WEDNESDAY, Jan. 2 (HealthDay News) -- Doctors or nurses reporting a potentially dangerous infectious disease outbreak may find themselves on hold with their local health department for an hour or more, a new phone survey finds.

That hold time applies only when someone actually picks up -- researchers could not get through on at least one call testing the disease-reporting hotline of two out of five health departments.

Only one in three local health departments connected the researchers -- who portrayed themselves as medical professionals reporting a possible disease outbreak -- with a trained public health professional within 30 minutes.

A timely response is necessary in the event of a disease outbreak, said the team from the Rand Corporation, an independent health policy research program. At the time the research was done, the U.S. Centers for Disease Control and Prevention recommended that a trained public health professional be available to take the confidential details of any outbreak in less than 30 minutes from the time the phone is answered.

For the study, conducted between May and October 2006, the research team placed five to 10 unannounced tests on the telephone-based disease-reporting systems of a representative sample of 74 local health departments nationally. They placed a total of 596 calls posing as a local doctor or nurse seeking to report an urgent, confidential infectious disease case to a trained public health professional.

When the callers reached the public professional, they said the call was just a test, and no further action was needed.

The callers were on hold an average of 63 minutes before they were able to talk to a trained professional, according to the study, published in the February edition of the American Journal of Public Health. The callers were unable to get through at least once to 40 percent of the health departments. However, 31 percent of the departments connected the callers to a trained health professional in under half an hour.

In one case, the researchers in the survey reported waiting more than 16 hours and 43 minutes to speak to a trained health professional.

"These are complex systems, and there are a number of places where the system can break down," David J. Dausey, lead author of the report and an associate policy researcher at Rand, said in a prepared statement. "If you have a single individual responsible for ensuring the call gets evaluated properly, it appears to be more effective than an electronic system where you have to 'press one' to reach this person or 'press two' to leave a message. If someone is out of the office that day, for example, it could lead to problems."

The researchers argued that appropriate training and a standard protocol are both necessary for people responding to phone calls reporting infectious disease outbreak.

Dausey noted that since the study was conducted, the CDC has shortened its guidelines for reaching a trained public health professional from 30 minutes to 15 minutes.

More information

To learn more about infectious disease reporting, visit the U.S. Centers for Disease Control and Prevention.

WEDNESDAY, Jan. 2 (HealthDay News) -- Most free drug samples go to wealthy and insured patients, not to the poor and uninsured who may need them most, Harvard researchers report.

In fact, more than four-fifths of those who receive samples are insured, while less than one-fifth are uninsured and less than one-third have low incomes (below $37,000 for a family of four), the researchers found.

"Free drug samples influence prescribing and also introduce potential safety problems," said lead researcher Dr. Sarah Cutrona, a physician with the Cambridge Health Alliance and an instructor of medicine at the Harvard Medical School. "Despite these problems, many doctors support the program because [they say] free samples 'allow us to get free medications to our neediest patients,' " she said.

However, most free samples don't go to the neediest patients, Cutrona's group found.

In the study, Cutrona's team collected data on almost 33,000 people who participate in the annual Medical Expenditure Panel Survey. The researchers reported their findings in the February issue of the American Journal of Public Health.

The researchers found that the use of free drug samples is widespread, with more than 12 percent of Americans receiving one or more free drug samples in 2003. In addition, among those taking at least one prescription drug, 18.7 percent got free samples.

A study in the April 26, 2007, issue of the New England Journal of Medicine found that 78 percent of doctors received free drug samples and 94 percent had some relationship with pharmaceutical companies.

However, few free samples went to the needy, Cutrona and her colleagues found. In fact, those who received free samples were those with better access to medical care. Whites and people who spoke English were also more likely to receive free samples than members of ethnic, linguistic or racial minorities, according to the report.

In addition, getting medical care in an office rather than a clinic and taking more medications also increased the chances of receiving free drug samples.

Cutrona doesn't think that doctors deliberately ignore uninsured and poor patients when it comes to handing out samples, it's just that doctors in private practice are less likely to see the poor and uninsured.

Although drug companies tout drug sampling as a way to help needy patients, Cutrona disagrees. "These findings suggest that free samples serve as a marketing tool and not as a safety net," she said. "We need to examine whether free samples belong in our offices."

One expert contended that the study reveals the true marketing purposes of drug samples.

"It seems both the pharmaceutical industry and doctors share a Pollyanna view of free drug samples as a way of reducing costs for indigent patients," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "The reality, according to the data reported in this study, is quite different. The drugs are more likely to serve marketing than a 'safety net' function."

To serve as a real safety net, the use of free drug samples must be woven into the appropriate health care settings and situations, Katz said. "Otherwise, we have at best somewhat deceptive marketing, at worst, hypocrisy."

Reacting to the study, the Pharmaceutical Research and Manufacturers of America (PhRMA), an industry trade group, took issue with the findings.

"Instead of second-guessing motives, Harvard researchers would better serve patients by examining health outcomes," PhRMA Senior Vice President Ken Johnson said in a prepared statement. "Clearly, free samples often lead to improved quality of life for millions of Americans, regardless of their income."

"Unfortunately, many uninsured and underinsured patients do not receive their medical care from office-based practitioners," Johnson said. "As important as free pharmaceutical samples are in improving health care, they represent one -- not the only -- option for patients in need," he added.

More information

For more information on access to care, visit the Kaiser Family Foundation  .

TUESDAY, Jan. 1 (HealthDay News) -- Making and keeping a New Year's resolution to sleep better could help you achieve other health goals, experts at the American Academy of Sleep Medicine say.

"There is growing medical literature showing that many of us in today's 24/7 society are not getting the basic sleep we need every day," Dr. Ron Kramer, a physician at the Colorado Neurology Institute's Sleep Disorders Center in Englewood, Colo., said in a prepared statement.

"At the same time, there is increasing evidence from human sleep researchers that chronic lack of even a few hours of sleep a night can result in significant health consequences," he said. "These consequences include an increased risk of accidents; fatigue that makes you prone to depressive symptoms or not enough energy to exercise; and even chemical changes that stimulate your brain to eat more and to eat more salty and sugary food."

"Resolve to sleep well this year, and you may find that the energy to exercise and the self-control for healthy eating may then more easily follow," said Kramer.

Adults need seven to eight hours of sleep each night, while teens should sleep about nine hours per night. School-aged children require between 10 to 11 hours a night, and children in preschool need between 11 and 13 hours a night, according to the AASM.

Wondering if you're getting the shuteye you need? The society offers seven key signs that you need more sleep:

• Depending on an alarm clock -- and repeatedly smacking the snooze button -- to wake up in the morning.
• Driving drowsy or falling asleep at the wheel.
• Drinking more than one cup of coffee a day to stay alert.
• Making mistakes that could be avoided with better concentration.
• Forgetting things more easily.
• Feeling blue, anxious or frustrated.
• Becoming sick more frequently. Sleep is necessary for a strong immune system.

These problems can be resolved with more and better sleep, according to the AASM, which offers these tips on getting a good night's sleep:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Get a full night's sleep every night.
• Do not go to bed hungry, but don't eat a big meal before bedtime either.
• Avoid alcohol, foods or drinks that contain caffeine, and any medicine that has a stimulant, prior to bedtime.
• Avoid any rigorous exercise within six hours of your bedtime.
• Make your bedroom quiet, dark and a little bit cool.
• Get up at the same time every morning.

More information

To learn more about how to improve your sleep habits, visit the American Academy of Family Physicians  .

FRIDAY, Dec. 14 (HealthDay News) -- Research in the tiny stickleback fish could shed light on skin color changes in humans.

A team at Stanford University School of Medicine has spotted a gene that's responsible for color differences in both species.

While it may seem that the small fish and humans have little in common, they share many similarities, noted study senior author David Kingsley, professor of developmental biology. Both the sticklebacks and humans migrated out of ancestral environments to new locations a few thousand generations ago and both developed new traits -- such as skin color changes -- to be able to live in those new settings.

Kingsley and his colleagues compared DNA from lighter and darker sticklebacks and found that the lighter fish had mutations in a gene called Kit ligand. The researchers then analyzed DNA from people with different skin colors and found that those with lighter skin also had an altered form of the Kit ligand gene.

"It is the same genetic mechanism between organisms that are very different from each other," Kingsley said in a prepared statement.

The Kit ligand gene makes a protein that plays a role in maintaining the melanocyte skin cells that control pigmentation.

While this gene isn't the only factor that determines skin color, it does seem to account for about 20 percent of the pigmentation differences between people of African and European descent, Kingsley said.

The study is published in the Dec. 14 issue of the journal Cell.

More information

The PBS Web site has an article about differences in human skin color  .