Showing posts with label disease. Show all posts
Showing posts with label disease. Show all posts
Disease and Population Health Management Programs Do NOT Exclude Other Conditions
Tuesday, May 13, 2014
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| Playing whacamole |
"Health care blogging will never lead any serious beer money."
"Disease management coaching focuses exclusively on just one disease."
These are three falsehoods that bubble up in the unlikeliest of places, including cable news outlets, replying to the DMCB spouses asking "and what did you do today?" and webinars, webcasts and other educational meetings about population health and disease management.
While the Disease Management Care Blog finds all three vexing, the most irksome is the canard that the commercial health coaching service providers purposely limit their programs to just one chronic condition, like diabetes, weight loss or readmission prevention.
While that may have been the case in the earliest versions of disease management, that narrow approach was dropped years ago. Thats because patients typically seek advice for a wide range of overlapping concerns and the good nurses hired by the vendors will respond to them. The vendors also understand that their shared risk and performance guarantees depend on claims expense that is driven by the synergies of multiple co-morbidities.
While a purchaser, insurer or accountable provider organization may start out with a focus on a population defined by a single condition - such as diabetes mellitus - that doesnt mean their protocols and care plans wont span the continuum of care and include hypertension, tobacco abuse, depression, housing, chatting about the grandkid and responding to concerns whether this will be finally be NBA superstar LeBron James year.
And the published literature supports the DMCBs contention that modern population health management is multifaceted. Examples include this seven-condition program for dually eligible Medicaid beneficiaries in Georgia, this Midwest employer-sponsored program that enrolled persons with multiple care needs and this physician-focused program that used pay-for-performance to improve measures across multiple conditions. Check out some vendor web sites and youll see erences to "whole person health," the "interrelated aspects of social, emotional, and physical health" and "a holistic view of member health across internal and external care management initiatives."
That being said, the DMCB knows that perception and reality can be two different things. Given the whac-a-mole persistence of the "single disease" myth, the DMCB says the population health management community may benefit clarifying the broadness as well as the depth of their offerings as they continue to build their brand.
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Delaying retirement could lower the risk of brain disease in the elderly
Sunday, May 11, 2014
Delaying retirement could lower the risk of brain disease in the elderly - Recent research has shown that people who delayed retirement have a lower risk of brain diseases such as Alzheimers and dementia compared with those who retired at the age of 60 years.
The research was conducted on 429,000 employees in France. They found that the risk of dementia decreased when somebody delay their retirement and keep working at the age of 60 years and over.
"Our data show strong evidence for a decreased risk of dementia and brain disease associated with old age when one is put off retirement and continue working in old age," said Carole Dufoil researchers from INSERM, as reported by Reuters.
INSERM found that there is a reduced risk of Alzheimers by 14 percent for those who retire at age 65 years, compared with those who retired at the age of 60 years. The results obtained through observations of the participants for 12 years and ended in 2010.
Dean Hartley, director of the Alzheimers Association explains that the physical and intellectual activities undertaken by the elderly to help them reduce the risk of brain diseases such as Alzheimers and dementia. Even so Hartley argued that more research is needed to determine the exact reason behind the link between pensions and the risk of brain disease.
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The research was conducted on 429,000 employees in France. They found that the risk of dementia decreased when somebody delay their retirement and keep working at the age of 60 years and over.
"Our data show strong evidence for a decreased risk of dementia and brain disease associated with old age when one is put off retirement and continue working in old age," said Carole Dufoil researchers from INSERM, as reported by Reuters.
INSERM found that there is a reduced risk of Alzheimers by 14 percent for those who retire at age 65 years, compared with those who retired at the age of 60 years. The results obtained through observations of the participants for 12 years and ended in 2010.
Dean Hartley, director of the Alzheimers Association explains that the physical and intellectual activities undertaken by the elderly to help them reduce the risk of brain diseases such as Alzheimers and dementia. Even so Hartley argued that more research is needed to determine the exact reason behind the link between pensions and the risk of brain disease.
Vitamin D3 Halts Inflammation to Lower Cardiovascular Disease Risk
Tuesday, May 6, 2014
Thousands of research studies have demonstrated the powerful health-promoting properties of the prohormone compound, vitamin D3. Researchers publishingin The Journal of Immunology explain the specific molecular and signaling events by which vitamin D inhibits inflammation in the human body. In a very detailed analysis, scientists show that low blood circulating levels of vitamin D do not adequately inhibit the inflammatory cascade necessary to turn off this potentially destructive mechanism.
Low levels of inflammation, normally used by the body to fight pathogenic invaders, become a primary cause of heart disease, diabetes, many cancer lines and Alzheimer’s dementia. Additional evidence reportedin the British Journal of Nutrition demonstrates that adequate vitamin D levels reduce critical markers of cardiovascular health and can lead to significant reductions in body fat in overweight and obese people. It is critical to have your vitamin D level checked, and supplement as necessary to lower inflammation levels and risk of heart disease.
Vitamin D Lowers Inflammation to Prevent Chronic Disease and Stimulate Immune Response Systems
Dr. Elena Goleva, lead scientist from National Jewish Health, found that prior studies with vitamin D show a clear and positive link between blood levels of the prohormone and a variety of different health outcomes. Dr. Goleva and her team looked for specific mechanisms to explain precisely how vitamin D functions at the cellular level to prevent disease in the human body.
Dr. Goleva and her team of researchers noted that vitamin D is a catalyst that initiates “a clear chain of cellular events, from the binding of DNA, through a specific signaling pathway, to the reduction of proteins known to trigger inflammation.” To test how vitamin D acts on immune and inflammatory pathways, team scientists exposed human white blood cells to varying levels of vitamin D and exposed them to an agent known to promote intense inflammatory responses and advance disease processes.
Vitamin D Lowers Inflammatory Markers and Increases Health-Promoting HDL Cholesterol
White blood cells that were incubated with no vitamin D or a solution of 15 ng/mL produced very high levels of the pro-inflammatory cytokines IL-6 and TNF-alpha. In vivo, these signaling messengers are known to be responsible for the development and progression of cardiovascular disease, certain forms of cancer and dementia. Cells incubated at a concentration of 30 ng/mL and above showed a significantly reduced response, while the highest level of inflammatory inhibition occurred at 50 ng/ml.
Supporting evidence for the health-promoting effect of vitamin D as reported in the journal BMJ shows marked improvement in cardiovascular biomarkers including HDL cholesterol. Additionally, researchers found the hormone-like substance lowered the risk of lipid peroxidation, the process responsible for making LDL cholesterol molecules sticky and prone to form atherosclerotic plaque. They also determined that high circulating levels of vitamin D were associatedwith “significant reductions in fat mass”in overweight and obese people.
There should be no doubt that the millions of people living with grossly sub-optimal vitamin D levels are dramatically increasing their risk of developing a plethora of potentially deadly illnesses. Health-minded individuals will ensure they maintain a circulating blood level of 50 to 70 ng/mL by means of a 25(OH)D blood test to regulate systemic inflammation and fight chronic disease.
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