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Study Identifies Opportunities to Improve Support Programs for Clinicians Involved in Adverse Events

A majority of healthcare organizations have programs to provide emotional support to healthcare workers after adverse events, but features vary widely and there are substantial opportunities to improve services, according to a study by Agency for Healthcare Research and Quality (AHRQ). Clinicians involved in medical errors are often referred to as "second victims" because they can experience persistent negative effects such as guilt, embarrassment, self-doubt, and fear that can have serious consequences on their well-being, work performance, and patient safety. Researchers conducted an electronic survey of 575 members of the American Society for Healthcare Risk Management, including risk managers, executives, patient safety officers, directors of quality and compliance officers, to ascertain how they would characterize the structure and performance of their provider support program, if a program was available. Investigators found that although 74% of healthcare organizations maintain a support system, they vary widely and many lack important elements recommended by national standards. The study underscores the need for healthcare organizations to provide support systems for healthcare workers involved in adverse events. The study and abstract, "Risk Managers' Descriptions of Programs to Support Second Victims After Adverse Events," were published in the Journal of Healthcare Risk Management.

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Easier Said Than Done

Consumers older than 65 may have difficulty using Web applications to identify providers who meet their needs, according to an AHRQ-funded study. Researchers created a Web application that enabled Rhode Island consumers to compare home healthcare agencies based on information such as services offered and health outcomes. They conducted usability testing of the Web application using two focus groups, totaling 14 older consumers looking for information about home healthcare agencies and six hospital case managers. Investigators noted that although Web applications are a cost-effective way to disseminate information, it is important to ensure that people with low literacy, low health literacy, and low computer proficiency can access, understand, and use these applications. Although the researchers based their initial design on best practices, user testing showed that they overestimated the extent to which older adults were familiar with using computer applications. Researchers subsequently adopted simpler navigation and additional user prompts. The study and abstract were published in the May 15 issue of the journal eGEMS (Generating Evidence & Methods to improve patient outcomes).

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AHRQ Stats: Pediatric Hospital Stays

Among pediatric asthma and diabetes patients, the rate of hospital stays that could have been prevented increased 21% from 2008 to 2012. That reversed trends in 2003 to 2008, when the rate of preventable hospital stays declined 34% for asthma patients and 16% for diabetes patients. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #192).

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NIH Analysis Shows Americans Are in Pain

A new analysis of data from the 2012 National Health Interview Survey has found that most American adults have experienced some level of pain, from brief to more lasting pain, and from relatively minor to more severe pain. The analysis helps to unravel the complexities of a Nation in pain. It found that an estimated 25.3 million adults (11.2%) had pain every day for the preceding 3 months. Nearly 40 million adults (17.6%) experience severe levels of pain. Those with severe pain are also likely to have worse health status. The analysis was funded by the National Institutes of Health's National Center for Complementary and Integrative Health (NCCIH) and was published in The Journal of Pain. Pain is one of the leading reasons Americans turn to complementary health approaches such as yoga, massage, and meditation-which may help manage pain and other symptoms that are not consistently addressed by prescription drugs and other conventional treatments. For this reason, NCCIH research priorities include the study of complementary approaches to determine their effectiveness for treating symptoms such as pain.

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Among the findings of the analysis:


* An estimated 23.4 million adults (10.3%) experience a lot of pain.


* An estimated 126 million adults (55.7%) reported some type of pain in the 3 months prior to the survey.


* Adults in the two most severe pain groups were likely to have worse health status, use more healthcare, and suffer from more disability than those with less severe pain. However, approximately half of individuals with the most severe pain still rated their overall health as good or better.


* There were associations between pain severity and race, ethnicity, language preference, gender, and age. Women, older individuals, and non-Hispanics were more likely to report any pain, whereas Asians were less likely.


* Minorities who did not choose to be interviewed in English are markedly less likely to report pain.


* The impact of gender on pain varies by race and ethnicity.



Read more about the report:


NIH Study Shows No Benefit of Omega-3 or Other Nutritional Supplements for Cognitive Decline

Although some research suggests that a diet high in omega-3 fatty acids can protect brain health, a large clinical trial by researchers at the NIH found that omega-3 supplements did not slow cognitive decline in older persons. With 4,000 patients followed over a 5-year period, the study is one of the largest and longest of its kind. It was published in the Journal of the American Medical Association. The NIH study raises doubt about any benefits omega-3 and dietary supplements like these may have for cognitive decline.

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"Contrary to popular belief, we didn't see any benefit of omega-3 supplements for stopping cognitive decline," said Emily Chew, M.D., deputy director of the Division of Epidemiology and Clinical Applications and deputy clinical director at the National Eye Institute, part of NIH.


Teens Using E-Cigarettes May Be More Likely to Start Smoking Tobacco

Students who have used electronic cigarettes by the time they start ninth grade are more likely than others to start smoking traditional cigarettes and other combustible tobacco products within the next year, according to a new study funded by the NIH. E-cigarettes deliver nicotine to the lungs by heating a liquid solution that contains nicotine and other chemicals to produce an aerosol that the user inhales, a process often called "vaping."

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The study compared tobacco use initiation among 222 students who had used e-cigarettes, but not combustible tobacco products, and 2,308 who had neither used e-cigarettes or combustible tobacco products when initially surveyed at the start of ninth grade. During the first 6 months after being surveyed, 30.7% of those who had used e-cigarettes started using combustible tobacco products, such as cigarettes, cigars, and hookahs, compared to only 8.1% of those who had never used e-cigarettes. Over the following 6 months leading into the start of 10th grade, 25.2% of e-cigarette users had used combustible tobacco products, compared to just 9.3% of nonusers. The paper was published in the Journal of the American Medical Association.


Hypothermia and Older Adults

Frigid weather can pose special risks to older adults. The National Institute on Aging, part of the National Institutes of Health (NIH), has some advice for helping older people avoid hypothermia-when the body gets too cold-during cold weather.

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Hypothermia is generally defined as having a core body temperature of 95 [degrees]F or lower and can occur when the outside environment gets too cold or the body's heat production decreases. Older adults are especially vulnerable to hypothermia because their bodies' response to cold can be diminished by underlying medical conditions such as diabetes and by use of some medicines, including over-the-counter cold remedies. Hypothermia can develop in older adults after relatively short exposure to cold weather or even a small drop in temperature.


Someone may suffer from hypothermia if he or she has been exposed to cool temperatures and shows one or more of the following signs: slowed or slurred speech; sleepiness or confusion; shivering or stiffness in the arms and legs; poor control over body movements; slow reactions; or a weak pulse.


Here are a few tips to help older people avoid hypothermia:


* Make sure your home is warm enough. Set the thermostat to at least 68 [degrees]F to 70 [degrees]F. Even mildly cool homes with temperatures from 60 [degrees]F to 65 [degrees]F can lead to hypothermia in older people.


* To stay warm at home, wear long underwear under your clothes, along with socks and slippers. Use a blanket or afghan to keep your legs and shoulders warm and wear a hat or cap indoors.


* When going outside in the cold, it is important to wear a hat, scarf, and gloves or mittens to prevent loss of body heat through your head and hands. A hat is particularly important because a large portion of body heat can be lost through the head. Wear several layers of warm loose clothing to help trap warm air between the layers.


* Check with your doctor to see if any prescription or over-the-counter medications you are taking may increase your risk for hypothermia.