Real World Health Care Blog

Tag Archives: NIH

National Institute on Aging Outlines Alzheimer’s Priorities

As part of our series on Alzheimer’s Disease, Real World Health Care spoke with Creighton Phelps, Ph.D., acting director, Division of Neuroscience, National Institute on Aging, National Institutes of Health. Dr. Phelps discusses the challenges facing AD researchers and how the NIA is working to overcome them.

Real World Health Care: In terms of comparative effectiveness research for Alzheimer’s disease, where is the NIA focusing its efforts and why?

Dr. Creighton Phelps

Dr. Creighton Phelps

Creighton Phelps: Currently, because we do not have treatments to delay or prevent Alzheimer’s, comparative effectiveness research is not really an option. That said, Alzheimer’s disease is a complicated disorder and we are funding research into genetic, behavioral, and environmental factors that may all play a role in disease onset and progression. As a result, not one, but many interventions may be needed. For this reason, we can’t leave any stone unturned. NIA is funding drug-discovery projects, trials using pharmacological interventions, preventative lifestyle interventions, and caregiving interventions.

RWHC: What are some of the biggest challenges researchers and industry face in developing AD therapies?

CP: Clinical trials focused on finding a prevention or cure are imperative to Alzheimer’s disease and related dementias research. But a big challenge is that it is often difficult to recruit participants into trials. We need participants with cognitive impairments, as well as those without; we need ethnic minorities; we need people age 65 and older, and also younger adults. This point of comparison helps us to determine which changes in the brain are specifically related to Alzheimer’s disease and which can be attributed to aging. Increased participation in clinical trials will really hasten our search for effective therapies. Additionally, participants with dementia need a study partner to assist the participants during the trial, which adds another level of burden for families and loved ones. But without the generous participation of clinical trials volunteers, we won’t find a cure for Alzheimer’s.

RWHC: How is the NIA helping to overcome these challenges?

CP: NIA is working hard to overcome these and other challenges, and we are grateful that both public and private organizations, and the general public, also place a high priority on dementia research.

Congress just boosted federal funding for Alzheimer’s disease and related dementias research by $350 million dollars. It is anticipated that this increased budget will accelerate investigator-initiated discovery after years of smaller budget increases. The budget increase will enable new, highly collaborative initiatives.

In 2011, President Obama signed into law the National Alzheimer’s Project Act. This called for the creation and maintenance of an integrated National Plan to overcome Alzheimer’s, with the ultimate goal being to find a prevention or cure by year 2025. As mandated in the National Plan, NIA hosted Alzheimer’s Disease Summits in 2012 and 2015, bringing experts from pharma, academia, and advocacy groups together to advance the research agenda. NIA also worked with the National Institute of Neurological Disorders and Stroke to hold two Alzheimer’s Disease-Related Dementias Summits in 2013 and 2016 to examine the issues central to the other dementias that sometimes overlap with Alzheimer’s.

This spirit of collaboration can also be seen in the groundbreaking Accelerating Medicines Partnership (AMP). AMP is a bold new venture among the NIH, 10 biopharmaceutical companies, and several nonprofit organizations that aims to transform the current model for developing new diagnostics and treatments for chronic diseases. AMP-AD, which applies this innovative model to Alzheimer’s disease, will enable the rapid sharing of large biomedical datasets that may lead to speedier discovery of therapeutic targets.

RWHC: Can you please provide an overview of some of the more promising therapeutic targets (particularly those moving out of the lab and into human studies) on which the NIA is focused? Where you can, please explain why those have become a priority.

CP: NIA is funding, often in collaboration with others, prevention trials testing drugs that may clear amyloid protein—a hallmark of the disease—in cognitively normal volunteers at high risk for developing the disease due to genetics or who show abnormal amyloid levels in their brains, as visualized by PET Scans. The hope is that by treating the disorder earlier in the disease process that we may delay or even prevent the disease.

RWHC: Where does the NIA see the greatest need for research into Alzheimer’s disease: diagnosis, symptom management, stopping/slowing the progression of the disease, or prevention of AD? Why?

CP: Currently, about 5.2 million Americans age 65 and older are living with Alzheimer’s disease; many thousands more are diagnosed with related disorders, such as Lewy body or frontotemporal dementia. An even greater number are in the pre-symptomatic stages, sometimes called Mild Cognitive Impairment (MCI) or prodromal disease. These numbers are expected to more than double by 2050 unless we find one or more treatments. Alzheimer’s and other forms of dementia are expected to cost the United States $236 billion this year. Of course, the ultimate goal is to treat and prevent the disease. But these staggering statistics reveal that any discoveries—whether in diagnosis, symptom management, stopping/slowing disease progression, or preventing the disease—could help the millions currently afflicted.

RWHC: Besides translational and comparative effectiveness research, what other initiatives does the NIA support in relation to Alzheimer’s disease? Any highlights to share in terms of non-pharmacological intervention research?

CP:  With these additional financial resources, we are able to fund many new and exciting projects. The additional $350 million will enable: the development of new human cellular models of Alzheimer’s that may enable rapid screening of hundreds of thousands of molecules as potential therapeutic agents. It will also allow us to establish translational centers that will develop and apply cutting-edge approaches to drug discovery and development. Other upcoming projects include population studies of trends in the incidence and prevalence of dementia, the development of novel interventions to support dementia caregivers, and clinical trials of therapies in people at the highest risk of dementia.

Big Data in Healthcare: Speaking with Dr. Philip Bourne, National Institutes of Health

Our series on Big Data in Health Care continues this week with a conversation with Dr. Philip Bourne, Associate Director for Data Science, National Institutes of Health. Dr. Bourne discusses the goals of the NIH Big Data to Knowledge (BD2K) program and the challenges faced in leveraging big data to improve health outcomes.

Real World Health Care: Why did the NIH establish BD2K?

Dr. Philip Bourne, National Institutes of Health

Dr. Philip Bourne, National Institutes of Health

Philip Bourne: Several years ago, NIH Director Francis Collins set up a data and informatics working group in response to the increasing amounts of digital data being generated in biomedical research. That working group led to the development of BD2K.

RWHC: What are the goals of BD2K?

PB: As set out by the working group’s report, the goals of BD2K are to promote the “fair” finding, access, sharing, incorporation and re-use of digital content and analytical tools within the entire spectrum of health care. Our goals also include promoting enhanced and diversified training around the process of analyzing large amounts of data and achieving sustainability of the complete digital biomedical ecosystem.

RWHC: “Big data” is a big buzzword these days, and it’s being leveraged among a wide range of industries with varying degrees of success. Where does the health care industry currently stand in terms of its overall ability to generate, gather, analyze and share big data toward the goal of improving positive health outcomes?

PB: I think there’s a good analogy here between revolutionary changes in other industries and the potential revolutionary change that big data may bring to health care. Take the photography business as an example. When photography went digital, it disrupted the industry and created a completely different business proposition. Today, the photography industry has less to do with pictures and more to do with visual communications platforms like Instagram.

The same kind of disruptor has the potential to happen in health care with the digitization of information. The disruption is happening slowly, even though the growth of digital content has been exponential. Next, we need to get to the “infection point” where big data takes off and becomes disruptive.

Because health care is not a true free market economy like photography, there are more restrictions. Today, the patient really does not have control over his or her health information, but if they had such control, it could be transformative.

RWHC: What are some of the biggest challenges facing the health care industry in terms of its ability to use big data to improve health outcomes?

PB: One of the biggest challenges is the lack of qualified professionals and training for those professionals in conducting analytics. Big data also represents a cultural shift in the industry as we move away from traditional ways of doing research to newer analytical methods. We need more education on the implications of that shift.

RWHC: Where is the health care industry seeing the most success in using big data to improve health outcomes, especially as it relates to health care delivery, treatment optimization and cost containment?

PB: The industry is just beginning to define and use data in different ways, and early stage successes haven’t been widely publicized. With that said, our new ability to mine health data records and analyze them to identify changes is statistically significant and provides important predictive tools. For example, researchers at Stanford are studying body mass indexes (BMIs) in specific regions to see if there is any correlation between BMI and the amount of fast food restaurants in those regions.

RWHC: Are there any individual BD2K programs or projects about which you’re particularly excited? What sort of initiatives can we expect to see from BD2K during 2016?

PB: We’ve recently been focusing on privacy, which is a clear issue when it comes to human subjects: How does the industry protect patient privacy? We’re also bringing in different types of professionals who have experience in analytics, but in other industries such as digital media and entertainment. We recently had a funding call in this area and are looking forward to seeing how these non-health care professionals apply their skills to biomedical problems — how the entertainment industry can help us visualize large amounts of data in a meaningful way.

We also continue to focus on developing the Commons, which is a shared virtual space where scientists can work with the digital objects of biomedical research. We have a mandate from the federal government and the NIH to promote the sharing and accessibility of research output: outcomes of clinical trials, papers, software and other data. The Commons lets us do that. It’s kind of like putting a bunch of Lego blocks in a public square and seeing what people can do with them.

Categories: Big Data, General

Three Ways You Can Reduce the Impact of Cardiovascular Disease this American Heart Month

Most of the readers of this blog know that cardiovascular disease (CVD) is the number one killer of men and women in this country. According to the Centers For Disease Control and Prevention, CVD is a leading cause of disability, preventing Americans from working and enjoying family activities. Out-of-hospital cardiac arrests cause the deaths of an estimated 250,000 Americans each year. CVD costs the United States over $300 billion each year.

Joel Zive

Joel Zive

There are many small but significant actions we can take. Here is what you can do to make a difference: empower or continue to empower patients to take care of themselves.

1. Address the cost of heart medication

If the cost of your medicine is an issue, talk to your doctor or contact a patient assistance program that may be able to help with prescription co-pays.

2. Encourage healthy behaviors

Want people to eat better? Give them coupons for healthy food. Exercise? Give them coupons for short-term memberships to health clubs.

The stakes are higher in our country’s current health care landscape. With more people on health insurance than ever before, we need to do everything we can to empower people to seek help before an emergency and talk to their doctor about what they can do to take better care of themselves. This will have a direct effect on deaths from heart disease.

3. Ask your employer about Automatic External Defibrillators

There are instances in which individuals are dealt devastating genetic hands of cards. Recently, the Philadelphia Inquirer highlighted the plight of a Philadelphia family that had a genetic link to hypertrophic cardiomyopathy, a disease of the heart muscle.

For those who do experience heart issues, or even have a major event such as cardiac arrest, Automatic External Defibrillator (AED) devices can significantly increase the likelihood of survival. AEDs have been available for over 20 years, but in recent years, device makers have reduced the size and cost and increased usability of defibrillators, making public access defibrillation viable. “We believe ease of use is one of the most important qualities in an AED because the potential user may not be well-trained in resuscitating a victim of sudden cardiac arrest,” said Bob Peterhans, General Manager for Emergency Care and Resuscitation at Philips Healthcare. “This is consistent with the American Heart Association’s criteria for choosing an AED.”

While risk factors for CVD are often genetic, the majority of CVD is triggered by factors that are controllable: smoking, diet, and exercise. And this is where individual efforts need to be focused.

For more information on preventing CVD, check out the American Heart Association’s guidelines for taking care of your heart, which are broken down by age. The Centers for Disease Control and Prevention also offer an American Heart Month guide to controlling risk factors for cardiovascular disease. You may also want to check out The Heart Truth, a campaign from the National Institutes of Health to make women more aware of the danger of heart disease.

Read more Real World Health Care heart health-related posts:

Are you taking steps to prevent cardiovascular disease? If you, a family member, or a friend has CVD, what is working for treatment? Share your experiences and insights in the comments section.

Should clinicians replace medication with an ancient spiritual practice?

Researchers from Johns Hopkins University sifted through over 18,000 studies on a potential treatment for pain, anxiety and depression, narrowing their meta-analysis to 47 scientifically rigorous clinical trials. The results, published in the journal JAMA Internal Medicine, revealed what many have experienced over thousands of years: while it’s not a cure-all, this treatment can help alleviate pain, anxiety and depression. The treatment? Meditation.

David Sheon

David Sheon

Meditation began as an ancient spiritual practice but is now also utilized outside of traditional settings to promote health and well-being. The study findings incorporate the effects of mindfulness meditation on over 3,500 participants who were selected to take part in either a meditation regimen or a different therapy, such as exercise. Overall, researchers found that the effect of meditation on participants was moderate and on par with that of prescription medications.

While this is a promising result on the benefits of meditation, the researchers identified a number of limitations. The study did not find any evidence of meditation affecting other health concerns such as positive mood, attention, substance use, eating habits, sleep and weight. Also, meditation did not provide any long-term therapy as compared to medication. “The benefits did attenuate over time — with the effectiveness of meditation decreasing by half, three to six months after the training classes ended,” said study leader Dr. Madhav Goyal, an assistant professor of medicine at Hopkins. “We don’t know why this occurred, but it could have been that they were practicing meditation less often.”

Still, Dr. Goyal said he is encouraged by the study’s results, specifically because of the short training periods for the participants. There may be greater potential for individuals with more instruction or experience in meditation. “Compared to other skills that we train in, the amount of training received by the participants in the trials was relatively brief,” he said. “Yet, we are seeing a small but consistent benefit for symptoms of anxiety, depression and pain. So you wonder whether we might see larger effects with more training, practice and skill.”

While the new study suggests that in some cases, meditation may be used in addition to or in lieu of prescription drugs to treat pain, anxiety and depression, it is important for patients to consult their doctors before altering any course of treatment.

At RealWorldHealthCare.org, we have been interested in meditation’s potentially positive impact on health. Last April, we posted about a recent study in which meditation halved the risk of death, heart attack and stroke in African American men.

Meditation may have economic benefits as well. According to a July 2013 Huffington Post blog, Aetna’s employee health care costs went down by 7 percent in 2012 after the company implemented a wellness program, which CEO Mark Bertolini attributes to reducing stress through meditation and yoga. In recognition of its positive health impact, some insurance companies provide benefits for meditation instruction. For example, CareFirst’s Options Discount Program offers up to 30% off fees for participating meditation instructors. In 2010, Americans spent more than $11 billion on antidepressants, according to the American Psychological Association.

The National Center for Complementary and Alternative Medicine of the NIH offers an introduction to meditation, its uses and guidance for those who wish to practice meditating. The National Meditation Specialist Certification Board, an organization that seeks to promote meditation as a specialized field in health care, keeps a directory of meditation specialists, and there are many other such directories available online or through participating insurance providers.

In a Psychology Today article guiding those interested in mindfulness meditation, Dr. Karen Kissel Wegela emphasizes that sick or healthy, meditation can help people cope. “The sitting practice of mindfulness meditation gives us exactly this opportunity to become more present with ourselves just as we are,” she says. “This, in turn, shows us glimpses of our inherent wisdom and teaches us how to stop perpetuating the unnecessary suffering that results from trying to escape the discomfort, and even pain, we inevitably experience as a consequence of simply being alive.”

Have you ever meditated? Have you or someone you know ever meditated to treat depression, pain or anxiety? Did you find it effective?

Categories: General

MD and DO Medical Schools Consider Major Changes to Education Model

Experts from allopathic medical colleges (those that graduate MDs) and from osteopathic medical colleges (those that graduate DOs) have been actively exploring ways to lower the cost of medical and graduate school without sacrificing the quality of the education.

Paul DeMiglio

Paul DeMiglio

Groundbreaking recommendations were issued Monday that seek to improve osteopathic medical education in the U.S. and help fuel a new generation of primary care physicians who will be equipped to meet the demands of today’s changing health care landscape. One out of four students headed to medical school this fall are attending osteopathic medical school.

Released by the Blue Ribbon Commission (BRC) – a medical panel comprised of some of the nation’s leading experts in osteopathic medical education – the report (“A New Pathway in Medical Education”) coincides with publication of a related story in Health AffairsBRC aims to find a solution to the primary care physician shortage by transforming the osteopathic medical education model, reducing inefficiencies and addressing high costs as well as rising student debt.

Osteopathic physicians, or DOs, emphasize “helping each person achieve a high level of wellness by focusing on health promotion and disease prevention” through hands-on diagnosis and treatment, according to the American Association of Colleges of Osteopathic Medicine (AACOM). Licensed to practice in all 50 states, DOs work in various environments across specialties.

MD education experts also recognize an urgency for changing medical education. Transforming the way students are trained to practice medicine is key to improving access to quality care for patients, according to an October 30th Perspective article (“Are We in a Medical Education Bubble Market?”) that appeared in the New England Journal of Medicine (NEJM). The article underscores why lowering the cost of health care and reducing the cost of medical education go hand in hand.

“If we want to keep health care costs down and still have access to well-qualified physicians, we need to keep the cost of creating those physicians down by changing the way that physicians are trained,” the authors are quoted as saying in a news release from Penn Medicine. “From college through licensure and credentialing, our annual physician-production costs are high, and they are made higher by the long time we devote to training.” 

Cleveland Clinic, Ohio University Heritage College of Osteopathic Medicine Lead by Example
The Cleveland Clinic’s South Pointe Hospital is partnering with the Ohio University Heritage College of Osteopathic Medicine (OUHCOM) to implement the BRC findings through a new pathway that has five components:

  • Focus on community needs served by primary care physicians.
    Emphasize primary prevention and improvement of public health to raise the quality and efficiency of care.
  • Advance based on knowledge, not years of study.
    Build a curriculum that centers on biomedical, behavioral and clinical science foundations so that the graduates’ readiness for practice can be better assessed through outcomes specific to medical education.
  • Boost clinical experience.
    Offer clinical experience from the first year instead of doing so later on. Increase responsibility throughout the training, and streamline training between undergraduate and graduate school to avoid redundancies and inefficiencies.
  • Require a range of experiences.
    These should include hospital, ambulance, and community health systems to provide the best learning experience.
  • Require modern health system literacy.
    Focus on health care delivery science including principles of high quality, high value, and outcomes-based health care environments.

Dr. Robert S. Juhasz, DO, president of South Pointe Hospital, says that Cleveland Clinic and OUHCOM will work to develop a curriculum that emphasizes early clinical contact to ensure “we are providing the right care, in the right setting for the right person at the right time.”

The partnership, Dr. Juhasz says, “will transform primary care education,” and go far to help shift the focus of medical education “toward competency-based rather than time-based education. We want learners to be engaged, practice-ready primary care physicians and be equipped to care for the communities they serve.”

South Pointe, which has trained DOs for 40 years, is renovating its facilities to now accommodate OUHCOM. Starting in July, 2015 it will train 32 osteopathic medical student residents per class.

The implications of BRC’s recommended changes, according to Dr. Juhasz, “will enhance our primary care base for delivery of care in a patient-centered model, increasing access and quality and reducing costs,” while also cultivating a learning environment that will “encourage more students to enter DO and find hope and joy in serving patients so that they will want to work in the area they train.”

Lead author of the NEJM article — David A. Asch, MD, MBA, Professor of Medicine and Director of the Center for Health Care Innovation at Penn Medicine — says that medical colleges can play a critical role in helping to avoid a burst in the “medical education bubble.” One solution is for schools to lower the cost of tuition and reduce high debt-to-income ratios that could discourage medical students from pursuing careers in fields where more physicians are needed, including primary care.

“Doctors do well financially,” he says, “but the cost of becoming a doctor is rising faster than the benefits of being a doctor, and that is catching up to primary care more quickly than orthopedics, and that ratio is close to overtaking the veterinarians.”

Now tell us what you think. What ways do you think medical school could be overhauled? What incentives can be provided to attract more students to study medicine and become doctors, particularly in primary care, to help reduce the rising provider shortage?

August Health Awareness Days Provide Opportunities to Take Action

As young people across the country go back to school, patient advocates and government stakeholders are leveraging awareness days to help communities learn about health issues impacting children, prevention strategies and efforts to improve care. Here are some examples:

Children’s Eye Health and Safety Month
Each August organizations including the Envision Foundation underscore the need for screenings and examinations to promote early detection, intervention and prevention of vision problems in children.

Paul DeMiglio

Paul DeMiglio

Vision disorders in children cost Americans more than $5.7 billion in direct and indirect expenses each year, while the overall cost of vision problems nationwide soars to an estimated $139 billion (includes long-term care, productivity loss and medical bills), according to Prevent Blindness America. Treating eye disorders and vision loss early in life helps protect children from developing chronic, lifelong conditions that become more expensive to treat because of long-term, indirect costs that increase as populations age.

“The beginning of a new school year is an exciting time in a child’s life,” Hugh R. Parry, President and CEO of Prevent Blindness America, said in a statement.  “By working together with parents and educators, we hope to give all our kids a bright and healthy start!”

National Immunization Awareness Month
According to the Centers for Disease Control and Prevention (CDC), the National Public Health Information Coalition (NPHIC) highlights the need to improve national immunization coverage levels throughout August. To communicate the importance of immunizations now and throughout the year, NPHIC also developed a toolkit tailored to various populations including babies and pregnant women, pre-teens and teens, young adults, and adults. The toolkit seeks to:

  • Encourage parents of young children to get recommended immunizations by age 2.
  • Help parents ensure older children, preteens and teens have received all recommended vaccines by the time they return to school.
  • Remind college students to catch up on immunizations before they move into dormitories.
  • Educate adults, including health care workers, about vaccines and boosters they may need.
  • Urge pregnant women to get vaccinated to protect newborns from diseases like whooping cough.
  • Raise awareness that the next flu season is only a few months away.

The CDC also makes a wide array of resources available for those who want to learn more about the importance of immunizations or spread the word.

Neurosurgery Outreach Awareness Month
The American Association of Neurological Surgeons (AANS) is among the organizations that underscores why the beginning of the school year is a great time to educate communities about strategies to prevent sports-related head and neck injuries like concussions. AANS provides tools to help others more effectively identify symptoms of potentially serious head/neck injuries and take preventive steps to ensure safety, also offering the following tips:

  • Buy and use helmets or protective headgear approved by the American Society for Testing Materials for sports 100 percent of the time.
  • Remain abreast of the latest guidelines and rules governing sports with a high prevalence of head injuries including cheerleading, volleyball, and soccer.

“Concussion awareness, understanding the symptoms of a potential concussion or other traumatic brain injury, is critically important in all sports,” AANS Public Relations Committee chair Kevin Lillehei, MD, FAANS, said in a statement. “Educating the public is one of the best weapons we have when it comes to combating these types of injuries. That is why it’s so important to raise awareness in the community and explain just what some of the effects are that these injuries have.”

Psoriasis Awareness Month
Sponsored by The National Psoriasis Foundation each year, Psoriasis Awareness Month is dedicated to “raise awareness, encourage research and advocate for better care for people with psoriasis.”

The most common autoimmune disease in the US affecting 7.5 million Americans, Psoriasis occurs when the immune system sends out faulty signals that speed up the growth of skin cells and produce red, scaly patches that itch and bleed. About 20,000 children under 10 are also diagnosed, often experiencing symptoms that include pitting and discoloration of the nails, severe scalp scaling, diaper dermatitis or plaques.

As part of Psoriasis Awareness Month, NPF is creating a community of “Pscientists” to “answer real‑world questions about psoriasis and psoriatic arthritis.”

Spinal Muscular Atrophy Awareness Month
Although it’s considered a “rare disorder” with approximately 1 in 6000 babies born affected by it, Spinal Muscular Atrophy (SMA) is a motor neuron disease that causes voluntary muscles to weaken and in some cases can lead to death, according to the National Institutes of Health’s (NIH) National Institute of Neurological Disorders and Stroke (NINDS). Types I, II and III belong to a group of hereditary diseases that weaken the voluntary muscles in the arms and legs of infants and children, contributing to breathing issues, difficulty eating and drinking, impaired mobility and orthopedic complications.

Families of SMA, which has coordinated activities around SMA Awareness Month since 1996, and the Muscular Dystrophy Association (MDA), are two national organizations that support those living with SMA. Click here to learn about events this month, community networks and research projects for treatment and therapies.

What activities are taking place in your community to support one or more of these awareness days? What could the institutions in your neighborhood, workplace or at your school be doing year-round to more effectively engage populations about critical health issues?

Categories: Access to Care

Turning DASH Strategy into Reality for Improved Cardio Wellness Outcomes: Part II

As part of their health & wellness program, the largest health insurer sent me a refrigerator magnet highlighting the National Institutes of Health’s (NIH) Dietary Approach to Stop Hypertension Diet (DASH).  In their accompanying letter, the company stated that the refrigerator magnet is a “tool to help you manage your blood pressure.”

Shawn J. Green

Shawn J. Green

The DASH Eating Plan refrigerator magnet was a nice gesture to remind clients to consume less sodium and incorporate more vegetables and fruits into their diet to lower blood pressure.  However, is this the most effective wellness tool to engage and motivate individuals to change their eating habits?

As we learned in last week’s post, plant-based diets – especially those rich in leafy greens, such as spinach and arugula – elevate cardio-protective nitric oxide.  For many pre-hypertensive individuals, staying with a plant-based diet is a critical driver to prevent elevated blood pressure and the diseases associated with hypertension.

Yet many Americans continue to fall far short of eating recommended daily servings of vegetables that elevate natural nitric oxide levels in our body.

A new model is needed to drive behavioral change. So how do we consistently integrate cardio-protective plant-based diets into our daily dietary lifestyle?

Berkeley Test may be a start.

Berkeley Test’s Saliva Nitric Oxide Test Strips and its iPhone Cardio Diet Tracker are designed to break bad habits and empower folks from various walks of life to incorporate plant-based foods into their daily diets.  These engaging tools provide a model to influence dietary change on a personal level that supports lasting compliance with measurable outcomes.

Designed to detect nitric oxide status in the body throughout the day, Berkeley Test developed the next generation proprietary nitric oxide test strip; for less than 70-cents, an easy-to-use, 1-minute saliva test strip enables consumers to make immediate and real-time dietary lifestyle adjustments.

Once users finish the strip test, they can use Berkeley Test’s Cardio Diet Tracker App to compare their results to a color-coded indicator showing whether nitric oxide levels are on target. After 2-3 hours, the user is alerted to check their nitric oxide status.  Users can leverage the Cardio Diet Tracker App to more effectively adhere to plant-based diets by tracking nitric oxide status in conjunction with the type, frequency, and amount of nitric oxide-potent foods eaten to sustain their levels.

Michael Greger, M.D., of NutritionFacts.org, suggests that Berkeley Test may offer hope by bringing plant-based foods into our dietary lifestyle in an engaging fashion. At the very least, it will remind us to eat our greens on a more frequent basis, he says.

Berkeley’s strip-app bundled technologies demonstrate that self-assessing, analyzing, and fine-tuning wellness outcomes with a shared, open, interactive community can be a catalyst to sustain plant-based cardio-protective diets in our daily lifestyle. The value of Berkeley Test’s model is not only demonstrated in how it equips consumers to make healthier dietary choices, but also in its ability to connect users by allowing them to share dietary successes with their Facebook friends.  In today’s society, wellness outcomes and fitness is highly social and valued.

Individuals – who range from Olympians seeking to boost their physical endurance to baby boomers looking for an easier way to eat healthfully and prevent high blood pressure – are embracing these innovations.  As more people turn to Berkeley’s strip and mobile App to improve adherence to plant-based diets, such as DASH and Ornish, natural communities of mutual support are growing.  These networks offer a unique venue to share experiences, provide strategies for success and a forum to discuss common challenges, refine approaches and achieve desired outcomes.

A dynamically open community to share new knowledge about wellness and create a model for achieving and maintaining healthy living and eating is what we hope Berkeley’s ‘health biomarker’ test strips (such as nitric oxide and mobile App combo) provides.

So, what is your nitric oxide level, today?

World Hepatitis Day Spotlights Importance of Early Detection to Improve Prevention and Treatment Strategies

This Sunday, July 28, is World Hepatitis Day, an observance that reminds us that hepatitis (inflammation of the liver) remains largely unknown as a major health threat. Approximately half a billion people worldwide and 4.4 million people in the U.S. live with chronic viral hepatitis, with one million deaths resulting from the disease each year.

Linda Barlow

Linda Barlow

The goal of World Hepatitis Day is to move from awareness to action to address the “silent epidemic” of viral hepatitis – so named because most people don’t experience symptoms when they first become infected, often not until they develop chronic liver disease many years later.

Stakeholders in government and private industry are stepping up to answer the call, supporting early detection and medical intervention as key starting points to effectively address the epidemic.

Earlier this month, Quest Diagnostics announced a partnership with the CDC to improve public health analysis of hepatitis C screening, diagnosis and treatment for the 3.2 million Americans living with it. Under the collaboration, anonymous patient data will be evaluated to identify and track epidemiological trends in hepatitis C virus infection, testing and treatment and determine how those trends differ based on gender, age, geography and clinical management.

“Our collaboration with the CDC underscores the importance of using diagnostic information to derive useful insights enabling effective prevention, detection and management programs for diseases with significant impact on public health,” Jay Wohlgemuth, M.D., senior vice president, science and innovation, Quest Diagnostics, said in a statement.

Early detection was also the focus of a 2012 National Institutes of Health (NIH) study published in Proceedings of the National Academy of Sciences. In the study, researchers concluded that elevated blood levels of a specific enzyme and a specific protein early on in the course of hepatitis C infection were much more likely to develop into advanced fibrosis or cirrhosis. The study found:

  • The long-term course of chronic hepatitis C is determined early in infection.
  • Rapidly progressive disease correlated with persistent and significant elevations of alanine aminotransferase (ALT), an enzyme released when the liver is damaged or diseased.
  • Rapidly progressive disease correlated with persistent and significant elevations of the protein MCP-1 (CCL-2), a chemokine that is critical to the induction of progressive fibrogenesis and ultimately cirrhosis.

Armed with this information, clinicians are expected to make a fairly accurate assessment of which patients are likely to develop advanced disease rapidly. Instead of waiting for a new class of drugs to be approved, these patients are likely to be pressed to start treatment right away – with the goal of treating the virus before it causes cirrhosis of the liver.

Because hepatitis does not result in symptoms until serious liver damage occurs, getting tested is also crucial. In fact, the CDC recommends that everyone born from 1945-65 get a one-time test for hepatitis C because they are five times more likely than American adults in other age categories to be infected and face an increased risk of dying from hepatitis C-related illnesses.

The first FDA-approved hepatitis C genotype test is now available in the U.S. From Abbott, the fully automated Realtime HCV Genotype II test determines the specific type or strain of the HVC virus present in the blood of an HCV-infected individual.

To locate organizations where you can access services including Hepatitis testing, vaccines and treatment, click here. You can also take this 5-minute Hepatitis Risk Assessment to obtain a personalized report from the CDC.

Early awareness and prevention-based practices are crucial to avoiding hepatitis. But what else can be done to ensure access to and availability of reliable and cost-effective screening and diagnostics, in addition to safe and simple treatment regimens for people with the disease?

We hope this post serves as a resource for journalists covering or interested in writing stories about World Hepatitis Day and related issues. Also stay tuned for our follow-up post next week that will address the cost-savings implications of vaccination and early treatment of hepatitis.

Say Goodnight to Unhealthy Diet Habits for Better Sleep

Are you having trouble getting enough zzz’s? If so, it might be time for a quick inventory of your bed-time diet to avoid another round of tossing, turning and sleep deprivation come the next day.

Paul DeMiglio

Paul DeMiglio

Although a variety of health factors play a role in the duration and quality of your sleep, watching what you eat and drink is a good place to start.

Avoid going to bed hungry, but don’t eat a heavy meal either.
Having a light snack a few hours before bed helps your body achieve the hormonal balance it needs to fall asleep, especially for many of those with insomnia. Antonio Culebras, MD, neurology professor at the State University of New York Upstate Medical University in Syracuse, says the following snacks are healthy choices before you hit the sheets:

  • Small bowl of cereal and milk
  • A few cookies
  • Toast
  • A small muffin

Be careful, though. Heaping on the portions will put your digestive system to work and risk keeping you up later as a result. Diabetes patients should discuss any diet regimen with a doctor first.

Stay away from alcohol or caffeine.
This doesn’t just mean the usual suspects like coffee and soda, but also extends to less-obvious options including chocolate, non-herbal teas, diet drugs and even some pain relievers.

Drinking matters.
One too many cups of your favorite beverage might mean more disruptive late-night trips to the bathroom.

Good diet choices are a step in the right direction to sleeping better, feeling better, and even saving health care costs. With 60 million Americans experiencing sleep disorders or sleep problems, the National Institutes of Health (NIH) estimates associated medical expenses to be  $16 billion annually.

Have you tried to change your bedtime eating habits? Did it help you sleep? Share your story.

Self-Service Kiosks Provide Innovative Path to Testing and Connection to Providers

The recent proliferation of affordable do-it-yourself consumer tools is one way patients are now empowered to take control of their health through prevention and wellness strategies.

One successful example is SoloHealth Station – a free, self-service kiosk offering comprehensive vision, blood pressure, weight and body mass index screenings. Currently located in select Wal-Mart, Safeway, Sam’s Club and Schnucks Markets, more than 10 million people have already used the kiosk in the past two years.

A $1.2 million grant from the National Institutes of Health played a major role in expanding the company’s free medical screening technology, education and wellness programs to a wider audience, including traditionally underserved communities.

“Seventy-one percent of SoloHealth Station users are at medium to high risk of hypertension and 51 percent are overweight or obese,” says Bart Foster, CEO and Founder of SoloHealth. “At the core, we believe that awareness and action can lead to preventative measures that lead to lower costs. So, consumers who realize they are at high risk of BP or BMI would be more propelled to click through to access a doctor or search and scan our database. They are now empowered with knowledge they probably never had before and they want to act on it.”

Foster shares some compelling data that illustrates how SoloHealth links patients to providers:

  • Nearly 40,000 users have clicked through to one or more nearby doctors via the kiosk’s search function.
  • Users with high risk of blood pressure problems are 57 percent more likely to choose a physician.
  • Users with high risk of BMI problems are 97 percent more likely to select a doctor.
  • Users taking the Health Risk Assessment are over seven times more likely to choose a physician.

SoloHealth Station leverages an interactive touch-screen and incorporates videos as part of a 4.5-minute process that guides about 85,000 users each day through its tests. Individuals then receive a comprehensive follow-up health assessment, view their test results, get suggestions for improvement and are given access to a vast network of accredited medical professionals.

Some urge caution about self-service health kiosks, raising concerns about patient privacy, how companies might use personal health data, the quality of their medical information, and whether advertisers and other sponsors might shape their advice and referrals for commercial reasons.

Foster points out that even with the spread of health kiosks, medical professionals remain necessary.

“Technology like the SoloHealth Station can make access to health services and tools easy, free and convenient,” he says. “We believe people will use these accessible tools to take better control of their health care. Once enlightened about a potential health problem, the majority of consumers will act. And knowing is better than not knowing, because prevention leads to better outcomes and lower costs.”

Have you used a SoloHealth Station or other self-help kiosk? Would you do it again? Why or why not? Comment below.

Categories: Access to Care