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December 2002


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QUALITY OF CALIFORNIA NURSING HOMES QUESTIONED

According to a review of nursing homes in the state, more than 75% of California nursing homes fail to meet federal standards, and more than four in 10 violate a state law mandating minimum nurse-staffing levels. The 32-month study, conducted by the California HealthCare Foundation, also found that close to eight in 10 nursing staff members left their jobs from 2000 to 2001.

The study also found that many nursing home residents received less than 5 minutes of assistance with eating and were given bathroom help less than twice in 12 hours. “These things are obviously related,” says Charlene Harrington, the study’s lead researcher and a professor at the University of California-San Francisco School of Nursing. “Low staffing levels are responsible for the poor quality, and something needs to be done about it.”

To that end, the foundation has launched a Web site, www.calnhs.org, that provides detailed information on all 1,406 nursing homes in California. The site compares their performance on measures such as nursing staff turnover by assigning stars, with one star representing the worst home and three stars the best. “We are trying to not only measure quality, but to try to inspire improvement,” says Harrington.

However, the Web site has drawn criticism from some who say that it lacks publicly available information, such as convictions or prosecutions against nursing homes, and that it does not allow consumers to request top-performing homes in each category.

At any rate, the movement to spur nursing home changes is a national one as well. This past June, the US General Accounting Office said that nursing aide staffing is a good predictor of the quality of homes. Another report, conducted by the University of Colorado Health Sciences Center and completed last December, found that higher levels of nurse staffing reduced the need to hospitalize residents for treatable conditions and infections. Residents also experienced fewer pressure sores and less weight loss when they had additional help.

The California HealthCare Foundation also found that about 44% of homes were not in compliance with the state’s nursing staff standards in 2000 and 2001. It appears that due to the shortage of nurses and nurse aides, it took some homes extra time to comply.

STUDY SAYS NERVE CELL TREATMENT COULD HELP SPINAL CORD PATIENTS

A new study published in the October edition of the Journal of Neurotrauma suggests that small nerves can be inserted and stimulated to grow in damaged areas of the spinal cord, possibly leading to improved treatments for people with spinal cord injuries.

The study, conducted by researchers at the University of California-Irvine and the Long Beach Veterans Administration Medical Center, showed that tiny nerve cells taken from the rib cage, fortified with a growth inducer, and transplanted in the spinal cord caused significant reversal of paralysis in rats with spinal cord injuries. The researchers were then able to partially restore hind leg movement in rats with severed spinal cords.

The growth inducer used in the study, a molecule called aFGF, is common in most nerve cells. The rats that received aFGF in addition to nerve grafts were able to move their hind legs and could support some of their weight on those legs following treatment. However, rats that received either aFGF or nerve cell grafts alone showed little improvement.

The study’s researchers pointed out that regeneration is typically difficult, due to the damaged area inhibiting growth of new nerve-cell connections. However, they say, the study seems to show that this combination of growth factors, nerve cells, and physical stimulation helps to overcome these inhibitions.

RULING SAYS ADA DOES NOT APPLY TO INTERNET

A recent federal ruling stated that the Americans with Disabilities Act (ADA) applies only to physical spaces such as restaurants and offices, and not to the Internet.

The ruling was in response to a lawsuit filed against Southwest Airlines, alleging that the company’s Web site was too difficult for blind people to navigate. The lawsuit was filed by Access Now, an advocacy group for the blind, in an attempt to force Southwest to redesign the site.

However, US District Judge Patricia Seitz wrote in her dismissal of the case that “to expand the ADA to cover ‘virtual’ spaces would be to create new rights without well-defined standards. The plain and unambiguous language of the statute and relevant regulations does not include Internet Web sites.”

Seitz also said it is clear the ADA does not apply to the Internet, because Congress was very careful in specifying what kinds of physical spaces are covered by the ADA.

The ADA, enacted in 1990, states that any place of public accommodation must be accessible to people with disabilities. That includes 12 categories, such as hotels, restaurants, shopping malls, universities, and bowling alleys.

If Southwest had lost the case, the outcome could have had far-reaching effects by imposing broad new requirements on companies hoping to do business online.

SOME BRAIN INJURIES CAUSE “FOREIGN” ACCENTS

Researchers at England’s Oxford University have located an area of the brain that causes some stroke patients or accident victims to suddenly develop “foreign” sounding accents.

A very small number of stroke victims suffer brain injuries that produce a shift in pronunciation, known as “foreign accent syndrome.” The first known case of the syndrome was reported in 1941, and involved a Norwegian woman who developed what her neighbors thought was a German accent after she recovered from shrapnel injuries.

However, most patients with this syndrome can be helped with speech therapy and are back to normal speaking patterns within 2 years, according to Jennifer Gurd, MD, one of the Oxford researchers.

GUITAR PLAYERS SUSCEPTIBLE TO MUSCULOSKELETAL PROBLEMS

A study recently conducted by researchers at the Robens Center for Health Ergonomics at the University of Surrey, England, found that young, inexperienced electric guitar players were at risk of developing musculoskeletal problems such as repetitive strain injury (RSI) caused by poor posture and excessive grip on the guitar strings.

Researchers said that amateur guitarists often developed poor posture because of their habit of looking at the strings while playing. They also exerted more pressure on the instrument’s strings than more experienced musicians. The most common symptoms were neck, shoulder, wrist, and hand pain.

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