Health and Disability

In a study published Sept. 15 in JAMA-Neurology, Joshua Miller, professor of nutritional sciences at the Rutgers School of Environmental and Biological Sciences, found that people with low levels of vitamin D experienced rates of cognitive decline at a much faster pace than people with adequate vitamin D status. (Click here to see a JAMA Network video interview with Joshua Miller.)

“There were some people in the study who had low vitamin D who didn’t decline at all and some people with adequate vitamin D who declined quickly,” said Miller. “But on average, people with low vitamin D declined two to three times as fast as those with adequate vitamin D.”

Over the past decade, growing evidence has established the gut microbiota as one of the most important determinants of metabolic disorders such as obesity and type 2 diabetes. Indeed, obesogenic diet can drastically alter bacterial populations (i.e., dysbiosis) leading to activation of pro-inflammatory mechanisms and metabolic endotoxemia, therefore promoting insulin resistance and cardiometabolic disorders. To counteract these deleterious effects, probiotic strains have been developed with the aim of reshaping the microbiome to improve gut health. In this review, we focus on benefits of widely used probiotics describing their potential mechanisms of action, especially their ability to decrease metabolic endotoxemia by restoring the disrupted intestinal mucosal barrier. We also discuss the perspective of using new bacterial strains such as butyrate-producing bacteria and the mucolytic Akkermansia muciniphila, as well as the use of prebiotics to enhance the functionality of probiotics. Finally, this review introduces the notion of genetically engineered bacterial strains specifically developed to deliver anti-inflammatory molecules to the gut.

To guide these improvements, CDC has released a new resource: Core Elements of Antibiotic Stewardship for Nursing Homes. The Core Elements for Nursing Homes expand upon CDC's recommendation last year that all acute care hospitals implement an antibiotic stewardship program designed to optimize treatment of infections while reducing adverse events associated with antibiotic use.

Ultimately, nursing home antibiotic stewardship activities should, at a minimum, include the following:

1.  Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use.
2.  Accountability: Identify leaders who are responsible for promoting and overseeing antibiotic stewardship activities at the nursing home.
3.  Drug expertise: Establish access to experts with experience or training in improving antibiotic use.
4.  Action: Take at least one new action to improve the way antibiotics are used in the facility.
5.  Tracking: Measure how antibiotics are used and the complications (e.g., C. difficile infections) from antibiotics in the facility.
6.  Reporting: Share information with healthcare providers and staff about how antibiotics are used in the facility.
7.  Education: Provide resources to healthcare providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.

"We encourage nursing homes to work in a step-wise manner implementing one or two activities at first, then gradually adding new strategies from each core element over time," 

Bone mass increased by up to 7% in parts of the exercised hip's outer shell or cortex. The results also showed increases in the density of the layer of spongy bone under the cortex.

These effects were also seen in the thinnest areas of the hip bone - the parts that are most likely to suffer a fracture during a fall.

The findings could help to prevent and manage osteoporosis, a disease that is responsible for more than 8.9 million fractures worldwide every year, resulting in an osteoporotic fracture every 3 seconds, according to the International Osteoporosis Foundation.

Patients who were single or divorced, patients who were uninsured or were Medicaid beneficiaries, and patients who lived in areas with lower income had substantially elevated risks of dying prematurely. "We believe these three factors indicate lack of material and social support preventing young patients from successfully walking the long and difficult road towards a cure," said Uma Borate, MD, lead author of the study, and assistant professor in the UAB Division of Hematology and Oncology.

The researchers used magnetic resonance imaging to measure the size of hippocampi (there are two in the brain - left and right) in Australian adults aged 60-64 years and participating in the PATH study - a large longitudinal study of ageing conducted at the ANU. They also measured the participants' regular diets and took into account a range of other factors that could affect the hippocampus.

The results of the study, now published in the international journal BMC Medicine, suggest that older adults who eat more unhealthy foods, such as sweet drinks, salty snacks and processed meats, have smaller left hippocampi. It also shows that older adults who eat more nutrient-rich foods, such as vegetables, fruits and fish, have larger left hippocampi. These relationships existed over and above other factors that may explain these associations, such as gender, levels of physical activity, smoking, education or depression itself.

Priest also will be deputy director of Michigan’s Medical Services Administration, the department said in a news release. He replaces retired Medicaid Director Steve Fitton as of Oct. 12.

As Snyder’s deputy strategy director, Priest advised on issues such as health care and insurance. He was also director of the Bureau of Medicaid Policy and Health System Innovation in what was the Michigan Department of Community Health, before it merged with the Michigan Department of Human Services this year.

Priest was also the project manager for the state’s health insurance exchange and helped created the Healthy Michigan Plan, which expanded medical coverage to more low-income adults who otherwise don't qualify for Medicaid.