With over 500 downloads per day, ‘iStethoscope’ has clearly piqued some people’s interest. The question is, are any of them doctors? The iPhone’s potential in the healthcare field is no secret, but thus far such uses have been confined to the likes of blood sugar meters and non-smoking apps. Is it possible for a medical professional to simply place her phone against your chest, and listen to and record your heart? Will doctors use their iPhones to perform ultrasounds, or to perform on-the-spot blood analysis? Maybe, but we won’t lie: If our doctor came to the examination room and started pressing his beat-up 3G against our chest, he’d only hear a heart attack.

By a unanimous vote, the California Occupational Safety and Health Standards Board approved revisions to the state’s heat illness prevention standard last week that agricultural organizations said will add clarity to the rules.

Modifications to the standard approved last Thursday add high-heat provisions for five industries, including agriculture, and clarify the shade requirement, including a “shade up” temperature trigger and limited exception to that requirement.

California became the first state in the nation to develop a regulation to protect employees from heat illness. First issued as an emergency regulation in 2005, the standard was made permanent in 2006. The regulation requires employers to provide outdoor employees with drinking water, shade breaks and training in heat-illness prevention. Employers also must have written compliance and emergency-response procedures.

The California Farm Bureau Federation said it will continue its training and outreach to ensure farm employers understand and comply with the standard.
“Farm Bureau and other organizations will continue doing all we can to educate farmers, farm employees and their supervisors about how to avoid heat illness. In the past several years, we have trained farmers and supervisors who work with some 400,000 farm employees,” said Bryan Little, CFBF director of labor affairs and chief operating officer of Farm Employers Labor Service. “We have distributed hundreds of thousands of heat-safety cards and posted heat-safety information at work sites and on water coolers, and we have run heat-safety announcements on Spanish-language radio stations.”

Revisions to the standard include the following:

High-Heat Procedures
• High-heat procedures are required for agriculture, construction, landscaping, oil and gas extraction, and transportation or delivery of agricultural products, construction material or other heavy materials when the temperature is 95 degrees or higher. These procedures include, to the extent practicable: ensuring effective communication so employees can contact their supervisor when necessary; observing employees for alertness and signs or symptoms of heat illness; reminding employees throughout the work shift to drink plenty of water; and closely supervising a new employee for the first 14 days of employment. This last provision is not required if the employee when hired indicates he or she had been doing similar outdoor work for at least 10 of the past 30 days for four or more hours per day.

Shade
• Above 85 degrees, enough shade must be present so at least 25 percent of a crew’s employees can sit fully in it in a normal posture without touching each other.
• At 85 degrees or lower, timely access to shade must be provided upon an employee’s request.
• By showing it is infeasible or unsafe to have shade continuously present at temperatures exceeding 85 degrees, an employer may use alternative procedures for providing access to shade that provide equivalent protection. Discussing this exception at last week’s standards board meeting, Cal/OSHA Chief Len Welsh gave as an example an employee operating an all-terrain vehicle. Noting it would not be feasible for shade to be near the employee while traveling long distances, an acceptable alternative procedure would be for the employer to provide the employee with an umbrella that the employee could open and use when needed.

Training
• Before starting work that should reasonably be anticipated to result in exposure to the risk of heat illness, employees (including supervisors) must be provided with effective training in required topics on ways to avoid heat illness and steps to take if it occurs.

Gov. Arnold Schwarzenegger praised the board’s action.

“These amendments will better protect the health and safety of thousands of California workers who make their living under the sun, and I applaud the board for adopting them,” Schwarzenegger said. “My administration continues its commitment to enforcing California’s first-in-the-nation heat regulation standards, and I urge all employers of outdoor workers to ensure they are in compliance with these new amendments.”

After the emergency standard was adopted in 2005, the California Farm Bureau and other agricultural organizations teamed with Cal/OSHA to help train and educate employers and supervisors about how to stay safe when working outdoors in high temperatures.

“Everyone on the farm needs to take responsibility for heat safety: farmers and ranchers, supervisors and the individual employees themselves,” Little said. “We will continue our efforts to make sure everyone understands what they need to do to remain safe on hot days.”

Welsh said California’s heat illness prevention rule is making a difference in saving lives.

“We have significantly changed behavior. We certainly have educated employers and employees about the need for heat-illness prevention. Our rate of compliance is really going steadily upward,” Welsh said. “I can’t think of a single case in our history where we’ve targeted an issue like this and actually tracked the impact we are having on the industry in terms of changing behavior. This kind of progress is really unprecedented.”

The revised heat illness prevention standard is expected to take effect in October, once administrative procedures for formal adoption have been completed.

CFBF recommends that farm employers take advantage of training opportunities to be offered on the new requirements of the revised standard and to incorporate them in their compliance programs. To help employers comply with the standard, FELS provides resources at www.fels.net; click on Supply Catalog, then on Heat Illness Products.

For more information on heat safety and training materials, visit the CFBF Rural Health and Safety page at www.cfbf.com/rhs/.
(Christine Souza is an assistant editor of Ag Alert. She may be contacted at csouza@cfbf.com.)

California Farm Bureau Federation, 2300 River Plaza Drive, Sacramento, CA 95833

An App with Heart

Whether you’re a medical professional subscribing to important updates or just want to monitor your glucose levels, there are more apps available almost everyday for your favorite smart phone. All the news about great apps used to be all about the iPhone. Now, Google’s open-source Android operating system has grown into a formidable player in the world of smartphones.

And with the growth in its user base has come a flood of apps. While the quantity of apps available in the Android Market isn’t in the same league as what iPhone users can find in the Apple App Store, the quality certainly is there. With a little help from Google and an app developer or two, FierceMobileHealthcare has compiled a list of free and interesting healthcare-related apps that help make the lives of healthcare professionals and patients a little easier. Click on any of the links below to get started.

1. Epocrates Rx
2. Calculate by QxMD
3. PubMed Mobile
4. Skyscape Medical Resources
5. Relief Central
6. Mini Nurse – Lite
7. Hospital Intel
8. USA Graduate School: Medical
9. National Comprehensive Cancer Network Guidelines
10. iTriage Mobile Health
11. Heart Rate Monitor
12. Glucose Meter
13. MedPage Today Mobile
14. Prescriber’s Letter
15. FierceMarkets

Related Slideshows:

15 Free Healthcare Apps for the BlackBerry
15 Free Healthcare Apps for the iPhone

Photo Courtesy of Panera Bread , Salad Review Text: Holley Grainger, MS, RD

More than ever, people are looking for healthy meal choices, even when it’s “fast food.” Of course our doctors and our nurse practitioner encourage their patients to make healthy eating part of their lifestyle. Lucky for us we have a Panera Bread practically next door to us here at Miller and Betteravia in Santa Maria. But, as much as we love Panera, there’s a big difference on the “healthfulness scale,” between salads on their menu.

Thumbs Up: Panera Bread Strawberry Poppyseed & Chicken Salad (pictured)
This bright and colorful salad is filled with phytochemicals thanks to a healthy dose of strawberries, blueberries, mandarin oranges, and pineapple. One bowlful delivers a helping of antioxidants to keep your heart healthy. A serving of chicken makes it super satisfying too—for only 280 calories and 8 grams of fat. Ask for a reduced-fat vinaigrette or dressing on the side. We like their reduced-fat balsamic vinaigrette for just another 60 calories and 5 grams of fat.

Thumb’s Down: Tomato, Mozzarella & Basil Salad
While this salad sounds healthy and fresh, the Asiago Croutons jack up the stats to 770 calories, 47 grams of fat, and 1200 milligrams of sodium. Leave off the croutons and you’ll shave 340 calories, 14 grams of fat, and 650 milligrams of sodium.

via Intelligent Clothing Fibers Could Have Medical Applications – Technology For Change.

How many Z's does it take to catch up?

A study in the Aug. 1 issue of the journal SLEEP suggests that a dose of extra sleep on the weekend may be good medicine for adults who repeatedly stay up too late or wake up too early during the workweek. However, even a night of 10 hours in bed may not be enough to cure the negative effects of chronic slee of p restriction.

Results show that neurobehavioral impairments such as increased lapses of attention and delayed reaction times accumulated across a period of five days when sleep was restricted to less than four hours per night. Behavioral, subjective and physiological measures of alertness improved significantly after a night of recovery sleep, with larger doses of sleep producing greater gains. Yet some neurobehavioral deficits continued to linger after the maximum recovery dose of 10 hours in bed, during which participants slept for an average of about nine hours. The study suggests that complete recovery from sustained sleep restriction may require even more sleep during one night or multiple nights of extended sleep.
“Recovery of alertness dimensions was remarkably dependent on the duration of the recovery time in bed,” said principal investigator David F. Dinges, PhD, director of the Unit for Experimental Psychiatry and chief of the Division of Sleep and Chronobiology at the University of Pennsylvania School of Medicine in Philadelphia, Pa. “However, the sleep restriction was severe enough that recovery of alertness was not complete following a single night of extended sleep, indicating a residual sleep debt remained. Lifestyles that involve chronic sleep restriction during the workweek and during days off work may result in continuing buildup of sleep pressure and in an increased likelihood of loss of alertness and increased errors.”
The study involved 159 healthy adults with a mean age of 30 years, which is the largest number of subjects to be involved in a single laboratory-based, sleep-restriction experiment. Fifty-seven percent of participants were African-American. Following two baseline nights of 10 hours time in bed, 142 participants were randomized to the sleep restriction protocol of four hours in bed from 4 a.m. to 8 a.m. for five consecutive nights. Then they were randomized to one of six doses of recovery sleep ranging from zero hours to 10 hours in bed for one night. The other 17 participants were randomized to a control group and spent 10 hours in bed on all nights.
Beginning at 8 a.m. each day, participants completed 30-minute computerized neurobehavioral assessments every two hours during scheduled periods of wakefulness. Assessments included a 10-minute Psychomotor Vigilance Test and the Karolinska Sleepiness Scale. A modified Maintenance of Wakefulness Test also was conducted at baseline, on the fifth day of sleep restriction and on the recovery day.
Mean total sleep time dropped from 8.47 hours at baseline to 3.72 hours on the first night of sleep restriction. Relative to the control group, sleep restriction degraded all neurobehavioral functions across the five days of sleep loss. One night of recovery sleep then improved all neurobehavioral outcomes as sleep doses increased. However, lapses of attention, subjective sleepiness, reaction times and fatigue scores all remained elevated above baseline levels in the 27 participants who spent 10 hours in bed on the recovery night.
“The additional hour or two of sleep in the morning after a period of chronic partial sleep loss has genuine benefits for continued recovery of behavioral alertness,” said Dinges. “The bottom line is that adequate recovery sleep duration is important for coping with the effects of chronic sleep restriction on the brain.”
Extrapolations estimated that at least 10 hours of recovery sleep would be necessary for sleep-restricted participants to match the functional levels of the well-rested control group. However, the authors noted that circadian constraints on sleep duration may prevent individuals from getting enough sleep in one night to achieve recovery. Acute recovery in a single night would be more likely if the sleep restriction is less severe than that which participants experienced in the study.
Dinges also noted that performance and alertness deteriorated profoundly when the five nights of restricted sleep were followed by a night of either no sleep or only two hours of time in bed.
“This highlights the importance of avoiding all-night sleep deprivation following a period of restricted sleep,” he said.
The research was supported by grants from the National Institutes of Health and in part by the National Space Biomedical Research Institute.
Previous research led by Dinges found that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. The study published in the journal SLEEP in 2003 found that chronic restriction of sleep to six hours or less per night for 14 consecutive days produced cognitive performance deficits equivalent to up to two nights of total sleep deprivation.
In a 2009 study in the journal SLEEP, Dinges and Mathias Basner, MD, reported that people who worked eight hours or more woke up earlier in the morning than people who worked less than eight hours, but they did not go to bed earlier at night. The study also found that watching TV was the primary activity people engaged in before going to bed. The authors suggested that giving up some TV viewing in the evening is one strategy to reduce chronic sleep restriction.
The peer-reviewed, scientific journal SLEEP is published monthly by the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The AASM is a professional membership society that is the leader in setting standards and promoting excellence in sleep medicine health care, education and research.
Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Academy of Sleep Medicine.

Story Source: American Academy of Sleep Medicine (2010, August 1). Catching up is hard to do: Negative