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What Parents Need to do with Their Children’s Leftover Pain Medicine

What Parents Need to do with Their Children’s Leftover Pain Medicine

Throughout the United States, the rates of prescription pain drug addiction and death continue to increase, placing a substantial burden on the nation’s healthcare system. This problem persists despite the development of new policy initiatives aimed at limiting access to these medications for both adults and younger patients. Studies show that about one in four high school seniors has used narcotic pain drugs, but parents may downplay the risks of these drugs because they are prescribed by a physician. “For adolescents, a known point of access to pain medication is pills in the home that are left over from a previous prescription,” says Sarah J. Clark, MPH. Recently, Dr. Clark and colleagues at the C.S. Mott Children’s Hospital surveyed a national sample of parents of children aged 5 to 17 about their experiences with pain drug prescriptions for their children as a part of the hospital’s national poll on children’s health. The survey, which was administered to 1,176 randomly selected parents, sought to identify how frequently parents keep leftover pain medications in the home and to assess whether or not parents are receiving guidance on what to do in these situations. A Common Problem According to the poll, prescription pain medications were common in U.S. households with children. “We found that three in 10 parents reported that they had received at least one pain drug prescription for their children in the last 5 years, most commonly for surgery or injury,” says Dr. Clark. “About 60% of those prescriptions were for a narcotic like oxycodone or hydrocodone and 8% were for non-narcotic pain relievers. Narcotics prescriptions were more common among...
Mortality Rates at Teaching Hospitals Lower Compared with Non-Teaching Hospitals

Mortality Rates at Teaching Hospitals Lower Compared with Non-Teaching Hospitals

Patients admitted to major teaching hospitals are less likely to die compared with patients admitted to minor teaching or non-teaching hospitals, according to a large national study from Harvard T.H. Chan School of Public Health. “While we know that teaching hospitals fulfill an important mission around teaching and research, we have known less about the quality of care they provide,” said Ashish Jha, K.T. Li Professor of Health Policy at Harvard Chan School, director of the Harvard Global Health Institute, and senior author of the study. “We find that across a very wide range of medical and surgical conditions, patient receiving care at teaching hospitals have superior outcomes.” Previous studies have compared outcomes at U.S. teaching hospitals — those affiliated with medical schools, at which medical students are trained — with outcomes at non-teaching hospitals, and those studies have suggested that patients generally fare better at teaching hospitals. But many of the seminal studies on the topic are decades old. Related Articles New Study Examines Child Death Rates in Motor Vehicle Crashes by State ATS: Lower ARDS Mortality at High-Volume Intensive Care Units Treatment in Hospital by Older Doctors Tied to Higher Mortality Weekend Admissions for PCI Tied to Higher In-Hospital Mortality For the new study, researchers analyzed data for 21.5 million hospitalizations of Medicare beneficiaries at 4,483 hospitals across the U.S — 250 major teaching hospitals, 894 minor teaching hospitals, and 3,339 non-teaching hospitals — between 2012 and 2014. The study looked at 30-day mortality rates for 15 common medical conditions, such as pneumonia, congestive heart failure, and stroke, and for six surgical procedures, including hip replacement, coronary...
#PWChat Recap: EHRs – The Good, the Bad, and the Ugly

#PWChat Recap: EHRs – The Good, the Bad, and the Ugly

As part of our continuing series of TweetChats, Physician’s Weekly, along with co-host Dr. Nicholas DiNubile, hosted the latest #PWChat on May 24 to discuss “EHRs: The Good, the Bad, and the Ugly.” Dr. DiNubile is an orthopedic surgeon specializing in sports medicine. He is also a clinical assistant professor of the Department of Orthopaedic Surgery at the Hospital of the University of Pennsylvania. Dr. DiNubile has been chosen in “Best Doctors in America” as well as “Guide to America’s Top Surgeons.” Joined by other physicians and interested patients, we debated topics such as whether or not EHRs are a good investment, potential benefits of EHRs, how to achieve the potential benefits of EHRs, what has kept these benefits from being widely achieved, and much more; so much more that we didn’t get to all the questions, so: Look for part 2 of this chat at 9:00pm ET on a TBD Wednesday in the coming few weeks!   Below is a recap of the discussion. Follow the full transcript on Twitter. Question 1 Q1: Why isn’t #EHR adoption higher than the 67% reported in March 2017? #PWChat — Physician’s Weekly (@physicianswkly) May 25, 2017 A1. Many have been waiting for the right product that fits his work flow and for #interoperability. #PWchat — Linda Girgis, MD (@DrLindaMD) May 25, 2017 Imagine if Lebron-WHILE PLAYING-had to keep his own stats & document every move? What would he accomplish? –>docs current #EHR mess #PWChat pic.twitter.com/xy3cUI7eBx — Nicholas DiNubile MD (@drnickUSA) May 25, 2017 Id offer adoption isn’t higher bc we haven’t seen EHRs that meet needs of drs or pts.MU isn’t enough incentive to implement bad tech...
New Study Examines Child Death Rates in Motor Vehicle Crashes by State

New Study Examines Child Death Rates in Motor Vehicle Crashes by State

Unintentional injury is the leading cause of pediatric death in the U.S. and motor vehicle crashes (MVCs) are the most common cause of injury. A new paper published in the Journal of Pediatrics by researchers at Center for Surgery and Public Health (CSPH) at Brigham and Women’s Hospital (BWH) and UT Southwestern Medical Center in Dallas, is the first to examine state-level factors contributing to variation in pediatric mortality in motor vehicle crashes and to identify trends across states. On average across all states, researchers found that 20 percent of children involved in a fatal crash were unrestrained or inappropriately restrained at the time of the crash. Thirteen percent were inappropriately seated in the front seat, and nearly 9% of drivers transporting a child passenger were under the influence of alcohol. The study’s authors estimate that a 10% absolute improvement in child restraint use–decreasing the average number of unrestrained or inappropriately restrained children from 20% to 10% nationally–would avert approximately 232 pediatric deaths per year, or more than 1,100 over five years. These findings highlight the importance of child restraint use and reinforce guidelines on child restraints published by the American Academy of Pediatrics (AAP) in 2011. “In order to prevent children from being killed in motor vehicle crashes, we must understand the effects of state-level regulations, their implementation and enforcement,” said Lindsey Wolf, MD, MPH, general surgery resident at BWH, research fellow at CSPH and lead author of the study. “Since laws governing child traffic safety are made at the state level, we formulated a study design that would produce state-by-state geographic results, which could easily be utilized...
American College of Physicians Gives 7 Recommendations to Improve American Health Care to Congress

American College of Physicians Gives 7 Recommendations to Improve American Health Care to Congress

The American College of Physicians today released a set of recommendations aimed at providing a forward-thinking agenda for health care reform, ‘A Prescription for a Forward-Looking Agenda to Improve American Health Care.’ The paper articulates ACP’s view that now is the time to move away from the debate over repealing and replacing the ACA, and instead, urges Congress and the administration to join with ACP and others to create and implement a forward-looking agenda to improve American health care. “Patients need to have coverage and access and existing gaps need to be closed, but they need other things, too. They need an effective health care system that puts their health and well-being first,” said ACP President, Jack Ende, MD, MACP. “Our paper offers specific policies to make this happen.” The paper details the 7 key elements of an effective health care system: expanding access and coverage; bringing greater value for the dollars spent; reducing the crushing administrative burden on physicians and patients; leveraging technology to improve patient care; supporting a well-trained physician workforce; reducing barriers to care of patients with chronic diseases; and, supporting scientific research and policies to improve public health. Related Articles President-Elect Trump & What Lies Ahead for the U.S. Healthcare System Health Care Reform Tied to Higher Uptake of Mammography What Is the Future of Healthcare Under President Trump? What the Future of Healthcare Will Look Like Under President Trump (Part...
The Sound of Safety: Preferences and Perceptions of Music in the Operating Room

The Sound of Safety: Preferences and Perceptions of Music in the Operating Room

Studies have shown that playing music in the operating room (OR) while performing surgery can benefit operative staff by improving their levels of physiologic stress and enhancing operative performance. However, other investigations have shown that playing music in the OR can impede anesthesiologists’ concentration and impair surgeons’ performance as well as their ability to manage stressful situations. “Safety in the OR is highly dependent on team performance,” says Claudius Conrad, MD, PhD. “When performing extensive surgeries, a heterogeneous team must work well together to achieve optimal outcomes.” Little is known about the impact of playing music on OR team concentration and communication. Data are also lacking with regard to whether or not music preferences and perceptions in the OR differ by demographic and professional factors. Surveying the Scene For a study published in Surgery, Dr. Conrad and colleagues conducted a multi-institutional analysis of more than 280 preoperative patients and nearly 400 attending physicians, residents, and nurses in anesthesiology and surgery. “We designed and utilized a questionnaire that would globally test how music is perceived in the OR, what is important when music is being played, and the differential perceptions of music by the various groups participating in the analysis,” explains Dr. Conrad. “We also wanted to understand patient’s opinions about whether music should be played in the OR and, if so, whether they would want their surgeon to determine what music should be played.” According to the survey results, patients highly favored playing music in the OR, with 43% indicating that music should be played often. When asked who should choose the music that is played in the OR,...
First Study Shows Tie Between Probiotic and Improved Symptoms of Depression

First Study Shows Tie Between Probiotic and Improved Symptoms of Depression

Probiotics may relieve symptoms of depression, as well as help gastrointestinal upset, research from McMaster University has found. In a study published in the medical journal Gastroenterology (May 2), researchers of the Farncombe Family Digestive Health Research Institute found that twice as many adults with irritable bowel syndrome (IBS) reported improvements from co-existing depression when they took a specific probiotic than adults with IBS who took a placebo. The study provides further evidence of the microbiota environment in the intestines being in direct communication with the brain said senior author Dr. Premysl Bercik, an associate professor of medicine at McMaster and a gastroenterologist for Hamilton Health Sciences. “This study shows that consumption of a specific probiotic can improve both gut symptoms and psychological issues in IBS. This opens new avenues not only for the treatment of patients with functional bowel disorders but also for patients with primary psychiatric diseases,” he said. Related Articles Overweight in Childhood May Up Lifetime Risk of Depression Personalized Psychiatry Matches Therapy to Specific Patients with Depression Gender Differences in Depression Tend to Appear About Age 12 Anxiety and depression in working-age cancer survivors: a register-based study IBS is the most common gastrointestinal disorder in the world, and is highly prevalent in Canada. It affects the large intestine and patients suffer from abdominal pain and altered bowel habits like diarrhea and constipation. They are also frequently affected by chronic anxiety or depression. The pilot study involved 44 adults with IBS and mild to moderate anxiety or depression. They were followed for 10 weeks, as half took a daily dose of the probiotic Bifidobacterium longum NCC3001,...
Comparison of Antibiotic Treatments for Cellulitis

Comparison of Antibiotic Treatments for Cellulitis

Among patients with uncomplicated cellulitis, the use of an antibiotic regimen with activity against MRSA did not result in higher rates of clinical resolution compared to an antibiotic lacking MRSA activity; however, certain findings suggest further research may be needed to confirm these results, according to a study published by JAMA. Emergency department visits for skin infections in the United States have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). To determine whether addition of a MRSA-active antimicrobial improves outcomes in patients with cellulitis, Gregory J. Moran, M.D., of Olive View-UCLA Medical Center, Los Angeles, and colleagues randomly assigned emergency department patients presenting with cellulitis without a wound or abscess to receive a regimen with activity against MRSA, the antibiotics cephalexin plus trimethoprim-sulfamethoxazole (n = 248), or a regimen lacking MRSA activity, cephalexin plus placebo (n = 248) for 7 days. Related Articles Orbital Cellulitis Reported After Use of Facial Soft-Tissue Filler About 30 Percent Misdiagnosed With Lower Extremity Cellulitis Clinical Characteristics and Outcomes of Patients With Cellulitis Requiring Intensive Care Infectious diseases specialist management improves outcomes for outpatients diagnosed with cellulitis in the emergency department Among the participants, 496 were included in the modified intention-to-treat analysis and 411 in the per-protocol analysis. In the per-protocol population, clinical cure occurred in 83.5 percent of participants in the cephalexin plus trimethoprim-sulfamethoxazole group vs 85.5 percent in the cephalexin group. In the modified intention-to-treat population, clinical cure occurred in 76.2 percent of participants in the cephalexin plus trimethoprim-sulfamethoxazole group vs 69 percent in the cephalexin group. The authors write that because the results from the modified intention-to-treat analysis did not...
Assumption of the Risk

Assumption of the Risk

“If a patient chooses to come to me for medical care and I explain the risks and they agree to the treatment then how can they turn around and sue me.  Aren’t they agreeing to those risks?” This question, often posed by doctors, is actually about a legal doctrine called “assumption of the risk”. This is a defense against a negligence claim based on the plaintiff having actually agreed fully to take on the risk that he or she is now suing about. Assumption of the risk does actually superficially sound a great deal like the informed consent doctrine because  under it someone must be informed of specific risks and agree to go ahead anyway and it does not cover reckless or intentional conduct. Many physicians therefore believe that a patient can, by agreeing to medical care, immunize them against a later claim of malpractice unless they are actually grossly negligent or intentionally improper in providing that care. So, why doesn’t a signed consent just stop a medical malpractice case at the start? Why can’t the defendant doctor plead “assumption of risk” and end the case? After all, patients are informed of the risks as well as the benefits of a treatment and then agree to go ahead anyway. The reason is that the assumption of the risk doctrine actually does not apply to medical care. Let’s look at where it does apply to understand why that is. Express assumption of the risk is usually asserted in cases involving injuries that occurred during inherently dangerous recreational activities, like hang-gliding or bungee-jumping. It is founded on a release that the person...
Cardiac Rehab Benefits Older Acute Myocardial Infarction Patients

Cardiac Rehab Benefits Older Acute Myocardial Infarction Patients

Despite national guidelines strongly supporting the use of cardiac rehabilitation (CR) in patients after they suffer an acute myocardial infarction (AMI), many trials have shown that participation in such programs is relatively low. Some research has questioned the value of CR among AMI patients because studies have not consistently shown that these programs can lead to mortality benefits. “Compounding the issue is the fact that CR programs are often considered costly and inconvenient for patients,” says Jacob A. Doll, MD. “As such, data are needed in which outcomes associated with CR are assessed among AMI patients, especially for high-risk groups like the Medicare population.” Published estimates have shown that patients aged 65 and older account for more than half of the 15.4 million Americans with heart disease, but these individuals have especially low participation rates in CR programs after AMI. In addition, older adults are underrepresented in prevention trials. Participating in CR has been shown to improve functional capacity and quality of life for older adults, but the optimal number of CR sessions that these patients need to attend in to be beneficial is unclear. Examining Trends For a study published in the American Heart Journal, Dr. Doll and colleagues examined the characteristics of older individuals with AMI who participated in a greater or lesser number of CR sessions and looked at the association between the number of sessions attended and medication adherence as well as clinical outcomes. “It’s important to note that all participants had attended at least one CR session after their AMI,” Dr. Doll says. The authors could examine contemporary outcomes because they linked a national...
Assessing Oral Anticoagulant Prescription for Atrial Fibrillation

Assessing Oral Anticoagulant Prescription for Atrial Fibrillation

The CHADS2 and CHA2DS2-VASc scores have been developed to help estimate the risk of thromboembolism in patients with AF based on specific risk factors. “Current guidelines call for using these tools to determine the absolute risk of stroke and help clinicians decide if prescription oral anticoagulants (OACs) are warranted to reduce stroke risk,” says Jonathan Hsu, MD, MAS. Addressing the Issue Despite the well-established association of AF with stroke, several large-scale studies indicate that OAC prescription rates are low among at-risk candidates. “Although OACs can benefit patients with AF, little is known about the extent to which OAC prescribing occurs in real-world practice to help reduce the risk of stroke,” says Dr. Hsu. To address this research gap, he and his colleagues had a study published in JAMA Cardiology that evaluated the prevalence of OAC prescription by cardiovascular specialists. For the study, the authors used outpatient data from a large national registry to examine the real-world prevalence of treatment with OACs, antiplatelet therapy only, or no antithrombotic therapy in patients with AF based on CHADS2 and CHA2DS2-VASc scores. The primary outcome was prescription of an OAC with warfarin sodium or a non–vitamin K antagonist OAC. In total, more than 429,000 outpatients with AF were included in the analysis. Results of the study showed that cardiovascular disease specialists were more likely to prescribe an OAC in patients with more stroke risk factors, based on both the CHADS2 score and the CHA2DS2-VASc score. Each 1-point increase in risk score correlated with a higher likelihood of AF patients receiving an OAC prescription when compared with aspirin-only prescriptions. “However, fewer than 50% of...
Heart Attack Risk 17-Times More Likely Following Respiratory Infections

Heart Attack Risk 17-Times More Likely Following Respiratory Infections

The risk of having a heart attack is 17 times higher in the seven days following a respiratory infection, University of Sydney research has found. Published today in Internal Medicine Journal, this is the first study to report an association between respiratory infections such as pneumonia, influenza and bronchitis and increased risk of heart attack in patients confirmed by coronary angiography (a special X-Ray to detect heart artery blockages). “Our findings confirm what has been suggested in prior studies that a respiratory infection can act as a trigger for a heart attack,” said senior author Professor Geoffrey Tofler, cardiologist from University of Sydney, Royal North Shore Hospital and Heart Research Australia. “The data showed that the increased risk of a heart attack isn’t necessarily just at the beginning of respiratory symptoms, it peaks in the first 7 days and gradually reduces but remains elevated for one month.” Related Articles Common Pain Relievers May Increase Heart Attack Risk During Respiratory Infections Sudden Drop in Temperature Increases Risk of Respiratory Infections Managing Acute Respiratory Tract Infections New Blood Test Allows Doctors to Diagnose Heart Attack Quicker The study was an investigation of 578 consecutive patients with heart attack due to a coronary artery blockage, who provided information on recent and usual occurrence of symptoms of respiratory infection. Seventeen per cent of patients reported symptoms of respiratory infection within 7 days of the heart attack, and 21 per cent within 31 days. Patients were interviewed about their activities before the onset of their heart attack, including if they experienced a recent “flu-like illness with fever and sore throat”. They were considered affected...
Substantial Differences Between US Counties for Death Rates from Ischemic Heart Disease, Stroke

Substantial Differences Between US Counties for Death Rates from Ischemic Heart Disease, Stroke

Although the absolute difference in U.S. county-level cardiovascular disease mortality rates have declined substantially over the past 35 years for both ischemic heart disease and cerebrovascular disease, large differences remain, according to a study published by JAMA. Cardiovascular disease remains the leading cause of death in the United State despite declines in the national cardiovascular disease mortality rate between 1980 and 2015. Mortality rates for smaller regions of the country, such as counties, can differ substantially from the national average; these differences have important implications for local and national health policy. Gregory A. Roth, M.D., M.P.H., of the Division of Cardiology, Institute for Health Metrics and Evaluation, University of Washington, Seattle, and colleagues used death records from the National Center for Health Statistics and population counts from the U.S. Census Bureau, the National Center for Health Statistics, and the Human Mortality Database from 1980 through 2014 to estimate mortality rates from cardiovascular diseases by U.S. county (n = 3,110). Related Articles Women & Ischemic Heart Disease – Coming to a Consensus Global Burden of Cardiovascular Disease Assessed Risk of Heart Failure Up for Rheumatoid Arthritis Patients Specific Autoimmune Diseases Tied to Subsequent Dementia Risk The researchers found that the mortality rate for cardiovascular diseases in the U.S. declined from 507 deaths per 100,000 persons in 1980 to 253 deaths per 100,000 persons in 2014, a relative decline of 50%. In 2014, cardiovascular diseases accounted for more than 846,000 deaths. There were substantial differences between county ischemic heart disease and stroke mortality rates; smaller differences were found for diseases of the myocardium, atrial fibrillation, aortic and peripheral arterial disease, rheumatic...
Treating Older Patients with Acute Myocardial Infarction

Treating Older Patients with Acute Myocardial Infarction

Each year in the United States, about 1 million Americans are hospitalized for acute myocardial infarction (AMI), and nearly half of these individuals are expected to have a recurrent major adverse cardiovascular event. According to current guidelines, secondary prevention strategies for patients with AMI include treatment with aspirin, β-blockers, statins, platelet P2Y12 receptor inhibitors, and ACE inhibitors or angiotensin receptor blockers. These therapies have been shown to provide long-term survival benefits for those who have suffered an AMI, but studies indicate that adherence to prescribed drug regimens following an AMI is often low. This can result in higher risks for mortality and hospital readmission. “Hospital readmissions following AMI are an important challenge in healthcare, and many of these individuals are readmitted early after they’re discharged,” says Tracy Y. Wang, MD, MHS, MSc. In recent years, greater attention has been paid to finding strategies that can increase the likelihood of earlier outpatient follow-up after AMI patients are hospitalized. Early follow-up may help prevent adverse events. Studies indicate that up many AMI patients who are readmitted to the hospital have not had an outpatient physician visit prior to their readmission. “Early follow-up is now incorporated into provider payment models and national quality improvement guidelines,” Dr. Wang says, “but it’s unknown if the timing of outpatient follow-up of AMI patients is associated with better medication adherence.” Taking a Closer Look For a study published in JAMA Cardiology, Dr. Wang and colleagues conducted a retrospective analysis of more than 20,000 Medicare-aged patients who were discharged after an AMI to see if the timing of outpatient follow-up was associated with better medication adherence. Patients...
Hypertension Before the Age of 55 Increases Risk of Cardiovascular Death

Hypertension Before the Age of 55 Increases Risk of Cardiovascular Death

According to a new study, diagnosis of high blood pressure at an earlier age is associated with greater risk of cardiovascular death and signifies an inherited predisposition for the disease. The findings, which appear in the British Medical Journal, offer important prognostic information in assessing an individual’s cardiovascular risk. It is well known that hypertension confers substantial risk for developing cardiovascular outcomes when present in either younger or older age. However, there are currently limited data to guide clinicians on the possible relevance of distinguishing between the importance of hypertension that develops earlier in life and that which develops later in life. Using data from the Framingham Heart Study (FHS), researchers from Boston University School of Medicine (BUSM) studied several decades worth of blood pressure readings collected over multiple generations. The researchers tracked which individuals developed high blood pressure earlier or later in life, identified patterns of earlier versus later onset hypertension among families and then compared the lifetime risks of cardiovascular disease in people with earlier versus later onset hypertension. Related Articles Hypertension May Positively Affect Ovarian Cancer Prognosis Age at First Childbirth and Hypertension in Postmenopausal Women New Models of Pregnancy-Associated Hypertension Low-Sodium Diet Might Not Lower Blood Pressure ‘We now know that there are at least two types of high blood pressure of which patients and providers should be aware — one type that develops earlier in life, which likely represents an inherited trait, and another that develops later in life that could possibly have more to do with lifestyle factors. Most importantly, the type that develops earlier in life is related to greater lifetime risk...
Brain-Training Computer Game Helps Kids Choose Healthier Diets

Brain-Training Computer Game Helps Kids Choose Healthier Diets

Children who played a seven-minute game devised by University of Exeter psychologists made healthier choices when asked to pick foods afterwards. The game involves reacting to images of healthy food by pressing a button, and doing nothing if unhealthy foods are shown. “The sight of foods like chocolate can activate reward centres in the brain at the same time as reducing activity in self-control areas,” said Lucy Porter, the lead researcher on the project. “Our training encourages people to make a new association – when they see unhealthy food, they stop. Related Articles Guidance on Dietary Sugar Intake Based on Low-Quality Evidence Food is Medicine for HIV-Positive, Type 2 Diabetes Patients “Many health promotion schemes rely on education and willpower and require a lot of time, staff and money, but our game potentially sidesteps these issues by creating a free, easy tool for families to use at home. “The research is at an early stage and we need to investigate whether our game can shift dietary habits in the long-term, but we think it could make a useful contribution.” Click here to read the full press...
How Ethnicity and Culture Impact the Health and Well-Being of Older People

How Ethnicity and Culture Impact the Health and Well-Being of Older People

Importantly, many of these older adults are more diverse than ever before. By 2050, for example, “minority” older adults will account for nearly 40% of the 80 million Americans aged 65 and older. To increase our sensitivity to health disparities, culture, and health literacy, experts in ethnogeriatrics—the study of how ethnicity and culture impact the health and well-being of older people—at the American Geriatrics Society (AGS) recently published a position statement. The document, published in the Journal of the American Geriatrics Society, describes strategies for achieving high-quality multicultural geriatric care. It serves as a blueprint for providing culturally effective, respectful care that meets the unique needs of our richly diverse older adult patient population. Inequities Persist While health inequities are already well-documented among older people, they are even more pronounced for multi-cultural older Americans. Minority individuals older than age 65 have higher rates of disease and disability when compared with Caucasian men and women of the same age. Additionally, of the 36% of Americans who report limited health literacy, most are older, less educated, and not white. Sadly, many minority individuals also tend to mistrust health personnel and systems. They also lack trust in medical research. These factors can undermine the therapeutic bond and exacerbate barriers to high-quality multicultural care. Seeing More Than Age As outlined in the AGS position statement, delivering culturally effective care means exploring and being responsive to the unique care needs of each patient during every clinical encounter. Putting processes or systems in place to ensure that patients are asked about their ethnicity, their preferred language, their level of education, and their familiarity with helpful...
Less Than Half of Americans Can Recognize Anxiety

Less Than Half of Americans Can Recognize Anxiety

Most people don’t know what to do about depression even when they spot it. And nearly 8 in 10 don’t recognize prescription drug abuse as a treatable problem. Those are just some of the findings of a new national survey on issues surrounding mental-health literacy by Michigan State University scholars. “Our work is designed to help communities think about how to address behavioral health challenges as they emerge, whether that’s drug abuse, anxiety or other issues, and the challenges such as suicide that can accompany them,” said Mark Skidmore, an MSU professor and co-investigator on the project. The national survey examines mental health literacy on four major issues: anxiety, depression, alcohol abuse and prescription drug abuse. The work is funded by the U.S. Department of Agriculture and the Substance Abuse and Mental Health Services Administration, an agency within the U.S. Department of Health and Human Services, and administered by the National Institute of Food and Agriculture, within Agriculture Department. Related Articles Depression, Anxiety Prevalent in Hospice Caregivers Anxiety, Depression May Up Mortality Risk for Some Cancers Mortality Risk in T2DM Increased With Depression and/or Anxiety Depression in young people affects the stomach, anxiety the skin Skidmore said the web-based survey — which involved nearly 4,600 total participants — aims to give health officials and policymakers a better understanding of where to target education and prevention efforts for major societal issues such as prescription drug abuse. Public health officials are calling the opioid epidemic — which killed more than 33,000 people in 2015 — the worst drug crisis in American history. According to the survey, 32 percent of all respondents...
Guidelines for Managing Breast Cancer Survivors

Guidelines for Managing Breast Cancer Survivors

According to national estimates, breast cancer ranks as the most common non-cutaneous malignancy among women, representing four in 10 female cancer survivors in the United States. The 5-year survival rate after breast cancer treatment is almost 85% for all stages, according to studies. More than 245,000 women will be newly diagnosed with invasive breast cancer this year, and an estimated 2.8 million breast cancer survivors are alive in the U.S. Considering the likelihood of long-term survival among these patients, it is important to address the unique post-treatment needs of these women so that clinicians can provide quality healthcare. A Helpful Document Recently, the American Cancer Society (ACS) and the American Society of Clinical Oncology (ASCO) issued breast cancer survivorship care guidelines. Published in the Journal of Clinical Oncology and in CA: A Journal for Clinicians, the guidelines were developed to enhance the quality of clinical follow-up care for patients who have completed active treatment for breast cancer. The ACS/ASCO guideline expert panel looked at more than 1,000 scientific articles and studies and included 237 as the evidence base. Recommendations provided in the guideline are based on current evidence in the literature and expert consensus opinion. “It’s important that physicians are aware of this document so that they can use it as a tool in patient care,” says Corinne R. Leach, PhD, MS, MPH, who chaired the guideline writing group. Since the document was released, ACS has developed both a digital application for the survivorship care guidelines for clinicians as well as an online patient self-management tool. The clinician app is available on iTunes while the patient self-management tool can...
Two Types of Skin Cancer are on the Rise

Two Types of Skin Cancer are on the Rise

New diagnoses for two types of skin cancer increased in recent years, according to a Mayo Clinic-led team of researchers. Their paper, published today in Mayo Clinic Proceedings, uses medical records from the Rochester Epidemiology Project to compare diagnoses of basal cell carcinoma and squamous cell carcinoma — both nonmelanoma skin cancers — between 2000 and 2010 to diagnoses in prior years. The Rochester Epidemiology project is a medical records linkage system and research collaborative in Minnesota and Wisconsin. The researchers report that, between 2000 and 2010, squamous cell carcinoma (also called cutaneous squamous cell carcinoma) diagnoses increased 263 percent, and basal cell carcinomas increased 145 percent. They compared the 2000-2010 period to two other segments of time: 1976-1984 and 1985-1992. Women 30-49 experienced the greatest increase in basal cell carcinoma diagnoses; whereas, women 40-59 and 70-79 experienced the greatest increase in squamous cell carcinomas. Men had an increase in squamous cell carcinomas between the first and second time period studied (1976-1984 and 1985-1992), but experienced a slight decline in the 2000-2010 period. However, for basal cell carcinomas, men over 29 showed similar increases in diagnoses in the 2000-2010 period then the two earlier periods. Click here to read the full press...
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