Tylenol has a long history of bumps in the road, starting with drug-tampering problems back in 1982, which resulted in the brand being held up as an example of what to do when disaster strikes your product.  Take responsibility.  Take Action.  Don’t make excuses.

The public was reassured by how the Tylenol scare was handled and sales eventually returned to the brand.  Tylenol came to mean a trusted and safe product once again.  And in a market with unimaginable generic competition, that trust went a long way toward making consumers feel like the branded choice was the right choice.

More recent troubles, however, cannot be blamed on nameless and faceless culprits who are threatening the safety of the American public.  This time the responsibility for manufacturing irregularities fall solidly in the lap of McNeil.  There is no denying that they must take responsibility, there is nowhere else to put it.  But the public is not so quick to forgive this time.

Part of the difference is that this time McNeil is truly to blame for the issue.  And the other part of the difference comes from how the world has changed in those intervening 28 years.  In the world of 1982, the news of the recall and corrective action came through formal channels and gossip about the problem was contained within neighborhoods.  In the world of 2010, news of the recall hit Twitter and Facebook long before it made the front pages of the newspaper or local news broadcasts.  Along with the immediacy of informing the public, McNeil was unable to control the message, and unprepared to deal with the fallout.  Their customer service resources were inadequate, their recall website not up to date, their response times were not up to snuff.

So now, in addition to being worried about the threat that recalled medications might hold for their families, people are angry that McNeil isn’t managing the situation as well as they could.  The brand is breaking.

As the process of restocking medicine cabinets with generic versions of McNeil’s recalled drugs is documented in minute detail via social media networks, more and more people see that generics offer safe, cost-effective alternatives to the branded drugs.  The more social proof that consumers see that the generics are just as effective, the more likely they will be to continue to eschew the branded products.  There is no upside of going back to Tylenol or Benedryl.  Those names are tainted with both the manufacturing issues (real or imagined, it makes no difference) and the customer service disappointments.

The bar for what consumers expect from a generic drug is much lower.  Does it work?  Does it cost less than the branded product?  Is it safe?  Customer service and advertising and image don’t enter into the equation for these purposes.

By dropping the ball so many times, McNeil is training consumers to be satisfied with a less impressive package.  It will be interesting to see if they are able to resolve and recover from this current crisis situation.  As surprised as I am to say this, my bets in this case are against the brand.

Aha! Could I have been sickened with more than one cold strain at the same time? In the journal Science this year, a team of researchers showed that when two strains of the virus infected a person, they could definitely  link up and swap genetic material in a process of recombination… Yes! this was possible in the rhino virus  in a typical cold season. Recombination could cause new strains to emerge rapidly.

In PLoS One, an online open-access journal,  a study reports  that scientists in China followed 64 children with colds and found evidence, though small, of recombination events and what they called “triple infections”: children carrying both a cold strain and other respiratory viruses, like influenza or adenovirus.

Practically speaking, is there evidence  that carrying two cold strains necessarily results in longer or more severe symptoms?

Nobody’s sure about that, especially when studies show that in up to a quarter of cases in adults, a cold infection may result in no symptoms at all…

As I reach for another Advil Cold & Sinus I just feel better about the possibility…

We always intuited that  exercise enhanced our psychological states, but now  scientists are learning how exercise, a physiological activity,  directly affects mood and anxiety- that  exercise remodels the brain, making it more resistant to stress.

Exercise alters the activity of dopamine, a neurotransmitter in the brain, and appears to dampen the effects of oxidative stress. In an experiment led by researchers at the University of Houston and reported at the Society for Neuroscience meeting,” rats whose oxidative-stress levels had been artificially increased with injections of certain chemicals were extremely anxious when faced with unfamiliar terrain during laboratory testing. But rats that had exercised, even if they had received the oxidizing chemical, were relatively nonchalant under stress. When placed in the unfamiliar space, they didn’t run for dark corners and hide, like the unexercised rats. They insouciantly explored.”

“It looks more and more like the positive stress of exercise prepares cells and structures and pathways within the brain so that they’re more equipped to handle stress in other forms,” says Michael Hopkins, a graduate student affiliated with the Neurobiology of Learning and Memory Laboratory at Dartmouth. “It’s pretty amazing, really, that you can get this translation from the realm of purely physical stresses to the realm of psychological stressors.”

Alas, these stress-reducing changes on the brain  influenced  by exercise  don’t happen overnight.  In the University of Colorado experiments, for instance, rats that ran for only three weeks did not show much reduction in stress-induced anxiety, but those that ran for at least six weeks did. “Something happened between three and six weeks,” says Benjamin Greenwood, a research associate in the Department of Integrative Physiology at the University of Colorado, who helped conduct the experiments. Dr. Greenwood added that it was “not clear how that translates” into an exercise prescription for humans. We may require more weeks of working out, or maybe less. And no one has yet studied how intense the exercise needs to be. But the lesson, Dr. Greenwood says, is “don’t quit.” Keep running or cycling or swimming. (Animal experiments have focused exclusively on aerobic, endurance-type activities.) You may not feel a magical reduction of stress after your first jog, if you haven’t been exercising. But the molecular biochemical changes will begin, Dr. Greenwood says. And eventually, he says, they become “profound.”

The findings were released during Mental Illness Awareness Week that recently took place on Oct. 4-10.

According to Michael J. Fitzpatrick, Executive Director of the National Alliance on Mental Illness, “Unemployment today stands at almost 10 percent. Nationwide, we face a mental health crisis as well as an economic crisis.”

Approximately 15 million U.S. adults (5 percent to 8 percent of the adult population) are affected by major depression each year, and only 50% seek treatment, regardless of their economic or employment situation the survey found.

“Having a routine gives you a sense of control over the day,” says Ian A. Cook, MD, director of the Depression Research Program at UCLA. “We know that helps, and we know that not having a sense of control makes people feel worse.”

– Exercise is proven to be a great mood-booster.

– A basic healthy eating plan will do wonders.

– Get a good night’s sleep.

–  Set realistic goals daily and try to meet them.

–  Incorporate some downtime for fun or relaxation into your schedule.

– Have a support network of family and friends and don’t distance yourself from them.

–  Make sure you have some responsibilities that give you a sense of accomplishment and keep you active.

– Try a natural supplement such as fish oil, but only after checking with your doctor.

– Stay away from substance abuse.

– When you’re in a rut, go out of your way to try something new and different. Push yourself to go to a museum . . .Volunteer at a soup kitchen . . . Take a language class. . .

Here are some cognitive ways to fight automatic negative thinking:

– Use logic when you have exaggerated terrible thoughts about yourself.
“Try to impose some reason,” says Cook. “Inject some reality.” Is it really true that no one likes you? Is there real evidence for that?  Sure, you might feel like the most stupid and hateful person on the planet, but really, what are the odds?”

– Clear your head of negativity by taking a break. Breathing exercises or a simple walk around the room can help.

Just remember not to ignore serious signs of depression. If you’re not functioning make sure to get professional help.

The CHAP study took place from 1993-2005 in three Chicago neighborhoods and the 9,318 participants were ages 65 or older. Among that population there were 1,544 reported cases of self-neglect (mean age of 73.2 years old) and in the average follow-up within almost a year, there were 927 deaths (47.8%) in that group.

Elder abuse of any kind also generated a greater mortality rate, with a 61.6% death rate within an average of 2.7 years.

By the self neglect cases,  the increased mortality rate wasn’t affected by whether or not the senior’s cognitive or physical functions were impaired. However by confirmed abuse cases there was a significant difference – increased mortality was not associated with elder abuse of high functioning seniors, demonstrating that this group was more likely to recognize abuse and seek help.

A new study, reported in the Aug. 15 issue of Journal of Clinical Sleep Medicine, finds that cognitive therapy has a beneficial effect on osteoarthritis patients and insomniacs – assisting them in their quest for a good night’s sleep.

Cognitive behavior therapy for insomnia or CBT-I,was given by an experienced clinical psychologist who taught participants cognitive restructuring techniques that helped change unrealistic beliefs and irrational fears regarding sleep or lack of it.

Handwritten sleep logs kept by participants documented their sleep patterns, and pain level was graded by the Short-Form McGill Pain Questionnaire (MPQ) and the Body Pain Subscale (SF-PAIN) question from the Medical Outcomes Study Short Form-36 Pain.

Results showed that after CBT-I treatement, patients were falling asleep faster than before, and remained sleeping approximately 37 minutes longer. CBT-I seems to be an effective tool for treatment of osteoarthritis in conjunction with other pain management techniques, and may also work well with other chronic pain conditions.

As of yet, only 45 million swine flue vaccines will be ready by Oct. 15, a far cry from the 120 million doses originally anticipated. Pregnant women, public health workers and small children will be the first to be immunized and this priority group numbers approximately 160 million individuals, according to the U.S. Centers for Disease Control and Prevention.

After those considered high-risk are inoculated, U.S. health officials will recommend that people ages 25 through 64 receive H1N1 shots. It is interesting to note that those 65 and older are actually at lower risk of contracting swine flu, since the flu strains they encountered as children provides some protection.  As soon as the seasonal flu shot is available it is highly recommended that all seniors get them. Once all those under 65 receive the  swine flu vaccine, inoculations will be recommended for seniors.

The vaccine production is moving slower than expected due to the slow growth of the vaccine substance, as well as a shortage of manufacturers available to actually package the vaccine.

“The amount vaccine manufacturers are getting out of millions of eggs is less than expected, and it’s taking longer to make,” explained Dr. John Treanor, professor of medicine and of microbiology and immunology at the University of Rochester Medical Center in New York.

The second delay factor is being addressed by the government who has increased efforts to recruit more companies for packaging.

Clostridium difficile.

The name might be unfamiliar, but the pathogen is on the rise. There has been a sharp increase in the prevalence of C. diff in hospitals around the country, according to a survey taken in 648 hospitals in 47 states.

As many as 13 out of every 1,000 patients tested positive for Clostridium difficile, with 94% showing symptoms of the accompanying disease: diarrhea, fever, appetite loss, nausea, and stomach pain. About 4% of patients will die from the disease.

How does this compare to C. diff levels in the past? Between 2000 and 2005, the number has more than doubled.

This may be partially due to prescription techniques. C. diff isn’t affected by most antibiotics, so broad spectrum antibiotics, which kill all other bacteria, give C. diff room to grow and thrive. Whenever possible, physicians should prescribe narrowly targeted antibiotics, to prevent C. diff from expanding unchecked.

Based on an article by Jacob Goldstein in the WSJ

]]> http://ncnrehab.com/blog/?feed=rss2&p=46 0 http://ncnrehab.com/blog/?p=28 http://ncnrehab.com/blog/?p=28#comments Fri, 01 Aug 2008 14:14:50 +0000 Ruth Folger Weiss http://www.rehabilistation.com/blog/?p=28