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Health Notes for July 3, 2014

Nurses defend contracts, promote patient safety

Minnesota nurses say they will continue to defend their contracts and foster patient safety, despite a ruling by the U.S. Supreme Court Monday that only certain health care employees must pay union fees.

In its 5-4 decision in Harris v. Quinn, the high court struck down an Illinois state law requiring some government employees, including home health care workers, to pay the unions that represent them. The court upheld a similar, separate precedent that applies to many public-sector employees.

 “The opinion is disappointing,” said Linda Hamilton, a registered nurse and president of the Minnesota Nurses Association. “The court sees home health care workers as somehow less than full-time state employees.”

The ruling creates a category of “quasi-public” government employees that can choose not to join a union.

In a statement, the association argued that the decision could diminish the quality of care patients receive. The group cited a study commissioned by the Institute of Labor in Bonn, Germany, which found that unionized hospitals were more effective in treating patients than non-unionized hospitals. The study affirms that “sensitive medical” outcomes are better in unionized hospitals, including fewer cases of hospital-acquired infections.

“We know that Minnesota nurses and other health care workers will continue to organize, because we are stronger when we stand together, and our patients are better off,” Hamilton said.

Study: Delayed treatment better for one infection

Patients diagnosed with a certain AIDS-related infection should take their time before starting therapy, according to a new study from the University of Minnesota Medical School.

Researchers found that patients with cryptococcal meningitis, a deadly fungal infection affecting the brain, are 15 percent more likely to recover if they undergo therapy four to six weeks after diagnosis, as opposed to the traditional one to two weeks.

“The overall result is quite surprising,” said lead author David Boulware. “As with every other AIDS-related infection, starting HIV therapy sooner is better. It appears that brain infections are different.”

The second-most common AIDS-defining illness, cryptococcal meningitis affects about 350,000 people worldwide each year. In the United States, about 20 percent of patients diagnosed with cryptococcal meningitis die during their first hospital visit.

Research was conducted in Africa — where the death rate during initial hospitalization is nearly 50 percent — in collaboration with universities in Uganda and Cape Town, South Africa.

Researchers tracked 177 cryptococcal meningitis patients, about half of whom received therapy within two weeks of diagnosis, while the other half delayed therapy for at least four weeks. The participants were followed for one year and received standard treatment for their infections.

Boulware said the research already has influenced U.S. and international treatment guidelines for cases of cryptococcal meningitis related to AIDS.

Findings appeared in the June 26 issue of the New England Journal of Medicine.

State cautions holiday drivers

The Fourth of July is one of the deadliest holidays on Minnesota roads, and the Minnesota Department of Public Safety is asking residents to exercise care while driving this weekend.

More crashes occur on state roads on the Fourth of July than during any other summer holiday, the department says, and more than 4,500 crashes have occurred since 2004.

“In the summer … people tend to drive at higher speeds, and crashes are more severe, which results in more fatalities and serious injuries,” said Donna Berger, director of the Office of Traffic Safety.

Last year in Minnesota, 562 crashes resulted in 332 injuries and seven fatalities during a four-day stretch surrounding the holiday.

Of the 59 fatalities reported around the Fourth of July over the past 10 years, 34 were linked to alcohol, the department says.