Health and Medical News and Resources

General interest items edited by Janice Flahiff

[News article] Ohio study tracks air pollution from fracking

From the 13 May 2015 Summit County Citizen Voice

Fracked nation.

Findings confirm health risks to people living near oil and gas wells

Staff Report

FRISCO — Careful air sampling near active natural gas wells in Carroll County, Ohio showed the widespread presence of toxic air pollution at higher levels than the Environmental Protection Agency considers safe for lifetime exposure, according to scientists from Oregon State University and the University of Cincinnati.

The study reinforces the need for more extensive air quality monitoring in fracking zones around the country, where exposure to the poisonous emissions are likely to lead to increased risk of cancer and respiratory ailments.

“Air pollution from fracking operations may pose an under-recognized health hazard to people living near them,” said the study’s coauthor Kim Anderson, an environmental chemist with OSU’s College of Agricultural Sciences.

Anderson and her colleagues collected air samples during a three-week period last February in a highly fracked area, with more than one active well site per square mile. The study was spurred by local residents who wanted to know more about possible health risks.

The air samplers were placed  on the properties of 23 volunteers living or working at sites ranging from right next to a gas well to a little more than three miles away. The samples were sent to Anderson’s lab at OSU, where the analysis showed  high levels of PAHs across the study area. Levels were highest closest to the wells and decreased by about 30 percent with distance.

Even the lowest levels — detected on sites more than a mile away from a well — were higher than previous researchers had found in downtown Chicago and near a Belgian oil refinery. They were about 10 times higher than in a rural Michigan area with no natural gas wells.

The scientists said they were able to differentiate between pollution coming directly from the earth and from other sources like wood smoke or auto exhausts, supporting the conclusion that the gas wells were contributing to the higher PAH levels.

The researchers then used a standard calculation to determine the additional cancer risk posed by airborne contaminants over a range of scenarios. For the worst-case scenario (exposure 24 hours a day over 25 years), they found that a person anywhere in the study area would be exposed at a risk level exceeding the threshold of what the EPA deems acceptable.

The highest-risk areas were those nearest the wells, Anderson said. Areas more than a mile away posed about 30 percent less risk.

Anderson cautioned that these numbers are worst-case estimates and can’t predict the risk to any particular individual.

“Actual risk would depend heavily on exposure time, exposure frequency and proximity to a natural gas well,” she said.

“We made these calculations to put our findings in context with other, similar risk assessments and to compare the levels we found with the EPA’s acceptable risk level.”

The study has other caveats, Anderson said, the main one being the small number of non-random samples used. In addition, findings aren’t necessarily applicable to other gas-producing areas, because PAH emissions are influenced by extraction techniques and by underlying geology.

The study, which appears in the journal Environmental Science & Technology‘s online edition, is part of a larger project co-led by the University of Cincinnati’s Erin Haynes, OSU’s Anderson, her graduate student Blair Paulik and Laurel Kincl, director of OSU’s Environmental Health Science Center.

 

May 20, 2015 Posted by | Public Health | , , , , , | Leave a comment

[Reblog] Hospitals find ways to navigate homeless into shelters

From the 17 May 2015 post by Susan Abram

Patient dumping, or when a hospital discharges a homeless patient to Skid Row or onto the street, has become rare, but still does occur. With so many homeless people who require medical care, hospitals in Los Angeles and across the nation are trying to find ways to help the homeless recuperate after being discharged. There are programs in Los Angeles, but they still are few and far between. Jonathan Lopez, who is a former homeless navigator, has helped many.  Many more like him are needed. From my story (Daily News, October, 2013): 

May 20, 2015 Posted by | health care | , , , , | Leave a comment

“Electronic cigarette flavourings alter lung function at the cellular level” – AMERICAN THORACIC SOCIETY

May 20, 2015 Posted by | Uncategorized | Leave a comment

[Magazine article] 80% of Sunscreens Don’t Really Work or Have ‘Worrisome’ Ingredients: Report

From the 19 May 2015 Time Magazine article

The Environmental Working Group (EWG) released its 2015 sunscreen guide on Tuesday, which reviewed more than 1,700 SPF products like sunscreens, lip balms and moisturizers. The researchers discovered that 80% of the products offer “inferior sun protection or contain worrisome ingredients like oxybenzone and vitamin A,” they say. Oxybenzone is a chemical that can disrupt the hormone system, and some evidence suggests—though not definitively—that adding vitamin A to the skin could heighten sun sensitivity.

The report points to Neutrogena as the brand most at fault for promising sun protection without delivering. The EWG says that Neutrogena claims its baby sunscreens provide “special protection from the sun and irritating chemicals” and is labeled “hypoallergenic,” but it contains a preservative called methylisothiazolinone that has been deemed unsafe for use in leave-on products by the European Commission’s Scientific Committee on Consumer Safety. The company also boasts of high SPF levels like SPF 70 or SPF 100+, even though the U.S. Food and Drug Administration (FDA) says there’s only notable protection up to SPF 50, the report adds. Neutrogena did not respond to requests for comment by publication time.

In the new report, EWG also provides a Hall of Shame of products that don’t deliver on their sun protection promises, as well as a database for users to search how protective their particular sun products are—and find one that works.

To stay protected this summer, the researchers suggest, use sunscreens with broad spectrum SPF of 15 or higher, limit time in the sun, wear clothing to cover exposed skin and re-slather your sunscreen every couple hours.

 

May 20, 2015 Posted by | Consumer Health | , , , , | Leave a comment

‘Non-Profit IDNs’: Where’s Da Beef?

By Gregg A. Masters, MPH

I have followed this narrative for quite some time albeit inside the industry contained debate of whether so-called ‘non-profit’ [501(c)3] hospitals or their parent systems (really more aptly characterized as “tax exempt”) actually earn this financial advantage via material ‘returns’ to the communities they serve.

NASI_Goldsmith studyAs can be expected you have the party line of the American Hospital Association (AHA) a trade group of predominantly non-profit members vs. that of it’s for-profit brethren The Federation of American Hospitals (FAH). You can guess which side of the argument each of them favor.

Now thanks to a recently published landmark study ‘Integrated Delivery Networks: In Search of Benefits and Market Effects’ by Healthcare Futurist Jeff Goldsmith, PhD et al, of the 501(c)3 cast of characters in the related but more often than not distinctly different ‘IDN culture’ we extend that line of inquiry into what has been a somewhat conversational ‘safe…

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May 20, 2015 Posted by | Uncategorized | Leave a comment

US Government Admits Americans Have Been Overdosed On Fluoride

I’ve come across similar articles. Perhaps fluoridation is OK, but one size fits all (public water supplies) is not the best route. Individuals vary in their needs for (added) fluoride.

May 20, 2015 Posted by | Uncategorized | Leave a comment

Design and Best Use of mHealth Apps

How to Choose A Better Health App [http://www.kevinmd.com/blog/2011/08/choose-health-app.html}(by LEXANDER V. PROKHOROV, MD, PHD at KevinMD.com on August 8, 2011) contains advice in the following areas
Set realistic expectations
Avoid apps that promise too much
Research the developers
Choose apps that use techniques you’ve heard of
See what other users say
Test apps before committing

—-
I’ve collected a guide to health/medical apps at https://sites.google.com/site/healthnewsresources/home/health-apps

DolleCommunications Blog

Chosing the right mHealth App can be confusing. Chosing the right mHealth App can be confusing.

Chosing the right mHealth app can be confusing. Today, we see an array of health & mHealth mobile apps designed for consumers. But are you using them correctly, or are you wasting your precious time and money?

Whether it be for monitoring of exercise, fitness, or weight loss, or for more serious conditions like diabetes, sleep disorders, or shunt malfunction in hydrocephalus, consumers and developers would be wise to better understand how health and mHealth apps can benefit one’s health. The biggest problem I see is how health and mHealth apps are categorized, which then determines how they will be used. So I have written up a few suggestions to better help consumers and developers in selecting their mHealth apps. I have grouped health and mHealth apps into three (3) categories.

mHealth Technology, are we there yet? mHealth Technology, are we there yet?

First, a little info about me. I am an early designer and pioneer of a 1997 neuromonitoring app, the DiaCeph Test, intended to run as a dedicated PDA…

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May 20, 2015 Posted by | Uncategorized | Leave a comment

Different Chronic Illnesses Demand Different Connected Health Strategies

The cHealth Blog

One possibility is that when I write about chronic illness, I am largely focusing on those conditions that are silent in nature (e.g., hypertension, diabetes, high cholesterol, obesity). We made a decision some years ago to build the case for connected health around the management of these illnesses because:

  1. They are costly. By some estimates these chronic diseases account for 70% of U.S. health care costs.
  2. They have a significant lifestyle component. This backdrop seems an ideal canvas for connected health interventions because they involve motivational psychology, self-tracking and engagement with health messages. These chronic illnesses pose a unique challenge in that the lifestyle choices that accelerate them are for the most part pleasurable (another piece of cheese cake? spending Sunday afternoon on the couch watching football, smoking more cigarettes and drinking more beer.) In contrast, the reward for healthy behavior is abstract and distant (a few more minutes of…

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May 20, 2015 Posted by | Uncategorized | Leave a comment

[Reblog] THE BATTLE OF INTERPRETING RESEARCH RESULTS TO SPECIFIC AUDIENCES

From the 28 April 2015 post at Nordic EBM

Klingons3

Evidence-based medicine has been called “cookbook medicine” by some of its more vocal critics. This implies that evil faceless organisations like Cochrane aim to turn all healthcare workers into mindless automatons who blindly follow dictums derived solely from scientific evidence. I hope it doesn’t surprise many in that this has never been the aim of Cochrane, or EBM in general, nor will it ever be. EBM, or EBP if you prefer the term ‘practice’ rather than the more vague ‘medicine’, is a belief system that rests on three pillars (cf. five in Islam). The EBM pillars are: 1) best available scientific evidence (i.e. the purview of Cochrane and yours truly), 2) clinical experience and 3) patient preferences and values. So, the main gist is that evidence doesn’t matter – no matter how scientific – if we don’t have a clinician at hand to interpret it for the benefit of a particular patient equipped with a particular set of values. For example, in a situation where two very similar patients have the same condition, one might wish to achieve speedy return to work whereas the other might rather avoid pain at all cost. The clinician would then use his or her judgment to identify the best course of treatment for both based on experience and what us science types have to offer. However, let us now leave the two pillars of clinical experience and patient preferences to be explored in future posts so that we can chew the first a bit more.

Now, the evidence bit in EBM is often understood to mean results of systematic reviews(a fancy type of research). Inasmuch as they offer an abstracted truth devoid of context (see my earlier post on mathematical ghosts) they still need to be interpreted for use in particular circumstances. This doesn’t always have to be done for every single patient by every single clinician separately. Think of the usefulness of reinventing the wheel for every drive. Often the thinking behind the interpretation and application of evidence can be written down and made use of by many. On a population level this means drafting guidelines. However, it is important to note that when scientific evidence is freely available one does not need to wait for formal committees to grow their beards long enough to formulate official guidelines. Especially when even supposedly professional guideline developers can do a really poor job (see previous post by Margot Joosen). In fact, all informed people and communities should participate in making sense of and advocating for the use of research to back up health decisions. In the end it affects the quality of care they receive.

May 20, 2015 Posted by | health care | , , , , , , | Leave a comment

[Reblog] A 5-star rating system for nursing homes and the unintended consequences on health care disparities

From the 8 May 2015 post at Science Health

Information about the quality and performance of health care facilities can be confusing to consumers. Dozens of government organizations, trade groups and websites rate doctors, hospitals and long-term care facilities on all kinds of scales, from patient satisfaction to medical outcomes.

In 2008, the Centers for Medicare and Medicaid Services (CMS) attempted to simplify some of this data by creating a five-star rating system for nursing homes. The idea was that public reporting would drive improvement in care, helping nursing home residents and their families choose higher quality facilities, in turn encouraging nursing homes to improve quality to retain residents.

This data can be of limited use, however, for people whose decisions are constrained by insurance networks, cost and geography. People who are enrolled in both Medicare and Medicaid, often called “dual eligibles,” are particularly limited in their choices for long-term care. They are much more likely to have lower incomes, disabilities or cognitive impairment, and to receive low-quality health care in poor neighborhoods than other Medicare beneficiaries.

A new study in the May issue of Health Affairs by public health researchers from the University of Chicago, Harvard, and Penn confirms that despite best intentions, the new rating system exacerbated health disparities between this dual eligible group and non-dual eligible nursing home residents, i.e. those with better financial support. By 2010, two years after the system began, both groups lived in higher quality nursing homes overall, but non-dual eligible residents were more likely to actively choose a higher-rated nursing home. The gap between the two groups also increased: dual eligibles were still more likely to live in a one-star home, and less likely than non-dual eligibles to live in a top-rated home.

May 20, 2015 Posted by | health care | , , , , , , | Leave a comment

Foods You Can Count on for Health

FOOD, FACTS and FADS

LOVE THIS SLIDESHOW – GREAT PICTURES AND GOOD INFORMATION!

CLICK HERE

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May 20, 2015 Posted by | Uncategorized | Leave a comment

[News article] The microbiome and the midnight snack: How gut microbes influence the body’s clock

From the 13 May 2015 Science Life article

LeoneCHMgraphicalabstract

Poor sleep has long been linked with changes to the metabolism. Disruption of the body’s internal clock can lead to changes in appetite and cravings for unhealthy food, which in turn leads to more serious health problems like obesity, diabetes and heart disease.

New research from the University of Chicago highlights a third component to that cycle: the millions of microbes that live in the intestines. These organisms respond to the same environmental cues as their host organism; their activity and metabolism is intertwined with the sleep/wake cycles and feeding schedules of the animal.

May 20, 2015 Posted by | Nutrition | , , , , | Leave a comment

[Reblog] Illnesses, injuries linked to medical devices a ripe area for investigation #ahcj15

From the 14 May 2015 post by the Association of Health Care Journalists

Most medical devices marketed in the United States do not need formal approval from the U.S. Food and Drug Administration.

Members of a panel at Health Journalism 2015 on medical device coverage provided a variety of advice for reporters covering and of the implants, instruments and diagnostic tools common to the modern medical machine.

Moderator of the session was Chad Terhune, aLos Angeles Times reporter who recently found himself chasing an outbreak of carbapenem-resistant enterobacteriaceae (CRE) linked to dirty duodenoscopes. Contributing to the discussion were panelists USA Today investigative reporterPeter Eisler and Scott Lucas, associate director of accident and forensic investigation at the ECRI Institute.

A recent CRE outbreak at Ronald Reagan UCLA Medical Center illustrates the broader issues of medical device approval and oversight. The Olympus scopes used at the Los Angeles hospital, and at other facilities around the nation where the superbug infected patients, did not require any formal study or approval from the FDA before hitting the market because they were considered “substantially equivalent” to a previous models. Equivalency, Eisler explained, allows thousands of devices to move from labs to patients with little more than a short 510K statement that the manufacturer files with the FDA.

Only 10 percent of devices, such as those which “sustain or support life, are implanted, or present potential unreasonable risk of illness or injury” fall into the FDA’s “premarket approval’” category requiring a greater level of regulatory scrutiny, including safety and effectiveness studies, before sale.

Things are not much better once devices hit the market.

It is important to understand that medical devices seldom stand alone, he said. They are usually part of much broader systems used to deliver care safely to patients. When a patient dies after a ventilator fails, for example, it may be that alarms, communications networks or staffing protocols designed to quickly detect and report the failure did not work.

Thus, if reporters want to understand what went wrong in a specific incident, they should ask about more than the device itself. “The system approach to an investigation is key to finding the answer,” Lucas said.

Also be aware that hospitals are supposed to have detailed plans that tell employees what to do when there is a problem with a device. Sequestering machines that malfunction, and downloading data from them before it is purged, are examples of best-practice steps that reporters can ask about.

Handling the pitch

So what should a reporter do when he or she receives a glowing pitch from a local hospital about the latest device?

Terhune suggests starting with Medicare’s open payments database to see if the doctors involved have a financial interest in the device that’s being pitched. While a financial interest is not necessarily a deal breaker for coverage, it is something reporters should know about going in and make sure they can adequately address in their coverage.

Next, look at whatever FDA approval process was required for the device

..,

May 20, 2015 Posted by | health care | , | Leave a comment

[Reblog] Debunking myths designed to hinder price, quality transparency efforts

From the 18 May 2015 post from the Association of Health Care Journalists

When writing about transparency in health care prices and quality, journalists should expose the myths that health care providers promote. That’s the advice Francois de Brantes gave during a session on price and quality transparency at Health Journalism 2015 last month.


Providers promote the false ideas that gathering accurate price and quality data is difficult, if not impossible, and that variations in price result from the severity of illness in populations, de Brantes explained. By debunking these myths, journalists would inform policymakers and the public that there are ways to calculate the prices of medical episodes of care accurately, and that price variation can be controlled. “Price varies because of the way physicians practice,” he said.

Among those myths:

  • Price is a trade secret
  • Disclosing prices would impede the ability of health plans, hospitals and physicians to compete effectively
  • Revealing prices enables collusion and thus violates antitrust law
  • Publishing prices leads to higher health care costs.

Both Quincy and Suzanne Delbanco (@SuzanneDelbanco), executive director of the Catalyst for Payment Reform, made the point that price and quality transparency are similar in that both seem simple but are in fact extremely complex topics to cover. Most consumers, for example, are unaware of such quality measures as hospital infection rates and the CAHPS Hospital Survey from the federal Agency for Healthcare Research and Quality, Quincy said.

 

 

May 20, 2015 Posted by | health care | , , , , , | Leave a comment

   

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