From the 4 March 2015 announcement
Today, the U.S. Food and Drug Administration launched the agency’s first mobile application (app) specifically designed to speed public access to valuable information about drug shortages.
The app identifies current drug shortages, resolved shortages and discontinuations of drug products.
Drugs in short supply can delay or deny needed care for patients. Drug shortages may also lead health care professionals to rely on alternative drug products, which may be less effective or associated with higher risks than the drug in shortage.
“The FDA understands that health care professionals and pharmacists need real-time information about drug shortages to make treatment decisions,” said Valerie Jensen, associate director of the Drug Shortage Staff in the FDA’s Center for Drug Evaluation and Research. “The new mobile app is an innovative tool that will offer easier and faster access to important drug shortage information.”
App users can search or browse by a drug’s generic name or active ingredient, and browse by therapeutic category. The app can also be used to report a suspected drug shortage or supply issue to the FDA.
The agency developed the drug shortages app to improve access to information about drug shortages, as part of the FDA’s efforts outlined in the Strategic Plan for Preventing and Mitigating Drug Shortages.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
Open the medicine cabinet of a senior and you’re likely to find scores of pill bottles. Physicians are often unaware of all the medications a patient is taking, which can result in unnecessary additional prescriptions, non-prescription medications and potential drug-drug interactions that cause unexpected adverse effects. When a cancer diagnosis is thrown into the mix, the drug-drug interactions can become even more complex. A new study evaluates the currently available screening tools for determining if and when seniors with cancer are taking too many medications and finds that a more comprehensive medication assessment and monitoring plan is needed to improve treatment for this population.
From the news release
…By taking the first detailed look at how one such parasite periodically assumes a new protein disguise during a long-term infection, new research at Rockefeller University challenges many assumptions about one of the best-known examples of this strategy, called antigenic variation, in the parasite that causes African sleeping sickness.
Here’s how it works. Many animals, including humans, have immune systems capable of learning to recognize pathogens based on those pathogens’ antigens, usually proteins on their surface. After encountering an antigen, the immune system generates its own proteins called antibodies to target that antigen. By continually changing antigens, a pathogen evades those antibodies.
The authors discuss how the use of quarantine can unintentionally introduce secondary and tertiary effects. If individuals show symptoms but are not isolated immediately, they will contaminate the quarantine group, and if individuals without symptoms are cohorted with a group already symptomatic, the risk of transmission will increase. The other unintended consequence is to patients admitted to hospitals for other medical reasons, e.g., heart attacks, strokes, trauma, and cancer.
The issue of psychological stress during quarantine is also addressed. These include fear of the disease and possible confinement, and the effects on family, friends and colleagues.
Before civil liberties are suspended, decision-makers must use evidence-based data to support their decisions. Public health officials and political figures should avoid taking unnecessary harsh precautions in their effort to appear on top of the situation. Per Dr. Barbisch, Major General, US Army (ret): “Quarantine should only be used if the inherent restrictions will effectively reduce the spread of the disease.”
[News release] Medicaid Is a Very Good Investment Even If It Does Not Lower Cholesterol, Blood Pressure, or Blood Sugar
Quality-Life Year Gains Average $62,000
March 26, 2015 — Researchers atColumbia University’s Mailman School of Public Health analyzed the results of the Oregon Health Experiment, where eligible uninsured individuals were randomly assigned Medicaid or to stay with their current care. Considered controversial because the experiment found no measurable gains for physical health it did reveal benefits for mental health, financial wellbeing, and preventive screening. In terms of quality-adjusted life years, the researchers showed that Medicaid is an excellent value—a $62,000 gain in quality-adjusted life years. Study findings are online in the American Journal of Public Health.
[News release] An International Team of Researchers Discover Strong Association Between Lifestyles of Indigenous Communities and Gut Microbial Ecologies
…the team presents an in-depth analysis of the gut microbiome of the Matses, an Amazonian hunter-gatherer community, which is compared with that of the village of Tunapunco, who are highland small-scale farmers, as well as with urban city-dwellers in Norman, Okla.
In comparing the three groups to previously published studies in Africa and South America, the team observed a striking trend. Human gut microbiota cluster together based on subsistence strategy more than geographic proximity. Thus, hunter-gatherers in South America and Africa are more similar to each other than either are to rural agriculturalists or to urban-industrialists, even from neighboring populations.
It is now well accepted that human gut microbiomes are actively involved in health and that changes in our gut microbes from living more sanitized, industrialized lifestyles, has led to susceptibility to certain autoimmune disorders like asthma and allergies.
Also, it has become clear that industrialization has led to a decrease in gut microbiome diversity. Moreover, in the gut of industrialized peoples, one particular bacteria genus is conspicuously absent, Treponema. These bacteria have co-existed with humans and other primates for millions of years, so their absence in industrialized people is disconcerting.
In an editorial posted online today in the Annals of Emergency Medicine, two practicing emergency medicine physicians from the University of California, Davis, and Brown University — both thought leaders at the forefront of finding solutions to the public health crisis of gun violence — urge their colleagues to take direct action to protect the health and safety of patients and communities.
Their editorial follows the Feb. 24 call to action by eight health professional organizations, including the American College of Emergency Physicians, and the American Bar Association, to reduce firearm injuries and deaths in the U.S. — unprecedented support that suggests mobilization to prevent firearm violence may be underway.
“Firearm violence causes nearly as many deaths as motor vehicle crashes,” said Garen J. Wintemute, an emergency medicine professor at UC Davis and a national authority on evidence-based strategies to prevent firearm violence. “Firearms are involved in most homicides and suicides, and the number of suicides by firearm is increasing — especially among older white men.
“Emergency medicine physicians have limited opportunities to prevent a death once a shooting has occurred, because most people who die from their wounds do so where they are shot. Gun ownership or having a gun in the household is a well-documented risk factor for a violent death. For that reason, we believe physicians should also work to help prevent shootings,” he said.
The authors describe how America successfully reduced motor-vehicle-related deaths by better vehicle and roadway design and public policies that make driving under the influence a crime. Yet no comparable public-health campaign focused on reducing gun violence has been launched.
The authors particularly emphasize the need for a national policy requiring background checks on all transfers of firearms to help prevent access to firearms by those who are prohibited from having them. They recommend adding two other high-risk groups to the list of individuals who are prohibited from purchasing firearms. These include persons with a history of violent misdemeanor convictions, such as assault and battery and domestic violence, as well as those with a documented history of addiction and alcohol abuse.
“Controlled studies of felons, those who have committed violent misdemeanors and persons prohibited for mental-health reasons have all shown reductions in risk for future violence of 25 percent or more when these individuals are denied firearm purchases,” said Megan Ranney, an emergency medicine physician and director of the Emergency Digital Health Innovation program at Rhode Island Hospital and the Warren Alpert Medical School of Brown University.
The authors also address mental illness and gun violence. While they agree with recommendations that focus on behavior and expanded access to treatment, they emphasize that serious mental illness directly accounts for only 4 percent of interpersonal violence. In contrast, mental illness is associated with between 47 and 74 percent of suicides. The risk of firearm injury increases when mental illness coexists with alcohol abuse, drug abuse and a history of prior violence.
“Physicians need to include questions about firearms when assessing risk of violence in their patients, and need to act on the information, especially when patients are expressing thoughts of dangerousness to themselves or others, are intoxicated or are in the emergency department for a violence-related injury,” Ranney said.
At a time when civilian fatalities from gunshot wounds for 2004 to 2013 have outnumbered combat fatalities from World War II, the authors welcome the unprecedented support from leading organizations of health and legal professionals for policy recommendations to reduce gun violence.
“Physicians can take direct action to protect the health and safety of patients and communities,” Wintemute said. “While we may not all agree on all the specifics, enough of us will agree on enough of them to make a difference for the better.”
The Violence Prevention Research Program is an organized research program of the University of California, Davis, that conducts leading-edge research to further America’s efforts to understand and prevent violence. Since its founding over 30 years ago, the program has produced a uniquely rich and informative body of research on the causes, nature and prevention of violence, especially firearm violence. Current areas of emphasis include the prediction of criminal behavior, the effectiveness of waiting period and background-check programs for prospective purchasers of firearms, and the determinants of firearm violence. For more information, visit www.ucdmc.ucdavis.edu/vprp
Founded in 1863, Rhode Island Hospital in Providence, R.I., is a private, not-for-profit hospital and is the principal teaching hospital of The Warren Alpert Medical School of Brown University. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Last year, Rhode Island Hospital received more than $55 million in external research funding. It is also home to Hasbro Children’s Hospital, the state’s only facility dedicated to pediatric care. For more information on Rhode Island Hospital, visitwww.rhodeislandhospital.org, follow us on Twitter @RIHospital or like us on Facebook http://www.facebook.com/rhodeislandhospitalpage.
While legislation expanding how and where Texans can carry weapons is dominating the Legislature this week, one state lawmaker is targeting the doctor’s office as a place to keep the federal government from learning who owns guns.
Over the objections of the medical community, state Rep. Stuart Spitzer, R-Kaufman, has filed a bill that would prohibit doctors from asking patients whether they own a firearm and makes the Texas Medical Board, which licenses physicians, responsible for doling out punishment.
Improved Decision-Making in How to Use New Technology May be Key to Decrease in Complications Associated with Fracture Healing Procedures
A team of orthopedic surgeons from the Perelman School of Medicine at the University of Pennsylvania has found that modern technology for healing distal femur fractures is as safe and effective as its more established alternative, without a potential shortfall of the older approach. The team found that when done correctly, there are no significant differences between the two approaches – “locked plating” and “non-locked plating” – in terms of healing rates, need for corrective surgery, or hardware failure. The findings are being presented on Thursday, March 26, 2015, at the American Academy of Orthopaedic Surgeons Annual Meeting in Las Vegas.
he team examined medical records of 95 patients who underwent surgery to repair distal femoral fractures. Though relatively uncommon in the general population, an increase in the number of these fractures is expected as the population ages. For 80 percent of the patients studied, the fracture healed within 3.5 months of surgery, while 20 percent needed corrective surgery. The researchers found that patients whose surgeons used locked plating – which historically required a second revision surgery roughly 40 percent of the time – had no more setbacks than patients whose providers used non-locked plating.
The two methods differ by virtue of their use of locking and non-locking screws, respectively, to attach metal plates to fractured bone in order to provide stability and promote healing. While locked plating virtually eliminates the possibility of the plate moving, it has been associated with pronounced stiffness and rigidity around the healing bone, which can prevent the broken bone from healing.
“Plates used in distal femur surgery come in various sizes, and have as many as 16 to 20 apertures, or screw holes,” explained the study’s senior author Samir Mehta, MD, chief of the division of Orthopaedic Trauma at the Perelman School of Medicine at the University of Pennsylvania. “In the early days of locked plating, some surgeons used screws in every one of these apertures, which we think lead to stiffness, rigidity and pain for patients. Today, surgeons are more judicious, using far fewer screws and picking and choosing which holes to insert the screws in based on factors in the case at hand. This improved decision-making on the part of surgeons is what we believe has resulted in the significant decrease in techincal problems associated with locked plating.”
According to the researchers, the one factor that had a significant impact on fracture healing was if the fracture was open. Additionally, two factors increased the risk of poor healing for the participant population, but did not reach statistical significance: diabetes and non-weight bearing status postoperatively. The latter finding points the way toward early weight-bearing by patients, typically within a few days of surgery, rather than remaining in bed.
“As surgeons become more adept at application of both established and developing implant technologies, outcomes will continue to improve,” said lead investigator Ryan M. Taylor, MD, a fifth-year resident in the department of Orthopaedic Surgery at the Perelman School of Medicine at the University of Pennsylvania. “However, we must remain cognizant of patient specific variables such as age, weight, and pre-existing comorbidities, which can affect overall care strategies and management.”
The study highlights that LGBTQI populations face barriers to health insurance such as when partnerships and marriages are not legally recognized; concerns about disclosure in a health care setting, discrimination, misconceptions, legal and financial barriers and the disenfranchised stress and distress of caregiving same-sex partners.
Additionally, there are higher rates of smoking and substance abuse and low screening rates resulting in poor patient outcomes and survival rates for LGBTQI populations. Her review, The Importance of disclosure: Lesbian, gay, bisexual, transgendered, queer/questioning, and intersex individuals and the cancer continuum, was published in the American Cancer Society’s journal, Cancer.
Researchers identified that the real or perceived limited access to care due to fear of discrimination and lack of sensitivity and knowledge of LGBTQI issues stood as roadblocks to patient care. In a study of family physicians only 1 in 80 reported routinely asking patients about sexual orientation, while the majority reported rarely or never asking. The National Institutes of Health and the Institute of Medicine now recognize gender identify and sexual orientation as vital aspects of a health history and the need for improved research in this population.
“For many years, physicians did not ask patients about their sexual orientation. The importance of recognizing gender identity and sexual orientation is critical to ensuring the best quality and evidence-based care is available to patients,” explained Quinn.
Heart-healthy fats are good, but not in coffee
There’s a lot of hype lately about the most recent coffee trend. Take your morning cup-of-joe, add two tablespoons of butter and some oil, and call it Bulletproof Coffee. No doubt it’s an interesting flavor, but it’s the claims of increased energy and weight loss that seem to be giving this morning jolt traction.
It’s not just any butter and coffee. Those supporting this idea say it has to be unsalted, grass-fed butter and medium-chain triglyceride oil (MCT) added to low-toxicity coffee beans. But can a mixture like that really live up to what proponents are saying?
What happens to butter in your body
There’s no real research into whether butter-spiked coffee is good for you, but we do know some things about how butter affects your digestion.
According to existing research, fat in butter contains glycosphingolipids, fatty acids that ward off gastrointestinal tract infections, especially in very young children and older adults.
Its omega-3 and omega-6 fats also slow down your body’s metabolism of caffeine, so you hold on to energy longer and avoid the crash that comes when the stimulant wears off.
More about MCT
MCT, most commonly found in coconut oil, is also good for our bodies and brains. When it comes to our bodies, we don’t store MCT in our adipose tissue, the fat around and inside our muscles, like the other dietary fats we eat.
Most of those fats are long-chain triglycerides, but MCTs are shorter. They travel directly to the liver where they’re processed into powerful energy particles called ketone bodies.
In addition, if your brain loses the ability to break down its primary fuel source, glucose, due to cognitive impairment or some other disorder, it can use ketone bodies as an excellent, alternative source. Researchshows that people with cognitive impairment who ingest MCT experience an almost immediate improvement in mental function.
So, do the health benefits of butter and MCT mean you should add them to your morning coffee? To begin with, if you don’t already drink coffee, I don’t recommend you start. If you do, though, I still don’t endorse your adding butter and oil to it, and I have no plans to do it either.
Healthy fats and oils do have a place in our daily diets, but I’m not convinced that enhancing our coffee with them is the best way to incorporate them.
Remember, correlation does not mean cause! See also the rebuttal below
Air pollution is linked to a higher risk of stroke, particularly in developing countries, finds a study published in The BMJ today. In a second article, new research also shows that air pollution is associated with anxiety.
Stroke is a leading cause of death and kills around 5 million people each year worldwide. Common risk factors include obesity, smoking and high blood pressure. But the effect of the environment, such as, air pollution is uncertain because evidence is lacking.
In a systematic review and meta analysis, a team of researchers from Edinburgh University looked at the association between short term air pollution exposure and stroke related hospital admissions and deaths. In total, they analysed 103 observational studies that covered 28 countries across the world.
Gaseous pollutants included in the analysis were carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone. In addition, particulate matter was included: PM 2.5 (fine particles less than 2.5 µm in size) and PM 10 (coarse particles less than 10 µm in size).
Results showed an association between carbon monoxide (1.5% increased risk per 1 ppm), sulphur dioxide (1.9% per 10 ppb) and nitrogen dioxide (1.4% per 10 ppb) and stroke related hospital admissions or death. The weakest association was found for ozone.
Both PM 2.5 and PM 10 were associated with hospital admissions or deaths due to stroke, by 1.1% and 0.3% per 10 µg/m3 increment respectively. The first day of air pollution exposure was found to have the strongest association.
Low- to middle-income countries experienced the strongest associations compared to high-income countries. Only 20% of analysed studies were from low- to middle-income countries – mostly mainland China – despite these countries having the highest burden of stroke.
Both studies were observational and no definitive conclusions can be drawn about cause and effect, and the teams of researchers call for more research.
Bacteria that cause many hospital-associated infections are ready to quickly share genes that allow them to resist powerful antibiotics. The illustration, based on electron micrographs and created by the Centers for Disease Control and Prevention, shows one of these antibiotic-resistant bacteria. Credit: CDC/James Archer
Antibiotic resistance is poised to spread globally among bacteria frequently implicated in respiratory and urinary infections in hospital settings, according to new research at Washington University School of Medicine in St. Louis.
The study shows that two genes that confer resistance against a particularly strong class of antibiotics can be shared easily among a family of bacteria responsible for a significant portion of hospital-associated infections.
Drug-resistant germs in the same family of bacteria recently infected several patients at two Los Angeles hospitals. The infections have been linked to medical scopes believed to have been contaminated with bacteria that can resist carbapenems, potent antibiotics that are supposed to be used only in gravely ill patients or those infected by resistant bacteria.
“Carbapenems are one of our last resorts for treating bacterial infections, what we use when nothing else works,” said senior author Gautam Dantas, PhD, associate professor of pathology and immunology. “Given what we know now, I don’t think it’s overstating the case to say that for certain types of infections, we may be looking at the start of the post-antibiotic era, a time when most of the antibiotics we rely on to treat bacterial infections are no longer effective.”
“The researchers found that many of the youngest teen mothers didn’t want to have sex with the fathers, but did anyway because they did not know how or didn’t feel they could say “no.” ”
The above sentence really gave me pause. I always felt I could say no, and did. And was respected for it.
Granted I was raised in a stable home and was told I was going to college at age 5 (OK, exaggerating a bit!). Although the boys in grade school had roles we girls didn’t at Catholic school in the 60’s (altar servers, crossing guards), I never felt inferior to them, deep down. If circumstances were different…wondering how I would have faced challenges in many areas…
If Diane could reverse time, she never would have slammed the door–an act of teen frustration and ongoing family conflict that finally got her kicked out of her mother’s house.
Thus began a cascade of events that, a few years later, led to her pregnancy at age 19.
Diane is one of 108 teenage moms interviewed about their lives and pregnancies in On Becoming a Teen Mom: Life Before Pregnancy (University of California Press, 2015), a new book by Case Western Reserve University sociologists Mary Patrice Erdmans and Timothy Black that focuses on life events resulting in teen motherhood, revealing some realities behind the statistics.
The general perception is that teen pregnancy is a social problem, like drug addiction and crime, and that it is on the rise, said Erdmans, associate professor of sociology.
In fact, the number of births to teen moms has dropped 44 percent between 1991 and 2010, and down another 10 percent in 2012-13 from the previous year (the most recent reporting years) for moms age 15 to 19, according to the Centers for Disease Control and Prevention.
Erdmans and Black, also an associate professor of sociology, along with a team of interviewers, traveled throughout Connecticut over two years, collecting the life stories of first-time mothers, 108 of whom were teen moms. The mothers discussed what it was like in their families, neighborhoods and school while they were growing up. They talked about their relationships, the pregnancy and the decision to have a child.
“We now have a picture of what’s happened in these mothers’ lives before they became pregnant,” Erdmans said, “portrait that differs from general perceptions about teen pregnancy that tend to focus on the consequences of early childbearing.”
The authors address several myths about teen births:
- Teen births are a cause of poverty. They found most teen mothers were living in poverty before they became pregnant.
- Teen mothers will drop out of school. They found many teen mothers had dropped out or disengaged from school long before they became pregnant, while those doing well in school tended to stay and graduate.
One-fourth of the teen mothers from all socio-economic levels told stories of sexual abuse when they were young.
Others spoke of wanting to be accepted by peers, rebelling from extremely strict parents and a lack of knowledge about conception and contraceptives.
The researchers found that many of the youngest teen mothers didn’t want to have sex with the fathers, but did anyway because they did not know how or didn’t feel they could say “no.” They kept and raised their babies, even in cases where the pregnancy resulted from rape.
Their stories call attention to preventing pregnancies by improving unsafe neighborhoods, lowering high rates of urban poverty and overcoming systematic gender inequalities that rob women of their ability to say “no” at any point in a relationship, the researchers conclude.
Erdmans points out that many teen pregnancies could be prevented, beyond using birth control and abortions, by having better schools from first grade on.
Many teen moms, especially from inner cities, were unprepared for the academic and social challenges of high school. They reported getting pregnant within two years after quitting high school.
Over the last 30 years, short sight, or myopia, has become a global health problem. The most dramatic rise has been in Singapore, Taiwan, China’s cities and elsewhere in East Asia. Rates can be as high as 80-90 per cent among children leaving secondary schools in the region. As many as a fifth of them have severe myopia and so are at high risk of eye problems in later life. In Western countries rates are increasing; although not as rapidly as in East Asia.
The Myopia Mystery
The cause of myopia, and the means to prevent it, are unclear despite more than 150 years of scientific research. Many theories have been put forward to explain why children’s eyesight gets worse as they go through school. Too much close work is one of the more popular ones, while heredity is another. Both have been hotly debated down the years.
Is Myopia Like Rickets?
The new study compares the history of school myopia with the bone disease rickets. During the 17th century, rickets was common among children in England and then reached epidemic levels through northern Europe and North America. In some cities, 80 per cent of children were affected. The remedy proved elusive until the 1920s, when scientists found that a lack of sunlight, resulting in vitamin D deficiency, was the cause of rickets. Myopia, like rickets, is a seasonal condition which seems to get worse in the winter. Recent research on myopia has revived an old theory from the 1890s, that school children who spend more time outdoors have lower levels of myopia. However, unlike rickets, low ambient light levels rather than low vitamin D levels seem to be the deciding factor in myopia.
Population growth could cause global demand for water to outpace supply by mid-century if current levels of consumption continue. But it wouldn’t be the first time this has happened, a Duke University study finds.
Using a delayed-feedback mathematical model that analyzes historic data to help project future trends, the researchers identified a regularly recurring pattern of global water use in recent centuries. Periods of increased demand for water — often coinciding with population growth or other major demographic and social changes — were followed by periods of rapid innovation of new water technologies that helped end or ease any shortages.
Based on this recurring pattern, the model predicts a similar period of innovation could occur in coming decades.
“Researchers in other fields have previously used this model to predict earthquakes and other complex processes, including events like the boom and bust of the stock market during financial crises, but this is the first time it’s been applied to water use,” said Anthony Parolari, postdoctoral research associate in civil and environmental engineering at Duke, who led the new study.
“What the model shows us is that there will likely be a new phase of change in the global water supply system by the mid-21st century,” Parolari said.
“This could take the form of a gradual move toward new policies that encourage a sustainable rate of water use, or it could be a technological advancement that provides a new source of water for us to tap into. There’s a range of possibilities,” he said.
Data on global water use shows we are currently in a period of relatively stagnant growth, he said. Per-capita water use has been declining since 1980, largely due to improved efficiency measures and heightened public awareness of the importance of conserving Earth’s limited supply of freshwater. This has helped offset the impacts of recent population growth.
“But if population growth trends continue, per-capita water use will have to decline even more sharply for there to be enough water to meet demand,” he said. The world’s population is projected to surge to 9.6 billion by 2050, up from an estimated 7 billion today.
“For every new person who is born, how much more water can we supply? The model suggests we may reach a tipping point where efficiency measures are no longer sufficient and water scarcity either impacts population growth or pushes us to find new water supplies,” Parolari said.
Water recycling, and finding new and better ways to remove salt from seawater, are among the more likely technological advances that could help alleviate or avoid future water shortages, he said.
The article has more on this “bill”.
‘what if restaurants billed like hospitals?’ Here’s what he came up with.
Date:March 19, 2015
Summary:Wireless sensors recording human interactions explain the transmission of germs, such as MRSA, in hospitals, according to new research.
The results indicate that the study of individuals contact may help identify increased risk of transmission situations and ultimately reduce the burden of nosocomial S. aureus transmission.
The researchers say: “Contact networks have been increasingly used in modeling the spread of infectious diseases. Yet, the contacts collected were often incomplete or used proxies that were thought to capture situation at risk. In this unique experiment, the joint analysis of contact and carriage validates the use of close-proximity interactions recorded by electronic devices, and opens a new field for prevention measures in hospitals.”
[Report] County-Level Variation in Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, 2012
The map illustrates the geographic variation across counties and shows that counties with the highest prevalence of Medicare beneficiaries with 6 or more chronic conditions are located predominantly in southern states (eg, Texas, Florida, Kentucky) and northeastern states (eg, New York, Pennsylvania). Counties with the lowest prevalence are found mostly in western states (eg, Oregon, Montana, Wyoming). [A text description of this figure is also available.]
Preventing chronic conditions and controlling costs associated with the care for people with chronic conditions are public health and health care priorities. The number of chronic conditions increase with age: more than two-thirds of Medicare beneficiaries 65 years or older have 2 or more chronic conditions, and more than 15% have 6 or more (1,2). People with multiple chronic conditions use more health care services than people who do not have them, and they account for a disproportionate share of health care spending (2,3). The prevalence of multiple chronic conditions varies substantially by state (4); more granular geographic information on multiple chronic conditions can provide a better understanding of the burden of chronic conditions and the implications for local public health programs and resources. The objective of this geographic information system (GIS) analysis was to describe county-level prevalence patterns of Medicare beneficiaries with 6 or more chronic conditions.
Navigate This Article
From the 16 March 2015 Brookings news release
Achieving better health outcomes at a lower cost and succeeding with payment reforms that shift from volume to value is difficult without health information technology (IT). Health IT can engage and support health care providers, patients, and consumers with access to timely and accurate clinical information from electronic health records (EHRs) and other sources. It can also provide access to cost and coverage information that avoids burdensome administrative processes and unexpected costs. Health IT can achieve these benefits through interoperability across information and data exchange platforms – avoiding duplicative parallel systems and additional data entry. Engaged patients and providers, supported by flexible, usable and useful health IT, can make informed shared decisions about testing and treatment which can lead to more timely, efficient, and higher-value health care.
[News release] Survey Finds Physicians Want to Learn More About Diet and Cardiovascular Disease Prevention
From the 13 March 2015 Newswise article
Most physicians are aware of the importance of lifestyle factors in preventing cardiovascular disease (CVD) — and believe diet is as important as statin therapy and exercise, according to a new survey from NYU Langone Medical Center.
Researchers found that a majority of doctors would welcome additional training in diet and nutrition so that they can effectively inform patients on the subject. The study will be presented at the American College of Cardiology’s 64th Annual Scientific Session as a poster presentation.
The 28-question online survey, created by a team from the NYU Langone Center for the Prevention of Cardiovascular Disease, was designed to identify gaps in nutritional knowledge and to evaluate physician attitudes and practices concerning diet in the prevention of CVD. The survey was completed by 236 cardiologists and internal medicine physicians and trainees.
Most of the survey respondents (78 percent) were open to additional training and thought it would result in better patient care. Just over half of the physicians said they currently spend three minutes or less educating patients on diet and lifestyle.
Overall the survey respondents did comparatively well, answering about two thirds of the knowledge-based questions correctly. Surprisingly, cardiologists scored no better than internal medicine physicians.
“We found physicians had a decent knowledge of general nutritional principles, but their practical knowledge was somewhat suboptimal,
[News release] Insuring undocumented residents could help solve multiple U.S. health care challenges
From the 18 March 2015 UCLA news release
UCLA health care policy analysis finds four key problem areas for Latinos under Affordable Care Act
Latinos are the largest ethnic minority group in the United States, and it’s expected that by 2050 they will comprise almost 30 percent of the U.S. population. Yet they are also the most underserved by health care and health insurance providers.
Latinos’ low rates of insurance coverage and poor access to health care strongly suggest a need for better outreach by health care providers and an improvement in insurance coverage. Although the implementation of the Affordable Care Act of 2010 seems to have helped (approximately 25 percent of those eligible for coverage under the ACA are Latino), public health experts expect that, even with the ACA, Latinos will continue to have problems accessing high-quality health care.
Alex Ortega, a professor of public health at the UCLA Fielding School of Public Health, and colleagues conducted an extensive review of published scientific research on Latino health care. Their analysis, published in the March issue of the Annual Review of Public Health, identifies four problem areas related to health care delivery to Latinos under ACA:
- The consequences of not covering undocumented residents.
- The growth of the Latino population in states that are not participating in the ACA’s Medicaid expansion program.
- The heavier demand on public and private health care systems serving newly insured Latinos.
- The need to increase the number of Latino physicians and non-physician health care providers to address language and cultural barriers.
“As the Latino population continues to grow, it should be a national health policy priority to improve their access to care and determine the best way to deliver high-quality care to this population at the local, state and national levels,” Ortega said. “Resolving these four key issues would be an important first step.”
Insurance for the undocumented
Whether and how to provide insurance for undocumented residents is, at best, a complicated decision, said Ortega, who is also the director of the UCLA Center for Population Health and Health Disparities.
For one thing, the ACA explicitly excludes the estimated 12 million undocumented people in the U.S. from benefiting from either the state insurance exchanges established by the ACA or the ACA’s expansion of Medicaid. That rule could create a number of problems for local health care and public health systems.
For example, federal law dictates that anyone can receive treatment at emergency rooms regardless of their citizenship status, so the ACA’s exclusion of undocumented immigrants has discouraged them from using primary care providers and instead driven them to visit emergency departments. This is more costly for users and taxpayers, and it results in higher premiums for those who are insured.
In addition, previous research has shown that undocumented people often delay seeking care for medical problems.
As the ACA is implemented and more people become insured for the first time, local community clinics will be critical for delivering primary care to those who remain uninsured.
“These services may become increasingly politically tenuous as undocumented populations account for higher proportions of clinic users over time,” he said. “So it remains unclear how these clinics will continue to provide care for them.”
A new study has found some scientists are unknowingly tweaking experiments and analysis methods to increase their chances of getting results that are easily published.
The study conducted by ANU scientists is the most comprehensive investigation into a type of publication bias called p-hacking.
P-hacking happens when researchers either consciously or unconsciously analyse their data multiple times or in multiple ways until they get a desired result. If p-hacking is common, the exaggerated results could lead to misleading conclusions, even when evidence comes from multiple studies.
“We found evidence that p-hacking is happening throughout the life sciences,” said lead author Dr Megan Head from the ANU Research School of Biology.
The study used text mining to extract p-values – a number that indicates how likely it is that a result occurs by chance – from more than 100,000 research papers published around the world, spanning many scientific disciplines, including medicine, biology and psychology.
“Many researchers are not aware that certain methods could make some results seem more important than they are. They are just genuinely excited about finding something new and interesting,” Dr Head said.
“I think that pressure to publish is one factor driving this bias. As scientists we are judged by how many publications we have and the quality of the scientific journals they go in.
“Journals, especially the top journals, are more likely to publish experiments with new, interesting results, creating incentive to produce results on demand.”
Dr Head said the study found a high number of p-values that were only just over the traditional threshold that most scientists call statistically significant.
“This suggests that some scientists adjust their experimental design, datasets or statistical methods until they get a result that crosses the significance threshold,” she said.
“They might look at their results before an experiment is finished, or explore their data with lots of different statistical methods, without realising that this can lead to bias.”
The concern with p-hacking is that it could get in the way of forming accurate scientific conclusions, even when scientists review the evidence by combining results from multiple studies.
For example, if some studies show a particular drug is effective in treating hypertension, but other studies find it is not effective, scientists would analyse all the data to reach an overall conclusion. But if enough results have been p-hacked, the drug would look more effective than it is.
“We looked at the likelihood of this bias occurring in our own specialty, evolutionary biology, and although p-hacking was happening it wasn’t common enough to drastically alter general conclusions that could be made from the research,” she said.
“But greater awareness of p-hacking and its dangers is important because the implications of p-hacking may be different depending on the question you are asking.”
The research is published in PLOS Biology.
Increasing Publicly Funded Family Planning Services Could Substantially Reduce These Costs
U.S. government expenditures on births, abortions and miscarriages resulting from unintended pregnancies nationwide totaled $21 billion in 2010, according to “Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010,” by Adam Sonfield and Kathryn Kost. In 19 states, public expenditures related to unintended pregnancies exceeded $400 million in 2010. Texas spent the most ($2.9 billion), followed by California ($1.8 billion), New York ($1.5 billion) and Florida ($1.3 billion); those four states are also the nation’s most populous.
Previous research has demonstrated that investing in publicly funded family planning services enables women to avoid unwanted pregnancies and space wanted ones, which is good not only for women and families, but also for society as a whole. In the absence of the current U.S. publicly funded family planning effort, the public costs of unintended pregnancies in 2010 would have been 75% higher.
Sonfield and Kost report that the total gross savings from averting all unintended pregnancies in 2010 would have been $15.5 billion. This is less than the total public cost of all unintended pregnancies, because even if all women had been able to time their pregnancies as they wanted, some still would have had planned births that were publicly funded. These potential savings do not account for the cost of providing family planning services and other interventions that might be required to prevent the unintended pregnancies.
“Reducing public expenditures related to unintended pregnancies requires substantial new public investments in family planning services,” says Sonfield. “That would mean strengthening existing programs, such as the Title X family planning program, as well as working to ensure that the Affordable Care Act achieves its full potential to bolster Medicaid and other safety-net programs. We know we can prevent unintended pregnancies and the related costs. There are public programs in place that do it already, but as these data show, there is significantly more progress to be made.”
The new research also highlights the central role played by Medicaid and other public insurance programs in providing critical pregnancy-related care—including prenatal care, labor and delivery, postpartum care and infant care—that help keep women and babies healthy. Fifty-one percent of the four million births in the United States in 2010 were publicly funded, including 68% of unplanned births and 38% of planned births.
“These findings demonstrate the continuing importance of Medicaid and other public health insurance programs in preserving maternal and child health, and in supporting pregnancy-related care,” says Adam Sonfield, coauthor of the new report.
For more information:
Fact Sheet: Unintended Pregnancy in the United States (national)
Fact Sheet: Publicly Funded Family Planning Services in the United States (national)
urveys show that around 70% of US Internet users consult the Internet when they require medical information. People seek this information using both traditional search engines and via social media. The information created using the search process offers an unprecedented opportunity for applications to monitor and improve the quality of life of people with a variety of medical conditions. In recent years, research in this area has addressed public-health questions such as the effect of media on development of anorexia, developed tools for measuring influenza rates and assessing drug safety, and examined the effects of health information on individual wellbeing. This tutorial will show how Internet data can facilitate medical research, providing an overview of the state-of-the-art in this area. During the tutorial we will discuss the information which can be gleaned from a variety of Internet data sources, including social media, search engines, and specialized medical websites. We will provide an overview of analysis methods used in recent literature, and show how results can be evaluated using publicly-available health information and online experimentation. Finally, we will discuss ethical and privacy issues and possible technological solutions. This tutorial is intended for researchers of user generated content who are interested in applying their knowledge to improve health and medicine.
From the 18 March 2015 EurkAlert!
“Though trust can have negative consequences, especially among older adults at risk of falling for scams and fraud, the studies found no evidence that those negative consequences erode the benefits of trust.”
In 28 countries, more medicine has unexpected effects
COLUMBUS, Ohio – Across much of the Western world, 25 years of expansion of the medical system has actually led to people feeling less healthy over time, a new study has found.
A researcher at The Ohio State University used several large multinational datasets to examine changes in how people rated their health between 1981 and 2007 and compared that to medical expansion in 28 countries that are members of the Organization for Economic Co-operation and Development.
During that time, the medical industry expanded dramatically in many of those countries, which you might expect would lead to people who felt healthier.
“Access to more medicine and medical care doesn’t really improve our subjective health. For example, in the United States, the percentage of Americans reporting very good health decreased from 39 percent to 28 percent from 1982 to 2006,” Zheng said.
In fact, Zheng conducted what is called a “counterfactual analysis” using the data to see what would have happened if the medical industry hadn’t expanded at all in these countries since 1982. In this analysis, other factors that are generally linked to improved health, such as economic development, were left unchanged.
Under this scenario, the analysis predicted that self-rated health would have increased in these 28 countries. For example, the percentage of Americans reporting very good health could have increased by about 10 percent.
“It seems counterintuitive, but that’s what the evidence shows. More medicine doesn’t lead to citizens feeling better about their health – it actually hurts,” Zheng said.
The study appears in the July 2015 issue of the journal Social Science Research.
The OECD is an organization of countries, including the United States and many countries in Europe, that accept the principles of representative democracy and free-market economy. This study included information from OECD Health Data, World Development Indicators, the World Values Survey and theEuropean Values Study.
Zheng measured three kinds of medical expansion. One was medical investment, which includes health care spending per capita and total health employment; medical professionalization and specialization, which includes the number of practicing physicians and specialists; and expanded pharmaceutical industry, which includes pharmaceutical sales per capita.
Zheng said there are several reasons why medical expansion may actually lead people to feel less healthy. For one, more diseases are discovered or “created,” which increases the risk of being diagnosed with “new” diseases. Three examples, he said, include the rise in diagnoses of attention deficit hyperactivity disorder (ADHD), depression and autism.
In addition, there is more aggressive screening, which turns up more diseases in people. Overdiagnosis can potentially cause harm to perfectly healthy people, he said.
As more medical care becomes more widely available, people may expect better health, perhaps to an unrealistic degree, Zheng said.
“Consumers begin demanding more medical treatment because of the declines in subjective health and the increasing expectations of good health, and medical expansion continues. It is a cycle,” Zheng said.
In a separate but related study published online in Social Science Research, Zheng found that Americans’ confidence in medicine has declined over the last three decades, again at the same time as medical expansion.
“The decline in confidence has occurred at the same rate, regardless of gender, age, income or any other factor,” Zheng said.
From the 29 March 2015 Sandia news release
LIVERMORE, Calif.—Technologies developed in Sandia National Laboratories’biosciences program could soon find their way into doctors’ offices — devices like wearable microneedles that continuously analyze electrolyte levels and a lab-on-a-disk that can test a drop of blood for 64 different diseases in minutes.
At a recent seminar for potential investors and licensees, part of the Sandia Technology Showcase series, Sandia bioscientists presented eight ready-to-license technologies in three key areas: medical diagnostics, biosurveillance and therapeutics and drug discovery.
It’s a simple claim made on thousands of personal care products for adults and kids: hypoallergenic. But what does that actually mean? Turns out, it can mean whatever manufacturers want it to mean, and that can leave you feeling itchy. Speaking of Chemistry is back this week with Sophia Cai explaining why “hypoallergenic” isn’t really a thing. Check it out here:
Denmark’s largest research project on chemical cocktail effects infood, spearheaded by the National Food Institute, Technical University of Denmark, has just been completed. It has established that even small doses of chemicals can have significant negative effects if they are present together. A reliable method for calculating the effects of chemical cocktails has been developed in the project. The project has also shown a need for limiting the Danish population’s exposure to certain substances.
The fact that the traditional way of assessing potential harmful effects of chemicals only takes the individual chemicals into account has long been of concern. Especially since this approach does not take into account the effects that can occur in humans when the chemicals are present at the same time in a cocktail. A serious concern is that substances can amplify each other’s effects, so that their combined effect becomes greater than what can be predicted by looking at the individual chemicals.“Our research shows that indeed, little strokes fell great oaks also when it comes to chemical exposure. Going forward this insight has a profound impact on the way we should assess the risk posed by chemicals weare exposed to through the foods we eat.”
A recently completed, four-year research project on cocktail effects in foods, led by the National Food Institute, has established that when two or more chemicals appear together, they often have an additive effect. This means that cocktail effects can be predicted based on information from single chemicals, but also that small amounts of chemicals when present together can have significant negative effects.
”Our research shows that indeed, little strokes fell great oaks also when it comes to chemical exposure. Going forward this insight has a profound impact on the way we should assess the risk posed by chemicals we are exposed to through the foods we eat,” Professor Anne Marie Vinggaard from the National Food Institute says.
Danes’ exposure to chemicals via foods
In order to assess the risk posed by various chemicals, it is essential to know what the typical human exposure to a particular chemical is. The cocktail project has created an overview of the amount of pesticides and other contaminants that humans are exposed to via foods.
This work has shown that Danes’ intake of pesticides through foods is relatively limited. However, there is a need for reducing exposure to substances such as lead, cadmium, PCBs and dioxins.
The endocrine disrupting effects of chemicals have generally not been adequately studied. However, in cases where knowledge about the effects is available, the results show a need to reduce the intake of endocrine disrupting chemicals from current levels, such as phthalates and fluorinated chemicals.
The National Science Foundation (NSF or Foundation) has developed a plan outlining a framework for activities to increase public access to scientific publications and digital scientific data resulting from research the foundation funds. The plan, entitled “Today’s Data, Tomorrow’s Discoveries,” is consistent with the objectives set forth in the Office of Science and Technology Policy’s Feb. 22, 2013, memorandum, “Increasing Access to the Results of Federally Funded Research,” and with long-standing policies encouraging data sharing and communication of research results.
As outlined in section 3.1 of the plan, NSF will require that either the version of record or the final accepted manuscript in peer-reviewed scholarly journals and papers in juried conference proceedings or transactions must:
- Be deposited in a public access compliant repository designated by NSF;
- Be available for download, reading and analysis free of charge no later than 12 months after initial publication;
- Possess a minimum set of machine-readable metadata elements in a metadata record to be made available free of charge upon initial publication;
- Be managed to ensure long-term preservation; and
- Be reported in annual and final reports during the period of the award with a persistent identifier that provides links to the full text of the publication as well as other metadata elements.
This NSF requirement will apply to new awards resulting from proposals submitted, or due, on or after the effective date of the Proposal & Award Policies & Procedures Guide (PAPPG) that will be issued in January 2016.
Ethics and equity in research priority-setting: stakeholder engagement and the needs of disadvantaged groups
Originally posted on Soumyadeep B:
Read the full paper published by Dr. Soumyadeep B et al at Indian Journal of Medical Ethics here (Click: Open Access)
Originally posted on Eat Like Jean:
Those of you who are dietitians in the U.S. are undoubtedly aware of the entity that is the Academy of Nutrition and Dietetics (AND). They both dictate the practicing of dietetics and provide the recommendations for healthy eating in America. What you may not be aware of is the myriad special interest groups hanging out in the pockets of the AND. A press release has just been made announcing the new partnership between the AND and Kraft Foods. Kraft will be added to the list of AND’s corporate sponsors, and “foods” like Kraft American Cheese and boxed Macaroni and Cheese will now be promoted as healthy food options for your children. It should also be mentioned that AND’s sponsor list already includes Coca-Cola, Pepsi, ConAgra, and McDonald’s. Meanwhile, the Academy maintains that this move is not an endorsement of Kraft foods. Doesn’t make sense, does it?
View original 190 more words
Originally posted on FLXHUB:
By: Reed Abelson
In downtrodden East Cleveland, a three-story family health center has replaced the city’s full-service hospital. Seven thousand miles away in Abu Dhabi, a gleaming 24-story hospital is preparing to admit patients this year.
Back in Ohio, shoppers at Marc’s, a local discount grocer and pharmacy in Garfield Heights, can enter a kiosk equipped with a stethoscope, a blood pressure cuff and a two-way video screen that lets a patient talk directly to a doctor.
These disparate ventures bear the imprimatur of the renowned Cleveland Clinic, one of the most respected nonprofit health systems in the nation, as it tries to manage the extraordinary changes now transforming health care.
While it has traditionally relied on its ability to provide high-priced specialty care, the system, along with every stand-alone community hospital and large academic medical center, is being forced to remake itself. Patients are increasingly seeking care outside…
View original 1,393 more words
Originally posted on TIME:
Loneliness kills. That’s the conclusion of a new study by Brigham Young University researchers who say they are sounding the alarm on what could be the next big public-health issue, on par with obesity and substance abuse.
The subjective feeling of loneliness increases risk of death by 26%, according to the new study in the journal Perspectives on Psychological Science. Social isolation — or lacking social connection — and living alone were found to be even more devastating to a person’s health than feeling lonely, respectively increasing mortality risk by 29% and 32%.
“This is something that we need to take seriously for our health,” says Brigham Young University researcher Julianne Holt-Lunstad, an author of the study. “This should become a public-health issue.”
The researchers emphasized the difference between the subjective, self-reported feeling of loneliness and the objective state of being socially isolated. Both are potentially damaging, the study…
View original 288 more words
Consumer Reports’ new guidelines show you how to make the best choices for your health—and for the environment
How risky are pesticides? | What’s the evidence that pesticides hurt your health? | Who may be at greatest risk from pesticide exposure? | Does eating organic mean I won’t be eating any pesticides? | Should I skip conventionally grown produce? | Rules to shop by
Across America, confusion reigns in the supermarket aisles about how to eat healthfully. One thing on shopper’s minds: the pesticides in produce. In fact, a recent Consumer Reports survey of 1,050 people found that pesticides are a concern for 85 percent of Americans. So, are these worries justified? And should we all be buying organics—which can cost an average of 49 percent more than standard fruits and vegetables?
Experts at Consumer Reports believe that organic is always the best choice because it is better for your health, the environment, and the people who grow our food. The risk from pesticides in produce grown conventionally varies from very low to very high, depending on the type of produce and on the country where it’s grown. The differences can be dramatic. For instance, eating one serving of green beans from the U.S. is 200 times riskier than eating a serving of U.S.-grown broccoli.
“We’re exposed to a cocktail of chemicals from our food on a daily basis,” says Michael Crupain, M.D., M.P.H., director of Consumer Reports’ Food Safety and Sustainability Center. For instance, the Centers for Disease Control and Prevention reports that there are traces of 29 different pesticides in the average American’s body. “It’s not realistic to expect we wouldn’t have any pesticides in our bodies in this day and age, but that would be the ideal,” says Crupain. “We just don’t know enough about the health effects.”
If you want to minimize your pesticide exposure, see the chart below. We’ve placed fruits and vegetables into five risk categories—from very low to very high. (Download our full scientific report, “From Crop to Table.”) In many cases there’s a conventional item with a pesticide risk as low as organic. Below, you’ll find our experts’ answers to the most pressing questions about how pesticides affect health and the environment. Together, this information will help you make the best choices for you and your family.
Originally posted on HealthCetera - CHMP's Blog:
The repeated public examples of subtle and blatant racism demonstrate the importance of conversations about the role of racism in the health and well-being of individuals, families and communities. As part of Healthstyles’ ongoing series on health disparities, co-producers Kenya Beard, EdD, NP-C, and Diana Mason, PhD, RN, FAAN, talks about these issues with Willie Tolliver, PhD, MSW, professor in the School of Social Work at Hunter College and three of his social work students: Jason Cartwright, James Gilliam, and Kim Wolfe. Their authentic and candid discussions about the deaths of Eric Gardner and Michael Brown include their own experiences with racism and how it plays out in the lives of all of us.
So tune in on Thursday, March 19, 2015, to Healthstyles on WBAI, 99.5 FM in New York City (www.wbai.org) or click here to listen anytime:
HealthCetera is sponsored by the Center for Health, Media…
View original 10 more words
From the 12 March 2015 news release at Medical Xpress
Microbes in the human body are estimated to outnumber human cells by 10 to 1, yet research on how they affect health is still in its infancy. A perspective article published by Cell Press on March 12th in Trends in Biotechnology presents evidence that gut microbes produce gases that may contribute to gastrointestinal diseases and could be used as biomarkers for one’s state of health. As means to measure these potential biomarkers, the authors suggest two novel gas-sensing systems, one of which is an electronic gas sensor in the form of a pill you can swallow. These systems may offer a reliable and economical way to understand the impact of intestinal gases on human health, paving the way for the development of new diagnostic techniques and therapies.
BioNews is an online British magazine that covers genetics, assisted conception, and stem cell research. Founded in 1999 with a grant from the Baroness Mary Warnock, the site offers a mix of news and commentary on both scientific advancements and the political, legal, ethical, and social issues that arise with these advancements. Recent articles have unpacked Europe’s approval of stem cell marketing, highlighted some bad journalism on egg donors, and explored the possible medical applications of graphene. In addition to the excellent news coverage, the site offers a large glossary of terms related to genetics, assisted conception, and stem cell research. Few free, web-based magazines can compete with BioNews when it comes to coverage of biotech and related topics. [CNH]
From The Scout Report, Copyright Internet Scout 1994-2015. https://www.scout.wisc.edu
[Report] Raising Minimum Wage Good for Public Health, Not Just Wallets: Advocates Call for Federal Increas
Raising Minimum Wage Good for Public Health, Not Just Wallets: Advocates Call for Federal Increase
For a growing chorus of public health practitioners, raising the minimum wage is a fundamental step in addressing two key determinants of health: income and poverty.
CDC has released the updated Community Health Status Indicators (CHSI) online tool that produces public health profiles for all 3,143 counties in the United States. Each profile includes key indicators of health outcomes, which describes the population health status of a county and factors that have the potential to influence health outcomes, such as health care access and quality, health behaviors, social factors, and the physical environment.
Each profile includes key indicators of health outcomes, which describes the population health status of a county and factors that have the potential to influence health outcomes, such as health care access and quality, health behaviors, social factors, and the physical environment.
The re-designed online application includes updated peer county groups, health status indicators, a summary comparison page, and U.S. Census tract data and indicators for sub-populations (age groups, sex, and race/ethnicity) to identify potential health disparities. In this new version of CHSI, all indicators are benchmarked against those of peer counties, the median of all U.S. counties, and Healthy People 2020 targets. Organizations conducting community health assessments can use CHSI data to:
- Assess community health status and identify disparities;
- Promote a shared understanding of the wide range of factors that can influence health; and
- Mobilize multi-sector partnerships to work together to improve population health.
From the 10 March 2015 EurekAlert!
Massive health program: $34 billion spent on women and children since 2010; New goal: End preventable deaths of women and young children
An ambitious 2010 initiative to improve the health of women and children around the world has turned into the fastest growing global public health partnership in history, attracting $60 billion in resources. Some $34 billion, nearly 60 percent of the total, has already been disbursed.
The Every Woman Every Child movement has now gathered more than 400 commitments by more than 300 partners around the world, ranging from governments and foundations to business, civil society and low-income countries themselves.
The movement stems from the Global Strategy for Women’s and Children’s Health, launched by United Nations Secretary-General Ban Ki-moon in 2010 to accelerate progress towards the Millennium Development Goals (MDGs) for health.
Every Woman Every Child has set off a major wave in attention to improving essential health care for millions of poor women and children. Major gains in the past five years include greater professional maternity care, family planning, prenatal and postnatal care, childhood vaccinations, oral rehydration therapy and improving access to drugs to prevent mother-to-child transmission of HIV.
The result of such increased care is that maternal and child death rates have fallen in every one of the Global Strategy’s 49-targeted countries in the latest four years.
“The synergy between education and health is evident. Education and health are, quite simply, the drivers of change and development. Education empowers women and girls to live healthier lives and as a result, fewer children are dying. The evidence is clear, better education leads to better health outcomes.
“One of the most important lessons we have learned through the Millennium Development Goals is that to make progress we need an integrated and multifaceted approach,” says Kathy Calvin, president of the UN Foundation. “Effective partnerships are not just about financing; they also tap into partner expertise, innovation, and resources to deliver results. Every Woman Every Child has shown that when each sector contributes its unique strengths and capacities, we can save lives.”
Keys to progress
Significant improvements in key health indicators mainly in 49-targeted countries during its five-year history of Every Women Every Child include:
- 870,000 new health care workers.
- 193 percent increase in prevention of mother-to-child HIV treatment.
- 49 percent increase in oral rehydration therapy for treating infant diarrhea.
- 44 percent increase in exclusive breastfeeding.
- 25 percent rise in post-natal care for women.
- 25 percent rise in skilled birth attendance.
Voices in people’s heads are far more varied and complex than previously thought, according to new research by Durham and Stanford universities, published in The Lancet Psychiatry today.
One of the largest and most detailed studies to date on the experience of auditory hallucinations, commonly referred to as voice hearing, found that the majority of voice-hearers hear multiple voices with distinct character-like qualities, with many also experiencing physical effects on their bodies.
The study also confirmed that both people with and without psychiatric diagnoses hear voices.
The findings question some of the current assumptions about the nature of hearing voices and suggest there is a greater variation in the way voices are experienced than is typically recognised.
The researchers say this variation means different types of therapies could be needed for voice-hearers, such as tailored Cognitive Behavioural Therapy (CBT) geared towards distinct voice sub-types or patterns of voice hearing.
Current common approaches to help with voices include medication, CBT, voice dialogue techniques and other forms of therapy and self-help.
Auditory hallucinations are a common feature of many psychiatric disorders, such as psychosis, schizophrenia and bipolar disorder, but are also experienced by people without psychiatric conditions. It is estimated that between five and 15 per cent of adults will experience auditory hallucinations during their lifetimes.
This is one of the first studies to shed light on the nature of voice-hearing both inside and outside schizophrenia, across many different mental health diagnoses.