Michigan Disability Resistance

Sappy and superficial, but interesting nonetheless...

http://bit.ly/2ygBWmS

I thereby became very excited when I read about a new trend for seniors- something called “Senior Cohousing” – where you live in an “intentional neighborhood” – surrounded by your friends – and you share in things like the same dining area, library, fitness center, garden, TV room etc.

“Senior Cohousing” is trending right now.

It’s a great concept for older people like myself, who are part of what I call the “Wellderly.”

“Wellderly” means that we’re older, but don’t feel old or act our age!

My goal is to stay “Wellderly” for as long as possible – so I can enjoy the benefits of many things in life – including this concept of Cohousing with fellow wellderly friends.

Cohousing sounds like a blast – plus – it’s reported to improve longevity – according to the Canadian Cohousing Network.

Seniors who cohouse are said to live at least ten years longer than they might otherwise live in traditional senior housing.

It is estimated that by 2050, the number of people over 60 years old will triple from what it is now.  I will be one of those people in that huge group – who’s looking for the most comfortable and enjoyable way to spend their senior years!

I love the idea of living in cohousing surrounded by friends – where I only need to walk a few feet to meet up with a someone for coffee or enjoy a walk in a shared garden.

Who’s with me?

Maintenance always gets cut first when money is tight...

http://bit.ly/2MtSo6x

Nebraska is both a largely rural and geographically long state.

Omaha, one of its largest cities, could be as much as a seven-hour drive from towns on its westernmost border. That made it hard for health officials on the far side of the state to make it out for periodic state chapter meetings of Association for Professionals in Infection Control and Epidemiology (APIC) hosted in that city on the east side of the state.

And that was what struck Margaret Drake, a healthcare-associated infection preventionist for the Nebraska Department of Health and Human Services.

Performing on-site inspections of 36 health facilities in rural areas of Nebraska, she and a group of researchers found that those facilities known as Critical Access Hospitals faced special challenges when it came to infection control practices. She is the lead author of an abstract presented Wednesday on the topic at the annual national APIC meeting.

"They are rural, they are isolated and they don't have all the resources more urban hospitals have," Drake said. "And because they are small, they often think: 'We don't do as many Foley catheters or central line catheters so we don't have to focus as much on that or audit that.'" 

In fact, research shows lower volume hospitals would likely need more training than hospitals that have larger volumes and more practice performing those procedures. The study found that the largest gaps were in the areas of injection safety, central line-associated bloodstream infection prevention and catheter-associated urinary tract infection prevention. 

Examinations of the hospitals found that many of the employees put in charge of overseeing infection control may not have received certain types of training, for example, in understanding how to identify the biggest infection risks in a hospital by conducting a risk assessment. They might be splitting their time between infection control, quality control and serving as a full-time, functioning bedside nurse due to resource challenges.

"We need people to get behind the fact that you need to devote the time to infection control, you need to have an infection control preventionist focused on this," Drake said.

The study, which was funded by the CDC, was entirely voluntary and meant to raise awareness and offer recommendations rather than castigate anyone, Drake said: "The hospitals were very open to this."

http://bit.ly/2ygffPX

In September 2016, the federal Centers for Medicare & Medicaid Services (CMS) issued revised nursing home regulations that had been thoughtfully developed over four years to promote residents’ health and safety. Now, however, under the current administration, CMS is backtracking and weakening resident protections.

Starting in January 2017, nursing home lobbyists began urging CMS to eliminate or delay enforcement of some of the revised regulations, and to significantly reduce penalties imposed when a nursing home violates the law. Disturbingly, CMS too often has followed the lobbyists’ recommendations.

Protections have been weakened since January 2017, and, the current administration’s actions suggest an intent to further undermine these protections. This is bad news for nursing home residents, for their family and friends, and for anyone who cares about the well-being of older Americans.

Here are some troubling steps that CMS already has taken. Residents benefit from early care planning and antibiotic standards, but CMS created an 18-month moratorium on money penalties for violations of these requirements. Arbitration agreements are harmful to residents, but CMS proposes to reverse a ban on arbitration agreements and instead authorize nursing homes to require them. A new regulation requires nursing homes to notify a local ombudsman whenever they move to evict a resident, but now CMS has requested comments on how they might eliminate that requirement.

Read the issue briefs below for more detailed information:

Duh...

http://bit.ly/2JKF0Jq

First time administration of antipsychotic medications to children and teenagers diagnosed with disruptive behavior disorders was associated with increased body fat and decreased insulin sensitivity, a randomized clinical trial showed.

Three commonly used antipsychotic medicines -- aripiprazole, olanzapine, and risperidone -- were tested and demonstrated an increase in the combined rate of overweight and obesity amongst participants from 30% at baseline to 46.5% after 12 weeks of treatment, according to Ginger E. Nicol, MD, of Washington University, St. Louis, Missouri, and colleagues.

Anti-psychotic medications are associated with weight gain and its sequelae. Childhood onset of obesity and insulin resistance carries a greater risk for type 2 diabetes and cardiovascular disease than onset in adults.

This first-of-its-kind study is important given the fact that off-label prescription of antipsychotic medication is commonly used to treat disruptive behavior disorders in non-psychotic children and teenagers, with the greatest use in publicly insured young people, the authors noted.

This is a great insightful overview of the misguided incentives in drug development. Post research and approval, there are also ethical problems in the way the expansion of drug use through marketing impacts people with multiple and chronic health conditions and disabilities. These problems extend to all evidence-based treatment approaches and can't be "fixed" by lawsuits or new rules....

http://bit.ly/2HIm6Rl

There are numerous ethical concerns regarding the licensing and prescription of pharmaceuticals. I was aware of many of them before I began my career in research. However, some things can only be truly learned through experience.

The crux of trials 101:- It is neither cost-effective nor practically feasible to conduct life long studies of drug usage in chronic conditions. For obvious reasons, it would be very difficult to find a stable cohort of patients who would wish to participate in research indefinitely, especially alongside dealing with a difficult medical complaint.

Trial methodology is designed to test a hypothesis, aligning patient eligibility criteria, protocol procedures and primary/secondary data endpoints, to best demonstrate desirable, marketable treatment outcomes. All while hopefully keeping side effect collateral to a minimum.

The emphasis falls therefore, on short-term tolerance i.e. pharmacodynamics and pharmacokinetics. Simplified, this is how the drug reacts in the body and how the body reacts to a drug, respectively. In pragmatic terms, this involves assessing a given bunch of data points such as, absorption, distribution, metabolism and excretion. Under these umbrellas, there are a number of vital specifics, such as dose ranging and half-life i.e. time taken for the drug to metabolically reach 50% of the original dosage concentration. Then of course there’s efficacy and side effects, or adverse events.

This is not an exhaustive list, but a means to address the point that such check boxes, fit neatly within a given study phase and specific assessment parameters.

Clinical trials rarely and can’t really, last long enough to reflect prolonged pharmaceutical usage outcomes. Since medicine and science is ever-evolving, there is always a new competitor star product emerging to take the spotlight, and steal away big pharma priority where funding and resource allocation is concerned.

My first job in academic research consisted of a blur of over worked under paid research fellows, all scrabbling over each other to get noticed by some Professor or other. They were ruthless in their work ethic, hungry for names on publications and very reluctant to offer each other even the smallest amount of help. I witnessed firsthand, medics who would fake favourable study outcomes to guarantee their sought after recognition and subsequent PhD. The worrying thing is, when such a study reached the pages of a well known medical journal, it actually influenced international treatment recommendations. After all, research facilities in hospitals are central to the development of evidence-based medicine.

I can’t say categorically if said tampered outcomes would’ve proved harmful to anyone, but it was certainly a deviation from the patient’s standard methods of treatment, and was supposedly a preventative recommendation. How can one later prove whether therapeutic intervention to stop something from happening, was the only influence in an unchanged medical baseline?