What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.
FDA Approves Powerful New Opioid Despite Warnings of Likely Abuse
The Food and Drug Administration approved a new form of an extremely potent opioid to manage acute pain in adults, weeks after the chairman of the advisory committee that reviewed it asked the agency to reject it on grounds that it would likely be abused. Via NY Times.
How Daylight Saving Affects Your Sleep and Overall Health
Daylight Saving Time ends and gives Americans the feeling of an extra hour in the morning, which could negatively affect their health. “Ever since the institution of Daylight Saving Time, there has been controversy regarding whether it accomplishes its goals or not, and if so — at what cost. Via USA Today.
Type 2 Diabetes: Every Important Fact to Know about Causes, Symptoms, and Treatments
The most common type of diabetes, type 2 diabetes occurs when your blood sugar (also called blood glucose) is elevated over a long period of time. At the same time, your body either doesn't use insulin properly or doesn't make enough insulin. Our bodies need insulin to move glucose into cells so it can be used for energy. Via Prevention.
Why Doctors Hate Their Computers
In recent years, it has become apparent that doctors have developed extraordinarily high burnout rates. In 2014, 54% of physicians reported at least one of the three symptoms of burnout, compared with 46% in 2011. Only a third agreed that their work schedule “leaves me enough time for my personal/family life,” compared with almost two-thirds of other workers. Female physicians had even higher burnout levels (along with lower satisfaction with their work-life balance). A Mayo Clinic analysis found that burnout increased the likelihood that physicians switched to part-time work. It was driving doctors out of practice. Via The New Yorker.
New Spinal Cord Therapy Helps Paralyzed Patients Walk Again
Three men who were paralyzed from the waist down are able to walk again with a new type of therapy that uses electrical stimulation, scientists announced today. More than four years prior, the men had all suffered major spinal cord injuries that left them with limited or no movement in their legs. The results, published in the journal Nature, come on the heels of two reports last month of similar therapies that were able to help people with major spinal cord injuries walk for the first time in years. A team at the University of Louisville reported in September that stimulating the spinal cord—known as neurostimulation—allowed two people to stand independently and walk with assistive devices, like a walker. In a separate study published the same day, researchers at the Mayo Clinic showed that they had achieved similar results in another person. Via National Geographic.
Duncan Hines Cake Mix Recall: FDA Probes Salmonella Risk
Food giant Conagra Brands is recalling 2.4 million boxes of its Duncan Hines cake mix, with federal health officials warning that one variety of the popular product tested positive for salmonella. The Centers for Disease Control and Prevention has received reports of five illnesses linked to Duncan Hines, according to the Food and Drug Administration. Reports of additional illnesses are expected due to time lags between when an illness occurs and when the CDC receives confirmed lab results. "The FDA is investigating the manufacturing facility that made recalled Duncan Hines cake mixes," an announcement posted late Monday by the agency stated. "FDA and the CDC informed Conagra Brands that a sample of Duncan Hines Classic White Cake Mix that contained Salmonella Agbeni matched the Salmonella collected from ill persons reported to the CDC. This was determined through Whole Genome Sequencing, a type of DNA analysis." Via CBS News.
Societies Publish New Guidance for the Treatment of Slow, Irregular Heartbeats
"Treatment decisions are based not only on the best available evidence but also on the patient's goals of care and preferences," said Fred M. Kusumoto, MD, cardiologist at Mayo Clinic Florida in Jacksonville and chair of the writing committee. "Patients should be referred to trusted material to aid in their understanding and awareness of the consequences and risks of any proposed action." Yet, according to the authors, there are still knowledge gaps in understanding how to manage bradycardia, especially the evolving role of and developing technology for pacing. "Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice," Kusumoto said. Via Medical Xpress.
Another Burst of Polio-Like Cases in Children Alarms Doctors
Every two years since 2014 the Centers for Disease Control and Prevention has documented a spike in AFM, almost always in children. The CDC is investigating 219 reports of patients with AFM so far this year, with 80 cases in 25 states confirmed, up from 33 the year before. In 2016 the CDC confirmed 149 cases of AFM and in 2014 there were 120 cases. Doctors and the CDC differ on the possible cause of the condition and how to treat it. Many doctors speculate AFM is largely fueled by a common virus called the enterovirus, which for most people causes nothing more than a routine upper-respiratory infection. But the CDC believes there could be other culprits. Some experts believe the condition likely existed before 2014 and think there could be more cases, since there is no national requirement to report as there is for many other conditions, including influenza and measles. Via Wall Street Journal.
Morning People Are Less Likely to Develop Breast Cancer, UK Study Suggests
Women who wake up early have a lower risk of developing breast cancer, according to researchers in the United Kingdom. A team at the University of Bristol in England analyzed data from 180,215 women enrolled with the UK Biobank project, and 228,951 women who had been part of a genome-wide association study of breast cancer led by the international Breast Cancer Association Consortium. The findings, which were not peer-reviewed, were presented at the NCRI Cancer Conference in Glasgow, Scotland. Using a genetic method known as Mendelian randomization, researchers found that women who prefer mornings have a 40 to 48 percent reduced risk of developing breast cancer. Also, the research notes that women who slept longer than seven to eight hours had a 20 percent increased risk per additional hour slept. Via USA Today.
Training the Next Generation of Doctors and Nurses
In what looks like an urgent game of catch-up, medical and nursing schools across the country are retooling how and what they teach. This is also getting a boost from concern about the looming shortage of primary caregivers. While “the national narrative is that we need more” doctors and nurses, said Erin Fraher, director of the Carolina Health Workforce Research Center, “that is precisely the wrong way to frame this. The question has to be: Where are the places in the U.S. where patients cannot get access to diabetes care, access to prenatal care?” Those questions are redesigning health care education, with more community-based clinic rotations, special programs (and scholarships) for rural and underserved students, and a greater role for nurses and nurse practitioners. As schools seek to make learning more efficient, technology — including virtual reality, augmented-reality software and high-fidelity simulations (mannequins “breathe,” cry, sweat and respond to medication) — is a big part of that. And it must be, given that students have to learn more information, faster. Much of medicine is slow; you can’t shortcut taking a medical history. But visiting the pathology lab to study a colon sample? Via NY Times.