Knowing what causes snoring can greatly help you both to find relief if you are already suffering from its effects or to find ways of preventing yourself from becoming a poor victim.

Though not regularly the cause of aggravated problems (except for social embarrassment and potential risks of discontented relationship), it is still best if you are not a sufferer yourself.

Many fall victim in this noisy nighttime dilemma. While some are not aware that they have the condition, many are known to seek ways to get around the troubles that it causes.

Like most other conditions, snoring can be prevented. If you are close to becoming a snorer yourself or if you know one who shows initial signs of developing this condition, you can find good use in the advises that we have in this article. Please read on.

Snoring occurs when the collapsible part of the throat meets. Coupled with the passage of air into the throat, these dangling parts are likely to produce vibrations that create the noisy sounds. Why this condition occurs at night is not a mystery.

While it is true that we breathe 24 hours a day, we only snore when our body is totally relaxed. Thus, it is often advised that snorers maintain a tensed sleeping position until the body gets used to this state.

If you do not like the idea, however, you can prevent snoring through practicing a sideward sleeping position to widen the passage through which air may run through. This passage is congested when we sleep on our backs since our heads are forced to fall back. Additionally, our lower jaw is encouraged to open, therefore creating a space wherein the tongue can droop back. When this occurs, the normal air passage will be obstructed by these components.

We all know that when a passage narrows, the pressure that regularly runs through it will increase. This principle occurs in the throat which explains why there are people who snore and there are those who don’t, and why snores come in different intensity and sounds.

Obesity is known to induce snoring. This is due to the fact that heavier people are more likely to have extra (and often unnecessary tissues). The neck of an overweight person is known to have more muscles and adipose tissues that hamper the normal delivery of breathing.

Thus, to prevent the possibility of producing nighttime respiratory vibration, one is advised to refrain from gaining too much weight. Not only would you escape from major health threats such as general unhealthiness of the body or coronary diseases, you can also save yourself from distracting your bed partner’s sleep and your own.

Some people practice mouth breathing. Add to the fact that this is generally not a healthy practice, mouth breathing can also raise one’s susceptibility towards snoring. It may seem awkward to switch back to nasal breathing initially though, but in time you would learn to breathe naturally using your nose while sleeping. In the end, you would be thankful that you took time and learned patience in eliminating this habit.

If you would notice, most advice for preventing snoring concerns lifestyle-changing practices. This is because snoring, as a whole, doesn’t necessarily have to root from biological causes while we may find sufferers who are actually bothered by nasal deformities or extra large adenoids and tonsils.

About the Author

Author writes for Snoring Solution, Get Rid of Cellulite and Six pack abs.

Article Source: Content for Reprint

[Source : Full text health articles - Content for Reprint]

Last year, we posted about the guilty plea by the US arm of the Canadian firm Biovail to charges that it paid physicians kickbacks to prescribe a long-acting version of the drug diltiazam. This week, the plea was formalized, per Reuters,

A U.S. unit of Canadian drugmaker Biovail Corp (BVF.TO) has pleaded guilty to conspiracy and kickback charges, ending a case over its Cardizem hypertension drug, the U.S. Justice Department stated on Monday.

Prosecutors stated Biovail has been sentenced to pay $22.2 million in fines, formalizing an agreement reached last year. It also concurred to pay $2.4 million to settle civil claims. Both involved charges it improperly paid physicians and other prescribers up to $1,000 to advocate Cardizem.

When we originally posted about this case, we focused on the unprofessional behavior of the physicians who accepted the payments apparently in turn for prescribing. However, this is also yet another in a string of cases in which charges of unethical behavior by a huge health care organization (a drug company this time) are settled by the company paying a fine, but not by any penalties accruing to any people at the company who authorized, ordered, or implemented the unethical actions. We have written about many such cases (see this).

Also this week, a US judge addressed another proposed legal settlement of an important parallel case in the world of finance, and how he ruled suggests what needs to be done to truly discourage unethical behavior by health care organizations. The background, summarized by the New York Times, is:

Giving voice to the anger and frustration of many ordinary Americans, Judge Jed S. Rakoff issued a scathing ruling on one of the watershed moments of the financial crisis: the star-crossed takeover of Merrill Lynch by the now-struggling Bank of America.

Judge Rakoff refused to approve a $33 million deal that would have settled a lawsuit filed by the Securities and Exchange Commission against the Bank of America. The lawsuit alleged that the bank failed to adequately disclose the bonuses that were paid by Merrill before the merger, which was completed in January at regulators’ behest as Merrill foundered.

Now consider some of the Judge’s main points, and how they might apply to the many settlements of cases of unethical behavior of health care organizations. Per an editorial in the Wall Street Journal,

Judge Rakoff was having none of it. In a 12-page thought, he tore into the SEC for ignoring its own guidelines and penalizing shareholders rather than the individuals who supposedly acted improperly. The settlement ‘does not comport with the most elementary notions of justice and morality, in that it proposes that the shareholders who were the victims of the Bank’s alleged misconduct now pay the penalty for that misconduct.’

Note that the settlement of nearly each health care case involved a payment by the organization, but none by the people who authorized, ordered, or implemented the unethical behavior in questions. In those cases involving public for-profit corporations, just like the current one, the shareholders were the ones footing the bill. In most such cases, the shareholders were also ultimately victims in that it was their money that ultimately paid for the bad behavior, just like in this case. So in those cases the shareholders, who were victims of the companies’ managers’ bad behavior, were penalized while the managers got off Scot free.

(In cases involving not-for-profit organizations, in parallel, one could argue that it was the organizations’ line employees and other constituencies who were both the payers of the penalties and the victims of the conduct.)

Also,

As for the SEC’s argument that this shareholder punishment will result in better management, the judge called it ‘absurd.’

The judge also had little sympathy for the SEC’s argument that it would be too difficult to pursue executives, since they had been guided by lawyers. ‘If that is the case, why are the penalties not then sought from the lawyers? And why, in any event, does that justify imposing penalties on the victims of the lie, shareholders?’ he asked.

In most settlements of parallel cases in health care, the relevant government agency usually suggested that the settlement will lead to better behavior by the organization. As we have noted before, the take-away lessons for managers was more likely that bad behavior will at worst lead to increased costs of doing business, but no penalties to the people involved. Such lessons would likely reinforce managers’ decisions to behave unethically when doing so would benefit the managers themselves in the short run.

In parallel cases in health care, the relevant government bureau has rarely explained why it didn’t pursue the managers who authorized or ordered the behavior, or the lawyers that advised them, for that matter. The current case advocates that there was no logical rationale for failing to hold the people responsible accountable, except…

[The judge stated] broadly the deal ‘recommends a rather cynical relationship between the parties: the SEC gets to claim that it is exposing wrongdoing on the part of the Bank of America in a high-profile merger; the Bank’s management gets to claim that they’ve been coerced into an onerous settlement by overzealous regulators. And all of this is done at the expense, not only of the shareholders, but also of the truth.’

And it is likely in health care that previous settlements arose out of such a cynical relationship. The government agency got to claim it was exposing wrongdoing. The executives of the offending organization got to claim they were coerced into an onerous settlement by overzealous regulators. The main casualty was the truth.

Again, in my humble opinion, until the people responsible for the bad behavior experience negative consequences from that behavior, they’ll continue to perform, direct, and condone bad behavior. We will not achieve real health care reform in the US until we effectively deter unethical, self-serving behavior by leaders of health care organizations.

[Source : Health Care Renewal]

On Health Care Renewal, we have often shown how the governance of health care organizations might be unaccountable, unrepresentative of relevant constituencies, opaque, and not subject to ethical standards. Conversely, we have repeated the need to make the governance of health care organizations accountable, representative, transparent, and ethical. Meanwhile, our US debate about health care reform seems to be driven by leaders of powerful health care organizations, while common citizens need to scream to be heard.

Maybe we could benefit from a lesson from another country. As reported in the Bulletin of the WHO, Thailand seems to have found a way to get ordinary citizens and members of civil society involved in a civil, organized health care discussion.

For Dr Suwit Wibulpolprasert, chairman of the committee organizing Thailand’s first National Health Assembly (NHA), which took place from 11 to13 December 2008 in Bangkok, opening up the debate on public health is an essential part of developing effective national policy. ‘In the past, health policy has tended to be drawn up by politicians and officials,’ Wibulpolprasert says. ‘But the National Health Assembly is a forum for the public to pool views and initiate health agendas that truly address people’s needs.’

More than 1500 people attended the conference, the first of its kind to take place since the passing into law of the National Health Act of 2007, which also brought the NHA into existence.

A broad cross-section of Thai society was represented, including 178 delegations from government agencies and provincial authorities, the private sector and civil society. In addition, groups including stateless people living near the Myanmar border gave presentations at technical briefings for participants. Dr Kumanan Rasanathan, from WHO’s Department of Ethics, Equity, Trade and Human Rights, described the meeting as ‘a very interesting exercise in participatory governance’.

The 12 topics that were up for discussion were distilled from more than 68, including such familiar ones as universal access to medicines and equal access to basic public health services. Also addressed were matters as diverse as agriculture and food prices in the current economic crisis and safe media access for youth and family – an agenda that included a proposal for addressing problems of children addicted to on the internet games and television.

‘The broad slate of topics reflects the intention to encourage input from everyone,’ says Rasanathan, ‘and improve public participation as well as intersectoral collaboration.’ In other words, the assembly’s organizers actively encouraged the participation of stakeholders from outside the field of public health – from education, agriculture and industry, to name but a few.

‘The Thais have adapted much of the machinery of the World Health Assembly [WHO’s supreme decision-making body] for their own context,’ says Rasanathan, who noted that each of the 178 constituent groups had equal talking rights. Briefing papers were produced and resolutions were passed on each of the agendas. As with WHA resolutions, these resolutions are not binding.

According to Dr Amphon Jindawatthana, secretary-general of the National Health Commission Office, once the resolutions have been adopted they are considered by the National Health Commission, which reworks them for ministerial review and possible inclusion in national policy.

Given the hurdles that still need to be cleared once a resolution is passed at the Assembly, one might be forgiven for dismissing the body as something of a talking shop.

This is a charge that Wibulpolprasert firmly denies. He is convinced that NHA-formulated resolutions will certainly lead to policy, and policy that’s closer to the needs of Thailand’s 63 million people.

The 2009 Assembly will be held in December. Details can be found here.

I wonder if we would be having a more productive health care debate in the US if the way had been prepared by a US National Health Assembly? Maybe if the multi-million dollar a year leaders of health care organizations had to listen to the concerns of ordinary people, and some practicing health care professionals, a tiny common sense might penetrate into the bubble created by their superclass membership.

[Source : Health Care Renewal]

Here is a fascinating, spot-on exchange regarding biomedical information science between Bill Moyers on PBS and the new President of Dartmouth College Dr. Jim Yong Kim (link). My comments in [red italics]:

DR. JIM YONG KIM: My own particular take on it is that I think for many, many years, we’ve been working under the fantasy that if we come up with new drugs and new treatments, we’re done. ??The rest of the system will take care of itself. In my view, the rocket science in health and health care is how we deliver it. And unfortunately, there is not a single medical school that I know of that actually teaches the delivery of health care as one of the essential sciences. ??In other words, what we have learned about organizations is that it is very difficult to get a complex organization, a group of people, to work consistently toward a goal. In the business world, if you don’t do it well, the market gets rid of you. You go out of business. But many hospitals executing very poorly persist for a very, very long time. So my own view of it is that we have to rethink fundamentally the kind of research we do and the kind of people we educate, so that they will consider the complexity of delivery as a topic that we can take on and study and learn about as a science. [And possess a broad and deep enough background to comprehend these issues at very fine-grained levels, which in my opinion includes a rigorous scientific background to start with - ed.]

BILL MOYERS: What do you mean, complexity of delivery?

DR. JIM YONG KIM: Well, just think about a single patient. So a patient comes into the hospital. There’s a judgment made the minute that patient walks into the emergency room about how sick that person is. And then there are relays of information from the triage nurse to the physician, from the physician to the other physician, who comes on the shift. ??From them to the ward team, that takes over that patient. There is so many just transfers of information. You know, we have not looked at that transfer of information the way that, for example, Southwest Airlines has. Apparently they do it better than any other company in the world. [I would add that the nature of such transfers and the complexity of the information itself is far simpler in the Airline business than in medicine, so this isn’t the best analogy - ed.]

BILL MOYERS: Computers?

DR. JIM YONG KIM: No, they’ve taken seriously the human science of how you transfer simple information from one person to the next. [Note how Dr. Yong Kim wisely dismisses personal as the solution, in favor of people. He does not suffer the syndrome of inappropriate overconfidence in personal - ed.] And in medical school, and in the hospitals that I have worked in, we have done it ad hoc. Sometimes we do it well. Sometimes we don’t do it well. But what we know is that transfer of information is critical. Now to me, again, that’s the rocket science. That is the human rocket science of how you make health care systems work well ??What we need now is a whole new cadre of people who understand the science, who really are committed to patient care. But then also consider how to make those human systems work effectively. We’ve been calling it, aspirationally, the science of health care delivery. And we do it at Dartmouth. ??30 years ago, one of our great faculty members, Jack Wennberg, started asking a pretty easy question. Why is there variation, for example, in the number of children who get their tonsils taken out, between one county in Vermont versus another? ‘Cause one of his kids was in school at one place. Another of his children were in the school in another place. ??And in one place, nearly everyone had their tonsils out. And in another place, almost no one did. And of course, he found that there happened to be a doctor there who liked to take tonsils out and benefited from it. And he kept asking this question, you know, outcome variation. He called it the evaluative clinical sciences. And I think that’s really the forerunner to what we are talking about in terms of the science of–

BILL MOYERS: Fancy–

DR. JIM YONG KIM: –health care delivery.

I have the ability to add that part of that “cadre of people who comprehend the [information transfer] science” exists, in the form of Medical Informatics specialists (e.g., as produced by these organizations and many others in the U.S. and worldwide). Understanding the complexities of information transfer also calls for understanding the clinical environment and, in my view, the biomedical science as well.

However, you might never know this via reading statements from some of the non-clinical HIT leaders such as “computers enable complexity” [as opposed to well-trained and experienced medical experts - ed.]

It is indeed unfortunate that most hospital ads seeking Medical Informatics expertise are for “Director level” positions with tiny control of resources, i.e., they are “Director of Nothing” roles, diluting the contributions of such experts in the highly politicized and territorial environment of a hospital IT department.

Unfortunately, most in hospital IT this day are just repackaged business computing personnel of a management information systems (MIS) background whose lack of knowledge of these topics or cavalier attitudes about them has actually harmed the progression of health IT as a practical tool, as I have profusely documented on this blog (e.g., here) and at my educational HIT site here.

An example of just how difficult the “rocket science” of information transfer can be is this, from a psychiatrist:

I work on an acute psychiatric inpatient unit. We see each patient on rounds everyday, write a note in the chart each day and bill each day. However, the nature of psychiatric units are that patients wander freely around the unit. Consequently, whenever I walk onto the unit, I often have interactions with one or more patients, just in the short distance between the door and the nursing station. Some of those are brief but still give me a sense of how they are doing at that point, other interactions involve brief questions from the patients, still others involve walking to the patients’ room and sitting down to discuss a particular issue in greater depth with the patient and/or family.

Each of these involves a direct patient to clinician interaction and require that I exercise judgment (often a judgment that they’re doing OK). Yet none of these are billable interactions and most are not documented.

I was aware of this from my own medical school clerkship in psych. The fact that these valuable interactions are largely undocumented (except in the doctor’s gray matter) merely shows that modeling the real world of healthcare into neat, tidy little containers of information is harder than modeling the inventory and sale of widgets, due to the complexities of healthcare. One more of those “EHR as panacea” exceptions …

(And even the modeling of widgets is not always done well. I went to my local MicroCenter last week seeking an EIDE-to-USB hard drive enclosure, to use the orphaned 80Gb hard drive I upgraded in my Mac Mini to serve as a Time Machine backup drive. Their inventory system showed they’d a dozen on hand; nobody could find them, anywhere. A week later - yesterday - the same situation prevailed.)

Finally, a quibble. Later in the exchange Dr. Yong Kim makes the statement that “Right now, the physicians who are running these hospitals have never been trained. Most of them have never been trained in system thinking, in strategy, in management.”

As most hospitals are not run by doctors, I’d have to disagree with that statement. It perhaps should be redirected to the non-medical businesspeople in the C-suite and on the hospital Boards who do run hospitals, to which I’d add “who have never been trained in biomedicine.”

– SS

[Source : Health Care Renewal]

Nowadays, people choose medical practitioners based on their perceptions rather than relying on endorsements from local authorities and so on.  It has become increasingly important for doctors to market their medical practices in order to build their brand, reach out to new patients, and increase business from current patients. 

No matter how great of a doctor you are, your skills will mean little if no one knows you are out there.  Some doctors are reluctant to embrace marketing strategy because they think that being a great doctor is all you need to do in order to find new patients and keep your current ones.  However, the truth is that visibility is incredibly important in this competitive marketplace.  The only way to achieve visibility is through launching a medical marketing campaign.  Here are the 5 Ps of medical marketing. 

1.       Product

The product of a medical practice is the service you are offering your patients.  For example, if you are a cosmetic surgeon, your product is the cosmetic operations and treatments you offer.  The atmosphere of your practice is also important.  It is crucial to make a very good first impression so when patients come to your practice, you must ensure that the atmosphere of your practice is relaxing, comforting, and friendly.  Make sure that your practice is clean, well-maintained, and well-lit.  The colors of your décor and the lighting can make a massive difference in the way patients perceive your practice.  Although the most important aspect of your product is providing excellent cosmetic operations and treatments, you have to give the overall impression that your practice is ideal for your target market. 

2.       Price

The price of your products is not only what you charge for your services – it is also defined by the perceived value of your services.  The expectations of your customers will depend on the price you charge.  For example, if you go to a five-star restaurant, you expect to receive top level service and food.  If you service you receive at the five-star restaurant is comparable to the service you would receive at a fast food restaurant, and the food is mediocre at best, you will be disappointed and feel that you did not receive the perceived value of the product.  This will probably lead you to tell everyone you know to avoid the restaurant.  Likewise, people will spread the word that your practice should be avoided if you do not live up to the perceived value of your product.  On the other hand, when your service matches its price, you will get a lot of word-of-mouth referrals.  This provides you with free viral marketing benefits for your practice. 

3.       Place

The place of your medical practice is where it is located.  The location of your practice is essential to your success.  Factors such as its visibility and whether or not there is public transport that takes patients there will make a big difference in how many new patients you can attract on a consistent basis.  If there are any logistical challenges that get in the way of patients arriving at your practice, try to eliminate them if possible.  If your practice is far away and hard to get to for the majority of your target market, you may want to consider relocating, unless you offer such highly specialized services that people would be willing to travel far to receive them. 

4.       Position

Your position in your market is defined by the competitive advantages you offer.  What makes your practice unique and stand out from the rest?  You must define your unique position in your market in order to develop an effective marketing plan.  Your perception of your practice may be very different from how your patients perceive it.  Determine how your patients perceive your medical practice in comparison to competing medical practices by doing surveys and providing them with feedback cards. 

5.       Promotion

Although many people mistakenly believe that medical marketing is solely about promotion, the truth is that promotion should be the very last step in your marketing campaign.  In order to promote your practice successfully, you have to plan extensively.  The first 4 Ps are very important and must come first because they help you determine your competitive advantage and which areas of your practice you need to change or improve.  Promotion of your medical practice involves a combination of PR, advertising, and direct marketing.  Promotion requires a lot of resources so it is very important to plan carefully in order to ensure that you get a high ROI on your medical marketing campaign.

Once you define what the 5 Ps of your medical practice are, you need to find a professional medical marketing firm that can help you put your plan into action and build a highly successful medical marketing campaign.  There are several medical marketing firms to choose from so your best bet is to narrow down your choices and compare them based on the results of their previous campaigns.  Results must be measurable so you can be sure that the firm will be able to live up to their promises. 

About the Author

John whites is a medical marketing expert who works full time with health care providers to increase their visibility on the web space to get people connected with the Medical Professionals.

Article Source: Content for Reprint

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