Health and Medical News and Resources

General interest items edited by Janice Flahiff

Carol McCall Thinks Big Data Can Change Healthcare

From the 15 February post at Pixels and Spills

Does it all really boil down to numbers?

Carol McCall, Chief Strategy Officer at GNS Healthcare shared some sobering figures during her Keynote at the Health & Wellness Hub for Social Media Week this past Monday. Among the data points she mentioned were:

– 8000 people age in to Medicare every day

– if unchanged, healthcare costs and interest on the national debt will take up all US revenue by 2025

– a recent NEW ENGLAND JOURNAL OF MEDICINE study revealed that among determinants of health, only 10% was accounted for by actual healthcare practices ((behavior and genetics accounted for over 70%)

With figures like that, most people would want to get as far away from hard data as possible. But McCall argues that the key to big data is interpretation and with the right communications, these types of figures can be powerful drivers for change. She argues that we need to create new roles for ourselves and one of these should be a role for the pursuit of health (as opposed to traditional nomenclature/roles like “patient”).  She also believes that social media can be a critical accelerator for defining these new roles….

 

February 20, 2012 Posted by | health care | , | Leave a comment

Michael Graves Wants to Redesign the Patient Experience (Low Tech Redesigns)

From the 16 February Pixels and Spills post

One of the most compelling sessions of this week’s Health and Wellness program at Social Media Week was Michael Graves’ fascinating (and at times very moving) talk on redesigning everything from hospital rooms to wheelchairs. At the core of Graves’ presentation was the need to embrace the patient perspective and bring empathy in to the design process. Sound advice for both digital and analog designers.

A world renowned architect and designer (there a fair chance you have on of his Target products in your kitchen) GRaves was paralyzed about a decade ago. Since then, he’s devoted a large part of his practice to redesigning health devices and technology to better serve the needs of their users. As Graves points out, very few designers ever think that they may end up in a wheelchair or suffering from a debilitating condition but if they embrace this perspective they can create vastly more effective products….

Graves used the example of his own home, where he replaced a curb designed to hold back water from a shower stall with a simple drain, immediately rendering the stall accessible for himself and other non-ambulatory users. He tried to share this knowledge with one of his employees who was designing a hotel for a client but only succeeded in getting partial buy in from the designer. Clearly, empathy is something not easily taught…

You can view Graves’ entire presentation here

February 20, 2012 Posted by | Consumer Safety | , , | Leave a comment

Cranky today? Even mild dehydration can alter our moods

From the 17 February 2012 Eureka Alert

Most people only think about drinking water when they are thirsty; but by then it may already be too late.

Even mild dehydration can alter a person’s mood, energy level, and ability to think clearly, according to two studies recently conducted at the University of Connecticut’s Human Performance Laboratory.

The tests showed that it didn’t matter if a person had just walked for 40 minutes on a treadmill or was sitting at rest – the adverse effects from mild dehydration were the same. Mild dehydration is defined as an approximately 1.5 percent loss in normal water volume in the body.

The test results affirm the importance of staying properly hydrated at all times and not just during exercise, extreme heat, or exertion, says Lawrence E. Armstrong, one of the studies’ lead scientists and a professor of physiology in UConn’s Department of Kinesiology in the Neag School of Education….

n the tests involving the young women, mild dehydration caused headaches, fatigue, and difficulty concentrating, according to one of the studies, which appears in the February issue of The Journal of Nutrition. The female subjects also perceived tasks as more difficult when slightly dehydrated, although there was no substantive reduction in their cognitive abilities.

In the tests involving the young men, mild dehydration caused some difficulty with mental tasks, particularly in the areas of vigilance and working memory, according to the results of the second UConn study. While the young men also experienced fatigue, tension, and anxiety when mildly dehydrated, adverse changes in mood and symptoms were “substantially greater in females than in males, both at rest and during exercise,” according to the study. The men’s study was published in the British Journal of Nutrition in November 2011.

“Even mild dehydration that can occur during the course of our ordinary daily activities can degrade how we are feeling – especially for women, who appear to be more susceptible to the adverse effects of low levels of dehydration than men,” says Harris Lieberman, one of the studies’ co-authors and a research psychologist with the Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine in Natick, Mass. “In both sexes these adverse mood changes may limit the motivation required to engage in even moderate aerobic exercise. Mild dehydration may also interfere with other daily activities, even when there is no physical demand component present.”

Why women and men are so adversely affected by mild dehydration is unclear, and more research is necessary. But other research has shown that neurons in the brain detect dehydration and may signal other parts of the brain regulating mood when dehydration occurs. This process could be part of an ancient warning system protecting humans from more dire consequences, and alerting them to the need for water to survive.

In order to stay properly hydrated, experts like Armstrong recommend that individuals drink eight, 8-ounce glasses of water a day, which is approximately equivalent to about 2 liters of water. People can check their hydration status by monitoring the color of their urine. Urine should be a very pale yellow in individuals who are properly hydrated. Urine that is dark yellow or tan in color indicates greater dehydration. Proper hydration is particularly important for high-risk groups, such as the elderly, people with diabetes, and children….

February 20, 2012 Posted by | Consumer Health | | Leave a comment

European scientists call for greater integrity, openness, clarity and public engagement

From the 18 February Eureka News Alert

European-based speakers representing the fields of nuclear energy, genetically modified organisms, and harm reduction science in tobacco made the plea on 18 February at the Annual Meeting of the American Association for the Advancement of Science held in Vancouver, Canada. The panelists, each with pertinent experience of real-life scientific support to policy-making, offered first-hand advice on best practices and pitfalls when architecting science policy on both sides of the Atlantic. The 18 February symposium, titled “Exploding Myths on Reactor Security, Harm Reduction, and Genetically Modified Organisms,” featured a call for greater integrity, openness, clarity and public engagement on difficult to communicate issues of global significance. A key message was that science and policy do have a crucial relationship. But scientists should not think that they are policy-makers. Equally, science must remain independent. ‘Bad science’ and spin must be challenged more. Science coming out of industry must be trusted more. The symposium was moderated by the Irish Chief Scientific Advisor and Champion of EuroScience Open Forum 2012, Professor Patrick Cunningham….

Irish Chief Scientific Adviser, Professor Patrick Cunningham, in summing up, said that: “In policy decisions, important factors beyond the reach of science are often involved: fear, hype, ignorance, profit, resentment, economic and political advantage. And science does not always have clear answers. However, science and scientists have a special claim to be heard, provided they are committed to:

 

  • Integrity: to uphold the inherent honesty of scientific enquiry and debate
  • Openness: to keep the lab door open, and making clear any special interests
  • Clarity: to speak in terms the public can understand
  • Engagement: to demonstrate that we take our duty to society seriously.”

 

He added: “At the same time, policymakers should encourage scientists to speak out even when their research or assessment may be unpopular. Scientists should learn to stand up, shout up and when necessary, shut up. The voice of the rational middle ground should be louder.”

February 20, 2012 Posted by | Medical and Health Research News | , , | Leave a comment

Common Flame Retardant Linked to Social, Behavioral and Learning Deficits

From the 16 February 2012 article at Science Daily

Mice genetically engineered to be susceptible to autism-like behaviors that were exposed to a common flame retardant were less fertile and their offspring were smaller, less sociable and demonstrated marked deficits in learning and long-term memory when compared with the offspring of normal unexposed mice, a study by researchers at UC Davis has found. The researchers said the study is the first to link genetics and epigenetics with exposure to a flame retardant chemical….

 

February 20, 2012 Posted by | Consumer Health, environmental health | , , | Leave a comment

Even Without Combat, Military Service Changes Personality, Makes Vets Less Agreeable

From the 20 February Medical News Today article

“Military recruits are a little less warm and friendly to begin with and the military experience seems to reinforce this – as after service, men score even lower on agreeableness when compared to individuals who did not go into the military,” Jackson says. “Interestingly, this influence appears to linger long after the soldier has re-entered the workforce or returned to college.”
Jackson points out that being less agreeable is not always a negative human trait. While it may make it more challenging to maintain positive relationships with friends and romantic partners, it can be seen as a positive influence on career success.

“On the flip side,” he says, “people with lower levels of agreeableness are often more likely to fight their way up the corporate ladder and to make the sometimes unpopular decisions that can be necessary for business success.”

 

February 20, 2012 Posted by | Psychology, Workplace Health | , , | Leave a comment

Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace

From the 19 February Full Text Report summary

Background
Stigma and discrimination present an important barrier to finding and keeping work for individuals with a mental health problem. This paper reviews evidence on: 1) employment-related disclosure beliefs and behaviours of people with a mental health problem; 2) factors associated with the disclosure of a mental health problem in the employment setting; 3) whether employers are less likely to hire applicants who disclose a mental health problem; and 4) factors influencing employers’ hiring beliefs and behaviours towards job applicants with a mental health problem….

February 20, 2012 Posted by | Workplace Health | , , , | Leave a comment

Can an App a Day Keep the Doctor Away? (2010 closing interactive panel of the National Conference on Health Communication, Marketing, and Media)

This 68 minute video touches on aspects of digital health and wellness in its broadest sense.
(The actual discussions start around the 10 minute mark after introductions, overviews, etc)

Panelists

Jay Bernhardt, PhD

MPH (Moderator)

James Andrews;

“e-Patient Dave” deBronkart

Bradford W. Hesse, PhD

Dana Lewis

This discussion of  application and use of computers, information, and communication technology to all aspects of health includes

  • Health promotion and prevention, disease prevention
  • Healthcare and self-care and disease management
  • The systems which underlie all this work
  • e-health, m-health, ihealth

Discussion questions…

  •  Are we in a health care technology revolution or evolution? (with themes as patient empowerment, health care organization & structures)
    Are tools as email
  • Are patients empowered? Do they know they can ask questions and do they? And will this cause health institutions to adapt to empowered patients?
  • How is social media enabling advocacy? (as Twitter)
  • 39  billion is predicted to be spent on digital health, how will this affect the digital health revolution/evolution?
  • How can the current information centered paradigm (for accounting and billing systems) be reconciled with the evolving patient centered paradigm (for empowerment)
  • Search engine optimization in health, is it possible? relationship to social media as Facebook
  • Twitter and Facebook searches beginning to outnumber search engines, what does this mean for health?
  • “Infomercials” by panelists
    • Trust in physicians is rising because (not in spite of) internet.. physicians are explaining Web-based material patients are bringing in
      HINTS – Health Information National Trends Survey (an open source survey from the US National Cancer Institute)
      call for items from 2010-2014
    • Patient Protection and Affordable Care Act is changing what is being done in health care because prevention is a focus of this law. This act is driving the use of technologies so people can be better informed about their health and make better decisions.
      Informatics for Consumer Health ” focuses on a coordination of health information, technology, and health care delivery that empowers providers to manage care and increases the ability of consumers to gain mastery over their own health. This may be accomplished by promoting the use of information technology and communication between health care providers and their patients to share vital medical information across clinical settings in timely and reliable ways, and utilize electronic tools to achieve these objectives.”
    • Everywhere – a company which helps clients manage social media, build social media content and communities, and  integrate a social media campaign into an existing communications strategy.
      • Participation is the new marketing because the audience, target populations are creating content and are  more empowered; transparency and authenticity are now hallmarks of organizations
      • UStream to create a television station (Jane Fonda conference had 26,000 people around the world exercising at the same time)
      • [at 44:05] Five Tips on Building Community (Using Social Media)
        • Be humble (you’re a participant, not an owner
        •  Learn to use the new telephone
        • Less selling and more engaging
        • Not what you say but what they say that counts
        •  Be interesting (don’t be afraid to take chances with the new social media)
    • Social Media and Health Care is happening everywhere, HIPPA does not hamper this
      • Surgery videos can raise awareness thru included commentaries on prevention, treatment options, etc
      • hashtags in Twitter are useful for conversing, getting questions answered, sharing, crowdsourcing as #hscm
    • e-Patient Dave
      • patients are the most underutilized resource in our healthcare system
      • patient community as treatment option source
      • white paper 62 minutes
      • lethal lag time of 2-5 years
      • AHRQ..what kinds of appt, questions to ask

February 20, 2012 Posted by | health care | , , , | Leave a comment

Study quantitatively evaluates factors underlying Medicare decisions on medical technology

From the 6 February posting at the CEA Registry blog

Our new study, recently published online in Medical Care (“Factors Predicting Medicare National Coverage: An Empirical Analysis” (1)), highlights factors underlying Medicare decisions on medical technology.

Interventions considered to be particularly controversial or expected to significantly impact the Medicare program in the United States are considered in National Coverage Determinations (NCDs).  Medicare coverage for interventions is limited to eligible items and services deemed “reasonable and necessary” for the diagnosis or treatment of an illness or injury.  What constitutes reasonable and necessary has not, however, been clearly defined.

This study is the first of its kind to quantitatively evaluate the factors associated with positive NCDs…

…Key findings include:
•    CMS favors proven interventions. Compared to interventions with clinical evidence deemed “insufficient”, interventions with good or fair quality supporting evidence were approximately six times more likely to receive a positive decision (p<0.01).
•    Interventions with available alternatives are less likely to be covered. Compared with interventions with no available alternative, those for which an alternative was available were approximately eight times less likely to receive a positive decision (p<0.01).
•    CMS accounts for value in coverage decisions. Compared with technologies estimated to be dominant, i.e., more effective and less costly than the competing intervention considered, those with no published estimate of cost-effectiveness were approximately five times less likely to receive a positive coverage decision (p<0.05).
•    Coverage decisions have become more restrictive over time. Compared with coverage decisions made in the years 1999 to 2001, decisions made from 2002 to 2003 were more than three times less likely to be positive (p<0.05).  Decisions made from 2004 to 2005 were also more than three times less likely to be positive (p<0.1), and from 2006 to 2007 decisions were almost ten times less likely to be positive (p<0.01).

This analysis can help the medical community better understand the type of evidence that Medicare considers in NCDs.  CMS and other payers may also benefit from this kind of external review of coverage decisions as it can help ensure the consistency of decisions and the integrity and accountability of the coverage process.

 

February 20, 2012 Posted by | health care | , , , | Leave a comment

   

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