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Patients are considered older adults when age 65 and beyond. In a cardiology unit, those below 50 are almost considered pediatric, from a cardiovascular perspective. During the next 25 years, the population age greater than 85 years will be more than double-from 6.3 million in 2015 to 14.1 million by 2040. Many commonly used drugs have serious side effects, such as increased risk of bleeding, renal failure, life-threatening electrolyte disturbances, and dangerous arrhythmias. Surprisingly, many of these drugs have not been tested in older patients. As a result, it is unclear if these drugs have benefit or if they can cause harm in older adults.

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Dr. Karen Alexander, a cardiologist at the Duke Clinical Research Institute, noted the following: "Things really start to change for adults when they reach 75 years ... it is this group that physicians and drug developers need to be thinking about."


In 1989, The Food and Drug Administration put forth nonbinding recommendations on how older adults could be included in clinical trials. Twenty years later, the elderly remain excluded from randomized trials. "Exclusion criteria such as inability to make clinic appointments, renal dysfunction, or diagnosis of a cancer, even it was treated and no longer active, often preferentially exclude elderly patients. It is harder to get older patients to understand what you are doing. Often elderly patients are not driving themselves, so these become factors that limit the participation of elderly patients in clinical trials."


Healthcare providers may overlook the elderly because of subjective feelings that the patient may be harmed in a trial. The consequences of excluding elderly patients from clinical trials are significant and result in a substantial lack of evidence for therapies in elderly patients who present with cardiovascular diseases. Such patients, who are often at the highest risk of dying, may stand to gain the most benefit from drugs and cardiac procedures; however, the potential for harm may also be exaggerated in this frail population.


Collaboration is needed to ensure that the elderly are represented throughout the drug development process. As our population ages, we need to ensure that we are actually helping, and not harming, older adults.- Accessed 4/18/2016



HealthCare Chaplaincy Network (HCCN) released the first evidence-based scope of practice for professional chaplaincy, giving spiritual care specialists, other providers, and administrators a framework to provide quality spiritual care in healthcare settings. The 18 recommendations include reducing spiritual distress, increasing client satisfaction, and facilitating meaning-making for clients and family members.


The scope of practice articulates how chaplains can help their organizations meet these indicators and "effectively and reliably produce quality spiritual care. These long-awaited and robust tools work in tandem to move forward the field of spiritual care and professional chaplaincy," said Rev. Eric J. Hall, HCCN's president and CEO. "They send a loud message about how spiritual care can be fully integrated into healthcare and provide the path for administrators, clinical teams, spiritual care providers, and others to seamlessly achieve that goal." Both new documents reflect HCCN's efforts to fill gaps in the delivery of spiritual care, increase the integration of professional chaplaincy on healthcare teams, and raise the overall level of care. Although chaplains are considered the spiritual care specialists in healthcare settings, the emergence of the competencies impacts overall spiritual care and other disciplines, and, ultimately, patients and their families.


See for the complete scope of practice and the quality indicator documents.-Healthcare Chaplaincy Network News Release, 3/16/2016



A survey of 500 HealthMine insured consumers noted that 59% of consumers who use digital health apps and tools suffer from a chronic condition; 52% of these individuals are enrolled in a wellness program, and 33% received their health device/app from their wellness program. However, only 7% use a disease management tool. The survey reveals that consumers' use of health applications and devices has doubled in the past two years, but the right digital health tools are not necessarily getting into the hands of those who need them most.


However, respondents utilized a variety of digital health apps and tools not necessarily related to their chronic condition. Activity trackers and nutrition apps were among the most popular:

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Bryce Williams, CEO and president of HealthMine, commented, "The use of digital health in wellness is growing, but it's not necessarily being personalized to the individual level. Wearable activity trackers are just one tool in the box, and plan sponsors should customize both digital health technology and program incentives to meet the unique needs of each member."- Accessed 4/18/2016

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Eight-year-old Luke Dennison was born without fingers on his left hand, after developing symbrachydactyly, a congenital abnormality of the hand. Most children with symbrachydactyly have excellent function in daily activities but due to the length of their arm, do not qualify for most prosthetics. "I feel a strong sense of pride as a father that my wife and I are able to provide our son with a new hand. Through e-Nable and our Ultimaker2 3D printer, we are able to come up with a new hand whenever he needs one. Luke loves being able to pick the colors of his hand and show new designs off to his friends at school. E-Nable and Ultimaker have made it easy for us to give our son the life he deserves," says Gregg Dennison.


"Being able to provide someone with a new assistive hand device, free of charge, not only changes their life but also mine and everyone working with e-Nable. More than 5,000 volunteers create, innovate, re-design, and give a helping hand to those that need it, whether it is helping to print parts, creating a completed device, or helping to guide others as they build one themselves," notes Aaron Brown, e-Nable volunteer.


To hear Luke's story, visit: Public Relations, Inc. Press Release, 8/12/2015

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"If what you believe is what you say and do, the guiding provocation runs like this: Show me your receipts, your text messages, your gas mileage, your online history, a record of your daily doings, and just to get things started, a transcript of the words you've spoken aloud in the course of a single day, and then we might begin to get a picture of your religious commitments. What doors of perception might begin to open when we allow ourselves to look at religion-and our own lives-in this way? What personal hypocrisies do we keep obscured to ourselves when don't?"


"The space of your worship is the space of your life. It's all made plain in the details of every kind of personal investment. A worship service? We're welcome to schedule them as often as we like, but it won't mean our worship stops or starts according to our schedules. The living witness of what we do with our lives speaks even as it writes out the detailed histories, and it doesn't operate according to all those unsustainable compartmentalizations we use to fool ourselves and others. No blind trust, we might say, in the playing out of my religion."-From Life's Too Short To Pretend You're Not Religious by David Dark, 2016, InterVarsity Press, Downers Grove, IL.


-PulseBeats compiled by Cathy Walker