Doctor/Patient Communication Key in Fight Against Unnecessary Antibiotic Prescription

Patient satisfaction is essential to doctors in all settings and nowhere is this more important than in the general practitioner’s office.  Satisfied patients typically have more trust for their doctors, follow medical instructions more readily, and return consistently for followups and other types of appointments.  Dissatisfied patients can be difficult to manage at best and in many cases simply switch providers or delay seeking care.

One area that challenges medical professionals today is the expectation from the patient that Antibiotics can and will help most any illness.  Always under pressure to keep appointment durations tightly controlled leads some doctors to choose between taking the time to explain why antibiotics won’t help with certain illnesses and simply prescribing an antibiotic for the patient’s comfort.

Recommendations for Doctor/Patient communication include telling parents of young children that unnecessary antibiotics can be harmful by creating conditions where resistance is more likely to develop.  Also, by speaking with patients in a consultative manner as opposed to a mere dispensation of information will encourage patients to think more critically about their condition and any potential unintended effects.  There should be no underestimation of the power of taking one’s patient seriously.

For adults cases of pharyngitis, most instances are self-limiting and are best helped by traditional care methodologies.  Ensuring that the patient is aware of the power of supportive care during illnesses is imperative in defeating the obligatory expectation of antibiotic treatment.  In the case of rhinosinusitis many cases are viral, upper respiratory tract infections although differentiation between viral and bacterial is challenging.  Symptoms lasting for less than 7 days are less likely to have a bacterial infection.  Guidelines for practitioners for adults and children are available from the Centers for Disease Control and Prevention.

Patients themselves are also a necessary part of the equation in preventing the spread of antibiotic resistant bacteria.  Knowing that there is a difference between a viral and bacterial infection can only help today’s doctors communicate more effectively with patients.  Truly, the Doctor/Patient nexus is the one of the most effective and accessible methods for turning the tide against the potential for antibiotic resistance in ourselves and our communities.

Improved Compliance Needed to Ensure Long-term Efficacy of Transgenic Crops

Diabrotica virgifera virgifera or western corn rootworm is a serious threat to corn farming causing widespread destruction to the roots of plants from feeding larvae. Transgenic strains of corn were developed to leverage toxin producing genes from Bacillus thuringiensis (Bt) as an insecticide.

Bt delta endotoxin has been in use since the 1960’s as a direct application insecticide and saw it’s first large-scale deployments as a transgenic GMO in 2003.  By 2010, over 143 million acres (58 million hectares) were planted in the United States.  Bt corn posses Bt delta endotoxin in varying concentrations throughout the plant body.  When an insect comes into contact with Bt delta endotoxin the protein bonds with internal organs (gut) causing a structural breakdown there by releasing bacteria into the bloodstream causing septicemia and death.

The promise of Bt corn among other things is a reduction to the level of insecticide required during growing seasons which in turn modify the cost and operating expenditures of agribusinesses across the United States.  Many health and environmental advocates target insecticide use as a major problem and a reduction in use may be seen as a welcome change in the corn industry’s methodology.

Proper management of Bt corn planting is essential in ensuring that this resource remains a viable deterrent to the western corn rootworm and other pests for as long a period of time as possible.  A high-dose/refuge method for maintaining the efficacy of Bt corn involves setting aside ‘refuge’ plantings of non-Bt corn preventing selective pressure from building, keeping genetic populations dilute in terms of resistance.  The high-dose/refuge practice which was highly effective until the 1990’s saw a dramatic loss of efficacy.

Recent investigations have shown that fields infested with Bt-resistant strains of D. virgifera virgifera were associated with insufficient or non-compliant refuge plantings of non-Bt corn.  Recent surveys throughout the Midwest have estimated that merely 50-70% of farming operations are compliant.

More emphasis on proper management of Bt corn is needed to ensure that this advanced bioinsecticide realizes it’s full potential not only for business concerns but to also ensure that agribusiness is able to keep pace with an exploding global population in the decades to come.  It is hard to ignore the fact that the campaign against the western rootworm is simply one of many battles fought waged by agriculture in the modern age and discipline and strict adherence to proscribed polices for management

Reference & Citations:

Your Smart Device is Making You Weird: GPS Induced Stupidity

isliderWhen a technology becomes reliable to a certain level people tend to free themselves from thought and responsibility to varying degrees.  Take for example the Global Position System (GPS), once an important tool limited to military applications, GPS is now standard and rightfully expected by consumers purchasing mobile devices, vehicles and more.

Whether you are in your car, on foot, or just planning an outing you are in need of direction and location information.  And, few technologies give quite as much assurance as GPS-aided navigation.

Our main thinking point for today’s article is this:

What happens when people over-rely on a convenience technology that is not necessarily always accurate?  If people stop thinking for themselves then what happens to the rest of us?

You be the judge, here are a few snippets from news stories around the web highlighting some of the not-so-great moments of GPS Induced Stupidity in another installment of a segment I like to call, Your Smart Device is Making You Weird.

The 32-year-old man, a computer maven, was on temporary assignment for an I.B.M. contractor in New York and wandered through the rolling hills here one evening, trusting in the cyber-driven intelligence of his car’s G.P.S. device rather than his own. As a result, according to Metro-North, he ended up making a right turn onto the railroad tracks and getting the undercarriage of his rented Ford Focus wedged between the rails. The man calmly hauled out his suitcase, called 911 and waited to wave the train to a stop. But the train couldn’t brake in time and ended up dragging the car for 100 feet until it burst into a fireball.

Read it Here

Most tales of GPS-Induced Stupidity do not end in fiery carnage (yet), but we see from this snippet that not even tech savvy people are safe from technology related ignorance.

A Bavarian man was given a persuasive lesson in the fallibility of technology Thursday night when he crashed into another car and injured an 11-year-old boy after obeying his car navigation device’s command to turn around on a divided autobahn.

Amazingly, the man, 45, took a U-turn on the divided motorway and began driving down the wrong side because the satellite navigation computer told him to turn around, police said in a statement.

Read it Here

Strange as it may sound, there is no replacement for using one’s eyes to aid in the operation of motor vehicles or heavy machinery.

The teen, who had two juveniles in the car with him in violation of the state’s graduated license rules, was headed westbound on Route 33 in his Ford Mustang when, he told police, his GPS told him to make a left turn onto Sweetmans Lane, police said.

The 17-year-old cut across the eastbound lanes of Route 33 and struck a vehicle on the left side at about 7:50 p.m. Saturday, according to police. The impact turned that car around 180 degrees before it came to rest facing oncoming traffic. The driver of that vehicle was taken to an area hospital after complaining of neck pain.

A third car struck the rear bumper of the Mustang, pushing that car into a spin before it too came to rest facing the eastbound oncoming traffic. A fourth vehicle traveling in the eastbound lanes swerved left to avoid the multiple car accident scene, when that car struck the curbed median, damaging both right-side tires, and rolling into the westbound lanes before coming to a stop.

The 17-year-old driver, from the Morganville section of Marlboro, was issued motor vehicle summonses for careless driving, making an improper turn and violating the terms of his provisional driver’s license.

 Read it Here

Of course, we expect poor judgment from young drivers so this is perhaps not the best example of GPS Induced Stupidity. You can view disturbing statistics related to young drivers here.

Three young women escaped the sinking Mercedes-Benz SUV after the vehicle’s GPS directed them down a boat launch and into the Mercer Slough in Bellevue, Washington.

The driver thought she was on a road while following her GPS unit just after midnight, but she was actually heading down the boat launch. All three women made out safely, but the SUV was completely under water. Officials said the three were in town for a conference and were trying to get to a hotel in Bellevue.

“They were trying to re-route their path and found this boat launch near the entrance to I-90 in South Bellevue and just kept driving into the water,” Mr Keenan said.

Read it Here

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As amusing as these stories are they may speak to something larger about Human nature in terms of technology. Perhaps there is a natural expectation that technology will someday alleviate most of the ‘burdens’ people experience in their daily lives.  Even if this were the case such a thing is surely far into the future.

Only you as an individual can truly be responsible for your own safety, but when others fall prey to over reliance on technology or mere stupidity you may find that there is only so much you can do to prevent the consequences of GPS Induced Stupidity.