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Acsys Interactive: Empowering Patients And Clinicians To Co-Produce Quality Care
A collaborative team with members from the Yale Center for Medical Informatics, Yale-New Haven Children"s Hospital/Yale School of Medicine and Acsys Interactive have responded to a national call for proposals from the Robert Wood Johnson Foundation Project HealthDesign:Rethinking the Power and Potential of Personal Health Records, with the design of a trial involving a diverse pediatric population with multiple chronic illnesses. We will be testing whether and how information about patterns of everyday living can be collected and interpreted such that patients can take action to better manage their health and clinicians can integrate new insights into clinical care processes. It is envisioned that leading edge technology such as the Google Health PHR platform along with Apple"s iPhone or iTouch mobile devices will be used to capture the ODLs. The proposed project team includes specialists experienced in these approaches and ethnographic evaluation; in pediatric disease management; in patient-centered care involving patient-clinician-technology partnerships; in bioethics; and in IT technical development.
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New Jersey Senator Proposes Plan To Avert HIV/AIDS Drug Copayments
New Jersey state Sen. Joseph Vitale (D) -- chair of the Senate Health, Human Services and Senior Citizens Committee -- earlier this week proposed a plan to temporarily reduce rebate checks to senior citizens earning $100,000 to $150,000 in an effort to alleviate the effects of possible budget cuts on certain populations, the Newark Star-Ledger reports. Vitale"s proposal also would avert planned $6 to $15 prescription drug copayments for people living with HIV/AIDS in the state (Livio, Newark Star-Ledger, 5/12). The copayments are part of Gov. Jon Corzine"s (D) $29.8 billion spending proposal for the state"s new fiscal year and would collect $1.36 million by creating copayments for HIV/AIDS drugs based on a sliding scale determined by income. The copayments would affect 9,000 people living with HIV/AIDS who have obtained no-cost medicine from the state because they do not qualify for other assistance programs. Advocates said that the copayments will hurt patients who are already struggling because of the poor economy (Kaiser Daily HIV/AIDS Report, 4/23). According to the Star-Ledger, Vitale"s proposal would save the state $15.7 million, including $9.7 million needed to allow 17,000 low-income families to enroll in the state"s health insurance program, FamilyCare. Senate Budget Committee Chair Barbara Buono (D) said that she does not believe it is possible to restore program cuts "given the collapse of revenues." According to the Office of Legislative Services, the current deficit for this year"s budget, which ends June 30, is at least $1.2 billon. Vitale said, "Our convictions are going to be tested as we come to terms with the fact that we simply don"t have enough money to fund all of the state"s priorities." He added, "But unless funding is restored for programs like NJ FamilyCare, Medicaid drug benefits and the AIDS Drug Distribution Program, I will be voting against the" fiscal year 2010 budget (Newark Star-Ledger, 5/12).
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The First Harmonised Standard For Organic Health And Beauty, UK
The Soil Association is pleased to announce a new EU-wide, harmonised standard for organic health and beauty products.
Endocrinology

Smoking Associated With More Rapid Progression Of Multiple Sclerosis

Patients with multiple sclerosis who smoke appear to experience a more rapid progression of their disease, according to a report in the July issue of Archives of Neurology, one of the JAMA/Archives journals. Cigarette smokers are at higher risk of developing multiple sclerosis (MS), according to background information in the article. However, the effect of smoking on the progression of MS remains uncertain. Brian C. Healy, Ph.D., of Brigham and Women"s Hospital, Harvard Medical School and Massachusetts General Hospital, Boston, and colleagues studied 1,465 patients with MS who visited a referral center between February 2006 and August 2007. Participants had an average age of 42 and had MS for an average of 9.4 years. Their progression was assessed by clinical characteristics as well as by magnetic resonance imaging (MRI) over an average of 3.29 years. A total of 780 (53.2 percent) of the patients had never smoked, 428 (29.2 percent) had smoked in the past and 257 (17.5 percent) were current smokers. During follow-up, seven never-smokers began smoking and 57 current smokers quit. Current smokers had significantly more severe disease at the beginning of the study in terms of scores on disability scales and also in the analysis of MRI factors. Current smokers were also more likely to have primary progressive MS, characterized by a steady decline, rather than relapsing-remitting MS (involving alternating periods of attacks and symptom-free periods). A group of 891 patients was assessed over time to evaluate the rate of conversion from relapsing-remitting MS to secondary progressive MS (steady decline that develops after a period of relapsing-remitting symptoms). During an average of 3.34 years, 72 patients (20 of 154 smokers, 20 of 237 ex-smokers, and 32 of 500 never-smokers) experienced this progression. "The conversion from relapsing-remitting MS to secondary progressive MS occurred faster in current smokers compared with never-smokers but was similar in ex-smokers and never-smokers," the authors write. An adverse effect of smoking on the progression of MS would be consistent with previous research, the authors note. Components of cigarette smoke are known to have toxic effects on brain and neural tissue; for example, cyanides, which have been associated with the destruction of nerve cells" myelin coating (a characteristic feature of MS) in animals. "Other chemicals in smoke (e.g., nicotine) can compromise the blood-brain barrier or have immunomodulatory effects," the authors write. "Cigarette smoke increases the frequency and duration of respiratory infections, which have been linked to risk of MS and to the occurrence of MS relapses." "In conclusion, the results of this large and in part prospective investigation support the hypothesis that cigarette smoking has an adverse effect on progression of MS as measured by clinical and MRI outcomes," they conclude. "Although causality remains to be proved, these findings suggest that patients with MS who quit smoking may not only reduce their risk of smoking-related diseases but also delay the progression of MS." Arch Neurol. 2009;66[7]:858-864. Archives of Neurology


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