Friday, February 26, 2010
"Doctors and educators with a special interest in Women's Health have seen the need for a repository of information where they can find, share, and contribute information on sex- and gender- specific care of women," says Dr. Janice Werbinski, MD, chair of the Women’s Health Working Group (WHWG), and Associate Clinical Professor at Michigan State University’s College of Human Medicine. “Since the establishment of the Office of Women's Health at the NIH, much sex- and gender-specific information has been discovered and reported, but it remains fragmented and decentralized.”
Physicians, faculty, health organizations, and health professionals interested in Advancing Women's Health are encouraged to use the free teaching tools, curricular material, academic resources, clinical case studies and contribute original content.
The Medpedia platform provides medical professionals and organizations a central place to record their knowledge and receive national and international recognition and visibility for their expertise. Medpedia, which launched in February 2009, also includes a collaborative online medical encyclopedia, a Professional Network and Directory for health professionals and organizations, and Communities of Interest in which medical professionals and non-professionals can share information about conditions, treatments, lifestyle choices, etc. Medpedia also recently added several new pieces to the platform including Medpedia Answers for asking and answering medical and health questions; Medpedia Alerts for displaying real-time medical and health news alerts; and Medpedia News & Analysis for sharing medical news and analysis.
Editor's Note: This blog feeds to Medpedia.
Thursday, February 25, 2010
Current guidelines recommend not performing mammograms on persons with a life expectancy of less than five years. The average lifespan for elderly women with severe dementia is 3.3 years, according to the study from the University of California, San Francisco. Researchers found 18% with severe dementia received the exam. That translates to roughly 120,000 unnecessary mammograms per year with a price tag exceeding $12 million.
The ACS guidelines suggest that any cancerous cells found in an elderly woman with severe dementia would likely not grow fast enough to affect life expectancy. The potential harms of the procedure—such as diverting time and resources away from therapies that could actually improve quality of life—outweigh the benefits, according to report authors.
Wednesday, February 24, 2010
2,929 people, aged 65 and older, were studied over 13 years. All did not have dementia at the start of the study. During follow-up, 1,287 were hospitalized for a non-critical illness and 41 were hospitalized for a critical illness, while 1,601 of the participants were not hospitalized.
Among those hospitalized for one or more non-critical illnesses, there were 228 cases of dementia, and among those hospitalized with one or more critical illnesses, there were five cases of dementia. There were 146 cases of dementia reported among the participants who weren't hospitalized.
Researchers concluded that patients hospitalized for a non-critical illness were 40 percent more likely to develop dementia than those who weren't hospitalized.
Is it the hospitalization or the illness to begin with that causes this increase? The jury is out.
"These results also could suggest that factors associated with acute illness, and to a greater degree with critical illness, may be causally related to cognitive decline."wrote Dr. William J. Ehlenbach of the University of Washington, Seattle.Perhaps the hospital stay only exacerbates the issues. Any way you look at it, still gets back to basics. Most of what lands us in the hospital, not all but most, is directly related to our life choices.
Tuesday, February 23, 2010
Researchers analyzed 69 million discharge records from hospitals in 40 states between 1998 and 2006. The length of stay and mortality rates for the infections didn’t change substantially over time.
Information for you - hospitals have records of their infection rates. Some hospitals, with good statistics, publish those rates. Others don't. Concerned about coming out of a hospital sicker than you went in? Then ask pointedly about infection rates for your hospital and the infection control procedures they have in place.
Monday, February 22, 2010
The report further says that Medicare spending increases in the past were due to inpatient hospital services, especially for heart disease.
Heart disease ranked first in terms of share of growth from 1987 to 1997. However, from 1997 to 2006, heart disease fell to 10th, while other medical conditions – diabetes being the most prevalent – accounted for a significant portion of the increase.
They suggested that increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.The researchers recommend that, as Congress reshapes the U.S. healthcare system, they should address changed health needs through evidence-based preventive care.
But here's the thing. Preventive care is in our grasp. We don't need legislation to mandate it. You can lead a horse to water after all but.... We have become an entitled culture and taking care of ourselves when there is a pill, device or treatment that can do it for us is just not attractive.
There is a lot of blame for why the healthcare system is broken but rest assured WE are a part of that blame.
Thursday, February 18, 2010
“Agencies that provide services to older individuals may be unfamiliar or uncomfortable with the needs of this underserved population,” said Health and Human Services Secretary Kathleen Sebelius. “The Resource Center will provide information, assistance and resources for both mainstream aging organizations and LGBT organizations and will provide assistance to LGBT individuals as they plan for future long-term care needs.”
I certainly applaud any agency that can snag needed resources for their constituents. But it sort of bothers me that even aging issues now have to be segregated by ethnic, religious and sexual persuasion. Getting old is getting old and presents challenges for everyone. Yes are those challenges different for the gay population? Certainly. But they are no different than the challenges my mother faces, my in-laws and countless thousands of others. We have a hard enough time educating the so called "mainstream" public about aging that it seems all of these disparate efforts need to unite around common aging themes so as to educate and empower everyone.
Wednesday, February 17, 2010
The long-awaited repository is missing serious disciplinary actions against what are probably thousands of health providers, according to an investigation by the nonprofit news organization ProPublica in collaboration with the Los Angeles Times. Read more here.
Tuesday, February 16, 2010
Other previous studies show that seniors are 10 times more likely to experience a fall while staying in a nursing home.
Daily doses of vitamin D could be a good way to help significantly reduce those falls, researchers suggest. The report appears in the Cochrane Library journal.
Taking that a step further, wouldn't the same apply to non-nursing home residents? Check with your doctor about using Vitamin D supplements.
Monday, February 15, 2010
People with Alzheimer's are already known to suffer from loss of smell. But the new research pinpoints a direct link between development of amyloid plaques and a worsening sense of smell. The mice tested with the plaques had to spend more time sniffing odors to remember them, and they had a hard time telling the difference between odors."This is a revealing finding because, unlike a brain scan, a laboratory-designed olfactory test may be an inexpensive alternative to early diagnosis of Alzheimer's," said study co-author Daniel W. Wesson, of New York University School of Medicine and the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, N.Y.
Friday, February 12, 2010
Now, an international team of researchers from the U.S., Japan and China conducted a study that concluded that the electromagnetic waves generated by ordinary cell phones can prevent and even reverse the progression of Alzheimer's disease in lab mice.
Researchers exposed two groups of mice—one predisposed to developing Alzheimer's, the other a control group—to electromagnetic waves similar to those created by common cell phones. They discovered that the waves protected younger mice prone to developing Alzheimer's from cognitive impairment. Meanwhile, the memory problems of older mice already exhibiting symptoms of the disease vanished, according to the report. Also, the normal mice showed above-average memory capacity after several months of exposure.
It took several months for the positive effects to appear in the mice. Though researchers speculate that similar results in humans could take years to achieve, they suggest the electromagnetic waves could provide an effective, drug-free treatment for Alzheimer's. The report appeared in the Journal of Alzheimer's Disease.
Humorous aside. We bought my 88 year old mom a cell phone so she could have it for emergencies. She still drives and I can never get her on the phone at her house. So I try the cell. Of course where is it? At her house. Did she forget it? No. She just didn't think she would need it. It would be interesting to know how long of an exposure you need to cell phones to prevent or reverse the disease. Of course as that is taking place, the other scientists will be arguing that we will grow a second head because of exposure to phones.
The drug thiazolidinedione (TZD) is commonly used to treat insulin resistance in patients with type 2 diabetes. Researchers studied 19,070 men and women, 4,511 of whom had a prescription for the drug. After one year, researchers began to notice a trend among older women.
There was no increased risk of fractures for men who participated in the study, but among women aged 65 and older there was a 50% increase in the risk of fracture after one year on TZD. The location of the fractures was unusual as well. While most fractures among the elderly occur in the hip or vertebra, TZD was associated with increased fractures in the upper extremities and distal lower extremities.
So check with your doctor.
(Original source: McKnights)
Thursday, February 11, 2010
Healthy Choices - making healthy food choices by empowering yourself. Read and understand food labels. The administration is working with the FDA to make these more consumer friendly. They're not just for your kids but you too. As part of this initiative, the US Department of Agriculture plans to revamp the food pyramid symbol and online interactive tools.
Physical Activity - According to the web site set up for this campaign, "Children need 60 minutes of active and vigorous play every day to grow up to a healthy weight. Consider that 8-18 year-olds devote an average of 7 ½ hours to using entertainment media including TV, computers, video games, cell phones and movies."
So look at your day. Do you take a walk at lunch, use the stairs instead of the elevator, exercise in the morning, at lunch or after work? Hmmm. And kids aren't the only ones watching too much TV, playing on Facebook, etc.
Accessible and Affordable Healthy Food - this from the web site - "More than 23 million Americans, including 6.5 million children, live in low-income urban and rural neighborhoods that are more than a mile from a supermarket. These communities, where access to affordable, quality, and nutritious foods is limited, are known as food deserts. By using the new interactive Food Environment Atlas, users can see the location of food deserts across the country and other indicators of how successful communities are in accessing healthy food."
I would venture that many of those reading this blog are not in food deserts and have access to healthy food.
Any way you cut it, kids model what their parents do. And boomers and seniors are plagued with multiple chronic conditions that stem from their own bad behaviors that yes probably started when they were kids. But you are never old to change. Or set an example for someone else.
So everyone, "Let's Move."
Wednesday, February 10, 2010
A group of the nation’s leading health, consumer, and aging advocates has formed a new alliance, The Long-Term Quality Alliance (LTQA), which aims to broaden efforts to improve quality of care to include community-based settings as well as nursing homes. It will do so by fostering “person-centered” quality measures for people who need long-term services and supports to enhance their quality of life, reduce unnecessary hospitalizations and utilizations, and decrease costs.
“The way we currently measure the quality of long-term care in this country focuses too much on clinical services delivered in nursing homes. The perspectives of consumers and their family caregivers have largely been ignored,” says Alliance Chair Mary Naylor, PhD, RN, Marion S. Ware Professor in Gerontology at the University of Pennsylvania’s School of Nursing. “In this rapidly changing long-term care environment, we need to advance a set of measures that reflect what is important to consumers and apply those across all settings.
The LTQA Board is comprised of 29 leaders from organizations representing caregivers, consumers, quality improvement, nursing homes, accreditation, aging issues, foundations, the federal government, private payers, and academia. The group was formed to respond to the increasing demand for long-term care and the expanding field of providers who are delivering that care, including in home- and community-based settings such as assisted living facilities and adult day care.
The Alliance will focus initially on two important health care issues that have been identified as national health priorities – how to improve care coordination or transitions in care and how to avoid unnecessary hospital admissions among frail and chronically ill people. Naylor says that these two areas offer the greatest promise for improving quality, consumer experiences, and efficiency, as well as reducing costs.
I like two things about this - they are looking beyond the clinical to total experience and they are looking at the continuum of services not just nursing homes. I believe this is THE group to watch.
Tuesday, February 9, 2010
Past studies have indicated that low levels of marijuana's “active ingredient,” THC, could help prevent the accumulation of Amyloid plaques in the brain, and even stimulate brain cell growth.
A new study by Canadian researchers comes to a different conclusion. Using mice that carry a human genetic mutation that causes Alzheimer's disease, researchers studied the effects of HU210, a synthetic version of marijuana-derived compounds.
Mice treated with HU210 did not perform better than untreated mice on memory tests, according to the report. Furthermore, mice given higher doses of the synthetic compound had fewer brain cells than other mouse cohorts. The synthetic compound doesn't appear to have any beneficial effects on mice with Alzheimer's, according to the researchers.
The study appears in the current issue of the journal Current Alzheimer Research.
Now that is a buzz kill.
Monday, February 8, 2010
Anthem Blue Cross Regarding Letter from Secretary of Health and Human Services
February 8, 2010
Anthem Blue Cross in California has received the letter from Secretary Sebelius. We will reply to her promptly. It is important to note that individual medical insurance premiums do not reflect an individual member's personal claims experience. Therefore, as medical costs increase across our member population, premium increases to the entire membership pool result. Unfortunately, in the weak economy many people who do not have health conditions are foregoing buying insurance. This leaves fewer people, often with significantly greater medical needs, in the insured pool. We regret the impact this has on our members. It highlights, why we need sustainable health care reform to manage the steadily rising costs of hospitals, drugs and doctors . As such, it is important to go back to the beginning and get health care reform done right. At the same time, we are engaging with a broad range of key stakeholders across California to discuss the state's individual insurance market and share ideas on how we can collectively partner on meaningful change.
Anthem Blue Cross
We understand and strongly share our members’ concerns over the rising cost of health care services and the corresponding adverse impact on insurance premiums. Unfortunately, the individual market premiums are merely the symptoms of a larger underlying problem in California’s individual market - rising health care costs. The increasing demand for medical services, the use of new prescription drugs, and demand for advanced technologies are driving up the cost of health care at an unprecedented rate. Anthem is investing in many initiatives to reduce the cost of care, promoting wellness and preventive care for our members and communities, as well as, working with providers to encourage high-quality, evidence-based care, which costs less over time. In addition, our health plans offer members significant discounts through access to a large network of health care providers across the country. These efforts, however, cannot completely offset all the increases linked to the cost of care. The pricing structure of our individual products is a reflection of the medical risks and costs associated with this market. As the cost of care increases, premiums rise accordingly.
Anthem regularly evaluates its rate structure to make sure that the cost of claims incurred is offset by the premiums collected, and that we anticipate the cost of future, expected claims. At times, based on the cost of covering benefits, rates may be either raised or lowered. To assist members who are looking to explore alternative plan options, Anthem offers a team of licensed Health Plan Advisors. These advisors are dedicated to assisting members in finding solutions to meet the balance between their coverage needs and their budget, especially in these challenging economic times.
Regarding how often an adjustment is made to a member’s rates:
Anthem complies with all state regulations regarding rate increases and depending on the plan, we are required to provide members with a 30 day notice of any rate adjustment.
It is important to note that premiums are expensive because the underlying health care costs are expensive. Anthem offers a variety of health benefit plans, and we are dedicated to working with our members to find health coverage plans that are the most appropriate, and affordable for their needs. We are more than happy to take a look at a member’s health benefit plan and review possible options to more closely meet the member’s current needs. This may include moving to a lower priced plan.
We are determined to support quality care for our members, we share their concerns about the upward rise in premiums and must adjust our rates as needed to cover the costs and risks associated with providing quality health care for all of our individual members.
I believe that the truth is in the middle somewhere. But Anthem makes some good points and points that I have written about in the past.
First, the insured patient also is paying for the uninsured patient. Hospitals rely on higher payments from traditional insurers to offset what they say are inadequate payments from Medicaid and less than satisfactory payments from Medicare. They count on higher payments from insurers like Anthem to help offset lower payments and to pay for the increasing amount of uninsured patients walking through their emergency departments where they must treat them. People are delaying care because they have no insurance and are therefore sicker when they need it. That drives up costs. Then you add to the fact what Anthem states - that the healthcare experience (that is a term HR professionals use) for the insured population becomes the basis for premiums. With the healthy opting out of insurance and the sicker staying in, the claims experience (read healthcare costs) will be higher and that is spread among everyone. So I may be in great shape and take care of myself but my obese colleague who smokes and is on my health plan as well uses more resources that I pay for in the end.
I also want to call your attention to this line from their statement: The increasing demand for medical services, the use of new prescription drugs, and demand for advanced technologies are driving up the cost of health care at an unprecedented rate.
I totally agree with this. We have become a society that demands the best. Worse we have become a society that says hey why take care of myself when their will be a drug, a device or a cure for what ails me. So we as individuals are responsible for this as well.
I applaud all the wellness efforts too but frankly there is only a fraction of people taking advantage of them.
That is why reform is not addressing some very systemic issues raised here before.
But I would also suspect that the amount cited by HHS may not be the amount that Anthem actually experiences from all of these converging forces. After all there is a strong profit story that HHS spells out and insurers are in business to make a profit.
This is so much more complicated than is being put forth in health care reform. My fear is that watered-down legislation that does not address systemic issues is going to be railroaded through in the end.
Department of Health and Human Services Secretary Kathleen Sebelius today sent a letter to Anthem Blue Cross and called on the company to publicly justify its decision to raise premiums for its California customers. Here follows the letter:
February 8, 2010
President, Anthem Blue Cross
Delivered Via Fax
Dear Ms. Margolin,
One of the biggest pressures facing families, businesses and governments at every level are skyrocketing health insurance costs. With so many families already affected by rising costs, I was very disturbed to learn through media accounts that Anthem Blue Cross plans to raise premiums for its California customers by as much as 39 percent. These extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable for hundreds of thousands of Californians, many of whom are already struggling to make ends meet in a difficult economy.
Your company's strong financial position makes these rate increases even more difficult to understand. As you know, your parent company, WellPoint Incorporated, has seen its profits soar, earning $2.7 billion in the last quarter of 2009 alone.
I believe Anthem Blue Cross has a responsibility to provide a detailed justification for these rate increases to the public. Additionally, you should make public information on the percent of your individual market premiums that is used for medical care versus the percent that is used for administrative costs. Policy holders in the individual market deserve to know if their premium increases would be invested in better medical care or insurance company overhead costs like salaries, profits, and advertising. I am aware that the State of California is investigating this matter, and urge Anthem Blue Cross to cooperate fully. In the meantime, I will be closely monitoring the situation.
At a time when health care costs are a critical threat to families as well as the nation's economy, I hope you appreciate the urgent nature of this request. I look forward to your prompt reply.
Secretary of Health and Human Services
Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.
"There is accumulating evidence that the risk of age-associated diseases, including heart disease and some types of cancers, are more closely related to biological rather than chronological age," Samani said in a news release from the University of Leicester and King's College London.
Study co-leader Dr. Tim Spector said in the release that "what our study suggests is that some people are genetically programmed to age at a faster rate."
Due to their genes, he said, some people may age even faster when exposed to things "like smoking, obesity or lack of exercise, and end up several years biologically older or succumbing to more age-related diseases."
This is all fine and good if you actually know how your genes stack up and those genetic tests are not necessarily available or affordable. So err on the safe side. Take care of yourself so that your cells don't have a conniption!
Thursday, February 4, 2010
New terms are being bantered about in healthcare. One is the accountable care organization. The idea is that a group of providers - primary care physicians, specialists, hospitals - would come together and be responsible for the cost and quality of care for a given population. In theory, and in talking with some hospital administrators, this organization could spread to include nursing and assisted living facilities, after all they are part of the continuum. So how do you make that happen with so many disparate parties, agendas and politics. Take a few lessons from Apple CEO Steve Jobs.
Just as the size of a plate influences how much one eats they found that utensils also have an effect on dosing. "Clearly we know that there are a lot of people -- despite all the alternatives they are offered -- who open the kitchen drawer and grab a spoon to serve up their liquid medicine," observed Wansink.
Each student was first asked to pour out exactly 5 milliliters of a liquid cold medicine, using a normal-sized teaspoon so they could clearly visualize how much that amount would be.
Following that exercise, each participant was randomly asked to attempt two more medicine pours: one into a medium-sized tablespoon and a second into an even larger spoon. Confidence levels were assessed to see how secure the students were in their ability to correctly pour the proper dosage.
Despite the fact that most students had "above average" confidence that they had poured accurate doses while using one or the other tablespoon, the authors found that dosages actually varied depending on the size of the spoon.
When using the medium-sized tablespoon, the students underdosed by more than 8 percent, on average. And when using the larger tablespoon, they overdosed by nearly 12 percent, on average.So the lesson for today for you and loved ones - stick to more reliable dosing instruments, such as measuring caps or droppers, dosing spoons and/or dosing syringes when administering liquid medicines.
For additional information on liquid dosing recommendations, visit the U.S. Food and Drug Administration.
Wednesday, February 3, 2010
For instance, trial information can show up alongside a Medpedia article covering the same condition, it can appear in a personalized feed of someone interested in that condition, or in a patient community related to that condition.
The biggest barrier to completing clinical trials is finding enough people to take part in them. Medpedia hopes that this new resource will help. By creating tools that make it easier for patients, caregivers and clinicians to find relevant trials, and by raising awareness of existing trials in context, potential treatments can be tested faster and more efficiently and reach those patients that need them most.
Medpedia Clinical Trials updates every 24 hours from the data on ClinicalTrials.gov, a registry of federally and privately supported clinical trials conducted in the United States and around the world. The search results provide details on a trial's purpose, who may participate, locations, and contact information. The ClinicalTrials.gov database is overseen by the National Library of Medicine (NLM) at the National Institutes of Health (NIH), and is the largest clinical trials database, holding registrations from over 80,000 trials from more than 170 countries in the world.
For full disclosure, readers should know that this blog feeds to Medpedia. The Medpedia platform includes a collaborative online medical encyclopedia, a Professional Network and Directory for health professionals and organizations, and Communities of Interest in which medical professionals and non-professionals can share information about conditions, treatments, lifestyle choices, etc. Other parts of the Medpedia platform include Medpedia Answers for asking and answering medical and health questions; Medpedia Alerts for displaying real-time medical and health news alerts; and Medpedia News & Analysis for sharing medical news and analysis.
I believe it is a great resource and that is why I participate. Check Medpedia out. You may find some worthwhile information there.
Tuesday, February 2, 2010
If people live long enough, it's likely they will become increasingly frail. But "it can be delayed," researchers say.
Much of it is rooted in unhealthy habits picked up in early and middle age -- "especially a lack of physical exercise, smoking and poor nutrition."Does this sound like a broken record? I continue to emphasize to people in my writing and talks that how we take care of ourselves today will determine how we prosper (or not) in our older age.
2010 - how about you make it about you this year? Not to say we should not be taking care of each other but sometimes all the giving leaves nothing for you. Take care of you and you will be better able to care for others and avoid frailty and worse later in life.
Monday, February 1, 2010
In a second study, those same researchers performed a similar test on seniors with mild cognitive impairment or early stages of Alzheimer's. They discovered that seniors had an easier time recalling a celebrity's name, but their ability to recall details was significantly more impaired.
Researchers suggest that this type of semantic memory test could become a valuable tool in assessing those at risk for dementia and Alzheimer' disease. The report appears in the Canadian Journal on Aging.