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Immunization Schedule For Adults

Immunization Schedule For Adults

Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2018* FREE

David K. Kim, MD, MA; Laura E. Riley, MD; Paul Hunter, MD; on behalf of the Advisory Committee on Immunization Practices ()
2017 Combined Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States; 6 pages
2017 Combined Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States; 6 pages
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New Study Shows Patient Care Alerts Nearly Doubled in One Year

New Study Shows Patient Care Alerts Nearly Doubled in One Year

Alerts and Related Patient Record Queries Provide Critical Health Information to Healthcare Professionals to Support and Improve Patient Care Coordination

NEW YORK, NY – More healthcare professionals are receiving patient care alerts and increasingly performing related patient record queries through the Statewide Health Information Network for New York (SHIN-NY), according to a new report by the New York eHealth Collaborative (NYeC).

The preliminary report used data from HEALTHeLINK, Healthix, and Rochester RHIO—three of New York’s eight regional health information exchange networks connected by and comprising the Statewide Health Information Network for New York. The study looked at patient care alerts trends and their role in expanding the usage of an additional SHIN-NY service, patient record queries. The SHIN-NY allows participating healthcare professionals, with patient consent, to quickly access electronic health information and securely exchange data statewide.

Researchers found that subscription alert services, where participating SHIN-NY providers receive real-time notifications when a patient is admitted to or discharged from a hospital or emergency department, increased by 95 percent from 2016 to 2017. At the same time, query-based exchanges prompted by alerts, where providers request patient records for more comprehensive information at the time they are needed, increased by 102 percent.

“This study demonstrates the SHIN-NY is working, usage is growing, and every day it is helping providers manage their patients’ care. Alerts and queries are free services offered to participating providers—we need everyone to get connected,” said Valerie Grey, Executive Director of NYeC.

“We hear from our participant doctors every day and see more and more evidence as to how HEALTHeLINK and the SHIN-NY are working in support of better, more efficient patient care,” said Dan Porreca, HEALTHeLINK Executive Director. “With our ability to alert providers of their patients’ admissions and discharges to healthcare facilities, including local emergency department visits in real time and the ability to query HEALTHeLINK to understand what happened with their patient during that visit, care coordination is enhanced greatly. They can also schedule timely and needed follow-up visits to review diagnoses and new medications with their patients, ultimately reducing the chance of future readmissions.”

“Our participants have come to rely upon clinical alerts for helping to manage patients with complex issues. To better support care management workflows, Healthix provides clinical summaries or CCDs with alerts, pushing data to providers so they receive the patient’s clinical history with the alert. This enables them to make real-time clinical decisions,” said Tom Check, President and CEO of Healthix.

“Alerts directly support and impact transitions of care across our 13-county region and the whole of New York,” says Jill Eisenstein, President and­ CEO, Rochester RHIO. “They help our Rochester RHIO partners take more immediate and beneficial actions, resulting in a higher ­­degree of efficient and effective patient care.”

The report also analyzed how organizations across the care continuum utilized additional SHIN-NY services after receiving alerts. Long-term care, health homes, federally qualified health centers, and primary care clinics received the most alerts. Specialists had the highest rate of follow-up queries to search for patient records through the SHIN-NY.

The report, funded by NYeC and prepared by researchers at Indiana University Richard Fairbanks School of Public Health and Weill Cornell Medical College, compared data from the second quarters of 2016 and 2017. It is a first-of-its-kind study surrounding the quantification of the relationship of alerts and query-based exchange. The study provides a baseline measurement to conduct additional research and gain a more comprehensive view of the value and role of alerts in providing clinicians with real-time information about their patients to support care coordination.

The next phase of the study will assess potential cost savings and patient outcomes with the usage of alerts and corresponding queries.

The preliminary report is available at www.nyehealth.org/alerts-study

About Rochester RHIO

Rochester RHIO is a secure electronic health information exchange serving authorized medical providers and over one million patients in Monroe, Allegany, Chemung, Genesee, Livingston, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, and Yates counties in upstate New York. The service allows a medical care team to share records across institutions and practices, making patient information available wherever and whenever needed to provide the best care. Patients benefit from fewer repeated tests, easier second opinions, a reduced risk of mistakes caused by poor handwriting or incomplete records, and more informed care during office visits and emergencies. It is a Qualified Entity of the Statewide Health Information Network for New York (SHIN-NY). Healthcare professionals and patients can learn more by visiting RochesterRHIO.org

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Eat Turmeric to Boost Memory and Lift Spirits, Says New Study at UCLA

Eat Turmeric to Boost Memory and Lift Spirits, Says New Study at UCLA

Eat Turmeric to Boost Memory and Lift Spirits, Says New Study at UCLA

A new study by UCLA researchers has concluded that the daily consumption of curcumin, a powerful medicinal compound found in turmeric, could improve memory and lift your mood. Prabha Siddarth, an Indian American research statistician at UCLA’s Semel Institute, was also among the paper’s authors.

 

From fighting inflammation to relieving sore joints to clearing infections, the health benefits of turmeric, which contains the powerful medicinal compound called curcumin, have been long known. And now a new study conducted by UCLA researchers claims that the yellow colored Indian spice can improve memory and mood in people with mild, age-related memory loss.

The research, published online Jan. 19 in the American Journal of Geriatric Psychiatry, examined the effects of an easily absorbed curcumin supplement on memory performance in people without dementia, as well as curcumin’s potential impact on the microscopic plaques and tangles in the brains of people with Alzheimer’s disease.

The study followed a group of adults for 18 months while monitoring their behavior and cognitive abilities. It involved 40 subjects (age 51–84 years) who had mild memory complaints. Participants were randomly assigned to receive either a placebo or 90 milligrams of curcumin twice daily for that time period.

Those who took a daily supplement of curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received the placebo did not, said Dr. Gary Small, director of geriatric psychiatry at UCLA’s Longevity Center and of the geriatric psychiatry division at the Semel Institute for Neuroscience and Human Behavior at UCLA, and the study’s first author. In memory tests, he said, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood.

Indian American research statistician at UCLA’s Semel Institute Prabha Siddarth was also among the paper’s authors.

“Exactly how curcumin exerts its effects is not certain,” said Small. “But it may be due to its ability to reduce brain inflammation, which has been linked to both Alzheimer’s disease and major depression.”

“These results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years,” Small added.

However, four people taking curcumin, and two taking placebos, experienced mild side effects such as abdominal pain and nausea.

The researchers plan to conduct a follow-up study with a larger number of people. That study will include some people with mild depression so the scientists can explore whether curcumin also has antidepressant effects.

Submitted for posting by Dr. Sadanand Mishra.

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The Cost of Medical Liability Claims

The Cost of Medical Liability Claims

34% of physicians have been sued:

The AMA released three new trend reports demonstrating the high frequency and cost burden of medical liability claims.

“Information in this new research paints a bleak picture of physicians’ experiences with medical liability claims and the associated cost burdens on the health system,” David O. Barbe, MD, MHA, president of AMA, said in a press release. “The reports validate the fact that preserving quality and access in medicine, while reducing cost, requires fairness in the civil justice system. Every dollar spent on the broken medical liability system is a dollar that cannot be used to improve patient care.”

In the first report, the AMA evaluated how often physicians are subjected to medical liability claims. The report found that it is common for physicians to get sued, with 34% having a claim filed against them during their career. The likelihood of getting sued increases with age — almost half (49.2%) of physicians aged 55 years and older have been sued vs. 8.2% of physicians aged 40 years and younger.

The occurrence of liability claims varies greatly between specialties, according to the report. General surgeons and OB/GYNs have the greatest risk of being sued, whereas pediatricians have the lowest risk. More than half of general surgeons and OB/GYNs have been sued before the age of 55 years.

“Even though the vast majority of claims are dropped, dismissed or withdrawn, the heavy cost associated with a litigious climate takes a significant financial toll on our health care system when the nation is working to reduce unnecessary health care costs,” Barbe said.

The second report examined indemnity payments, expenses and claim disposition and found that the average expense incurred on medical liability claims increased 64.5% from 2006 to 2015, amounting to $54,165. Dropped, dismissed or withdrawn claims (68.2% of all claims in 2015) still contributed to the cost burden, averaging a cost of $30,475 per claim in 2015 and contributing to 38.4% of total expenses, according to the report.

In the third report, the AMA assessed the annual changes in medical liability insurance premiums from 2008 to 2017. The report revealed that more premiums increased than decreased since 2015, which was a reversal of the trend observed earlier in the study. In addition, 12% to 17% of premiums rose from the prior year since 2010.

 

 

 

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Homemade Yogurt Resolves Irritable Bowel Symptoms

Homemade Yogurt Resolves Irritable Bowel Symptoms

Damian McNamara

December 07, 2017

ORLANDO — The daily consumption of homemade yogurt can lead to a complete resolution of symptoms in patients with irritable bowel syndrome, a prospective study shows.
“We were surprised by the response. We had 189 patients in the study, and 169 had remission within 6 months,” said Manju Girish Chandran, MBBS, from the Mary Breckinridge ARH Hospital in Hyden, Kentucky.
And some of the participants had lived with symptoms of irritable bowel syndrome for 9 or 10 years, she reported here at the World Congress of Gastroenterology.
“Our study is based on the fact that there is an internal gut–brain microbiome axis,” Dr. Chandran told Medscape Medical News. “If you modulate the intestinal microbiome, you can actually achieve remission in some cases.”
Medication does not adequately treat the symptoms of irritable bowel syndrome for many people, she said. As a result, “they just live with it.”
That is one of the reasons Dr. Chandran and her colleagues wanted to assess the potential of homemade yogurt with Lactobacilli to influence the gut microbiome.

Part of a Regular Diet

For their study, the team enrolled 189 consecutive patients diagnosed with irritable bowel syndrome at one of two medical centers in Eastern Kentucky.
Patients were instructed to consume 2 to 3 cups of yogurt every day and record their symptoms in a chart. Their responses were assessed every 2 months for 6 months.
Complete remission — defined as the relief of pre-existing irritable bowel syndrome symptoms and one or two normal bowel movements daily — was achieved by 89% of the study participants.
The yogurt is inexpensive and easy to make. First, boil a gallon of milk for 5 minutes and let it cool to lukewarm. Next, mix in 1 cup of Dannon plain yogurt, which is used as a starter and source of Lactobacilli. Place in an oven with the light on overnight (do not turn the oven on), and then refrigerate the next morning. Save 1 cup from each batch to use as a starter for the next batch.
“You can make enough yogurt for 1 week, and it’s pretty cheap,” Dr. Chandran pointed out. “And it doesn’t have to be eaten as plain yogurt.” Because it can be mixed with fruit or used in a smoothie, it doesn’t “feel like it’s a medicine; it is part of a regular diet.”
This is the first study to show “that yogurt — even though it’s homemade — is usable in IBS,” said Ronnie Fass, MD, from the MetroHealth Medical Center in Cleveland.
“In traditional diets, we recommend that people with IBS be careful with milk-related products,” he told Medscape Medical News. “This study suggests what we thought all along is not so clear cut.”
“The homemade yogurt with Lactobacillus was very effective at controlling symptoms of belly pain and alterations in bowel movements. It did both, to my surprise,” Dr. Fass said. “This is the kind of study that could change standard of care, although more work is needed.”

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