Novel device to improve performance of underactive bladders

Researchers have developed a new device that can monitor bladder volume in real-time and effectively empty the bladder.

* This article was originally published here

Vegan Fettuccine Alfredo

A creamy, cheesy Vegan Fettuccine Alfredo Sauce that not only is crazy tasty, easy and quick to make, but also happens to be super good for you? Oh yes, it exists! And this? is it!

Fettuccine Alfredo is one of those classic recipes that need no introduction… I mean, who isn’t familiar with this super comforting, creamy, cheesy, garlicky pasta dish, and who hasn’t granted it top spots on their list of favorite foods?

Unfortunately, as delicious as it may be, this cream, butter and cheese laden classic isn’t the best choice one could make, nutrition-wise…

Luckily, this vegan version does much better for your body, without even asking you to compromise on anything at all! It’s crazy rich and creamy, mega cheezy and garlicky, super smooth and silky and every ounce as decadent and comforting as its dairy loaded counterpart.

The real kicker though, is that this healthier version is quicker, and easier to make than the real deal… I’m telling you, there’s nothing not to love about this recipe.

Even non-vegans will be all over it!

(more…)

The post Vegan Fettuccine Alfredo appeared first on The Healthy Foodie.

* This article was originally published here

Tracking The Pandemic: How Quickly Is The Coronavirus Spreading State By State?

View our map and graphics to see where COVID-19 is hitting hardest in the U.S., which state outbreaks are growing the fastest and which are leveling off.

(Image credit: Connie Hanzhang Jin/NPR)

* This article was originally published here

Stand up! How I’m incorporating a balance board into my home office routine

A few years back I heard that sitting is the new smoking. That concerned me, since I’m the type that tends to stay glued to my seat throughout the workday, especially when working from home. Some colleagues and clients have standing desks –or even treadmill desks!– but they never appealed to me.

The Apple Watch has been helpful in encouraging me to stand up. While I ignore most of its other prompts (like the suggestion to Breathe) I am quite responsive to the notification I get 10 minutes before the top of the hour, imploring me to stand up at least once before the clock strikes.

Recently, FluidStance offered to let me test out its Plane balance board, billed as a product that brings “movement and happiness to your workplace.” Bottom line: I like it and  you might, too.

The board itself. (Blue part is the bottom but it’s attractive enough that I thought it might be the top!)

With #COVID19 in the air, I don’t get a lot of excitement. So it’s always a highlight to receive a package on the doorstep. The balance board came in a long, thin box; when I opened it up I was impressed with the cloth backpack. I felt pretty cool carrying it up to my home office past my teenagers!

Dad is so cool!

It took me a couple minutes to figure out which end was up. (I got it wrong at first.) And my initial joy was tempered when I read the label on the board.

WARNING, USE AT YOUR OWN RISK! This product creates an unstable surface. Use of this product may result in injury or death. Use at your own risk.

Till death do us part!

Injury I can live with. But death? Even if sitting is the new smoking (and that’s actually controversial) death is still the old death!

Although my balance is good, I’ve never had much luck with skateboards, wakeboards, surfboards of anything kind of board. I was particularly good with the pogo stick as a kid, however.

I need not have worried, because the FluidStance board is really easy to balance on. If you do fall off, it’s about 3 inches so no biggie! It does provide a nice stimulus –better than just standing on the floor, and it’s easy to swivel around, too, should the temptation strike you.

I didn’t want to risk messing up my hardwood floor, so I put a mat under my chair. It protects the floor but does make it a little harder to swivel. When I’m not standing (which is still most of the time) I put my feet on it and use it as a footrest.

I’ve always done audio conference calls, but the pandemic seems to be pushing what would have been in-person meetings and even many phone calls into the video realm. Since I’m not even walking from one conference room to another, I’m sitting even more and am making an effort to stand.

The balance board is good to stand on during conference calls, but it presents a couple of challenges. For audio, I’m a bit far from the speaker phone –but I’ve checked with others and my sound seems good. But for video calls my head ends up out of camera range, even if I tilt the monitor up. I could probably do something about that with a webcam or mounting my laptop on a shelf, but I haven’t. These are minor annoyances but it means I don’t use the board as much as I might like to.

I’m not sure whether there are measurable benefits from using the balance board, but in any event I do like it and plan to keep using it. The literature that came with the deck said, “We aim to blur the lines between work and play, making work a more fluid and natural part of our whole lives.” I can feel that.

The FluidStance product is very well built. It’s solid, attractive and durable. Built in California, it’s well positioned to ride the de-globalization that seems likely post-COVID.

I recommend it.

—–

By healthcare business consultant David E. Williams, president of Health Business Group.

The post Stand up! How I’m incorporating a balance board into my home office routine appeared first on Health Business Group.

* This article was originally published here

Where did all the emergencies go?

Do you need me?

When COVID-19 hit, hospitals knew they would see a decline in elective surgeries and routine visits. After all, they canceled them! But the volume of patients visiting the emergency room has also dropped dramatically, and no one can seem to fully explain it. Sure, maybe we could expect fewer car crashes and skiing injuries. But heart attacks and strokes? If anything it seems like those numbers should be going up due to higher stress levels. Yet, the analyses in cardiac care during the pandemic show a sharp decline not only in elective cardiac procedures, but also in cardiac catheterizations for acute heart attacks, specifically, those with ST segment elevations – the most life threatening type.  

Conventional wisdom tells us that the drop in ER visits is a bad thing. Patients must be dying at home, outcomes must be worsening, and the patients that do survive will show up as train wrecks once the pandemic subsides. Those assumptions are probably true to a certain extent, but the open question is how true?   Acute conditions and complications warrant acute care.  But in the routine care of behavioral health and other chronic conditions such as diabetes and hypertension, extensive overuse of the emergency room rather than other ambulatory settings has been a prime area of concern and debate for several years.  

We know that ERs are overused in normal times. And we think they’re underused now during the pandemic, but to what extent should be analyzed and debated as we inform the necessary adaptation of our systems of care.  We expect to see an incredible amount of variation in ER utilization as the situation unfolds, by specific patient populations, urban vs rural settings, and geography-specific COVID-19 case burden. 

We are encouraged that Datavant has convened a wide variety of industry players to construct a COVID-19 Research Database, a set of de-identified data sets made freely available to enable rapid studies at scale.  The new initiative fills an important gap between quick observations that are available from small sets of real world data and clinical trials, which are robust but slow.

The ER phenomenon we’re discussing is not completely unprecedented. Researchers (and ER staff) have long observed the ‘big game effect’ – where ER visits decline as people defer them to watch their favorite team. (The Health Business Blog first reported on it in 2005: Red Sox’ success eases health care crisis.) Some, but not all, of those visits are avoided entirely without negative consequences. The COVID-19 pandemic provides an opportunity for a much longer time series. Let’s use it as a chance to study what’s going on so we can apply the lessons learned as we emerge.

What could explain sustained, lower utilization of the ER? There are a few possibilities:

1. Many seemingly serious problems resolve on their own when people just wait. If people avoid the ER out of fear, the ‘tincture of time’ will often do the job.
2. Less aggressive ambulatory settings are proving effective: the physician’s office, a telehealth visit, or home remedies.
3. The momentum and logic of the ER setting makes matters seem more serious than they really are. Once someone appears there’s always something to find. (As a doctor colleague once told me, “Show me someone who’s perfectly healthy and I’ll give him a full workup to demonstrate otherwise.”)
4. The ER is the entry point for admission to the hospital. Under fee for service, hospitals need to admit patients to make money. Depending on the proportion of available beds during these uncertain times, hospitals may be even more economically motivated than usual to fill open beds. So, once a patient arrives, they may be staying.
5. A significant portion of ER traffic is composed of so-called ‘frequent fliers.’ Usually, they are tolerated, but in the current environment, ER staff are motivated to triage non-COVID-19 patients away from the hospital as efficiently as possible. Once this becomes evident, the ‘frequent fliers’ ground themselves.
6. How many times have you called your doctor’s office or pharmacy and heard the recording say, “If this is a medical emergency, hang up and dial 9-1-1”? That definitely got people used to the idea that the ER is a good place for care. Clearly people are ignoring that messaging now!

So what should we do with this unexpected information?

1. More finely tune financial incentives to discourage unneeded utilization while not discouraging needed care. We know from experience that bluntly requiring large patient financial contributions drive down both good and bad utilization.
2. Educate people about the downside of ER visits (infection risk, treatment that’s too aggressive, likelihood of admission to hospital, provider that doesn’t know you) to balance out the current bias for ER care. People will be more receptive now and won’t immediately think that health plans are only trying to ration their care. 
3. Consider other changes in benefit design to help the decreased utilization persist, including increased access and reimbursement for home services, telehealth, and remote management tools.
4. Encourage physician offices and others to make better efforts to intervene quickly and prevent people from going to the ER just for convenience. This could include on-demand availability of telehealth consultations and other digital/remote management for which they would be reimbursed.

—–

By healthcare business consultant David E. Williams, president of Health Business Group and Surya Singh MD, president of Singh Healthcare Advisors.

The post Where did all the emergencies go? appeared first on Health Business Group.

* This article was originally published here

Calif. Governor Expected To Order Closure Of All Beaches And State Parks

After large crowds cooled off along the shoreline last weekend, Gov. Gavin Newsom warned that type of behavior would put the state's progress battling the coronavirus in jeopardy.

(Image credit: Marcio Jose Sanchez/AP)

* This article was originally published here

Higher thrombus risk in men with obesity in adolescence

Men with a history of obesity in their late teens are, in adult life are more at risk of a blood clot (thrombus) in a leg or lung, according to a new study. The risk rises successively and is highest in those who were severely obese in adolescence.

* This article was originally published here

Antibiotic exposure can 'prime' single-resistant bacteria to become multidrug-resistant

Researchers report that, for a bacterial pathogen already resistant to an antibiotic, prolonged exposure to that antibiotic not only boosted its ability to retain its resistance gene, but also made the pathogen more readily pick up and maintain resistance to a second antibiotic and become a dangerous, multidrug-resistant strain.

* This article was originally published here

Observer quotes David Williams on Tesla’s prospects during pandemic

Car sales are plummeting around the globe, yet Tesla sales –and its stock– are holding up for now.  It’s not exactly a healthcare story, but the Observer cited David Williams as a source anyway, in Tesla Seems Immune to Coronavirus’ Blow to Automobile Sales –But Is It?

“Although Tesla is not completely insulated from the downturn, I do believe that their situation is unique and they will be able to sell everything they make,” David Williams, president of Health Business Group, a management consulting firm, told Observer. Last week, Williams placed an order for a Tesla Model Y, “even though I don’t know when it will arrive or what the economy will be like at that time,” he said. “It’s a combination of wanting something fun and innovative and wanting to reduce my carbon footprint. I think my situation is typical of Tesla customers.”

The post Observer quotes David Williams on Tesla’s prospects during pandemic appeared first on Health Business Group.

* This article was originally published here

Tracking The Pandemic: How Quickly Is The Coronavirus Spreading State By State?

View our map and graphics to see where COVID-19 is hitting hardest in the U.S., which state outbreaks are growing the fastest and which are leveling off.

(Image credit: Daniel Wood/NPR)

* This article was originally published here