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The miscalculated fear of an opioid crisis in Haiti
Opioids are an essential class of drugs used in pain management. In recent years, complex mechanisms pertaining to their abusive use have prompted a deadly crisis which is unfolding in the United States. The U.S. Centers for Disease Control and Prevention stated that 91 Americans lose their lives daily due to an overdose of opioid drugs. This public health crisis has inspired much apprehension even among Haitian diaspora in the United States. Although needed painkillers are notably lacking in developing countries, the fear of a similar path has led a high-profile personality to advise against their use in Haiti. Indeed, he...
Source: Kevin, M.D. - Medical Weblog - February 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kenny-moise" rel="tag" > Kenny Moise, MD < /a > Tags: Policy Pain Management Primary Care Source Type: blogs

Fermented foods to beat back SIBO and dysbiosis
If you’ve been following the Wheat Belly discussions, you already know that efforts to cultivate healthy bowel flora in the wake of wheat/grain elimination is a key factor in regaining health. While I’ve emphasized the importance of a high-potency (e.g., 50 billion or more CFUs per day), multi-species probiotic supplement and prebiotic fibers, I’ve not focused on the importance of fermented foods. This issue comes to light in particular with our experience in battling small intestinal bacterial overgrowth, or SIBO. Dysbiosis, or disrupted composition of bowel flora in the colon, is exceptionally common, e...
Source: Wheat Belly Blog - February 19, 2018 Category: Cardiology Authors: Dr. Davis Tags: Undoctored Wheat Belly Lifestyle bowel flora fermented foods grain-free Inflammation kefir kimchi kombucha probiotic sibo small intestinal bacterial overgrowth yogurt Source Type: blogs

Managing Chaos: Lessons Learned From the Emergency Department
By: Teresa Chan, MD, FRCPC, MHPE T. Chan is assistant professor, Division of Emergency Medicine, Department of Medicine, Michael G. DeGroote School of Medicine & Faculty of Health Sciences, and program director, Clinician Educator Area of Focused Competence Program, McMaster University, Hamilton, Ontario, Canada. “We need a doctor in Resusc 1 STAT!” “I’m worried that my child has an ear infection.” “Dr. Chan, can you take a look at this ECG for Bed 8?” “Doc, do you think I have cancer?” In a single shift, I may hear all of these … and more. As an academic emergency physician (EP), I might see two do...
Source: Academic Medicine Blog - February 13, 2018 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective emergency department multi-patient environments organizing information patients Source Type: blogs

Up and Down, Again
Everyone has ups and downs in their life, especially with their health. Or maybe I have more ups and downs than the average person.  Okay, maybe my health has been on a downward slide for awhile few years now.However, I realized the other day that I was actually feeling pretty well for the first time in quite a while. I mean my back has been sore but the rest of me has actually been doing okay. Its kind of nice actually. And it makes me think how long its been since I felt that well.I had been feeling as if I was over-medicated in some ways for the past few years. I changed my pain management doctor and had reduced so...
Source: Caroline's Breast Cancer Blog - February 9, 2018 Category: Cancer & Oncology Tags: being healthy healthiness tired unhealthiness Source Type: blogs

Proposed Medicare Changes to Limit Opioid Prescribing
by Chad KollasOn February 1, 2018, the Centers for Medicare& Medicaid Services (CMS)published its Advance Notice of Methodological Changes for Calendar Year 2019. Included in these proposed rules were several directives intended to reduce" Opioid Overutilization ” (see p. 202), including formal adoption of the “90 morphine milligram equivalent (MME) threshold cited in the CDC Guideline, which was developed by experts as the level that prescribers should generally avoid reaching with their patients (p. 203). ” CMS proposed “adding additional flags for high-risk beneficiaries who use ‘potentiator’ drugs (such...
Source: Pallimed: A Hospice and Palliative Medicine Blog - February 4, 2018 Category: Palliative Care Tags: CMS health policy kollas medicare opioids Source Type: blogs

Exploring Team Composition in Palliative Care
By Brianna Morgan (@BriannaMorganNP) and Elise Tarbi (@EliseConant)Amidst rapid growth in the number of palliative care programs,the December 2017 issue of the Journal of Palliative Medicine calls for a pause to consider the blueprints for how we build moving forward. In the issue,Kousaie and von Gunten (2017) compare two hospitals, one that has an established advanced practice nurse only model of palliative care delivery (APN model), and a second hospital implementing an interdisciplinary team including physicians, APNs, social workers, chaplains, and pharmacists (team model) for the same purpose. Compared to the APN mode...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 27, 2018 Category: Palliative Care Tags: advance apn morgan nurse physician research tarbi team teamwork The profession Source Type: blogs

Tai Chi For Seniors: Exercises, Benefits, and Tips For The Elderly
View Original Article Here: Tai Chi For Seniors: Exercises, Benefits, and Tips For The Elderly Tai chi, a form of Chinese martial arts that focuses on slow, controlled movements. It’s low impact and gives people with limited mobility a chance to improve their balance, range of motion and coordination. Research shows that tai chi for seniors can reduce the incidence of falls in elderly and at-risk adults by about 43 percent. With fewer than 34 percent of aging adults getting enough exercise, it’s important for caregivers, older individuals and people who work with seniors to know about this gentle but effective activity...
Source: Shield My Senior - January 8, 2018 Category: Geriatrics Authors: Vin Tags: Senior Safety Source Type: blogs

Key Articles in Health IT from 2017 (Part 2 of 2)
The first part of this article set a general context for health IT in 2017 and started through the year with a review of interesting articles and studies. We’ll finish the review here. A thoughtful article suggests a positive approach toward health care quality. The author stresses the value of organic change, although using data for accountability has value too. An article extolling digital payments actually said more about the out-of-control complexity of the US reimbursement system. It may or not be coincidental that her article appeared one day after the CommonWell Health Alliance announced an API whose main purp...
Source: EMR and HIPAA - January 4, 2018 Category: Information Technology Authors: Andy Oram Tags: 3D Printing ACO Apple Connected Health Digital Health Gadgets Genomics Google Healthcare AI Healthcare Analytics Healthcare API Healthcare Devices Healthcare IT Security Healthcare Reimbursement HIE Meaningful Use Medical D Source Type: blogs

The 1000th Thread!
This is the 1000th presentation to my bioethics blog since starting on Google Blogspot.com in 2004.There has been many topics covered. Though comments by the visitors has always been encouraged and, since as a " discussion blog " , comments leading to discussions I have felt was the definitive function here. Virtually none of the thread topics have gone unread and most have had some commentary, some with mainly particularly strong and emphatic opinions http://bioethicsdiscussion.blogspot.com/2013/01/should-pathologists-be-physicians.html, some with extensive up to 12 years long continued discussion http://bioethicsdiscussi...
Source: Bioethics Discussion Blog - December 24, 2017 Category: Medical Ethics Source Type: blogs

PhRMA Releases New Policy Proposals
On December 11, 2017, the Pharmaceutical Research and Manufacturers of America (PhRMA) issued statements of support for several policy proposals focused on resolving the opioid crisis. The proposals included: limits on prescribing, a ban on prescribing of Schedule II opioids in an office setting, ongoing prescriber training, and expanded access to addiction treatment options. Along with the policy proposals came an announcement that PhRMA and the Addiction Policy Forum have entered into a multi-year, multi-million dollar initiative to combat the opioid crisis and implement the Forum's plan to help solve the opioid crisis....
Source: Policy and Medicine - December 21, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs