The epidemic of the 20th century | "There is no help out there and if there is, it's really hard to find" | Burdensome transitions at end of life
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September 18, 2014
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The epidemic of the 20th century
It is very likely that the 20th century was the only century in which heart disease was the most common cause of death in America. The American Journal of Medicine (9/2014) Share: Email
Clinical Updates
"There is no help out there and if there is, it's really hard to find"
Young adults who are eligible for the Deferred Action for Childhood Arrivals (DACA) program have significant mental health concerns and face profound barriers to health care access. These barriers can be alleviated by immigration and health care reforms, as well as assurance of regular care through a medical home. (Full-text access is time limited.) Journal of Adolescent Health (9/2014) Share: Email
Burdensome transitions at end of life
Moving a long-term-care resident with dementia to the hospital near end-of-life can lead to confusion/delirium and negatively affect their quality of life. Experts agree that end-of-life care should focus on comfort, pain control and continuity of care in a familiar living environment. A Finnish study found 9.5% of residents had burdensome care transition during the last 90 days of life. Sheltered housing (assisted living) with 24-hour assistance may be less prepared for end-of-life than traditional nursing homes. (Free abstract only.) Journal of the American Medical Directors Association (9/2014) Share: Email
Do cancer screening discussions include shared decision-making?
Clinicians are encouraged to support patients in achieving shared decision-making (SDM) for cancer screening. The effectiveness of SDM processes and outcomes was evaluated for adults aged ≥50 years who made cancer-screening decisions. The authors found discussions often failed to provide balanced information and meet SDM criteria. The quality of cancer screening decisions could potentially be improved with increased SDM support. (Available for CME credit.) American Journal of Preventive Medicine (9/2014) Share: Email
Prevalence of illicit drug use in pregnant women
Drugs of abuse were found in 13% of patients presenting for prenatal care. Adding five questions to the intake process proves an appropriate screen. American Journal of Obstetrics & Gynecology (9/2014) Share: Email
Anthropometric indices do not adequately predict metabolic comorbidities in obese children
Anthropometric indices, such as body mass index (BMI), Z-score of the BMI, waist circumference and waist-to-height ratio, were assessed in obese children and adolescents to evaluate whether they correlated with metabolic variables. Although the indices were associated with metabolic impairments, they showed low to moderate accuracy in determining both single and clustered metabolic impairments. Therefore, these anthropometric indices may not be appropriate screening tools for metabolic assessment. The Journal of Pediatrics (8/2014) Share: Email
Metabolic syndrome and diastolic dysfunction
This study suggests that metabolic syndrome can lead to the development of diastolic dysfunction via mechanisms independent of hypertrophy. Differences in diastolic function were more pronounced at younger ages, highlighting the potential importance of early risk factor modification and preventive strategies in metabolic syndrome. The American Journal of Cardiology (9/15/2014) Share: Email
Medical News
Report: 14.5 million cancer survivors in the U.S.
One in 22 people in the U.S. has survived cancer, according to the American Association for Cancer Research, and the percentage of Americans who have survived cancer has tripled over the past 40 years. Advances in our understanding of cancer genetics and targeted treatments are changing the outcomes for many cancers, and experts say newer treatments also carry fewer side effects. Bloomberg Businessweek (9/16) Share: Email
Data show persistent increase in waist size, central obesity in U.S.
Research published in the Journal of the American Medical Association says the mean waist circumference among Americans rose from 37.6 inches in 1999-2000 to 38.8 inches in 2011-2012, while the prevalence of central obesity increased from 46.4% to 54.2% during the same period. Data also indicated men had smaller increases in mean waist size and abdominal obesity compared with women. Reuters (9/16) Share: Email
Male pattern baldness linked to prostate cancer risk in study
An analysis of data on almost 40,000 men ages 55 to 74 in the U.S. found that male pattern baldness was associated with a 39% increase in the risk of developing an aggressive form of prostate cancer. Researchers did not observe a similar link with other types of baldness, according to the study in the Journal of Clinical Oncology. U.S. News & World Report/HealthDay News (9/15) Share: Email
Business Practice News
Poll gauges physician views toward health care landscape
Data from the Survey of America's Physicians revealed the number of physicians who reported being overextended grew from 75% in 2012 to 81% in 2014, while only 19% had time to assess more patients. Researchers also found nearly 75% agreed there is a physician shortage and that Congress should allow for more residency slots and lift the federal funding cap. (9/16) Share: Email
AMA releases EHR usability framework
The American Medical Association has established eight priorities for improving usability and integration of EHRs in the clinical setting. The AMA said supporting team-based care, promoting health care coordination and facilitating technology-based patient engagement were among the keys to building a better EHR. (9/16) Share: Email
Patient's Perspective
Rate of uninsured dropped this year
The nation's uninsured rate fell from 20.4% last year to 18.4% in the first quarter of 2014, according to a federal survey. The survey results do not include health insurance applications received in late March and early April. The New York Times (tiered subscription model) (9/16), Bloomberg (9/16) Share: Email
Look for a way to lift someone up. If that's all you do, it's enough."
-- Elizabeth Lesser,
American entrepreneur Share: Email
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