Category Archives: Public health
RWJF Analysis of ACA Effects Finds No Increase in New Patient Visits
A new report, ACAView, from the Robert Wood Johnson Foundation (RWJF) and athenahealth, finds that in the first five months of 2014 there was no increase in new patient visits, when compared to the same time last year. The ACAView initiative was created to measure the impact of the Affordable Care Act (ACA) on providers, patients and physicians from 2014 through 2016. The report focuses on the provider perspective, showcasing how the ACA affects the practice patterns and economics of physicians and other care team members around the country. Potential reasons for the lack of an increase in visits include the newly insured being unfamiliar with the health care system, or even the winter weather. Read more on the Affordable Care Act.
Study: Nickel in an iPad Linked to Boy’s Allergic Skin Reaction
An ever-increasing reliance on consumer electronics may also mean rarer allergies are becoming more common, according to researchers who linked an 11-year-old boy’s allergic skin reaction to the nickel found in a first-generation Apple iPad. The study was published in the journal Pediatrics. Previous studies have linked the nickel in computers, smartphones and other electronics to allergic reactions; other common sources of nickel include ear piercings, clothing fasteners and dental work. “With the increasing prevalence of nickel allergy in the pediatric population, it is important for clinicians to continue to consider metallic-appearing electronics and personal effects as potential sources of nickel exposure,” according to the study. Read more on pediatrics.
Study: Changing Generic Pill Color, Shape Can Decrease Prescription Adherence
In addition to known considerations such as side effects and cost, the change in the appearance of prescription medications may also lead some people to stop taking their prescriptions, according to a new study in the Annals of Internal Medicine. In a study of more than 11,000 patients, researchers determined that a change in pill color would increase the odds that a patient would stop taking their heart medication by 34 percent, while a change in pill shape would increase the chances by 66 percent. This adds another wrinkle to the series problem of medication adherence; the American Heart Association estimates that three out of four Americans do not take their medication as directed. Read more on prescription drugs.
CDC Closes Flu and Anthrax Labs After Serious Lapses
After two serious lapses with anthrax and avian flu virus, the U.S. Centers for Disease Control and Prevention (CDC) announced it was temporarily closing its anthrax and flu laboratories and stopping shipments of all infectious agents. Last month at least 63 CDC employees may have been exposed to live anthrax bacteria after samples were sent to laboratories that were not prepared to handle the infectious agents. Anyone possibly exposed has been offered a vaccine and antibiotics; the CDC says no one was in danger.
In the second incident, technicians in a CDC lab accidentally contaminated a largely benign flu virus with a much more dangerous H5N1 bird flu strain. A lab worker who received a shipment of the strain and realized it was more dangerous than the sample expected contacted the CDC. And, in a third incident, the CDC also announced on Friday that two of six vials of smallpox vaccine recently found stored at the National Institutes of Health since 1954 contained live virus that could have infected people.
CDC has convened an investigation with finding expected later this week, as well as:
- Established a high-level working group, reporting to the CDC Director, to help accelerate improvements in laboratory safety; review and approve—on a laboratory-by-laboratory basis—resuming transfer of biological materials; and serve as the transition group for accountability on laboratory safety.
- Established a review group, under the direction of CDC’s Associate Director for Science, to look at the systems, procedures and personnel issues that led to the events, as well as how to prevent similar events in the future.
- Plans to take personnel action regarding individuals who contributed to or were in a position to prevent this incident.
Read more on infectious disease.
Military Servicemembers at Increased Risk of Financial Abuse
Members of the military are at increased risk of financial abuse, according to a new survey from the National Foundation for Credit Counseling (NFCC), and more must be done to help servicemembers protect themselves. An NFCC survey of active duty military personnel found that:
- 77 percent of respondents have financial worries
- 55 percent feel not at all or only somewhat prepared to meet a financial emergency
- 60 percent say they had to look outside of traditional institutions and utilized alternative, non-traditional lenders to meet their financial needs
In order to answer this need, the NFCC is working to give servicemembers a deeper understanding of personal finance through its Sharpen Your Financial Focus program, which includes materials that address their particular financial literacy challenges. The program presents 10 individual lesson topics, ranging from banking to planning for retirement. “No one should be victimized by financial abuse, particularly the military,” said Gail Cunningham, spokesperson for the National Foundation for Credit Counseling (NFCC). “One way to avoid financial abuse is through financial education, as an educated consumer is always a better consumer, one more equipped to identify fraud or deception and make wise financial decisions.” Read more on the military.
Study: Confusion Over Spoon Sizes Can Lead to Incorrect Medication Doses for Kids
Confusion over and differences in spoon sizes can lead to frequent medication dosing errors for children, according to a new study in the journal Pediatrics. Researchers observed 287 parents provide medicine to their children using teaspoons and tablespoons, finding that 39 percent incorrectly measured the dose they intended and 41 percent made an error in measuring what their doctor had prescribed. The findings indicate a growing need to change how doctors prescribe medicine for children. "A move to a milliliter preference for dosing instructions for liquid medications could reduce parent confusion and decrease medication errors, especially for groups at risk for making errors, such as those with low health literacy and non-English speakers," said the study's lead author Shonna Yin, MD, an assistant professor of pediatrics at NYU School of Medicine in New York City. Poison control centers receive approximately 10,000 calls each year related to incorrect dosages of oral liquid medications. Read more on pediatrics.
CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.
Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.
Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.
HHS, DOJ Release ‘Roadmap’ to Prevent Elder Abuse
The U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) have announced a new Elder Justice Roadmap to enhance elder abuse prevention and prosecution, while also highlighting the issue of elder abuse. An estimated one in 10 Americans over the age of 60 have experienced elder abuse or neglect. The Roadmap includes the DOJ’s development of an interactive, online curriculum to teach legal aid and other civil attorneys to identify and respond to elder abuse, as well as the HHS’ development of a voluntary national adult protective services data system. “Elder abuse is a problem that has gone on too long, but the Roadmap Report released today can change this trajectory by offering comprehensive and concrete action items for all of the stakeholders dedicated to combating the multi-faceted dimensions of elder abuse and financial exploitation,” said Associate Attorney General Tony West, in a release. “While we have taken some important steps in the right direction, we must do more to prevent elder abuse from occurring in the first place and face it head on when it occurs.” Read more on aging.
Study: Health Care Providers Must Do More to Ensure Pregnant Women Receive the Flu Vaccine
A new study finds that health care providers (HCPs) must do more to ensure pregnant women are vaccinated against influenza. After a review of 45 research papers, researchers determined that HCP influenza vaccine recommendations and on-site services would both help increase the current suboptimal vaccination rate. The study pointed to inadequate knowledge of the risks of influenza; doubts about vaccine safety, efficacy and benefits; and fear of adverse reactions for both the pregnant women and their unborn fetuses as barriers to vaccination. Many of the women in the review were also unaware that their pregnancies placed them at higher risk of complications from influenza. Read more on maternal and infant health.
Study: Younger Pro Pitchers at Higher Risk of Needing ‘Tommy John’ Surgery
Stephen Strasburg. Matt Harvey. Kerry Wood. All were or are hard-throwing Major League Baseball (MLB) pitchers who underwent “Tommy John” surgery early in their careers. Now, a new study from researchers at the American Orthopaedic Society for Sports Medicine indicates that entering the MLB at a younger age increases the risk of needing Tommy John surgery—which is a reconstruction of the ulnar collateral ligament in the elbow—at some point in a career. In a study of 168 pitchers who had Tommy John surgery and 178 age-matched pitchers who did not, approximately 60 percent of those who needed the surgery had it in the first five years of their career. They also had statistically more Major League experience, indicating that arm stress at a younger age heightens the risk of damage. “Having athletic trainers and team physicians closely look at when players’ pitching performance stats start to decrease may allow for steps to be taken before a surgery is needed. Our study also further highlights the need for kids not to overuse their arms early in their pitching careers,” said lead author Robert Keller, MD, of Henry Ford Hospital in Detroit, in a release. Read more on injury prevention.
Study: Global Child TB Rates 25 Percent Higher than Previously Realized
The true number of children who develop tuberculosis (TB) each year in the 22 countries with the worst TB rates is nearly 25 percent higher than the World Health Organization (WHO) estimated as recently as 2012, according to a new study in The Lancet Global Health. Researchers used mathematical modeling to determine that approximately 650,000 children in these countries develop TB each year; the WHO estimate was 530,000. The study also determined that approximately 15 million children are exposed to TB every year and 53 million are living with latent TB infections which can become infectious active TB. While the findings are troubling, they also indicate promising ways to reduce the risk. "Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB,” said lead author Peter Dodd, MD, from the University of Sheffield in the United Kingdom, in a release. "Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease." Read more on global health.
Severe Obesity Can Cut a Person’s Lifespan by Nearly 14 Years
Severe obesity can take nearly 14 years off a person’s life, according to a new study in the journal PLOS Medicine. Using data from 20 previous studies, researchers determined that severe obesity—defined as a body mass index (BMI) greater than 40—can cut lives short by anywhere from 6.5 to 13.7 years, due to increased risk of health problems such as heart disease, cancer and diabetes. "We found that the death rates in severely obese adults were about 2.5 times higher than in adults in the normal weight range," said lead investigator Cari Kitahara, a research fellow at the U.S. National Cancer Institute, according to HealthDay. Approximately 6 percent of U.S. adults are severely obese; severe obesity accounts for approximately 509 deaths per 100,000 men annually and 382 deaths per 100,000 women annually. Read more on obesity.
HHS: $100M for 150 New Community Health Centers
The U.S. Department of Health and Human Services (HHS) has announced approximately $100 million in available funds for communities to expand access to affordable, high-quality primary care through an estimated 150 new community health centers in 2015. Currently there are approximately 1,300 health centers with more than 9,200 service sites providing care to more than 21 million people in the United States and its territories. The centers, made possible under the Affordable Care Act (ACA), have also helped approximately 4.7 million people enroll for ACA coverage. Read more on community health.
HHS: $83.4M to Improve Community Access to Primary Health Care
The U.S. Department of Health and Human Services (HHS) is awarding $83.4 million to 60 Teaching Health Centers as part of the Affordable Care Act. The funds will go toward training more than 550 residents during the 2014-15 academic year, with the goal of strengthening primary care and improving access to health care in U.S. communities. Areas covered will include family medicine, internal medicine, pediatrics, obstetrics, gynecology, psychiatry, geriatrics and general dentistry. “This program not only provides training to primary care medical and dental residents, but also galvanizes communities,” said Health Resources and Services Administration Administrator Mary K. Wakefield, PhD, RN. “It brings hospitals, academic centers, health centers, and community organizations together to provide top-notch medical education and services in areas of the country that need them most.” Read more on access to care.
Community Preventive Services Task Force Recommends Universal Motorcycle Helmet Laws
Universal motorcycle helmet laws can prevent injuries and save lives while also saving communities the high health care costs associated with collisions, according to a new review of 69 studies and a separate economic review of 22 studies by the Community Preventive Services Task Force. Based on the conclusions, the task force—an independent, nonfederal, unpaid panel of public health and prevention experts—recommends all U.S. communities adopt universal helmet laws, with are more effective than no law or partial helmet laws at preventing severe injuries. The study found that the United States and other high-income communities saw substantial decreases in motorcycle-related deaths and injuries after enacting universal helmet laws, but the inverse when universal laws were repealed or replaced with other laws. Read more on injury prevention.
Study: Fungus Behind 2013 Yogurt Recall a Larger Threat than Previously Believed
The fungus behind an outbreak that led to the September 2013 recall of Chobani brand Greek yogurt is more dangerous than first believed, according to a new study in mBio, the online journal of the American Society for Microbiology. Initially the company believed that the Murcor circinelloides fungus was only a potential danger to people with compromised immune systems. However, as additional gastrointestinal were reported researchers continued their study, concluding that the “harmless” fungus was actually a strain with the ability to cause disease. “When people think about food-borne pathogens, normally they list bacteria, viruses, and maybe parasites. Fungal pathogens are not considered as food-borne pathogens. However, this incidence indicates that we need to pay more attention to fungi. Fungal pathogens can threaten our health systems as food-borne pathogens” said Soo Chan Lee of Duke University, an author on the study. Read more on food safety.
CDC: One in 25 U.S. Drivers Report Falling Asleep at the Wheel in the Previous 30 Days
Approximately one in 25 U.S. drivers reported falling asleep while driving at least once in the previous 30 days, according to the latest Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC). CDC data found that, from 2009-2010, people who slept six or fewer hours per night, snored or unintentionally fell asleep during the day were most likely to fall asleep behind the wheel. They also identified binge drinking and unsafe seatbelt use as linked to a higher risk of falling asleep while driving. The report data was culled from information from the 92,102 respondents in 10 states and Puerto Rico to the 2011–2012 Behavioral Risk Factor Surveillance System surveys. Read more on transportation.
Study: Adults with Dyslexia Far More Likely to Have Been Abused as Children
Approximately one third of dyslexic adults report having been physically abused as children, according to a new study in the Journal of Interpersonal Violence. The percentage was far less—seven percent—for adults without dyslexia. Researchers say more work is needed to identify the cause or causes for this disparity. “It is possible that for some children, the presence of dyslexia and related learning problems may place them at relatively higher risk for physical abuse, perhaps due to adult frustrations with chronic learning failure" said study co-author, Stephen Hooper, professor of Psychiatry and Pediatrics, and Associate Dean and Chair of Allied Health Sciences at the University of North Carolina School of Medicine, in a release. "Alternatively, given the known association between brain dysfunction and maltreatment, it could be that the experience of physical abuse may also contribute to and/or exacerbate such learning problems, secondary to increased neurologic burden." Read more on violence.
Poultry Recall Connected to Massive Salmonella Outbreak
Sixteen months after the start of a salmonella outbreak that has sickened nearly 600 people across 27 states, Foster Farms has announced it will recall contaminated chicken that has been linked to the outbreak. The California-based poultry company said the recalled products—produced at three facilities on March 8, 10 and 11 of this year—were distributed in California, Hawaii, Washington, Arizona, Nevada, Idaho, Utah, Oregon and Alaska. "This recall is prompted by a single illness associated with specific fresh chicken product, but in the fullest interest of food safety, Foster Farms has broadened the recall to encompass all products packaged at that time. Foster Farms regrets any illness associated with its products," said the company in a statement. Read more on food safety.
Widely Used HIV Drug Linked to Higher Suicide Risk
People infected with HIV whose treatment includes the widely used antiretroviral drug efavirenz appear to have double the risk of suicidal thoughts, attempts and completion compared to HIV patients not taking the medication, according to a study by several researchers at the Harvard School of Public Health and the University of North Carolina at Chapel Hill. The study was published in the Annals of Internal Medicine.
“When efavirenz is used as a component of antiretroviral therapy, patients should be monitored carefully for exacerbation of depression or evidence of suicidal thoughts or behavior,” according to the study.
The drug has been previously linked to central nervous system side effects and suicide, but until now a clear link to suicidal thinking, attempted suicide, or completed suicide was not clear. The effects persist for the time patients are on the drug. The researchers recommend that patients with HIV use alternative drugs, if possible, if they are at risk for depression. Read more on HIV.
Nutrition Screenings Should Be Regular Part of Geriatric Health Assessment
Most older adults typically have one or more chronic health conditions that can affect their food intake and should be asked about their food intake during health exams, according to a new study in Nutrition in Clinical Practice. The researchers said that health care providers should also look for signs of malnutrition, such as loss of subcutaneous fat, muscle loss and fluid accumulation. Read more on aging.
Many American Teens Follow Pro-Marijuana Twitter Feeds and Receive Pro-Marijuana Tweets
Hundreds of thousands of American teens are following marijuana-related Twitter accounts and getting pro-marijuana tweets several times each day, according to researchers at the Washington University School of Medicine in St. Louis. The researchers say the tweets are cause for concern because young people are especially responsive to social media influences and because patterns of drug use tend to be established in a person’s late teens and early 20s. The study was published in the Journal of Medical Internet Research and relied on tweets sent and received between May 1 and Dec. 31, 2013, from a single popular pro-marijuana Twitter feed. During the study period, the feed posted an average of 11 pro-marijuana tweets per day. Read more on substance abuse.
Report: Food Sodium Levels at Many Top Chains Continue to Be Unhealthily High
From 2009 to 2013, the nation’s top restaurant chains reduced the sodium in their foods by an average of only 1.5 percent annually, according to a new report from the nonprofit Center for Science in the Public Interest (CSPI). In a review of 136 meals from 17 chains, researchers determined that approximately 79 percent of the 81 adult meals contained more than 1,500 milligrams (mg) of sodium—or one mg more than the U.S. Centers for Disease Control and Prevention recommends as a full day’s limit. The study also found efforts to reduce sodium to be inconsistent, with some chains actually increasing the amounts over the studied time period. CSPI Executive Director Michael F. Jacobson said the findings indicate that the U.S. Food and Drug Administration’s “wait-and-see” approach to sodium in packaged and restaurant food doesn’t work and that a new approach is needed. Read more on nutrition.
CDC: Antibiotic-resistant Foodborne Germs Remain a Serious Public Health Issue
New data from the U.S. Centers for Disease Control and Prevention (CDC) indicates both positive and negative trends in the ongoing public health fight against antibiotic-resistant foodborne germs, which contribute to an estimated 430,000 U.S. illnesses every year. According to the data, multi-drug resistant Salmonella—which causes approximately 100,000 U.S. illnesses annually—decreased over the past decade, but Salmonella typhi resistance to certain drugs increased by 68 percent in 2012, meaning one of the common treatments for typhoid fever may not be effective. “Our latest data show some progress in reducing resistance among some germs that make people sick but unfortunately we’re also seeing greater resistance in some pathogens, like certain types of Salmonella,” said Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases. “Infections with antibiotic-resistant germs are often more severe. These data will help doctors prescribe treatments that work and to help CDC and our public health partners identify and stop outbreaks caused by resistant germs faster and protect people’s health.” Read more on food safety.
Four Communities to Share $120M in HUD Grants for Community Revitalization
Four U.S. communities will split nearly $120 million in U.S. Department of Housing and Urban Development (HUD) grants earmarked for the redevelopment of severely distressed public or HUD-assisted housing and their surrounding neighborhoods. "HUD's Choice Neighborhoods Initiative supports local visions for how to transform high-poverty, distressed communities into neighborhoods of opportunity," said HUD Secretary Shaun Donovan. "By working together, with local and state partners we will show why neighborhoods should always be defined by their potential—not their problems. Together, we will work to ensure that no child's future is determined by their zip code and expand opportunity for all."
The four communities are:
- Columbus (Ohio) Metropolitan Housing Authority — Columbus, Ohio
- Housing Authority of the City of Norwalk/Norwalk (Conn.) Redevelopment Agency
- City of Philadelphia, Office of Housing & Community Development/Philadelphia Housing Authority
- Housing Authority of the City of Pittsburgh/City of Pittsburgh
Read more on housing.
Study: New Requirements Needed for Hand Hygiene for Anesthesia Providers
Anesthesia providers frequently miss identified opportunities to clean their hands during surgical procedures, with the points immediately before patient contact and immediately after contact with the patient’s environment the times when they are least likely to practice proper hand hygiene, according to a new study in the American Journal of Infection Control. However, the findings also point to a larger problem: Complete compliance with all hand hygiene guidelines would take so much time that there would be no time to actually perform any procedures. The findings indicate “a need to create more practical—but still effective—methods of controlling bacterial transmission in anesthesia work environments.” Read more on prevention.
HHS: $840M to Help State, Local Agencies Improve Disaster Preparedness
The U.S. Department of Health and Human Services (HHS) has awarded approximately $840 million in grants to help state and local public health and health care systems improve their emergency response preparedness. Distributed through the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) program, the funds will ensure that communities are prepared to respond to an array of emergencies, including infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events. “Community and state preparedness is essential to the health security of all Americans,” said Nicole Lurie, MD, assistant secretary for preparedness and response (ASPR), in a release. “Events in the last few years have demonstrated how critical it is for health systems across the country to be ready and able to respond quickly and effectively.” Read more on disasters.
ACP: Annual Pelvic Exams Not Needed for Asymptomatic Women
Annual pelvic exams for women do more harm than good and should not be a routine part of health care for women who are not pregnant or who show no other signs of pelvic problems, according to new guidelines from the American College of Physicians (ACP). In a review, researchers found no studies on the effectiveness of pelvic exams in identifying cancers, infections and other health issues that they are commonly used to find. Researchers stressed that their findings only apply to pelvic exams and that women should still undergo recommended cervical cancer screening. Read more on prevention.