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Apple Targeting Heart Health With New App

Technology titan Apple Inc. (Nasdaq: AAPL) has taken yet another step toward becoming an important player in the health care world and a potential resource for home-based care providers, particularly when it comes to heart health.

Cupertino, California-based Apple announced Thursday that the newly available ECG app on its Apple Watch Series 4 model will offer a direct-to-consumer product that enables users to take an electrocardiogram from their wrist. The new capability will help capture heart rhythm data when participating Apple Watch users experience symptoms such as a rapid or skilled heart beat, valuable information that can then be shared with physicians or health care providers to prevent negative outcomes.

Electrocardiograms are records or displays of an individual’s heartbeat produced by electrocardiography.

“We are confident in the ability of these features to help users have more informed conversations with their physicians,” Sumbul Desai, Apple’s vice president of Health, said in a statement. “With the ECG app and irregular rhythm notification feature, customers can now better understand aspects of their heart health in a more meaningful way.”

The ECG app and electrocardiogram function — which use electrodes built into the back of smart watches — adds to Apple’s growing collection of health care tools.

In September, Apple also highlighted how its smart watch can detect when falls occur and alert emergency responders. To identify when a hard fall takes place, the Apple Watch Series 4 uses a built-in accelerometer and gyroscope that measures up to 32 G forces.

Apple’s latest innovation will specifically help identify atrial fibrillation (AFib), the most common form of irregular heart rhythm, according to the company. When left untreated, AFib is one of the leading conditions that can result in stroke, the most second common cause of death worldwide.

AFIB affects roughly 9% of older adults living in the United States, according to the U.S. Centers for Disease Control and Prevention.

“The idea that wearables can be used by both patients and their health care providers to manage and improve heart health holds promise and should also be approached with caution to ensure information and data are used responsibly and in concert with other evidence-based tools and guidelines,” said C. Michael Valentine, president of the American College of Cardiology, in a statement.

The ECG app’s ability to accurately classify an ECG recording into AFib and sinus rhythm was validated in a clinical trial of around 600 participants. The ECG app is available to smart watch users for free after downloading the latest software update.

Written by Robert Holly

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Article source: https://homehealthcarenews.com/2018/12/apple-targeting-heart-health-with-new-app/

The right to health

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Article source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33141-6/fulltext

Proposed changes to ‘public charge’ rule could hurt public health

The Trump administration has proposed an immigration policy that could seriously harm public health efforts, potentially reversing gains made in healthcare access and trust earned in our communities.

In fact, there are already reports that legal immigrants who are eligible for critical public assistance programs are disenrolling or steering clear out of fear and confusion.

The administration’s proposed changes to the “public charge” rule would make receipt of certain public assistance, like Medicaid, grounds for denying a legal immigrant a green card. For decades, such denials have applied only to those likely to become primarily dependent on the government for subsistence. This new rule goes much further.

The Kaiser Family Foundation has estimated that the changes would lead to disenrollment of as many as 4.9 million Medicaid/Children’s Health Insurance Program enrollees across the nation. CHIP is not in the proposed change, but the analysis predicts that fear will cause parents of even U.S.-born children to steer clear of participation.

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As the CEO of L.A. Care Health Plan, the largest publicly operated health plan in the country, I can tell you that we have estimated that more than 170,000 of our 2.2 million members alone could be impacted by this sweeping expansion of grounds for denial.

There is no doubt that the proposed changes would harm the health of immigrants, their families and others. Many will likely drop out of Medicaid and SNAP, the nutrition assistance program formerly known as food stamps, to safeguard their eligibility for permanent legal residency. Without insurance, these people will likely have to forgo preventive healthcare. What happens then? How can we, as a nation, force families to choose between nutritious food and necessary medical care or the opportunity to become a citizen?

Immigrant or not, people will inevitably need healthcare. With the cost of care beyond the means of many affected by the rule change, they will wait and wait, until ultimately they require emergency care—the costliest of all care, often requiring much more complex treatment. Costs go up for everyone when emergency departments are overused, and that means all taxpayers pay more for healthcare.

In California, where half of all children have a foreign-born parent, the rule would have an especially big impact. The American Academy of Family Physicians in September noted that if the proposed change is enacted, it will “endanger public health,” not just immigrant health. The physicians say that by avoiding necessary medical care legal immigrants will increase the risk to their own health and the health of others. One specific area of concern is immunizations. The Centers for Disease Control and Prevention estimated that influenza killed more than 80,000 people in the U.S. during the last flu season. How many legal immigrants and families will forgo a simple flu shot this season out of fear driven by this senseless policy proposal?

Furthermore, U.S.-born children of many of these legal immigrants will also suffer, especially if those threatened by the changes decline food or housing assistance out of fear. The Department of Homeland Security itself admits reduced participation in such programs could lead to worse health outcomes, including increased prevalence of obesity and malnutrition; increased poverty and housing instability; and reduced productivity and educational attainment. Echoing the AAFP, DHS says the new rule could increase the prevalence of communicable diseases, including among U.S. citizens. It also recognizes the potential economic cost as there will be an increase in uncompensated care for immigrants who show up in the emergency room.

Policies that would block legal immigrant families from having a healthy, productive future in the U.S. do not represent the values on which this country was built. The Wharton School in June 2016 released a study titled The Impact of Immigration on the United States’ Economy, which found immigrants—whether documented or undocumented, high- or low-skilled—to be net positive contributors to the U.S. economy. Without good health, that could change.

Interested in submitting a Guest Expert op-ed? Send drafts to Assistant Managing Editor David May at dmay@modernhealthcare.com.

Article source: https://www.modernhealthcare.com/article/20181208/NEWS/181209974

Top 10 workplace safety articles in 2018 — Safety+Health magazine, published by the National Safety Council

The National Safety Council eliminates preventable deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy.

Learn more about the NSC mission.

Article source: https://www.safetyandhealthmagazine.com/articles/17787-favorite-safetyhealth-articles-in-2018

Home Health Spending Holds Steady As Overall Health Care Spending Slows

While overall U.S. health care spending growth continued to slow in 2017, home health spending growth held steady with its 2016 rate, according to the Centers for Medicare Medicaid Services (CMS).

Health care spending across all sectors grew at a rate of 3.9% in 2017, compared to rates of 4.8% in 2016 and 5.8% in 2015, according to the CMS study. As such, spending rose to $3.5 trillion, or $10,739 per person.

Meanwhile, in 2017, home health spending grew at a rate of 4.3%, the same as the previous year, to $97 billion. In 2015, the home health spending rate was 5.3%.

Slowed total health care spending growth in 2017 can be attributed to a number of factors, according to the study, which will appear in the January 2019 issue of Health Affairs.

Primary reasons include slower growth in spending for hospital care, physician services, clinical services and retail prescription drugs, “with residual use and intensity of these services contributing substantially to the trend.”

Additionally, slower growth in 2017 for Medicare spending and private health insurance was a factor, but faster Medicare and out-of-pocket spending helped offset it, according to CMS.

“The rate of growth in 2017 was similar to the increases between 2008 and 2013, which preceded the faster growth experienced during 2014–15 — a period that was marked by insurance coverage expansion and large increases in prescription drug spending,” the study in Health Affairs reads. “Slower growth in health care spending in 2017 was mainly attributable to the use and intensity of goods and services, particularly for hospital care, physician and clinical services, and retail prescription drugs.”

The majority of 2017 home health spending can be attributed to Medicare and Medicaid, which together made up 76% of it, according to CMS.

Medicare spending grew 4.2 in 2017 to $705.9 billion, compared with 3.6% in 2016. Meanwhile, Medicare expenditures grew 2.9 percent last year reaching $581.9, compared to 3.9 percent the year before, according to the study.

Written by Bailey Bryant

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Article source: https://homehealthcarenews.com/2018/12/home-health-spending-holds-steady-as-overall-health-care-spending-slows/

Home Health Salaries, Turnover Rates Rise in 2018

Salaries for home health care employees saw a slight jump from 2017 to 2018. Unfortunately, so did turnover rates.

That’s according to the latest Home Care Salary Benefits report from Oakland, New Jersey-based Hospital Healthcare Compensation Service, which provides salary and benefits studies, along with custom marketplace studies, for the health care industry.

Released in November, the latest Home Care Salary Benefits Report is based on responses from more than 1,450 home health agencies across the United States. The report is published in cooperation with the National Association for Home Care Hospice (NAHC), an industry advocacy group based in Washington, D.C.

From 2017 to 2018, the average salary for executive directors and CEOs rose 3.16% to $207,487, according to the report. Salaries for chief operating officers and program directors climbed 4.28% on a year-over-year basis to $160,519, while salaries for top-level financial executives increased by 2.69% to $148,364.

For licensed practical nurses (LPNs), the average wage was $23.70 per hour in 2018, an increase of 3.40% from the year prior. Registered nurses (RNs) saw an increase of 2.39% from 2017 in hourly wages, which climbed to $35.34 this year.

Physical therapists, occupational therapists and speech pathologists saw 2018 hourly wages of $44.79, $41.36 and $40.91, respectively. Receptionists and medical records clerks had among the lowest hourly wages, according to the report.

In total, the report covers more than 60 home health jobs, including information on salary, bonuses, hourly rates and benefits.

Of the more than 1,450 home health providers that participated in the Hospital Healthcare Compensation Service report, the vast majority – nearly 84% — were for-profit agencies. Slightly more than 9% were not-for-profit organizations, while 7% were based out of hospital systems.

Taking turnover into consideration

In addition to highlighting salary information for dozens of home health positions, Hospital Healthcare Compensation Service’s report, the 28th overall, also details annual turnover rates by job category.

At 24.49%, home care aides saw the highest turnover rate in 2018, according to the report. Therapists, in comparison, had the lowest turnover rate, at 12.58%. Turnover rates for top-level executives checked in at 14.93%.

Non-exempt employees had a much higher turnover rate than exempt employees.

The national average turnover rate for all home health employees was 21.23% in 2018, an increase of more than 2% compared to 2017. Although minor, the upward trending turnover rate for all home health employees does not bode well for agencies, as caregiver recruiting and retention is widely cited as a top operational challenge.

Still, the data from the Home Care Salary Benefits Report is significantly lower than other available reports, which have placed the turnover rate for home health employees at 50% or higher.

Of the agencies that participated in Home Care Salary Benefits Report, 100% offered health insurance, with the national average health premium increasing slightly from $7,116 in 2017 to $7,316 in 2018. More than 65% of participants reported that part-time employees are eligible for health insurance, while more than 92% of agencies reported domestic partners are eligible for health insurance. Additionally, 98.4% of participants reported that same sex spouses are eligible for health insurance.

Written by Robert Holly

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Article source: https://homehealthcarenews.com/2018/12/home-health-salaries-turnover-rates-rise-in-2018/

HRC Co-Authors Article About Non-Binary-Inclusive Health Care

HRC Children, Youth and Families Program Coordinator Sula Malina and staff at the National LGBT Health Education Center authored an important new resource for health care providers who work with non-binary patients. The article, “Communicating With Patients Who Have Non-binary Gender Identities,” published in the Annals of Family Medicine, details best practices for communicating with patients who identify as non-binary.

“I became committed to this work after leaving a doctor’s office in tears, worried that few providers out there would understand how to address my body and identity,” said Malina, who identifies as non-binary. “I realized that this experience is by no means unique to non-binary people — particularly those like myself who benefit from white privilege and reliable access to healthcare.”

All patients, Malina said, and especially those living at the intersection of multiple marginalized identities, deserve access to providers who practice cultural humility. “If providers approach these conversations with respect, a willingness to learn, and the understanding that patients know their own bodies best, they can earn critical trust among populations too often overlooked,” they said.

Using an example of a young, non-binary patient, the article addresses concerns that can arise in a medical setting, ranging from terminology to the best methods for apologizing after making a mistake. As the authors note, “As an underserved population at disproportionate risk for discrimination, victimization and suicidal ideation, non-binary people are especially in need of health care clinicians who affirm their gender identities.” The piece also incorporates a brief glossary explaining specific non-binary gender identities and a table displaying the proper use of nonbinary pronouns.

HRC Foundation and the University of Connecticut’s 2017 survey of more than 12,000 LGBTQ youth revealed sobering statistics around the experiences of more than 5,600 gender-expansive respondents. Despite a high risk of negative health and mental health outcomes, only seven percent of non-binary youth surveyed are out to all of their doctors and health care providers with respect to their gender identity and/or sexual orientation, indicating that they are likely not receiving the best care possible. Given low acceptance rates among family and educators noted in HRC’s 2018 Gender-Expansive Youth Report, and high risk of physical and verbal harassment or assault, access to affirming care is absolutely critical for non-binary people of all ages.  

HRC Foundation’s Health and Aging Program is dedicated to improving the health and well-being of LGBTQ people. Learn more about the Health and Aging Program’s initiatives, such as the Healthcare Equality Index (HEI) here.

Article source: https://www.hrc.org/blog/hrcs-sula-malina-co-authors-journal-article-about-the-basics-for-non-binary

Mental health: The NHS patients who are ‘abused and ignored’

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New rights should be given to severely ill mental health patients detained in hospital to stop abuse and neglect of this vulnerable group, a review says.

The 1983 Mental Health Act is outdated and needs an overhaul, sectioning is being misused and does not properly protect patients’ rights, it says.

The independent review – ordered by the government – heard from patients who had suffered during their detentions.

The prime minister said the injustices were unacceptable and promised action.

‘Anxious and suicidal’

Kate King, 56, spent seven years in and out of hospitals in East Anglia after being admitted in 2004 following a period of post-natal depression.

She said her detention probably saved her life as she had been really struggling following the birth of her two children but her experience, in a variety of units, had been “awful” at times.

“I was abused and ignored. I lost my voice,” she said.

She said she had experienced other patients being aggressive and swearing at her, with one even stalking her.

But she also complained about her treatment at the hands of staff.

“I was restrained face down on a mattress. One nurse even told me I should kill myself,” she said.

“When I tried to object or complain, I was not listened to. There was good care too – I remember once being taken go-karting. But my experiences left me anxious and suicidal.”

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What is the solution?

Mrs King formed part of the working group put together to review the way the Mental Health Act worked.

It included mental health professionals, academics and patients.

The 18-month review recommended a number of changes, including:

  • new rights for patients to legally challenge their treatment
  • more frequent opportunities to challenge detention
  • legally binding advanced care plans so patients could express how they wanted to be treated if they were sectioned
  • a requirement for doctors to record when and why they chose to ignore patient requests
  • an end to police cells being used as a place of safety and less frequent use of police cars to transport patients
  • the right to choose a “nominated person” to have control of a patient’s care if they were sectioned – at the moment it automatically goes to their nearest relative

Professor Sir Simon Wessely, who chaired the review, said it was time to bring the act up to date.

“It was written when people with a mental health problem were something to be afraid of. But the way we think about mental health and illness has changed dramatically, so now they are more likely to be seen as people to be helped.

“The act needs to help them more – to make it easier for people to express their choices and preferences about how they want to be treated and harder for them to be ignored.”

He added black and ethnic minorities along with people with learning disabilities and autism appeared to be particularly ill-served by the act as they had higher rates of detention.

Speaking to Radio 4′s Today programme, Sir Simon said BME groups had higher rates of mental illness “probably because of early experiences of discrimination and exclusion”.

He also said it was important to note that such groups were more likely to be perceived as a risk.

How many patients does this affect?

The act deals with patients who are detained in hospital. Every year about 1.8 million patients receive mental health treatment – but only one in 20 of these is treated in hospital.

About half of those are admitted voluntarily, with nearly 50,000 detained against their will for their own protection or the protection of others.

The numbers being detained have been rising – up by 40% in the past 10 years.

Sir Simon said there is no one reason for the increase but added that it is partly down to society becoming more “risk averse” but also because there are fewer alternatives to detention.

The rise in population will account for a small proportion of the rise but beyond that there is concern the act may be being misused.

There have been reports of dementia patients being detained, while black and ethnic minority patients are much more likely to be sectioned.

As well as reducing the number of detentions, the review group wants to see a reduction in the use of compulsory treatment orders whereby patients are released from hospital under supervision.

They say public safety will not be put at risk.

But they acknowledge the changes will require greater investment in community services, particularly crisis care to stop people deteriorating to such an extent that they need hospital treatment.

The recommendations relate to England and Wales only. The review team said Scotland had already started making some of these changes, while Northern Ireland has agreed to review its own laws.

What has been the reaction?

Mental health charities are overwhelmingly supportive of the recommendations.

Mind chief executive Paul Farmer said the legislation was outdated, with thousands of people every year having to endure “poor treatment”.

Mark Winstanley, of Rethink Mental Illness, said the charity had “long campaigned” for reform of the act.

“Countless people have told us how they felt disrespected and lost all control of their care while treated under the act,” he said.

And even doctors acknowledged change was needed. Royal College of Psychiatrists president Prof Wendy Burn said detention was clearly “incredibly stressful” for patients and there needed to be a focus on improving their experiences.

Prime Minister Theresa May said the review would be used to make changes to the legislation.

“The disparity in our mental health services is one of the burning injustices this country faces that we must put right,” she said.

“For decades, it has somehow been accepted that if you have a mental illness you will not receive the same access to treatment as if you have a physical ailment. Well, that is not acceptable.”

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Article source: https://www.bbc.com/news/health-46459434

Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis

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Article source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32558-3/fulltext

Men’s penises are half-an-inch SMALLER if they are exposed to high levels of chemicals in non-stick frying pans and …

Men could end up with penises half-an-inch shorter than usual if their parents were exposed to high levels of a chemical used in non-stick frying pans.

Scientists have found the chemicals, called PFCs, can interfere with male hormones and lead to sexual organs being ‘significantly’ shorter and thinner.

And this effect is not only seen in the womb, the researchers said. PFCs could have toxic effects in teenagers, too. 

The chemicals, also found in waterproof clothing and greaseproof packaging for food, get into the bloodstream and reduce testosterone levels.

Scientists found young men who grew up in an area polluted with PFCs have penises 12.5 per cent shorter and 6.3 per cent thinner than healthy men. 

Chemicals called PFCs are common in everyday items and, notably, used to be used to make the Teflon coating for non-stick frying pans ¿ but researchers in Italy have found they could be absorbed by the body during youth and make men's penises smaller

Chemicals called PFCs are common in everyday items and, notably, used to be used to make the Teflon coating for non-stick frying pans – but researchers in Italy have found they could be absorbed by the body during youth and make men’s penises smaller

Researchers at the University of Padua in Italy made the discovery after measuring the penises of 383 men with an average age of 18.

Padua, near Venice, is in one of four areas in the world known to have high levels of PFC pollution, which used to be used in Teflon coating until it was phased out in 2013.

The chemicals, officially called perfluoroalkyl compounds, are also a health hazard in Dordrecht in the Netherlands, Shandong in China, and West Virginia in the US.

The Italian researchers found PFCs will bind to testosterone receptors and reduce levels of the male sex hormone used in the body.

As a result, men grow up with smaller penises, less healthy and mobile sperm and a shorter distance between their scrotum and anus – a sign of lower fertility.

‘As the first report on water contamination of PFCs goes back to 1977, the magnitude of the problem is alarming,’ said the researchers, led by Dr Andrea Di Nisio.

‘It affects an entire generation of young individuals, from 1978 onwards.’

PFCs come in hundreds of forms and are widely used to make everyday products more convenient and longer-lasting.

They are found in fast food packaging, paper plates, stain-resistant carpets, windshield washing fluid, fire-fighting foam and waterproof clothing.

PFCs are also in some glues, cosmetics, medicines, electronics, cleaning products, polishes and waxes, insecticides and paints.

But their toxic and potentially cancer-causing effects are only in the early stages of being understood by scientists.

TOXIC PFCs ARE IN WATER SUPPLY OF MILLIONS OF AMERICANS 

More than six million people in the US drink and use water that is contaminated with deadly toxins, a study revealed in 2016.

Life-threatening concentrations of carcinogenic man-made chemicals PFASs, a type of PFC, were found in public water tanks across America. 

The chemical is normally used to fight fire, insulate pipes, and stain-proof furniture.

The most at-risk states are (in order): California, New Jersey, North Carolina, Alabama, Florida, Pennsylvania, Ohio, New York, Georgia, Minnesota, Arizona, Massachusetts, and Illinois.

The Harvard University study warned the figures are likely underestimates, since government data does not account for a third of the country – and therefore omits around 100 million people.

PFASs have been used over the past 60 years in industrial and commercial products ranging from food wrappers to clothing to pots and pans.

They have been linked with cancer, hormone disruption, high cholesterol, and obesity. 

Safety officials have yet to find a way to remove PFASs from wastewater by standard treatment methods.

Studies have linked the chemical to early menopause, low birth weight, lower fertility, thyroid problems, high cholesterol, bladder cancer and worse immune system function.

The chemicals can get into the body by being absorbed by the intestines from food and drinking water, or be breathed in.

From here they get into the bloodstream and can be toxic for foetuses when consumed by the mother and for teenagers, who undergo big hormonal changes.

For men, being exposed to PFCs while in the womb can result in higher levels of female hormones in adulthood, and developing smaller penises.

In Dr Di Nisio’s study, the penises were measured of 212 men who grew up in an area with high exposure to PFCs, and 171 men who grew up away from the area.

All were from the Veneto region of Italy, but were categorised by whether they lived in a red, yellow or green zone based on levels of PFC pollution. 

Part of the region is highly polluted because run-off from a chemical factory and wastewater treatment plant made it into a major river and the drinking water.  

The non-exposed men (green zone) had an average flaccid penis length of 10cm (3.9ins) – measured along the top from body to tip – while the men in the polluted areas were just 8.75cm (3.4ins) long.

Their penises were thinner, too, but by a smaller margin: the healthy men measured 10.3cm (4ins) in circumference compared to 9.65cm (3.7ins) for the polluted penises.

Dr Di Nisio and his team said not much can be done about the problem until PFCs are banned or phased out, and even then the problem is likely to continue.

PFCs are highly stable chemicals and the ones already released into the environment are expected to remain there for longer than the human species.

‘This study documents that PFCs have a substantial impact on human male health as they directly interfere with hormonal pathways potentially leading to male infertility,’ the researchers wrote.

And Dr Di Nisio told IFL Science: ‘At least here in Italy, it is very difficult to know if a product contains these chemicals.

‘In the case of a product where it is explicitly stated “PFOA-free”, I do not feel safe anyway, because PFOA is only one of hundreds of possible PFC compounds, and they can all be dangerous.

‘Therefore it is very hard to avoid any contact with any PFC.’

PFCs used to be used in Teflon coating on non-stick frying pans but were phased out in 2013 and replaced with a less controversial chemical.

DuPont and Chemours, the manufacturers of Teflon, had to pay a $671million (£525m) settlement last year following the spillage of PFCs into a river in West Virginia.  

The leak allegedly contaminated local water supplies and was linked to diseases including testicular and kidney cancers. 

Chemours now makes non-stick coatings with a chemical called PTFE, which it says does not have any PFCs in it. 

Despite some high-profile companies phasing out the use of damaging PFCs, they are still used around the world in imported goods, the Environmental Protection Agency says.

The research was published in the Journal of Clinical Endocrinology and Metabolism.

Article source: https://www.dailymail.co.uk/health/article-6462775/Mens-penises-half-inch-smaller-chemicals-non-stick-frying-pans.html