HealthNet News

May/June 2018

Linking Connecticut Patients and Families to Reliable Health Information

In This Issue: Dangers of Keyless Cars; Midwives in the U.S.: and Transparency in Healthcare Pricing

Keyless Ignitions Have a Deadly Side Effect

Turning your car off with the push of a button would seem like a modern convenience. Keyless ignitions, however have a deadly side effect -- death due to carbon monoxide poisoning.  According to an article in the New York Times, drivers of keyless cars are "weaned from the habit of turning and removing a physical key to turn off the motor." This loss of habit combined with quieter new engines lead drivers, especially older ones, to mistakenly believe they have turned off the engine when, in fact, the car is still running.

The Society of Automotive Engineers has called for safety features to remind drivers to turn off the engine including a feature that would shut the engine off automatically. These safety features, which would cost pennies per vehicle, have met with fierce push-back from the auto industry. As a result, ignition safety features are optional for auto manufacturers. The New York Times identified 28 deaths and 45 injuries due to carbon monoxide poisoning since 2006. Authors of the article note these figures could be higher.

Check out Consumer Reports for a list of car brands with audible alerts in their keyless models. The article also lists those brands without an alerting system.

Smart Speakers Are Game Changers for Those with Visual Impairments

Selecting work outfits, setting cooking timers, scheduling grocery deliveries, and hailing Uber rides are just some of the ways people with visual impairments are using smart speakers like Alexa to live their lives more independently. Although smart speakers are mainstream, PC Magazine notes these devices check off all the boxes when it comes to accessibility.

More examples of how artificial intelligence is helping people with visual impairments master everyday tasks can be found in a recent article in the Wall Street Journal.

Diabetes Self-Management Classes Are Money Makers for Hospitals

Diabetes self-management programs teach patients how to manage their blood sugar, what to eat, and the importance of exercise to avoid the disease's serious complications. Patients with type II diabetes who enroll in these programs often lose weight and see their blood sugars return to the normal range. According to Kaiser Health News, hospitals see diabetes education classes as a way to make money and promote their brand. A Kaiser Health survey found charges for these group courses ranging from about $400 to over $1,700. Patients should check with their insurance companies to find out whether diabetes education programs are covered. They should also determine whether their insurance company will pay the full amount charged by the hospital.

Fourth-Trimester Project Looks at New Mom's Care After Childbirth

A groundbreaking project at the University of North Carolina at Chapel Hill (UNC) has been following postpartum women and their healthcare providers to learn how new moms are being served and how their healthcare could be improved for them. The 12 weeks following childbirth has been dubbed the "4th Trimester." UNC researchers discovered new moms have false ideas about how quickly their bodies recover. New moms are also unaware of complications like nerve damage and incontinence, and may be too embarrassed to discuss symptoms with their doctors. Women also don't know that there are treatments that can help. While there are abundant resources to support the health and well-being of the newborn, women typically receive just one visit six weeks after birth. Read more about this important issue on the news site Vox.

Why Are There so Few Midwives in the United States?

The U.S. spends more money on healthcare than any other industrialized country in the world, yet we have the highest rate  of newborn and maternal deaths related to childbirth. Could more midwives improve the safety of childbirth? Midwives in the U.S. participate in less than ten percent of births. In Great Britain, midwives deliver half of all babies. In Sweden, Denmark, and France, midwives lead roughly 75 percent of deliveries. While newborn and maternal deaths are increasing in the U.S., they are declining in other industrialized countries.

A video on the ProPublica website explores the history of midwifery in the U.S. The ProPublica website also references a recent study in journal PLOS One that found increased midwife participation across all healthcare settings correlated with better health outcomes for mother and child.

Good Design Helps People with Disabilities Navigate the World

"Access + Ability," an exhibition at the Cooper-Hewitt Smithsonian Design Museum in New York showcases how design can be more inclusive and allow greater participation by people of differing abilities. On display are 70 works that help people with disabilities navigate the world. The works include a shirt with magnetic closures; SoundShirt, a shirt that translates the experience of listening to music for people with hearing impairments; and a watch that uses haptic vibration technology to allow users with tremors to regain the use of their hand.

Curators planned the exhibit with users and caregivers. Verbal tours with a sensory component are available on the first Friday of the month. For those who can't visit the museum in person, Cooper-Hewitt has posted photos and descriptions of all 70 items online. Their blog explores how designers are tackling access and inclusion. 

Cancer Centers Advertisements Misrepresent Clinical Trials 

Cancer centers competing for patients advertise clinical trials as innovative treatment options and suggest that participation in clinical trials gives patients an edge on their care. Two physicians writing in JAMA Oncology argue that these advertisements are misleading and misrepresent the purpose of clinical trials. Suggesting that clinical trials give patients an edge hides the fact that patients in trials are often randomized. This means some patients are controls and receive the standard of care rather than the novel treatment. Centers may use emotive language to emphasize the individual benefits of participating in clinical trials, but do not disclose risks or potential for harm. The authors of the JAMA Oncology article share their views on the STAT medical reporting website.

Yoga Offers Health Benefits to People with Type II Diabetes

Evidence is growing that yoga offers measurable health benefits for people with Type II diabetes, prediabetes, and related conditions. Among the benefits are better management of blood glucose levels, as well as increased flexibility and fitness, and reduced stress. While there is abundant evidence of yoga's health benefits, little is known about how yoga works. An explanation involving gene expression and inflammation is described in an article in Frontiers in Immunology. Yoga may also be effective because it is modifiable to a person's level of fitness and flexibility, it is inexpensive, and may be easier to stick to than other forms of exercise.

The National Center for Complementary and Integrative Health website offers an in-depth look at yoga and a 16-minute video which reviews the science supporting yoga for health and well-being. If you are interested in trying yoga, your town's recreation department, senior center, or YMCA may offer classes. You can also search for certified yoga instructors on the Yoga Alliance website. Yoga Alliance teacher training programs require at least 200 hours of training with a specified number of hours in areas including techniques, teaching methodology, anatomy, physiology, and philosophy.  

Finding Effective Behavioral Health Treatments for Children

The Child Health and Development Institute (CHDI) has created a searchable database  of behavioral health practices that are evidence-based. Programs may be school-based, clinic-based, group-based, or offered to individuals. Searchers provide their location, how far they are willing to travel, and the type of treatment program they are looking for. After clicking the search button, a map appears with a list of practitioners providing that treatment.

You can link to the CHDI's "Evidence-Based Practices Directory" from KidsMentalHealthInfo.com. This website which is supported by CHDI, also offers information about childhood trauma, mental health in schools, and infant mental health.

Rehab Centers Use Internet Support Groups to Recruit New Patients

Marketers for addiction rehabilitation centers are using Facebook to woo addicts to "rehab hubs" in Florida and Southern California. In some cases, rehab companies run Facebook addiction-support groups without disclosing their financial interests. These rehab companies then use Facebook to "fish" for leads or "hang out" waiting for prospects. According an exposé written by The Verge, (a journalism project of Vox Media that examines how technology will affect our future lives), The Affordable Care Act has made it easy to obtain coverage for addiction treatment, making drug addiction rehab very profitable.

Hospital Pricing a Mystery?

Authors of a new study in JAMA Internal Medicine found that despite government and industry initiatives to increase pricing transparency, patients today are even less likely to get a firm price for procedures. The authors had previously surveyed hospitals and doctor's offices in 2011 for pricing for orthopedic procedures. The most common outcome of multiple calls to hospitals and doctor's offices was no price quote given at all over the phone.

A report released by the "Health Care Pricing Project," found large variations in pricing for the same test or procedure at different hospitals in the same city and even for different patients in the same hospital. The report found that prices were determined most often by negotiations between private insurers and hospitals, as well as the relative market power of hospitals and insurers. "Monopoly hospitals" charged prices that were 15 percent higher than areas with four or more hospitals. Few hospitals charged according to the Medicare fee schedule. 

More Health Information You Can Use:

• Biomedical tattoo catches cancer early

• Shoebox-sized lab detects infectious diseases from a drop of blood

• Audio-based app helps people with visual impairment explore their surroundings

• Personalized brain maps make brain surgery safer