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When screening tests turn healthy people into patients
Medical News Today
As part of its campaign against "too much medicine" The BMJ has published reviews that question the value of screening for breast cancer in women and aneurysm in men — asking whether the harm of "over-diagnosis" outweighs the benefit of detecting and treating real cases of disease. In the case of breast cancer, the analysis of the history of screening for the disease, written by a public health expert, calls for "urgent agreement" in the debate and controversy that exists between scientists.
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This Week at AzNA
Carol Stevens and Robin Schaeffer travel to Nevada for the Multi-State Division Leadership Meeting and the annual meeting with the Western Executive Directors. Does Debbie Blanchard follow through on her vow to eat salad instead of pasta? Find out about this and more by reading This Week at AzNA.
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|May 1||Promise of Nursing
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Budget battles have begun
Last Thursday, a 9.1 $billion budget was agreed upon by Governor Ducey and legislative Republicans and was sent to the House and Senate for first readings by the committees of the whole (COW). Public hearings in the House and Senate Appropriations committees were scheduled for the same day with floor debate and a final vote planned for Friday, March 6. Opposition to the proposed budget may slow that process down. While cuts to education garners headlines, the proposed cuts of up to 5% to health care providers of Medicaid is noteworthy to nurses. The cuts would trim $37 million in state spending. That does not take into consideration the three-fold loss of matching federal funds that would result from such cuts.
Medicaid and the legislature remain at odds
Maricopa County Judge Katherine Cooper has set oral arguments for the challenge to former Gov. Jan Brewer’s Medicaid expansion program for July 10. Thirty-six current and former AZ legislators are pursuing this lawsuit which has been traveling through the courts since February, 2014. Gov. Doug Ducey has said he opposed the expansion but indicated that he would continue the program and keep defending the case.
APRN Lobby Day delivers education to legislators
AzNA and specialty organizations representing the CRNA (Certified Registered Nurse Anesthetist); CNM (Certified Nurses Midwife); CNP (Certified Nurses Practitioner) and CNS (Certified Nurse Specialist) joined to support APRN (Advanced Practice Registered Nurse) Lobby Day on March 4. The mission of the 53 APRNs at the capitol was to educate their legislators about the importance of practicing to the full extent of their education and training. A handout designed by ANA outlines the four main APRN groups and describes their various scopes of practice. That handout was delivered to legislators in person by APRNs determined to cut through the acronyms and put a face on advanced practice nursing.
What does the future hold for Nina Pham?
By Joan Spitrey
Nurse Nina Pham recently filed a lawsuit against her employer, Texas Health Resources, for negligent training and a violation of privacy in the wake of the Ebola incident in Dallas. Pham helped take care of Thomas Eric Duncan, who walked into a Dallas community hospital infected with the Ebola virus he contracted in Liberia, and she became the first person to contract Ebola in the United States. Pham's future in healthcare may be challenging. It will be interesting to see where her career takes her.
Chronic care management: 4 steps to implementation
Medicare's new chronic care management program offers practices of all specialties a major opportunity to reap revenue from services they've thus far provided for free. With 1,000 qualified patients, a practice could earn an additional $511,200 per year. IT concerns top the list of barriers to the program, FiercePracticeManagement has reported, and some practices may also need to add to their existing infrastructure and staff to implement code 99490. But while practices are doing their best to design programs that enhance patient care, there is little guidance available to do so.
Lupus: Hospitalizations for infections continue to rise
The rate of hospitalization for serious infections among patients with systemic lupus erythematosus (SLE) has been on the rise in recent decades, and has increased to a greater extent than for individuals without SLE, a national study found. In 1996 the age-adjusted relative risk of hospitalization for pneumonia among SLE patients was 5.7 (95 percent CI 5.5-6) compared with the general population, while the relative risk for admission for urinary tract infection was 9.8 (95 percent CI 9.1-10.7), according to researchers.
Regular primary care visits linked to better control of diabetes mellitus
Journal of the American Board of Family Medicine via Healio
Consistent primary care utilization is associated with blood pressure and glycemic control among American Indian/Alaska native adults with diabetes mellitus, according to a recently published study. "Coordinated patient-centered primary care can improve health outcomes for patients with [diabetes mellitus], and access to primary care providers can reduce emergency department use, hospitalizations, morbidity, mortality and cost," Matthew D. Berman, Ph.D., of the Institute of Social and Economic Research at the University of Alaska, and colleagues wrote.
Study examines palliative care in cardiac intensive care units
Increased palliative care education and training among clinicians who are involved in cardiac critical care could benefit care, according to a study published in the March 1 issue of The American Journal of Cardiology. Researchers examined the role of palliative care in cardiac intensive care units (CICUs). Data were included for 1,368 patients admitted from Jan. 1 through Dec. 31, 2012.
A new vaccine targets more HPV strains
The New York Times
A new vaccine has been shown to protect against nine different forms of the cancer-causing human papillomavirus, or HPV, compared with just four strains covered by the current Gardasil vaccine. But will people use it? The vaccine, called Gardasil 9, was approved by the federal Food and Drug Administration in December, but the study that led to the approval was just published this month in The New England Journal of Medicine. While the HPV vaccine already has contributed to a steep drop in the prevalence of HPV among teenagers, it also carries a stigma, and its use in the United States has been limited.
Most thyroid nodules have favorable prognosis
Internal Medicine News
During five years of follow-up, cancer arose in only 0.3% of thyroid nodules that were cytologically and sonographically benign at baseline, according to a large prospective study published online March 3 in JAMA.
Furthermore, only two of the five nodules that became cancerous had grown beforehand, reported Cosimo Durante, M.D., of the Sapienza University of Rome and his associates. "These data suggest that the American Thyroid Association's recommendation for indication for repeat cytology should be revised. Clinical and sonographic findings should probably play larger roles in the decision-making process," the researchers said.
Study singles out cerebral blood flow as potential biomarker for concussion
Physical Therapy Products
Recent research indicates that cerebral blood flow recovery in the brain may serve as a biomarker of outcomes in patients post-concussion. The study appears online in JAMA Neurology. The study's background singles out reduced cerebral blood flow (CBF) as a marker of concussion severity in animal models, according to a news release issued by the JAMA Network Journals.
Risk factors for heartburn: Excess weight, smoking
Excess pounds and smoking might each raise the likelihood of frequent heartburn or gastroesophageal reflux disease (GERD), according to a large study from Norway. Other factors linked to higher odds of new GERD symptoms included getting older, being a woman, having less education and even quitting smoking — if it led to weight gain. To see what characteristics predict development of GERD, the researchers analyzed data on nearly 30,000 people in Nord-Trondelag County, Norway.
Healthcare providers, patients scramble ahead of high court Obamacare decision
As the U.S. Supreme Court takes on a make-or-break Obamacare case this week, a growing number of U.S. patients and their healthcare providers are already devising a Plan B in case they lose medical coverage.
The Court's ruling, expected by late June, will determine whether millions of Americans will keep receiving federal subsidies to help them pay for private health insurance under President Barack Obama's healthcare law.
Anemia linked to adverse outcomes in atrial fibrillation
For patients with atrial fibrillation receiving anticoagulant treatment, the presence of anemia is associated with increased risk of thromboembolic events, bleeding complications, and mortality, according to research published online in the Journal of Thrombosis and Haemostasis. Researchers examined whether anemia is associated with thromboembolic events and bleeding in patients with atrial fibrillation. The authors conducted a retrospective analysis of the RE-LY trial database that randomized 18,113 atrial fibrillation patients with a risk of stroke to receive dabigatran or warfarin.
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