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Thursday, January 6, 2011

What Repealing the Affordable Care Act Will Cost Families, Seniors, Small Businesses, States… | The White House

This week, Republicans in the House of Representatives unveiled a bill that will repeal the Affordable Care Act and take us back to the days when insurance companies controlled the health care people could receive. This doesn’t come as a surprise, as Republican leaders have been threatening repeal since President Obama signed the reforms into law on March 23, 2010. But what is surprising is how carelessly they are disregarding the consequences of taking away the new freedoms, control over health care decisions, and the cost savings the law provides the American people, including

Unprecedented accountability and transparency in the insurance market;

Reduced prescription drug costs for seniors; tax credits for small businesses to defray the costs of employee coverage;

Protection against double-digit premium increases; preventive care without cost sharing; support for working class families by providing them tax credits to help pay for coverage;

Improved quality health insurance coverage for all Americans by creating competitive new state based health insurance marketplaces called Exchanges; and

Affordable, quality health coverage for all Americans regardless of their age and gender, or if they have a pre-existing condition.

via whitehouse.gov

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Wednesday, January 5, 2011

Exhausted by Chronic Fatigue Syndrome, and Its Doubters - NYTimes.com

Chronic fatigue syndrome causes a host of debilitating symptoms: profound exhaustion, disordered sleep, muscle and joint pain and severe cognitive problems, among others. But what causes the syndrome itself?

Well

Share your thoughts on this column at the Well blog.

Go to Well »

Since the first cases in the United States were identified in the 1980s, scientists have been divided over that question. Some have suspected that one or more viral infections are likely to play a central role.
But many other researchers — not to mention relatives, friends, employers, doctors and insurers of the million or more Americans estimated to suffer from the illness — have dismissed it as stress-related, psychosomatic or simply imaginary.
Now recent back-to-back announcements have highlighted both the volatility of the issue and the ambiguity of the science, and have alternately heartened and dismayed patients.

via nytimes.com

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Holiday Marketing to Hispanics: Navidad más feliz | The Lipstick Economy

During the holiday season, Hispanic consumers (yes, that means Hispanic women) spend on average $730.30 compared to non-Hispanics’ $683.08, or $47.26 more. And they even sneak in more purchases for themselves – $141.95 versus $104.46 for non-Hispanics. This data comes from a BigResearch study on Hispanic holiday spending trends.

Here are some other differences between Hispanics and non-Hispanics:

1. Hispanics list clothing and accessories as their number one gift this year, versus non-hispanics who prefer gift cards. Also indexing high among Hispanics are electronics and beauty items.

2. Quality and customer service are more important in determining where they shop, versus discounts or price; even though 67% say the economy will affect their spending plans this year. Discount stores are still the number one shopping destination, followed by department stores.

3. Hispanics are twice as likely to use their smartphone to research a purchase. The Hispanic population is generally younger and 67.6% own a smartphone compared with 57% non-Hispanics.

via jamiedunham.wordpress.com

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Parenting, Part II: Weight is heavy topic to discuss with grown children - USATODAY.com

Kim Painter has written about health and wellness for USA TODAY since 1987. She is the mother of two teen boys.

Daphne Oz puts it bluntly: " 'You've gotten fat' is a pretty hard thing to hear from a parent." But it is something that, in one form or another, many young adults do hear from their parents, says the author of The Dorm Room Diet.

And weight is something many parents desperately want to discuss with their grown children, says Ruth Nemzoff, a resident scholar at Brandeis Women's Studies Research Center in Waltham, Mass. She writes and speaks on relationships between parents and grown children and says that weight is a hot topic among parents in her audiences.

"I hear this constantly," she says. "They'll say, 'My daughter is really bright. She's got a Ph.D., but she's really fat. What can I do? Can I say anything?' "

At this time of year, when so many people think of weight loss, the temptation to speak up may be especially strong. And if you happen to be at the end of a winter break with a college student who gained the dreaded freshman 15 (or, more likely, 5 or 8 pounds), this may seem like a perfect time to talk weight.

But think before you speak. And consider saying nothing at all.

That's the advice of Jane Isay, author of two books on family relationships, including Walking on Eggshells: Navigating the Delicate Relationship Between Adult Children and Parents. "Our kids know what we are thinking before we say it," she says. "The idea that they are not aware that you are worried about their weight is nuts."

And, she says, "every overweight person has a mirror and knows what she looks like." She asks parents to consider their power: "Any criticism from a parent is heard through a megaphone."

via usatoday.com

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Helping patients experience death, PhillyBurbs.com:

A handful of local hospitals recently started volunteer programs that train ordinary people to sit with those who are alone and dying.

Angelo DeLorenzo spends many nights watching people as they die.

Occasionally, the person wants to talk, sometimes through the night. Often, the patient is unconscious, but DeLorenzo reads to him or her, plays the harp or sits quietly and prays.

Everyone deserves a good death, DeLorenzo believes. No one should die without someone there to hold a hand, whisper reassuring words and make sure the person is comfortable.

So DeLorenzo stays with these dying patients at St. Mary Medical Center, where he frequently takes the overnight shift. The Middletown hospital is one of a handful in the area that have started end-of-life programs, where ordinary people such as DeLorenzo, a chaplain intern, are trained to provide comfort care for people who have no close family available.

"No One Dies Alone" - the name of the program at St. Mary - originated at an Oregon hospital in 2001. It has since spread around the world. More than 1,100 hospitals and hospices have requested copies of the program's manual, said Carleen McCornack, coordinator of the mission center of Sacred Heart Medical Center in Eugene, where the program started.

via phillyburbs.com

These types of programs will go along way towards easing patients and family members into accepting the death of a loved one.

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Venoscope - The Vein Finder

Venoscope, LLC has been the leader in utilizing LED technology for transillumination since 1989. It holds patents for its Venoscope® pediatric and adult transilluminator as well as patents for its Neonatal Transilluminator, both utilizing LED technology. The Venoscope® isproducts have FDA 510k premarket approval.
Venoscope, LLC company and sales distribution offices are located in Lafayette, LA. Our friendly staff stands ready to answer any questions you may have as. We will conduct an In-Service over the phone if you desire to prove how easy it is to learn and use.
Phone (800)284-7655 or (337)234-8993 FAX (337)268-4080
e-mail: info@venoscope.com
www.venoscope.com
Physical Address: 1018 Harding St., Suite 104 Lafayette, LA 70503
Mailing Address: P.O. Box 52703 Lafayette, LA 70505-2703

via venoscope.com

Adding this to our IV section.
http://www.intravenousnursing.com

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Hospital care easier, faster with standing orders - CNN.com

My patient one day, a spry 80-year-old, started to cough and feel short of breath during a blood transfusion: classic signs of a transfusion reaction. I stopped her IV, but she needed a steroid to bring her breathing back to normal.

Unable to reach her primary physician, we called in a rapid-response team. An ICU doctor, respiratory therapist, two ICU nurses, a nurse anesthetist, and MDs and RNs from the floor all rushed into the room . . . . to authorize giving my patient this one needed drug.

The patient did not need rescuing, just a dose of solumedrol, and I could have given her that dose, without wasting the time and energy of multiple nurses and doctors, if we had a protocol, or "standing order," in place in my hospital for treating transfusion reactions.

A standing order is a kind of treatment algorithm used in hospitals to expedite care. Protocols are designed by doctors and nurses, implemented by nurses, and are typically used either in specific emergencies or to deliver routine care. A protocol for treating low blood sugar is an example of treating an emergency; putting silver nitrate in a newborn's eyes counts as routine.

Protocols make a lot of sense, according to Nancy Foster, vice president for Quality and Safety Policy for the American Hospital Association. The AHA supports the use of standing orders because, Foster says, "Standardization is an effective way to make sure we do the right thing for the right patient at the right time."

via cnn.com

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I'll Never Ration. Not Me. Not I. - NYTimes.com

Opposition to health-care rationing is a little like opposition to growing up. It sounds great. It’s just not very practical.

A society’s resources are always limited. So we have to make choices about what we can afford and what we can’t. Not everyone can afford to own a vacation home — which means vacation homes are rationed. Not everyone can afford to live in towns with excellent public schools — which means that good public education is rationed.

Similarly, we can’t afford to try every feasible medical treatment on every patient. Instead, we make choices. The most obvious form of rationing is the millions of Americans who lack health insurance today. Most of them get less medical care than they need and, in the process, keep down the nation’s total medical bill.

But even those with health insurance experience rationing. How? In many ways.

This country has not spent the money to install computerized medical records, and we suffer more medical errors than many other countries. We underpay primary care doctors, relative to specialists, and we’re left stewing in waiting rooms while our primary-care doctors try to see as many patients as possible. Specialists are usually not paid for time they spend collaborating with doctors in other specialties, and many hard-to-diagnose conditions go untreated. Nurses are usually not paid to counsel people on how to improve their diets or remember to take their pills, and manageable cases of diabetes and heart disease become fatal.

via economix.blogs.nytimes.com

At some point we'll need to accept the fact that we cannot all have every test, every operation, every treatment, every new medicine or see every specialist.

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Internet in Medicine: 2000 vs 2010 « ScienceRoll

Whenever I talk about using social media in medicine to doctors, they seem to think there are more cons than pros regarding this issue. Well, I like reminding them about some major differences between 2000 and nowadays.

What would I do if in 2000 Now

I need clinical answer Try to find a collegue who knows it Post a question on Twitter

I want to hear patient story about a specific condition Try to find a patient in my town Read blogs, watch Youtube

I want to be up-to-date Go to the library once a week Use RSS and follow hundreds of journals

I want to work on a manuscript with my team We gather around the table Use Google Docs without geographical limits

Here is what Web, MD looked like in 2000 and what it looks like now:

via scienceroll.com

Think you can ignore social media in your practice and workplace? Maybe. However you could embrace, utilize it and enhance your performance too.

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Phys Ed: If You Are Fit, You Can Take It Easy - NYTimes.com

New Year’s resolutions tend to war with wintertime malaise. Resolution urges you to work out. Malaise suggests that you linger in bed. But there’s good news for those of us torn between these impulses. A number of newly published studies offer compelling reasons to get out and exercise on the one hand, as well as new estimates of just how little we can do and still benefit on the other.

The most sobering of the recent studies, published last month in The British Journal of Sports Medicine, looked at a large group of retired elite male athletes, most now in their 50s. Some had remained physically active, although they were no longer competing. Others had taken fully to sloth, avoiding almost all exercise. When the researchers examined the health profiles of the two groups, they found, to no one’s surprise, that the sedentary ex-athletes had a much higher risk of metabolic abnormalities, including insulin resistance, than their more active counterparts. Training hard and often in their youth had not conferred lifelong health benefits on the athletes as they aged, not if they now sat around all day.

Similarly, although in a more compressed time frame, a study published earlier this year found that when a group of world-class kayakers completely quit training (at the end of a competitive season), they rapidly lost strength and endurance. After only five weeks of not training, according to one measure of strength, they’d sloughed off about 9 percent of their muscular power and 11 percent of their aerobic capacity.

via well.blogs.nytimes.com

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Nursefriendly.com

Thursday, January 6, 2011

What Repealing the Affordable Care Act Will Cost Families, Seniors, Small Businesses, States… | The White House

Wednesday, January 5, 2011

Exhausted by Chronic Fatigue Syndrome, and Its Doubters - NYTimes.com

Well

Holiday Marketing to Hispanics: Navidad más feliz | The Lipstick Economy

Parenting, Part II: Weight is heavy topic to discuss with grown children - USATODAY.com

Helping patients experience death, PhillyBurbs.com:

Venoscope - The Vein Finder

Hospital care easier, faster with standing orders - CNN.com

I'll Never Ration. Not Me. Not I. - NYTimes.com

Internet in Medicine: 2000 vs 2010 « ScienceRoll

Phys Ed: If You Are Fit, You Can Take It Easy - NYTimes.com

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What would I do if	in 2000	Now
I need clinical answer	Try to find a collegue who knows it	Post a question on Twitter
I want to hear patient story about a specific condition	Try to find a patient in my town	Read blogs, watch Youtube
I want to be up-to-date	Go to the library once a week	Use RSS and follow hundreds of journals
I want to work on a manuscript with my team	We gather around the table	Use Google Docs without geographical limits