Source:?http://www.BharatBhasha.com
Article Url: http://www.bharatbhasha.com/health.php/319956

Article Added on Wednesday, August 31, 2011
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Summer Camps Offer Orange County Social Skills Training | Free ...

If you are the parent of a child diagnosed with attention deficit hyperactivity disorder you know the frustration and exasperation that can be associated with ADHD treatment. Orange County families can experience mixed results with traditional therapeutic approaches to childrens? behavioral disorders. It may work for some children, but is not as effective for others. However, a promising new approach is now available in an exciting California summer camp setting.

This Orange County ADHD therapy combines the joys of childhood with clinical behavioral modification techniques. Set in a quintessential summer camp atmosphere, these camps are available to kids ages six to eighteen who face the life challenge of managing a behavioral or mood disorder. Their conditions can range from depression, anxiety, Asperger?s disorder, attention deficit hyperactivity disorder, and other similar circumstances. The goal of this therapeutic approach is to empower these children with knowledge about their individual condition and behavioral triggers, enabling them to find greater personal and interpersonal success throughout their life.

To help these children accomplish this goal, clinically trained staff members interact closely with camp attendants. A low staff to child ratio enables this. Typically there might be one staff member to every four young camp attendants, and one staff member to every six older children. With the guidance of these staff members, children have the opportunity to participate in exciting activities like rock climbing, and learn new hobbies like arts and crafts. There is more to these activities than meets the eye, each new experience and adventure offers a crucial opportunity for Orange County social skills training. And clinically trained staff members guide these experiences.

Because children who face mood and behavioral conditions often struggle in interpersonal situations, this focus is an integral part of Orange County ADHD therapy. During camp activities staff members carefully observe the behavior patterns of each child, taking note of their individual strengths and weaknesses. Using these field notes, staff members create a behavioral modification plan tailored to each child, designed to enhance their strengths and control their weaknesses.

This plan is shared with each child and their parents or guardians. A strong support network is key to successful ADHD treatment, and Orange County families work to reinforce the ideas and suggestions of camp staff in their homes. These plans provide each child with practical techniques and social skills training. Orange County children begin to experience more interpersonal success when practicing their new abilities at camp and at home, and as they do their self-confidence begins to soar.

The results of this new found skill set and self-esteem manifest outside of camp as well. Parents and family members often report that their child is able to better manage their condition at home, school and in other groups after attending Orange County ADHD therapy camps. Such reports should not be minimized. Because one of the greatest challenges children with behavioral or mood disorders face is the ability to find interpersonal success, the sooner they can develop this ability the better, and the more successful and happy they are likely to be.

Many parents are so thrilled with these camps that also function as Orange County social skills classes that they continue to enroll their child in after school programs associated with the camps that are held during the school year. As certain diagnosed disorders, like attention deficit hyperactivity disorder, are recognized medical conditions, some insurance programs may help families cover the costs of tuition for these programs.

The investment of time and tuition into such programs is certainly not a loss. Rather, these children and their families gain knowledge, empowerment and a skill set that will help them to be more successful?not to mention the enjoyable childhood memories associated with summer camp. When looking for ADHD treatment, Orange County parents can find a hopeful solution for their child in the form of these therapeutic summer programs.

Author Bio:

Children have fun and receive Orange County Social Skills Training while attending Quest Therapeutic Camps of Southern California. Our special needs camp provided evidenced based Orange County ADHD Therapy, ADHD Treatment Orange County and Orange County Social Skills Classes. Visit QuestCampsOfSoCal.com to learn more about our Social Skills Training Orange County. Contact us for further details.

Source: http://articletyme.com/summer-camps-offer-orange-county-social-skills-training/

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Ask What Are The Basic Types Of Horse Breed? | The Pet City

[unable to retrieve full-text content]Knowing what are the basic types of horse breed is the simple, beginner information for anyone interested in the history or modern uses of this domesticated, noble animal. There are currently over three hundred breeds ...

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RealTime Fantasy Sports - Frank Gore signs 3-year extension with ...

SAN FRANCISCO (AP) - Frank Gore signed his three-year contract extension with the San Francisco 49ers on Wednesday, keeping the two-time Pro Bowl running back with the team through 2014.

Gore agreed Tuesday to the $21 million deal, with $13.5 million in guaranteed money. In what was to be the final year of his contract, Gore had hoped to land a new deal before the Niners' Sept. 11 season opener at home against the defending NFC West champion Seattle Seahawks - and he got it.

The 28-year-old Gore missed the final five games of 2010 after fracturing his right hip in a Monday night game at Arizona on Nov. 29. He is fully healthy and begins the year third on San Francisco's all-time rushing list, needing 931 yards to become No. 1.

While Gore has said it is one of his goals to pass the late Hall of Famer Joe Perry as San Francisco's career leader in yards rushing (7,344), he is determined to first do all he can to help turn the franchise back into a contender under first-year coach Jim Harbaugh.

The 49ers finished 6-10 last season after a surprising 0-5 start, failing to reach the playoffs or post a winning record for the eighth straight year.

Harbaugh on Tuesday called Gore a ``true 49er.''

Gore's agent, Drew Rosenhaus, met face to face with the 49ers brass at team headquarters for much of the day Monday. Gore considered that progress, not to mention the fact general manager Trent Baalke and team President Jed York had said they wanted Gore to be a ``49er for life.''

Gore said he even spoke to Baalke about working for the organization when he's done playing.

Gore didn't play in last Saturday's 30-7 loss to the Houston Texans, and Harbaugh wouldn't say whether he would play in Thursday night's exhibition finale at San Diego. It's nothing new for him to sit, as Gore has rarely played during the preseason in the past.

Gore held out for the first four days of training camp, but hasn't shown any signs of being behind or hindered by the hip. He insists he is ready to go and feels like the ``22-year-old Frank Gore'' again.

Gore had sought a contract comparable to the $43 million, five-year deal running back DeAngelo Williams - 20 days older than Gore - recently received from the Carolina Panthers. That includes $21 million guaranteed. Williams missed the final 10 games last year with a sprained right foot.

Gore ran for 853 yards and three touchdowns last year before getting hurt. He also caught 46 passes for 452 yards and two TDs. His 24 100-yard rushing games are the most in 49ers history.

Gore follows two other 49ers stars to receive big contracts before the start of a new season.

Tight end Vernon Davis signed a five-year extension worth $37 million overall, including $34 million guaranteed, a night before the 2010 season opener at Seattle. That made him the highest-paid tight end in NFL history.

In May of last year, All-Pro linebacker Patrick Willis received a $50 million, five-year contract extension that takes him through the 2016 season and includes $29 million in guaranteed money. He earns $10 million per season.

Gore and the rest of the 49ers will wear Perry's No. 34 on their helmets this season. Perry, the first player with back-to-back 1,000-yard rushing seasons and nicknamed ``The Jet'' for his sensational speed, died in April at age 84.

Source: http://www.rtsports.com/football-news/1000078078

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