Relationships hold the key to giving terminally ill patients the spiritual care they need. However, researchers have pinpointed a mismatch between patients' expectations and understanding when it comes to spirituality, and what medical and family caregivers offer. New recommendations to improve this situation appear today, in the journal Palliative Medicine.

The terms 'spirituality' and 'spiritual care' are becoming buzzwords in palliative care. But although most terminally ill patients rate care for their spiritual needs as very important, the professionals caring for them often have trouble defining what that means.

Using the definition of spirituality 'a personal search for meaning and purpose in life, which may or may not be related to religion,' Cardiff University's Adrian Edwards together with Hong Kong based researchers Naomi Pang, Vicky Shiu and Cecelia Chan scoured the palliative care literature to create a systematic meta-study of spirituality. They incorporated qualitative data from 19 studies on 178 patients and 116 healthcare providers in their analysis.

Edwards' team found that although policy organizations advocate integrating physical, psychosocial and spiritual aspects within palliative care, not all patients understand the term 'spirituality.' Having said that, according to quantitative studies, 87 percent of patients consider spirituality important in their lives, while 51 to 77 percent of patients specifically consider religion important. The initial challenge is to clarify what spirituality means in healthcare, and to reduce the gap between policy and patient expectations.

The articles selected for the meta-study were published between 2001 and 2009, and encompassed patients from the UK, US, Australia, Taiwan and Japan, and included atheists, Taoists, Christians and Buddhists. The majority, however, were white, with a Judeo-Christian background, and suffering from cancer.

Parents may be surprised, even disappointed, to find out they don't influence whether their teen tries alcohol.

But now for some good news: Parenting style strongly and directly affects teens when it comes to heavy drinking - defined as having five or more drinks in a row - according to a new Brigham Young University study.

The researchers surveyed nearly 5,000 adolescents between the ages of 12 and 19 about their drinking habits and their relationship with their parents. Specifically, they examined parents' levels of accountability - knowing where they spend their time and with whom - and the warmth they share with their kids. Here's what they found:

• The teens least prone to heavy drinking had parents who scored high on both accountability and warmth.
• So-called "indulgent" parents, those low on accountability and high on warmth, nearly tripled the risk of their teen participating in heavy drinking.
• "Strict" parents - high on accountability and low on warmth - more than doubled their teen's risk of heavy drinking.

Prior research on parenting style and teen drinking was a mixed bag, showing modest influence at best. Unlike previous research, this study distinguished between any alcohol consumption and heavy drinking.

According to information the manufacturer of Gardasil, a vaccine against human papillomavirus, presented to the FDA prior to approval, if a person has already been exposed to HPV 16 or 18 prior to injection, then Gardasil increases the risk of precancerous lesions, or worse, by 44.6 percent.

This information is not advertised, and the FDA has not recommended screening for HPV prior to vaccination. The FDA did not even demand that a warning be included in the package insert.

According to Examiner.com:

"Now, Merck's research is indicating that Gardasil may also 'provide cross-protection' against other strains of HPV that are closely related to HPV 16 and 18 ... This means prior exposure to these additional strains may pose an increased risk for cervical cancer also, if combined with vaccination."

Sources:

Examiner.com June 30, 2010
Morbidity and Mortality Weekly Report, May 28, 2010
Waco Tribune-Herald, June 21, 2010
ABC News Health Medical Unit, August 19, 2009

A report published in Britain recently recommends Ireland and other countries reverse its decision to follow the American example, and stop putting the poisonous chemical called fluoride in public drinking water and hygiene products.

Published in the peer-reviewed journal Toxicology - the official journal of the British Toxicology Society and the German Toxicology Society - author Dr. Robert Verkerk said "mass fluoridation of the public water supply [must be]stopped immediately. This is borne out by actual data from Ireland which shows that every third child is affected [by a high risk of dental fluorosis]."

Fluorosis is a condition which causes staining on the teeth and indicates unhealthy toxicity in the body.

Researchers at the University of Medicine and Dentistry of New Jersey (UMDNJ) have identified a direct link between phthalates, the substances that make plastics more pliable and durable, and inflammation in newborns - and are encouraging more limited use of the plasticizers. Their paper, "Inflammatory Effects of Phthalates in Neonatal Neutrophils," appears in the August 2010 edition of the journal Pediatric Research.

Previous studies have shown that premature babies are exposed to extraordinarily high concentrations of phthalates because of long-term exposure to phthalates in plastic medical equipment used during neonatal intensive care. These include multiple types of tubing, such as breathing tubes, feeding tubes, intravenous tubes, that these babies rely upon to survive. However, concern arises regarding the impact of that exposure on babies' health.

Another Johnson & Johnson manufacturing plant -- this one making heartburn and gas relief drugs Pepcid, Imodium and Mylanta - was cited for a pattern of quality lapses similar to those seen at the company's shuttered Tylenol plant.

Earlier this month, safety inspectors from the Food and Drug Administration issued a "Form 483" to Johnson & Johnson's Lancaster, Pa., plant.

A Form 483 is issued after an FDA inspection finds problems with a company's manufacturing practices.

The Lancaster plant is owned by Johnson & Johnson-Merck Consumer Pharmaceuticals, a joint venture of J&J and Merck (MRK, Fortune 500), but is operated by the company's McNeil division.

Hospitals will be forced to show they are preventing malnutrition in their patients or else lose their accreditation after continuing concerns about how vulnerable patients are fed.

Elderly patients who stay are hospitalised for long periods are dying from malnutrition because hospitals do not currently consider food part of clinical care, said Claire Hewat, the chief executive of the Dietitians Association of Australia.

And nearly two years after the Garling inquiry heard elderly people were "starving" in public hospitals, some NSW patients were still left unable to open and eat their food.

In this week's Health Blog, the Wall Street Journal's Katherine Hobson asks readers to chime in on a "debate" among family doctors over the ethics of corporate sponsorship of medicine.

But first, the backdrop. Last year, the American Academy of Family Physicians announced "a new corporate partnership program" and its first partner was to be The Coca-Cola Company. Soon thereafter, about 20 doctors resigned from the organization in protest, drawing attention to the matter by Food Politics author Marion Nestle as well as advocacy groups such as the Campaign for a Commercial-Free Childhood. (Full disclosure: I serve on CCFC's steering committee.)

The grant amount was described as being in the "strong six figures" by AAFP. Here is how the group described the partnership in its October 2009 press release:

The Consumer Alliance is a program that allows corporate partners like The Coca-Cola Company to work with the AAFP to educate consumers about the role their products can play in a healthy, active lifestyle. As part of this partnership, The Coca-Cola Company is providing a grant to the AAFP to develop consumer education content on beverages and sweeteners for FamilyDoctor.org, an award-winning consumer health and wellness resource.

A nonprofit doctors group filed a lawsuit against the U.S. Food and Drug Administration (FDA) this month, after they failed to notify patients of dietary alternatives to dangerous diabetes drugs such as Avandia, a highly scrutinized diabetes medication. The group, Physicians Committee for Responsible Medicine (PCRM), alleged they petitioned the FDA to require that such alternatives be included on labels for the drugs, but to no avail, according to a Monday, July 19, 2010 PCRM news release.

Plaintiffs in the case, who are all doctors, alleged that while the PCRM sent the FDA an administrative petition regarding the lack of labels alerting patients of substitutes to dangerous diabetes medications, administration commissioner Margaret Hamburg, M.D., did not appear to act on the matter.

The Environmental Protection Agency is holding public hearings today to review a proposed safe exposure limit for dioxin, a known carcinogen and endocrine disruptor produced as a common industrial byproduct.

It's all but impossible to avoid exposure to dioxin. Research done by the Environmental Working Group has shown that adults are exposed to 1,200 times more dioxin than the EPA is calling safe - mostly through eating meat, dairy and shellfish - and mothers pass it on to babies in the womb and in breast milk. A nursing infant ingests an amount 77 times higher than what the EPA has proposed as safe exposure. (Formula is also widely contaminated with the stuff.)