THURSDAY, Jan. 22 (HealthDay News) -- Nurses want to, and should be, included in the discussion when physicians talk to patients about serious medical mistakes that were made, a new study shows.

The study, published in the January issue of The Joint Commission Journal on Quality and Patient Safety, said nurses play a critical role with the patient and leaving them out of such discussions weakens the disclosure experience for the patient or their family. For example, excluding nurses from disclosure planning sessions can inadvertently make them appear evasive when later questioned by patients or patients' families.

"Improving the quality of error disclosure to patients is a top priority in health care," study author Sarah E. Shannon, vice associate dean for academic services in the University of Washington School of Nursing, said in a commission news release. "Error disclosure needs to be a team sport. This means quickly sharing information among the team about the error: what happened; why it occurred; what is being done to mitigate potential harm and prevent future errors; and what the patient has been told, will be told, and when."

As a result, the authors call for a team disclosure process that follows established policies allowing nurses and other caregivers into the mix. They also suggest training be provided about how to talk to patients and families about errors.

The study, which surveyed almost 100 nurses, found that while they discussed mistakes within their control with their patients, they were reticent to talk and disclose about others' mistakes that affected the patient, although they would want more of a role in that process. Being left out of the disclosure process may contribute to moral distress, less job satisfaction and increased job turnover, the authors said.

More information

The American Academy of Family Physicians has more about how patients can help prevent medical errors  .

TUESDAY, Jan. 20 (HealthDay News) -- President Barack Obama vowed during his campaign to expand access to health insurance and reform health care. Early indications now suggest that, despite an ailing economy -- or perhaps because of it -- he is resolved to keep his promise.

In the weeks leading up to Tuesday's swearing-in ceremony, the 44th president began setting the stage for health reform.

Many health policy leaders praised his nomination of former South Dakota Sen. Tom Daschle to serve as Secretary of Health and Human Services. Daschle, who is also leading the Obama administration's newly created White House Office of Health Reform, is thought to have a solid grasp of health policy, having outlined his vision for reform in the 2008 book Critical: What We Can Do About The Health-Care Crisis.

Earlier this month, Obama laid out an economic stimulus plan that positions health care as a cornerstone of financial growth and recovery. During his campaign, he identified health reform as a top priority, along with economic recovery and energy independence.

"The thing that's intriguing to me is, this seems to be a nice recognition of how big and how important health care is as part of the economy," said R. Paul Duncan, professor and chairman of the department of health services research, management and policy at the University of Florida in Gainesville. "There seems to be a notion that if we do good things in health care, they will not simply cost us, but in addition, they are likely to produce economic benefit."

A new national survey by the Kaiser Family Foundation and the Harvard School of Public Health suggests that Americans would also like to see action on health reform. While economic recovery is far-and-away their top concern (73 percent), 43 percent said reforming health care reform should be a top priority, after fighting terrorism (48 percent).

Experts in health care policy are also advocating systemic change. According to a recent survey of "health care opinion leaders," conducted by the nonprofit Commonwealth Fund, 92 percent of experts favor or strongly favor allowing Americans who can't get insurance through employer plans or Medicaid/SCHIP to purchase insurance through a national health insurance exchange, as Obama has suggested.

"There really is an historic wind of opportunity for health reform," Kaiser Family Foundation President and Chief Executive Officer Drew Altman said at a press briefing on the Kaiser/Harvard survey results. In part, that opportunity is brought about by the public's concerns about paying for health care and health insurance amid a deep recession, he noted.

However, the survey also revealed wide divisions in public opinion, with roughly half (49 percent) saying they are not willing to pay more to expand access to health insurance and 47 percent saying they are. Such underlying tensions in public opinion could be exploited, "especially if there is a protracted debate," Altman conceded.

Under Obama's plan, medium and large employers that don't offer employee health benefits would pay a tax to help fund coverage -- a so-called "play-or-pay" mandate. He also pledged to expand eligibility under Medicaid and the State Children's Health Insurance Program (SCHIP). And he would create a plan much like the Federal Employee Health Benefits Program to help individuals who don't have job-based coverage or don't quality for other public programs.

The House of Representatives, acting on one leg of that plan last week, voted to reauthorize and expand SCHIP. The measure would add 4 million children to the federal-state program over the next four and a half years. The Senate Finance committee approved a similar measure, which heads to the full Senate.

Other health reform measures Obama has proposed are aimed at reducing wasteful spending and improving health-care quality. Some of these are tucked into the $825 billion economy stimulus package unveiled by House Democrats earlier this month. The measure sets aside $20 billion to help the nation's doctors and hospitals computerize patient medical records, for example, and $3 billion for preventive care.

Another $87 billion would go to shore up state Medicaid programs that are reeling amid heightened demand for services.

"I think that is a hugely positive acknowledgement of reality, and it's a big enough number of dollars that it should ultimately help states and their Medicaid enrollees," Duncan said.

Obama's resolve, along with bipartisan leadership on health reform among key Congressional committees, has fueled hope that the new administration might make headway where previous administrations have failed.

"We are at the early rah-rah stage of health reform, and this could change still, but it has certainly added momentum to the effort so far," Altman said.

More information

For differing views on the Obama Administration's health care proposals, visit the Heritage Foundation   and the Urban Institute  .

FRIDAY, Jan. 16 (HealthDay News) -- The coat colors and patterns of wild and domestic animals are different primarily because of human intervention over thousands of years, a new study suggests.

A particular gene -- the melanocortin-1 receptor (MC1R) gene -- plays a key role in the appearance of animals' coats. British researchers studying this gene in wild and domestic pigs found that nearly all DNA mutations in the farm animals changed the protein that affects coat color and pattern.

Some of the mutations were consecutive, or layered, indicating they had been perpetuated by farmers over thousands of years, the researchers said.

The mutations affecting the coat were not found in the wild pigs, which had a consistent black-brown coloring that acts as camouflage. Predators, the researchers believe, may have helped weed out any pigs with mutations that made them stand out in appearance.

"Early farmers may have decided to change the coat of their livestock for a number of reasons," study co-author Greger Larson, a research fellow in the department of archaeology at Durham University in England, said in a news release issued by the school. "One is that it facilitated animal husbandry since it is easier to keep track of livestock that are not camouflaged. Another could be that it has acted as a metaphor for the improved characteristics of the early forms of livestock compared with their wild ancestors."

But another possibility, Larson said, "is that the early farmers were as amused and as taken with biological novelty and diversity as we are today."

The study, done in conjunction with Uppsala University in Sweden, appears online in PLoS Genetics.

More information

The U.S. National Library of Medicine has more about gene mutations.

THURSDAY, Jan. 15 (HealthDay News) -- The more alcohol costs, the less people drink it.

That's the conclusion of a new analysis of data from more than 100 studies gauging the impact of higher booze pricing -- typically in the form of higher taxes -- on American drinking habits.

"The price level at which alcohol is sold affects what people drink," observed Alexander C. Wagenaar, a professor of epidemiology and health policy research at the University of Florida's College of Medicine. "And the pattern clearly appears to be that when prices go down, people drink more. And when prices go up, people drink less."

"I don't think it's that surprising," acknowledged Wagenaar. "But it is very important. Because drinking is one of the leading causes of death and medical problems and injuries and addiction. So, we are constantly trying a variety of things to prevent these consequences. And here we find overwhelming, cumulative scientific evidence involving over a hundred studies that show that there is, in fact, a good tool that, no question, shapes drinking practices."

The analysis was reported in the Jan. 15 online issue of the journal Addiction.

In the study, Wagenaar and his colleagues searched databases dating back (in some cases) to the 19th century. They selected 112 studies tracking the relationship between alcohol pricing and consumption.

For the most part, Wagenaar said, the studies examined the impact of price through the prism of taxation, because "holding everything else constant, what affects prices is tax. In fact, prices and taxes are so intimately connected, they're really one and the same thing."

His team found repeated evidence that prices/taxes affect the consumption of all types of alcoholic beverages, as well as all the drinking behavior of all types of drinkers, from young to old and from light to heavy drinkers.

In fact, hiking the price of alcohol via taxation is the most consistently successful means of reducing drinking, the researchers said.

Other factors can affect the way tax and price manipulation play out, including the geographical region affected, the timing of price changes, and the average income of the local population.

The findings echo those of another study, also conducted by Wagenaar's group, that found that deaths from alcohol-linked disease decline as the price of a drink rises. Those findings were published in the American Journal of Public Health in November.

Just how much of a tax increase is necessary before drinking habits change?

"Well, if you do a survey, and ask the general public if they would change their drinking practices if the price went up by, say, a dime, everyone would say no," he noted. "But in the aggregate, across the whole population, when you do these studies, you do see a direct relationship between a modest price increase and consumption drops. It really doesn't take much to see the difference."

One expert said that price changes need to be dramatic to effect real population-wide change, however.

"Given the fact that excessive alcohol use is harmful, there's a rationale for increasing taxation on alcohol because, sure, the more you increase it, the more you would cut back on use," said Dr. Marc Galanter, director of the division of alcoholism and drug abuse in the department of psychiatry at New York University School of Medicine in New York City. "But you'd have to increase it tremendously -- to rather high and punitive levels -- to have a major impact."

"So, the question is whether it is feasible to raise the price of alcohol through taxation to the extent that it would materially affect the abusive use of alcohol," he said. "Practically speaking, beer, for example, is no more expensive than a carbonated beverage, by and large. So, among college-age and under-age drinkers -- some of whom will become alcohol-dependent because of heavy use during their youth -- how much would you really have to increase the price of beer in order to have a material impact? A lot," Galanter said.

More information

There's more on alcoholism at the U.S. National Library of Medicine.