Health and Disability

The World Healthcare Organization specifies five moments for hand hygiene to reduce the risk of healthcare-associated infection:

1. before touching a patient;
2. before a clean procedure;
3. after exposure to body fluids;
4. after touching a patient; and
5. after touching a patient's surroundings.

"This work adds to the body of evidence pertaining to intraoperative bacterial transmission because it identifies targets for improved frequency and quality of environmental cleaning as well as important periods for hand hygiene compliance, namely induction and emergence from general anesthesia," state the authors.

One of the issues that we have with The Conversation Project is that the online materials suggest that a nursing facility is the only alternative to being “independent”.  (The notion seems to be to ask, “If you had to go to a nursing facility, wouldn’t you rather have an advance directive that declines life-sustaining treatment?”)

It’s very disturbing that they don’t seem to have heard about Olmstead and home and community based services.  Why don’t they ask, “If you could get long term services and supports (LTSS) to stay in your own home, would you choose to live with a disability?”  (You can read more about our issues with The Conversation Project in our recent blog about our comment letter to New York’s Dept. of Health.)

Admittedly, it’s a long haul.  ADAPT has been working the LTSS issue for 24 years.  Every state had some type of Olmstead activity by now, but no state gives everyone the choice to receive long term care services at home, so we have more work to do.  Here’s a press release about the next step, led by ADAPT and Senator Tom Harkin.

The study showed that there is an association between both quality and duration of sleep and brain function which changes with age.

In adults aged between 50 and 64 years of age, short sleep (<6hrs per night) and long sleep (>8hrs per night) were associated with lower brain function scores. By contrast, in older adults (65-89 years) lower brain function scores were only observed in long sleepers.

Dr Michelle A Miller says "6-8 hours of sleep per night is particularly important for optimum brain function, in younger adults". These results are consistent with our previous research, which showed that 6-8 hours of sleep per night was optimal for physical health, including lowest risk of developing obesity, hypertension,diabetes, heart disease and stroke".

.....the CNS of patients with fibromyalgia appears to both heighten the response to painful stimuli and perceive normally non-painful stimuli as painful. A major implication here is that fibromyalgia and possibly related states like chronic fatigue syndrome are drastically different in origin than other conditions common to rheumatology clinics like osteo- and rheumatoid arthritis, both of which result in discernible tissue damage.

Better still for fibromyalgia sufferers is that it’s now relatively treatable. Several neurotransmitter-modulating drugs and drug classes appear to be effective, including some pain medications and antidepressants. Among these, three treatments are now FDA-approved. Possibly more effective, according to the current evidence, are exercise, cognitive-behavioral therapy — a form of psychotherapy based in altering negative thoughts and behaviors — and simply patient education. Clauw stresses that while medications can help alleviate symptoms, patients rarely see significant symptom improvement without also adopting self-management approaches like stress reduction, quality sleep and exercise.

Activity in the amygdala, a brain region associated with emotional processing, was lower in the tinnitus and hearing-loss patients than in people with normal hearing. Tinnitus patients also showed more activity than normal-hearing people in two other brain regions associated with emotion, the parahippocampus and the insula. The findings surprised Husain.

"We thought that because people with tinnitus constantly hear a bothersome, unpleasant stimulus, they would have an even higher amount of activity in the amygdala when hearing these sounds, but it was lesser," she said. "Because they've had to adjust to the sound, some plasticity in the brain has occurred. They have had to reduce this amygdala activity and reroute it to other parts of the brain because the amygdala cannot be active all the time due to this annoying sound."

"It's a communication issue and a quality-of-life issue," she said. "We want to know how we can get better in the clinical realm. Audiologists and clinicians are aware that tinnitus affects emotional aspects, too, and we want to make them aware that these effects are occurring so they can better help their patients."

Among the key recommendations for consumers is to contact their utility company prior to any disaster to ensure they are properly identified as power-dependent customers, and to have an HPEN emergency kit as well as a basic emergency kit. They also advocate for consumers to have an emergency contact list that includes names and contact information for designated family and friends, physicians, and pharmacy and homecare providers.

The researchers recommend that the homecare providers' EPPs be focused on ensuring safety of consumers and employees, minimizing any interruption of services, and preparing contingency plans or designating back-up providers.

The researchers also recommend that providers develop an EPP manual for their HPEN consumers and that they provide their consumers with supplies to have on hand in case they require an alternate method or type of feeding.

If you or a loved one has received unsatisfactory care from a hospice, here are a few steps that experts recommend you take:

●Make sure you know what a hospice ought to provide. The American Hospice Foundation, a consumer advocacy group, offers information here:americanhospice.org/learning-about-hospice

Here is how Medicare defines the hospice services it pays for:www.medicare.gov/publications/Pubs/pdf/02154.pdf........

Older people with HIV are more likely to experience mental health and neurocognitive impairments than other people of the same age, as well as more social isolation. A study in the United States found that 94 per cent of people with HIV who were over 50 have at least one other chronic illness, with an average of three conditions.

Pension plans and health care facilities are not designed for, or expecting, people to have these issues at younger ages, Dr. Rourke said. Geriatric physicians are not trained for working with HIV, and those trained for HIV are not trained in geriatrics.

As a large number of people with HIV approach retirement age, policy makers need to develop new policies or adapt the existing ones to improve their social and economic outlook. He said people aging with HIV who are still working may need more time off to take care of themselves or rest breaks during their shifts; reforming retirement benefit programs could allow people with HIV to remain in the workforce as long as possible; retirement homes and long-term facilities need to be more welcoming places for older people living with HIV.

Excessive exposure to television viewing has long been associated with negative health consequences along with an impact on early brain development. Adding evidence is the new study led by researchers at the University of Navarra, Spain, which links watching TV for more than three hours to a two-fold increased risk of premature death from any cause.