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AAA Warman Home Care’s E-Update is intended to bring to you timely and useful articles and information at the click of the mouse. It is sent monthly in an effort to keep you apprised of what is happening across the healthcare continuum of care effecting hospital, hospice and rehabilitation social workers and case managers, as well as Assisted Living, Independent Living and Skilled Nursing facility executives. Warman understands that time is limited and has undertaken to share with you important industry information without your having to search for it.
Women should think twice before buying their next pair of high-heels or pumps, according to researchers at the Institute for Aging Research of Hebrew SeniorLife in a new study of older adults and foot problems.
The researchers found that the types of shoes women wear, specifically high-heels, pumps and sandals, may cause future hind-foot (heel and ankle) pain. Nearly 64 percent of women who reported hind-foot pain regularly wore these types of shoes at some point in their life.
"We found an increased risk of hind-foot pain among women who wore shoes, such as high-heels or pumps, that lack support and sound structure," says lead author Alyssa B. Dufour, a graduate student in the Institute's Musculoskeletal Research Program.
Published in the October issue of the journal Arthritis Care & Research, the study is one of the first to examine the association between shoe wear - beyond just high-heel use - and foot pain. The researchers, who analyzed foot-examination data from more than 3,300 men and women in The Framingham Study, say past shoe wear among women is a key factor for hind-foot pain. They found no significant link between foot pain and the types of shoes men wear.
While foot pain is a common complaint in the U.S. adult population - foot and toe symptoms are among the top 20 reasons for physician visits among those 65 to 74 years of age - relatively little is known about the causes of foot pain in older adults. Women are more likely than men to have foot pain; however, it is not known if this is due to a higher prevalence of foot deformities, underlying disease, shoe wear, or other lifestyle choices.
From a list of 11 shoe types, study participants were asked about the one style of shoe they currently wear on a regular basis, what they regularly wore during five age periods in the past, and if they experience pain, aching or stiffness in either foot on most days. Nearly 30 percent of women and 20 percent of men reported generalized foot pain, which is in line with other foot-pain studies. Ms. Dufour's team, however, found a significant association in women who reported hind-foot pain and past shoe wear that included high-heels and pumps.
The shoe types were classified as "poor" (high-heels, pumps, sandals and slippers), "average" (hard- or rubber-soled shoes and work boots), and "good" (athletic and casual sneakers). More than 60 percent of women reported wearing "poor" shoes in the past, compared to only 2 percent of men (13 percent of women said they currently wear "poor" shoes).
When we walk, a significant biomechanical shock is delivered to the foot each time our heel strikes the ground. "Good" shoes, such as sneakers and other athletic footwear, often have soles and other features that soften this shock and protect the foot. The heel and ankle take the brunt of this shock, which may be why women who wear high-heeled shoes often report pain in this part of the foot.
"Young women," says Ms. Dufour, "should make careful choices regarding their shoe types in order to potentially avoid hind-foot pain later in life."
Scientists at the Institute for Aging Research conduct rigorous medical and social studies, leading the way in developing strategies for optimizing individuals' strength, vigor and physical well-being, as well as their cognitive and physical independence, in later life. Hebrew SeniorLife is a 105+-year-old organization committed to maximizing the quality of life of seniors through an integrated network of research and teaching, health care and housing.
Poor fitting shoes can cause a number of foot problems for diabetics and non-diabetics alike. They can cause bunions, corns, calluses, hammertoes and other disabling foot problems that are a significant public health risk in the United States. More than 43 million Americans have foot problems, many of which are serious enough to warrant medical attention.
Alyssa B. Dufour, a graduate student in the Musculoskeletal Research Program at the Institute for Aging Research of Hebrew SeniorLife and the lead author of a recent study on shoe wear and foot pain, suggests the following tips for making sure your shoes fit properly:
Ms. Dufour says to keep in mind this basic principle: your shoes should conform to the shape of your foot - your feet should never conform to the shape of your shoes.
SOURCE: Hebrew SeniorLife Institute for Aging Research, September 30, 2009
Researchers at UCSF Medical Center have begun enrollment for an early-stage clinical trial to evaluate the safety and efficacy of an adult stem cell therapy for patients who have just experienced their first acute myocardial infarction, or heart attack. The trial is part of a multi-center national study.
The cells used, known as mesenchymal stem cells, were obtained from the bone marrow of healthy adult donors. Depending on their location in the body, mesenchymal stem cells give rise to bone, cartilage, fat, muscle and connective tissue.
The experimental therapy is intended to combat the symptoms related to heart damage that continue to develop following a heart attack, including low pumping capacity, inflammation and increased scar tissue. Although the exact mechanisms of the stem cells' actions in this setting are not yet known, previous studies have suggested that they could reduce the amount of scar tissue and inflammation caused by heart attack.
A previous UCSF study on the impact of bone marrow-derived stem cells on heart attacks in mice provided evidence that stem cells work by assisting in tissue repair on the cellular level, resulting is less damage and improved function.
The new clinical trial is the first stem cell clinical trial in cardiology at UCSF.
"This is an important and exciting step for physicians and scientists seeking to translate research into beneficial treatments for patients," said Yerem Yeghiazarians, MD, co-director of the Adult Cardiac Catheterization Laboratory, director of the UCSF Translational Cardiac Stem Cell Program and lead investigator of the cardiac stem cell study.
"Many of us have been working for a long time to have a therapy for patients that could improve organ damage at the basic level," he added. "UCSF is one of the fastest hospitals in the nation at treating heart attack with angioplasty, according to the National Cardiovascular Data Registry. We are hoping that this stem cell therapy will prove successful in improving heart function and minimize the damage even more."
All patients arriving at UCSF's Emergency Department with heart attack will continue to be treated with standard measures. Patients who meet the medical criteria for the trial will be able to elect to receive the stem cell therapy within seven days after their heart attack.
To be eligible, male and female patients must be between the ages of 21 and 85, and have a baseline ejection fraction - the measurement of blood pumped out of the ventricles per heart beat - between 30 and 45 percent.
The stem cell therapy is delivered to patients via a one-time IV-infusion, performed on-site at UCSF. The infusion takes approximately half an hour. Patients will be followed for two years and progress will be assessed with MRI and ultrasound imaging in addition to the standard battery of cardiac measures, including electrocardiogram (ECG) and heart function monitoring.
The goal of the therapy is to prevent the permanent damage that heart attacks cause. According to the American Heart Association, more than half a million Americans will experience their first heart attack in 2009. Up to six years after a first heart attack, 18 percent of men and 35 percent of women will have another heart attack.
The two-year, Phase II trial will test the safety and efficacy of a stem cell therapy called Prochymal, developed by Osiris Therapeutics, Inc. Results from a Phase I (safety) trial - which did not involve UCSF - were announced by the company in Feb., 2009 (http://investor.osiris.com/releasedetail.cfm?ReleaseID=364825).
Despite early promising cardiac stem cell studies conducted at academic medical centers nationally and internationally, researchers still have questions about how stem cells work in the body in order to benefit heart patients.
"This and future studies hope to answer some of these questions. For instance, how is the therapeutic benefit achieved? Do these cells differentiate into heart muscle cells? Do they minimize cell death after a heart attack or do they act by other mechanisms to improve the cardiac function?" said Yeghiazarians.
To seek answers to these questions, UCSF launched a Translational Cardiac Stem Cell Research Program in 2003. The program includes a multi-disciplinary team of practicing clinicians and basic and translational scientists with expertise in the various aspects of cardiac development and physiology. The program is dedicated to the study of adult stem cells and their role in treating diseases of the heart and circulatory system.
"The aim of our laboratory is to advance the basic science and to translate our findings from the lab bench to treat our patients at the bedside," said Yeghiazarians.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
SOURCE: University of California – San Francisco, October 1, 2009
A new study published in the medical journal Neurology suggests that impaired kidney function is a risk factor for cognitive decline in old age.
The study, conducted by researchers at Rush University Medical Center, found that poor kidney function was linked specifically with cognition related to memory functions. Damage to one of these functions, episodic memory, which retrieves memories of time, place, associated emotions and other contextual knowledge, is often the earliest sign of Alzheimer's disease.
"Given the dearth of modifiable risk factors for age-related cognitive decline, these results have important public health implications," said Dr. Aron Buchman, a neuroscientist in the Rush Alzheimer's Disease Center. "Further work to understand the link between kidney function and the brain may provide new strategies for preventing memory loss in elders."
Buchman said the findings suggest that there are common disease processes that affect both the brain and the kidneys in the elderly, and hypothesized that underlying vascular problems, such as diabetes and hypertension, may account for the association between kidney problems and cognitive decline.
The study analyzed data for 886 older adults who participated in the Rush Memory and Aging Project, a group of community-dwelling seniors with a mean age of 81, all of them initially free of dementia. The participants were examined annually for up to six years to track changes in cognition over time. Cognitive assessments included multiple tests that were summarized as a composite measure of overall cognition and of five individual cognitive abilities.
The individual cognitive systems assessed were visuospatial ability; perceptual speed, or the ability to quickly and accurately compare letters, numbers, objects, pictures or patterns; semantic memory, related to meaning, understanding and other concept-based knowledge; working memory, which temporarily stores and manipulates information; and episodic memory.
Ruling out the influence of factors like aging and medications, which can affect cognition, the researchers found that poor kidney function, assessed at the beginning of the study, was linked with a more rapid rate of decline in cognition over the next several years not in visuospatial ability or perceptual speed, but in three specific areas: episodic, semantic and working memory.
The rate of decline in cognition was equivalent to that of a person seven years older at baseline, Buchman said.
The study was supported by funds from the National Institute on Aging, the Illinois Department of Public Health and the Robert C. Borwell Endowment Fund.
SOURCE: Rush University Medical Center, September 29, 2009
H1N1 influenza could slow growth in key industries and stall already-weak GDP growth in the third and fourth quarters of 2009, says a health economist in the University of Alabama at Birmingham (UAB) School of Business.
"Tourism and travel are vitally important sectors in the economy of many U.S. cities and communities," Bryce Sutton, Ph.D. "Depending upon the severity of the spread of the virus, consumers and businesses may respond by restricting travel and vacation plans, which would dampen an already weak recovery in these areas."
AAA estimates that as many as 60 million Americans annually travel 50 miles or more from home during the country's peak travel periods, which fall on the days that surround the Thanksgiving and Christmas holidays. Sutton says airlines, hotels and other service industries negatively impacted by recent trends of tightened consumer spending could face double jeopardy should H1N1 infections or simply fears of exposure keep would-be travelers at home.
Other business sectors could suffer, too, if sick workers and absences cut deeply into productivity and revenues, Sutton says.
"Although business managers have had time to prepare contingency plans, those that already have cut the numbers of employees in an effort to reduce costs during the downturn may be hardest hit," Sutton says. "In many cases, companies that already are working with the bare minimum staffs face further productivity challenges should large numbers of the remaining employees contract H1N1."
Sutton says more research is needed to measure the more precise impact of the H1N1 virus once the traditional U.S. flu season has passed. Until then, statements on the economic influence of the virus will reflect educated predictions based on the history of previous pandemics and their reported economic effects.
"The most recent case we have to study is the Asian SARS outbreak in the early 2000s, which negatively impacted a range of industries in Asia. The effects led to a regional loss of between 0.5 and 2 percent of GDP," Sutton says. "H1N1 impact predictions are based on examples like this one in which virus fears traditionally have had a negative influence on the economies of impacted regions.
"However, the H1N1 preparation has been much better when compared to the response of health agencies during the SARS outbreak and that could counter some potential negative impacts," he says.
SOURCE: University of Alabama at Birmingham, September 24, 2009
A wireless, credit-card-sized sensor that can detect whether health care workers have properly washed their hands upon entering a patient's room is being studied at the Virginia Commonwealth University Medical Center. The device could greatly reduce the number of hospital acquired infections nationwide since most are transmitted through contact due to poor hand-washing practice.
The VCU Medical Center was chosen as a study site because of its higher-than-average rate of hand hygiene compliance, nearly twice the national average. The sensor is worn like a name badge and is programmed to detect the presence of ethyl alcohol, the most common ingredient in hand cleansing solutions used in hospitals.
When a health care worker enters a patient's room, a small, wall-mounted sensor sends a signal to the badge to check for the presence of alcohol. The worker places their hands near the badge to obtain a reading. Lights on the badge glow red if no alcohol is present, indicating the need to wash hands. A green light indicates alcohol is present.
Experts say nearly 2 million hospital-acquired infections occur each year, resulting in about 5,000 deaths and more than 90,000 illnesses. Research shows that simple hand washing by medical staff could cut the number of infections in half.
"Health care workers don't deliberately avoid washing their hands; they get distracted or are so busy moving from one thing to the next they don't remember to do it," said Mike Edmond, M.D., chief hospital epidemiologist, and principal investigator of the study. "Until now, the only way we've been able to track hand washing habits is through direct observation. This new system continuously monitors and records data and serves as a constant reminder."
VCU will study the device over a two-week period in a 21-bed unit of the hospital. Data gathered will measure how many times staff members followed proper hand washing procedure and how often they had to be reminded. The study also will assess staff perceptions of the technology and how compliance data compared with direct observation studies in the same unit.
The device was developed by BioVigil, LLC.
VCU was selected as the study site because of its high hand washing compliance rate about 87 percent nearly double the national average and because of the aggressive patient and environmental safety initiatives that have been established within the organization.
The hand hygiene program is part of an aggressive environmental and patient safety campaign at the VCU Medical Center called Safety First, Every Day. The goal of the campaign is to make the medical center the safest health care institution in the country with no events of preventable harm to patients, employees and visitors.
SOURCE: Virginia Commonwealth University, September 17, 2009
AAA Warman Home Care is a family-owned Residential Service Agency which has been providing in-home health care services to thousands of clients for the past twenty years. Warman specializes in providing the highest quality of private duty, non-medical care and companionship for the elderly, those recuperating after hospitalization / rehabilitation, the terminally ill, disabled, alone or at-risk. It is our goal to assist our clients in living the most independent, healthy and comfortable lives in the privacy of their own homes.
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