Data Mining Method Helps Hospitals Better Identify Needs Of Their Sickest Pediatric Patients And Could Reduce Health Care Costs

Main Category: Pediatrics / Children's Health
Also Included In: Cystic Fibrosis;??Diabetes;??Blood / Hematology
Article Date: 17 Nov 2010 - 4:00 PST window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend ? printer friendly ? opinions ?

Children with chronic health conditions such as cystic fibrosis, type 1 diabetes, sickle cell diseases and cerebral palsy represent less than two percent of the population but can consume more than 50 percent of resources at children's hospitals throughout the country. Coordinating care for these children has historically been difficult because hospitals have varying methods to identify them in their systems. In a new study led by John Neff, MD, of Seattle Children's Research Institute, researchers developed a unique method to identify children with serious lifelong chronic conditions using hospital discharge data that will enable children's hospitals to improve the quality of care for these patients and reduce costs. The study, "Identifying Children with Lifelong Chronic Conditions for Care Coordination Using Hospital Discharge Data," published online November 15 in Academic Pediatrics.

"In the long run, if we can identify these children, their cost patterns and needs, hospitals can then work with the state and health plans to provide support for the care coordination that they need. This should result in better quality of care and hopefully lower costs for these children," said Dr. Neff, clinical director at The Center for Children with Special Needs at Seattle Children's Hospital.

"One of the big barriers in the past is that hospitals have not known who their patient population is and have not been able to systematically identify them," added Neff. "Categorizing children with complex or multiple chronic conditions is particularly difficult because of the general infrequency and variable nature of their conditions. Because hospitals haven't had a reliable method to identify these patients, they haven't been able to effectively coordinate their care or know the cost implications to their own hospital."

Findings suggest that children with lifelong chronic conditions require a disproportionate share of resources in children's hospitals and when measured over several years are likely to accrue a high percentage of health costs. The study reviewed one hospital's records from 2007; these children represented 41.1 percent of Seattle Children's Hospital total patients and 71.4 percent of patient days.

Neff and co-investigators combined the use of hospital discharge data from Seattle Children's Hospital and its primary care clinic, Odessa Brown Children's Clinic (OBCC) over seven years from 2001 through 2007. They selected patients whose primary care occurred at OBCC and hospitalization and emergency department care were likely to be at Children's. Using Clinical Risk Groups (CRGs) software to analyze the data - CRGs is a risk adjustment method that has been used with health plan data to identify and stratify individuals into condition and severity groups, but has not previously been used to analyze patients in hospital discharge data - patient information was classified according to complexity of diseases and primary chronic conditions. That data was merged with hospital discharge data to identify what hospital services those patients used.

As a result of this data and methodology, Seattle Children's Hospital is launching a study that will examine how to improve the coordination of care for patients with lifelong chronic conditions, decrease their need for hospitalization and improve their quality of life. The study will follow approximately 600 of these medically complex patients for two years in a clinic that will work with patients' primary care providers to develop care plans and other interventions to improve their care and reduce the need for hospitalization.

"This will be the most comprehensive study of its kind," said Mark Del Beccaro, MD, pediatrician-in-chief at Seattle Children's Hospital. "If we succeed in showing we can improve care and lower costs for the patients and their families, this will also have tremendous implications nationally as these most complex and fragile of patients utilize a significant portion of health care expenditures in every community and state."

Neff's study collaborators were Seattle Children's Holly Clifton, MPH, Kathleen J. Park, MD, MPH, Caren Goldenberg, MPH, Jean Popalisky, DNP, RN, James W. Stout MD, MPH, and Benjamin S. Danielson, MD.

Source:
Louise Maxwell
Seattle Children's

Please rate this article:
(Hover over the stars
then click to rate)

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

All opinions are moderated before being added.

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

View the original article here

The American Diabetes Association Encourages People To Take Control Of Their Health On World Diabetes Day

Main Category: Diabetes
Article Date: 14 Nov 2010 - 0:00 PST window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend ? printer friendly ? opinions ?

During American Diabetes Month® this November, the American Diabetes Association will join the International Diabetes Federation to raise awareness of diabetes on November 14 -- World Diabetes Day. November 14 is the birthday of Sir Frederick Banting, the co-discoverer of insulin.

This year's World Diabetes Day theme is Diabetes Education and Prevention. The 2010 slogan is Let's Take Control of Diabetes. Now. The campaign aims to highlight diabetes symptoms and prevention measures, among other things.

"Diabetes is a serious epidemic facing not only our nation, but the world. It is the leading cause of blindness, kidney disease and amputations, plus it doubles your risk of heart attack and stroke," commented Elizabeth Mayer-Davis, PhD, RD, President-Elect, Health Care & Education, American Diabetes Association. "But knowing the signs and symptoms of diabetes, both type 1 and type 2, can help with early detection and treatment. Type 2 diabetes and many diabetes complications can be prevented or delayed with lifestyle intervention."

Nearly 24 million children and adults in the United States have diabetes. Another 57 million Americans are at risk for type 2 diabetes. According to the International Diabetes Federation, more than 285 million people worldwide have diabetes.

During World Diabetes Day and throughout November's American Diabetes Month, the American Diabetes Association is encouraging greater awareness of a disease that kills more Americans each year than breast cancer and AIDS combined.

Diabetes often goes undiagnosed because many of its symptoms seem harmless:

Type 1 diabetes symptoms

Frequent urination
Unusual thirst
Extreme hunger
Unusual weight loss
Extreme fatigue and irritability

Type 2 diabetes symptoms*

Any of the type 1 symptoms
Frequent infections
Blurred vision
Cuts/bruises that are slow to heal
Tingling/numbness in the hands/feet
Recurring skin, gum or bladder infections
*Often people with type 2 diabetes have no symptoms.

"Studies have shown that type 2 diabetes can be prevented or delayed. Thirty minutes a day, five days a week, of moderate physical activity (such as brisk walking) and a 7% reduction in body weight (or about 15 pounds if you weigh 200 pounds) can help lower your risk for type 2 diabetes," commented Mayer-Davis. "In addition, many diabetes complications, whether you have type 1 or type 2, can be prevented or delayed with exercise and healthy eating."

Source:
American Diabetes Association

Please rate this article:
(Hover over the stars
then click to rate)

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

All opinions are moderated before being added.

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

View the original article here

Fat cells reach their limit and trigger changes linked to type 2 diabetes

ScienceDaily (Nov. 8, 2010) ? Scientists have found that the fat cells and tissues of morbidly obese people and animals can reach a limit in their ability to store fat appropriately. Beyond this limit several biological processes conspire to prevent further expansion of fat tissue and in the process may trigger other health problems.

Research funded by the Biotechnology and Biological Sciences Research Council (BBSRC), the Medical Research Council (MRC) and the European Union Sixth Framework Programme, shows that a protein called secreted frizzled-related protein 1 (SFRP1) is produced by fat cells and may be involved in changes to our metabolism that could increase the risk of diabetes and cardiovascular disease. The work was carried out at the University of Cambridge and will be published in a future edition of the International Journal of Obesity Research.

Professor Antonio Vidal-Puig from the Institute of Metabolic Science, University of Cambridge said: "We have known for some time that many obese individuals are at greater risk of developing diabetes, cardiovascular disease and also cancer. But this is not true for all obese people."

Dr Jaswinder Sethi, also from the Institute of Metabolic Sciences, University of Cambridge added: "What we still do not fully understand, is how the expansion of fat tissue is regulated in healthy people and how this process of regulation might be different in those obese people who have health problems such as the metabolic syndrome."

One hypothesis is that storing surplus fat in itself may not lead to metabolic syndrome but there may be a maximum limit of how much fat a person can store safely before the body's natural responses lead to the debilitating chronic health problems often associated with obesity.

Dr Sethi continued: "To investigate this we have been using a combination of molecular cell biology, human gene profiling and mouse genetics as tools to understand what is happening as fat cells and tissues develop and then, in some very obese people, lose their normal process of regulation."

The researchers have found that the level of SFRP1 increases as fat cells and tissues increase in volume until it peaks at about the point of mild obesity. There is evidence that SFRP1 is involved in recruiting new fat cells, thereby facilitating the expansion of fat tissue up until this point where it peaks.

"SFRP1 seems to be very closely linked to some sort of tipping point, after which the way in which our fat tissue is regulated changes significantly and there are knock-on consequences to our wider metabolism. We think that in very obese people this may be an early event that triggers metabolic syndrome and the chronic health problems associated with it, such as diabetes and cardiovascular disease," said Dr Sethi.

The fat tissue of people who are obese and also have diabetes shows signs of not being regulated as it usually would be. In this tissue, the researchers also see the levels of SFRP1 begin to fall so as to prevent further expansion of the tissue. It is this fall in SFRP1 that has knock-on effects on metabolism that may in part explain the link between morbid obesity and metabolic syndrome.

The researchers believe that SFRP1 works in concert with other molecules to respond to the availability, or not, of energy. Together these molecules also determine to what extent our fat tissue can continue to expand as we consume more calories than we burn.

Professor Douglas Kell, BBSRC Chief Executive said: "Research such as this leads to better understanding of the biochemistry that drives normal human physiology. In particular we can see how we usually respond to extremes brought on by the various onslaughts of our lifestyles and environments. Increasing our understanding of the fundamentals of metabolic signalling is an important part of working towards an increase in health span to match our increasing life spans."

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Biotechnology and Biological Sciences Research Council (BBSRC), via AlphaGalileo.

Journal Reference:

C Lagathu, C Christodoulides, C Y Tan, S Virtue, M Laudes, M Campbell, K Ishikawa, F Ortega, F J Tinahones, J-M Fernandez-Real, M Ore?i?, J K Sethi, A Vidal-Puig. Secreted frizzled-related protein 1 regulates adipose tissue expansion and is dysregulated in severe obesity. International Journal of Obesity, 2010; DOI: 10.1038/ijo.2010.107

Note: If no author is given, the source is cited instead.

View the original article here

NYC Minority Seniors Celebrate, Take Charge of Their Diabetes

Posted on: Wednesday, 10 November 2010, 08:00 CST

Nearly 1,400 have Completed Diabetes Wellness Workshops; Goal is 2,500

BRONX, N.Y., Nov. 10, 2010 /PRNewswire-USNewswire/ -- In honor of American Diabetes Month, more than 100 Latino and African-American New York City seniors will travel to the Bronx today to celebrate having "graduated" from Diabetes Wellness Workshops (DWW), and will learn how to continue to take charge of their diabetes. The event will mark a milestone for the DWW program, which uses evidence-based practices to help seniors manage their diabetes: nearly 1,400 City seniors have graduated. The goal of IPRO, the independent nonprofit that manages the program in New York, is to educate 2,500 seniors by August 2011.

New York City has been hit hard by diabetes, and minority and poor communities have been especially devastated. One in eight New York City residents has diabetes, nearly 60 percent of whom are African American or Latino. According to the New York City Department of Health and Mental Hygiene (1), diabetes incidence is highest in low income neighborhoods, and death rates for diabetes are highest among African-American and Latino New Yorkers and those living in the lowest-income neighborhoods. Diabetes has increased 13 percent in New York City since 2002.

"There is a strong need for educational programs that address this epidemic and help decrease diabetes-related disparities," says Alan Silver, M.D., M.P.H., Medical Director, IPRO. "We are thankful that our partners have been able to help us work toward these objectives."

Among IPRO's partners in the Diabetes Wellness Workshops are the New York City Department for the Aging and New York City Housing Authority, which enable IPRO to hold multiple, ongoing workshops at senior centers and senior housing complexes throughout the five boroughs. The American Diabetes Association, another partner, helps refer workshop participants. Bilingual educational materials are provided through the New York City Department of Health and Mental Hygiene Take Care New York partnership. Representatives of all three organizations are expected to participate in today's program, and will be honored for their critical support.

"It is fitting that we hold this event during American Diabetes Month, as we seek to bring Americans together to stop diabetes," says Helene Velazquez, Associate Director, Latino Initiatives, American Diabetes Association of Greater New York. "We are proud to partner with IPRO in this effort."

"Learning how to manage and cope with a chronic disease like diabetes can be a challenge, which is why we were glad to partner with IPRO to bring the Diabetes Wellness Workshops directly to senior centers," says New York City Department for the Aging Commissioner Lilliam Barrios-Paoli. "This is just one initiative that is making this city more age-friendly and ensures older New Yorkers can continue to enjoy active, vibrant lives."

The DWW program is part of a community-based initiative by the Centers for Medicare & Medicare Services (CMS) to address the diabetes epidemic among members of some minority groups. Workshops are free and open to all Medicare beneficiaries who have diabetes, while outreach efforts are geared toward African Americans and Latinos. IPRO, an independent nonprofit healthcare quality improvement organization (QIO), manages the New York DWW program for CMS. Six QIOs from throughout the United States are involved in this initiative.

"Diabetes Wellness Workshops empower people with diabetes to take charge of their disease," says Janice Hidalgo-Melendez, DWW Project Manager. "With the support of our partners, we are using evidence-based approaches to help reduce disparities and improve the health of New Yorkers, one patient at a time."

The Diabetes Wellness Workshop is a type of program known as diabetes self-management education (DSME). DSME addresses cultural, social and behavioral concerns of people with diabetes to help them better manage their own disease through planning and acquiring better coping skills. A free, six-week course, the DWW program is offered in English and Spanish at community locations throughout the five boroughs. Workshop sessions cover such topics as monitoring one's body, physical activity and exercise, nutrition and diet, identifying and preventing complications, medications and medical care, and enlisting the support of family and friends. A recent report (2) recommended the further expansion of DSME classes in New York, as well as insurance reimbursement for those classes.

Today's graduation program will be held at the Betances Community Center, 465 St. Ann Avenue, Bronx, NY. For information on IPRO's free Diabetes Wellness Workshops, call 1-800-671-1841 or visit http://www.ipro.org/index/diabetes-disparities.

About IPRO IPRO is a national organization providing a full spectrum of healthcare assessment and improvement services that foster more efficient use of resources and enhance healthcare quality to achieve better patient outcomes. Founded in 1984, IPRO is highly regarded for the independence of its approach, the depth of its knowledge and experience, and the integrity of its programs. IPRO holds contracts with federal, state and local government agencies, as well as private-sector clients, operating best-of-class programs in more than 33 states and the District of Columbia. A national not-for-profit organization, IPRO is headquartered in Lake Success, NY and is a 501(c)(3) corporation.

This material was prepared by IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 9SOW-NY-THM7.1-10-59

1 New York City Dept. of Health & Mental Hygiene, "NYC Vital Signs," November 2009.

2 New York State Health Foundation and Healthcare Association of New York State, "Diabetes: A Hidden Health Care Cost Driver in New York," October 2010.

SOURCE IPRO

Source: PR Newswire

More News in this Category

View the original article here

Fat Cells Reach Their Limit And Trigger Changes Linked To Type 2 Diabetes

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Diabetes;??Heart Disease
Article Date: 10 Nov 2010 - 1:00 PST window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend ? printer friendly ? opinions ?

Scientists have found that the fat cells and tissues of morbidly obese people and animals can reach a limit in their ability to store fat appropriately. Beyond this limit several biological processes conspire to prevent further expansion of fat tissue and in the process may trigger other health problems.

Research funded by the Biotechnology and Biological Sciences Research Council (BBSRC), the Medical Research Council (MRC) and the European Union Sixth Framework Programme, shows that a protein called secreted frizzled-related protein 1 (SFRP1) is produced by fat cells and may be involved in changes to our metabolism that could increase the risk of diabetes and cardiovascular disease. The work was carried out at the University of Cambridge and will be published in a future edition of the International Journal of Obesity.

Professor Antonio Vidal-Puig from the Institute of Metabolic Science, University of Cambridge said "We have known for some time that many obese individuals are at greater risk of developing diabetes, cardiovascular disease and also cancer. But this is not true for all obese people."

Dr Jaswinder Sethi, also from the Institute of Metabolic Sciences, University of Cambridge added "What we still do not fully understand, is how the expansion of fat tissue is regulated in healthy people and how this process of regulation might be different in those obese people who have health problems such as the metabolic syndrome."

One hypothesis is that storing surplus fat in itself may not lead to metabolic syndrome but there may be a maximum limit of how much fat a person can store safely before the body's natural responses lead to the debilitating chronic health problems often associated with obesity.

Dr Sethi continued "To investigate this we have been using a combination of molecular cell biology, human gene profiling and mouse genetics as tools to understand what is happening as fat cells and tissues develop and then, in some very obese people, lose their normal process of regulation."

The researchers have found that the level of SFRP1 increases as fat cells and tissues increase in volume until it peaks at about the point of mild obesity. There is evidence that SFRP1 is involved in recruiting new fat cells, thereby facilitating the expansion of fat tissue up until this point where it peaks.

"SFRP1 seems to be very closely linked to some sort of tipping point, after which the way in which our fat tissue is regulated changes significantly and there are knock-on consequences to our wider metabolism. We think that in very obese people this may be an early event that triggers metabolic syndrome and the chronic health problems associated with it, such as diabetes and cardiovascular disease," said Dr Sethi.

The fat tissue of people who are obese and also have diabetes shows signs of not being regulated as it usually would be. In this tissue, the researchers also see the levels of SFRP1 begin to fall so as to prevent further expansion of the tissue. It is this fall in SFRP1 that has knock-on effects on metabolism that may in part explain the link between morbid obesity and metabolic syndrome.

The researchers believe that SFRP1 works in concert with other molecules to respond to the availability, or not, of energy. Together these molecules also determine to what extent our fat tissue can continue to expand as we consume more calories than we burn.

Professor Douglas Kell, BBSRC Chief Executive said: "Research such as this leads to better understanding of the biochemistry that drives normal human physiology. In particular we can see how we usually respond to extremes brought on by the various onslaughts of our lifestyles and environments. Increasing our understanding of the fundamentals of metabolic signalling is an important part of working towards an increase in health span to match our increasing life spans."

Source:
Nancy Mendoza
Biotechnology and Biological Sciences Research Council

Please rate this article:
(Hover over the stars
then click to rate)

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

All opinions are moderated before being added.

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

View the original article here

The Impact Of Chronic Diseases On Patients Also Depends On Their Perception Of The Disease

Editor's Choice
Main Category: Psychology / Psychiatry
Also Included In: Diabetes
Article Date: 23 Oct 2010 - 0:00 PDT window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend ? printer friendly ? opinions ?

Researchers at the University of Granada have developed a test to measure and assess chronic patients' cognitive representation of their disease. This advance will enable the development of clinical psychological treatments much more efficient than those currently employed.

What do we mean by "common sense" when we talk about a disease? What affects the ideas and beliefs that patients have of their disease? Researchers at the University of Granada have developed a test for measuring and assessing chronic patients' cognitive representation of their disease. This advance will enable the development of clinical psychological treatments much more efficient than those currently employed.

The cognitive representation of a disease is the ideas and beliefs that patients have in relation to their condition, at a given time. These ideas are based around five aspects: symptoms, causes, impact of the disease on patients' lives, way and measures for controlling the condition, time-line and progression of the disease.

Cognitive representation is said to be based on "common sense", since patients are not experts and their ideas and perception of their disease are based on their own experience, self-knowledge and other sources (social, family environment, health center, etc). The researchers state that "the idea that patients have of their disease affects their own coping and adaptation to it".

This study was conducted by Macarena De los Santos Roig, at the department of Social Psychology and Methodology of Behavioral Sciences of the University of Granada, and led by professor Cristino Perez Melendez.

155 Patients

To carry out this study, the researchers used a sample of 155 patients with diabetes Type 1, treated at the Department of Endocronology of the University Hospital San Cecilio, Granada. Patients were given different tests and, although the study centered on patients with diabetes, this test is intended to be applicable to any patient with a chronic disease.

The study revealed that the profile of diabetic patients reporting many symptoms, with the perception of their disease having heavy impact on their lives, low perceived controllability, and a chronic course present significantly worse physical, psychological and social functioning, as well as a poor mental health, lower vitality and worse overall (physical) health, than those who represent their disease differently.

Conversely, patients face their disease more actively, (they seek social support, apply behavioral coping and express their emotions), when they perceive that their disease has significant impact on their lives, but some control is observed. Such results confirm the reliability of the scores obtained on the scale developed in this study. Thus, its effectiveness is demonstrated.

Although other similar assessment tools already existed in other countries, they had been deficiently translated (not adapted, and presenting some deficiencies) into Spanish by national researchers. Consequently, the tool developed by the University of Granada is the most complete and reliable of all existing assessment tools.

Source: Department of Social Psychology and Methodology in Behavioral Sciences, University of Granada

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Please rate this article:
(Hover over the stars
then click to rate)

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

All opinions are moderated before being added.

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

View the original article here