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Trial links higher monthly doses of vitamin D with increased risk of falls

Higher monthly doses of vitamin D were associated with no benefit on lower extremity function and with an increased risk of falls in patients ages 70 or older, according to a randomized clinical trial.

Findings appear in an article published Jan. 4 on the website of JAMA Internal Medicine.

Lower extremity function that is impaired is a major risk factor for falls, injuries and a loss of autonomy. Vitamin D supplementation has been proposed as a possible preventive strategy to delay functional decline. However, according to a news release, definitive data are lacking.

To gather more data, Heike A. Bischoff-Ferrari, MD, DrPH, of the University Hospital Zurich, Switzerland, and co-authors conducted a one-year, randomized clinical trial. Their study included 200 men and women ages 70 or older who had fallen in the past.

Participants were divided into three study groups: 67 people in a low-dose control group who received 24,000 IU of vitamin D3 per month; 67 people who received 60,000 IU of vitamin D3 per month; and 66 people who received 24,000 IU of vitamin D3 plus calcifediol per month. The study measured improvement in lower extremity function, achieving 25-hydroxyvitamin D levels of at least 30 ng/mL at six and 12 months, and reported falls.

The authors found:

Of the 200 participants, 58% were vitamin D deficient at baseline.
Doses of 60,000 IU and 24,000 IU plus calcifediol were more likely to result in 25-hydroxyvitamin D levels of at least 30 ng/mL but they were associated with no benefit on lower extremity function.
Of the 200 participants, 60.5% (121 of 200) fell during the 12-month treatment period.
The 60,000 IU and 24,000 IU plus calcifediol groups had higher percentages of participants who fell (66.9% and 66.1%, respectively) compared with the 24,000 IU […]

By |January 22nd, 2016|Categories: News||1 Comment

New research shows four patterns of symptoms after military brain injury

Four distinct patterns of symptoms occur after mild traumatic brain injury in military service members, according to new research that also validates a new tool for assessing the quality-of-life impact of TBI.

The research results appear in the January-February issue of The Journal of Head Trauma Rehabilitation, an annual special issue devoted to TBI in the military. JHTR is the official journal of the Brain Injury Association of America and is published by Wolters Kluwer.

In print and online, the special issue includes 13 original research studies on TBI in the military, including a special focus on how TBI affects quality of life. TBI is a major concern in military personnel, both deployed and nondeployed, according to a news release. More than 294,000 service members suffered TBI between 2000 and 2013, according to a news release. More than 80% of these injuries were mild TBI, also known as concussion.
Four subtypes of symptoms after military TBI
Jason M. Bailie, PhD, of the Defense and Veterans Brain Injury Center and colleagues analyzed patterns of neurobehavioral and psychiatric symptoms in more than 1,300 veterans who had suffered combat-related mild TBI within the past two years. The goal was to develop a classification, or taxonomy, of symptoms after mild TBI in military personnel.

The analysis identified four clusters, or subtypes, of symptoms. The largest group of veterans — about 38% — had good recovery, with relatively low rates of behavioral and mental health symptoms, findings showed.

About 22% of veterans had primarily psychiatric symptoms, according to the analysis. This included mood symptoms associated with post-traumatic stress disorder, such as hyperarousal and dissociation or depression. But findings showed veterans in this group were less likely to have cognitive difficulties or headaches.

Another 22% had primarily […]

By |January 19th, 2016|Categories: News||0 Comments

Extra therapy associated with better hip fracture results, study finds

Patients recovering from hip fractures who receive an extra hour per week of rehabilitation therapy in short-term nursing care facilities have better long-term outcomes than those who receive less rehab, according to a new study.

The research, led by an investigator with Weill Cornell Medicine in New York, suggests policymakers should consider the value of rehabilitation centers against potential spending reductions.

In the study, published Jan. 1 in the journal Physical Therapy, investigators found a roughly 3% increase in the likelihood of discharge home from skilled nursing facilities among patients who received an additional hour of therapy per week.

The study was based on data collected nationally from 481,908 hip-fracture patients enrolled in Medicare from 2000-09. The patients received skilled nursing care, which attempts to help the patient regain functional independence to achieve a successful discharge into the community. According to the study, hip-fracture patients who are in good health benefit most from extra therapy time; however, the findings showed patients who had the highest levels of impairment were not likely to benefit from additional therapy.

“There’s an assumption that additional therapy being provided in skilled nursing facilities does not improve patient outcomes, but there isn’t a strong evidence-base,” the study’s lead author, Hye-Young Jung, PhD, an assistant professor of healthcare policy and research in the Division of Health Policy and Economics at Weill Cornell Medicine, said in a news release. “Policymakers are seeking to reduce expenditures for these services, which may lead to less therapy provided to patients and poorer outcomes. My study is basically saying, ‘Let’s actually look at the therapy minutes and see if patients benefit from more therapy.’”

The study, which also included investigators from the Alpert Medical School of Brown University in Providence, R.I., […]

By |January 15th, 2016|Categories: News||0 Comments

Study: Music therapy makes pulmonary rehab more effective for COPD

Patients with chronic obstructive pulmonary disease and other chronic respiratory disorders who received music therapy and standard rehabilitation saw an improvement in symptoms, psychological well-being and quality of life compared with patients receiving rehabilitation alone, according to a recent study.

The research was conducted by investigators at The Louis Armstrong Center of Music and Medicine at Mount Sinai Beth Israel in New York. Study findings, which were published in the December issue of Respiratory Medicine, suggest music therapy might be an effective addition to traditional treatment.

COPD is the third leading cause of death in the U.S., according to the CDC, with symptoms including shortness of breath, wheezing, an ongoing cough, frequent colds or flu and chest tightness. Patients with COPD often are socially isolated, unable to get to medical services and underserved in rehabilitation programs, making effective treatment difficult, according to a news release.

The 68 study participants were diagnosed with chronic disabling respiratory diseases, including COPD. During six weeks, a randomized group of these patients attended weekly music therapy sessions. Each session included live music, visualizations, wind instrument playing and singing, which incorporated breath control techniques. Certified music therapists provided active music-psychotherapy. The music therapy sessions incorporated patients’ preferred music, which encouraged self-expression, increased engagement in therapeutic activities and an opportunity to cope with the challenges of a chronic disease.

“The care of chronic illness is purposefully shifting away from strict traditional assessments that once focused primarily on diagnosis, morbidity and mortality rates,” Joanne Loewy, DA, director of the Louis Armstrong Center for Music and Medicine at MSBI, said in the release. “Instead, the care of the chronically ill is moving toward methods that aim to preserve and enhance quality of life of our patients and […]

By |January 12th, 2016|Categories: News||0 Comments

Study: Infertility treatments don’t increase risk of developmental delays

Children conceived via infertility treatments are no more likely to have a developmental delay than children conceived without such treatments, according to a recent study.

Investigators at the National Institutes of Health, the New York State Department of Health and other institutions published the research Jan. 4 on the website of JAMA Pediatrics. The findings might help to allay longstanding concerns that conception after infertility treatment could affect the embryo at a sensitive stage and result in lifelong disability, according to a news release.

The authors found no differences in developmental assessment scores of more than 1,800 children born to women who became pregnant after receiving infertility treatment and those of more than 4,000 children born to women who did not undergo such treatment.

“When we began our study, there was little research on the potential effects of conception via fertility treatments on U.S. children,” Edwina Yeung, PhD, an investigator in the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in the release. “Our results provide reassurance to the thousands of couples who have relied on these treatments to establish their families.”

Also taking part in the study were researchers from the University at Albany, N.Y.; the New York State Department of Health, also in Albany; and CapitalCare Pediatrics in Troy, N.Y. The Upstate KIDS study enrolled infants born to women in New York State (except for New York City) from 2008-10. Parents of infants whose birth certificates indicated infertility treatment were invited to enroll their children in the study, as were all parents of twins and other multiples. The researchers also recruited roughly three times as many singletons not conceived via infertility treatment.

Four months after […]

By |January 11th, 2016|Categories: News||0 Comments

Report: 90% of industries affected by health information data breaches

Stolen medical information affects 18 out of 20 industries examined in a report from Verizon Enterprise Solutions, according to a news release.

However, the report found, many organizations outside of healthcare do not realize they even keep protected health information. Common sources of PHI are employee records (including workers’ compensation claims) or information for wellness programs, and the data are generally not well protected, according to the report.

These findings are part of a first-time report from Verizon’s Data Breach Investigations Report team that provides a detailed analysis of confirmed PHI breaches involving more than 392 million records and 1,931 incidents across 25 countries, according to the release. For the report, PHI was considered information on an individual that is covered by state, federal or international data breach laws.

For the report, authors analyzed PHI data breaches in the healthcare industry including ambulatory healthcare services, hospitals, nursing and residential care, and social assistance across North America, Europe and the Asia-Pacific region.

“Many organizations are not doing enough to protect this highly sensitive and confidential data,” Suzanne Widup, senior analyst and lead author for the report, said in the release. “This can lead to significant consequences impacting an individual and their family and increasing healthcare costs for governments, organizations and individuals. Protected health information is highly coveted by today’s cybercriminals.”

According to past studies cited in the report, people are withholding information — sometimes critical information — from their healthcare providers because they are concerned there could be a data breach.

“Healthcare organizations need to realize that patients trust them with their data and if that trust is broken, the implications can be huge,” Widup said in the release.

The report cites an example in which an unwillingness to fully disclose information […]

By |January 8th, 2016|Categories: News||0 Comments

Childhood concussions can impair brain function 2 years later: small study

Pre-adolescent children who have suffered sports-related concussions have impaired brain function two years after injury, according to a small study.

Investigators with the University of Illinois in Urbana-Champaign published the results Nov. 26 on the website of the International Journal of Psychophysiology.

According to the CDC, in 2009 nearly 250,000 children and teens were treated in EDs for sports- and recreation-related traumatic brain injury including concussion in the U.S. While organized sports at all levels have implemented safety protocols for preventing and treating head injuries, most pediatric concussions still result from athletic activities.

Research studying the long-term effects of childhood concussions is limited. Several researchers claim only a small portion of children have developmental deficits after a concussion. However, other reports indicate more serious consequences of head injury, including long-term cognitive deficits.

“Our data indicate that children who sustain a concussion demonstrate deficits in brain function and cognitive performance approximately two years after injury, relative to others their age who do not have a history of mild traumatic brain injury,” Charles Hillman, PhD, University of Illinois kinesiology and community health professor, said in a news release. Hillman, who also is affiliated with the Beckman Institute for Advanced Science and Technology, led the research with R. Davis Moore, PhD, a recent U of I graduate and a postdoctoral fellow at the University of Montreal.

The study included 30 children, ages 8-10, who are active in athletic activities. Fifteen of the children were recruited two years after a sports-related concussion, and the remaining children had no history of concussion.

The researchers assessed the children’s ability to update and maintain memory, and pay attention and inhibit responses when instructed to do so. The team also analyzed electrical signals in the brain while the […]

By |January 5th, 2016|Categories: News||0 Comments

National health spending grew 5.3% in 2014, driven by ACA, prescription drugs

In 2014, healthcare spending in the U.S. grew at an estimated rate of 5.3% to $3 trillion, or $9,523 per person, according to an analysis from the Office of the Actuary at the Centers for Medicare and Medicaid Services.

The previous five years saw historically low growth, which averaged 3.7%; in 2013 the average growth was 2.9%, according to a post by Lucy Larner on the HealthAffairsBlog. The analysis will appear in the January 2016 issue of the journal Health Affairs.

“Two main factors were responsible for health spending growth in 2014 — coverage expansion associated with the Affordable Care Act and faster growth in prescription drug spending,” lead author Anne B. Martin, an economist in the Office of the Actuary at CMS, said in the blog post. “However, it is unknown how these drivers of healthcare spending will affect trends over the next few years as the new health insurance landscape continues to evolve.”

About 8.7 million more people gained insurance coverage in 2014 compared with 2013, according to CMS. These additional people boosted the percentage of the population with insurance to 88.8% in 2014 from 86% in 2013. According to CMS, that’s the highest percentage since 1987.

The increase in those with coverage helped lower the out-of-pocket costs to consumers, according to Fortune magazine article “U.S. health care spending accelerates after historic lows,” by Laura Lorenzetti.

“Despite the overall spending pick up, growth in consumer out-of-pocket spending slowed down slightly to 1.3% from 2.4% the year before,” Lorenzetti wrote in the article.

“Millions of uninsured Americans gained healthcare coverage in 2014,” CMS Acting Administrator Andy Slavitt, said in a CMS release.“And still, the rate of growth remains below the level in most years prior to the coverage expansion, […]

By |January 1st, 2016|Categories: News||0 Comments

Shingles increases short-term risk of stroke in older adults

Adults older than 50 have a 50% increased risk of stroke in the 90 days after having shingles, according to a study in Mayo Clinic Proceedings.

More than 95% of the world’s adult population is infected with the virus that causes chickenpox, according to a news release, and as many as one third of these individuals will develop shingles (herpes zoster) in their lifetime.

Shingles is caused by reactivation of the chickenpox virus, varicella zoster, which causes a painful skin rash to erupt in a limited area. It is more common in older adults and those with weak immune systems, but anyone who has had chickenpox can develop shingles.

Past studies in Europe and Asia have suggested an increased risk of stroke and myocardial infarction after shingles, but there have not been any previous studies in the U.S., according to the release. Findings from the new study were published Dec. 15 online.

In the new study, investigators assessed the risk of stroke and MI in a U.S. community-based population. About 5,000 adults older than 50 in Olmsted County, Minnesota, who had a confirmed episode of shingles, were matched with a group of age- and sex-matched individuals from the same community who had no history of shingles.

Researchers assessed the risks for stroke and MI separately. Patients with a previous stroke were excluded from the stroke analyses, and those with a previous MI were excluded from the MI analyses. The short-term risk of stroke and MI were assessed at three months, six months, one year and three years after shingles.

“We found there was a 50% increased risk of stroke for three months after shingles, but we also found that people who had shingles had many more risk factors for stroke […]

By |December 28th, 2015|Categories: News||0 Comments

Medicare Home Health Flexibility Act introduced in U.S. Senate

If a new bill introduced in the U.S. Senate becomes law, OTs would be able to conduct initial assessments in the home health setting, according to a news release.

The Medicare Home Health Flexibility Act, S. 2364, introduced Dec. 8 by Sens. Ben Cardin, D-Md., and Dean Heller, R-Nev., would allow home health agencies the flexibility to use the most appropriate skilled rehabilitation professionals to open cases and conduct initial assessments when related exclusively to rehab cases and when skilled nursing care is not provided.

Currently, OTs are unable to conduct initial assessments in the home health setting.

“This discrepancy causes unnecessary inefficiencies and barriers to providing patients with effective, timely and appropriate therapy services in the home health setting,” Christina Metzler, chief public affairs officer for the American Occupational Therapy Association, said in the release.

Occupational therapy has long been a valued component of the home healthcare team because of therapists’ expertise in identifying home safety issues and in establishing routines to maximize client compliance with the plan of care, according to the release. The proposed legislation recognizes those contributions and seeks to address the existing arbitrary restrictions.

“As our healthcare system continues to evolve and our country’s population ages, we must strive to maximize individuals’ ability to live fuller, more independent lives,” Metzler said in the release. “Patients are increasingly receiving care in home and community settings where occupational therapy plays a pivotal role. We are grateful for Senators Cardin and Heller’s leadership in recognizing the value of addressing this discrepancy for Medicare beneficiaries.”

Existing regulation allows for the initial assessment to be made by the appropriate rehabilitation skilled professional only when the need for that service establishes home health eligibility. Because occupational therapy is not a qualifying […]

By |December 25th, 2015|Categories: News||3 Comments