Category Archives: Health

Research: “Designing Tech For Healthy Aging In Place” (UC San Diego Video)

Digital tools including mobile apps, wearable sensors, and social network platforms offer unprecedented opportunities in health research and healthcare. However, this rapidly emerging sector is outpacing existing regulatory structures and challenging norms for ethical practice.

Camille Nebeker, EdD, MS, Associate Professor of Behavioral Medicine in the Department of Family Medicine & Public Health at the UC San Diego School of Medicine describes how technologies, including wearable sensors and artificial intelligence, are leveraged to capture personal health data and infer health status. Nebeker presents the ethical considerations specific to informed consent, risks of harm and potential benefits while underscoring the role that funding agencies, policy makers, researchers, ethicists, and editors have in creating the infrastructure needed to advance safe digital health research and practice.

Nutrition Studies: 70% Of U.S. Fast-Food Meals Are “Poor Dietary Quality”

“Our findings show dining out is a recipe for unhealthy eating most of the time,” said Dariush Mozaffarian, senior author and dean of the Friedman School. 

At fast-food restaurants, 70 percent of the meals Americans consumed were of poor dietary quality in 2015-16, down from 75 percent in 2003-04. At full-service restaurants, about 50 percent were of poor nutritional quality, an amount that remained stable over the study period. The remainder were of intermediate nutritional quality.

BOSTON (Jan. 29, 2020, 9:00 a.m. EST)—The typical American adult gets one of every five Tufts School of Nutrition Science and Policy logocalories from a restaurant, but eating out is a recipe for meals of poor nutritional quality in most cases, according to a new study by researchers at the Friedman School of Nutrition Science and Policy at Tufts University.

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Published today in The Journal of Nutrition, the study analyzed the dietary selections of more than 35,000 U.S. adults from 2003-2016 in the National Health and Nutrition Examination Survey (NHANES) who dined at full-service (those with wait staff) or fast-food restaurants, which included pizza shops and what has become known as fast-casual. The researchers assessed nutritional quality by evaluating specific foods and nutrients in the meals, based on the American Heart Association 2020 diet score.

To read more about study

Exercise: Older Adults With Higher Muscle Mass Reduce Cardiovascular Disease By Over 80% (Study)

From a Journal of Epidemiology & Community Health online release:

Jounal of Epidemiology &amp; Community Health January 2020The 10 year CVD (cardiovascular disease) incidence increased significantly across the baseline SMI (skeletal muscle mass index) tertiles (p<0.001). Baseline SMM (Skeletal muscle mass) showed a significant inverse association with the 10 year CVD incidence (HR 0.06, 95% CI 0.005 to 0.78), even after adjusting for various confounders. Additionally, participants in the highest SMM tertile had 81% (95% CI 0.04 to 0.85) lower risk for a CVD event as compared with those in the lowest SMM tertile.

Background Skeletal muscle mass (SMM) is inversely associated with cardiometabolic health and the ageing process. The aim of the present work was to evaluate the relation between SMM and 10 year cardiovascular disease (CVD) incidence, among CVD-free adults 45+ years old.

INFOGRAPHIC-ACSM-resistance-training-for-health

Methods ATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek general population (Caucasians; age ≥18 years; 1514 men). The 10 year study follow-up (2011–2012) captured the fatal/non-fatal CVD incidence in 2020 participants (50% men). The working sample consisted of 1019 participants, 45+ years old (men: n=534; women: n=485). A skeletal muscle mass index (SMI) was created to reflect SMM, using appendicular skeletal muscle mass (ASM) standardised by body mass index (BMI). ASM and SMI were calculated with specific indirect population formulas.

The global population is ageing at an unprecedented speed, especially in Europe. As a concept, ageing is considered a continuous process starting from birth and is accompanied by various physiological changes and a number of comorbidities1 2 that affect health and quality of life.3 4 Skeletal muscle mass (SMM)4 alterations are among these physiological changes.

SMM tissue decline, as a part of these physiological changes, starts in middle age (or even earlier, in the 30s) and progresses in more advanced age.5 It has been shown that SMM declines with a rate of more than 3% per decade starting from the age of 30+.6 Half of the human body’s mass is actually SMM and it has an active role in numerous metabolic pathways.5 7 SMM decline is related, among others, to various disability patterns, poor mental health and increased mortality.5 7 8 In addition, well documented studies have shown that SMM alterations are related to cardiovascular health,9 10 even different muscle morphology.11 Recently, Srikanthan et al 12 reported the importance of muscle tissue in relation to cardiovascular disease (CVD) and total mortality in stable CVD patients.

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Studies: Heart Surgery Patients Can Be Safely Discharged In 3 Days

From a News-Medical.net online release:

Northwestern Medicine logo“Patients can go home after a shorter length of stay in the hospital without increased risk of complications and rehospitalizations,” said Dr. Malaisrie. “Because we found no detrimental effect of accelerated discharge, both patients and physicians should not be averse to discharging patients when medically ready.”

Dr. Malaisrie anticipates that the Northwestern Medicine cardiac ERAS program will result in faster recoveries, reduced complications, decreased time in the hospital, lower costs, and improved patient/family satisfaction. In the future, the researchers plan to closely examine both traditional clinical endpoints and patient-reported outcomes from the program.

“Expectations for recovery after cardiac surgery are being reset in the current era,” he said. “What does this mean for patients? It means that prolonged or taxing recovery is no longer required. Patients should know that recovery from heart surgery is not only quicker, but also better with ERAS programs.”

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Healthcare Podcasts: “Cityblock” Seeks To Keep People Out Of Hospital

This week on Prognosis, we look at one startup that’s trying to redesign care for some of the most vulnerable patients, taking into account the complex realities of their lives. The company is trying to improve care for people and communities the medical system often fails – and it believes that fixing those failures will not only make people healthier, it will also save money.

In America, poverty is linked to shorter lifespans. The wealthiest 1% of Americans live more than a decade longer than the poorest 1%, and the longevity gap has expanded in recent years. The medical community is increasingly examining the role that poverty and difficult social circumstances play in illness. Some people are asking whether the health care system could do more to address the things that influence people’s health beyond their medical care.

Website

Sleep Health: “The Neurology And Psychology Of Insomnia”

From a Psychology Today online article:

For those with insomnia, however, the stressor appears to be the lack of sleep, and the desire for sleep becomes a stressor in itself. In other words, the fixation on getting sleep leads to feelings of stress over not falling asleep, which begins a vicious loop. According to a model first proposed by Kales et al. in 1976, patients The Anatomy of Insomniacs infograpiccan develop a conditioned fear of not being able to sleep, which puts them in a state of hyperarousal when they attempt to fall asleep. This makes their inability to sleep a self-fulfilling prophecy.

Insomnia is the most common sleep condition in the world, with half of adults globally reporting occasional episodes. Chronic insomnia, though far less prevalent, affects as many as 10 to 15 percent of the adult population.

Though these sleep problems are extremely common, the neurobiological mechanisms behind insomnia are not entirely understood. Research suggests that emotional stressors do play an outsized role in contributing to sleep problems, and it is well documented that mood and anxiety disorders are common comorbidities with insomnia. This seems like common sense. Emotional arousal, whether due to a state of anxiety or because of intrusive thoughts, makes it difficult to relax, thereby inhibiting one’s ability to either initiate sleep or get back to sleep after waking.

To read more

Medical Podcasts: The Time Physicians Spend On Patient’s Electronic Health Records (NEJM)

New England Journal of Medicine Podcast logoListen to a chat with Julia Adler-Milstein, the author of an editorial that comments on a recent Annals of Internal Medicine study detailing the amount of time clinicians typically spend hunched over their EHRs during a patient visit.

Why aren’t you able to navigate your electronic health record (EHR) as easily as you can find a recipe on, say, Google?

And, what about those requirements for documenting everything?

Links:

Annals of Internal Medicine editorial

Annals paper on the time clinicians spend

Running time: 17 minutes

Medical Care: “Restoring Hearing Loss – The Patient Experience” (Penn ENT)

At Penn Medicine ENT, we offer patients the most advanced developments in hearing technology. Our multidisciplinary approach to medicine ensures that each patient path is tailored to the patient’s specific needs.

  • When they come to our center, patients typically begin by having a diagnostic assessment.
  • Often, those patients are also seeing an ear, nose and throat physician after they have their hearing evaluation.
  • Together, the team can then make the appropriate recommendation of what should come next.

In terms of hearing devices, we offer access to almost every hearing aid manufacturer available, as well as advanced implantable technology. This includes the auditory brain stem implant, which Penn Medicine is the first in the region to offer.

Hearing is currently the only sense that we can completely restore. We’re proud to be able to offer our patients everything available to help restore their communication with family and friends.