08/30/17

The CDC warns that the reptiles can carry bacteria even if they look healthy and clean

From: https://www.cbsnews.com/news/salmonella-outbreak-tied-to-pet-turtles/

Mayo Clinic Section of Reproductive Genetics

From: Mayo Clinic https://www.youtube.com/watch?v=1HzsaHOucQk

5 easy-to-remember rules to jumpstart weight loss

From: Mayo Clinic https://www.youtube.com/watch?v=60SBjfp2WRE

Secrets of people who bring their lunches

From: Mayo Clinic https://www.youtube.com/watch?v=CmZYMoYMuQc

9 tips for staying active during cancer treatment

From: Mayo Clinic https://www.youtube.com/watch?v=N70vj_biFtA

How to recover from a tough training workout

From: Mayo Clinic https://www.youtube.com/watch?v=XX-WT_L5SQw

8 myths about heart disease you need to know

From: Mayo Clinic https://www.youtube.com/watch?v=r2G-0D0SFu4

10 ways to keep your brain young

From: Mayo Clinic https://www.youtube.com/watch?v=EHDaIJKzARo

10 ways to accept help when you have cancer

From: Mayo Clinic https://www.youtube.com/watch?v=NruVXnCNMMU

How plant-based foods help fight cancer

From: Mayo Clinic https://www.youtube.com/watch?v=N6Aj5kzfCHk

Tips for taming cancer stress

From: Mayo Clinic https://www.youtube.com/watch?v=BC22yyj8ilw

Have you wondered about botox for migraines?

From: Mayo Clinic https://www.youtube.com/watch?v=HVPkG5s2Czk

What to know about the ketogenic diet for epilepsy

From: Mayo Clinic https://www.youtube.com/watch?v=gRypuSYV0Fw

How to prep for healthy eating all week

From: Mayo Clinic https://www.youtube.com/watch?v=X0_opEr7BAY

Your guide to fuel prep for an endurance race

From: Mayo Clinic https://www.youtube.com/watch?v=zSGvk85p_BU

Steps you can take after a brain tumor diagnosis

From: Mayo Clinic https://www.youtube.com/watch?v=qDaY7SVpZj4

Painkillers Could Raise Arthritis Patients' BP

Widely used NSAID drugs may not be as safe as previously thought, researchers warn

From: http://www.webmd.com/arthritis/news/20170830/painkillers-could-raise-arthritis-patients-bp?src=RSS_PUBLIC

The BDA and its work with the media

From: BritishDietetic https://www.youtube.com/watch?v=FFeCzUIEeIk

Become a research maven at ADA evidence-based dentistry workshop

Could systematic reviews do more to help inform clinical decisions? The ADA Center for Evidence-Based Dentistry hopes so, and wants to empower researchers and clinicians to make that happen.

From: By Michelle Manchir http://www.ada.org/en/publications/ada-news/2017-archive/august/become-a-research-maven-at-ada-evidence-based-dentistry-workshop

Help ADA Foundation provide emergency disaster relief

The disaster that is unfolding in Texas and Louisiana as a result of Hurricane Harvey has likely affected hundreds of dentists, and the ADA Foundation is asking ADA members to consider making a contribution to the ADA Foundation Emergency Disaster Grant Program.

From: http://www.ada.org/en/publications/ada-news/2017-archive/august/help-ada-foundation-provide-emergency-disaster-relief

Looking for a plastic surgeon on Instagram? #Beware

You may end up with a hair stylist or a dentist instead, a new study finds

From: https://www.cbsnews.com/news/looking-for-a-plastic-surgeon-on-instagram-beware/

FDA approves first gene therapy to treat leukemia

CAR-T cell treatment is called "a brand new way of treating cancer"

From: https://www.cbsnews.com/news/fda-approves-first-gene-therapy-in-u-s-to-treat-leukemia/

America's new dads are older than ever

The average age of new fathers has risen in recent decades, raising questions about the possible social and public health impact

From: https://www.cbsnews.com/news/americas-new-dads-are-older-than-ever/

Beware The Plastic Surgeon You Found on Instagram

You may end up with a barber or a dentist instead

From: http://www.webmd.com/beauty/news/20170830/beware-the-plastic-surgeon-you-found-on-instagram?src=RSS_PUBLIC

America's New Dads Are Older Than Ever

Average age of new fathers has risen to 31, study finds

From: http://www.webmd.com/men/news/20170830/americas-new-dads-are-older-than-ever?src=RSS_PUBLIC

Student researchers invited to apply for ADA Foundation award

The ADA Foundation is accepting applications for a new award that aims to help a student's research career that advances the oral health of the public.

From: http://www.ada.org/en/publications/ada-news/2017-archive/august/student-researchers-invited-to-apply-for-ada-foundation-award

Upcoming webinar to help dentists navigate regulatory environment

The regulatory environment is full of ever-changing regulations that can make it difficult for dentists to ensure they're up-to-date on, and in compliance with, the many regulations that need to be followed in the practice.

From: http://www.ada.org/en/publications/ada-news/2017-archive/august/upcoming-webinar-to-help-dentists-navigate-regulatory-environment

FDA Approves First-of-Its-Kind Cancer Treatment

The FDA has approved a first-of-its-kind treatment, called CAR T-cell therapy, to treat a type of leukemia in children and young adults.

From: http://www.webmd.com/cancer/news/20170830/fda-approves-breakthrough-cancer-treatment?src=RSS_PUBLIC

The BDA and its work with the media

From: BritishDietetic https://www.youtube.com/watch?v=FFeCzUIEeIk

Patient-Centered Medical Home: A new model for medical care

The world of primary care is challenging right now. It can be frustrating for both patients and doctors.

From the patient’s perspective

Let’s say you’re basically healthy, but overweight. You can’t quite get your diet under control. You’d like your doctor’s help and maybe some testing, like thyroid. So you call your primary care doctor. You work through the practice’s phone tree and leave a message for the nurse. The nurse may get back to you within a day or a few days, and after you talk, she or he will pass the message on to your doctor, who says you should come in. Then it takes a week or so to get an appointment.

At that visit your doctor talks to you about your diet, and it becomes clear that you tend to eat too many carbs when you feel stressed. Just as you’re about to share why you feel stressed, the appointment is over. But your doctor orders a few labs, refers you to a nutritionist, and hands you a list of therapists and suggests you “call around to see who may be a good fit, to discuss stress management.” What often happens next is that it takes several days to hear back from a nutritionist (which means you need another appointment likely at a less-than-convenient location). At this point it’s all so frustrating that you may or may not ever make those calls to potential therapists.

From the doctor’s (my) perspective

Most doctors truly enjoy seeing and talking with patients, and we want to help. That’s why we undertook this long, expensive, and psychologically challenging career path. But, doctors must see a certain number of patients to earn their salary, and there has been pressure to see more. Then, every hour of clinic time equals over an hour of desk work: responding to the patient phone and email messages, checking labs, communicating with specialists, reviewing and signing physical therapy and visiting nurse orders, filling out disability forms, writing necessary chart notes, and documenting for billing. And maybe calling a few patients.

Rarely, when the schedule is light, a doctor can have more in-depth conversations with patients. If there had been enough time, you may have shared that you’re in a toxic, depressing work environment, and that you overeat to cope with stress and emotional issues. When we know that, doctors can screen for clinical depression and offer treatment, as well as provide more meaningful counseling on coping skills, nutrition, and self-care.

But that’s not how it usually works. And doctors dislike it as much as patients do. Doctors hate feeling pressured to see more patients, rushing through visits, referring out to specialists who may or may not communicate back, and then slogging through all that administrative work. The result is frustrated doctors and patients, and more expensive care. We wish there was more time, as well as a nutritionist and a full-time therapist on-site with whom we could smoothly and efficiently confer and collaborate.

But the primary care world is changing… for the better

That entire model is being flipped on its head, which is a good thing.

This is where the concept of the Patient-Centered Medical Home (PCMH) comes in. The “home” does not refer to a place, but rather, to a model of care. Here’s how it works.

Your primary care physician will be one member of a team who will offer comprehensive care all under one “roof.” Moving forward, people will pay for their health insurance, and their primary care doctor will receive one flat payment from insurance to cover most of the care provided. The amount will be based on the patient’s health issues and complexity. There will be far less “fee-for-service,” that is, billing for each visit. Services such as behavioral health and nutrition will be located in the office. Physicians and patients will determine specific health goals, which can then result in bonus incentives. Practices will be rewarded for things like helping a patient lose weight and get blood sugar under control — that is, for keeping them healthy and out of the emergency room and hospital.

But how do you keep people healthier more efficiently? We will use more modern and creative tools to keep track of a patient’s status and progress from home, with tools such as health equipment that links in to the chart, and computers for virtual visits. We will hire more nursing staff to call patients and assist with monitoring from afar. We doctors will also need to be more accessible, with more phone calls or e-visits. Hiring extra staff and buying new equipment is expensive, but that is the investment we need to make in order to function in this new world.

Not just any practice can up and decide that they’re a medical “home.” There is a rigorous certification process through an outside agency, and then there is oversight to ensure that goals are being met. The model is also designed with the patient front and center. There is a big patient satisfaction component.

Will it work? Most studies of PCMH-certified practices have shown improvements in diabetes control, adherence to medications, as well as a decrease in post-hospital discharge emergency room visits and deaths, and at lower costs — particularly among chronically ill patients. Most also showed that both patients and providers liked the new model. (A few studies have shown mixed results.)

There is no question that primary care really needs to change, and the PCMH model is incredibly promising. It deserves to be implemented, but also needs to be studied more.

Resources

Patient-Centered Medical Home Recognition and Diabetes Control Among Health Centers: Exploring the Role of Enabling Services. Population Health Management, May 2017.

Team-based versus traditional primary care models and short-term outcomes after hospital discharge. Canadian Medical Association Journal, April 2017.

Association Between Patient-Centered Medical Homes and Adherence to Chronic Disease Medications: A Cohort Study. Annals of Internal Medicine, January 17, 2017.

Medical homes and cost and utilization among high-risk patients. American Journal of Managed Care, March 2014.

Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use. JAMA Internal Medicine, August 2014.

Medical homes: cost effects of utilization by chronically ill patients. American Journal of Managed Care, February, 2015.

Improving patient care. The patient centered medical home. A Systematic Review. Annals of Internal Medicine, February 2013.

Patient-centered Medical Home capability and clinical performance in HRSA-supported health centers. Medical Care, May 2015.

Patient Centered Medical Home at Massachusetts General Hospital

The post Patient-Centered Medical Home: A new model for medical care appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/patient-centered-medical-home-a-new-model-for-medical-care-2017083012260

9 ways to make the Mediterranean diet work for you

From: Mayo Clinic https://www.youtube.com/watch?v=bXFAWPSFuio

ADA to Delta Dental: Stop objectionable practices in EOBs

Various Delta Dental plans have engaged in "highly objectionable practices" in their explanation of benefits statements that threaten the doctor-patient relationship, wrote ADA President Gary L. Roberts and ADA Executive Director Dr. Kathleen T. O'Loughlin in an Aug. 9 letter to the president/CEO of the Delta Dental Plans Association.

From: By David Burger http://www.ada.org/en/publications/ada-news/2017-archive/august/ada-to-delta-dental-stop-objectionable-practices-in-eobs

3 things parents should know about complementary and alternative medicine

Follow me on Twitter @drClaire

More and more, I have families in my practice who are trying out treatments and therapies I didn’t prescribe. Most of the time, it’s absolutely fine. Other times, it’s not.

“Complementary and alternative medicine” is a broad term that refers to treatments that are not generally part of traditional Western medicine. It includes things like herbal remedies, dietary supplements or alternative diets, acupuncture, acupressure, homeopathy, Chinese remedies, Reiki, or hypnosis. It also includes things like yoga or meditation — and chiropractic medicine.

Many of these therapies have become increasingly mainstream. In fact, more than 1 in 10 US children, and more than half of US children with chronic medical conditions, have used them. As use of these therapies grow, often fueled by what people read on the Internet and social media, it’s important that people get informed and educated, especially if they are going to use them on their children. That’s why the American Academy of Pediatrics (AAP) published a report entitled “Pediatric Integrative Medicine” in the journal Pediatrics.

Here are three things all parents should know about complementary and alternative medicine:

1. Many of them are very useful. It’s not as if Western medicine has the corner on all medical knowledge. Some of these therapies, like acupuncture, have been around for literally thousands of years. The more we study these therapies, the more we learn about the ways they can be helpful. Acupuncture can be very helpful for chronic pain. Probiotics can help fight diarrhea, and docosahexaenoic acid (DHA) found in fish oil helps fetal brain development and may help children with attention problems. Yoga has been found to help youth with attention problems also, as well as those with asthma or irritable bowel syndrome. Our understanding of health and medicine is expanding, and many physicians routinely recommend many therapies that used to be dismissed. But there is a problem…

2. Most of them are poorly regulated. For a drug to be licensed for sale, it has to go through extensive testing. The same is not true of herbal, vitamin, or other “alternative” treatments. Because they are classified as “food” rather than medicine, they aren’t tested or regulated anywhere near as carefully, and they don’t have to prove their claims. If you buy an herbal remedy or a dietary supplement, you have absolutely no way of knowing everything that is in it (some have been found to include dangerous ingredients like lead or arsenic) and no way of knowing if it will do what the manufacturer says it will.

This is also true of practitioners. To be licensed as a doctor or nurse, you have to go to an accredited program, pass national examinations, and prove ongoing competency. That isn’t necessarily the case with many who practice alternative medicine. While there are some licensing boards and ways that practitioners can be accredited, there is currently no comprehensive way to ensure quality of care.

Western medicines also has a tradition of ongoing self-examination, of doing studies to be sure that treatments work and are safe, and an infrastructure to support that tradition. While there have been, and continue to be, many studies of complementary and alternative medicine, there is nowhere near the same tradition and infrastructure. This is something the AAP says needs to change. This is not to say that there aren’t excellent practitioners and excellent treatments. It’s just that it’s much harder to know if the person treating you or your child has the right training and skills and if the treatment is safe, let alone helpful for the condition. Which is why…

3. Parents need to do their homework—and talk to their child’s doctor—before using complementary or alternative medicine with their children. Before you try any treatment, learn about it. The National Center for Complementary and Integrative Health, part of the National Institutes of Health, is a great resource to learn about complementary and alternative medicine and specific treatments. It’s also really important to talk to your doctor. It’s important to be sure that what you are doing won’t interfere with any other treatment. For example, St. John’s Wort, an herb that is commonly used to treat depression, can interact or interfere with many commonly prescribed medications. It’s important to check with your doctor to be sure that what you are doing is safe for your child’s particular condition or situation.

Most of all, it’s important that your doctor know about your concerns for your child and why you want to use the treatments in the first place. If you are worried about your child’s growth or appetite, for example, let your doctor be sure there isn’t something more serious going on before you use dietary supplements. While doctors may not know everything about non-traditional treatments (the AAP report says doctors need more education about them), we care very much about your child’s health and want very much to work with you to find all the ways to get and keep your child healthy and happy.

The post 3 things parents should know about complementary and alternative medicine appeared first on Harvard Health Blog.

From: Claire McCarthy, MD https://www.health.harvard.edu/blog/3-things-parents-should-know-about-complementary-and-alternative-medicine-2017082912337

Outbreak of Salmonella Again Traced to Pet Turtles

FDA: Serious Problems at Florida Stem Cell Clinic

From: http://www.webmd.com/food-recipes/food-poisoning/news/20170830/outbreak-of-salmonella-again-traced-to-pet-turtles?src=RSS_PUBLIC

After repeal scare, Obamacare has never been more popular

As states move to shore up coverage, public support for the health insurance program has surged in recent weeks

From: https://www.cbsnews.com/news/obamacare-repeal-has-never-been-more-popular/