Supreme Court to Hear Health Care Case in Late March

Public Health--Research & Library News

From the New York Times, news that the Supreme Court has scheduled 3 days to hear arguments on this case.  On March 26, the court will hear arguments on whether a federal law (Anti-Injunction Act) makes challenges to the mandate premature until 2015.  On March 27, the court will hear arguments on whether Congress exceeded its constitutional authority in requiring people to buy insurance or pay a penalty.  On March 28, the court will hear arguments on whether the provision requiring people to buy insurance may be severed from the balance of the statute, and on whether Congress was entitled to expand the scope of Medicaid.

View original post

The Academy of Nutrition and Dietetics advocates for expanded nutritional coverage under Medicare

Evidence on cost savings and health benefits of nutritional intervention published in the Journal of the Academy of Nutrition and Dietetics

From the 11 December 2011 Eureka news alert

Philadelphia, PA — The Academy of Nutrition and Dietetics has prepared a request to submit to the Centers for Medicare and Medicaid Services (CMS) to expand coverage of medical nutrition therapy (MNT) for specific diseases, including hypertension, obesity, and cancer, as part of the CMS National Coverage Determination (NCD) Process. Most chronic health conditions can be controlled or treated with medical nutrition therapy, yet Medicare will only reimburse nutrition therapy services provided by a registered dietitian for individuals with diabetes and renal disease. “That’s just not enough if we want to improve the health of the nation and rein in escalating healthcare costs,” says Marsha Schofield, MS, RD, LD, the Academy’s Director of Nutrition Services Coverage.

Read the entire news article

The article is “The Academy of Nutrition and Dietetics National Coverage Determination Formal Request [Full Text of the article],” by Prashanthi Rao Raman, Esq, MPH, and Erica Gradwell, MS, RD, in the Journal of the Academy of Nutrition and Dietetics, Volume 112, Issue 1 (January 2012) published by Elsevier.

In an accompanying podcast Ms. Schofield, Ms. Blankenship, and Ms. Gradwell discuss the NCD process undertaken by the Academy and share insights about its potential impact on healthcare and the role of the registered dietitian. The podcast is available at  http://andjrnl.org/content/podcast.

Related articles

• The Academy of Nutrition and Dietetics advocates for expanded nutritional coverage under Medicare (medicalxpress.com)
• The Academy of Nutrition and Dietetics advocates for expanded nutritional coverage under Medicare (eurekalert.org)
• A Dietitian Reflects on the Recent Nutrition Conference (fooducate.com)
• The ADA Needs to Change More than just its Name (fooducate.com)
• Medicare Offers Medical Nutrition Therapy (mayorshealthline.wordpress.com)

Holiday Reunion With Elderly May Include ER Visit

 

Image via Wikipedia

From the 19 December 2011 Medical News Today article

…….Here are DeSilva’s five tips on how to tell if a senior relative needs immediate medical attention:

The person is unkempt with poor personal hygiene.

The home is very messy, dirty and has a foul odor.

Minimal movement by the person appears to be painful.

Mentally, the person is agitated or confused.

The person has not seen a physician in several months and is visibly unwell.

“Try to contact the primary-care physician first and alert them to the situation,” DeSilva said. But if holiday schedules or lack of information prevent that, bring them to the closest Emergency Department.

In the Emergency Department, you can expect the following:….

Study Reveals Health-Literate Patients Not Always Adept At Managing Heart Failure Care

Image via Wikipedia

A patient’s education level is not a fail-safe predictor of how well they will manage symptoms related to complicated chronic diseases, such as heart failure, according to a Purdue University study.

“Our research indicates that some of the better-educated heart failure patients in our sample did not manage their symptoms as well as those who were less educated,” said Karen S. Yehle, an assistant professor of nursing who specializes in cardiovascular conditions. “We’re not sure why this is. It could be that heart failure patients with lower health literacy experience symptoms more often and, therefore, know how to manage them better. No matter the reason, it’s a reminder to doctors, nurses and pharmacists to communicate clearly and thoroughly to all patients, regardless of how much information or guidance they might believe a particular patient needs.” …

…

“Overall, we found that health literacy – a patient’s ability to read and understand health information – was associated with proper daily care and management for heart failure patients,” Chen said. “But there was a statistically significant negative relationship with self-care management, or when patients respond to heart failure symptoms. When patients with higher health literacy did not have symptoms, they were better at adhering to the day-to-day care of the condition in comparison to those with lower health literacy. However, when symptomatic, they appeared to have more difficulty in addressing the condition-related problems.” ..

“It’s critical that providers have better insight into how to communicate with their patients or follow up with them about their self-care,” Plake said. “From a practitioner viewpoint, you can’t assume that the information delivered to a patient is interpreted the way you want it to be. We can’t make the assumption that if someone is highly educated they are more likely to take better care of themselves.”

Related articles

• Heart failure study: Health-literate patients not always adept at managing care (eurekalert.org)

Increasing Condom Use, Reducing Sexually Transmitted Infections Through Behavioral Interventions

From the 19 December 2011 Medical News Today article

Behavioral interventions aimed at reducing sexual risk behaviors, such as unprotected sex, are effective at both promoting condom use and reducing sexually transmitted infections (STIs) long after the initial intervention, according to a new report in the Journal of Acquired Immune Deficiency Syndromes. …

…Researchers found that behavioral interventions – which included HIV education, motivation and skills-based training aimed at negotiating safer sex behaviors – were successful at improving condom use and reducing incident STIs, including HIV, for up to four years. This meta-analysis is believed to be the first to examine the incidence of HIV in a wide range of at-risk populations.

Scott-Sheldon says that while it may seem intuitive that behavioral changes, such as increased condom use, will result in fewer STIs, previous studies have been unable to support that assertion.

“The association between behavioral and biological outcomes is complex, since transmission of STIs depends on a number of factors, including partner type, characteristics, and perceptions of partner safety,” she says. “Examining both outcomes, and factors associated with sexual risk behaviors, should be important in determining the efficacy of behavioral interventions.” …

Read the entire news article here

Related articles

• Behavioral interventions can increase condom use, reduce sexually transmitted infections (medicalxpress.com)
• Behavioral interventions can increase condom use, reduce sexually transmitted infections (eurekalert.org)
• Unsafe Sex More Likely After Drinking, Study Confirms (livescience.com)
• Average man has 9 sexual partners in lifetime, women have 4 (telegraph.co.uk)
• Protecting adolescent girls from unwanted unprotected sex (scienceblog.com)
• The Custom-Sized Condoms Are Now Legally Available [Sex] (gizmodo.com)
• 1 in 4 girls have sex under age (suncda-w8.wpng.newsint.co.uk)

A Bandage That Spurs, Guides Blood Vessel Growth

From the 19 December 2011 Medical News Today article

Researchers have developed a bandage that stimulates and directs blood vessel growth on the surface of a wound. The bandage, called a “microvascular stamp,” contains living cells that deliver growth factors to damaged tissues in a defined pattern. After a week, the pattern of the stamp “is written in blood vessels,” the researchers report.
A paper describing the new approach will appear as the January 2012 cover article of the journal Advanced Materials.

“Any kind of tissue you want to rebuild, including bone, muscle or skin, is highly vascularized,” said University of Illinois chemical and biomolecular engineering professor Hyunjoon Kong, a co-principal investigator on the study with electrical and computer engineering professor Rashid Bashir. “But one of the big challenges in recreating vascular networks is how we can control the growth and spacing of new blood vessels.”

“The ability to pattern functional blood vessels at this scale in living tissue has not been demonstrated before,” Bashir said. “We can now write features in blood vessels.”

Other laboratories have embedded growth factors in materials applied to wounds in an effort to direct blood vessel growth. The new approach is the first to incorporate live cells in a stamp. These cells release growth factors in a more sustained, targeted manner than other methods, Kong said. …

 

Related articles

• Team designs a bandage that spurs, guides blood vessel growth (eurekalert.org)
• Team designs a bandage that spurs, guides blood vessel growth (physorg.com)
• Hydrogel helps grow new scar-free skin over third degree burns (gizmag.com)

Most Chimpanzee Research No Longer Necessary

[On a somewhat related note…

About three years ago I created an Online Library Guide entitled Animal Research Alternatives to aid researchers at the university where I worked as a reference librarian.  Specifically it aimed to “To support research scientists in searching the literature in order to comply with the Animal Welfare Act (7USC 2131-2156)”

The guide includes overviews on laws & regulations, how to plan before searching the biomedical literature, and a database selection guide.

The process of creating the guide was challenging, but very enjoyable.]

From the 18 December 2011 article at AllGov by Noel Brinkerhoff

(photo: io9.com)

A panel of experts commissioned by the National Institutes of Health (NIH) has concluded that most of the research involving chimpanzees is not necessary. According to the most recent count, there are 937 chimpanzees being used for research in the United States, including 612 for projects funded by the U.S. government. They are most commonly used for hepatitis-related research.

On December 15, the NIH suspended new grants for research that uses chimps.

The NIH asked researchers to examine the many ways chimps are utilized in medical and social experiments to determine the value of this work. The panel decided that “while the chimpanzee has been a valuable animal model in past research, most current use of chimpanzees for biomedical research is unnecessary.”

However, the study stopped short of recommending that chimps never be used by scientists.

They said there is rationale for using the primates in research on: monoclonal antibody therapies; comparative genomics; and non-invasive studies of social and behavioral factors that affect the development, prevention, or treatment of disease.

Guidelines also were offered for justifying the use of chimps, these being:

·       That the knowledge gained must be necessary to advance the public’s health;

·       There must be no other research model by which the knowledge could be obtained, and the research cannot be ethically performed on human subjects; and

The animals used in the proposed research must be maintained either in ethologically appropriate physical and social environments (i.e., as would occur in their natural environment) or in natural habitats.

In April, Sen. Maria Cantwell (D-Washington) introduced the Great Ape Protection and Cost Savings Act of 2011, which would prohibit invasive research on chimpanzees.

Related articles

• Most Biomedical Research Chimps Can Retire, Panel Finds (organicauthority.com)
• Fewer animal experiments thanks to nanosensors (Eureka alert)
• NIH to Limit Use of Chimps in Research (artofthestem.com)
• Experiments With Chimps (andrewsullivan.thedailybeast.com)
• U.S. report recommends stringent limits on use of chimpanzees in biomedical, behavioural research (thehindu.com)
• Chimpanzee Research on Way Out (bigthink.com)
• Research Chimpanzees Offered Hope (theage.com.au)
• First Guidelines for Lab Chimps Drawn Up (livescience.com)
• NIH Curtails Chimpanzee Research in Wake of IOM Report (news.sciencemag.org)
• Chimpanzees in Biomedical and Behavioral Research: Assessing the Necessity (bespacific.com)

Report On Human Subjects Protection Released By President’s Bioethics Commission

From the 19 December 2011 Medical News Today article

The Presidential Commission for the Study of Bioethical Issues has issued its report concerning federally-sponsored research involving human volunteers, concluding that current rules and regulations provide adequate safeguards to mitigate risk. In its report, “Moral Science: Protecting Participants in Human Subjects Research,” the Commission also recommended 14 changes to current practices to better protect research subjects, and called on the federal government to improve its tracking of research programs supported with taxpayer dollars. …

….

Key Findings:

In the report’s central finding, the Commission found that the “U.S. system provides substantial protections for the health, rights, and welfare of research subjects.”

In assessing the current regulations that protect human subjects, the Commission learned that there is no central source with information about the overall size, scope, and cost of the government’s research involving human subjects. [Flahiff’s emphasis]The Commission requested information from 18 individual agencies that conduct most federal human subjects research, but discovered that many federal offices could not provide basic data about the research they support.[Flahiff ‘s emphasis]…

…

Recommendations:

The Commission recommended several areas where improvements could be made to current rules and procedures. “Immediate changes can be made to increase accountability and thereby reduce the likelihood of harm or unethical treatment,” Gutmann said.

The Commission recommends that each federal department or agency supporting research with human subjects maintain a core set of data for their research programs that includes the title and lead investigator of each project, the location of each study, and the amount appropriated for the research. Each office should aid the public in learning more about the government’s research efforts by developing or improving publicly available electronic systems or releasing information through a government-wide system. To support these efforts, the Commission suggested that the Office for Human Research Protections or another office should administer a central web-based portal that links to each individual department or agency system. In addition, the government should consider developing a unified federal research database, which may ultimately be more cost-effective and efficient. ….

 

Related Resources

• The full text of the report may be found here
• Press release of the report may be found here

Related articles

• Report: Moral Science – Protecting Participants in Human Subjects Research (bespacific.com)
• President’s Bioethics Commission releases report on human subjects protection (medicalxpress.com)
• President’s Bioethics Commission releases report on human subjects protection (eurekalert.org)
• U.S. panel finds gaps in bioethics protections (thehindu.com)
• US panel urges protection of humans in research (vanguardngr.com)
• Panel Calls for Closer Tracking of U.S.-Funded Human Research, Proposes Compensation Fund (news.sciencemag.org)
• Obama goes troubleshooting on clinical trials (simondenegri.com)
• Bioethics Panel Urges Stronger Protections for Human Subjects (scientificamerican.com)