Really?: The Claim: Always Wash Your Hands With Hot Water, Not Cold

Really?: The Claim: Always Wash Your Hands With Hot Water, Not Cold: "Is warm or hot water really more effective than cold in preventing the spread of infections?

With swine flu sweeping across the country, health officials are reminding Americans to wash their hands often to reduce the spread of the disease.

Soap and warm water have long been said to prevent the spread of infections, but is warm or hot water really more effective than cold?

In its medical literature, the Food and Drug Administrationstates that hot water comfortable enough for washing hands is not hot enough to kill bacteria, but is more effective than cold water because it removes oils from the hand that can harbor bacteria.

But in a 2005 report in the Journal of Occupational and Environmental Medicine, scientists with the Joint Bank Group/Fund Health Services Department pointed out that in studies in which subjects had their hands contaminated, and then were instructed to wash and rinse with soap for 25 seconds using water with temperatures ranging from 40 degrees Fahrenheit to 120 degrees, the various temperatures had “no effect on transient or resident bacterial reduction.”

They found no evidence that hot water had any benefit, and noted that it might increase the “irritant capacity” of some soaps, causing contact dermatitis. “Temperature of water used for hand washing should not be guided by antibacterial effects but comfort,” they wrote, “which is in the tepid to warm temperature range. The usage of tepid water instead of hot water also has economic benefits.”

THE BOTTOM LINE

Hot water for hand washing has not been proved to remove germs better than cold water."

Total retirement 'bad for you'

Total retirement 'bad for you': "Giving up work completely on retirement could be bad for your health, US research suggests."

WA prisons ramp up Taser use - WA today

WA prisons ramp up Taser use - WA today: "

WA prisons ramp up Taser use WA today He said that since the devices were introduced, inmate injuries and Workcover claims by guards had dropped off markedly. "(The department has) absolutely ...

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Shame 'boosts hand-washing rate'

Shame 'boosts hand-washing rate': "People are more likely to wash their hands when they have been shamed into it, research in service station toilets suggests."

Developments in asbestos cancer risk assessment

Developments in asbestos cancer risk assessment: "Efforts have been made for 25 years to develop asbestos risk assessments that provide valid information about workplace and community cancer risks. Mathematical models have been applied to a group of workplace epidemiology studies to describe the relationships between exposure and risk. EPA's most recent proposed method was presented at a public meeting in July 2008.Risk assessments prepared by USEPA, OSHA, and NIOSH since 1972 were reviewed, along with related literature.None of the efforts to use statistical models to characterize relative cancer potencies for asbestos fiber types and sizes have been able to overcome limitations of the exposure data. Resulting uncertainties have been so great that these estimates should not be used to drive occupational and environmental health policy. T..."

Organizational justice and markers of inflammation: The Whitehall II study [Original article]

Organizational justice and markers of inflammation: The Whitehall II study [Original article]: "

Objectives: Low organizational justice has been shown to be associated with increased risk of various health problems, but the underlying mechanisms remain unclear. We tested whether organisational injustice contributes to chronic inflammation in a population of middle-aged men and women.

Methods: This prospective cohort study uses data from 3205 men and 1204 women aged 35–55 years at entry into the Whitehall II study (Phase 1, 1985-1988). Organisational justice perceptions were assessed at Phase 1 and Phase 2 (1989-1990) and circulating inflammatory markers C-reactive protein and interleukin-6 at Phase 3 (1991-1993) and Phase 7 (2003-2004).

Results: In men, low organisational justice was associated with increased C-reactive protein levels at both follow-ups (Phase 3 and 7) and increased interleukin-6 at the second follow-up (Phase 7). The long term (Phase 7) associations were largely independent of covariates, such as age, employment grade, body mass index and depressive symptoms. In women, no relationship was found between organisational justice and C-reactive protein or interleukin-6.

Conclusions: This study suggests that organisational injustice is associated with increased long-term levels of inflammatory markers among men.

Justice at Work and Metabolic Syndrome: the Whitehall II Study [Original article]

Justice at Work and Metabolic Syndrome: the Whitehall II Study [Original article]: "Objectives:

Growing evidence shows that high levels of justice are beneficial for employee health, although biological mechanisms underlying this association are yet to be clarified. We aim to test whether high justice at work protects against metabolic syndrome.

Methods:

A prospective cohort study of 20 civil service departments in London (the Whitehall II study) including 6123 male and female British civil servants aged 35 to 55 years without prevalent CHD at baseline (1985-1990). Perceived justice at work was determined by means of questionnaire on two occasions between 1985 and 1990. Follow-up for metabolic syndrome and its components occurring from 1990 through 2004 was based on clinical assessments on three occasions over more than 18 years.

Results:

Cox proportional hazard models adjusted for age, ethnicity and employment grade showed that men who experienced a high level of justice at work had a lower risk of incident metabolic syndrome than employees with a low level of justice (hazard ratio 0.75; 95% confidence interval: 0.63-0.89). There was little evidence of an association between organizational justice and metabolic syndrome or its components in women (hazard ratio 0.88; 95%CI: 0.67-1.17).

Conclusions:

Our prospective findings provide evidence of an association between high levels of justice at work and the development of metabolic syndrome in men.

Do pre-employment influences explain the association between psychosocial factors at work and coronary heart disease? The Whitehall II study. [Origina

Do pre-employment influences explain the association between psychosocial factors at work and coronary heart disease? The Whitehall II study. [Original article]: "Objectives:

To examine whether the association between psychosocial factors at work and incident coronary heart disease (CHD) is explained by pre-employment factors, such as family history of CHD, education, paternal education and social class, number of siblings, and height.

Methods:

A prospective cohort study of 6435 British men aged 35-55 years at phase 1 (1985-1988) and free from prevalent CHD at phase 2 (1989-1990). Psychosocial factors at work were assessed at phases 1 and 2 and mean scores across the two phases were used to determine long-term exposure. Selected pre-employment factors were assessed at phase 1. Follow-up for coronary death, first non-fatal myocardial infarction or definite angina between phase 2 and 1999 was based on clinical records (250 events, follow-up 8.7 years).

Results:

The selected pre-employment factors were associated with risk for CHD: hazard ratios (CI 95%) were 1.33 (1.03-1.73) for family history of CHD, 1.18 (1.05-1.32) for each quartile decrease in height, and 1.16 (0.99-1.35) for each category increase in number of siblings. Psychosocial work factors also predicted CHD: 1.72 (1.08-2.74) for low job control and 1.72 (1.10-2.67) for low organisational justice. Adjustment for pre-employment factors changed these associations by 4.1% or less.

Conclusions:

In this well-characterised occupational cohort of British men, the association between psychosocial factors at work and CHD was largely independent of family history of CHD, education, paternal educational attainment and social class, number of siblings, and height.

Effects of Alcohol and Sleep Restriction on Simulated Driving Performance in Untreated Patients With Obstructive Sleep Apnea

Effects of Alcohol and Sleep Restriction on Simulated Driving Performance in Untreated Patients With Obstructive Sleep Apnea: "

Background: Because of previous sleep disturbance and sleep hypoxia, patients with obstructive sleep apnea (OSA) might be more vulnerable to the effects of alcohol and sleep restriction than healthy persons.

Objective: To compare the effects of sleep restriction and alcohol on driving simulator performance in patients with OSA and age-matched control participants.

Design: Driving simulator assessments in 2 groups under 3 different conditions presented in random order.

Setting: Adelaide Institute for Sleep Health, Sleep Laboratory, Adelaide, Australia.

Participants: 38 untreated patients with OSA and 20 control participants.

Measurements: Steering deviation, crashes, and braking reaction time.

Intervention: Unrestricted sleep, sleep restricted to a maximum of 4 hours, and ingestion of an amount of 40% vodka calculated to achieve a blood alcohol level of 0.05 g/dL.

Results: Patients with OSA demonstrated increased steering deviation compared with control participants (mean, 50.5 cm [95% CI, 46.1 to 54.9 cm] in the OSA group and 38.4 cm [CI, 32.4 to 44.4 cm] in the control group; P < 0.01) and significantly greater steering deterioration over time (group by time interaction, P = 0.02). The increase in steering deviation after sleep restriction and alcohol was approximately 40% greater in patients with OSA than in control participants (group by condition interaction, P = 0.04). Patients with OSA crashed more frequently than control participants (1 vs. 24 participants; odds ratio [OR], 25.4; P = 0.03) and crashed more frequently after sleep restriction (OR, 4.0; P < 0.01) and alcohol consumption (OR, 2.3; P = 0.02) than after normal sleep. In patients with OSA, prolonged eye closure (>2 seconds) and microsleeps (> 2 seconds of theta activity on electroencephalography) were significant crash predictors (OR, 19.2 and 7.2, respectively; P < 0.01). Braking reaction time was slower after sleep restriction than after normal sleep (mean, 1.39 [SD, 0.06] seconds vs. 1.22 [SD, 0.04] seconds; P < 0.01) but not after alcohol consumption. No group differences were found.

Limitation: Simulated driving was assessed rather than on-road driving.

Conclusion: Patients with OSA are more vulnerable than healthy persons to the effects of alcohol consumption and sleep restriction on various driving performance variables.

Primary Funding Source: Australian National Health and Medical Research Council.

Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households: A Cluster Randomized Trial

Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households: A Cluster Randomized Trial: "

Background: Few data are available about the effectiveness of nonpharmaceutical interventions for preventing influenza virus transmission.

Objective: To investigate whether hand hygiene and use of facemasks prevents household transmission of influenza.

Design: Cluster randomized, controlled trial. Randomization was computer generated; allocation was concealed from treating physicians and clinics and implemented by study nurses at the time of the initial household visit. Participants and personnel administering the interventions were not blinded to group assignment. (ClinicalTrials.gov registration number: NCT00425893)

Setting: Households in Hong Kong.

Patients: 407 people presenting to outpatient clinics with influenza-like illness who were positive for influenza A or B virus by rapid testing (index patients) and 794 household members (contacts) in 259 households.

Intervention: Lifestyle education (control) (134 households), hand hygiene (136 households), or surgical facemasks plus hand hygiene (137 households) for all household members.

Measurements: Influenza virus infection in contacts, as confirmed by reverse-transcription polymerase chain reaction (RT-PCR) or diagnosed clinically after 7 days.

Results: Sixty (8%) contacts in the 259 households had RT-PCR–confirmed influenza virus infection in the 7 days after intervention. Hand hygiene with or without facemasks seemed to reduce influenza transmission, but the differences compared with the control group were not significant. In 154 households in which interventions were implemented within 36 hours of symptom onset in the index patient, transmission of RT-PCR–confirmed infection seemed reduced, an effect attributable to fewer infections among participants using facemasks plus hand hygiene (adjusted odds ratio, 0.33 [95% CI, 0.13 to 0.87]). Adherence to interventions varied.

Limitation: The delay from index patient symptom onset to intervention and variable adherence may have mitigated intervention effectiveness.

Conclusion: Hand hygiene and facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset. These findings suggest that nonpharmaceutical interventions are important for mitigation of pandemic and interpandemic influenza.

Primary Funding Source: Centers for Disease Control and Prevention.

ORIGINAL CONTRIBUTION: Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicia

ORIGINAL CONTRIBUTION: Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians: "

Context Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce.

Objective To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients.

Design, Setting, and Participants Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo).

Main Outcome Measures Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months.

Results Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; = –6.8; 95% CI, –4.8 to –8.8; depersonalization, 8.4 to 5.9; = –2.5; 95% CI, –1.4 to –3.6; and personal accomplishment, 40.2 to 42.6; = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; = –4.1; 95% CI, –1.8 to –6.4); total mood disturbance (33.2 to 16.1; = –17.1; 95% CI, –11 to –23.2), and personality (conscientiousness, 6.5 to 6.8; = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = –0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = –0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001).

Conclusions Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

ORIGINAL CONTRIBUTION: Surgical Mask vs N95 Respirator for Preventing Influenza Among Health Care Workers: A Randomized Trial

ORIGINAL CONTRIBUTION: Surgical Mask vs N95 Respirator for Preventing Influenza Among Health Care Workers: A Randomized Trial: "

Context Data about the effectiveness of the surgical mask compared with the N95 respirator for protecting health care workers against influenza are sparse. Given the likelihood that N95 respirators will be in short supply during a pandemic and not available in many countries, knowing the effectiveness of the surgical mask is of public health importance.

Objective To compare the surgical mask with the N95 respirator in protecting health care workers against influenza.

Design, Setting, and Participants Noninferiority randomized controlled trial of 446 nurses in emergency departments, medical units, and pediatric units in 8 tertiary care Ontario hospitals.

Intervention Assignment to either a fit-tested N95 respirator or a surgical mask when providing care to patients with febrile respiratory illness during the 2008-2009 influenza season.

Main Outcome Measures The primary outcome was laboratory-confirmed influenza measured by polymerase chain reaction or a 4-fold rise in hemagglutinin titers. Effectiveness of the surgical mask was assessed as noninferiority of the surgical mask compared with the N95 respirator. The criterion for noninferiority was met if the lower limit of the 95% confidence interval (CI) for the reduction in incidence (N95 respirator minus surgical group) was greater than –9%.

Results Between September 23, 2008, and December 8, 2008, 478 nurses were assessed for eligibility and 446 nurses were enrolled and randomly assigned the intervention; 225 were allocated to receive surgical masks and 221 to N95 respirators. Influenza infection occurred in 50 nurses (23.6%) in the surgical mask group and in 48 (22.9%) in the N95 respirator group (absolute risk difference, –0.73%; 95% CI, –8.8% to 7.3%; P = .86), the lower confidence limit being inside the noninferiority limit of –9%.

Conclusion Among nurses in Ontario tertiary care hospitals, use of a surgical mask compared with an N95 respirator resulted in noninferior rates of laboratory-confirmed influenza.

Trial Registration clinicaltrials.gov Identifier: NCT00756574

Published online October 1, 2009 (doi:10.1001/jama.2009.1466).

Mobilisation or immobilisation for cervical radiculopathy? [EDITORIALS]

Mobilisation or immobilisation for cervical radiculopathy? [EDITORIALS]

Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial [RESEARCH]

Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial [RESEARCH]: "

Objective To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy.

Design Randomised controlled trial.

Setting Neurology outpatient clinics in three Dutch hospitals.

Participants 205 patients with symptoms and signs of cervical radiculopathy of less than one month’s duration

Interventions Treatment with a semi-hard collar and taking rest for three to six weeks; 12 twice weekly sessions of physiotherapy and home exercises for six weeks; or continuation of daily activities as much as possible without specific treatment (control group).

Main outcome measures Time course of changes in pain scores for arm and neck pain on a 100 mm visual analogue scale and in the neck disability index during the first six weeks.

Results In the wait and see group, arm pain diminished by 3 mm/week on the visual analogue scale (β=–3.1 mm, 95% confidence interval –4.0 to –2.2 mm) and by 19 mm in total over six weeks. Patients who were treated with cervical collar or physiotherapy achieved additional pain reduction (collar: β=–1.9 mm, –3.3 to –0.5 mm; physiotherapy: β=–1.9, –3.3 to –0.8), resulting in an extra pain reduction compared with the control group of 12 mm after six weeks. In the wait and see group, neck pain did not decrease significantly in the first six weeks (β=–0.9 mm, –2.0 to 0.3). Treatment with the collar resulted in a weekly reduction on the visual analogue scale of 2.8 mm (–4.2 to –1.3), amounting to 17 mm in six weeks, whereas physiotherapy gave a weekly reduction of 2.4 mm (–3.9 to –0.8) resulting in a decrease of 14 mm after six weeks. Compared with a wait and see policy, the neck disability index showed a significant change with the use of the collar and rest (β=–0.9 mm, –1.6 to –0.1) and a non-significant effect with physiotherapy and home exercises.

Conclusion A semi-hard cervical collar and rest for three to six weeks or physiotherapy accompanied by home exercises for six weeks reduced neck and arm pain substantially compared with a wait and see policy in the early phase of cervical radiculopathy.

Trial registration Clinical trials NCT00129714.

[Articles] Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomised parallel-group trial

[Articles] Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomised parallel-group trial: "A previous randomised controlled trial reported greater efficacy of surgery than of splinting for patients with carpal tunnel syndrome. Our aim was to compare surgical versus multi-modality, non-surgical treatment for patients with carpal tunnel syndrome without denervation. We hypothesised that surgery would result in improved functional and symptom outcomes."

[Articles] 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) poisoning in Victor Yushchenko: identification and measurement of TCDD metabolites

[Articles] 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) poisoning in Victor Yushchenko: identification and measurement of TCDD metabolites: "2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has a long half-life of 5–10 years in human beings as a result of its high lipophilicity, and little or no metabolism. We monitored TCDD, its form, distribution, and elimination in Victor Yushchenko after he presented with severe poisoning."

[Articles] Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised controlled crossover trial

[Articles] Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised controlled crossover trial: "Drugs for neuropathic pain have incomplete efficacy and dose-limiting side-effects when given as monotherapy. We assessed the efficacy and tolerability of combined nortriptyline and gabapentin compared with each drug given alone."

[Editorial] Is Europe fit for work?

[Editorial] Is Europe fit for work?: "“A healthy workforce means a healthy economy”, so says Fit for work, a report published last week by the Work Foundation, a not-for-profit organisation in London, UK. The Foundation has an eye on the economic recession and the need to improve productivity when concluding that the European Union workforce might not be healthy enough to compete internationally."

Guidance Values for Surface Monitoring of Antineoplastic Drugs in German Pharmacies

Guidance Values for Surface Monitoring of Antineoplastic Drugs in German Pharmacies: "

Objectives: Antineoplastic drugs are widely used in anticancer therapy due to their cytotoxic activity but many of them are classified as carcinogenic, mutagenic, or teratogenic to humans. In order to evaluate personal exposure, surface monitoring has been successfully applied for several years. In this study, we present a statistical description of our data set from 102 German pharmacies and propose ‘threshold guidance values (TGVs)’ to facilitate interpretation of monitoring results.

Methods: Our database included 1008 results for platinum (PT) and 1237 for 5-fluorouracil (FU) collected in 102 pharmacies in Germany. Wipe sampling on site was performed with one validated procedure. PT concentrations were measured by voltammetry and FU by gas chromatography/mass spectrometry. Data were stratified into 10 locations and statistically evaluated.

Results: Contamination was detected on all surfaces in the pharmacies with high levels on storage shelves and floors. The median values for the different locations ranged from 0.20 to 1.70 pg cm^–2 (mean: 0.57 pg cm^–2) for PT and from 2.50 to 10.00 pg cm^–2 (mean: 5.34 pg cm^–2) for FU. The mean 75th percentiles were 3.92 pg cm^–2 (PT) and 28.90 pg cm^–2 (FU). The TGV 1 value was set at the median value and results below demonstrate good working practices. Contaminations above the TGV 2, which was assigned at the 75th percentile, show a clear need for optimizing the handling procedures.

Conclusions: The introduction of TGVs helps to reduce occupational exposure and allows pharmacy personnel to benchmark their own contamination levels. This provides a basis for improvement in occupational safety precautions and for regular contamination controls.

Trends in Wood Dust Inhalation Exposure in the UK, 1985-2005

Trends in Wood Dust Inhalation Exposure in the UK, 1985-2005: "

Objectives: Wood dust data held in the Health and Safety Executive (HSE) National Exposure DataBase (NEDB) were reviewed to investigate the long-term changes in inhalation exposure from 1985 to 2005. In addition, follow-up sampling measurements were obtained from selected companies where exposure measurements had been collected prior to 1994, thereby providing a follow-up period of at least 10 years, to determine whether changes in exposure levels had occurred, with key staff being interviewed to identify factors that might be responsible for any changes observed.

Methods: Analysis of the temporal trend in exposure concentrations was performed using Linear Mixed Effect Models on the log-transformed NEDB data set and expressed as the relative annual change in concentration.

Results: For the NEDB wood dust data, an annual decline of geometric mean (GM) exposure of 8.1% per year was found based on 1459 exposure measurements collected between 1985 and 2003. This trend was predominantly observed in data from inspection visits (measurements collected on a mandatory basis by a Specialist HSE Inspector) (n = 1009), while data from representative surveys (measurements collected on a voluntary basis to provide information on current practices and exposures) remained relatively stable. Ten follow-up surveys in individual workplaces in 2004–2005 resulted in 70 new measurements and for each of the companies resurveyed, the GM of the wood dust exposure decreased between sampling surveys.

Conclusion: Analysis of the temporal trend in UK wood dust exposure concentrations revealed declines of 8% per annum. Interviews with key long-serving employees and management suggest that factors such as technological changes in production processes, response to new legislation, and enforcement agency inspections, together with global economic trends, could be linked to the downward trends observed.

Poster 70: Using Prazosin to Improve Sleep as the Initial Treatment of Operations Iraqi or Enduring Freedom Veterans With Blast-induced Mild TBI

Poster 70: Using Prazosin to Improve Sleep as the Initial Treatment of Operations Iraqi or Enduring Freedom Veterans With Blast-induced Mild TBI: "We examined whether treatment with sleep hygiene counseling and prazosin would improve sleep, headaches and cognitive performance. Outcome measures were assessed 9 weeks after initiating the intervention and again 6 months later. Results: Only 8% of subjects experienced a side effect (daytime somnolence – 4 subjects, light headedness – 2 subjects). Lightheadedness resolved when prazosin was reintroduced at 0.5mg at bedtime. Nine weeks after starting the intervention, 65 subjects reported restful sleep. Peak headache pain (0–10 scale) decreased from 7.28±0.27 to 4.08±0.19 (P (Source: Archives of Physical Medicine and Rehabilitation)"

Red flags often false alarms in back pain

Red flags often false alarms in back pain: "The usefulness of red flag questions in patients presenting with acute back pain in primary care has been questioned by an Australian study that found most had little diagnostic value and that serious undiagnosed pathology was rare."

Back pain gone in a year

Back pain gone in a year: "Reassuring news for patients with low back pain, with a new Australian study showing that four out of ten patients will recover within a year."

Seasonal vaccine protects against swine flu

Seasonal vaccine protects against swine flu: "New evidence suggests that the seasonal influenza vaccine offers some cross protection against pandemic influenza A/H1N1, particularly severe forms of the disease."