Palliative care, health policy, and health reform

From the Health Affairs Blog:

In the United States, value is the new health care imperative – improving quality while controlling costs.  We spend nearly twice the rate of comparable nations, yet have poorer health outcomes.  In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA), mandating a new emphasis on paying for value, not volume.

Our greatest opportunity to enhance value in US health care is to improve quality of care for older adults with serious illness – the group who uses the most health care services. Serious illness, in which patients are unlikely to recover, stabilize, or be cured, is life-altering for patients and family caregivers.  It includes advanced, symptomatic stages of diseases such as congestive heart failure, chronic lung disease, cancer, kidney failure, and dementia. Serious illness may also refer to the cumulative consequences of multiple conditions progressing over time, causing functional decline or frailty. 

We’ve made important progress in understanding high quality care for this population of patients.  Researchers have asked patients with serious illness and their families how they define high quality care.  Especially in serious illness, patients want control over treatment through shared decision-making.   Even when there is no cure, most patients still want health care that helps them live longer – but only if they can also get help with function, physical comfort, and attention to family, emotional and spiritual needs.

 Read the complete post here.

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New from the National Academies Press: Including Health in Global Frameworks for Development, Wealth, and Climate Change

From the NAP:

Including Health in Global Frameworks for Development, Wealth, and Climate Change is the summary of a three-part public webinar convened by the Institute of Medicine Roundtable on Environmental Health Sciences, Research, and Medicine and its  collaborative on Global Environmental Health and Sustainable Development. Presenters and participants discussed the role of health in measuring a country’s wealth (going beyond gross domestic product), health scenario communication, and international health goals and indicators. The workshop focused on fostering discussion across academic, government, business, and civil society sectors to make use of existing data and information that can be adapted to track progress of global sustainable development and human health. This report examines frameworks for global development goals and connections to health indicators, the role for health in the context of novel sustainable economic frameworks that go beyond gross domestic product, and scenarios to project climate change impacts.

Read, download, or by the workshop summary here.

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Rural health

From the Health Resources and Services Administration:

New publications focussing on rural health are now available from the HRSA Information Center.

  • Causes and Consequences of Rural Pharmacy Closures: A Multi-Case Study identifies factors that contributed to the closing of six local rural pharmacies and the impact of the closings in their communities.  Order using inventory code ORHP00584.
  • The Frontier Extended Stay Clinical Model: A Potential Health Care Delivery Alternative for Small Rural Communities analyzes whether the Frontier Extended Stay Clinic demonstration project successes in five remote and/or isolated clinics could be a reasonable emergency care and extended clinical stay model for other sites.  Order using inventory code  ORHP00582.
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Chemical informatio​n and the Jan 2014 West Virginia Elk River chemical release


You may be aware from multiple news sources that little information was available about 4-methylcyclohexanemethanol at the time of the spill in West Virginia’s Elk River earlier this month. Since the spill, government and private sector scientists have contributed to collecting and verifying information about the chemical. As a result, there is now a page on the Centers for Disease Control (CDC) website about the chemical and the methodology used by CDC to develop its recommendations.

There is also a new record in the NLM Hazardous Substances Data Bank (HSDB) for the chemical 4-Methylcyclohexanemethanol, which has a Chemical Abstracts Service registry number (CASRN) of 34885-03-5. Other terms for the spilled substance are “MCHM” or “crude MCHM” or “4-Methylcyclohexane methanol.”

Please note that in some social media and early news reports, the chemical was MISIDENTIFIED as Methylcyclohexanol (CASRN: 25639-42-3). This is NOT the correct chemical. In chemical incidents, it is unusual for little online information to be available about a substance. Chemicals can often be readily identified using online resources such as TOXNET and WISER. In the absence of published information, local and state officials request consultation with local, state, federal and industry experts. Typically, following such an incident there is immediate, ongoing, extensive consultation and communication among responders and experts to determine appropriate actions. When planning for providing health information following chemical incidents, it is critical for institutions and government agencies to know who to contact in uncommon situations as well as knowing the authoritative published sources of chemical information.


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New from the National Academies Press: Caffeine in Food and Dietary Supplements: Examining Safety

From the NAP:

Caffeine in Food and Dietary Supplements is the summary of a workshop convened by the Institute of Medicine in August 2013 to review the available science on safe levels of caffeine consumption in foods, beverages, and dietary supplements and to identify data gaps.  Scientists with expertise in food safety, nutrition, pharmacology, psychology, toxicology, and related disciplines; medical professionals with pediatric and adult patient experience in cardiology, neurology, and psychiatry; public health professionals; food industry representatives; regulatory experts; and consumer advocates discussed the safety of caffeine in food and dietary supplements, including, but not limited to, caffeinated beverage products, and identified data gaps.

Caffeine, a central nervous stimulant, is arguably the most frequently ingested pharmacologically active substance in the world. Occurring naturally in more than 60 plants, including coffee beans, tea leaves, cola nuts and cocoa pods, caffeine has been part of innumerable cultures for centuries. But the caffeine-in-food landscape is changing. There are an array of new caffeine-containing energy products, from waffles to sunflower seeds, jelly beans to syrup, even bottled water, entering the marketplace. Years of scientific research have shown that moderate consumption by healthy adults of products containing naturally-occurring caffeine is not associated with adverse health effects. The changing caffeine landscape raises concerns about safety and whether any of these new products might be targeting populations not normally associated with caffeine consumption, namely children and adolescents, and whether caffeine poses a greater health risk to those populations than it does for healthy adults. This report delineates vulnerable populations who may be at risk from caffeine exposure; describes caffeine exposure and risk of cardiovascular and other health effects on vulnerable populations, including additive effects with other ingredients and effects related to pre-existing conditions; explores safe caffeine exposure levels for general and vulnerable populations; and identifies data gaps on caffeine stimulant effects.

Read, download, or buy the workshop summary here.

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New edition of Health Communication Science Digest

From the Centers for Disease Control & Prevention (CDC):

This month in the Digest there are several papers reporting the effectiveness of public health communication messaging (Auchincloss et al; Beales & Kulick; Chang [2 papers]; Dillard & Main; Glanz et al; Huang & Yang; Lee, J.). Other reports examine audience segmentation and targeting (McInnes et al; Owen et al; Stanton & Guion) and aspects of health message framing (Berger & Iyengar; Jernigan et al; Kang & Walsh-Childers; Lee, S. et al; Schuldt; Smith et al). Issues in public health communication via new media (Abroms et al) and risk communication (Blanton et al) are reported. Health communication strategies are also highlighted (Marshall; Parvanta et al).

Read the complete Digest here.

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Change to the Public Health blog

Beginning in February, this blog will merge with the THL News blog.  Look for news of the library & beyond here.

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Library on the Road – Today, 1:00-2:30!

Need help using library resources for projects or classes?  Don’t know what a citation management program is, but need to find out?  Have questions about using library resources during the  building renovation?  Come to Library on the Road, when informationists from the Taubman Health Sciences Library come to SPH!  Look for us in 1629 Crossroads.

Library on the Road happens every Tuesday while classes are in session.

Can’t come on Tuesdays?  Send us an email at with your questions or to set up an individual consultation.

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E-cigarette poisonings & more in the new edition of Public Health Law News

From the CDC’s Office for State, Tribal, Local, & Territorial Support:

The new edition of Public Health Law News reprints an article from USA Today on the rise in reports of poisonings in children by e-cigarettes.

Other stories include reports from the states on changes in public health laws and an interview with Chester Antone, Councilman of the Tohono O’odham Nation Legislature.

Read the complete newsletter here.

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CSCAR: Statistical consulting @ UM

The Center for Statistical Consultation & Research (CSCAR) provides free consulting in data analysis & statistical methods to all UM researchers.  We are able to assist with the design, analysis, interpretation, & communication of research studies involving data.

CSCAR also presents workshops on statistical methods and software for data management & analysis.  Fall, Winter and Spring workshop offerings include Statistics Review, SAS, SPSS, Stata, SEM & Analysis with R.

Visit the CSCAR web page for current offerings for additional information.

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