Showing posts with label healthcare advocacy. Show all posts
Showing posts with label healthcare advocacy. Show all posts

Tuesday, March 29, 2011

Quality of Death and Dying in Patients who Request Physician-Assisted Death - Journal of Palliative Medicine

Background: Physician-assisted death (PAD) was legalized in 1997 by Oregon's Death with Dignity Act (ODDA). Through 2009, 460 Oregonians have died by lethal prescription under the ODDA.

Objective: To determine whether there was a difference in the quality of the dying experience, from the perspective of family members, between 52 Oregonians who received lethal prescriptions, 34 who requested but did not receive lethal prescriptions, and 63 who did not pursue PAD.

Design: Cross-sectional survey.

Measurements: Family members retrospectively rated the dying experience of their loved one with the 33 item Quality of Death and Dying Questionnaire (QODD).

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Sunday, March 27, 2011

Two-thirds of states cut mental healthcare funds: advocacy group | Reuters

Two-thirds of states cut mental health funding from their general fund budgets over the last two years, according to a report released by a mental illness advocacy group on Wednesday.

Kentucky with 47 percent, Alaska with 35 percent, and South Carolina and Arizona both with 23 percent made the largest percentage cuts to mental health spending in their general fund budgets, which do not include federal Medicaid funding, the study by the National Alliance on Mental Illness (NAMI) found.

"Cutting mental health means that costs only get shifted to emergency rooms, schools, police, local courts, jails and prisons," said NAMI executive director Michael Fitzpatrick. "The taxpayer still pays the bill."

"Some states are trying to hold the line or make progress, but most are cutting deep. This stands in contrast to the intense national concern about the mental health care system following the Arizona tragedy two months ago," he said.

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Admitting harm protects patients - Sunday, March 27, 2011 | 2 a.m. - Las Vegas Sun

As Nevada legislators debate this week whether to require hospitals to publicly report when they harm patients, they could learn a lot from Paul Levy’s experience in pulling back the veil of hospital secrecy.

Levy became a revolutionary figure in medicine when, as CEO of Beth Israel Deaconess — then the weak sibling among Harvard University’s teaching hospitals — he began blogging about injuries and infections suffered by his hospital’s patients. His competitors eventually followed suit and now, with Massachusetts law imposing transparency, they acknowledge openness has brought greater accountability and a more focused commitment to protecting patients.

“It’s not just fear of public embarrassment” that drives the improvements, said Dr. Ken Sands, chairman of Beth Israel Deaconess Medical Center’s health care quality department. “It’s an easy way to show something is a priority and is deserving of attention.”

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
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Saturday, March 26, 2011

'Dispense As Written' Prescriptions May Add $7.7 Billion To Annual Health Care Costs, Researchers Found

About 5% of prescriptions submitted by CVS Caremark Pharmacy Benefit Management (PBM) members in a 30-day period during 2009 included a "dispense as written" (DAW) designation.

This practice - whereby doctors or patients demand the dispensing of a specific brand-name drug and not a generic alternative - costs the health care system up to $7.7 billion annually, according to a new study by researchers at Harvard University, Brigham and Women's Hospital and CVS Caremark. Moreover, these requests reduce the likelihood that patients actually fill new prescriptions for essential chronic conditions.

In a study published this week in the American Journal of Medicine, the researchers demonstrate that DAW designations for prescriptions have important implications for medication adherence. They found that when starting new essential therapy, chronically ill patients with DAW prescriptions were 50 to 60 percent less likely to actually fill the more expensive brand name prescriptions than generics. "Although dispense as written requests would seem to reflect a conscious decision by patients or their physicians to use a specific agent, the increased cost sharing that results for the patient may decrease the likelihood that patients actually fill their prescriptions," the researchers said.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
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Wednesday, March 16, 2011

Budget Cuts Spell Crisis for Women with HIV « SpeakEasy

Rallies for workers’ rights in Wisconsin and other states have raised critical awareness about the potential implications — and targets — of budget cuts across the US. But in addition to the fate of unions and public sector employees at the local and state level — the majority of whom are women — the battle over budgets will also determine the fate of key social services, many of them on which women and children in particular depend.

Nothing makes this more real for us at the Ms. Foundation than when our grantees report how budget cuts will impact — indeed, threaten — their own programs and their own communities. For example, just a few weeks ago, the Washington Department of Health decided to cut funding for the state’s only women-specific HIV/AIDS education and support program — a program run by Seattle-based BABES Network-YWCA, our longtime grantee. This decision, BABES tells us, along with an additional funding cut at the county level, will result in a 75 percent reduction in their program budget — an untenable outcome that will leave hundreds of women without critical support services.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Sunday, March 13, 2011

Hospital confronts social media uprising over care of dying baby - The Globe and Mail

One of Canada’s most prestigious medical institutions has made the bold decision to go public with details of a highly emotional tug-of-war over a dying infant in an attempt to defend itself against a slew of threats, condemnations and criticisms playing out in social media.

The case highlights how the emerging influence of viral videos, online campaigns and social networks can quickly damage an organization and force even the most staid institutions to change their communications strategies.

More related to this story

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Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Friday, March 11, 2011

Body Image: Loving Yourself Inside and Out

Loving Your Body Inside and Out

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Women SmilingWith a positive or healthy body image, a woman has a real perception of her size and shape. She also feels comfortable with her body. With a negative body image, a woman has a distorted perception of her shape and size, compares her body to others, and feels shame and anxiety about her body. Being unhappy with your body can affect how you think and feel about yourself as a person. A poor body image can lead to emotional distress, low self-esteem, unhealthy dieting habits, anxiety, depression, and eating disorders. Developing a positive body image and a healthy mental attitude is crucial to a woman's happiness and wellness.

When you Look in the Mirror, do you Like What you See?

Is your body image positive or negative? If your answer is negative, you are not alone. Women in the U.S. are under pressure to measure up to a certain social and cultural ideal of beauty, which can lead to poor body image. Women are constantly bombarded with "Barbie Doll-like" images. By presenting an ideal that is so difficult to achieve and maintain, the cosmetic and diet product industries are assured of growth and profits. It's no accident that youth is increasingly promoted, along with thinness, as an essential criterion of beauty. The message we're hearing is either "all women need to lose weight" or that the natural aging process is a "disastrous" fate.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Joseph Nowinski, Ph.D.: Rethinking Societal Attitudes About People Who Get Cancer

In her 1978 book, "Illness as Metaphor," Susan Sontag argued that societal myths and metaphors surrounding disease can kill. How? By instilling shame and guilt in the sick. Sontag was the first writer to point out the basically accusatory tone of the metaphors we use to describe illness and its causes, as well as the essence of its cure. Examples she cited included tuberculosis, which was once popularly thought of as an illness that afflicted only individuals with delicate temperaments. Because they were supposedly constitutionally weak, these individuals were prone to wasting away. Accordingly, the "cure" for tuberculosis involved "rest" -- a prolonged stay in a sanatorium.

Sontag applied the same reasoning to debunk what she thought were myths surrounding cancer: It is not a curse or punishment, she argued. Our personality does not make us more or less likely to get cancer, and its successful treatment is not essentially a matter of our outlook. We do not get cancer because we are angry, or because we are lacking in some spiritual quality. To quote Sontag, "Theories that diseases are caused by mental states and can be cured by will power are always an index of how much is not understood about a disease." That was true for tuberculosis in the 20th century, and it is true today for cancer. Despite that truth, some cancer patients -- and in particular those who have been diagnosed with metastatic breast cancer that has spread to other organs -- continue to experience what amounts to a societal stigma. Consider the following correspondence between me and Ellen, who has metastatic breast cancer:

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

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Safe Staffing Saves Lives - ANA's National Campaign to Solve the Nurse Staffing Crisis

Nurses everywhere rank staffing as their biggest problem. Research shows it is a problem – for patients: Insufficient nurse staffing is linked with poorer patient outcomes, lengthened hospital stays and increased chance of patient death.

ANA’s Solution to Staffing

ANA advocates solving the problem by requiring hospitals to set nurse staffing plans for each hospital unit based on changing conditions:

  • Patient acuity (severity of illness)
  • Patient numbers
  • Nurse skills and experience
  • Support staff
  • Technology

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Wednesday, March 2, 2011

Texas Senate panel advances bill to protect nurses | AP Texas News | Chron.com - Houston Chronicle

A Texas Senate committee approved legislation Tuesday aimed at strengthening protection for nurses who report abuse by doctors.

The bill filed by state Sen. Jane Nelson, R-Flower Mound, protects nurses from being fired, discriminated against or punished. Nurses would be immune from criminal prosecution under the bill.

The bill now goes to the full Senate. If enacted, doctors would be fined up to $25,000 if convicted of retaliation.

Lawmakers saw a need for a more stringent law after two West Texas nurses were fired and criminally charged after reporting a doctor for allegedly practicing bad medicine.

The charges were dropped against Winkler County nurse Vicki Galle, but Anne Mitchell was prosecuted for "misuse of official information" and threatened with 10 years in prison.

Galle and Mitchell anonymously filed their complaint against Dr. Rolando Arafiles with the Texas Medical Board in 2009. But with help from the sheriff, Arafiles found out who the nurses were.

Despite Mitchell's acquittal, the case stirred outrage from medical communities nationwide. Nursing advocates want to ensure nurses can report malpractice without fear of retaliation.

"Patients are best served when nurses can advocate on their behalf," Nelson said. "The case of the Winkler County nurses highlighted the need for additional protection for nurses."

Mitchell said the decision to report Arafiles was carefully considered, and one she felt she had to make on behalf of her patients.

But the price she paid was high. She said her nursing career is over, her income has been cut in half and she continues to endure the effects of being labeled a whistleblower.

"That label basically reads 'don't hire me'," she said. "Nurses are frequently the last safety net for patients. If our voices are stifled, our patients will suffer. My hope is that the passage of this bill will prevent other nurses from having to go through what we went through."

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Tuesday, March 1, 2011

HHS Releases National Plan to Improve Health Literacy | HHS.gov

Today, the United States Department of Health and Human Services released The National Action Plan to Improve Health Literacy aimed at making health information and services easier to understand and use. The plan calls for improving the jargon-filled language, dense writing, and complex explanations that often fill patient handouts, medical forms, health web sites, and recommendations to the public.

According to the report, efforts to improve the health literacy skills of both the public and health professionals are needed to achieve a health literate society—a critical need as health reform generates more demand for consumer and patient information that is easy-to-understand and culturally and linguistically appropriate.

According to research from the U.S. Department of Education, only 12 percent of English-speaking adults in the United States have proficient health literacy skills. The overwhelming majority of adults have difficulty understanding and using everyday health information that comes from many sources, including the media, web sites, nutrition and medicine labels, and health professionals.

“Health literacy is needed to make health reform a reality,” said HHS Secretary Kathleen Sebelius. “Without health information that makes sense to them, people can’t access cost effective, safe, and high quality health services. But, HHS can’t do it alone,” she added. “We need payers and providers of health care services to communicate clearly and make the necessary changes to improve their communication with consumers, patients, and beneficiaries. Today’s plan is only the beginning of a long-term process with our many partners in all sectors that we hope will result in a society that encourages people to live longer, healthier lives.”

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
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856-415-9617, (fax) 415-9618

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Helping Patients Understand Their Medical Treatment - Kaiser Health News

An elderly woman sent home from the hospital develops a life-threatening infection because she doesn't understand the warning signs listed in the discharge instructions. A man flummoxed by an intake form in a doctor's office reflexively writes "no" to every question because he doesn't understand what is being asked. A young mother pours a drug that is supposed to be taken by mouth into her baby's ear, perforating the eardrum. And a man in his 70s preparing for his first colonoscopy uses a suppository as directed, but without first removing it from the foil packet.

Each of these examples provided by health-care workers or patient advocates illustrates one of the most pervasive and under-recognized problems in medicine: Americans' alarmingly low levels of health literacy — the ability to obtain, understand and use health information.

Translating Medical Jargon

Some technical terms and what they mean in plain English:

  • "myocardial infarction" (heart attack)
  • "hyperlipidemia" (high cholesterol)
  • "febrile" (feverish)

A 2006 study by the U.S. Department of Education found that 36 percent of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower. About 52 percent had intermediate skills: They could figure out what time a medication should be taken if the label says "take two hours after eating," while the remaining 12 percent were deemed proficient because they could search a complex document and find the information necessary to define a medical term.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.legalnursingconsultant.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Wednesday, February 23, 2011

Connected for Life Now Features Ask Mayo Clinic Nurse Line

Family Health Network is excited to announce that its Connected for LifeSM online program for caregivers of aging loved ones will now feature access to Ask Mayo Clinic nurse line.  Seniors who are part of the program will now have 24/7 access to expert health advice from Ask Mayo Clinic registered nurses.  This additional service further enriches the Connected for LifeSM online program which breaks down longstanding barriers to technology use by seniors and helps families stay in touch, monitor, and assist older family members who desire to live healthier and longer at home.

“Mayo Clinic is world renowned for being a leader in medical care, research and education,” said CEO of Family Health Network, Harry Bailes. “Now, in addition to connecting seniors with family members and caregivers, we can offer them access to Ask Mayo Clinic nurse line that represents one of an expanding list of additional resources available through membership in Connected for LifeSM

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Patients find plenty of health information on line, but not all of it is reliable

The Internet has no equal as an information storehouse. The trick is to know how to get right to a source of useful information and not waste time on Web sites that are biased, trying to sell you something or just plain wrong.

Marvin M. Lipman, Consumers Union's chief medical adviser, recalls having a patient who made a Google search and somehow settled on an abdominal aortic aneurysm (a worrisome bulge in the body's main blood vessel) as the logical explanation for his midback pain. No reassuring on Lipman's part eased the patient's apprehension. It took a sonogram to convince him he wasn't at death's door.

Lipman had another patient who was referred to him after her primary-care physician told her she had Graves' disease (an overactive thyroid). She arrived for her appointment armed with computer printouts of useful, accurate information and fully prepared to discuss the pros and cons of treatment options for her problem.

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Drug maker cited for not reporting side effects - Health - Health care - msnbc.com

U.S. health regulators have warned Sanofi-Aventis SA's U.S. unit for failing to submit reports of possible serious side effects in a timely manner.

In a January 28 letter made public on Tuesday, the Food and Drug Administration said an early response from the drugmaker and its "promised corrective actions are inadequate to address the deficiencies."

"We remain concerned that your .... adverse drug experience reporting system has not been fully validated, and may have resulted in inaccurate assessment and untimely submission of 15-day alerts," FDA said.

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Sunday, February 20, 2011

Antiseptic baths 'reduce infection risk' | News | Nursing Times

Using 2% chlorhexidine gluconate cloths for the daily bathing of inpatients, instead of soap and water, reduces the risk of hospital-acquired infections, according to US researchers.

The study found a 64% decrease in the risk of acquiring either MRSA or Vancomycin-resistant Enterococcus. A group of 7,699 general medical patients were bathed daily by healthcare assistants with CHG antiseptic cloths for the duration of their admission, while a control group of 7,102 patients were bathed with soap and water.

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Saturday, February 19, 2011

Traumatic Brain Injury, Legal Nurse Consulting, Law Resources

Legal Nurse Consultants specializing in Traumatic Brain Injury Issues:

Louise Cardillo, R.N. B.S., Cardillo Consultants:"Legal Nurse Consulting firm for ten years. I am a strong liason between attorney's, clients and experts. The strength of all cases is in meticulous attention to detail of medical records and choosing the appropriate expert. This aspect of consulting will bring your cases to closure with damages often above expectation. Experience in this field is critical to the success of working with a Legal Nurse Consultant. In addition, the nurse must have a strong clinical foundation and education.
1190 Honeoye Falls 5 Points Rd.
Honeoye Falls, New York 14472
E-Mail: louLNC@frontiernet.net
http://www.nursingexperts.com/cardillo/

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Brain Injury Association of America:"The Brain Injury Association of America was founded in 1980 by a group of individuals who wanted to improve the quality of life for their family members who had sustained brain injuries. Despite phenomenal growth over the past two decades, the Association remains committed to its grassroots. The Brain Injury Association of America encompasses a national network of more than 40 Chartered state affiliates across the country as well as hundreds of local chapters and support groups. By acting as a clearinghouse of community service information and resources, participating in legislative advocacy, facilitating prevention awareness, hosting educational programs and encouraging research, the Brain Injury Association of America and its affiliates reach the millions of individuals living with the "silent epidemic" of brain injury."
105 North Alfred Street, Alexandria, VA 22314
703-236-6000, fax 703-236-6001
FamilyHelpline@biausa.org
http://www.biausa.org/

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Brain Injury Information Page:"The Brain Injury Information Page provides information about brain injury, concussion, coma and head injury, for TBI survivors, spouses and caregivers. Our goal is to provide education and assistance with the process of diagnosis and proof of brain injury, sometimes called head injury. This page features articles, information and graphics about traumatic brain injury. Our View of Advocacy: We of the Brain Injury Law Group make our living as advocates. But advocacy implies more than being a lawyer. It means dedicating oneself to the community we serve - the survivor, the family member of the survivor, the medical professional. To that end, we have created this home page, to provide information, resources and links, to help you learn and solve the problems you face."
http://tbilaw.com/

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Florida Institute for Neurologic Rehabilitation, Inc. (FINR):"Brain injury and head injury rehabilitation information and resources from The Florida Institute for Neurologic Rehabilitation. FINR helps Brain injury survivors, both children and adult. The Florida Institute for Neurologic Rehabilitation, Inc. (FINR) is dedicated to excellence in the provision of rehabilitation, education and vocational services to both children and adult survivors of brain injury. Through the provision of individualized assessment, restorative service and foundational retraining in behavior, psych-social, cognitive, physical functioning, communication, daily living, education and vocational area, FINR seeks to assist its clients in attaining their maximum level of functioning and quality of life in the most normalized and least restrictive environment."
http://www.finr.net/

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Traumatic Brain Injury Information Page, National Institute of Neurological Disorders and Stroke (NINDS):"Traumatic brain injury (TBI) occurs when a sudden physical assault on the head causes damage to the brain. The damage can be focal, confined to one area of the brain, or diffuse, involving more than one area of the brain. TBI can result from a closed head injury or a penetrating head injury. A closed head injury occurs when the head suddenly and violently hits an object, but the object does not break through the skull. A penetrating head injury occurs when an object pierces the skull and enters the brain tissue. Several types of traumatic injuries can affect the head and brain. A skull fracture occurs when the bone of the skull cracks or breaks. A depressed skull fracture occurs when pieces of the broken skull press into the tissue of the brain. This can cause bruising of the brain tissue, called a contusion. A contusion can also occur in response to shaking of the brain within the confines of the skull, an injury called "countrecoup." Shaken baby syndrome is a severe form of head injury that occurs when a baby is shaken forcibly enough to cause extreme countrecoup injury. Damage to a major blood vessel within the head can cause a hematoma, or heavy bleeding into or around the brain. The severity of a TBI can range from a mild concussion to the extremes of coma or even death. A coma is a profound or deep state of unconsciousness. Symptoms of a TBI may include headache, nausea, confusion or other cognitive problems, a change in personality, depression, irritability, and other emotional and behavioral problems. Some people may have seizures as a result of a TBI."
http://www.ninds.nih.gov/health_and_medical/disorders/tbi_doc.htm

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National Resource Center for Traumatic Brain Injury:"The mission of the National Resource Center for Traumatic Brain Injury is to provide relevant, practical information for professionals, persons with brain injury, and family members. Many of our products were developed by nationally recognized experts. We have more than 20 years of experience developing intervention programs, assessment tools, and investigating the special needs and problems of people with brain injury and their families."
Virginia Commonwealth University's Medical College of Virginia
http://www.neuro.pmr.vcu.edu/

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The Perspectives Network, Inc.:"The Perspectives Network, Inc.'s primary focus is positive communication between persons with brain injury, family members/ caregivers/friends of persons with brain injury, those many professionals who treat persons with brain injury and community members in order to create positive changes and enhance public awareness and knowledge of acquired/traumatic brain injury."
Mailing Address: P. O. Box 121012, W. Melbourne FL 32912-1012
E-Mail Address: TPN@tbi.org
http://www.tbi.org/

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Rehabilitation Research Center (RRC) for Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI):"The Rehabilitation Research Center (RRC) for Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) conducts research to better understand and improve outcomes after TBI and SCI. Outcomes studied include the functional, vocational, and life satisfaction areas that are important to people with and without disabilities."
Rehabilitation Research Center for TBI & SCI 950 South Bascom Avenue, Suite 2011 San Jose, CA 95128 San Jose, California
phone number is 408/295-9896 Fax the RRC at 408/295-9913, tbisci@tbi-sci.org
http://www.tbi-sci.org/

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TBIchat.org:"Homepage for brain injury survivors & caregivers with pictures, stories, poems, art gallery, message board, question of the week board, homepages, & email lists."
http://www.braininjurychat.org/

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Traumatic Brain Injury LawyerShop:"Traumatic Brain Injury Lawyer Shop is a resource that allows you to find information from lawyers in your area who provide legal services pertaining to traumatic brain injury, TBI, closed head injury, concussion, and coma. While most legal directories offer some information about traumatic brain injury and TBI, the most valuable information comes from an attorney or lawyer who has experience involving traumatic brain injury lawsuits, coma lawsuits, concussion lawsuits or closed head injury lawsuits."
http://www.tbilawyershop.com/

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Traumatic Brain Injury National Data Center (TBINDC):"The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The TBI Model Systems consist of 17 comprehensive systems of care distributed throughout the United States that conduct innovative research and provide “model” care to persons who experience traumatic brain injury. The TBIMS program seeks to improve the lives of persons who experience traumatic brain injury, their families and their communities by creating and disseminating new knowledge about the course, treatment and outcomes relating to their condition."
Traumatic Brain Injury National Data Center c/o Kessler Medical Rehabilitation Research and Education Corp.
1199 Pleasant Valley Way West Orange, NJ 07052
http://www.tbindc.org/

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Prepaid Legal Services: There are many matters that you encounter on a daily basis which have a legal aspect, for instance, motor vehicle accidents and other types of injury claims, estate planning, probate and estate administration, matters pertaining to employment, sale or purchase of real estate, consumer transactions, auto repairs and sales, family and juvenile law, landlord/tenant issues, insurance matters, business, bankruptcy, tax and workers compensation. Literally, everything we do today touches upon the law in one way or another. With Prepaid Legal, you'll receive unlimited phone conversation/consultations on any legal matter at no additional cost.

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See also:

MedMal Consulting:'MedMal Consulting is a Physician owned and operated full-service medical malpractice evaluation and medical negligence consulting support firm. MedMal Consulting has doctors, legal nurse consultants, and medical legal litigation support personnel to assist with every aspect of your medical negligence case. Established in 1992, Dr. Herman and MedMal Consulting have over 18 years of experience in the medical legal field and have assisted in obtaining more than $147 million dollars in verdicts and settlements in medical malpractice cases."
MedMal Consulting, Inc.
P.O Box 391153
Cleveland, Ohio 44139
Phone: (216) 744-8907
Fax:(440) 248-8257
eMail: info@medmalconsulting.com
http://www.medmalconsulting.com/

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Send comments and mail to Andrew Lopez, RN

Last updated by Andrew Lopez, RN on Monday, December 6, 2010

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Friday, February 18, 2011

Released hospital patients' many unhappy returns

Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients.

A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.

An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found.

"Right now, when you go to the hospital, it's the do-it-yourself model. It's up to you to figure out what to do," said David Grant, author of the study for the California Discharge Planning Collaborative, a group of labor, senior and other advocacy organizations.

Patients, especially those who are elderly and lack social support, are often readmitted because they don't understand their discharge instructions, fail to take their medications or have complications that they can't handle.

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Monday, February 14, 2011

Patient Stories May Improve Health, NYTimes.com

The only reservation that he mentioned was the same one all the other patients had — he feared that death would come before the perfect organ.

But during one visit just before he finally got the transplant, he confessed that he had been grappling with another concern, one so overwhelming he had even considered withdrawing from the waiting list. He worried that he would not be strong enough mentally and physically to survive a transplant.

In desperation, he told me, he had contacted several patients who had already undergone a transplant. “That’s what made me believe I’d be O.K.,” he said. “You doctors have answered all of my questions, but what I really needed was to hear the stories about transplant from people like me.”

Patients and doctors have long understood the power of telling and listening to personal narratives. Whether among patients in peer support groups or between doctors and patients in the exam room or even between doctors during consultations, stories are an essential part of how we communicate, interpret experiences and incorporate new information into our lives.

Despite the ubiquitousness of storytelling in medicine, research on its effects in the clinical setting has remained relatively thin. While important, a vast majority of studies have been anecdotal , offering up neither data nor statistics but rather — you guessed it — stories to back up the authors’ claims.

Now The Annals of Internal Medicine has published the results of a provocative new trial examining the effects of storytelling on patients with high blood pressure. And it appears that at least for one group of patients, listening to personal narratives helped control high blood pressure as effectively as the addition of more medications.

Monitoring the blood pressure of nearly 300 African-American patients who lived in urban areas and had known hypertension, the researchers at three-month intervals gave half the patients videos of similar patients telling stories about their own experiences. The rest of the patients received videos of more generic and impersonal health announcements on topics like dealing with stress. While all the patients who received the storytelling DVD had better blood pressure control on average, those who started out with uncontrolled hypertension were able to achieve and maintain a drop as significant as it had been for patients in previous trials testing drug regimens.

“Telling and listening to stories is the way we make sense of our lives,” said Dr. Thomas K. Houston, lead author of the study and a researcher at the University of Massachusetts Medical School in Worcester and the Veterans Affairs medical center in Bedford, Mass. “That natural tendency may have the potential to alter behavior and improve health.”

Experts in this emerging field of narrative communication say that storytelling effectively counteracts the initial denial that can arise when a patient learns of a new diagnosis or is asked to change deeply ingrained behaviors. Patients may react to this news by thinking, “This is not directly related to me,” or “My experience is different.” Stories help break down that denial by engaging the listener, often through some degree of identification with the storyteller or one of the characters.

“The magic of stories lies in the relatedness they foster,” Dr. Houston said. “Marketers have known this for a long time, which is why you see so many stories in advertisements.”

In health care, storytelling may have its greatest impact on patients who distrust the medical system or who have difficulty understanding or acting on health information because they may find personal narratives easier to digest. Stories may also help those patients who struggle with more “silent” chronic diseases, like diabetes or high blood pressure. In these cases, stories can help patients realize the importance of addressing a disease that has few obvious or immediate symptoms. “These types of patients and diseases may be a particular ‘sweet spot’ for storytelling,” Dr. Houston noted.

This particular benefit from stories comes as welcome news not only for patients but also for doctors, who are increasingly reimbursed based on patient outcomes. “There’s only so much the doctor can do, so providers are looking for innovative ways to help their patients,” Dr. Houston said. While more research still needs to be done, the possibilities for integrating storytelling into clinical practice are numerous. In one possible situation, which is not all that dissimilar from popular dating sites, doctors and patients would be able to access Web sites that would match patients to videos of similar patients recounting their own experiences with the same disease.

Dr. Houston is currently involved in several more studies that will examine the broader use of storytelling in patient care and delineate ways in which it can best be integrated. Nonetheless, he remains certain of one thing: Sharing narratives can be a powerful tool for doctors and patients.

“Storytelling is human,” Dr. Houston said. “We learn through stories, and we use them to make sense of our lives. It’s a natural extension to think that we could use stories to improve our health.”

Join the discussion on the Well blog, Healing Through Storytelling.”

Click on the link to read the full story.

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