The Uber(ization) of In-Home Health Care

Caremap is a newly launched app for in-home care that, like Uber, connects users directly with service providers. And the lack of a middleman is one of the model’s most important distinctions, says founder and CEO Nectarios Charitakas.

“The whole time I was helping my parents, every time I told them, ‘Let’s get you care. It’s going to cost $30 or $35 an hour,’ they went ballistic. So I realized something had to be done. We had to bring a better price equilibrium. We had to help make it easier for families to find care,” says the enterprise IT veteran.

Unlike a traditional agency model, caregivers post their rate and users pay them directly via the app. Charitakas doesn’t take a cut. There is no administration fee. He’ll make money from users who choose to subscribe to the premium version of the app — the inspiration for its added features came from his own experience.

“So one of the problems I had was every time a caregiver took my mom or dad to an appointment, I never knew when the next follow-up was. So if your [Caremap] caregiver takes mom to a doctor’s appointment, they can’t close their shift until they go into the calendar to put in a follow-up.”

On both the free and premium versions, users can search a Market Place and connect with care providers — from non-accredited companion keepers to registered nurses — in their area. Appointments are scheduled via the app, and users can rate their caregiver(s). If you need care, you can also upload job postings with requirements – even language preference.

If the person in need of care isn’t tech-savvy, they can grant access to their profile and its administration. Charitakas believes being able to coordinate care remotely for a loved one can help ease the strain on family members.

Another pain point he decided to tackle was lack of information.

“My experience is that everything was a black hole. You had no idea if your caregiver was Mary Jane. You had no idea if she showed up, what time she showed up, what did she do and how is Mom. I found that very frustrating.”

Not only do caregivers have to “punch in” upon arriving and “out” at the end of his or her shift, the app uses geolocation to notify the user — and anyone to whom they’ve granted access — as to their impending arrival.

Disrupted immune system? Avoid getting a tattoo

The new issue of the journal BMJ Case Reports features the case study of a woman who sought medical assistance due to severe and persistent pain in her left hip, knee, and thigh after having gotten her left thigh tattooed some months earlier.

In 2009, she had a double lung transplant that needed long-term immunosuppressant therapy, to avoid a transplant rejection response.

This, of course, meant that her entire immune system was disrupted, and it would not react to foreign agents inside the body in the same way that it normally would.

9 days after getting this tattoo, she started having severe pain in her left knee and thigh, the management of which required strong painkillers.

In time, the symptoms became less severe. But after 10 months, they had not wholly disappeared.

"Her pain was still troublesome, constant in nature, and causing regular sleep disturbance," write the authors of the case analysis.

New Epilepsy Guidelines Shed Light on Explosion of New Drugs

For new-onset epilepsy, there's not yet strong enough evidence for the American Academy of Neurology (AAN) and the American Epilepsy Society (AES) to recommend third-generation antiepileptic drugs (AEDs) in their new treatment guidelines.

But for treatment-resistant epilepsy, several recently approved AEDs may be winners.

"The update was prompted by the explosion of new antiepileptic drugs that have been approved since the time of the first guideline and the overwhelming amount of information available on each one," Jacqueline French, MD, of the New York University Comprehensive Epilepsy Center, told MedPage Today.

Issued jointly by the two organizations and published online in Neurology, the updated guidance for new-onset and treatment-resistant epilepsy replace ones in effect since 2004. The FDA has approved six third-generation AEDs that were included in this review since that time -- eslicarbazepine (Aptiom), ezogabine (Potiga, which has been discontinued), lacosamide (Vimpat), perampanel (Fycompa), pregabalin (Lyrica), and rufinamide (Banzel) -- and two older AEDs for certain types of epileptic disorders, clobazam (Onfi) and vigabatrin (Sabril).

Mr. Connolly Has ALS

Gene Connolly, principal of Concord High School in New Hampshire, was known for his non-stop energy, a love for rock & roll, and the innate ability to connect with the school’s 1,600 students. However, in 2014, he was diagnosed with Amyotrophic Lateral Sclerosis (ALS), also knows as Lou Gehrig’s Disease. Since the onset of his illness, Connolly showed tremendous persistence, humor, and leadership, crediting the school and community as a source of unfailing support and understanding.

Mr. Connolly Has ALS chronicles Connolly’s final year as principal of the school, when his physical abilities - to speak and walk - are significantly limited by the debilitating disease. The outpouring of love and support from the students, evident as they interview him one-on-one with both personal and tough questions, is remarkable and inspiring.

Scientists Finally Think They Know What Causes Polycystic Ovary Syndrome – And How To Cure It 

Polycystic ovary syndrome (PCOS) is a condition that affects roughly one in five women – and now, scientists think they know why. (Just in time for National Women's Health Week.)

A study published in Nature Medicine found a link between hormonal imbalance in the womb and PCOS, specifically prenatal exposure to a growth factor called anti-Müllerian hormone (AMH). 

The team, led by Paolo Giacobini at the French National Institute of Health and Medical Research, realized levels of AMH were 30 percent higher in pregnant women with PCOS than those without. Because there is a hereditary component to the condition, they decided to test whether or not women with this hormonal imbalance give birth to daughters with PCOS. 

“It’s a radical new way of thinking about polycystic ovary syndrome and opens up a whole range of opportunities for further investigation,” explained Robert Norman from the University of Adelaide, Australia, reports New Scientist.

For the study, the researchers injected pregnant mice with AMH so that they had a higher than normal concentration of the hormone. Indeed, they gave birth to daughters who later developed PCOS-like tendencies. These included problems with fertility, delayed puberty, and erratic ovulation.

According to the researchers, the added AMH appeared to prompt the overstimulation of a particular set of brain cells called GnRH neurons, which are responsible for managing the body's testosterone levels. Hence, the offspring displayed higher levels of testosterone. The result: a "masculinization of the exposed female fetus" and a "PCOS-like reproductive and neuroendocrine phenotype" by the time they reached maturity.

But, excitingly, the team weren't just able to determine the cause of PCOS, they were able to reverse it (in mice, anyway). To do so, the researchers dosed the polycystic mice with an IVF drug called cetrorelix, which made the symptoms to go away.

This could be great news for the millions of women with the condition, often characterized by excessive hair growth, hair loss, acne, and obesity, though symptoms can vary from patient to patient. It is also the most common cause of infertility.

Next up, the team is planning to trial the drug in humans. Tests are planned to take place later in the year.

Food Allergy Most Common Allergic Condition in Autism

Early food allergy and other allergic conditions showed a positive association with autism spectrum disorder (ASD) in a large, nationally representative sample of U.S. children, and the association persisted after researchers adjusted for demographic and socioeconomic variables and other types of allergic conditions.

Food allergies were the most common allergic condition found in children with autism, and the association was consistent and significant in all age, sex, and racial/ethnic subgroups in the population-based, cross-sectional analysis of data from the National Health Interview Survey collected between 1997 and 2016.

In an invited commentary published with the study, Christopher J. McDougle, MD, of Massachusetts General Hospital and Harvard Medical School in Boston, explored the researchers' hypothesis that the association may be related to gut-brain-behavior axis abnormalities thought to exist in some children with ASD: "Such an association has been reported in both patients with ASD and animal models of ASD, particularly those with the maternal immune activation model of ASD.

"From a clinical perspective, patients with ASD who are minimally verbal to nonverbal may be unable to describe the pain and discomfort they experience secondary to food allergy and subsequent inflammation in the gastrointestinal tract. Instead, their physical distress may manifest as irritability, aggression, and/or self injury."

The prevalence of ASD among children in the U.S. has increased steadily in recent decades, according to findings from nationally representative surveys, Bao and colleagues noted, explaining that immunologic dysfunction is a potential link between environmental risk factors and ASD.

Symptoms of immune function abnormalities, such as frequent infections and increased prevalence of autoimmune conditions have been frequently reported among children with ASD and maternal infection, inflammatory cytokines, and autoimmune diseases during pregnancy were also associated with ASD in children in some studies.

Kent County Council's Shared Lives scheme supports unpaid carers in the county

This is England's Kent County, not Michigan's. A sort of Airbnb.....

We all need a break sometimes.

And that is especially important for those who are unpaid carers to enable them to continue looking after and supporting a friend or family member.

Kent Shared Lives, run by Kent County Council, can provide an alternative personalised break for eligible people with a range of different needs.

It is designed to be a real home from home service where approved hosts can take care of people with learning disabilities or difficulties, older people, those with dementia, mental health problems, sensory impairment, Autism or Asperger's.

Someone sharing a home with an approved host is given a safe and supportive environment where they can bring their own things and be supported in their hobbies, activities or interests.

From the homes of KCC approved hosts the Kent Shared Lives scheme can offer:

Short Breaks: Where a loved one would stay with a host for a couple of days or weeks at a time or longer if required.

Day Support: Which is based at the host’s home and can be on any given day of the week or time of the day and one session is up to five hours.

Long Term Care: Offered by Shared Lives and often an option for the future when someone's carer is unable to provide support. In these cases individuals would move in with a host and live as part of the family.

Kent County Council has a wide range of Shared Lives hosts around the county ranging from single people to couples and families who have availability to welcome someone into their lives.

Shared Lives is regulated by the Care Quality Commission and staff will always make sure everyone is happy with the chosen arrangement before it begins and regular checks are made to ensure everything is working well.

A referral from a care/case manager or social worker will be required to be considered for the scheme. To find out more please contact the team through facebook @kentsharedlives

via the website

A Typical Communication Pattern of People with Alzheimer’s

Dementia, in any form, is a heartbreaking disease that can take away one’s thinking and judgement abilities before they pass. To save face, people with dementia often pretend to know answers to questions, even if they really don’t. This often hides the severity of the disease and exasperates the fears and frustrations of the people who care for them. 

The act of pretending to know answers to keep up appearances is referred to as “saving appearance responses” (SARs), and a research group from Kumamoto University in Japan has performed the first statistical analysis of SARs in patients with various forms of dementia. Their findings revealed that those face-saving responses are particularly common in people with Alzheimer’s disease (AD), leading the researchers to recommend that doctors and caregivers should develop a more respectful attitude toward dementia patients who exhibit SARs because SARs imply conflicted feelings about questions that patients cannot answer correctly.

“SARs are a patient’s effort to show that they have no cognitive problems, but it seems that there are various psychological conflicts involved,” said Kumamoto University’s Dr. Masateru Matsushita of the Center for Medical Education and Research, leader of the study. “The reason more SARs are seen in AD may be because even though the memory function of the brain is in decline, thinking and judgment abilities are barely compromised. Attention to SARs might be helpful for more accurate dementia diagnosis. We expect that a better understanding of the characteristics of SARs, particularly in AD, will lead to earlier detection and better medical care for people suffering from dementia.”

Declines in Hospital-Acquired Conditions Save 8,000 Lives and $2.9 Billion in Costs

Data released today by the Agency for Healthcare Research and Quality (AHRQ) show continued progress in improving patient safety, a signal that initiatives led by the Centers for Medicare & Medicaid Services (CMS) are helping to make care safer. National efforts to reduce hospital-acquired conditions, such as adverse drug events and injuries from falls, helped prevent an estimated 8,000 deaths and save $2.9 billion between 2014 and 2016, according to the report.

The AHRQ National Scorecard on Hospital-Acquired Conditionsestimates that 350,000 hospital-acquired conditions were avoided and the rate was reduced by 8 percent from 2014 to 2016. Federal experts note that the gains in safety among hospital patients echoed earlier successes, including 2.1 million hospital-acquired conditions avoided between 2010 and 2014.

CMS has set a goal of reducing hospital-acquired conditions by 20 percent from 2014 through 2019. Through the work of the Hospital Improvement Innovation Networks (HIINs), CMS drives this aim through intensive, focused quality improvement assistance to more than 4,000 of the nation’s 5,000 hospitals by spreading best practices in harm reduction. The HIINs, together with federal agencies, private partners, and patient advocacy organizations, work collaboratively to make hospital care safer. Once the 20 percent reduction goal is met, AHRQ projects that during 2015 through 2019 there would be 1.8 million fewer patients with hospital-acquired conditions, resulting in 53,000 fewer deaths and saving $19.1 billion in hospital costs from 2015 through 2019.

Examples of hospital-acquired conditions include adverse drug events, catheter-associated urinary tract infections, central-line associated bloodstream infections, pressure injuries, and surgical site infections, among others.

Woman Cured of Advanced Breast Cancer With New Treatment

A woman’s advanced stage breast cancer that metastasized throughout her body was completely eradicated with her own immune cells, marking the first time immunotherapy has successfully treated late-stage breast cancer. 

According to The Guardian, Florida engineer Judy Perkins, 49, was selected to undergo the radical therapy after rounds of chemo failed to cure her breast cancer. She’d been given just three years to live. The immunotherapy used Perkins’ “own immune cells to find and destroy cancer cells that have formed in the body,” and doctors at the U.S. National Cancer Institute say she’s now been cancer-free for two years. 

“It feels miraculous, and I am beyond amazed that I have now been free of cancer for two years,” Perkins said. Doctors call her recovery a sign that science is at the “cusp of a major revolution” in figuring out how to treat cancer through all of its mutations. They caution that the treatment must still go through clinical trials and may not work for all cases.