Category Archives: P4 Medicine

Tests to Predict Heart Problems and Stroke May Be More Useful Predictor of Memory Loss than Dementia Tests

Captured by the American Academy of Neurology

Risk prediction tools that estimate future risk of heart disease and stroke may be more useful predictors of future decline in cognitive abilities, or memory and thinking, than a dementia risk score, according to a new study published in the April 2, 2013, print issue of Neurology®, the medical journal of the American Academy of Neurology.

“This is the first study that compares these risk scores with a dementia risk score to study decline in cognitive abilities 10 years later,” said Sara Kaffashian, PhD, with the French National Institute of Health and Medical Research (INSERM) in Paris, France.

The study involved 7,830 men and women with an average age of 55. Risk of heart disease and stroke (cardiovascular disease) and risk of dementia were calculated for each participant at the beginning of the study. The heart disease risk score included the following risk factors: age, blood pressure, treatment for high blood pressure, high density lipoprotein (HDL) cholesterol, total cholesterol, smoking, and diabetes. The stroke risk score included age, blood pressure, treatment for high blood pressure, diabetes, smoking, history of heart disease, and presence of cardiac arrhythmia (irregular heart beat). Read more….


Getting Teens Thinking Healthy, Helping Them COPE

In a crowd-favorite presentation during the Global Diabetes Summit, Bernadette Melnyk said, we all know people don’t change behavior easily, which is why she has focused much of her career on helping teens making healthy behavior changes to help them live healthier with a focus on mental health.

17 percent of teens are obese or overweight, but one in four adolescents has a mental health problem and less than 25 percent receive any treatment. According to Melnyk, substantial studies that shows that in overweight teens, the more likely they are to have a mental health disorder. These mental health conditions make it hard for teens to picture themselves even living healthy lifestyles. And in many studies when behaviors have been modified in studies and short-term gains have been achieved in high-risk populations, teens gained the weight back.

Melnyk’s secret sauce to this problem is her COPE program, which focuses on thinking, emotion, exercise, nutrition in hopes of decreasing teen’s doubts and increasing their ability make changes. In other words, if you teach teens to think differently, they can act differently. 

In each session, after working on goal setting, emotional coping skills, behavior therapy and more, the teens get up and moving with a “wheel of fitness” where they learn various activities and movement, which are all designed to be done in the middle of the classroom. They also learn about nutrition like social eating, portion sizes and nutrition labels. In the final sessions of the after-school program, they integrate how to put all these together and help the teens make a lifestyle plan.

Melnyk’s study showed many positives results from a decrease in BMI to decreases in depressive and anxiety symptoms. The purpose of her current study is to evaluate the efficacy of COPE/Healthy Lifestyles TEEN (thinking, emotions, exercise and nutrition) program on the healthy lifestyle behaviors, BMI, mental health and academic outcomes of 779 high school 14-16 year old adolescents.   The key regarding many of these findings in implementation. So she said: why does this matter to schools and why should they enact the COPE program?

She is also measuring academic outcomes and found that because of the cognitive behavioral skills the teens learned, they can improve their academic skill level because of the confidence and coping skills they learn in the program.

The COPE program will be used as either a preventive or management intervention program for overweight/obesity in adolescents. The program is now being developed so that it can be implemented in schools across the country. Her work in also now ongoing to adapt the program for school-age child and college-age youth.

Has focusing on your mental health ever helped you through an illness? How can we get more teens to learn the importance of improving their mental health?

Incorporate Healthy Meals

Thanks to @OSUWexMed’s nutrition services for providing these tips.
Whether you already live a healthy lifestyle or are trying to be healthier, reminders about how you can improve your overall health and wellness are helpful.
Planning ahead for meals can help you meet nutrition goals and not rely on “fast food” options at the end of a long day. When planning menus, try to ensure that five of the 14 (lunch and dinner) meals per week are “healthy.” By healthy this means meals 600 calories or less with no more than 1,000 milligrams of sodium.
If your usual meal averages 800-1,000 calories, you can save 4,000-8,000 calories over a month by doing the above, which equals to one to two pounds.
A healthy and balanced meal should include a starch, vegetables, protein, fruit and dairy. If this seems like too much food for one meal, try to get your daily dairy or fruit in as a snack. Here are examples of healthy meals that are all about 600 calories:
  • Grilled salmon – 3- to 4-ounce grilled salmon, a small baked sweet potato, 5 sprigs of asparagus, 1 cup of  1% milk, and a small apple.
  • Chicken sandwich – 2 slices of whole wheat bread, 3 ounces of baked chicken, 1 tablespoon of light mayo, lettuce, onion, tomato, 4 ounces of lite yogurt, 1 cup of strawberries.
  • Turkey cheese burger – 1 whole grain hamburger bun, 3- to 4-ounce turkey patty, lettuce, onion, tomato, a slice of low-fat cheese, and a small banana.
  • Spaghetti – 1 cup of whole wheat pasta, 3 ounces of ground turkey, 1/2 cup of spaghetti sauce, small side salad with some shredded cheese and light dressing, 3/4 cup of cantaloupe.

Okay – now you tell us. What are you favorite healthy meals?

Ohio State’s P4 Medicine Update, Oct. 23, 2012:

Captured by Sherri Kirk

Study: Patients Like Reading Their Doctors’ Notes

Captured by the Chicago Tribune

Both doctors and patients gave high marks to a program allowing patients to access their primary care physicians’ office notes online, in a new study.

Researchers at three U.S. practices found doctors’ initial concerns about the extra time it would take to write out notes and answer patients’ related questions didn’t pan out.

And almost everyone who got access to their notes for the study wanted to keep seeing them, even if some patients were concerned about privacy issues.

“We were thrilled by what we learned,” said Dr. Tom Delbanco, who worked on the study at Beth Israel Deaconess Medical Center in Boston.

“We had no clue that so many patients would read their notes, and that they would be both as enthusiastic and report so many clinically important changes in their behavior.”

Delbanco led the study with Jan Walker, a nurse at Beth Israel.

They and other researchers implemented the program at Beth Israel, Geisinger Health System in Northeast/Central Pennsylvania and Harborview Medical Center in Seattle.

The current study involved 105 primary care doctors and more than 13,000 of their patients who participated in the trial of the system, called OpenNotes.

Over the course of a year or more, 87 percent of those patients opened at least one note and four in ten responded to a survey about their general experience.

Most patients said having access to their doctors’ notes gave them more control over their care and helped them take any prescribed medications more reliably. That was all based on surveys; the researchers didn’t track how often patients actually filled their prescriptions, for example.

Between one-quarter and one-third of patients still had privacy concerns about having the notes online, but 99 percent wanted to keep their access after the study ended. Read more…

Personalized Cancer Treatments Approach Tipping Point

Captured by HealthLeaders Media

When then President Richard Nixon in 1971 called for a “cure for cancer,” he envisioned a crusade akin to the efforts that developed the atomic bomb and led to the moon landing.

But more than 40 years later, it has proven to be an elusive goal, and one that has changed dramatically over the decades. Now, the vision has transformed from seeking a singular cure for cancer to finding a multitude of cures for a complex disease that differentiates into the hundreds of types. The emerging singular focus now in the so-called war on cancer is personalized medicine, which involves tailoring drugs for each patient to attack that person’s individual kind of cancer. Some have dubbed it one pill for one patient, or even named it individualized medicine. Others have a different take, describing it more as precision medicine, narrowing treatment for groups with certain ailments.

To pursue and exploit innovative technology, some health systems are developing service lines or special institutes for personalized medicine, with a focus on one-patient-at-a-time cancer care. While some healthcare systems are making slow and cautious moves into the frontier of personalized medicine, others are moving quickly in a this-is-the-future-right-now environment.

Some are moving ahead because they “perceive themselves on the frontier of the movement in personalized medicine,” says Edward Abrahams, president of the Personalized Medicine Coalition, an education and advocacy organization based in Washington, D.C. “Not only do we hope systemic expenses can be cut with personalized medicine, but also the possibility of adverse events by targeting cost-effective diagnoses. Researchers will use tumor and patient genomes to find new therapies and drugs for individual patients.”

There are economic gaps that personalized medicine advocates believe can be bridged over time, particularly related to government reimbursements. As of now, there are technological improvements for genomic sequencing that are reducing costs significantly, according to Maurie Markman, MD, senior vice president of clinical affairs and national director of medical oncology for the Cancer Treatment Centers of America, which has five acute care hospitals and is headquartered in Schaumburg, Ill.

“The future is here,” Markman says, noting that there have been gradual and significant cost reductions for genome sequencing over the past decade or so. “Within the next year, it will be possible to sequence the entire genome of a tumor and the corresponding normal genome of an individual cancer patient for $3,000. Twelve to 15 years ago, it would cost about $6 million.” Read more…


No More Snickers? Junk food may be banned in NYC hospitals

Captured by The Associated Press

People nervously waiting around in New York City hospitals for loved ones to come out of surgery can’t smoke. In a few months from now, they can’t have a supersized fast-food soda. And soon, they won’t even be able to get a candy bar out of the vending machine or a piece of fried chicken from the cafeteria.

In one of his latest health campaigns, Mayor Michael Bloomberg is aiming to banish sugary and fatty foods from both public and private hospitals.

In recent years, the city’s 15 public hospitals have cut calories in patients’ meals and restricted the sale of sugary drinks and unhealthy snacks at vending machines. But now the city is tackling hospital cafeteria food, too. And the Healthy Hospital Food Initiative is expanding its reach: In the past year, 16 private hospitals have signed on.

Earlier this month, the city moved to ban the sale of big sodas and other sugary drinks at fast-food restaurants and theaters, beginning in March. Critics say the hospital initiative is yet another sign that Bloomberg is running a “nanny state,” even though the guidelines are voluntary and other cities — including Boston — have undertaken similar efforts.

Hospitals say it would be hypocritical of them to serve unhealthy food to patients who are often suffering from obesity and other health problems.

“If there’s any place that should not allow smoking or try to make you eat healthy, you would think it’d be the hospitals,” Bloomberg said Monday. “We’re doing what we should do and you’ll see, I think, most of the private hospitals go along with it.” Read more…