Feds call from more scrutiny of Coumadin use in nursing homes

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Inspectors are being asked to pay greater attention following analysis showing mistakes resulting in injuries and deaths

RedBloodCellsBy Charles Ornstein
ProPublica, Aug. 3, 2015
This story was co-published with The Washington Post.

The federal government is asking health inspectors nationwide to be on the lookout for errors by nursing homes in managing the blood thinner Coumadin, including those that lead to patient hospitalizations and deaths.

In a memo sent last month to state health departments, the Centers for Medicare and Medicaid Services cited a report by ProPublica and The Washington Post that focused on the harm caused by homes’ failure to manage the drug.

In some cases, homes gave residents too much of the drug, which caused internal bleeding. In other cases, they gave residents too little, leading to blood clots and strokes.

The analysis of government inspection reports found that, between 2011 and 2014, at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin.

In some cases, homes gave residents too much of the drug, which caused internal bleeding. In other cases, they gave residents too little, leading to blood clots and strokes. Continue reading

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Are you pregnant?

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Pregnancy: A Touchy Subject In Employee Wellness Assessments

“Are you pregnant?”

PregnancyBy Julie Appleby
KHN

It’s a topic employers generally avoid, since the Pregnancy Discrimination Act of 1978 prohibited sex discrimination on the basis of pregnancy.

But women’s advocates fear these long-standing protections could be undermined by some workplace wellness programs.

That question and “How old were you when you first became pregnant?” are both included in a health risk assessment offered to some clients of Audax Health, a wellness firm.

“How old were you when you first became pregnant?”

Similar queries are posed in health risk assessments offered by other wellness programs, say consumer groups, including the National Women’s Law Center.

“These are questions they should not ask,” because of the potential for discrimination, said Emily Martin, vice president and senior counsel for the NWLC,  in a letter to the Obama administration asking for a ban on such questions in wellness programs. Continue reading

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Fetal tissue attack is latest tactic in long GOP fight against Planned Parenthood

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Logo_plannedparenthoodBy Julie Rovner
KHN

Republican calls to defund Planned Parenthood over its alleged handling of fetal tissue for research are louder than ever. But they are just the latest in a decades-long drive to halt federal support for the group.

This round of attacks aims squarely at the collection of fetal tissue, an issue that had been mostly settled — with broad bipartisan support —  in the early 1990s. Among those who voted to allow federal funding for fetal tissue research was now-Senate Majority Leader Mitch McConnell, R-Ky.

McConnell made no mention of his previous position when he announced that the Senate would take up a bill to cut off Planned Parenthood’s access to federal funds before leaving for its summer break. The first vote on the bill is expected as soon as Monday. Continue reading

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Kraft recalls ‘Kraft Singles’ over choking hazard concern

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The Kraft Heinz Company Voluntarily Recalls Select Varieties of Kraft Singles Products Due to Potential Choking Hazard

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Only 3-Lb. and 4-Lb. Packages of Kraft Singles Included in Recall

From Kraft Heinz

The Kraft Heinz Company is voluntarily recalling select code dates and manufacturing codes of Kraft Singles individually-wrapped slices due to the possibility that a thin strip of the individual packaging film may remain adhered to the slice after the wrapper has been removed.

If the film sticks to the slice and is not removed, it could potentially cause a choking hazard.

The recall applies to 3-lb. and 4-lb. sizes of Kraft Singles American and White American pasteurized prepared cheese product with a Best When Used By Date of 29 DEC 15 through 04 JAN 16, followed by the Manufacturing Code S54 or S55. Continue reading

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A skeptics guide to health news and diet fads – On the Media

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Brooke Gladstone takes a deep dive into media misdirection on health and diet news, and puts together two Breaking News Consumer’s Handbooks to help you navigate the din.

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First, an object lesson on bogus studies that make headlines with John Bohannon; how to read health news with Gary Schwitzer of HealthNewsReview.org; and Timothy Caulfield, author of Is Gwyneth Paltrow Wrong about Everything?explains the science behind celebrity-endorsed diet trends and beauty treatments.

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SONGS: Roary’s Waltz – John Zorn; Accentuate The Positive – Syd Dale

 

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California survey: Newly insured satisfied with coverage, more financially secure

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Flag_of_CaliforniaBy Sarah Varney
KHN

SAN FRANCISCO — Americans have long stood out among residents of developed nations for how much they fret over, and are bankrupted by, health care costs.

But well into the second year of expanded coverage under the Affordable Care Act, those worries have eased significantly in the nation’s most populous state.

Californians no longer rank health care costs as their top financial concern.

statewide survey has found that newly insured Californians no longer rank health care costs as their top financial concern. It has dropped below other essentials such as housing, utilities and gasoline.

“This was exactly the goal,” said Dr. Bob Kocher, a senior Obama White House official in 2009 and 2010 who helped draft the federal health care law. “Financial security was an enormous factor in our design.”

California has made swift gains in extending health coverage to its residents. It was one of just 15 states and the District of Columbia that opted for a state-based marketplace and expanded the publicly funded Medicaid program for low-income Americans.  kff-ca-tracking-600

Those moves have paid off: About two-thirds of Californians who were uninsured in 2013 now have health insurance, according to the survey by the Kaiser Family Foundation, which was released Thursday. (Kaiser Health News is an editorially independent program of the Foundation.) Continue reading

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Top five stories of the week – August 2nd

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Credit: Dan Shirly

Credit: Dan Shirly

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All Vashon-Maury Island beaches closed for shellfish harvesting

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Paralytic shellfish poison found at unsafe levels

From Public Health – Seattle & King County

vashon island mapParalytic Shellfish Poison (PSP) has been detected at unsafe levels in shellfish on Vashon-Maury Island. As a result, the Washington State Department of Health (DOH) has closed Vashon-Maury Island beaches, including Quartermaster Harbor, to recreational shellfish harvest. This closure is an expansion on a July 23 alert for Quartermaster Harbor alone.

The closure includes all species of shellfish including clams, geoduck, scallops, mussels, oysters, snails and other invertebrates; the closure does not include crab or shrimp. Crabmeat is not known to contain the PSP toxin, but the guts can contain unsafe levels.

To be safe, clean crab thoroughly and discard the guts (“butter”). Working with partners, Public Health – Seattle & King County is posting advisory signs at beaches warning people to not collect shellfish.

Commercial beaches are sampled separately and commercial products should be safe to eat.

Anyone who eats PSP contaminated shellfish is at risk for illness. PSP poisoning can be life-threatening and is caused by eating shellfish containing this potent neurotoxin. A naturally occurring marine organism produces the toxin. The toxin is not destroyed by cooking or freezing. Continue reading

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Washington Salmonella outbreak expands to 90 cases

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CDC investigators to join state and local health officials next week

From the Washington State Department of Health

Credit: Rocky Mountain Laboratories,NIAID,NIH

Credit: Rocky Mountain Laboratories,NIAID,NIH

The Salmonella outbreak that may be linked to pork products has grown to 90 cases in several counties around the state. The ongoing outbreak is under investigation by state, local, and federal public health agencies.

With the increase in cases, state health officials have asked the federal Centers for Disease Control and Prevention (CDC) to send a special team to help with the investigation. This team of “disease detectives” will arrive in Washington next week.

The likely source of exposure for some of the ill people appears to have been whole roasted pigs, cooked and served at private events.

Disease investigators are searching for possible exposure sources from farm to table. An apparent link to pork consumption or contamination from raw pork is the strongest lead, though no specific source has yet been found.

The likely source of exposure for some of the ill people appears to have been whole roasted pigs, cooked and served at private events. Continue reading

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Screen pregnant women, new moms for depression – panel

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Blue Pregnant BellyBy Michelle Andrews
KHN

One in seven women experience depression during pregnancy or the first year after giving birth, yet many may not realize it or report their concerns to clinicians.

new proposal by the U.S. Preventive Services Task Force could help change that. It recommends that all women who are pregnant or within a year of giving birth be screened for perinatal depression, as it’s called.

The screening proposal is included as part of a broader recommendation to screen all adults for depression that the task force released this week for public comment.

One in seven women experience depression during pregnancy or the first year after giving birth.

The task force proposal would update the current guidelines, adopted in 2009, which recommend depression screening in all adults if clinicians are available to address depression care.

In the 2009 document, the task force didn’t review depression in pregnant and postpartum women and made no screening recommendation for them. Continue reading

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What an itch!: Swimmer’s edition

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From Public Health – Seattle & King County

Close your eyes. You’re floating on your back (wearing a life preserver, most likely) at your favorite lake, with ducks and geese gently quacking as they feed nearby. Puffy clouds overhead, willows on the bank, and lily pads forming a soothing backdrop for your relaxing float.

And then a microscopic parasite burrows into your skin. You just got swimmer’s itch!

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What is swimmer’s itch?
Swimmer’s itch (cercarial dermatitis) is an itchy rash caused by a parasite in lake water. If you come into contact with water contaminated with parasites the microscopic parasites can burrow into the skin. Continue reading

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Lessons for the Puget Sound from Chicago’s deadly Heat Wave

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heat-wave1-e1438208691939By Ashley Kelmore
Public Health – Seattle & King County

Our hotter-than-usual summer in the Pacific Northwest likely won’t reach the extremes of the 1995 Chicago summer heat wave, which killed 733 people.

But some of the issues from that catastrophe are relevant to us here and now, and Dr. Eric Klinenberg describes them in his fascinating book Heat Wave.

Klinenberg proposes that the temperature and humidity are not solely to blame for illness and death from heat.

Instead, it is the heat combined with the systems society has set up (or not set up) that failed people in a complicated way.

Similar neighborhoods, deadly differences

Klinenberg focuses on comparing two neighborhoods that are similar in basic demographics, and even have the same microclimate, but had VERY different death rates.

To explain this disparity, he looks at how the different neighborhoods function. Are people too scared to leave their buildings to seek cooler locations (such as libraries or movie theaters)?

Are they too worried about their finances to turn on the life-saving window AC unit to cool themselves down?

Are they isolated from support systems that could have intervened to make sure they were doing okay? In many cases, the answers are “yes,” “yes,” and “yes.”

Chicago’s government and how they responded (or failed to respond) was also a factor, according to Klinenberg.

Front-line police officers were tasked with community policing but didn’t check in on the community.

Fire chiefs ignored warnings from their staff that they should have more ambulances available.

And sadly, the health commissioner didn’t really ‘get’ that something was amiss. Klinenberg also explores the role the media played in not treating the story with the gravity it deserved until late into the heat wave. Continue reading

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Happy 50th birthday, Medicare. Your patients are getting healthier

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800px-Birthday_candles

Photo: Courtesy of Ed g2s under Creative Commons license

The past 15 years have seen a marked drop in deaths and hospitalizations among Medicare patients — people 65 and older. Teasing out why is tricky, but it seems a good trend for the 50-year-old program.

https://commons.wikimedia.org/wiki/User:Ed_g2s

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