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Daily Archives: December 3, 2013

Malaria treatment could improve in children

An analysis of patients from across the malaria endemic world suggests that a key antimalarial treatment could be improved by better dosing in young children. Antimalarial drug resistance has hampered malaria control programs for almost 60 years. A key factor in combatting this threat is to ensure that all antimalarial drugs are deployed in a way that ensures that the maximum number of patients are completely cured.

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Multifaceted program to improve patient continuity of care in hospitals associated with reduction in medical errors

Implementation of a multifaceted program to improve patient handoffs (change in staff caring for a patient) among physicians-in-training residents at a children’s hospital was associated with a reduction in medical errors and preventable adverse events, according to a study appearing in the December 4 issue of JAMA, a medical education theme issue. Handoff miscommunications are a leading cause of medical errors. “The Agency for Healthcare Research and Quality (AHRQ) and the Accreditation Council for Graduate Medical Education (ACGME) have identified improving handoffs as a priority in U.S.

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Diversity initiatives do not appear to increase representation of minorities on faculty of medical schools

From 2000 to 2010, the presence of a minority faculty development program at U.S. medical schools was not associated with greater underrepresented minority faculty representation, recruitment, or promotion, according to a study appearing in the December 4 issue of JAMA, a medical education theme issue. “Minority physicians and scientists have been inadequately represented among medical school faculty when compared with their representation in the U.S. population.

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Study examines incidence, trend of substance use disorder among medical residents

Among anesthesiology residents entering primary training from 1975 to 2009, 0.86 percent had a confirmed substance use disorder during training, with the incidence of this disorder increasing over the study period and the risk of relapse high, according to a study appearing in the December 4 issue of JAMA, a medical education theme issue. Substance use disorder (SUD) is a serious public health problem, and physicians are susceptible.

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Attending clinical and tutorial-based activities by medical students associated with better overall examination scores

Among fourth-year medical students completing an 8-week obstetrics/gynecology clinical rotation, there was a positive association between attendance at clinical and tutorial-based activities and overall examination scores, according to a study appearing in the December 4 issue of JAMA, a medical education theme issue. “Student attendance is thought to be an important factor in the academic performance of medical students on the basis that clinical contact and teaching are necessary to develop competence.

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Simulation-based communication training does not improve quality of end-of-life care

Among internal medicine and nurse practitioner trainees, simulation-based communication skills training compared with usual education did not improve quality of communication about end-of-life care or quality of end-of-life care but was associated with a small increase in patients’ symptoms of depression, according to a study appearing in the December 4 issue of JAMA, a medical education theme issue. “Observational studies have suggested that communication about end-of-life care is associated with decreased intensity of care, increased quality of life, and improved quality of dying.

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Gout runs strongly in families, suggests large-scale study

Researchers from the UK’s University of Nottingham and colleagues conducted a new study of the population of Taiwan, where there is a high rate of gout, and found that the condition clusters in families.The risk of developing gout was largely linked to shared modifiable factors, such as lifestyle and diet, while having close relatives with the disease also appeared to increase the risk, but to a lesser extent.They write about their findings in a recent online issue of Annals of the Rheumatic Diseases.

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Mice 'warn' sons of dangers through inherited fears

It seems that inheritance is not simply about parents passing genes to their offspring. Some inheritable changes in gene activity can be passed on without changing the DNA sequencing, as researchers from Emory University School of Medicine claim that mice can inherit the memory of their ancestor’s traumas and display similar responses when faced with the stimuli. The findings of this latest study in epigenetics, published in Nature Neuroscience, show that the offspring of laboratory mice trained to fear a particular smell demonstrated the same fear reaction as their ancestor.

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Oxytocin activates 'social' brain regions in children with autism

Researchers from Yale University have found that while engaging with social information, children with autism spectrum disorders experienced enhanced brain activity after a single dose of the hormone oxytocin was administered through a nasal spray.Results of their findings are published in the journal Proceedings of the National Academy of Sciences.Oxytocin is a naturally occurring hormone in the human body that has been implicated in social bonding.

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Reviews Mixed For 'Fixed' Health Care Website

Some said the Monday’s healthcare.gov relaunch — marked by heavy traffic — was “rocky” and “bumpy,” but administration officials maintained the user experience was much smoother as a result of fixes.   

Los Angeles Times: Healthcare.gov Has Rocky Relaunch
The Obama administration’s overhauled health care website got off to a bumpy relaunch Monday as a rush of consumers caused an uptick in errors and forced the administration to put thousands of shoppers on the HealthCare.gov site on hold. … Bataille said about ȅ5,000 visitors went to the site before noon, about double the normal traffic for a Monday morning. The volume caused pages to load slowly and the rate of errors to spike. About 10 a.m. EST, federal officials turned on a new queuing system that alerts some visitors to the site to come back later (Levey, 12/2).

The Associated Press/Washington Post: Updated Healthcare.gov Gets Mixed Reviews
helping people use the federal government’s online health exchange are giving mixed reviews to the updated site, with some zipping through the application process while others are facing the same old sputters and even crashes. The Obama administration had promised a vastly improved shopping experience on healthcare.gov by the end of November, and Monday was the first business day since the date passed (12/3).

The Washington Post: Heavy Traffic On Healthcare.gov After Fixes; Users Report Mixed Results On Insurance Site
The White House announced early Sunday that, given the recent improvements in the site, most HealthCare.gov shoppers should be able to have an experience like Issa’s. By 10 a.m., however, the Web site seemed to be struggling with high traffic. Federal health officials said they saw an increase in error rates and a slowdown in response times and decided to deploy “queueing” software designed to limit the number of users permitted on the site at one time (Kliff and Sun, 12/2).

Kaiser Health News: Capsules: Administration: Bugs Reduced At Healthcare.gov
For the first time since its mangled Oct. 1 launch, users can now go to the federal government’s insurance enrollment website and get detailed information about the costs and benefits of health plans in their county without first enrolling (Galewitz, 12/2).

Reuters: Retooled Obamacare Website Traffic Surges But Problems Remain
A surge of visitors clogged the U.S. government’s revamped health care insurance shopping website on Monday, signaling that President Barack Obama’s administration has a way to go in fixing the portal that showcases his signature domestic policy. Facing its first big test since officials proclaimed over the weekend that they had met their deadline to make HealthCare.gov run smoothly for the “vast majority” of users, the site performed markedly better than it did during its disastrous launch two months ago — but was still short of the crisply running insurance marketplace Obama once touted (Morgan and Krauskopf, 12/2).

Bloomberg: Health Exchange Insurer Bug Fixed As 800,000 Try Website
More than 800,000 visitors gave the hobbled Obamacare website another chance as the government continued to work on software repairs, including a fix to the system that sends customer data to insurers. The rush yesterday to healthcare.gov followed a Dec. 1 report saying that six weeks of work had improved its use for most consumers (Wayne, 12/3).

McClatchy: HealthCare.Gov Usage Soars In December
The troubled HealthCare.gov website was on pace to double its typical weekday volume of users, logging 375,000 unique visitors by noon Monday with more than 800,000 site visitors expected by day’s end, the Obama administration said. Officials expected site usage to soar in December as people scurry to enroll in coverage by Dec. 23 in order to have insurance that begins on January 1, 2014. Monday’s early volume proved those projections correct (Pugh, 12/2).

CQ HealthBeat: Healthcare.Gov Showing Strain As Volume Increases
Federal officials started diverting consumers from the federal health marketplace website on Monday after they saw worrisome response times and error rates when about 35,000 people were on healthcare.gov at the same time. Previously, they said they would put consumers in a queueing system when there were 50,000 users at a time (Adams, 12/2).

The Hill: Back-Up System Goes Into Effect For HealthCare.Gov
A back-up system was deployed for HealthCare.gov on Monday at a lower traffic rate than federal officials projected, signaling there could be further trouble with the system. The Centers for Medicare and Medicaid Services (CMS) acknowledged that the site’s try-again-later system was initiated as roughly 35,000 users tried to access HealthCare.gov at the same time (Viebeck, 12/2).

Kaiser Health News: Capsules: Many Consumers Report Improvements With Healthcare.gov
Vickie Fleisher-Gann had been trying since Oct. 1 to complete her Obamacare application so she could start shopping for insurance on healthcare.gov, but she kept getting stopped by error messages. With her policy expiring at the end of the year, she feared time was running out. On Sunday morning, the former Harrisburg, Pa., hospital administrator finally was able to complete her application, shop for a plan and enroll — all within about 30 minutes. “I was shocked when it worked,” said Fleisher-Gann, 61. “I just couldn’t believe it” (Galewitz, 12/2). 

CBS News: Shoppers, Insurers Still Face HealthCare.Gov Hiccups
Despite promises the website could handle 50,000 users at the same time, the queuing system was turned on Monday at approximately 35,000 users. Officials said they had to “maximize the smooth user experience” for those who applied first. There are also potential problems for the thousands who have signed up for new plans (Andrews, 12/2).

Meanwhile, here’s how the website is being viewed in specific states —

Kansas Health Institute: Healthcare.Gov Better In Kansas But Still Slowed By High Traffic
Despite improvements made since its disastrous October launch, the HealthCare.gov website today was still not able to seamlessly handle large numbers of consumers attempting to sign up by a Dec. 23 deadline for coverage that starts Jan. 1. Kansas is one of 36 states that chose to rely on the federal website rather than build one of its own (McLean, 12/2).

Miami Herald: Healthcare.Gov Improved, But South Florida Users Still Stymied
Long waits, error messages, unresponsiveness. Hallmarks of the troubled launch of the Health Insurance Marketplace at healthcare.gov continued to stymie South Florida residents and counselors trying to access the website on Monday — more than two months after the Oct. 1 launch, and despite the government’s self-imposed deadline of Nov. 30 for the system to function smoothly for the “vast majority of Americans” (Chang and Borns, 12/2).

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