Thursday, April 7, 2016

Running To Beat Schizophrenia | California Healthline

Marco Tapia, 28, was diagnosed with schizophrenia four years ago and runs regularly to help manage his condition. (Courtesy of the University of California, Los Angeles)





Exercise is good for the brain, whether normal or abnormal.  It has  been found that not only does exercise increase blood flow to the brain, exercise also has other indirect effects on the brain.

Like so many,the effects of exercise led to a serendipitous discovery.


For most of his life, Marco Tapia viewed exercise as a way to stay in shape. He played soccer growing up. It was recreation, and an opportunity to hang out with his friends.
But since Tapia was diagnosed with schizophrenia four years ago, physical activity has taken on a new, more urgent value for the 28-year-old.

A new study by researchers at UCLA’s Semel Institute for Neuroscience and Human Behavior shows that regular aerobic exercise has significant benefits for young schizophrenia patients, such as Tapia.
The research reveals that an intensive routine of both physical and mental exercises, especially in the early stages of schizophrenia, can help repair the deficits in memory, problem solving and social intelligence that are associated with the illness.

Tapia was part of a 10-week pilot study at the Aftercare Research Program, a clinic at the Semel Institute. He and his family found out about the free program after an episode of schizophrenia landed him in the hospital in 2012.

Combined with behavioral therapy, and medications this combined treatment may offer a meaningful quality of life for those diagnosed with schizophrenia. 

Self-portrait of a person with schizophrenia, representing that individual's perception of the distorted experience of reality in the disorder









“What’s striking to us is the power of combination,” Nuechterlein said. “Both [brain games and exercise] done separately help somewhat, but when done together, the boost in cognitive function is greater.”
In the pilot study, one group participated in computerized cognitive training, while a second group did the same computer training in addition to 150 minutes of exercise videos a week.
The patients completed a variety of tests, including a dot-to-dot drawing. The completion time for the group that exercised dropped from 37 to 25 seconds — not too far from the average completion time of 22 seconds among people without schizophrenia.
In a second and ongoing study, 32 people who experienced their first schizophrenic episode within the last two years were put through similar computer-based training. Half of them also engaged in aerobic exercises led by physical trainers.
Workouts were a combination of jumping jacks, lunges, running, and other types of cardiovascular exercise. The exercises don’t require special equipment and can be adapted almost anywhere, Nuechterlein said. The participants’ heart rate and calories were monitored

Today neuroscience, genomic, advanced brain imaging will all contribute to understanding this life-threatening  disease.


Running To Beat Schizophrenia | California Healthline

Tuesday, April 5, 2016

Patients and Consumers Use of Evidence

Conversation opened. 1 unread message.
What patients andconsumers must know about how their providers will be reimbursed in the future. It does not have much to do with how many services you will use.It is all based upon unproven algorithms










 
REMINDER:
Health Affairs Briefing, April 7, 2016
Patients' And Consumers' Use Of Evidence
#patientevidence


The health policy literature is filled with references to providers, but patients are all too often left out of the conversation regarding how to best meet their needs. Growing attention to patient-centered care - with the attendant need for a better understanding of patient goals, better methods for engaging patients in their care, and better measures of outcomes that have meaning for patients - recognizes the moral and practical need to view patients as the center of the health care system. 
The April 2016 issue of Health Affairs, "Patients' And Consumers' Use Of Evidence," contains a comprehensive examination of the issues related to engaging patients more fully in decisions about health care delivery.  You are invited to join us on Thursday, April 7, 2016, at a forum at the W Hotel in Washington, where authors from the issue will discuss their work.  Panels will cover:
  • The Patient Engagement Imperative
  • How Do We Engage Patients?
  • Patient Narratives
  • Report Cards
  • Engaging on Price and Quality
Among the confirmed speakers are: 
  • Cindy Brach, Senior Health Policy Researcher at the Agency for Healthcare Research and Quality, on NARRATIVE MATTERS: Even In An Emergency, Doctors Must Make Informed Consent An Informed Choice
  • Kristin Carman, Vice President, American Institutes for Research, on Understanding An Informed Public's Views On The Role Of Evidence In Making Health Care Decisions
  • Daniel Dohan, Professor, Health Policy and Social Medicine, University of California San Francisco, on The Importance Of Integrating Narrative Into Health Care Decision Making
  • Mark Fendrick, Professor, Internal Medicine, University of Michigan, on Value-Based Insurance Design: Improving Adherence Through Shifting Benefit Designs
  • Steven Findlay, Independent Journalist and Consumer Advocate, and Contributing Editor, Consumer Reports, on ANALYSIS & COMMENTARY Consumer Interest In Provider Ratings Grows, And Improved Report Cards And Other Steps Could Accelerate Their Use
  • Mirjam Garvelink, Postdoctoral Researcher, Research Center of the Chu de Quebec-Université Laval, on AGING & HEALTH: A Synthesis Of Knowledge About Caregiver Decision-Making Finds Gaps In Support For Those Who Care For Aging Loved Ones
  • Jessica Greene, Associate Dean, Research, George Washington University, on Summarized Costs, Placement Of Quality Stars, And Other Online Displays Can Help Consumers Select High-Value Health Plans
  • Danielle Lavallee, Research Assistant Professor, Division of General Surgery, University of Washington, on Incorporating Patient-Reported Outcomes Into Health Care To Engage Patients And Enhance Care
  • Marcelo Coca Perraillon, Assistant Professor, University of Colorado Anschutz Medical Campus, on AGING & HEALTH: Use Of Nursing Home Compare Website Appears Limited By Lack Of Awareness And Initial Mistrust Of The Data
  • Benjamin Ranard, Graduate Student, Perelman School of Medicine, University of Pennsylvania, on Yelp Reviews Of Hospital Care Can Supplement And Inform Traditional Patient Experience Of Care Surveys
  • Joe Selby, Executive Director, PCORI
  • Anna Sinaiko, Research Scientist, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, on Examining A Health Care Price Transparency Tool: Who Uses It And How They Shop For Care
  • Mildred Solomon, President and Chief Executive Officer, The Hastings Center, on ANALYSIS & COMMENTARY The Ethical Imperative And Moral Challenges Of Engaging Patients And The Public With Evidence
  • Ming Tai-Seale, Senior Scientist, Palo Alto Medical Foundation Research Institute, on Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior
  • Peter Ubel, Associate Director, Health Sector Management and Madge and Dennis T. McLawhorn University Professor, Duke University, on Study Of Physician And Patient Communication Identifies Missed Opportunities To Help Reduce Patient Out-Of-Pocket Spending
  • John Westfall, Professor of Family Medicine and Director of the High Plains Research Network, University of Colorado, on Reinventing The Wheel Of Medical Evidence: How The Boot Camp Translation Process Is Making Gains
  • Holly Witteman, Assistant Professor to the Vice Dean of Education and Professional Development, Université Laval, on One-Sided Social Media Comments Influenced Opinions And Intentions About Home Birth: An Experimental Study
  • Steven Woolf, Director, Center on Society and Health, Virginia Commonwealth University, on VIEWPOINT: Authentic Engagement Of Patients And Communities Can Transform Research, Practice, And Policy
  • Charlene Wong, Pediatrician, University of Pennsylvania/Children's Hospital of Pennsylvania, on For Third Enrollment Period Marketplaces Expand Decision Support Tools To Assist Consumers
Health Affairs is grateful to PCORI for its support of the
content on patients' use of evidence
 and the event.
WHEN:
Thursday, April 7, 2016 
9:00 a.m. - 1:00 p.m. 

WHERE:
W Hotel Washington, 515 15th Street, NW
Washington, DC (Metro Center) 



Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and Health Policy Briefs published twice monthly at www.healthaffairs.org. You can also find the journal on Facebook and Twitter. Read daily perspectives on the Health Affairs Blog. Download weekly "Narrative Matters" podcasts on iTunes. If you do not wish to receive e-mail notifications or invitations in the future, please email dboylan@projecthope.org.


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Friday, April 1, 2016

Pranks for April Fools Day in the Hospital, or Office

Please  wait for slow video to load



These were very funny and I wanted to share it with the Health Train Express family.
Have a safe April Fool's Day

gml

Introduction: Storm's Coming

It is a bit late for the weather forecast for health reform.


In October 2013 the leading edge and eye of the hurricane was here.  After many forecasters warned of it's approach to health care, some chose to evacuate (retire early), join group practices (shelters) and some persisted in their old ways, unable or unwilling to adapt.  The tidal surge removed most of the laggards.



In health care the mantra "Move ahead or face extinction" has become reality Those who chose to change are still working as physicians.  Some medical practices faced insovency and ended in bankruptcy.

Nicholas Negroponte, co-founder of MIT's Media Lab quote:  "Computing is not about computers anymore, it is about living".

The storm eye is the affordable care act....a low pressure area with cyclonic winds drawing in each  component of the American health systemm. In the cyclone are violent thunderstorms and tornados..  These analogies are the large group and integrated health systems.  Unlike individual and small group entities they carry more weight and influence on the storm.  Each has it's own  niche in  the system.

The storm effects the entire country to it's core, economic, social and health.  The storm is about human survival, much like a hurricane bearing down on the community (metropolitan, or rural.). The most vulnerable are those living in the lowlands, near the ocean.  This  demographic is most vulnerable and require the most protection from storm surge and strong winds. They are  also   the least influential and require special protection as the storm advances.

These analogies are a powerful vision of what is and has taken place during the last four years.  The uninsured have been the center of this storm.  The effort to include them in our insurance system has effected the entire system.

The sheer  number, to include 40 million is an almost overwhelming increase in patients.  In practical terms resources are limited. The administrative burden (which includes planning and implementation of new organizations, financing...regulation, delivery of care and the change from fee for service to quality-based and value are considerable.