The literature is clear – when life goes wrong, health goes wrong. Case in point – it’s now estimated that workplace stress alone is causing additional expenditures of between $125 to $190 billion a year – representing 5 to 8 percent of national spending on health care…and even more importantly – 120,000 deaths a year.
There are growing examples of individuals and organizations that get this stuff – and that are fielding solutions to help. Companies like Health Leads (meeting us on the lowest rung of Maslow’s Hierarchy and getting us access to heat, water, safety…), and Iora Health (meeting us squarely where we are and getting us support for our caregiver stress, our divorce, our substance issue…). I recently got to be part of the latest Robert Wood Johnson Foundation’s Pioneering Ideas Podcast (link below) and in the process learned how broadly this idea is spreading…Dr. Paul Tang of linkAges from Palo Alto Medical Foundation(a project RWJF supports) talks about stress, and its effects – especially on seniors – and what we can do about it. Harvard economist/MacArthur Genius Grant winner Sendhil Mullainathan shares ideas for transforming health and healthcare in a world where ‘attentional real estate’ – given the messy realities of life – is scarce. We double dog dare you to listen here:
As an industry with a mantra to heal, this is ground zero. We need to expand our definition of health to include life – and take this on not just as our obligation, but as our opportunity to address the fundamental drivers of health. And let’s not stop there. Let’s practice radical empathy with each other, and with ourselves. Let’s do it in the privacy of our homes, and let’s bring that raw authenticity with us to our work. Whatever you do to start acknowledging that health is life – start it now… maybe just by closing your eyes and inhaling a big fat breath of fresh air while reminding yourself, ‘I am not alone in this crazy world, because we all feel alone and on some level we are all crazy – but only in the very best of well-intentioned ways.’
[News article] Web-savvy older adults who regularly indulge in culture may better retain ‘health literacy’ — ScienceDaily
From the news article
Date:November 25, 2014Source:BMJ-British Medical JournalSummary:Older people who are active Internet users and who regularly indulge in a spot of culture may be better able to retain their health literacy, and therefore maintain good health, suggests research.…
There was a link between age and declining health literacy, and being non-white, having relatively low wealth, few educational qualifications, and difficulties carrying out routine activities of daily living.
Poorer memory and executive function scores at the start of the study were also linked to greater health literacy decline over the subsequent six years.
Around 40% of the entire sample said they never used the internet or email, while one in three (32%) said they did so regularly. Similar proportions said they had consistently engaged in civic (35%) and/or leisure (31%) activities over the six year follow-up period.
Almost four out of 10 (39%) said they had regularly engaged in cultural activities, such as going to the cinema, theatre, galleries, concerts or the opera, during this time.
Across all time points, internet use and engagement in civic, leisure, or cultural activities were lower among those whose health literacy declined.
After taking account of influential factors, only the links between regular internet use and engaging in cultural activities remained statistically significant.
But each factor appeared to exert an additive effect, and a combination of all four seemed to afford the best protection against health literacy decline, a finding that was independent of any tailing off in cognitive function.
This is an observational study so no definitive conclusions can be drawn about cause and effect.
[Reblog] Health Care for Dummies (and Innovators): In search of a practical definition of health | The Health Care Blog
From the 25 November 2014 post
(Don’t hold your breath, I really have no idea when it will be done. I can only work on it for about an hour every weekday.)
In reflecting on the health innovation conferences and conversations in which I’ve participated these past few years, I found myself musing over the following two questions:
1. What is health?
2. What does it mean to help someone with their health?
After all, whether you are a clinician, a health care expert, or a digital health entrepreneur, helping people with their health is the core mission. So one would think we’d be clear on what we’re talking about, when we use terms like health and health care.
But in fact, it’s not at all obvious. In practical parlance, we bandy around the terms health and health care as we refer to a wide array of things.
Actually defining health has, of course, been addressed by experts and committees. The World Health Organization’s definition is succinct, but hasn’t been updated since 1948:
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
A more recent attempt to define health, described in this 2011 BMJ editorial, proposed health as “’the ability to adapt and self manage’ in the face of social, physical, and emotional challenges.”
This left me scratching my head a bit, since it sounded more like a definition of one’s resilience, or self-efficacy. Which intuitively seem much related to health (however we define it), but not quite the same thing.
I found myself itching for a definition of health that would help me frame what I perceive as the health – and life – challenges of my older patients.
Also, it seemed impossible to articulate how digital health tools might help us care for an aging population, if one didn’t start with a practical definition of health.
So after doing an hour of research in the literature (and finding endless scholarly rabbit holes), I ended up trying to sketch a model of health that felt true to my experiences.
In this post, I’d like to share what I came up with, and get your feedback. Then in a follow-up post, I’ll write about what this might mean for defining health care, and our efforts to improve or facilitate health care.
What is health?
Health is a dynamic state. For an individual, it involves three core components:
• How are you feeling? How do your body and mind feel? Are you experiencing any pain? Bothersome sensations? Mental distress? This component of health addresses the individual’s experience of suffering.
• How well are your body and mind outwardly working? Are your body and mind working as you expect them to, or need them to, or want them to? Can you get around physically as you usually do? Can you manage your thinking tasks? Can you see, hear, speak, and otherwise communicate effectively with others? This component addresses the individual’s ability to leverage body and mind in order to manage one’s usual activities and life tasks.
• How well are your body and mind internally working? This component relates to one’s inner physiology and function. When we peer inside, whether with modern technology, via the careful pulse auscultation used in some cultures, or any other method, is anything awry? Do we find signs of disease, disorder, or disruption? In Western medicine, we consider the workings of organs and cells, but other cultures have their own “inner workings” that they assess when evaluating health.
These three components are in constant interplay with each other. Right now I’ll refer to them your wellbeing, your macrofunction, and your microfunction. (But I’m not sure those are best terms.)
These three components of health are also in constant interplay with our social and physical environments, as well as with our nutrition and our “lifestyle choices.” For instance, rich social encounters and purposeful work improve wellbeing, as well as immune function and other aspects of our microfunction. Air pollution might make us cough, and can negatively impact our lung function, along with other less visible parts of our health.
Are these many external factors, and our behavior choices, synonymous with “your health”? I would call them influences on your health, or in certain cases “health care”, rather than your health itself. (And they aren’t diagrammed above, although I’d like to add them eventually.) These factors are incredibly important, but we confuse matters when we conflate things that influence health — such as access to clinicians, clean water, walkable cities — with the actual health of an individual.
Why does a person’s health matter?
Better health is an important end in of itself.
But to a large extent, health is a means to a more important end: that of living life.
In other words, being able to do the things we care about, need to do, and want to do. Being able to do things that give purpose, meaning, and pleasure to our lives. Being able to do the things that make us feel like our selves.
This is kind of obvious, but it’s actually fairly easy to lose sight of this when we get immersed in the weeds of health and health care. (Which is why the Unmentionables at Health 2.0 is so fantastic: it’s a much-needed reminder that health serves life.)
[Caveat: There is a lot of overlap between the life activities, but I haven’t yet figured out how to diagram this. Graphic design is not my forte.]
What is a health problem?
As a doctor, my job is to help people address their health problems. And I’d like for the digital health entrepreneurs to create tools that work better for this purpose.
So what is a health problem? How to define what people seem to need help with? How to define what digital health tools should help us – whether we are a patient, a clinician, or a family caregiver – address?
Here is a practical definition: a health problem is anything that is “wrong” with one or more of the three components of health above.
• Wellbeing Problems: Examples include being in pain, being fatigued, having insomnia, feeling depressed, feeling anxious, feeling short of breath, and so forth. Many symptoms, pains, discomforts, and any other forms of suffering fall into this category.
• Macrofunction Problems: These might include having difficulty walking due to arthritis, problems exercising due to shortness of breath, or problems thinking due to dementia. You could also include vision problems, hearing problems, and speech difficulties due to stroke. These issues often cause noticeable functional impairments.
• Microfunction Problems: These would include problems such as having impaired glucose metabolism, high blood pressure, osteoporosis, kidney disease, as well as early stage cancer.
You’ll notice that problems with wellbeing and macrofunction are primarily person-defined. It’s the affected person – sometimes known as “the patient” – who experiences suffering, or difficulties in how the body and mind are working. Whereas microfunction problems are generally “expert-defined”: nobody knows they have osteoporosis until clinicians tell them.
Many diagnoses, diseases, or health stressors will cause problems in all three parts of health. For example, cancer symptoms and the related functional impairments (e.g. problems doing anything you can usually do) are the consequence of the cancer cells running amok within.
Congestive heart failure might cause uncomfortable dyspnea, as well decreased exercise tolerance, such that a person has difficulty managing usual ambulation and activities.
Of course, there is a lot of room to argue about what constitutes “wrong” with a given health component. Cultural and social factors influence how people perceive their own suffering, or overt impairments. And we could quibble endlessly about what is ideal blood pressure, and how we might otherwise assess how right or wrong a person’s body and mind are internally working.
Still, in many cases, if most of agree that something seems “wrong” with a given component of health, this should provide us with a decent practical starting point for identifying health problems.
Do we need to distinguish between microfunction and macrofunction?
I believe we do. Problems with macrofunction are the things that people notice in themselves (or in others, when it comes to cognitive macrodysfunction). These are what patients are often most concerned about.
Macrofunction problems, along with forms of suffering, are also what directly impacts people’s ability to participate in life tasks, and their short-term quality of life.
So helping people correct, mitigate, or adapt to these types of functional impairments is incredibly powerful, if you want to address health problems in a way that makes people’s lives materially better. This is an approach that is common in geriatrics, palliative care, physical and occupational therapy, and behavioral therapy.
Microfunction, on the other hand, is what people need technical assistance to assess. (Historically that assistance have been clinicians, but we’re on the cusp of seeing advanced diagnostic tools in the hands of the public.)
Much of the work that we doctors do in modern medicine, especially in primary care, is address physiologic problems that are scarcely perceptible to the affected person: high blood pressure, high cholesterol, type 2 diabetes, kidney disease, asymptomatic atrial fibrillation.
We do this work because we are trying to prevent or delay more overt health problems, such as those associated with suffering and macrodysfunction. So it’s certainly worthwhile work. But it doesn’t always feel satisfying or worthwhile to patients, especially if they are pre-occupied by other problems which are causing suffering or overt functional impairments.
In fact, it seems to be fairly common that patients and clinicians are focused on different aspects of health. A typical example: a doctor might decide to unilaterally prioritize tinkering with the microfunction, such as by prescribing more statins, even though a patient’s most pressing concern is falls or pain.
[Please visit the related articles for the pros and cons of HealthTap.
Yes, HealthTap is free and staffed by physicians.
However, the answers are short and may not be tailored to your specific needs. Nothing can replace consulting with a health care provider at an office visit.
The Forbes article below concludes “you’re getting a few sentences of free medical advice from a group of random physicians, with reputations attested to by other random physicians, who are taking the time to answer your question for free either because of a desire to generate new business or a desire to help their Fellow Man.”
HealthTap seems to be a good tool. However it is only an information source, and not a substitute for personal care by one’s health care provider.]
“HealthTap is an Interactive Health Network dedicated to improving everyone’s health and well-being. We do this by providing free online and mobile answers from thousands of leading physicians to your health questions, and by personalizing health information for you. HealthTap helps people better understand their health, make the best decisions for themselves and their families, and find the best doctors. We also help physicians better serve their existing patients and find new ones, while demonstrating their expertise and helping people everywhere.”
From the 26 2011 blog post HEALTHTAP: A SOCIAL NETWORK WITH ALL THE (HEALTH) ANSWERS?
Health Tap puts medical minds at the fingertips of its users. By doing so, it indirectly tailors information to the user’s needs..I was recently sick with a viral infection and my first thought was to type in my symptoms online. According to Google keyword tool, I’m not the only one. For the word “treatment”, Google gets about 37 million searches each month. For each of the words “sick”, “fever” and “symptom” Google receives about 7 million searches per month. The consumer health market is clearly there to support a site like Health Tap.
Benefits for Consumers
If the initial internet search happens regardless, it is more convenient for individuals to get their information from real physicians than from general sites like Wikipedia or Yahoo Answers, the former being too exhaustive and the latter lacking consistent credibility. The breadth of information that is already available on trustworthy sites such as WebMD and Mayo Clinic **will remain there for those who want exhaustive information.
Benefit for Physicians
By using the site, doctors can help people beyond the scope of their practice. They can also manage their professional internet presence in a less time-consuming manner than they can in a full blog. All they have to do is list their affiliations, connect to other physicians, and answer questions thoughtfully….
Added Value to Health Care
Does HealthTap add value to the health care or the practice of medicine? No, at least not yet. It does, however, adds to the value of social media. Social networks have become a reflection of what is present in the general public consciousness. Health care deserves a spot in that collective consciousness. Social networks are also useful for facilitating communication. Health Tap could support doctor-patient communication, especially between PCPs and their patients. As far as improving the practice of medicine, Health Tap is not there yet. However, if it can gain mass adoption, leveraging its influence to improve the health care system could be incredible.
** For a short list of trustworthy sites, please see General Guides with links (at Health and Medical News/Resources) by yours truly
- Doctor Q&A site raises $11.5M; now it needs more patients (news.cnet.com)
- HealthTap Uncovers The Secret Knowledge Network Of Doctors, Online (fastcompany.com)
- Is HealthTap Your New (Virtual) MD? (forbes.com)
- What about HealthTap? (scienceroll.com)
- HealthTap’s Social Network of 5,000 Doctors Is Ready to Give Free Advice (tissuepathology.com)
- The Emperor’s New Social Network (thehealthcareblog.com)
How often do you read about a study that says a pet is good for your health? Most of us would say fairly often. Apparently, only those that demonstrate health benefits hit the headlines, while others that either have no evidence or reveal some unpleasant data are ignored, researcher Howard Herzog revealed in the August issue of Current Directions in Psychological Science. Professor Herzog, from Western Carolina University Psychology Department, says that prior studies on the impact pets might have on longevity and health have produced a mishmash of conflicting results…
Dr. Paul Farmer, Dr. Jim Kim and professor Michael Porter
Boston, Mass. (July 28, 2011) –Today, the Global Health Delivery Project and Harvard Business Publishing released 21 teaching case studies examining the principles of health care delivery in resource-poor settings. The multidisciplinary body of work spans 13 countries and addresses the complexity of delivering life-saving health care technologies and care. These 21 teaching case studies are available to global health educators, students and practitioners at no cost through Harvard Business Publishing. To access the case studies, visit: www.ghdonline.org/cases.
Dr. Paul Farmer, chair of the Department of Global Health and Social Medicine at Harvard Medical School, said, “The publication of these cases—online, and freely accessible to the practitioners, students and educators who will benefit most from them—is an important step toward closing the know-do gap in global health. Increasingly, our feedback loop of research, teaching and service is directly strengthening the care we deliver on the ground and our ability to replicate and scale successes.”……
From a Posting in Youth Health 2.o “Health Communications in Video” by Kishan on July 17, 2011
The purpose of using videos in reducing the rates of STIs, for example, is to increase “knowledge and perception of STI/HIV risk, promoting positive attitudes toward condom use” and more importantly “building self-efficacy and skills to facilitate partner treatment, safer sex, and the acquisition, negotiation and use of condoms”.
Findings from the study on the effectiveness of “Safe in the City”, show that video based interventions are simple at a “relatively low cost, likely acceptability and likelihood of healthier behaviours being adopted and sustained over time” (Warner 2008)….
It is a commonly held belief that the fitter you are, the healthier you are. Is this so? Most experts agree that a certain level of fitness is required for health. However, this leads to several questions: What level of fitness qualifies as healthy? Can you be detrimentally fit? What is the equation for optimal fitness with optimal health? Assuming that the range of fitness runs from total couch potatoes to ultra-marathoners, how is one to determine an answer?
A recent study by researchers at McLean Hospital in Belmond, MA, analyzed the blood of marathoners less than 24 after the race finish and found abnormally high levels of inflammatory and clotting factors similar to the ones known to appear in heart attack victims. Dr. Arthur Siegel, director of Internal Medicine, and the study director said, “My concern is for people who exercise thinking ‘more is better’ and that marathon running will provide ultimate protection against heart disease. In fact, it can set off a cascade of events that may transiently increase the risk for acute cardiac events.” …
…..”Fitness does not necessarily equate to health. Optimal health is a combination of many things-both mental and physical. When mental or emotional stress levels are high, intense physical training may actually add to the body’s stress load, ” say Dian Griesel, Ph.D. and Tom Griesel, authors of TurboCharged: Accelerate Your Fat Burning Metabolism, Get Lean Fast and Leave Diet and Exercise Rules in the Dust (BSH, 2011)….
….Walking may be the ideal exercise. “Walking interspersed with short 30-60 second bursts of running is exactly what we were designed to do and has a most beneficial effect on our heart and circulatory system. Anyone can do it. No special equipment or gym memberships are required,” recommends Dian Griesel, Ph.D. who wears a pedometer at all times to track her mileage.
The Griesel’s remind us that repetitious, monotonous, stressful activities are not requirements for fitness. Rather, they conclude “The search for fitness does not have to take over our lives to be effective. Mowing a lawn, housecleaning or a good game of tag or Frisbee with a group of others count as healthful ways to improve fitness. Maybe we all need to find ways to simply get active, instead of stressing ourselves with trying to run marathons.”
- Measuring Your Personal Fitness Level (everydayhealth.com)
- Can You Be Both Fat and Fit? (everydayhealth.com)
From the press release
The number of bloodstream infections in intensive care unit patients with central lines decreased by 58 percent in 2009 compared to 2001, according to a new CDC Vital Signs report. During these nine years, the decrease represented up to 27,000 lives saved and $1.8 billion in excess health care costs. Bloodstream infections in patients with central lines can be deadly, killing as many as 1 in 4 patients who gets one….
“Preventing bloodstream infections is not only possible, it should be expected. Meticulous insertion and care of the central line by all members of the clinical care team including doctors, nurses and others at the bedside is essential. The next step is to apply what we’ve learned from this to other health care settings and other health care-associated conditions, so that all patients are protected,” said Thomas R. Frieden, M.D., M.P.H., CDC director.
In addition to the ICU findings, the report found that about 60,000 bloodstream infections in patients with central lines occurred in non-ICU health care settings such as hospital wards and kidney dialysis clinics. About 23,000 of these occurred in non-ICU patients (2009) and about 37,000 infections occurred in dialysis clinics patients (2008).
“This reduction is the result of hospital, local, state and national medical and public health efforts focused on tracking infection rates and then using that information to tailor and evaluate prevention programs,” said Denise Cardo, M.D., director of CDC’s Division of Healthcare Quality Promotion. “The report findings point to a clear need for action beyond ICUs. Fortunately, we have a prevention model focused on full collaboration that can be applied broadly to maximize prevention efforts.”
Infections are one of the leading causes of hospitalization and death for hemodialysis patients. At any given time, about 350,000 people are receiving hemodialysis treatment for kidney failure. Seven in 10 patients who receive dialysis begin that treatment through a central line….
- Patient Safety Awareness Week 3: Positive News on Infections, More Work Needed (hcfama.org)
- Rates of Pneumonia Dramatically Reduced in Patients on Ventilators in Michigan Intensive Care Units (nlm.nih.gov)
- Challenges In Stemming The Spread Of Resistant Bacteria In Intensive Care
- Simple Cotton Swab Slashes Reduce Post-Op Infection (Medical News today, June 2011)
- Infection Risk Lurks in Hospital ICUs (webmd.com)
The U.S. Department of Health and Human Services today issued its new Strategic Framework on Multiple Chronic Conditions― an innovative private-public sector collaboration to coordinate responses to a growing challenge.
More than a quarter of all Americans ― and two out of three older Americans ― have multiple chronic conditions, and treatment for these individuals accounts for 66 percent of the country’s health care budget. These numbers are expected to rise as the number of older Americans increases.
The health care system is largely designed to treat one disease or condition at a time, but many Americans have more than one ― and often several ― chronic conditions. For example, just 9.3 percent of adults with diabetes have only diabetes, according to the Medical Expenditure Panel Survey from the Agency for Healthcare Research and Quality (AHRQ). And as the number of chronic conditions one has increases, so, too, do the risks of complications, including adverse drug events, unnecessary hospitalizations and confusion caused by conflicting medical advice.
The new strategic framework ― coordinated by HHS and involving input from agencies within the department and multiple private sector stakeholders ― expects to reduce the risks of complications and improve the overall health status of individuals with multiple chronic conditions by fostering change within the system; providing more information and better tools to help health professionals ― as well as patients ― learn how to better coordinate and manage care; and by facilitating research to improve oversight and care.
“Individuals with multiple chronic conditions deserve a system that works for them,” said Assistant Secretary for Health Howard K. Koh, MD, MPH. “This new framework provides an important roadmap to help us improve the health status of every American with chronic health conditions.”
The management of multiple chronic conditions has major cost implications for both the country and individuals. Increased spending on chronic diseases is a key factor driving the overall growth in spending in the Medicare program. And individuals with multiple chronic conditions also face increased out-of-pocket costs for their care, including higher costs for prescriptions and support services.
“Given the number of Medicare and Medicaid beneficiaries with multiple chronic conditions, focusing on the integration and coordination of care for this population is critical to achieve better care and health for beneficiaries, and lower costs through greater efficiency and quality,” said Centers for Medicare and Medicaid Services Administrator Donald Berwick, MD.
The Affordable Care Act, with its emphasis on prevention, provides HHS with exciting new opportunities to keep chronic conditions from occurring in the first place and to improve the quality of life for patients who have them.
“We need to learn rapidly how to provide high quality, safe care to individuals with multiple chronic conditions. AHRQ’s investments assess alternative strategies for prevention and management of chronic illness, including behavioral conditions, in persons with varying combinations of chronic illnesses,” said AHRQ Director Carolyn M. Clancy, MD.
HHS has taken action in recent months to improve the health of individuals with multiple chronic conditions. Some examples include:
- Administration on Aging (AoA)/ Centers for Medicare and Medicaid Services Administrator (CMS)
AoA and CMS jointly announced $67 million in grants to support outreach activities that encourage prevention and wellness, options counseling and assistance programs, and care transition programs to improve health outcomes in older Americans.
- Agency for Healthcare Research and Quality (AHRQ)
AHRQ awarded more than $18 million dollars (American Recovery and Reinvestment Act) in two categories of grant awards to understand how to optimize care of patients with multiple chronic conditions.
- Assistant Secretary for Planning and Evaluation (ASPE)
As part of an existing $40 million ASPE contract, the National Quality Forum is undertaking a project to develop and endorse a performance measurement framework for patients with multiple chronic conditions.
CDC is supporting a new project ― Living Well with Chronic Disease: Public Health Action to Reduce Disability and Improve Functioning and Quality of Life ― in which the Institute of Medicine will convene a committee of independent experts to examine the burden of multiple chronic conditions and the implications for population-based public health action.
CMS has provided recent guidance to State Medicaid directors on a new optional benefit available Jan. 1, 2011, through the Affordable Care Act, to provide health homes for enrollees with at least two chronic conditions, or for those with one chronic condition who are at risk for another.
- Food and Drug Administration/ Assistant Secretary for Planning and Evaluation (FDA/ASPE)
FDA and ASPE launched a study to examine the extent to which individuals with multiple chronic conditions are being included or excluded from clinical trials for new therapeutic products.
- Indian Health Service (IHS)
IHS has expanded its Improving Patient Care Program to nearly 100 sites across the tribal and urban Indian health system to assist in improving the quality of health care for patients with MCC.
NIH has committed $42.8 million for a study to determine whether efforts to attain a lower blood pressure range in an older adult population will reduce other chronic conditions.
SAMHSA awarded $34 million in new funding to support the Primary and Behavioral Health Care Integration Program, which seeks to promote the integration of care with people with co-occurring conditions.
For more information about the new HHS Strategy on Multiple Chronic Conditions, go to:http://www.hhs.gov/ash/initiatives/mcc/
The Pollak Library California State University Fullerton has published a list of Free Databases from the US Government.
This item came via the Yahoo group NetGold, and was published by the owner Librarian David P. Dillard
Here are the the links to free Health and Medicine resources.
[Flahiff’s note: MedlinePlus is a great starting point for consumer level health/medical information. It goes beyond news to give great starting points for information on diseases and conditions. It includes videos (as surgeries), links to directories (as hospital and physician directories), options for email alerts, Twitter, and much more.
Drugs @ FDA is a great source, however, the NLM Drug Information Portal is a more comprehensive resource. This portal includes both consumer level and professional level drug information resources, including Drugs@FDA, MedlinePlus resources, and references from scientific journals as well as toxicology resources.
PubMed is the largest indexer of health/medical articles written by scientists, physicians,and other health care related professionals. Not all of the articles are available for free online. Please click here for suggestions on how to get individual health/medical articles for free or low cost.]
- PLoS: Public Library of Science
Full text. PLoS publishes peer-reviewed, open access scientific and medical journals that include original research as well as timely feature articles. All PLoS articles are immediately freely accessible online, are deposited in the free public archive PubMed Central, and can be redistributed and reused according to the terms of the Creative Commons Attribution License.
- Cancer Literature in PubMed
Search the Cancer subset in PubMed.
Search by drug name, active ingredient, application number, and more.
- PillBox Beta
Aids in the identification of unknown solid dosage pharmaceuticals using images to identify pills (color, shape, etc) as well as a separate advanced search (imprint, drug manufacture, ingredients, etc)
- Household Products Database
Health and safety information on householdproducts.
Health news on 800 topics on conditions, diseases, and wellness.
- National Academies Press
Full text books on behavioral and social sciences, biology, computers, earth sciences, education, energy, engineering, environmental issues, food and nutrition, health and medicine, industry and labor, math, chemistry, physics, space and aeronautics, transportation, and more.
- National Library of Medicine: Databases
Linds to databases and electronic resources from the NIH.
- NLM Gateway
From NIH. Accesses Medline, PubMed, Toxline, DART, ClinicalTrials.gov, and other government databases.
- NLM/NIH Resources
Links to NLM, NIH and other federal government resources.
- Nutrient Data Laboratory Database
The Nutrient Data Laboratory (NDL) has the responsibility to develop USDA’s National Nutrient Database for Standard Reference, the foundation of most food and nutrition databases in the US, used in food policy, research and nutrition monitoring.
- Nutrient Data Laboratory [USDA]
Search by keywords to retrieve nutrient data.
More than 19 million citations to biomedical articles from MedLine and life science journals. Some links to full text.
- PubMed Central
Full text articles from PubMed, the free digital archive of biomedical and life sciences journal literataure.
[Editor Flahiff’s note: I remember visiting my great aunt in a nursing home in the early 70’s (I was in my late teens) I found the stupor among the residents very sad…this story was very refreshing to read…
My husband can attest to the importance of personal attention…he is retired and goes to senior centers daily for lunch and the “pool halls”. He makes it a point to visit with those sitting alone at lunch…and has brought a number of folks out their shells during the past few years]
Instead of treating behavioral problems with antipsychotic drugs, the Ecumen chain of 15 homes is using strategies including aromatherapy, massage, music, games, exercise and good talk. The state is helping out.
The aged woman had stopped biting aides and hitting other residents. That was the good news.
But in the North Shore nursing home‘s efforts to achieve peace, she and many other residents were drugged into a stupor — sleepy, lethargic, with little interest in food, activities and other people.
“You see that in just about any nursing home,” said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minn. “But what kind of quality of life is that?”
Working with a psychiatrist and a pharmacist, Lanigan started a project last year to find other ways to ease the yelling, moaning, crying, spitting, biting and other disruptive behavior that sometimes accompany dementia.
They wanted to replace drugs with aromatherapy, massage, games, exercise, personal attention, better pain control and other techniques. The entire staff was trained and encouraged to interact with residents with dementia.
Within six months, they eliminated antipsychotic drugs and cut the use of antidepressants by half. The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.”…
….Medicare spends more than $5 billion a year on those [antipsychotic] drugs for its beneficiaries, including about 30 percent of nursing home residents. Several studies have concluded that more than half are prescribed inappropriately. The drugs are especially hazardous to older people, raising the risk of strokes, pneumonia, confusion, falls, diabetes and hospitalization….
Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms, he said, because “It’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.”
Federal regulators are cracking down on homes that don’t routinely reassess residents on psychotropic drugs. But use remains widespread….