Health and Disability

Dr. David Yen-Ting Chen, of Taipei Medical University in New Taipei City, Taiwan, and colleagues suggest the findings point to a need to treat older patients differently from younger patients following concussion or mildtraumatic brain injury (MTBI).

MTBI is a significant public health problem. It represents around 75% of all traumatic brain injury cases, which, according to the Centers for Disease Control and Prevention (CDC), accounted for approximately 2.5 million emergency department visits, hospitalizations and deaths in the US in 2010.

A Canadian research team led by Dr. Mark Ware from the Research Institute of the McGill University Health Centre (RI-MUHC) in Montréal has completed a national multicentre study looking at the safety of medical cannabis use among patients suffering from chronic pain. They found that patients with chronic pain who used cannabis daily for one year, when carefully monitored, did not have an increase in serious adverse events compared to pain patients who did not use cannabis. The results, which have been published online in The Journal of Pain, will serve as a benchmark study on the side effects of cannabis when used in pain management.

"This is the first and largest study of the long term safety of medical cannabis use by patients suffering from chronic pain ever conducted," says lead author, Dr. Ware, pain specialist at the Montreal General Hospital of the MUHC and associate professor in Family Medicine and Anesthesia at McGill University. "We found that medical cannabis, when used by patients who are experienced users, and as part of a monitored treatment program for chronic pain over one year, appears to have a reasonable safety profile."

The sweeping new analysis shows that the most experienced skilled nursing facilities were more than twice as likely as the least experienced to successfully discharge patients back to the community within 30 days of breaking a hip. The results, led by Brown University researchers, appear in the Journal of the American Geriatrics Society.

"While volume is not a direct measure of post-acute care quality, it appears that it is a good proxy that captures hard-to-measure aspects of quality, like the expertise of the staff, that are clearly associated with an outcome that patients care about: returning home soon and in a condition that allows them to remain at home without further institutionalization in a hospital or a nursing home," said lead author Pedro Gozalo, associate professor (research) of health services, policy and practice in the Brown University School of Public Health.

There is a divide between the people building technology tools for patients and the patients that may use them. Too often tools are built in the same way one might build a social media app or a news web site.

However, a great many users have a greater need for accessibility from these tools.

University of Washington researchers conducted a review of consumer-facing digital health tools on the market in 2014 and found that none of them were accessible.

Because people who are blind or have low vision are more likely to have health problems such as obesity or diabetes, it’s especially important that mobile health (mHealth) applications — health tracking sensors that connect with smartphone apps — work for those users.

In a new study, scientists from the Florida campus of The Scripps Research Institute (TSRI) describe a class of compounds with the potential to stop chronic itch without the adverse side effects normally associated with medicating the condition.

"Our lab has been working on compounds that preserve the good properties of opioids and eliminate many of the side effects," said TSRI Professor Laura Bohn. "The new paper describes how we have refined an aspect of signaling underlying how the drugs work at the receptor so they still suppress itch and do not induce sedation. Developing compounds that activate the receptors in this way may serve as a means to improve their therapeutic potential."

Does the drug industry have anything to worry about? Won’t any effort to control drug prices get bogged down in a divided and seemingly ever more dysfunctional Congress? Perhaps, but what is probably worrying industry most is rumors that HHS is looking at ways to use its existing regulatory authority to hold down drug prices. If the administration is seriously looking to use its existing authority, it could start by making sure any new trade agreements don’t undermine efforts in the US and internationally to hold down costs. On top of that, there are some ideas in the CAP proposal that could be implemented without legislation. Will the outrage over rising prices turn into serious remedies? It’s too soon to tell, but certainly this is a good time to be pushing.

More on Mergers: When No Is Not Enough

Insurance industry executives have been up on the Hill facing scrutiny over proposed mergers among some of the largest insurance companies in the nation. Unfortunately, the debate over the mergers is missing some essential elements. Would the mergers cause premiums to rise? Both economic theory and the available evidence suggest that the answer is yes. But if the mergers of insurers are blocked, while provider consolidations continue on, then premiums will also go up.

Federal

CARE for All Veterans Act (H.R. 2894) This bill expands eligibility for the family caregiver program of the Department of Veterans Affairs to include members of the Armed Forces or veterans who are seriously injured or who became ill (or aggravated such injury or illness) on active duty before September 11, 2001, (currently, limited to service after September 11, 2001).

Seniors Have Eyes, Ears, and Teeth Act (H.R. 3308) This bill expands Medicare coverage to include eyeglasses, hearing aids, and dental care.

This spring, four years after the nuclear accident at Fukushima, a small group of scientists met in Tokyo to evaluate the deadly aftermath.

No one has been killed or sickened by the radiation — a point confirmed last month by the International Atomic Energy Agency. Even among Fukushima workers, the number of additional cancer cases in coming years is expected to be so low as to be undetectable, a blip impossible to discern against the statistical background noise.

But about 1,600 people died from the stress of the evacuation — one that some scientists believe was not justified by the relatively moderate radiation levels at the Japanese nuclear plant.

Epidemiologists speak of “stochastic deaths,” those they predict will happen in the future because of radiation or some other risk. With no names attached to the numbers, they remain an abstraction.

But these other deaths were immediate and unequivocally real.

“The government basically panicked,” said Dr. Mohan Doss, a medical physicist who spoke at the Tokyo meeting, when I called him at his office at Fox Chase Cancer Center in Philadelphia. “When you evacuate a hospital intensive care unit, you cannot take patients to a high school and expect them to survive.”

Among other victims were residents of nursing homes. And there were the suicides. “It was the fear of radiation that ended up killing people,” he said.