Monday, 5 October 2015

Volunteers bring TLC to Health for the Homeless event

About 20 volunteers helped more than 80 people get chronic neck, shoulder, back and foot problems checked at an all-day Health for the Homeless event Saturday at the Union Gospel Mission’s men’s shelter in Pioneer Square.

Living in your shoes, sleeping on the street, a life on hard pavement leads to recurring health problems for the homeless.

Coupled with poor nutrition and limited health care, the issues may go unchecked and unresolved.

Chiropractor Kevin Nguyen organized more than 20 volunteers to donate their time for an all-day “Health for the Homeless” event at the Union Gospel Mission’s men’s shelter in Pioneer Square. Walk-ins, men and women were welcome.

More than 80 came Saturday to have chronic neck, shoulder, back and foot problems checked.

Nguyen says these problems are “worse in the homeless community because of their circumstances. People are often carrying heavy bags and (are) on their feet more than the average, creating lots of stress on the body.”

He brought a team of providers to give physical therapy, acupuncture, massages, chiropractic treatments and naturopathic approaches for free. For many, comfort and human touch were welcome. For the full article click here

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Volkswagen’s diesel deception linked to smog, health problems

Volkswagen’s diesel deception unleashed tons of extra pollutants in the United States, and although many have been quick to say that the rigged engines are not a highway-safety concern, they do present a health issue.

Unlike the ignition defect in GM vehicles that killed at least 124 people, the Volkswagen pollution is harder to link to individual deaths. But it did damage Americans’ health, and formulas used by researchers can estimate the number of lives lost from excess pollution in general.

So after consulting with experts, The New York Times calculated a possible death toll that, at its upper range, isn’t much smaller than the toll caused by the GM defect. The numbers — the methodology of which is explained later in this story — range from 40 to 106 additional deaths over the time the VW vehicles emitted their extra pollutants.

The estimates examine only the impact on public health in the United States, but the effects would have been substantially higher in Europe, where far more of the VW vehicles were sold.

Volkswagen said last week that it had installed software in 11 million diesel cars that cheated emissions tests, allowing the vehicles to emit far more pollutants than regulations permitted.

The chemicals — known as nitrogen oxides — have been linked to a host of respiratory and cardiovascular illnesses, and to premature deaths. Nitrogen oxides are a byproduct of burning fossil fuels at high temperatures, whether in autos, power plants or machines such as industrial boilers. The chemicals can be harmful to humans, and in warm, sunny conditions they can turn into ground-level ozone, or smog, and particle pollution. Nitrogen dioxide and ozone irritate the lungs, increasing airway inflammation, coughing and wheezing, and they can lower resistance to respiratory illnesses such as flu, especially with long-term exposure.

The chemicals also can worsen the suffering and heighten the risk of serious illness or death for those with conditions such as asthma and chronic obstructive pulmonary disease. Older and younger people are more vulnerable.

The impact of smog and soot pollution on global health is substantial: A recent paper by Jos Lelieveld, at the Max Planck Institute for Chemistry in Germany, and colleagues estimated that air pollution causes about 3 million premature deaths a year, and that the number of deaths could more than double by 2050. For the full article click here

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Health Check: is it OK to chew or crush your medicine?

Some people are incapable of swallowing tablets because of physical reasons, such as surgery or gastric reflux, while others struggle for psychological reasons. What can these people do when the doctor prescribes a drug that comes in tablet form?

The standard tablet is designed to be swallowed whole. Once in the stomach, it absorbs water, which causes it to swell and break apart. As it breaks apart, the drug dissolves over a predictable period of time, gets absorbed into the bloodstream and moves around the body.

Some people end up chewing tablets or crushing them up and mixing them with their food, but this can sometimes cause the medicine to not work properly. In some cases, ingesting a crushed tablet can even result in death.

Important clues

For a number of reasons some tablets shouldn’t be crushed or chewed. Most importantly, doing so may result in dose dumping; this is when the body very quickly absorbs a large amount of a drug. One consequence of dose dumping is an overdose of the drug, which can lead to death.

Some tablets also come with a special protective layer, called an enteric coating, which is designed to stop it from breaking apart in the stomach. The coating ensures the tablet disintegrates in the small intestine instead. If you chew an enterically coated tablet, the drug will not be absorbed properly and the medicine may be ineffective.

Tablets designed to be chewed have this indicated on their packaging. This is common for drugs designed for young children and certain types of tablets such as multivitamins. For the full article click here

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John Oliver Rips GOP’s Oregon Shooting Reaction: ‘Worst Time to Talk About Mental Health’

Following Thursday’s horrific mass shooting at Oregon’s Umpqua Community College, perpetrated by a 26-year-old armed with six guns, President Obama laid the blame squarely at the feet of the American people for not doing more about gun control.

“This is a political choice that we make to allow this to happen every few months in America,” said Obama. “We collectively are answerable to those families who lose their loves ones because of our inaction.”

The GOP’s crop of 2016 presidential candidates instead cited “mental health” as the chief cause of mass shootings.

This isn’t guns, this is really about mental illness. —Donald Trump.

Do we need to do a better job in mental health? You bet we do. —Mike Huckabee.

In many of these shootings, people have mental disturbances. —Ben Carson.

On Sunday night’s edition of Last Week Tonight with John Oliver, the witty satirist appeared incensed by the GOP candidates’ “mental health” default response in the wake of mass shootings, since it’s the only time right-wingers seem to bring up the country’s mental health problem. For the full article click here

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Saturday, 3 October 2015

UT Southwestern, Texas Health Resources form huge health care network

The University of Texas Board of Regents Friday approved a plan to meld several functions of UT Southwestern Medical Center with Texas Health Resources, to create one of the largest health care networks in the state.

Called Southwestern Health Resources, the new network involves more cooperation and alliance than change in legal structure.

Officials said it is not a merger, rather a commitment to combine electronic record keeping and coordinate patient care across a team that includes 3,000 physicians and 27 hospitals throughout North Texas.

The announcement comes as health care providers nationwide are using the buddy system to help improve efficiency and curb soaring health care costs.

“What we’re seeing is multiple strategies that get at consolidation,” explained Lee Spangler, vice president of medical economics with the Texas Medical Association. “Whether it’s an actual legal merger or just an allignment.”

State-funded UT Southwestern and Texas Health hope to create a new system that “offers the highest level of quality and safety and that is as efficient as possible so that we can … over time make health care more affordable,” Barclay Berdan, chief executive of Arlington-based Texas Health Resources, said at a news conference.

“We expect the new network will help improve quality and enhance affordability during a time when patients, insurers, and other payers are increasingly sensitive to health care costs,” he said.

The Texas Health board had earlier approved the plan.

Doctors working together

Under Southwestern Health Resources, which is expected to launch sometime between Jan. 1 and April 1, physicians that are part of the UT faculty, the Texas Health physicians group and some community physicians will work together as part of one network.

Officials also plan to create a joint operating company that will put Texas Health Presbyterian Hospital Dallas and UT Southwestern’s two hospitals — the new William P. Clements Jr. University Hospital and Zale Lipshy University Hospital — under a single management structure.

The ownership and names of the hospitals will not change, but they will operate together.

“What it means to patients of North Texas is they will have more options, a broader scope of care — from preventive care and primary care on up through the most complicated and specialized care — available in one system that has a distribution of physicians and facilities that stretches across North Texas,” Berdan said.

Daniel K. Podolsky, president of UT Southwestern, gave as an example a patient who might enter a Texas Health facility in Stephenville with pneumonia, only to discover a “malignancy that ultimately requires bone marrow transplantation.”

“As that person navigates from the care that is delivered close to home to needing the resources of a bone marrow transplantation unit such as we have at the Clements University Hospital, there will be continuity in that care,” he said. “There will be visibility from both ends. There’s coordination and lack of duplication.”

Podolsky also noted that the affiliation allows his institution “to expand our teaching and research missions” because it will be “part of a much larger system with a larger base of patients.”

Officials do not expect any layoffs to stem from the alliance and said some additional staff would be needed for the new joint operating company.

Executives described the cost to create the alliance as modest. Podolsky said there would be some information technology costs to “have the entire network, physicians and the hospitals on a compatible interactive IT platform.”

He noted, however, that having access to Texas Health’s network of facilities reduces the need for UT Southwestern to undertake major capital projects.

Population research center

Texas Health also has committed to spend “several million dollars” a year to create and operate a new center focused on “population health research.” Details on that still are being worked out.

“Working together we will evaluate and redesign care not just from individual episodes of care like a hospital admission,” said Berdan, “but being focused on how do we improve the opportunity for people to manage their well being, to manage their health.”

Texas Health and UT Southwestern are not the only health care providers looking to make a connection.

Baylor Scott & White Health, the largest nonprofit health system in Texas, said in July it would be one of nine Texas health systems joining forces to share clinical and administrative data to improve quality and efficiency, lower health care costs and accelerate medical innovation.

Baylor Scott & White Health was formed from the 2013 merger between Baylor Health Care System and Scott & White Healthcare.

The spirit of collaboration is fueled in part by government insistence that health care organzations focus on the overall health of the population, said Spangler of the Texas Medical Association.

“The government doesn’t want repeated tests,” he said. “Planning and coordination has to happen. The only way to do that is through some form of consolidation.”

Podolsky noted that because UT Southwestern is a state institution, some structural changes, such as a merger, were not viable options.

“One of the more innovative aspects of this was finding a mechanism for a state institution to really integrate with a private, albeit not-for-profit institution,” he said. “Therein was the reason we looked beyond what might be some of the standard options in the playbook.”

Follow Karen Robinson-Jacobs on Twitter at @krobijake.

Texas Health Resources

One of the largest faith-based nonprofit health systems in the United States and the largest in North Texas in patients and outpatients served.

The system includes Texas Health Physicians Group and hospitals under the banners of Texas Health Presbyterian, Texas Health Arlington Memorial, Texas Health Harris Methodist and Texas Health Huguley.

Network hospitals: 25 acute care, transitional, rehabilitation and short-stay hospitals owned, operated, joint-ventures or affiliated

Employees: More than 22,900 employees of fully owned/operated facilities; 2,000 employees of consolidated joint ventures

Operating revenue (fiscal year 2014): $4.06 billion

Interesting fact: 69 outpatient facilities, surgery centers, fitness centers, imaging centers, and more than 250 other access points

Source: Texas Health Resources

UT Southwestern

An academic medical center, known for its research, teaching and training and medical care.

The medical center has three degree-granting institutions: UT Southwestern Medical School, UT Southwestern Graduate School of Biomedical Sciences, and UT Southwestern School of Health Professions.

Network Hospitals: William P. Clements Jr. University Hospital, Zale Lipshy University Hospital

Employees: 13,800

Operating budget: Almost $2.3 billion

Interesting fact: Trains more than 4,700 medical, graduate and health profession students, residents and postdoctoral fellows a year

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