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Study: Low-Carb Diets May Be Better Than Low-Fat Diets for Losing Weight, Reducing Heart Disease

Low-carbohydrate diets may be more effective than low-fat diets for both losing weight and reducing the risk of heart disease, according to a new study in the Annals of Internal Medicine. Researchers assigned 148 patients either a low-carbohydrate or a low-fat diet, collected data at the start of the study, then again at 3, 6, and 12 months. Of the people who completed the study-59 in the low-carbohydrate group and 60 in the low-fat group-researchers determined that the low-carbohydrate diet was the more effective of the two, concluding that "[r]estricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors."

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An Unexpected Growth in the Nursing Workforce

More registered nurses (RNs) are delaying retirement, a phenomenon that is contributing to a larger-than-expected supply of nurses, according to a new study in Health Affairs. In 2000, healthcare economists predicted that the nursing workforce would peak at 2.2 million in 2012 and begin to shrink soon after as Baby Boomers-the first of whom turned 65 years old in 2011-began to retire. Those forecasts led to predictions of widespread nursing shortages developing in the latter half of this decade if nothing else happened to increase the supply of RNs. But those shortages may come later than expected, thanks to a surge in younger nurses in associate and baccalaureate degree nursing programs and also to the fact that older nurses are staying in the workforce for longer periods of time. Between 1969 and 1990, 47% of nurses who were working at age 50 were still working at age 62, and 9% were still working at age 69, according to the study. Between 1991 and 2012, 74% of older nurses were working at age 62 and 24%-or one in four-at age 69. All told, older nurses have extended their careers by an average of 2.5 years, a phenomenon that increased the 2012 RN workforce by 136,000.

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WHO Calls for Stronger Regulation of e-Cigarettes

The World Health Organization (WHO) has joined the American Heart Association and other organizations in calling for stronger regulation of e-cigarettes, which are a $3 billion worldwide industry. WHO is now recommending that their indoor use be banned until they are proven harmless to bystanders; the international health organization is also calling for its 194 member states to ban the sale of e-cigarettes to minors, as well as to ban or minimize their advertizing. According to the agency, regulation "is a necessary precondition for establishing a scientific basis on which to judge the effects of their use, and for ensuring that adequate research is conducted and the public health is protected and people made aware of the potential risks and benefits."

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To Build a Culture of Health, There's No Place Like Home

A century ago, it was normal for a doctor to make a house call to tend to a patient in need. By the time I was a child growing up in New Jersey in the 1970s and 80s, the practice had become virtually obsolete. The case for bringing healthcare back into the home is becoming more compelling every day. One place where we see the potential to make a big impact is with new parents and newborns. Last month, JAMA Pediatrics published new research on Effects of Nurse-Home Visits on Maternal and Child Health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis, TN, over a 19-year period. Specifically, they wanted to see whether home visits conducted by the nurse-family partnership before and after a birth influenced whether the mothers and children died prematurely. The research revealed that "mothers who did not receive nurse-home visits were nearly three times more likely to die from all causes of death than nurse-visited mothers." It also found that "there were lower rates of preventable child mortality from birth until age 20." The new findings come on top of other research showing that the same nurse-home visiting model leads to better prenatal health and behavior, reduces risks for child abuse, reduces chances that children would be hospitalized before the age of 2, and improves the mental health and behavior of children at home and in school.

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CDC: Majority of Parents Have Their Children Vaccinated

The majority of parents have their children receive routinely recommended vaccinations, according to the latest Morbidity and Mortality Report from the U.S. Centers for Disease Control and Prevention. The report found that in 2013:

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* More than 90% of babies were vaccinated against measles, mumps, and rubella; poliovirus; Hepatitis B; and varicella;


* 73% were vaccinated against rotavirus;


* 83% were vaccinated against Hepatitis A;


* 74% were vaccinated against Hepatitis B; and


* Less than 1% of children received no vaccines.



"I want to personally recognize the hard work of doctors and nurses coping with many challenges in the course of clinical work, and commend parents who, despite competing responsibilities, continue to prioritize immunization to keep their children healthy and safe," said Anne Schuchat, MD, Director of the National Center for Immunization and Respiratory Diseases. "These people are central in keeping young children healthy by ensuring they receive the recommended vaccines on schedule."


The Home Health-care Planning Improvement Act

The Home Health Care Planning Improvement Act (H.R.2504/S. 1332) would amend Title XVIII of the Social Security Act to have more timely access to home healthcare services for Medicare beneficiaries under the Medicare program. A quirk in Medicare law has kept advanced practice registered nurses from signing home healthcare plans and from certifying Medicare patients for the home healthcare benefit. This bill would address these problems by specifically allowing nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants to certify home healthcare services.


From the Nurses' Health Study 3

When the Nurses' Health Study began in 1976, there were 48 women for every man in nursing. Today, 1 in 10 nurses is male. Starting fall of 2014, men became eligible to join the Nurses' Health Studies as participants in the Nurses' Health Study 3 (NHS3). If you know a male nurse between 19 and 46 years old, please let him know about this exciting change! Most of the nurses who have joined the NHS3 during the last year learned about the study directly from current participants; others saw study flyers in a nurses' station at their jobs. With nearly 40,000 nurses already enrolled, the NHS3 will continue recruiting RNs, licensed practical nurses, and nursing students with the goal of enrolling at least 100,000 women and 20,000 men. Continue encouraging your colleagues to join this new study by visiting


Evaluating Patients for Possible Ebola Virus Disease: Recommendations for Healthcare Personnel and Health Officials

The purpose of this Health Alert Notice Advisory is to remind healthcare personnel and health officials to:

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(1) Increase their vigilance in inquiring about a history of travel to West Africa in the 21 days before illness onset for any patient presenting with fever or other symptoms consistent with Ebola;


(2) isolate patients who report a travel history to an Ebola-affected country (currently Liberia, Sierra Leone, and Guinea) and who are exhibiting Ebola symptoms in a private room with a private bathroom and implement standard, contact, and droplet precautions (gowns, facemask, eye protection, and gloves); and


(3) immediately notify the local/state health department.


Please disseminate this information to infectious disease specialists, intensive care physicians, primary care physicians, and infection control specialists, as well as to emergency departments, urgent care centers, and microbiology laboratories.


Community Health Workers Embedded in Inpatient and Outpatient Clinical Teams Enhance Access to Primary Care and Improve Health Outcomes for Low-Income Patients

The University of Pennsylvania Health System embeds community health workers into its clinical teams at hospitals and medical offices. Following the Individualized Management for Patient-Centered Targets (commonly referred to as IMPaCT) model, the community health workers provide low-income patients with emotional support and help them navigate the health system and obtain appropriate care and community-based services and support. In the inpatient setting, they provide support both in the hospital and for at least 14 days after discharge, whereas in the outpatient setting they support chronically ill patients for 6 months. In both settings, they work with patients to develop goals and related action plans, and provide customized support, including connections to needed services. In a randomized trial at two academic medical centers, the inpatient component of the IMPaCT model improved discharge-related communication, enhanced access to postdischarge primary care, and increased levels of patient activation, leading to fewer readmissions and depression-related symptoms and to positive feedback from patients.

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