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Early Palliative Care Improves Patients' Quality of Life

Also Increases Chances of Having End-of-Life Discussions, Study Shows

HealthDay News: Starting palliative care shortly after a person is diagnosed with incurable cancer helps patients cope and improves their quality of life, a new study shows. It also leads to more discussions about patients' end-of-life care preferences, the researchers added. Palliative care, also called comfort care, is given to improve the quality of life for patients who have a life-threatening disease or terminal illness, such as cancer. The goal is not to cure the patient, but to manage the symptoms of the disease, according to the U.S. National Cancer Institute. The new study included 350 people recently diagnosed with incurable lung or gastrointestinal cancer. They were randomly assigned to one of two care groups. One group received early palliative care integrated with cancer care. The other received cancer care alone. The patients were evaluated at 12 and 24 weeks after diagnosis. At 24 weeks, the early palliative care patients were much more likely to report using active and engaged coping styles than the standard cancer care patients. Early palliative care patients also had much higher quality of life and lower levels of depression at 24 weeks, but not at 12 weeks, the study found. Thirty percent of early palliative care patients said they had discussed end-of-life care preferences. Just 14% of standard care patients had similar talks. The study was presented recently at an American Society of Clinical Oncology (ASCO) meeting in San Francisco. Findings presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal. "What we found was the patients who received early palliative care were more likely to use adaptive coping strategies - meaning they were more likely to take some action to make their lives better as well as to accept their diagnosis," lead author Joseph Andrew Greer said in an ASCO news release. "Palliative care is a key ingredient to improving a quality of life, which is important to both patients and their families," said Greer. He's clinical director of psychology and a research scientist at Massachusetts General Hospital. ASCO spokesman Dr. Andrew Epstein said these findings help show the benefits of integrating palliative care into cancer care. "A diagnosis of cancer is never easy for patients, so it is promising that we now have a strategy of early palliative care that can help patients cope while improving their quality of life," Epstein said.

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Hospital Readmissions Less Likely for Discharged Heart Failure Patients Who Receive Combined Care

The chance of hospital readmission within 30 days of discharge is roughly 8% less for heart failure patients who receive early, intensive nursing services combined with at least one outpatient physician visit during the week following discharge, an AHRQ study concluded. Neither treatment used alone, however, had a significant effect on hospital readmission. The researchers examined almost 99,000 hospital stay records for Medicare patients admitted with heart failure who were discharged to home healthcare. "Reducing Readmissions Among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up" appeared online in Health Services Research.

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Many Adults Unaware That Using E-Cigarettes Can Hurt Kids

HealthDay News-Many Americans don't know that indoor use of electronic cigarettes exposes children to nicotine and leaves nicotine deposits on surfaces, a new survey shows. "E-cigarettes primarily emit a toxic aerosol, not harmless water vapor," said Robert McMillen, an associate professor of psychology at Mississippi State University, who was the author of the report. "Unfortunately, many parents are unaware of the risk that exposure poses for their children and do not implement household rules to protect their children," McMillen said in a news release from the American Academy of Pediatrics. In a survey of more than 3,000 adults in 2015, McMillen and his colleagues found: 68% did not allow e-cigarette use in their homes; more than three-quarters banned the battery-operated devices from the car; and over 8 in 10 said e-cigarettes should not be allowed in places with smoking bans. About three-quarters also said it was unacceptable for parents to use e-cigarettes in front of children. However, many adults were not clear about the potential dangers of e-cigarettes, the researchers also found. Only 37% of the respondents knew that exhaled e-cigarette vapor contains nicotine or that using e-cigarettes indoors deposits nicotine on surfaces. And almost half of the adults did not know that e-cigarette use around children exposes them to nicotine, according to the survey.

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Scientists Debunk the "5-Second Rule"

Germs Can Transfer Almost Instantly to Food Dropped on the Floor, Study Shows

HealthDay News: Most people have invoked the "five-second rule" after dropping something tasty on the ground at least once or twice in their lives. Is that food really safe to eat? Probably not, a new study says. After putting the five-second rule to the test, researchers at Rutgers University in New Brunswick, N.J., found contamination with bacteria can occur in less than one second. "The five-second rule is a significant oversimplification of what actually happens when bacteria transfer from a surface to food," said study lead researcher Donald Schaffner, a professor and extension specialist in food science. The scientists dropped foods of different textures, such as watermelon, bread, and gummy candy, on a variety of surfaces including ceramic tile, stainless steel, wood, and carpeting. The scientists then contaminated each of these surfaces with a salmonella-like bacteria known as Enterobacter aerogenes for various lengths of time. The surfaces were allowed to dry completely before each type of food was dropped. The researchers evaluated the transfer of the bacteria from each surface to each food item after letting it sit for less than 1 second, 5 seconds, 30 seconds, and 300 seconds. Overall, they assessed 128 different scenarios 20 times for a total of 2,560 measurements. Longer exposure to the "dirty" surfaces and moisture made the spread of germs worse. But the researchers found that contamination could occur in less than 1 second. The wetter the food, the more bacteria got on it. "Transfer of bacteria from surfaces to food appears to be affected most by moisture," Schaffner said. "Bacteria don't have legs, they move with the moisture, and the wetter the food, the higher the risk of transfer. Also, longer food contact times usually result in the transfer of more bacteria from each surface to food," he said. Watermelon was most contaminated after being dropped. Gummy candy had the least amount of bacteria, suggesting germs more easily transfer to wet or moist foods, the study. The researchers also found foods dropped on the carpet sample had less contamination than those dropped on tile and stainless steel. The food items dropped on wood had more variable levels of contamination. "The topography of the surface and food seem to play an important role in bacterial transfer," Schaffner said. The study was published in Applied and Environmental Microbiology.

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Opioid Epidemic Costs U.S. $78.5 Billion Annually: CDC

HealthDay News: Abuse of powerful prescription painkillers called opioids costs the U.S. economy $78.5 billion a year, according to a new government study. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) analyzed the financial toll of opioid abuse, including direct healthcare costs, lost productivity, and costs to the criminal justice system. "More than 40 Americans die each day from overdoses involving prescription opioids. Families and communities continue to be devastated by the epidemic of prescription opioid overdoses," said CDC Director Dr. Tom Frieden. "The rising cost of the epidemic is also a tremendous burden for the health care system." The study, led by Curtis Florence of the CDC's National Center for Injury Prevention and Control, found that healthcare accounted for about 30% of the costs associated with opioid abuse in 2013. Total spending for healthcare and substance abuse topped $28 billion. Insurance covered most of it, the study found. Nearly 25% of the economic burden was shouldered by public sources. They included Medicaid, Medicare, and other public insurance as well as government-funded treatment programs. State and local governments shouldered most of the $7.7 billion in criminal justice-related costs. They also lost tax revenue because productivity slipped, the study showed. The researchers reported that nearly 2 million Americans abused or were dependent on prescription opioids in 2013. That same year, 16,000 people died of opioid overdoses-up dramatically from 2007, the most recent year for which detailed estimates were available. Fatal overdoses cost the economy $21.5 billion, the study showed. The study findings were published in the journal Medical Care. The researchers pointed out that their findings didn't take into account the reduced quality of life for people dependent on opioids or the heartbreak felt by the loved ones of those who overdose.

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Cancer Caregivers Face Difficult Demands

Survey Results Suggest More Support Is Warranted

HealthDay News: People who care for loved ones with cancer face more challenges than those who look after someone with other health problems, a new study reports. "Caregiving can be extremely stressful and demanding - physically, emotionally, and financially," said Erin Kent, a program director at the U.S. National Cancer Institute. "The data show we need to do a better job of supporting these individuals as their well-being is essential to the patient's quality of life and outcomes." Researchers analyzed data from a 2015 national survey of more than 1,200 caregivers in the United States. Compared with other caregivers, cancer caregivers were 63% more likely to report a higher burden. They also spent nearly 50% more hours a week providing care. Cancer caregivers were also more likely than other caregivers to communicate with healthcare professionals and to advocate on behalf of the patient. And they were nearly twice as likely to say they needed more help and information with making end-of-life decisions. The study findings were scheduled for presentation Friday at an American Society of Clinical Oncology (ASCO) meeting in San Francisco. The findings should be viewed as preliminary until peer-reviewed for publication in a medical journal. "Our research demonstrates the ripple effect that cancer has on families and patient support systems," Kent said in an ASCO news release. This research provides a glimpse into some of the unique needs and challenges of caring for people with cancer, said ASCO expert Dr. Andrew Epstein. "Ensuring that caregivers are well supported should be an essential component of high-quality cancer care," he added. About 2.8 million people in the United States provide care for an adult family member or friend with cancer, according to the National Alliance for Caregiving.

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