Protecting Kids with temporary tattoos

food allergiesParents of the three million or so kids in the US who have been diagnosed with food allergies whose kids have severe food allergies know they can’t be too careful. One bite of the food they are allergic to could be deadly. Indeed, according to the CDS, more than 200 people with food allergies die every year as a result of anaphylaxis.

Now, Michele Walsh, a mother of three from Baltimore, has created SafetyTat  to help remind teachers, classmates and babysitters to be extra careful.

temp tattooThe safety tats are brightly colored temporary tattoos or long-lasting write-on stickers that can be placed prominently on a child’s arm, with information such as “ALERT: NUT ALLERGY” or other critical information.

When you leave a child in someone else’s care at school or camp, “no matter how many times you fill out the forms, you’re still taking a leap of faith,” Walsh says. “This is like my voice with my son when I’m not there. It’s almost like teaching them ‘stop, drop and roll…’ They know exactly what to do.”

Another company –  Allermates offers allergy education tools, stickers, alert bracelets and other products for kids. Allermates was created by Iris Shamus, inspired by her son’s multiple allergies and an incident at school. “When you have a child with a food allergy, you’re always worried. It’s just part of your life,” she says. “I wanted to have something a little more personalized for him to remind teachers and babysitters.”

allermatesIt began with a fun necklace, then a wristband and a large selection of products accompanied by cartoon characters such as Nutso, a charming peanut, to help her son understand, remember and confidently discuss his allergies.

It makes me feel so much more secure,” she says. “I know you can’t be there all the time when you’re a mom, and this gives you peace of mind.”

Anything that can help educate the patient about their problem and continue to make them aware about it is helpful whether it’s a temporary tattoo or a warning bracelet,” says Stan Fineman MD, immediate past president of the American College of Allergy, Asthma and Immunology.  “The important thing is for people to accurately find out what they’re allergic to and then make sure to take the appropriate precautions,” Fineman says. He says parents of kids with severe allergies should keep EpiPens on hand, check school policies, talk to school officials and bring in treats their kids can eat for special events.

allermates 2Betsy Shea of Chicago says both of her boys, 4-year-old Colin and 2-year-old Emmet, have nut allergies, and Colin wears Allermates’ green snap-on wristband featuring Nutso. She’s thinking about trying temporary tattoos for Emmet.

Having allergies herself, she remembers having to wear the traditional metal medical alert band, which made her feel different and self-conscious. But Colin “loves that band. He wears it with pride and thinks it’s just so cool. We couldn’t get him to take it off for a while,” she says.

We thinks it’s pretty cool too!

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Cutting Costs by Cutting Pills

Medical CostsAccording to some disturbing data released yesterday by the CDC, many US adults aren’t following doctor’s orders. And it’s not just the very young or very old, who, it could be claimed,  don’t know any better.

It turns out that adults under the retirement age are twice as likely to skip their prescribed medications in order to save money to save money.

And although spending on drugs is expected to increase an average of 6.6% a year from 2015 through 202, 20% of adults regardless of age, have asked their doctors for a lower cost treatment.

Americans spent $45 billion out-of-pocket on retail prescription drugs in 2011. But, “if you’re not insured or you face high co-payments, you’re going to stretch your prescriptions,” says Steve Morgan, an associate professor at the University of British Columbia’s School of Population and Public Health in Vancouver. “Even among insured populations, there is this invincibility mindset among the very young. Older people are more likely to adhere to chronic therapies over a longer period of time than younger.”

The study also found that 13% of those ages 18 – 64 reported not taking their medications as prescribed to reduce costs compared with 5.8% of those 65 and older.

cut pillStrategies that alter the way adults take their medications include skipping doses and consuming less than the prescribed amount. About 11% of those aged 18 – 64 also delayed filling a prescription compared with 4.4% of those 65 and older.

Uninsured adults were more likely to have tried to stretch their medications than those with Medicaid or private insurance.

But are such savings worth it? Failing to take medication as prescribed may actually increase costs to the U.S. health system, particularly if medication non-adherence results in increased hospitalizations, or complications of chronic diseases.

Anytime a patient chooses not to take drugs as prescribed, the pharmaceutical industry pharma loses sales. A recent study estimated that pharma loses $564 billion globally to non-adherence to drugs. Not surprisingly then, the industry is experimenting with reminders, to increase adherence. Nevertheless, a nudge from a text or a talking pill container might not inspire patients who are penny pinching.

I’d love to stay and chat, but I need to run to the pharmacy to refill my blood pressure meds that I ran out of several days ago!

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Does Your Doctor ‘Get You’?

Does your doctor understand you? Does he (or she) know what you’re thinking? Does he really feel your pain? In short, does he care?

Seems this is something you should really care about. According to a study just published in Academic Medicine, patients of doctors who are more empathic have better outcomes and fewer complications.

Researchers from Thomas Jefferson University together with a team from Parma, Italy evaluated relationships between physician empathy and clinical outcomes among 20,961 Italian diabetic patients and their 242 physicians.

The study was a follow up to a smaller one undertaken at Thomas Jefferson University that included 891 diabetic patients and 29 physicians, and showed that patients of physicians with high empathy scores had better clinical outcomes than patients of other physicians with lower scores.

This new, large-scale research study has confirmed that empathic physician-patient relationships is an important factor in positive outcomes,” said Mohammadreza Hojat, Ph.D., Research Professor in the Department of Psychiatry and Human Behavior and the Director of Jefferson Longitudinal Study at the Center.  “It takes our hypothesis one step further. Compared to our initial study, it has a much larger number of patients and physicians, a different, tangible clinical outcome, hospital admission for acute metabolic complications, and a cross-cultural feature that will allow for generalization of the findings in different cultures, and different health care systems.”

The Italian researchers used the Jefferson Scale of Empathy (JSE) –an instrument used to measure empathy in the context of medical education and patient care. The JSE includes 20 items answered on a seven-point scale (strongly agree = 7, strongly disagree = 1) and measures understanding of patient’s concerns, pain, and suffering, and an intention to help.

The primary outcome measure of the study was acute metabolic complications, including hyperosmolar state, diabetic ketoacidosis, and diabetic coma. These were used because they require hospitalization, can develop quickly, and their prevention is more likely to be influenced by the primary care physicians.

A total of 123 patients were hospitalized because of such complications. Physicians with higher empathy levels had 29 : 7,224 patients admitted to the hospital, whereas physicians with lower levels had 42 : 6,434 patients admitted.

There are many factors that add to the strength of the study. Firstly, because of universal health care coverage in Italy, there is no confounding effect of difference in insurance, lack of insurance or financial barriers to access care.

What’s more, this study was conducted in a health care system in which all residents enroll with a primary care physician resulting in a better defined relationship between the patients and their primary care physicians than what exists in the United States,” said co-author Daniel Z. Louis.

According to the Centers for Disease Control and Prevention, over 25 million people in the U.S. population have been diagnosed with diabetes, with almost 700,000 hospitalizations per year. There are approximately 2 million new cases per year. Worldwide, the number of total cases jumps to 180 million.

Results of this study confirmed our hypothesis that a validated measure of physician empathy is significantly associated with the incidence of acute metabolic complications in diabetic patients, and provide the much-needed, additional empirical support for the beneficial effects of empathy in patient care” said Dr. Hojat. “These findings also support the recommendations of such professional organizations as the Association of American Medical Colleges and the American Board of Internal Medicine of the importance of assessing and enhancing empathic skills in undergraduate and graduate medical education.”

Does your doctor get you? Let us know.

Swimming with Seals riskier than Surfing with Sharks?

Seals  –  those cute, semi-aquatic marine mammals hunted for generations by humans may be about to wreak their revenge.  While we don’t want to get into the pros and cons of the cull, we would like to warn our readers of a new strain of flu found in New England harbor seals.

According to experts, seal flu could potentially threaten people as well as wildlife. In a report just published online in mBio, scientists from several organizations, including Columbia University and the National Oceanic and Atmospheric Administration suggest that seal flu could lead to another pandemic just as we saw with bird and swine flu.

There is a concern that we have a new mammalian-transmissible virus to which humans haven’t been exposed yet. It’s a combination we haven’t seen in disease before,” said Anne Moscona MD, professor of pediatrics and of microbiology and immunology at Weill Cornell Medical College.

A dangerous virus infecting mammals increases the risk to us – not by direct infection – but by evolutionary development of even more riskier strains,” explained Bruce Hirsch, an infectious disease specialist at North Shore University Hospital in Manhasset, N.Y.

Although transmission via direct contact between humans and harbor seals is unlikely, the virus could find other ways to get to people.  For example, the strain might pass from seals to birds, expand its presence in the environment.  And because seal flu is able to target a protein found in the human respiratory tract, it may have the potential to mutate in ways that make it easily passed to or between humans.

The researchers analyzed the DNA of a virus linked to the death of 162 harbor seals in 2011 off the coasts of Massachusetts, New Hampshire and Maine. Five autopsies revealed that the seals died from infection with a type of flu known as H3N8.

Because pandemic flu can originate in unexpected ways, preparation is essential. The Centers for Disease Control and prevention (CDC) offers some excellent tips on its website.

And we suggest for this year at least you might be better off diving with dolphins than swimming with seals!

 

 

 

Whoa, whoa, whoa, whoa – Washing at the Handwash!

A few years ago the Centers for Disease Control and Prevention (CDC) estimated that about 1.7 million patients get a hospital acquired infection each year. Of these, 99,000 die. More recently they estimated that infections develop in about 1 to 3 out of every 100 patients who have surgery.

Separately, a new study just presented at the annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC) found that preventing further complications in patients who develop infections after hip or knee replacement surgery could save the U.S. health-care system as much as $65 million a year.

Hardly surprising then, that the pressure is mounting to reduce hospital-acquired infections. Some of this is being driven by Medicare who has started reducing  payments for hospital readmissions.

Infection-prevention specialists are now focusing on new practices and products to minimize patient exposure from the environment as well as from medical procedures and surgical instruments.

For example, Baycrest Geriatric Healthcare System in Ontario, were able to reduce the rate of transmission for the staph infection MRSA by 82% over a 33-month period by bathing patients daily with germ-killing cloths.   The cloths are presoaked with a powerful antimicrobial agent – chlorhexidine gluconate, which reduces organisms on a patient’s skin and leaves a residue that lasts up to six hours.  Baycrest, also screens all patients on admission to determine if they are colonized with MRSA on the skin, indicating the organism is present on the body but not yet causing an infection.

Many other innovative  infection-prevention ideas were suggested at the APIC “film festival”, which featured short videos including music, drama, dance, humor and animation to promote adherence to best practices.

SRxA’s Word on Health particularly liked the winning video “Scrub-A-Dub Dub”, which features Jerry Herman a former patient from the All Children’s Hospital in St. Petersburg, FL, along with his twin brother, Josie.

The 10-year-old, who spent several months in the ICU, almost totally paralyzed by Guillain-Barré Syndrome, reinforces proper hand-washing technique among staff, patients and families.

Can a hip-hop song improve health?  We think maybe it can.

Now Wash Your Hands Please

Word on Health was horrified to learn that when you meet someone and shake their hand, there’s a one in five chance that they didn’t wash their hands after going to the toilet.

A recent study of 2,000 adults found that more than half did not clean up before eating and even more worryingly, 3:1 men and almost 1:5 women said they also often failed to wash their hands after going to the toilet.

Of those, almost a quarter said they were not worried about hygiene after using their toilet at home because they would only be picking up germs from other members of their family, while one in five said their hands already looked clean without the need to wash them under a tap.

Although 88% of those questioned could correctly name at least one food bacterium such as salmonella, E. coli or campylobacter, many did not realize how easy they were to pick up.

According to the Centers for Disease Control and Prevention (CDC) and leading public health officials, hand washing is the single most important method of preventing the spread of infection.

Perhaps it’s because hand washing is so basic that it’s often taken for granted. Yet the quantity and variety of germs that we carry on our hands everyday is astounding. Each square inch of our skin contains about 5,000 different bacteria.  When we forget to wash our hands, or don’t wash our hands correctly, we can spread these germs to other people.

The importance of hand washing cannot be overstressed. It is so simple and yet forgetting to do it can have such serious consequences.” says Sir John Krebs, chairman of the UK’s Food Standards Agency.

And it’s not just children or the general public that forget to wash their hands, seems health workers are just as guilty.  In the US it is estimated that hand washing alone could prevent 20,000 patient deaths per year. Despite this, studies have shown that hand washing compliance among health-care workers is poor.

Things, it seems, are so bad that  Loyola University Health System has just hosted a forum led by hand-hygiene authority Professor Didier Pittet, MD, MS, and President of The Joint Commission Mark R. Chassin, MD, FACP MPP, MPH.

This forum was designed to educate healthcare leaders about proper hand washing techniques as well as provide strategies to overcome challenges to achieving a highly effective hand-hygiene program.

For those of you who missed the forum, SRxA’s word on Health is pleased to bring you some simple hand hygiene tips:

Always wash your hands before:

  • Preparing food
  • Eating
  • Treating wounds or giving medicine
  • Touching a sick or injured person
  • Inserting or removing contact lenses

Always wash your hands after:

  • Preparing food, especially raw meat or poultry
  • Using the toilet
  • Changing a diaper
  • Touching an animal or animal toys, leashes or waste
  • Blowing your nose, coughing or sneezing into your hands
  • Treating wounds
  • Touching a sick or injured person
  • Handling garbage or something that could be contaminated, such as a cleaning cloth or soiled shoes

Of course, it’s also important to wash your hands whenever they look dirty…or before you come to shake one of ours!

For more on hand hygiene we suggest you check out the CDC’s Clean hands save lives site.

Return of the Andromeda Strain?

The discovery of an exotic, infectious virus reveals leads to treatments for common lung diseases. Sounds like the plot of a new sci-fi novel turned movie?  Beautiful scientists battling a new superbug from outer space!

Not so, this one is all home grown and 100% non-fiction. According to the CDC, there have been three recent outbreaks of monkeypox in the United States.

Monkeypox is a rare viral disease that occurs mainly in the rain forest countries of central and west Africa. First discovered in laboratory monkeys in 1958, it has since shown up in rodents, squirrels, mice, rats, and rabbits. In 1970, monkeypox was reported in humans for the first time and in June 2003, the first documented infection occurred in the United States, most likely from imported pet prairie dogs.

Monkeypox infections in humans have been on the rise. Up to 10% of those infected, die of the disease. It can be caught from infected rodents, pets and monkeys and is thought to be transmitted by respiratory droplets during direct and prolonged face-to-face contact. Researchers attribute the rise of monkeypox infections to the end of smallpox vaccinations, which provided protection due to the similar nature of the two pox viruses.

Signs and symptoms of infection include fever, headache, muscle aches, backache, swollen lymph nodes, a general feeling of discomfort, and exhaustion. Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a papular rash. Death, when it occurs, is generally due to pneumonia.

But until now there have been few studies to look at how monkeypox infection damages the lungs. In the latest study, researchers at the Oregon National Primate Research Center infected macaque monkeys with the virus and followed the course of infection in the lungs of individual animals.

What they found was not only does the infection from monkeypox virus increase production of inflammatory proteins, it also decreases production of proteins that keep lung tissue intact and lubricated.

Going into this study, we thought monkeypox caused disease primarily by inducing inflammation in the lung, and that leads to pneumonia,” said lead author Joseph Brown, a systems biologist at the Department of Energy’s Pacific Northwest National Laboratory. “We were surprised to see how badly the virus wrecked the structural integrity of the lungs.”

The results suggest that inflammation contributes to disease but it may not be the main component. Interfering with the structural proteins may play a major role.

Ultimately, this type of research could have wider implications than viral infection. “This study serves as a great reference for pulmonary diseases,” said co-author Josh Adkins. “It opens up the doors for other lung fluid studies.”

If these results can be reproduced in people, doctors might be able to give surfactants – lubricating chemicals that aid in gas exchange – to help the lung function in patients with altogether more common diseases such as bronchitis, emphysema or even flu.

As always, SRxA’s Word on Health will keep you informed of all developments.