Vital Signs

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Will Dr. Emanuel opt for death at 75? Maybe not

6:45 pm, Sep. 22 |

Nobody has ever accused the famous Emanuel brothers—Dr. Ezekiel Emanuel of University of Pennsylvania, Mayor Rahm Emanuel of Chicago, or Hollywood agent Ari Emanuel—of humility. And no one who reads Dr. Emanuel's new essay in the Atlantic Monthly, “Why I Hope to Die at 75: An argument that society and families—and you—will be better off if nature takes it course swiftly and promptly,” will accuse him of that trait now.

Emanuel, 57, an oncologist and bioethicist who played a role in crafting the Obamacare legislation, tries to convince readers of the rightness of his own preference to only live to 75 and go out while he's still making solid professional contributions and his family and friends can remember him as a vigorous and productive person. He wants everyone to consider adopting his view, though he acknowledges that his physician father, now in his late 80s, is still happy despite having slowed down a lot.
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New research again points to impact of climate change on public health

6 pm, Sep. 22 |

On the heels of large protests held in several cities Sunday that called for action against climate change, new research adds to the chorus of voices that argue the issue should raise concerns over its associated public health risks.

A study published Monday in JAMA examining evidence going back two decades found indications of an association between climate change and adverse effects on health conditions.
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New doubts raised about e-cigs and smoking cessation

3:15 pm, Sep. 22 |

New doubts are being raised over claims about the use of electronic cigarettes as a tobacco-cessation alternative for cancer patients.

A study published in the Sept. 22 issue of the journal Cancer found e-cig use among cancer patients who also smoke tobacco increased dramatically between 2012 and 2013, from 10% to 38%.
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Rap video uses patient safety as a refrain

2:30 pm, Sep. 22 |

If the same-old, same-old is not working in terms of moving a healthcare organization toward a culture of safety, hospital quality leaders say it may be time to think outside the box.

Adding some spunk to the message may be one way to engage staff in a way that could—quite literally—be music to their ears.
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Why one congressman wants to scrap Medicare's hospital appeals deal

The CMS has been pretty quiet about its Medicare appeals settlement for hospitals, and now a congressman wants the agency to retract the offer altogether.

Rep. Kevin Brady (R-Texas), who serves as chairman of the House Ways and Means Subcommittee on Health, sent a letter to HHS Secretary Sylvia Mathews Burwell this week urging her, at a minimum, to explain how the government developed the settlement process.
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More tech support, trust needed to boost wellness plan participation, survey shows

Many employer-sponsored wellness programs need some healing hands themselves, particularly when it comes to embracing home and mobile health technology. That's especially true when employees still remain queasy about participating in the programs because of concerns their personal information might be used against them, a new study of employers and employees shows.

Neither ailment is incurable, however, according to the 22-page report, “Measuring Wellness, From Data to Insights,” by the The Economist Intelligence Unit, a research arm of U.K.-based Economist magazine.
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Double-digit premium hikes common in pre-ACA small-group market

Average premium increases in the small-group market typically ranged from 5% to 6.5% in most states from 2000 to 2013, according to a new analysis of insurance data from researchers at the Urban Institute. But double-digit increases were not unusual and the breadth of changes varied significantly from year to year.

“It really wasn't uncommon for there to be big swings in one direction or another in premiums in a given year,” said Linda Blumberg, a senior fellow at the Urban Institute and co-author of the report. “These things tend to even out.”
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CT scans may be overused for detecting kidney stones

5 pm, Sep. 17 |
Using an ultrasound rather than a CT scan for patients suspected of having kidney stones could be preferable to reduce unnecessary radiation exposure, concludes a new study in the New England Journal of Medicine. No significant differences were evident in detecting high-risk diagnoses, serious adverse events, pain scores, readmissions or hospitalizations among patients who were given ultrasounds as a first choice of imaging, the study found.

The research adds to a growing consensus finding use of CT scans for the initial detection of kidney stones might be associated not only with unnecessary radiation exposure but also higher costs.
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Wearable activity trackers: Do they help health and wellness?

3 pm, Sep. 17 |

The attention given Apple's new smartwatch and Health app has brought the debate center stage over whether wearable activity trackers conform to best evidence-based practices—and whether they work as promised. Authors of a just-published study in the Journal of Medical Internet Research concluded that many trackers do use evidence-based behavior techniques. But they remained unsure about whether those techniques effectively translate to better health and wellness.

The researchers examined 13 wearable activity trackers and their accompanying smartphone applications, including popular products from companies like Jawbone, Nike and Withings, and categorized them according to their adherence to 93 evidence-based behavior change techniques such as “prompt review of behavioral goals” and “provid[ing] instruction.”
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Insurance coverage, provider preference affect who gets bariatric surgery, report finds

3:45 pm, Sep. 16 |

Wide variations in whether Medicare patients undergo bariatric surgery to treat obesity suggest that insurance coverage and provider preference are heavily influencing who has access to the procedure, a new report indicates. What the report didn't find, however, was a correlation between the bariatric surgery rate and the rate of diabetes and obesity in the community.

Patients in Muskegon, Mich., for example, are 27 times more likely to undergo bariatric surgery than those in San Francisco, according to the report from the Dartmouth Atlas Project, a series that is looking at variations in care for surgical procedures.
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