Sleep-Deprived Surgeons Should Inform Patients Before Operating
Sleep-deprived surgeons should not be allowed to perform elective procedures—unless they've informed their patients of their lack of shut-eye and received written consent to operate. That's the proposal of three physicians published in this week's New England Journal of Medicine. Since there are no rules governing the number of hours fully trained physicians can work in one shift, hospitals should create policies that minimize the likelihood that sleepy surgeons will operate, the authors argue. Emergency procedures are an exception, since the benefits of a sleep-deprived surgeon operating likely outweigh the risks of not operating at all, according to the report. But elective procedures should not, for example, be scheduled the day after a surgeon was on call overnight. And surgeons should also explain their sleep status to patients, offering them the opportunity to reschedule or select a different surgeon. The editorial highlights research suggesting an 83 percent increase in the risk of surgical complications for patients who undergo elective daytime procedures performed by surgeons who slept less than six hours the previous night. The most common complications are massive hemorrhage and organ injury, according to the report. However, in an accompanying commentary the American College of Surgeons, an educational association to which roughly half of the nation's surgeons belong, disagreed with the proposal: "We believe that the solution the authors offer—mandatory disclosure—is unwarranted. Rather, we maintain that surgeons should be trained to identify and address this problem."
Even Kids on Sports Teams Don't Get Enough Exercise
Only about 25 percent of children who play organized sports get the government-recommended 60 minutes of activity each day, according to research in the Archives of Pediatrics & Adolescent Medicine. The children studied were active for 45 minutes on average—which is not so bad—but the young athletes spent 30 minutes standing around or sitting during each practice.
Since about 44 million kids take part in organized sports, that's a lot of children who aren't getting the workout they need, writes U.S. News contributor Nancy Shute. (That's especially true, since many schools have cut back PE, or eliminated it altogether.) Leagues and schools could improve the situation by emphasizing participation over competition, sponsoring teams for kids of all ages and skill levels, and holding more practices, according to the authors of the study, who are from San Diego State University and the University of California-San Diego. They also suggest coaches have the kids were pedometers or accelerometers during practice to gauge their activity level, as the researchers did in the study. [Read more: Even Kids on Sports Teams Don't Get Enough Exercise.]
What's the Biggest Mistake People Make When Starting a Fitness Program?
Don't start a fitness program too fast. It may have taken you 20 years to lose your conditioning, and yet you want to take 20 days to get it back, physician Kenneth Cooper writes for U.S. News. That approach can be dangerous, particularly for those 40 and older, and may result in major medical problems, both musculoskeletal and cardiovascular. Remember, the older you are, the faster you will lose your fitness and the longer it will take you to get back into shape. In younger people, under 40, it is just the reverse.
If you have been off for six weeks or longer, it should take at least six weeks to get back to your original state of fitness. Shorter periods of being off require less time. A good guideline is one week of retraining for the number of weeks you were off. Of course, these times are primarily for those 40 and older. People under 40 should require approximately half the time. [Read more: What's the Biggest Mistake People Make When Starting a Fitness Program?]