Health and Medical News and Resources

General interest items edited by Janice Flahiff

EPA Releases Updated Health Indicators Database [reblog]

From the 23 July 2015 ResearchBuzz post

Screen Shot 2015-07-28 at 8.37.04 AM

 

The Environmental Protection Agency (EPA) has released updated environmental and public health indicators and made them available in an online database. “This is an online update to EPA’s Report on the Environment. Users can explore 85 individual indicators– on our air, water, land, human exposure, health and ecological condition– using interactive graphs, tables, and maps, and download the data for each indicator.”

July 28, 2015 Posted by | environmental health, Public Health | , , | Leave a comment

Florida’s Penchant For Eating Armadillos Has Triggered A Leprosy Outbreak [Reblog]

My Peace Corps Liberia site (1980/81) was 10 miles away from a “leper colony” at a Methodist Mission.
Most of the residents were men with their families. Many made a living wood carving. How they did that with many of their finger extremities was incredible.  Bought quite a few carvings before I left, 2 or 3 commissioned.  Was never afraid of getting leprosy, was told during our Peace Corps training it took 17 years or so of very close contact.

Woodcarver (with leprosy) with finished carving

 

madonna  Madonna – commissioned for about $25, (“market rate”)

3carvings

Women with baby pounding rice (dehulling); hair pic (yiddi-fa); Madonna

From the 23 July 2015  UPPROX post  

shutterstock_83394460

If you’re a nerd like me, you’re fully aware that only two animals can contract leprosy: Armadillos and humans. This is an excellent reason to stay away from armadillos, but Floridians apparently never got that memo.

Why, you might ask, are Floridians handling armadillos? Well, you know the old joke about how armadillos exist to give Texans something to eat on the half-shell?Nobody explained that was a joke to Florida’s population. We’re not kidding: Shooting and eating armadillos is, for some reason, common enough in Florida tobecome a public health problem.

Just to underline how bizarre and dumb this is, leprosy is incredibly hard to get. Ninety-five percent of humanity is naturally immune to it, thanks to dormant versions of the virus being effectively everywhere, and you can only get it through prolonged contact with somebody who has it. Even then, it’s an exceptionally slow virus; you can have it for decades before you show any symptoms. Similarly, armadillos are very shy and hard to trap, so it’s not like they’re up in our business.

The good news is that leprosy is currently very treatable with multi-drug therapy techniques. Now, the shame of gunning down an ugly-cute animal and eating it, there’s no treatment for that except shame. Work on exporting shame to Florida is ongoing, and we hope to have the first treatments soon.

 

Read the entire post here

July 28, 2015 Posted by | Health News Items | , , , , , , , | Leave a comment

6 Things Every Woman Should Know About Yeast Infections [Reblog]

From the 25 July 2015 Time blog by Jennifer So

The symptoms can mimic other problems

One study found that as few as 11% of women who have never had a yeast infection could identify the symptoms, while other research has found that only one-third of women who thought they had a yeast infection actually did. Why the confusion?

The signs are similar to other down-there problems. If you have a yeast infection, you might notice burning, itching, pain during sex, and a thick white odorless discharge.

But if it smells fishy, it may instead be bacterial vaginosis (BV), and if you have only burning and pain during urination, that suggests a urinary tract infection. Bottom line: It can be difficult to figure out.

First-timer? Go to the doctor if you think you have one

 

Read the entire post here

July 28, 2015 Posted by | Consumer Health, Health News Items | , , | Leave a comment

Public Health 24/7 or Using Twitter to Advance Public Health

Innovations in Health Communications

Smartphones changed the way we connect with the world: most U.S. smartphone owners check their phone at least hourly.

Essentially we are staying in constant touch with each other through our handheld devices. According to recent Gallup report, 72 percent of the respondents claim to check their smartphone at least once an hour, most of them several times. Young Americans are the most frequent smartphone checkers. 22 percent of 18- to 29-year-olds peek at their phone every few minutes and another 51 percent check it a few times an hour.1 Could it be due to socializing on Twitter, a powerful networking service with more than 500 million active users who generate more than 58 million tweets and 2.1 billion search queries every day?2

I think that Twitter’s concept: access to information in real time on a global scale is an important way for public health professionals to improve…

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July 28, 2015 Posted by | Uncategorized | Leave a comment

5 Challenges Facing Medicaid At 50 [Reblog]

From the 27 July 2015 Kaiser Health News blog item

A “sleeper” provision when Congress created Medicare in 1965 to cover health care for seniors, Medicaid now provides coverage to nearly 1 in 4 Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes.

Enrollment has soared to more than 70 million people since 2014 when the Affordable Care Act began providing billions to states that chose to expand eligibility to low-income adults under age 65. Previously, the program mainly covered children, pregnant women and the disabled.

Unlike Medicare, which is mostly funded by the federal government (with beneficiaries paying some costs), Medicaid is a state-federal hybrid. States share in the cost, and within broad federal parameters, have flexibility to set benefits and eligibility rules.

Though it provides a vital safety net, Medicaid faces five big challenges to providing good care and control costs into the future:

President Lyndon B. Johnson signed the bill creating Medicare and Medicaid at the library of former President Harry Truman, who was in attendance, on July 30, 1965. (Photo courtesy of Truman Library)

July 28, 2015 Posted by | health care | , | Leave a comment

Are interventions to reduce sitting at workplace effective? [reblog]

From the 28 July 2015  post at al_gores_officeDR. SOUMYADEEP B

It is common for family physicians in developing nations like India to encounter patients whose profession demands sedentary lifestyle. Such patients present with back problems, obesity, cardiovascular diseases and diabetes and ask doctors for advice on how to decrease sitting. Workplaces need to address this issue by inculcating strategies to decrease sitting and improve health of their employees. Occupational physicians too need to suggest evidence-based strategies to employers. This article provides an evidence based summary about what interventions are actually effective for decreasing sitting at workplace.

Read the full Evidence Summary , published at Journal of Family Medicine and Primary Care here. (Open Access)

July 28, 2015 Posted by | Workplace Health | , , , , | Leave a comment

Large urban hospitals disadvantaged by medicare/medicaid patient satisfaction rating system [News release]

Large urban hospitals disadvantaged by medicare/medicaid patient satisfaction rating system.

From the 25 May 2015 Mt. Sinai news release

The largest urban health systems do worse on government patient satisfaction scores than smaller, non-urban hospitals according to a new study by Mount Sinai researchers published this month in the Journal of Hospital Medicine.

NEW YORK

 – May 19, 2015 /Press Release/  –– 

The largest urban health systems, which serve as safety nets for large patient populations with lower socioeconomic status and greater likelihood to speak English as a second language, do worse on government patient satisfaction scores than smaller, non-urban hospitals likely to serve white customers with higher education levels, according to a new study by Mount Sinai researchers published this month in the Journal of Hospital Medicine.

Patient satisfaction scores, in part due to the Affordable Care Act of 2010, are a key part of the formula that determines reimbursements levels to hospitals by the Centers for Medicare and Medicaid Services (CMS). The ACA has encouraged hospitals to evolve from a fee-for-service model to one based on measures of value, including patient satisfaction. Hospitals are rewarded or penalized based on metrics that assess quality and efficiency of care in part culled from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.

The study authors suggest that the current formulas need adjustment to be fair to large, urban hospitals, and offer a formula to achieve this equity.

“Our analysis found that the lowest satisfaction scores were obtained from population-dense regions of Washington, DC; New York State, California, Maryland and New Jersey, and the best scores were from Louisiana, South Dakota, Iowa, Maine and Vermont,” said senior author Randall Holcombe, MD, Professor, Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, and Chief Medical Officer for Cancer for The Mount Sinai Health System.

Across the country, large hospital size and non-English as a primary language predicted poor patient satisfaction scores while white race and higher education level predicted better scores,” said co-author Daniel McFarland, DO, Clinical Fellow, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai. “Other demographic factors were also important but these four were the most significant.”

“This study points out that the interpretation of patient satisfaction scores can be very complex,” said Sandra Myerson, MBA, MS, BNS, RN, Senior Vice President and Chief Patient Experience Officer of the Mount Sinai Health System. “It is important to understand these trends in order to provide the highest quality of patient experience.”

July 28, 2015 Posted by | health care | , , , | Leave a comment

Unemployment and Depression Among Emerging Adults in 12 States, Behavioral Risk Factor Surveillance System, 2010 [Report]

Unemployment and Depression Among Emerging Adults in 12 States, Behavioral Risk Factor Surveillance System,*** 2010 | Full Text Reports….

Introduction
The high rate of unemployment among emerging adults (aged 18 to 25 years) is a public health concern. The risk of depression is higher among the unemployed than among the employed, but little is known about the relationship between unemployment and mental health among emerging adults. This secondary data analysis assessed the relationship between unemployment and depression among emerging adults.

Methods
Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed.

Results
Almost 12% of emerging adults were depressed (PHQ-8 ≥10) and about 23% were unemployed. Significantly more unemployed than employed emerging adults were classified with depression. In the final model, the odds of depression were about 3 times higher for unemployed than employed emerging adults.

Conclusion
The relationship between unemployment and depression is significant among emerging adults. With high rates of unemployment for this age group, this population may benefit from employment- and mental-health–focused interventions.

***

BRFSS logo imageThe Behavioral Risk Factor Surveillance System (BRFSS) is the nation’s premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. Established in 1984 with 15 states, BRFSS now collects data in all 50 states as well as the District of Columbia and three U.S. territories. BRFSS completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world.

By collecting behavioral health risk data at the state and local level, BRFSS has become a powerful tool for targeting and building health promotion activities. As a result, BRFSS users have increasingly demanded more data and asked for more questions on the survey.

July 28, 2015 Posted by | Health Statistics, Psychology | , , | Leave a comment

Complex signaling between blood and stem cells controls regeneration in fly gut

Complex signaling between blood and stem cells controls regeneration in fly gut.

 

Buck Institute scientists say impaired interactions between macrophages and stem cells are likely players in human intestinal maladies like IBS, leaky gut and colorectal cancers 

May 25, 2015/NOVATO, CA:  Having a healthy gut may well depend on maintaining a complex signaling dance between immune cells and the stem cells that line the intestine. Scientists at the Buck Institute are now reporting significant new insight into how these complex interactions control intestinal regeneration after a bacterial infection. It’s a dance that ensures repair after a challenge, but that also goes awry in aging fruit flies — the work thus offers important new clues into the potential causes of age-related human maladies, such as irritable bowel syndrome, leaky gut and colorectal cancer.

“We’ve dissected a very complex signaling interaction,” said senior scientist and Buck faculty Heinrich Jasper, PhD. “By doing so temporally we’ve clearly established a role for the immune system both in initiating the regenerative process and in shutting it down – activities that are essential for maintaining tissue homeostasis.”

Publishing in the May 25, advance online edition of Nature Cell Biology, researchers in the Jasper lab show that the macrophage-like hemocytes (which comprise the cellular immune system in flies) go to the intestines ofDrosophila following damage. The hemocytes secrete the growth factor Dpp (a homologue of BMP, which has many functions, including the control of mobility, differentiation and invasiveness of normal cells), setting off the regenerative process by activating specific receptors in stem cells. In a fascinating twist, stem cells switch their response to Dpp in the middle of the regenerative response by turning on other Dpp-related receptors, which in turn instruct the stem cells to go back to a quiescent or quiet state.  Jasper says it’s a balancing act that both allows for healing and prevents excessive cell proliferation, which could lead to pre-cancerous dysplasia. “The temporal sequence of cell interactions during injury-induced regeneration is only beginning to be understood,” said Jasper. “The proper timing of these interactions may be key in maintaining a healthy gut.”

Jasper says aging makes it harder for the stem cells to switch gears between proliferation and quiescence and that flies suffer from age-related intestinal dysfunctions similar to those experienced by humans.

July 28, 2015 Posted by | Medical and Health Research News | , , , , , , , , , , , , , | Leave a comment

How the brain makes decisions [news release]

How the brain makes decisions.
From the 25 May 2015 MedicalExpress news release

 

Some types of decision-making have proven to be very difficult to simulate, limiting progress in the development of computer models of the brain. EPFL scientists have developed a new model of complex decision-making, and have validated it against humans and cutting-edge computer models, uncovering fascinating information about what influences our decision-making and ability to learn from it.

Decision-making comes in two major into two types: Markovian and non-Markovian, named after the mathematician Andrey Markov (1856-1922). Simply put, in Markovian decision-making, the next decision step depends entirely on the current state of affairs. For example, when playing backgammon, the next move depends only on the current layout of the board, and not on how it got to be like that. This relatively straightforward process has been extensively modeled in computers and machines.

Non-Markovian decision-making is more complex. Here, the next step is affected by other factors, such as external constraints and previous decisions. For example, a person’s goal might be to travel on the train. But what will happens when he arrives at the door to the train depends on whether or not he has previously visited the ticket booth to buy a ticket. In other words, the next step depends on how he got there; without a ticket, he cannot proceed to the desired goal. In neuroscience, the “buy-ticket” step is referred to as a “switch-state”.

Decision dynamics

The results of the study drew three major conclusions. First, that human decision-making can perform just as well as current sophisticated computer models under non-Markovian conditions, such as the presence of a switch-state. This is a significant finding in our current efforts to model the  and develop artificial intelligence systems.

Secondly, that delayed feedback significantly impairs human decision-making and learning, even though it does not impact the performance of computer models, which have perfect memory. In the second experiment, it took human participants ten times more attempts to correctly recall and assign arrows to icons. Feedback is a crucial element of decision-making and learning. We set a goal, make a decision about how to achieve it, act accordingly, and then find out whether or not our goal was met. In some cases, e.g. learning to ride a bike, feedback on every decision we make for balancing, pedaling, braking etc. is instant: either we stay up and going, or we fall down. But in many other cases, such as playing backgammon, feedback is significantly delayed; it can take a while to find out if each move has led us to victory or not.

Finally, the researchers found that the spiking neurons model matches and describes human performance very well. The significance of this cannot be overstated, as non-Markovian decision-making has proven to be very challenging for computer models. “This is a proof-of-concept study,” says Michael Herzog. “But the study makes an important contribution toward understanding, and accurately modeling, the human brain – and even surpassing its abilities with artificial intelligence.”

July 28, 2015 Posted by | Psychiatry, Psychology | | Leave a comment

A digital nightmare: When fitness bands become student-tracking devices [News release]

From the 25 May 2015 University of Queensland news release

A “nightmarish” vision of a future in which technology makes physical education more boring, judgmental and narrow is driving a new study by a University of Queensland academic.

Associate Professor Michael Gard from the School of Human Movement and Nutrition Sciences has begun a three-year research project on the digitisation of school health and physical education.

The project stems from the assumption that developments in digital technology present exciting educational opportunities but carry a new set of philosophical, educational and ethical questions and dilemmas.

“Will we leverage the power of digital technology to expand students’ minds and open up choices about how to live, or will we use it to monitor students’ behaviour and tell them how to live?” Dr Gard said.

“For example, much of the health-related technology that we are seeing involves asking children to count the calories they consume or expend when they are exercising. Is this this what we want students to be doing at school?

“There is a lot of money to be made from digitising school health and physical education and, make no mistake, companies are already vigorously marketing all kinds of health and fitness technologies to schools.

“Then you have the whole ‘big data’ concern about how your child’s records are used.”

 

“Then think of a perfect storm, where performance pay for health and physical education teachers is linked to children losing weight, and you introduce some very tricky ethical situations. Once again, some American states are moving in this direction.”

The study will also investigate how schools use digital technology to measure students, such as their BMI (body mass index), and what becomes of the data once collected.

July 28, 2015 Posted by | Health News Items | , , , , , , , | Leave a comment

Beware of hype about how consumers will benefit when health insurers merge [Reblog]

From the 27 July 2015 blog of the Association of Healthcare Journalists

GraphicStock

GraphicStock

 

Earlier this month, Thomas Greaney explained the antitrust issuescomprehensively in Health Affairs. “Because each market is local, antitrust analysis would also require an assessment of the competitive overlap in each region,” he wrote. Greaney, is the Chester A. Myers Professor of Law and director of the Center for Health Law Studies at Saint Louis University School of Law.

There is no evidence that insurance or provider monopolies are good for consumers, he wrote, citing Boston and Pittsburgh as evidence that big is not necessarily better in health care or health insurance.

For a good review of the regulatory hurdles insurers face, see this thorough analysisi*** in The New York Times by Robert Cyran. Regulators are concerned about how reduced competition may drive up prices, he explained, writing, “Insurance markets are highly concentrated, and big mergers will make them even more so.”

***Excerpt from The New York Times article
“What’s more, the argument that a big merger would create competition for an even heftier rival has already failed in other industries. In 2011, for example, Sprint, the third-largest cellphone service provider at the time, defended its plan to buy T-Mobile US, the fourth-largest, as necessary to keep its rivals Verizon and AT&T in check. The Federal Communications Commission and the Justice Department rejected the contention, making clear that shrinking the market to fewer than two nationwide carriers would harm consumers.”

So what might persuade the regulators?

The Affordable Care Act could be the answer. President Obama’s health care overhaul creates online exchanges for buying coverage, allowing insurers to expand into new markets without hiring expensive agents. The companies will still need the approval of state commissioners, but the lower barriers to entry should stir more competition – and, at least in the future, appease regulatory fears. It’s unclear whether that would be enough to counterbalance concerns over the top five insurers’ currently chunky market shares.”

July 28, 2015 Posted by | health care | , , , | Leave a comment

   

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