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DiversityNursing Blog

ER Visits on the Rise, Study Reports

Posted by Erica Bettencourt

Wed, Nov 26, 2014 @ 11:49 AM

By Robert Preidt

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The number of emergency department visits in the United States rose from about 130 million in 2010 to a record 136 million in 2011, according to the U.S. Centers for Disease Control and Prevention.

The findings also showed that fewer people were going to ERs with non-urgent medical needs: 96 percent of patients were identified as needing medical care within two hours of arriving at the ER. In 2010, that number was 92 percent, according to the research.

Sixty percent of patients arrived at the ER after normal business hours (after 5 p.m. on weekdays). One-third of visits were for patients on either end of the age spectrum -- younger than 15 or older than 65, the researchers found.

Almost 30 percent of visits were for injuries. The highest injury rates were among patients 75 and older, the study noted.

"The report also finds that there are large numbers of admitted patients who wait long times for inpatient beds," Dr. Michael Gerardi, president of the American College of Emergency Physicians (ACEP), said in an ACEP news release.

"Nearly two-thirds of patients waited two or more hours for beds in 2011, and nearly three-quarters of hospitals continued to board patients, even when the emergency department was critically overloaded. Hospitals must move admitted patients out of the emergency department faster to make room for the increasing number of people coming," he said.

It's believed that there will be about 140 million ER visits in 2014, according to the ACEP.

"The growth in patient demand aligns with what emergency physicians have been seeing and predicting: demand is going to increase," Gerardi said.

"Given that our nation's population is aging, and emergency departments have a critical role as the front line of responding to disasters and infectious disease outbreaks in America, such as what we saw with Ebola, we need to prepare for increased numbers of patients," he added.

Despite increasing use of ERs, most hospitals had not expanded their ERs as of 2011 and had no plans to expand them in the following two years, according to Gerardi.

"Emergency departments are essential to every community and must have adequate resources," he said. "They continue to be under severe stress and face soaring demands, despite the efficiency of caring for more than 136 million of the sickest patients each year using only 4 percent of the nation's health care dollar. This report is more evidence that we are going to need more resources, not less, in the future."

Source: www.nlm.nih.gov

Topics: ER, emergency room, studies, health, healthcare, nurses, health care, medical, physicians, hospitals

"Antibiogram" Use In Nursing Facilities Could Help Improve Antibiotic Use, Effectiveness

Posted by Erica Bettencourt

Wed, Nov 19, 2014 @ 02:25 PM

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Use of "antibiograms" in skilled nursing facilities could improve antibiotic effectiveness and help address problems with antibiotic resistance that are becoming a national crisis, researchers conclude in a new study.

Antibiograms are tools that aid health care practitioners in prescribing antibiotics in local populations, such as a hospital, nursing home or the community. They are based on information from microbiology laboratory tests and provide information on how likely a certain antibiotic is to effectively treat a particular infection.

The recent research, published by researchers from Oregon State University in Infection Control and Hospital Epidemiology, pointed out that 85 percent of antibiotic prescriptions in the skilled nursing facility residents who were studied were made "empirically," or without culture data to help determine what drug, if any, would be effective.

Of those prescriptions, 65 percent were found to be inappropriate, in that they were unlikely to effectively treat the target infection.

By contrast, use of antibiograms in one facility improved appropriate prescribing by 40 percent, although due to small sample sizes the improvement was not statistically significant.

"When we're only prescribing an appropriate antibiotic 35 percent of the time, that's clearly a problem," said Jon Furuno, lead author on the study and an associate professor in the Oregon State University/Oregon Health & Science University College of Pharmacy.

"Wider use of antibiograms won't solve this problem, but in combination with other approaches, such as better dose and therapy monitoring, and limiting use of certain drugs, we should be able to be more effective," Furuno said.

"And it's essential we do more to address the issues of antibiotic resistance," he said. "We're not keeping up with this problem. Pretty soon, there won't be anything left in the medical cabinet that works for certain infections."

In September, President Obama called antibiotic resistant infections "a serious threat to public health and the economy," and outlined a new national initiative to address the issue. The Centers for Disease Control and Prevention has concluded that the problem is associated with an additional 23,000 deaths and 2 million illnesses each year in the U.S., as well as up to $55 billion in direct health care costs and lost productivity.

Antibiograms may literally be pocket-sized documents that outline which antibiotics in a local setting are most likely to be effective. They are often used in hospitals but less so in other health care settings, researchers say. There are opportunities to increase their use in nursing homes but also in large medical clinics and other local health care facilities for outpatient treatment. The recent study was based on analysis of 839 resident and patient records from skilled nursing and acute care facilities.

"Antibiograms help support appropriate and prudent antibiotic use," said Jessina McGregor, also an associate professor in the OSU/OHSU College of Pharmacy, and lead author on another recent publication on evaluating antimicrobial programs.

"Improved antimicrobial prescriptions can help save lives, but they also benefit more than just an individual patient," McGregor said. "The judicious use of antibiotics helps everyone in a community by slowing the spread of drug-resistant genes. It's an issue that each person should be aware of and consider."

Multi-drug resistant organisms, such as methicillin-resistant Staphylococcus aureus, or MRSA, and other bacterial attacks that are being called "superinfections" have become a major issue.

Improved antibiotic treatment using a range of tactics, researchers say, could ultimately reduce morbidity, save money and lives, and improve patients' quality of life.

Source: www.medicalnewstoday.com

Topics: antibiotics, antibiogram, antibiotic resistance, nursing, health, health care, medical

From the NICU to the Moon: Babies in Intensive Care Dream Big

Posted by Erica Bettencourt

Mon, Nov 10, 2014 @ 03:13 PM

BY CHIARA SOTTILE

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Twice a day, Michele Forth drives 45 miles to the Neonatal Intensive Care Unit to visit her 4-month-old baby she affectionately calls "Miss Madilyn." She is a 6-pound fighter in pink pajamas — but to her family and the nurses who care for her day and night, she is so much more.

"Hi, pumpkin! You just waking up?" Forth coos. Nurse Adrianna "Adri" Zimmerman, wearing purple scrubs and a warm smile, hands Madilyn to her father who is quickly surrounded by his wife and two young sons.

"She fights harder than any adult that I know, let alone a 6-pound baby," says father Shane Forth, softly stroking Madilyn's delicate left foot in his hand.

It was in that spirit that the nurses chose to see Madilyn, one of nearly 100 babies cared for in the NICU at Children’s Healthcare of Atlanta every day. "We always talk about how feisty this one is or how sweet this one is,” Zimmerman says.

That bedside chatting took on a whole new life with a photo series called "From the NICU to the Moon" that imagines what the babies dream about as they wiggle and smile in their sleep, and what they might become someday. It also aims to educate parents about safe sleep for newborns.

The nurses and hospital communications team imagined Madilyn as a physician, surrounded by stethoscopes and Band-Aids. The photo series also features Brentley, the future astronaut, Arianna, the future chef, Sofia the ballerina, and Carolina as an Olympian.

Madilyn was born two months early and has what is called vacterl association (a collection of birth defects), resulting in multiple surgeries and months in the NICU. Zimmerman remembers Madilyn's arrival in the NICU like it was her own child.

"I think she's strong and she's definitely got the will to see whatever it is through to the end, so, if that happens to be med school in a few years, I would not be surprised," says Zimmerman. "It's funny how much personality these babies have."

And Mom is happy with the depiction. "Even though Miss Madilyn does have a whole bunch of obstacles ahead of her right now," she says, "she can do amazing things and she can aspire to be anything that she wants to be."

Carolina, the tiny Olympian, is “a strong-willed patient who has a lot of heart and she is letting nothing hold her back," says Jessica Wright, a NICU Nurse with 10 years of experience. "Just because they were born early doesn't mean they cannot do whatever they want when they grow up in life."

True to her athletic depiction, Carolina is hardly ever still in her crib. Gazing up at the green alligator and orange lion of her soother, Carolina playfully kicks her feet back and forth, her bright eyes fixed on Nurse Wright. "What are you thinking about?" Wright asks, her hand on Carolina's blue and pink ensemble, "You tell 'em about it, wiggle worm."

Sofia, the ballerina in the photo series, is also on the move. Since she was photographed, Sofia was able to leave the NICU and go home with her parents, Fred and Dawnyale "Dawny" Hill.

In the pale orange light of an Atlanta sunset, Fred and Dawny cradle their daughter in their arms on the family's front porch. It's Sofia's first time outside on the porch and her longest stint outside in the evening since she went home. "What do you think? What do you think? Hill asks his daughter, holding her hand. "Interesting, huh?"

Sofia spent 157 days, 20 hours, and 6 total minutes in NICUs. Respiratory and reflux issues keep this 5 1/2-month-old on an oxygen tank and feeding tube.

"She has some accessories, as we like to refer to them as," says Mr. Hill, about the oxygen tank and tubes. "They kind of travel with her."

But in the "NICU to the Moon" photos, Sofia left all the tubes behind for the stage and curtains. "It made her seem normal. The way the pictures kind of erased all of the cords. All of the tubes," says Hill of his daughter. "I saw the innocence of Sofia as opposed to my child in the NICU."

"She's got a family full of dancers on both sides so we definitely are excited to see Miss Sofia the ballerina come about," Dawny says with a laugh. "She'll be dancing around."

But for now, the Hills cherish moments with Sofia at home, like their evening bedtime routine. Mr. Hill carries Sofia on his chest while Dawny wheels the oxygen tank and other cords towards the bedroom. "Good holding your head, Sofia. Look at you," applauds Mrs. Hill.

As they gently place her on her back in her crib, Sofia rubs her eyes.

"Hey, you had a good day. You had a good day, right? Are you sleepy?" asks her father, the machine beeping and sighing next to the crib.

"Ready? Time to pray," Mr. Hill says, kneeling over the crib next to his wife. They pray for every organ in their daughter's body and give thanks to the doctors who helped bring her home.

"We will be keeping up our bedtime routine," Mrs. Hill says, looking at her husband. "Until she can start saying her prayers," he answers.

"Any child that has to go through that much opposition from day one, there's got to be something great for them to accomplish out of life, so my hope is that she accomplishes exactly what she was sent here to do," Mr. Hill says.

And with that, the bedroom light switches off and one more former NICU baby gets to dream of her future in her own crib.

Source: www.nbcnews.com

Topics: health, family, nurses, health care, medical, hospital, NICU, intensive care unit, babies, photography

You Might Be Allergic To Penicillin; Then Again, You Might Not

Posted by Erica Bettencourt

Mon, Nov 10, 2014 @ 02:54 PM

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Many people have been told, incorrectly, that they're allergic to penicillin, but have not had allergy testing. These people are often given alternative antibiotics prior to surgery to ward off infection. But when antibiotic choices are limited due to resistance, treatment alternatives may be more toxic, more expensive and less effective.

According to two studies presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, people who believe they have a penicillin allergy would benefit from consultation from an allergist and penicillin allergy skin testing. Once they know if they are allergic, they can be given appropriate -- and not more resistant -- treatment prior to surgery. Of the 384 people in the first study who believed they were allergic to penicillin, 94 percent tested negative for penicillin allergy.

"A large number of people in our study who had a history of penicillin allergy were actually not allergic," said allergist and ACAAI member Thanai Pongdee, MD, lead study author. "They may have had an unfavorable response to penicillin at some point in the past, such as hives or swelling, but they did not demonstrate any evidence of penicillin allergy at the current time. With that in mind, their doctors prescribed different medications prior to surgery."

In the second study, 38 people who believed they were allergic to penicillin were given penicillin skin testing to see if it was possible to help reduce the use of high-cost antibiotics. Of the 38 people tested, all of them tested negative to an allergy for penicillin. Once it was known they weren't allergic to penicillin, the medical center was able to change the medications of 29 of the patients, thereby significantly lowering prescription costs.

"When you are told you have an allergy to something, it's important to be seen and tested by an allergist, who has the specialized training needed for accurate diagnosis and treatment," said allergist James Sublett, ACAAI president-elect. "If you're truly allergic to a medication, your allergist will counsel you on an appropriate substitute."

Source: www.sciencedaily.com

Topics: allergies, health, health care, medical, medicine, testing, Penicillin

'Easy-to-walk Communities' Linked To Better Cognition In Older Adults

Posted by Erica Bettencourt

Mon, Nov 10, 2014 @ 01:42 PM

By Marie Ellis

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It is well known that exercise is good for the mind and body, but to what extent does the neighborhood or community in which we live affect our physical and mental health? New research from the University of Kansas suggests the walkability of a community has a great impact on cognition in older adults.

Previous studies have detailed the importance physical exercise has for executive function in older adults.

But how can the layout of a neighborhood encourage its residents to get out and walk? This is precisely what Amber Watts, assistant professor of clinical psychology at the University of Kansas, wanted to find out.

"Depending on which type of walking [leisure vs. walking to get somewhere] you're interested in, a neighborhood might have different characteristics," she says. "Features of a neighborhood that encourage walking for transportation require having someplace worth walking to, like neighbors' houses, stores and parks."

She adds that neighborhoods that encourage leisure walking have "pleasant things to look at," including walking trails and trees, and they should feel safe.

Her research, which she presented yesterday at the Gerontological Society of America's annual meeting in Washington, DC, suggests that neighborhoods that encourage walking can protect against cognitive decline in older adults.

To conduct her research, Watts used geographic information systems (GIS) to judge walkability. This involved maps that measure and analyze spatial data.

Better physical and mental health

Detailing how she collected her data, Watts explains:

"GIS data can tell us about roads, sidewalks, elevation, terrain, distances between locations and a variety of other pieces of information. We then use a process called space syntax to measure these features, including the number of intersections, distances between places or connections between a person's home and other possible destinations they might walk to."

She also looked at how complicated a route is from one location to another: "For example, is it a straight line from point A to point B, or does it require a lot of turns to get there?"

To conduct the study, Watts and colleagues tracked 25 people with mild Alzheimer's disease and 39 older adults without any cognitive impairment. Using the space syntax data, they created a "walkability score" for the participants' home addresses.

Then, they estimated the relationship between a person's neighborhood scores and how well they performed on cognitive tests over 2 years. The cognitive tests included three categories: attention, verbal memory and mental status. The team also factored in issues that might influence cognitive scores, including age, gender, education and wealth.

Results from the study suggest that communities that are easier to walk in are linked to better physical health outcomes - such as lower body mass and blood pressure - and cognition - including better memory.

Watts and her colleagues believe their findings could benefit older adults, health care professionals, caregivers and even architects and urban planners.

Do mentally complex neighborhoods act like a brain-training game?

Though elaborate community layouts may be expected to confuse older residents, Watts and her team found that they actually serve to keep cognition sharp.

"There seems to be a component of a person's mental representation of the spatial environment, for example, the ability to picture the streets like a mental map," Watts says.

She adds that complicated environments may demand more intricate mental processes in order to navigate them, which could keep the mind sharp. This is in line with previous studies, which have demonstrated how staying mentally active helps to preserve memory.

"Our findings suggest that people with neighborhoods that require more mental complexity actually experience less decline in their mental functioning over time," Watts adds.

She explains that a challenging environment keeps an individual's body and mind healthy:


"With regard to the complexity of neighborhood street layouts - for example, the number of turns required getting from point A to point B - our results demonstrate that more complex neighborhoods are associated with preserved cognitive performance over time.


We think this may be because mental challenges are good for us. They keep us active and working at that optimal level instead of choosing the path of least resistance."

A National Institute on Aging grant, KU Strategic Initiative Grant and Frontiers Clinical Translational Science award helped fund the study.

Source: www.medicalnewstoday.com

Topics: health, brain, health care, medicine, community, elderly, lifestyle, seniors, walking, neighborhoods, cognition, residents

30 Best Nursing Blogs Of 2014

Posted by Erica Bettencourt

Fri, Nov 07, 2014 @ 10:48 AM

By Jamie Bond

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Beginning in 1999, blogging became a route for individuals with a devotion to writing to share their talent. Blogging gives the author the ability to channel their thoughts in a manner that can be useful and enjoyable to readers.  Nurses encounter many learning situations which may be helpful to fellow nurses.  Blogs give the writer a means to share these experiences and readers a chance to learn and relate to others in a virtual setting.  In nursing, blogs serve multiple purposes including engaging fellow nurses in educational opportunities, networking, providing insight into unique avenues in nursing, and burnout prevention.

This list of top nursing blogs was compiled based on Facebook likes, frequency of postings, and number of followers. Many of the following blogs are top hits when conducting online searches and can also be followed on Twitter, Pinterest, and Google+. This list has been divided into sections for the reader’s convenience: general nursing, registered nurse, nurse practitioner, nursing student, nursing career, and women’s health.

GENERAL NURSING

    1. Confident Voices – Beth Boynton is a national speaker, professional coach, facilitator, and medical improv trainer. She writes this blog founded on respectful communication for nurses, physicians, patient advocates, and support staff to encourage safe, respectful work cultures.

    2. Disruptive Women in Healthcare – This blog targets challenging and inspirational concepts in the current healthcare field. There are over 100 individuals that actively contribute to this blog including elected officials, healthcare workers, patient advocates, researchers, and economists.

    3. Diversity Nursing – Diversity Nursing offers a variety of articles on all topics pertinent to nursing including health and wellness and career tips. This blog also includes a job board and a forum for open discussion amongst nurses and student nurses.
      Highlight: Nurses Among Most Influential People in Healthcare
    4. ER Nurses Care – Written by emergency room nurse Leslie Block, this blog uses her passion for nursing to demonstrate caring and compassion through her posts focusing on healthy living, injury prevention, and various current trending topics in healthcare.

    5. Living Sublime Wellness – Elizabeth Scala MSN/MBA, RN is a motivational speaker who focuses her writing on encouraging nurses to make the necessary changes in healthcare by facilitating out-of-the box critical thinking.

    6. Not Nurse Ratched – A nurse and freelance writer, Megen Duffy blogs about all things nursing while using her humor to lighten the mood as necessary. Duffy’s blog is highly followed online and on Facebook likely due to her down to earth writing style.

    7. Nurse Barb’s Daily Dose – Barb Dehn, RN, MS, NP is committed to deciphering convoluted health information in order to assist individuals in achieving optimal health and wellness. Nurse Barb’s Daily Dose contains articles pertaining to women’s health, parenting, caregiving, healthy living, and medical conditions.

    8. Nursetopia – Nursetopia features timely articles on all pertinent topics in healthcare. This blog inspires nurses by highlighting and displaying the positive influence nurses have on the healthcare culture.

    9. rtConnections – Renee Thompson is a motivational speaker and the author of “Do No Harm” Applies to nurses too! Strategies to protect and bully-proof yourself at work. Thompson gears her presentations toward clinical competence and bullying within the workplace and works to enhance effective communication within a healthy organization.

    10. The Nursing Show -The Nursing Show is not your typical blog.  It is filled with hundreds of short podcasts and easy to read articles pertaining various nursing topics geared toward nurses of all skill levels. All nurses are sure to find topics of interest in this diverse, educational blog.

REGISTERED NURSES

    1. According to Nurse Kateri – Kateri, RN, BSN, started this blog while on a personal journey to discover herself and now uses it to detail her personal experiences as they pertain to health and happiness. This blog features narratives relating to her career in pediatrics and pediatric intensive care.

    2. JParadisi RN’s Blog – Julianna Paradisi, RN is an accomplished artist and an oncology nurse who incorporates art into patient care. This blog focuses on the same while featuring some of her personal pieces of art as they relate to her writing.

    3. Nurse Eye Roll – Nurse Eye Roll was established by a newly seasoned nurse wishing to provide encouragement, inspiration, support, and laughter to student nurses. Nursing school is tough and Nurse Eye Roll is there to offer tips and suggestions about navigating the path toward graduation and successful board examination.

    4. The Nerdy Nurse – Brittany Wilson, RN, BSN is a nursing informatics nurse who prides herself by incorporating technology into healthcare in order to improve and streamline patient care. This blog is found on various lists of top nursing blogs and is highly followed on social media.  For more information, see what is nursing informatics?

NURSE PRACTITIONER

  1. Barefoot Nurse – Barefoot Nurse reviews real life experiences as they occur through the eyes of an advance practice nurse. Kelly Arashin, the author behind this blog, is unique in her profession because she is a dually board certified nurse practitioner in acute and critical care and a clinical nurse specialist.

  2. My Strong Medicine – Sean Dent is an acute care nurse practitioner by day and weightlifter and coach by night. This blog was originally designed to share his experiences as a nurse but now it contains more commentaries on his personal life, his love for CrossFit and weightlifting.

  3. NP Business Blog – Nurse practitioners whom are in private, independent practice are breaking the mold of traditional NP employment status and are often found without the available resources to answer common questions. Barbara C. Phillips developed this blog as a means for NPs to offer support to others in all avenues of business NPs may be involved in.

  4. NP Odyssey – In existence since 2009, this blog contains a wealth of valuable information and insight including what it takes to become a nurse practitioner and the challenges NPs frequently encounter. This blog also incorporates articles pertaining to recent headlines in healthcare and how they pertain to NP practice.

  5. The NP Mom -Brett Badgley Snodgross is a family nurse practitioner with a passion for pain management and palliative care. She writes informative, easy to read articles related to common concerns she sees in her practice ranging from dieting to hypertension to allergies and beyond.

NURSING STUDENT

  1. A Journey Through Nursing School and Beyond – This blog takes the reader through the entire process of climbing the ladder through nursing education. The author began this blog as a certified nurse assistant, became a LPN, then an RN, and is currently seeking a master’s degree in nursing education. Most entries are brief and include an update on coursework although others offer valuable tips and tricks of the nursing trade.

  2. Adrienne, Student Nurse – Adrienne, RN is passionate about the way nurses and nursing students use social media in their professional lives. Adrienne, Student Nurse is written with the goal of telling the story of being a student nurse in an effort to motivate others to accept the challenge of becoming a nurse.

  3. Becoming a RN – Follow Amy on her journey through nursing school through her blog where she recounts her trials, tribulations, and triumphs. This blog includes insight on navigating through the various challenges presented by nursing school and inspires nursing students to prevail.

NURSING CAREER

  1. Digital Doorway – Keith Carlson, RN utilizes his blog, Digital Doorway, to coach nurses so they may feel fulfilled in their nursing careers. One of the most well known bloggers in healthcare, Carlson blogs about career opportunities, social media in healthcare, and burnout prevention.

  2. Innovative Nurse – Kevin Ross, RN is the ‘Innovative Nurse’ behind this blog. Ross writes about numerous areas of career nursing such as time management, salary, mobile apps, networking, and workplace happiness in the healthcare arena.

  3. International Nurse Support – International Nurse Support provides nurses with the necessary strategies to be confident in their positions while empowering them to climb the profession’s ladder as they progress in their career. This blog is owned by Joyce Fiodembo, however guest bloggers are featured frequently.

  4. Off the Charts – Off the Charts is the online publication of the well renowned American Journal of Nursing. While this blog lacks the personal touch many other blogs convey, Off the Charts presents up to date research data provided in an easy to read format. Various bloggers are often featured on this blog including many other bloggers in this list.

  5. The Nursing Site Blog – Kathy Quan, RN, BNS, PHN, has been a nurse for greater than 30 years and utilizes this blog as a means to share her extensive knowledge with fellow nurses. Quan is the author of five books including The Everything New Nurse Book which helps new nurses transition from nursing school to bedside nursing.

  6. Your Career Nursing – Tina Lanciault, RN helps her readers find their niche in nursing by writing about alternative nursing careers. Your Nursing Career contains articles related to online learning, networking, lifestyles, product reviews, and entrepreneurship.

WOMEN’S HEALTH

    1. At Your Cervix – At Your Cervix is written by a newly graduated nurse midwife and nicely portrays the trials and tribulations a new nurse midwife may encounter in practice. The blog contains educational articles that pertain to women’s health as well as commentaries based on the situations she came across over the course of the bloggers first year in practice.

    2. Mimi Secor – Mimi Secor is an accomplished family nurse practitioner with over 30 years experience in women’s health. Outside of her private practice, Mimi Secor is a public speaker and nurse consultant who prides herself in promoting quality care in women’s health.

Source: www.bestmasterofscienceinnursing.com

Topics: nursing, health, health care, medical, medicine, blogs

Predicting The Top Medical Innovations For 2015

Posted by Erica Bettencourt

Mon, Nov 03, 2014 @ 11:05 AM

By Sara Cheshire

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Can we predict the future of medicine? Although designer babies and a disease-free world may or may not come to pass, you can get a glimpse of the most promising and upcoming medical innovations each year, via the Cleveland Clinic.

The clinic's Top 10 Medical Innovations list, which has been an annual undertaking since 2007, contains treatments and technologies that are expected to significantly change patient care and save lives.

To be considered, each innovation must have a good chance of being available to the public in the upcoming year, says Dr. Michael Roizen, chief wellness officer at the Cleveland Clinic and chairman of the committee that decides the list. The committee must also expect it to have a significant impact on a large part of the population.

The process starts with a panel of Cleveland Clinic physicians and scientists who submit their ideas. These suggestions, which Roizen said totaled about 700 for the 2015 list, are then narrowed down and voted on by 40 physicians in a variety of health fields.

Here's what they selected for 2015:

1. Mobile stroke unit

Videoconferencing has made its way into ambulances, specifically for treating stroke victims on the go. Hospital stroke neurologists can interpret symptoms via a broadband video link and instruct an onboard paramedic, critical care nurse and CT technologist on treatment. This new technology should improve the speed of medical care, which is important as strokes quickly damage and kill brain cells.

2. Dengue fever vaccine

The World Health Organization reports that about half of the world's population is now at risk for dengue fever, which up until now was preventable only by avoiding mosquito bites. The disease is a leading cause of death and illness in children in some countries. A new vaccine has been developed and tested, and is expected to be available in 2015.

3. Painless blood testing

For those who hate large needles, a nearly painless way to sample blood will be a welcome relief. Plus, it will be cheaper and provide faster results than today's blood test. The new technology takes blood from your fingertip, and the Cleveland Clinic reports that over 100 tests can be performed on just one drop of blood.

4. New way to lower cholesterol

New self-injectable drugs called PCSK9 inhibitors have shown to be very effective in lowering cholesterol. These drugs may prove to be helpful for people with high LDL cholesterol who don't have good results with statins. The FDA is expected to approve the first PCSK9 in 2015.

5 ways to lower cholesterol

5. Cancer drug that doesn't harm healthy tissue

Although chemotherapy can save lives, it can be hard on the body and attack healthy cells as well as cancerous ones. A welcome breakthrough in the world of cancer treatment, antibody-drug conjugates can deliver targeted treatment without damaging healthy tissue.

6. Immune booster for cancer patients

Immune checkpoint inhibitors have been shown to prevent cancer cells from "hiding" from the immune system, allowing the body to more effectively fight these abnormal cells. Combined with chemotherapy and radiation treatment, the drugs have shown significant, long-term cancer remissions for patients with metastatic melanoma, one of the most deadly forms of cancer.

7. Wireless cardiac pacemaker

Until this point, wires have been a necessary component in pacemakers. A new wireless pacemaker about the size of a vitamin can now be implanted in the heart without surgery. Its lithium-ion battery is estimated to last about seven years.

8. New medications for idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is a life-threatening disease that causes scarring in the lungs, leading to breathing difficulties and a shortage of oxygen in the brain and other organs. Life expectancy is only three to five years after diagnosis, but those numbers may change now that the FDA has approved two experimental drugs that slow the disease: pirfenidone and nintedanib.

9. Single-dose radiation therapy for breast cancer

The National Cancer Institute estimates that 40,000 women in the United States will die from breast cancer in 2014. The Cleveland Clinic cites multiple chemotherapy appointments, sometimes requiring the patient to travel long distances, as a hindrance to successful treatment. Intraoperative radiation therapy is a new solution. It treats a breast cancer tumor during surgery in a single dose, reducing time and cost spent on treatment.

10. New drug for heart failure

About 5.1 million people in the United States suffer from heart failure, according to the National Heart, Lung and Blood Institute. It is managed with a combination of drugs, but a new drug, angiotensin-receptor neprilysin inhibitor, has been granted fast-track status by the FDA because of its ability to cut the risk of dying from heart failure more effectively than current treatments.

For more information on the annual medical innovations list, including descriptions and videos, download the "Innovations" app or visit the website. A "where is it now" feature also includes updates on innovations that made the top 10 list in prior years.

"We look in past to see what we voted on to improve the process," Roizen said. "With one exception, we've been pretty good."

Source: www.cnn.com

Topics: technology, healthcare, health care, future, medical, cancer, vaccine, patient care, medicine, testing, treatments, innovations, diseases

Diet Stops Seizures When Epilepsy Drugs Fail

Posted by Erica Bettencourt

Wed, Oct 29, 2014 @ 02:48 PM

By JESSICA FIRGER

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When Jackson Small began having seizures at 7, his parents hoped and assumed at least one of the many epilepsy drugs on the market would be enough to get things under control. But one seizure quickly spiraled to as many as 30 a day.

"He would stop in his tracks and not be aware of what was going on for 20 or 30 seconds or so," his mother Shana Small told CBS News. Jackson was eventually diagnosed with juvenile myoclonic epilepsy, a type of epilepsy characterized by brief but often frequent muscle jerking or twitching.

But a number of medications typically prescribed to patients with this type of epilepsy were not effective. And so the quest to help Jackson gain control over his seizures led the family from their home in Orlando, Florida, to the office of a registered dietician at the NYU Langone Comprehensive Epilepsy Center in New York City.

They were there to discuss the medical benefits of heavy cream, mayonnaise, eggs, sausage, bacon and butter.

A lot of butter.

The plan was to treat Jackson with a diet that is heavy in fat, low in protein and includes almost no carbohydrates. It's known as the ketogenic diet and has long been in the arsenal of last-resort options for patients with epilepsy who are unresponsive to medication. Doctors may recommend a patient go on this special diet after unsuccessfully trying two or three prescriptions.

The diet works by putting the body in a "fasting" state, known as ketosis. "When we're fasting the body needs to find fuel so our body will break down fat storage and break down their own fat and enter a state of ketosis," Courtney Glick, the registered dietician who coordinated and fine-tuned Jackson's diet plan, told CBS News. "But with this diet, instead of breaking down the body's fat, the body breaks down dietary fat."

The ketogenic diet consists of as much as 90 percent fat. Some patients who feel they can't make such an extreme change adopt a modified Atkins diet, which is between 65 and 70 percent fat. It can be nearly as effective for controlling seizures, though every patient is different.

Though experts don't know everything about why this diet is effective for seizure control, they do know that eating mostly fat causes the body to fuel on ketones rather than glucose, which ultimately lowers insulin levels. This can have an anti-inflammatory effect on the body and may prevent seizures by calming the brain, said Glick.

One study by researchers at Dana-Farber Cancer Institute and Harvard Medical School found that a child's ability to stave off seizures is tied to a protein that affects metabolism in the brain. The protein, called BCL-2-associated Agonist of Cell Death, or BAD, also regulates metabolism of glucose. The researchers discovered that by modifying this, they switched metabolism in brain cells from glucose to ketone bodies, which are fat byproducts.

Glick said the diet plan didn't work for Jackson until he tried the most strict version, which was a 4 to 1 ratio of fat to protein and carbohydrates. Each day, he ate approximately 160 grams of fat, 8 to 10 grams of carbohydrates and 30 grams of protein, all of which amounted to about 1,700 calories a day.

Four months into the program, Jackson was seizure-free. He remained on the strict diet for two years with no return of seizures. His mother prepared foods from special recipes such as "keto" pizza made with a macadamia nut crust or chicken nuggets with coconut flour.

Over the summer -- after receiving a green light from his doctors -- Jackson, now 10 years old, began to wean himself off the diet, and his mother has slowly introduced foods such as breads and ice cream. He has maintained seizure-free and takes very little anti-seizure medication.

Research has found that for pediatric patients the anti-seizure effects of the diet often continue long after the child stops following the food plan, though the reason why remains unclear. This is typically not the case for adults, who may need to stay on the diet for life in order to control seizures.

"We've probably seen more kids go on the diets than adults, and adults are really set on their eating patterns," said Glick, adding that social obligations can make the diet difficult to fit into a grown person's lifestyle.

Jackson's mother said his doctors are hopeful that in the near future he may no longer need medication -- or a keto diet -- to stay seizure-free. "I think it's taught him a very important lesson about how food is as important as medicine, and how food affects the chemistry of your body," she said.

Source: www.cbsnews.com and http://www.dana-farber.org/

Topics: health, healthcare, health care, medication, children, diet, medical, food, seizures, Epilepsy

Will Overpopulation Lead To Public Health Catastrophe?

Posted by Erica Bettencourt

Wed, Oct 29, 2014 @ 02:39 PM

By David McNamee

four babies on a blanket

A new report finds that by 2100, there will be more people alive on the planet than has ever previously been predicted. We investigate what the consequences these extra bodies may have for maintaining public health.

The potentially catastrophic consequences of an exponentially growing global population is a favorite subject for writers of dystopian fiction.

The most recent example, Utopia - a forthcoming David Fincher-directed series for HBO - won critical acclaim in its original incarnation on UK television for its depiction of a conspiracy-laden modern world where the real threat to public health is not Ebola or other headline-friendly communicable viruses, but overpopulation.

Fears over the ever-expanding number of human bodies on our planet are not new and have been debated by researchers and policy makers for decades, if not centuries. However, recent research by University of Washington demographer Prof. Adrian Raftery - using modern statistical modeling and the latest data on population, fertility and mortality - has found that previous projections on population growth may have been conservative.

"Our new projections are probabilistic, and we find that there will probably be between 9.6 and 12.3 billion people in 2100," Prof. Raftery told Medical News Today. "This projection is based on a statistical model that uses all available past data on fertility and mortality from all countries in a systematic way, unlike previous projections that were based on expert assumptions."

Prof. Raftery's figure places up to an additional 5 billion people more on the Earth by 2100 than have been previously calculated.

A key finding of the study is that the fertility rate in Africa is declining much more slowly than has been previously estimated, which Prof. Raftery tells us "has major long-term implications for population."

Fertility rates declining more slowly in Africa than previously reported

A 2003 Centers for Disease Control and Prevention (CDC) report found that, in sub-Saharan Africa, both fertility and mortality rates were high, with the proportion of people aged over 65 expected to remain small, increasing from an estimated 2.9% in 2000 to 3.7% in 2030.

The CDC report notes that fertility rates declined in developing countries during the preceding 30 years, following a 20th century trend among developed countries. The pattern established by developed countries - and presumed to follow in developing countries - was that countries shift from high fertility and high mortality rates to low fertility and delayed mortality.

This transition starts with declining infant and childhood mortality as a result of improved public health measures. Improvements in infant and childhood mortality contribute to longer life expectancy and a younger population.

This trend of adults living longer, healthier lives is typically followed by a decline in fertility rates. The CDC report suggested that by 2030, there would be similar proportions of younger and older people in developing countries, by that point mirroring the age distribution in developed countries circa 1990.

Prof. Raftery's research, however, notes that in Nigeria - Africa's most populous country - each woman has an average of six children, and in the last 5 years, the child mortality rate has fallen from 136 per 1,000 live births to 117. This works out as a population increase of 20 people per square mile over the same timespan.

How will population growth affect developing countries?

But what does this mean for countries where the public health system is already stretched to breaking point - as has been demonstrated by the recent Ebola epidemic?

"Rapid population growth is likely to increase the burden on the public health service proportionally," answered Prof. Raftery.

"There are already big public health needs and challenges in high-fertility countries, and rapid population growth will make it even harder to meet them." However, if the fertility rate declines faster, Prof. Raftery suggests that high-fertility countries can reap "a demographic dividend."

He explained:

"This is a period of about a generation during which the number of dependents (children and old people) is small. This frees up resources for public health, education, infrastructure and environmental protection, and can make it easier for the economy to grow. This can happen even while the population is still increasing."

Does this suggest that an increasing population is not quite as much of a threat, but that it is more specifically the accelerations and decelerations in fertility rates that provide warning signs to future public health crises?

"Following a long run of an increasing human population growth rate, over the past half century the rate has been halved from about 2% to about 1%," Darryl Holman, professor of biological anthropology at the University of Washington, explained to MNT.

"The turnaround is quite remarkable," he said. "But as long as the growth rate remains positive, our species will eventually reach numbers and densities where technological solutions cannot ameliorate resource scarcity."

High population density leads to a much higher rate of contact between humans, which means that communicable diseases - ranging from the common cold to Dengue fever - can be much more easily transmitted.

And more people means greater efforts are needed to control waste management and provide clean water. If these needs cannot be adequately met, then diarrheal diseases become much more common, resulting in what Prof. Holman described to the University of Washington's news website The Daily UW as a "huge, huge, huge difference in mortality rates."

Taking a more general view, "the anticipated increase in the number of older persons will have dramatic consequences for public health, the health care financing and delivery systems, informal caregiving, and pension systems," wrote the authors of the CDC's 2003 report.

Overpopulation and the environment

"Can we assume that life on earth as we know it can continue no matter what the environmental conditions?," asked the authors of a 2001 Johns Hopkins School of Public Health report on the health consequences of population growth.

The Johns Hopkins report quoted figures demonstrating that unclean water and poor sanitation kill over 12 million people every year, while air pollution kills 3 million. In 64 of 105 developing countries, population has grown faster than food supplies.

By 2025, the report claimed, humankind could be using over 90% of all available freshwater, leaving just 10% for the world's plants and animals.

Prof. Holman summarizes the writings of experts Joel Cohen, E.O. Wilson, Paul Ehrlich and Ronald Lee, who have argued that the consequences of long-term environmental degradation - "specifically rising sea levels, disruption of agriculture and the increased frequency of extreme weather events resulting from anthropogenic climate change, exacerbated by resource scarcity" - create social problems that lead to social unrest.

With more people living together than ever before, it seems inevitable that this compounded social unrest would lead to increased warfare and fighting for resources.

According to the Johns Hopkins researchers, about half of the world's population currently occupies a coastal strip 200 kilometers wide - which means that 50% of us are squeezed together on just 10% of the world's land surface.

The projected flooding of these coastal regions as a result of global warming and rising sea levels could displace millions of people, result in widespread droughts and disrupt agriculture.

The Johns Hopkins team identified two main courses of action to divert these potential disasters.

Firstly - sustainable development. The report authors argued this should include:

  • More efficient use of energy
  • Managing cities better
  • Phasing out subsidies that encourage waste
  • Managing water resources and protecting freshwater sources
  • Harvesting forest products rather than destroying forests
  • Preserving arable land and increasing food production
  • Managing coastal zones and ocean fisheries
  • Protecting biodiversity hotspots.

The second vital area of action is the stabilization of population through good-quality family planning, which "would buy time to protect natural resources."

How to reduce fertility in a morally acceptable way?

Commenting on Prof. Raftery's finding that we may be welcoming an additional 5 billion individuals onto the planet by 2100 than had previously been estimated - a potential global population of 12.3 billion people - Prof. Holman admits that "it is difficult to know what the public health effects will be."

He explains:

"By then, we may see severe petroleum and fresh water resource shortages, climate changes that affect agriculture patterns that, in turn, affect food supplies. Reducing fertility in socially and morally acceptable ways seems like one public health strategy to avoid - or at least postpone - testing some of these limits."

In Utopia, a sinister governmental organization proposes to sterilize a large percentage of the population by rolling out a secretly modified vaccine in response to a manufactured flu pandemic. Obviously, that is not a socially or morally acceptable strategy for reducing fertility - but what is?

Experts consider boosting the education of girls in developing countries to be a prime solution.

As well as acquiring more control over their reproductive life, an educated female workforce should have more opportunities of employment and of earning a living wage. Studies report that the children of educated women also have better chances of survival and will become educated themselves. This pattern continuing across generations is associated with a decline in fertility rates.

A 2011 article by the Earth Policy Institute (EPI), analyzing data from the United Nations (UN), states that "countries in which more children are enrolled in school - even at the primary level - tend to have strikingly lower fertility rates."

In particular:

"Female education is especially important. Research consistently shows that women who are empowered through education tend to have fewer children and have them later. If and when they do become mothers, they tend to be healthier and raise healthier children, who then also stay in school longer. They earn more money with which to support their families, and contribute more to their communities' economic growth. Indeed, educating girls can transform whole communities."

The relationship between education, fertility and national poverty is a direct one. As the EPI authors add: "When mortality rates decline quickly but fertility rates fail to follow, countries can find it harder to reduce poverty."

The UN's 2012 Revision of the world population prospects report suggested if we make rapid reductions in family size, then it may still be possible to constrain the global population to 8 billion by 2045.

No projections are set in stone - all are contingent on what extent fertility rates will sway over the next century. And, as Prof. Holman pointed out to us, the nature of the threat posed by overpopulation has "been vigorously debated for over 200 years" with experts still not in complete accord.

For instance, in the 1980s, said Prof. Holman, the economist Julian Simon and ecologist Paul Ehrlich went on tour together, with a series of debates about the consequences of population growth.

"Ehrlich argued that continued population growth would lead to disaster for humans. Simon argued that population growth provided more people to invent new solutions to the problems confronting humans," said Prof. Holman, adding:

"Given the trends to this point, Simon has been 'more right.' One simple measure of this is mortality rates, which have decreased for most human groups. The flaw in Simon's argument may well be that we have never hit the limits of our finite earth. Positive population growth guarantees that we will, someday, hit some hard limits."

"So that," Prof. Holman concluded, "is the long term."

Source: www.medicalnewstoday.com

Topics: health, healthcare, research, disease, health care, CDC, public health, over population, future, population, people, Earth, data

Nearly 1 in 3 U.S. Babies Delivered by C-Section, Study Finds

Posted by Erica Bettencourt

Fri, Oct 24, 2014 @ 02:19 PM

By Robert Preidt

pregnancy784Cesarean delivery was the most common inpatient surgery in the United States in 2011 and was used in nearly one-third of all deliveries, research shows.

The new study found that 1.3 million babies were delivered by cesarean section in 2011. The findings also revealed wide variations in C-section rates at hospitals across the United States, but the reasons for such differences are unclear.

"We found that the variability in hospital cesarean rates was not driven by differences in maternal diagnoses or pregnancy complexity. This means there was significantly higher variation in hospital rates than would be expected based on women's health conditions," lead author Katy Kozhimannil, an assistant professor in the School of Public Health at the University of Minnesota, said in a university news release.

The researchers analyzed data from more than 1,300 hospitals in 46 states. They found that the overall rate of C-section was about 33 percent. Between hospitals, however, that rate ranged between 19 and 48 percent, according to the study.

For women who'd never previously had a C-section, the overall C-section rate was 22 percent. Depending on the hospital, that rate ranged between 11 percent and 36 percent, the researchers said.

C-section rates ranged from 8 percent to 32 percent among lower-risk women and from 56 percent to 92 percent among higher-risk women, according to the study published Oct. 21 in the journal PLoS Medicine.

The findings highlight the roles that hospitals' policies, practices and culture may have in influencing C-section rates, the study authors concluded.

"Women deserve evidence-based, consistent, high-quality maternity care, regardless of the hospital where they give birth, and these results indicate that we have a long way to go toward reaching this goal in the U.S.," Kozhimannil said in the news release.

Source: www.nlm.nih.gov

Topics: studies, delivery, birth, c-section, cesarean, women's health, healthcare, pregnancy, health care, hospitals

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