Executive Healthcare Management

GSI Health Appoints Lori Evans Bernstein as President

Thu, 20 Jan 2011 16:31:00 +0000

GSI Health, a leading health information solutions provider, is pleased to announce Lori Evans Bernstein has joined the company as President.

In her new role, Ms. Evans Bernstein will lead GSI Health's growth efforts as the company looks to expand its software as a service (SaaS) based health information exchange and management solutions that help provider organizations, government and health IT vendors reduce healthcare costs and improve healthcare quality.

Ms. Evans Bernstein will report to GSI Health Chief Executive Officer, LeRoy Jones. Prior to joining GSI Health, Ms. Evans Bernstein served as Chief Executive of a provider solutions division of ActiveHealth Management, a health management company owned by Aetna, Inc. She also served previously as Deputy Commissioner, New York State Department of Health, Office of Health IT Transformation and Senior Advisor to the nation's first National Coordinator for Health IT, Dr. David Brailer.

"We are thrilled to have a leader of Lori's stature join GSI Health. She is uniquely positioned to help us further achieve a leadership position in working with provider organizations, government and health IT industry partners as they address critical market needs for health information exchange and data management services to improve the quality of care and reduce costs," said Mr. Jones. "Lori's more than 18 years experience across the public and private sectors leading product strategy, market and business development and policy efforts in senior federal and state governmental roles and within some of the industry's most pioneering health IT companies, gives her a unique ability to help us and our customers address some of the industry's largest clinical information challenges."

"I am very excited about the opportunity to advance health information exchange across the continuum of care as an essential underpinning to advance new care delivery and payment models such as performance-based incentive programs, accountability among physicians, patient centered medical homes and provider-driven care management," said Ms. Evans Bernstein.

"At GSI Health our goal is to enable a new generation of smart, cloud-based end user applications - moving beyond today's conventional electronic health records - that are interchangeable and based on clinical and operational need of doctors, hospitals and patients meeting both their short term goals while also preparing for the future."

Ms. Evans Bernstein has held executive roles within health care and health IT corporations; senior federal and state governmental appointments; health care delivery system operations; and health services and policy research. She writes and speaks regularly on health IT across the country and participates in numerous industry and federal and state policy initiatives as a national expert. She has received various professional honors -- most recently named a 2007 rising star by Modern Healthcare and a 2009 40 under 40 business leader by Crain's New York Business Publication.

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Beetroot Juice Linked to Brain Health

Tue, 14 Dec 2010 14:01:00 +0000

New research suggests that, in addition to heart health benefits, beetroot juice could improve blood flow to the brain and therefore join the fight against dementia. According to scientists at Wake Forest University in the US, beetroot juice could prove a powerful tool in boosting brain health.

"There have been several high-profile studies showing that drinking beet juice can lower blood pressure, but we wanted to show that drinking beet juice also increases perfusion, or blood flow, to the brain," said Daniel Kim-Schapiro, director of the Translational Science Centre at Wake Forest University.

Improved blood flow to the brain is relevant to cognitive health and ageing because poorer blood flow in the brain among the elderly is believed to be linked to the onset of dementia. Beetroot is a high-nitrate food and nitrate has been found to help open blood vessels and improve blood flow, say scientists.

To do so, they took a group of 14 adults aged 70 or over and for two days fed half of them a high nitrate breakfast that included 16 ounces of beetroot juice, while the other half ate a low nitrate breakfast. After that, an MRI scan was taken before the two groups swapped breakfasts for two days before having another scan. The MRI scans revealed that blood flow to the white matter of the frontal lobes, an area commonly associated with dementia, was higher among those who had just had the high nitrate breakfast.

Perhaps not surprisingly, on the back of this recent research into the heart and stamina benefits of beetroot juice, it has begun to see its share of the market grow. In the UK, leading supermarket chain Waitrose recently revealed that sales had grown 82 percent over the past year, while bunched and prepared beetroot sales were also up 15 and 22 percent respectively.

Meanwhile the scientists at Wake Forest University behind this latest research say they are looking to exploit the market potential of beetroot juice and are currently working with a company to reduce the bitterness of the drink - with the aim of developing a new beetroot beverage. The university is also looking at ways of marketing the drink.

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Aspirin Reduces Cancer Risk by 21%

Tue, 07 Dec 2010 16:50:00 +0000

British researchers revealed in an article published in The Lancet that a daily dose in the range of 75mg to 500mg of Aspirin reduced the risk of cancer by 21 percent. In most cases, the effects increased with time, with better results persisting for up to 20 years.

The findings of the study involved 25,570 participants who had been on aspirin therapy for at least four years. In all cases the trials compared aspirin to a placebo.
As well as cancer, the study revealed that death by other means was reduced by 10 percent by those patients on 75mg of aspirin per day.

The effect of taking a daily dose of aspirin reduced cancer risk by 21 percent on average, although differing cancers faired differently. Esophageal/throat cancer risk was reduced by 60 percent, bowel cancer by 40 percent, lung cancer by 30 percent and prostate cancer by 10 percent.

The study was carried out by Study leader, Professor Peter Rothwell at Oxford University, who believes that his team's findings will have a major impact on public health policy.

The study from Prof Rothwell represents strong evidence that aspirin can prevent the development of cancer, especially in the gastrointestinal tract, It is of more than academic interest: it should stimulate a re-evaluation of the role of aspirin with wider use of the drug. At the same time, we are acutely aware that aspirin is not without risks. In particular, it can cause internal ulcer bleeding and patients on aspirin should take a protective anti-ulcer drug such as omeprazole," said Professor Chris Hawkey, President of the British Society of Gastroenterology.

"But aspirin is not the only measure needed to reduce the risks of cancer. Lifestyle measures such as remaining slim, not smoking or drinking to excess and eating a healthy diet all have an important part to play. People should not ignore warning symptoms like rectal bleeding especially if associated with tummy pain, change in bowel habit or weight loss."

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BoxTone Survey Indicates Rapid iPad Adoption

Tue, 07 Dec 2010 15:27:00 +0000

BoxTone(R), the expert in proactive Mobile Service Management (MSM) software, today announced results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members, which indicates that iPad deployments are accelerating in large part due to the mobile device's compelling point-of-care applications and uses.

"As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity. With help from BoxTone's Mobile Service Management software, healthcare institutions can fully realize the benefits of mobility at the lowest cost and risk."

Key findings include:

* More than 25 percent of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70 percent plan to deploy the devices within the next year.

* One-third identified point-of-care applications - including lab order visualization and results, clinical decision support and medical image viewing applications - as top priorities, while 18 percent identified general administration including billing, coding and claims applications as top priorities.

* When provided with a choice of options for potential iPad IT management challenges, nearly 75 percent identified secure configuration and deployment as the number one challenge and 53 percent identified mobile application and deployment as a key challenge.

The survey took place on October 26 during an online Webinar co-sponsored by BoxTone and HIMSS. Nearly 70 percent of the attendees were from hospitals or healthcare organizations with more than 1500 employees, which typically act as bellwethers for new healthcare IT trends. Another significant fact: 15 percent of attendees were executive-level employees or physicians, evidence that the device is viewed strategically in the healthcare sector.

"Since its launch earlier this year, the iPad is redefining how organizations leverage mobile technology in the enterprise and the healthcare community is leading this paradigm shift," said Alan Snyder, CEO, BoxTone. "As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity. With help from BoxTone's Mobile Service Management software, healthcare institutions can fully realize the benefits of mobility at the lowest cost and risk."

BoxTone's install base of more than 275 organizations worldwide includes many of the best- known healthcare and health-related organizations such as MD Anderson Cancer Center, University of Pittsburgh Medical Center, U.S. Department of Veterans Affairs, U.S Army Medical Command and Kaiser Permanente.

BoxTone software centrally controls Apple iPhone and iPad, BlackBerry, Google Android, Nokia Symbian and Windows Phone mobile devices; BlackBerry Enterprise Server, Microsoft ActiveSync and Good Technology mobile connectivity platforms; and a wide variety of enterprise mobile applications. Clients include one in three Fortune® 100 companies, three in five of the largest U.S. federal agencies and three of the top five IT service providers. BoxTone secures, manages and supports more than 625,000 mobile devices.

To learn more about the process for secure configuration and management of iPad in the enterprise, please go here.

About BoxTone

BoxTone's proactive Mobile Service Management (MSM) solution is trusted by more than 275 of the world's leading enterprises and government agencies, including 89 in the Global 2000, to continuously maintain optimal mobile performance & security at the lowest cost and risk. BoxTone's single unified mobile management console powered by patented automation technology addresses the entire mobile lifecycle: mobile device management, support management, operations management and business management. BoxTone delivers centralized control of all mobile devices including Apple iPhone and iPad, BlackBerry, Google Android, Nokia Symbian and Windows Mobile devices; mobile connectivity platforms including BlackBerry Enterprise Server, Microsoft ActiveSync and Good Technology; and enterprise mobile applications. Learn more from the expert in proactive Mobile Service Management (MSM) software solutions at www.boxtone.com.

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Unsuccessful Efforts Made to Increase Patient Safety

Mon, 29 Nov 2010 16:26:00 +0000

A recent study published in The New England Journal of Medicine revealed that the rate of patient harm resulting from medical care has remain unchanged between 2002 to 2007 in spite of efforts made to rectify this.

In 1999, the Institute of Medicine (IOM) reported that medical errors caused up to 98,000 deaths and in excess of one million injuries each year in the US. Measures taken to combat this have included implementing computerized provider order-entry systems, evidence-based care bundles, and reducing work shifts. As it remained unknown whether these transformations in procedures had been successful in relation to improvements in patient safety, the study - published November 25 - sought to establish whether these changes had succeeded in reducing patient harms.

In order to assess this, ten hospitals in North Carolina were chosen for review. North Carolina was identified as the most likely region to have achieved improvements in implementing such systems as hospitals here have shown a high level of commitment toward improving patient safety. Efforts included a high degree of hospital enrolment (96 percent) in a national improvement campaign, and extensive participation in statewide safety training programs.

A total of 100 admissions per quarter from January 2002 to December 2007 were reviewed across the 10 hospitals, and analysis of preventable ‘harms' was conducted on the basis of 588 harms that had been identified. Among these, 364 were rated as preventable. These included 13 that caused permanent harm, 35 which were life threatening, and in nine cases these harms contributed to the death of a patient.

As North Carolina has been a leader in efforts to improve patient safety, the study states that the results are most likely indicative of a nationwide trend.

However, results were not entirely negative. "Although the absence of large-scale improvement is a cause for concern, it is not evidence that current efforts to improve safety are futile. On the contrary, data have shown that focused efforts to reduce discrete harms, such as nosocomial infections and surgical complications, can significantly improve safety," the study states.

It concludes that further research is needed focusing on resources, regulation, and improvement initiatives in order to successfully reduce patient harms in the future.

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The origins of Malaria

Thu, 25 Nov 2010 15:43:00 +0000

To quell the many arguments that have floated around university laboratories in years gone by, a researcher has finally settled the score with regards to the much-blamed chimp and its disease transferring ways - by revealing that it was in actual fact the gorilla that passed on malaria to humankind.

Studying DNA from the droppings of roughly 3000 apes - including gorillas, chimpanzees and bonobos - Beatrice Hahn of the University of Alabama at Birmingham has discovered that the strain of malaria parasite most common in humans is virtually identical to one of many strains that infects gorillas. Hahn even goes as far to confirm that consequently, the bonobo and much-loved chimp is out of the picture, with strains that cannot compare to the gorilla's near-identical matter.

Hahn's team tested genetic material from the human immunodeficiency virus for their AIDS studies and took a similar approach for the latest work, looking for DNA from malaria parasites, including the plasmodium falciparum that causes most human cases.

"Wild apes, in particular the common chimps and the western gorillas, are naturally infected with at least eight or nine different Plasmodium species," said Hahn. "Now, how many mosquitoes were biting however many humans or gorillas I do not know. But the end result is, based on sequence analysis of 105 human Plasmodium parasites, that it looks like there was a single transmission."

Malaria, which kills 800,000 people a year according to the World Health Organisation (WHO), currently still has no known cure or vaccine, although drugs can aid in prevention and controlling the infection. However, these new findings could eventually get the ball rolling towards the complete eradication of malaria - as Larry Slutsker, head of the malaria program at the US Centers for Disease Control and Prevention, confirmed.

"If we were trying to eradicate, meaning we were trying to rid the planet of every last parasite and there was a reservoir of western gorillas, that would have implications for eradication. I don't think we are there, obviously."

While further research is now inevitable, it's a huge step forward in the fields of malaria research and comprehension - and a huge relief for the chimpanzee population.

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Low Vitamin D levels and Parkinson's Disease

Thu, 18 Nov 2010 15:44:00 +0000

Finnish researchers have claimed that a person with low vitamin D levels could be more at risk of developing Parkinson's disease later in life.

The report, that is published in Archives of Neurology, also states that vitamin D could prevent the degenerative disease as it protects the nerve cells that are gradually lost by those suffering from Parkinson's.

The study, which saw 3000 people reviewed, found that people with the lowest levels of the sunshine vitamin were at a ‘three-fold higher risk.' The research is 30 years in the making, with researchers from Finland's National Institute for Health and Welfare taking blood samples to measure vitamin D levels from the study group between 1978 and 1980.

The study group was then followed over the next 30 years to see who developed Parkinson's disease. It was revealed that those with the lowest levels of vitamin D were three times more likely to develop Parkinson's, compared with the group with the highest levels of vitamin D.

The benefits of vitamin D

The report has already led to reactions in the healthcare community with Marian Evatt, Assistant Professor of Neurology at Emory University School of Medicine, writing in an editorial in the US journal Archives of Neurology that health authorities should consider raising the target vitamin D level.

"At this point, 30 nanograms per millilitre of blood or more appears optimal for bone health in humans. However, researchers don't yet know what level is optimal for brain health or at what point vitamin D becomes toxic for humans, and this is a topic that deserves close examination."

While vitamin D occurs naturally in the body, it is made when the skin is exposed to sunlight, although some comes from foods like oily fish, milk or cereals. However, as people get older their skin becomes less able to produce vitamin D.

It has been known for a number of years that vitamin D helps calcium uptake and bone formation, but this is the first time that it could also play a role in the maintenance of the nervous system.

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A Change of Culture for Healthcare

Fri, 29 Oct 2010 09:36:00 +0100

Today the management of culture within healthcare is becoming more and more important. It is now viewed as a necessary part of the health system reform. In the United Kingdom, the National Health Service (NHS) reforms are based on the premise that any major cultural transformation of an organization must be secured alongside structural and procedural change, this in turn will deliver improvements in both quality and performance.

Culture change can be seen as a lever for performance improvements. The industry is well aware of the limitations of a mangeralist perspective. A new Committee of healthcare specialists believe that culture change within the industry must be targeted in one of two ways. Their first objective is to ‘do what you do better'. The Next Generation Healthcare Committee will meet at the NGH Summit in Miami.

"Many commercial organizations maintain a competitive edge by pursuing a policy of cultural continuity', they capitalize on the lessons, working practices and traditions that have worked for their company in the past, for this to work they focus on the growth or reproduction and repetition"

The second option is to look towards qualitative growth, this is a more appropriate option in a situation where the existing culture has become stale and a complete overhaul is required. This is also the position that the US healthcare system has found itself in.

"Second order change is often invoked in response to a growing crisis or deficiency in the existing culture, which cannot be addressed adequately by a change in culture but rather demands a fundamental change of culture. If politicians and management gurus are to be believed, health systems in many countries stand perennially on the threshold of such fundamental change."

After seeing high profile reports in the US which have documented gross medical errors, policy thinking is embracing the notion of culture change as a key element of health system redesign. Jeff Rose - VP Clinical Excellence, Informatics, Ascension Health wishes to address the committee on the principles published as A Leadership Framework for Culture Change in Health Care. He believes it is key to outline the core elements, or ‘5 C's' of culture change needed to move the US towards the adoption of new tools and processes in healthcare that enhance care quality and provider adoption in the interest of high reliability environments. It gives a simple and readily recalled set of principles by which the traditions and resistance of many healthcare organizations can be both led and managed by caregivers and executives so that expenditures on technology, information and evidence availability, collaborative processes and principles of high reliability human factors can speed our mutual journey to highest quality lowest cost medical practices in our rapidly changing world of technology, incentives and regulations.

Jeff Rose will be joined by representatives from Cleveland Clinic - Martin Harris, Chairman of IT Division and CIO, Catholic Health East - Mike McCoy, CMIO, MedStar Health - Gerard Burns, CMIO, Sentara Healthcare - David Levin, CMIO and VP Medical Informatics and Ascension Health - Jeffrey Rose, VP Clinical Excellence, Informatics.

Appeals for culture change in health systems have been a long time coming it is now key to draw upon a belief that culture is related to organizational performance. Are organizational cultures capable of being shaped by external manipulation? If so, what strategies are available to managers wishing to encourage an appropriate organizational culture?

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The Worst US Epidemics in Modern History

Thu, 28 Oct 2010 09:21:00 +0100

Epidemics have clung onto the underbelly of human existence for as long as time cares to remember. They've steered the course of history, brought populations together and torn them apart - but which ones have had the biggest effect on the US?

The US has been witness to its fair share of medical epidemics throughout the decades - from Polio to Typhoid, Smallpox to Typhus. Irrespective of age, social stature or ethnicity, one thing has always reigned true when it comes to epidemics both past and future: their ability to sweep indiscriminately through entire populations of people has never faltered - and most probably never will.

Yet rather ironically, since the days of modern medicine, trying to keep one step ahead of the game when it comes to epidemic predictions and vaccinations has, on occasion, actually had detrimental effects. So, in an effort to highlight both the over-hyped and under-estimated epidemics of years gone by, EHM has put forward its front-runners.

Polio epidemic: 1940-1953

With its presence being announced as far back as 1916 in Brooklyn, New York, it wasn't until the 1940's that the Polio epidemic really sunk its teeth into the American population. Although around 90 percent of polio infections caused no symptoms at all, if the virus entered the blood stream then it meant severe and crippling disabilities for the carrier, which unfortunately ended up as the usual precursor to the expiration of life.

Spanning just longer than a decade at its peak, the worst polio epidemic in US history came in 1952, where almost 58,000 cases were reported. Out of those figures, 3145 died and a further 21,269 were left with varying degrees of paralysis. The virus also managed to single-handedly introduce the world to the macabre yet life-saving iron lung that filled the wards of US hospital wards in the mid 90s and breathed for thousands of patients, hundreds of times a day.

Spanish Flu epidemic: 1918-1920

Although the exact geographical origin of the Spanish flu is still unknown, what is known is that the large majority of its victims were healthy young adults, which stands in stark contrast to most influenza outbreaks that predominantly affect juvenile, elderly or weakened patients. Lasting just over two years, the epidemic spread as far as the Arctic and remote Pacific islands. While estimates vary, between 50 million and 100 million people died, with a further 500 million - or a third of the world's population at the time - being infected with the disease.

Tissue samples from frozen victims were used to reproduce the virus for study in the latter half of the 1900s with modern techniques, which concluded that the virus most likely took hold by a cytokine storm - an overreaction of the body's immune system - which would go a long way in explaining the concentrated age profile of its victims.

Smallpox epidemic in Native Americans: 1663-1900

There are no credible descriptions of smallpox-like disease in the Americas before the westward exploration in the 15th Century AD. It introduced itself to the Caribbean and then the mainland in 1520, before working its way into the Amerindian population, and turned out to be a pivotal factor in the conquest of the Aztecs and Incas by the Spaniards. The subsequent settlement of the east coast of North America in 1633 was the precursor to devastating outbreaks of smallpox within the Native American population and subsequent native-born colonists.

Some estimates indicate that case fatality rates rocketed into the 80 to 90 percent zone in Native American populations during the smallpox epidemics, with many fearing to return to their homelands for many years. A unique disease to humans, fortunately today smallpox is one of only two diseases to have been eradicated by humans, with the other - Rinderpest - expected to be given an official declaration in 2011.

Russian Flu: 1889-1890 and 1977-1978

The first ever detailed recording of a flu pandemic, the Russian flu began - rather unsurprisingly - in Russia in 1889, before spreading rapidly throughout Europe. It reached North America late in 1889 and set up shop as a hub to work its way down towards Latin America before settling in Asia in early 1890. It took the lives of roughly one million people at the time, with many believing that would be the last of it.

Unfortunately, it resurfaced again in 1977 in the form of an H1N1 strain, mostly targeting children and young adults under the age of 23, as a similar strain had substantially immunized the remaining adult community in 1947. Fortunately, the virus was included in the 1978-1979 influenza vaccine, minimizing fatality levels and future outbreaks.

Typhoid fever: 1920-1950

Before the advent of public sewage systems, typhoid was common in the US, occurring in 100 out of every 100,000 people in 1920 - that number had reduced significantly to 33.8 per 100,000 people in 1950 with the introduction of better sanitation and infrastructure. But perhaps the most famous outbreak of typhoid fever in the US came in the early 1900s from a chef called Mary Mallon. Given the title "Typhoid Mary", she was taken into custody in 1907 by local health officials when it was shown that a number of typhoid cases in the area could be traced to kitchens where she worked.

She was held for three years on Brother Island in New York's East River and then released on the condition that she never again worked as a cook. She didn't take heed, and five years later was detained again after further outbreaks were traced back to kitchens she had worked in. She spent the rest of her life in Brother Island until her death in 1938.

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Healthcare Reform Discussion in Miami

Fri, 22 Oct 2010 10:54:00 +0100

Last week the leading names in Healthcare Finance met in Miami to discuss the effects of the new healthcare reform.

Since the Reform proposal back in the spring there have been endless and conflicting statements outlining the potential pitfalls of the proposal, and the effect it will have on the American healthcare system. However those in attendance last week only deal with the facts and how they will implement a variety of systems to deal with the changes.

The government believes that by insuring everyone, the cost of healthcare-per-person will decrease significantly; at the moment those who can afford their insurance usually cover the costs of those who cannot. The problem has now been faced head-on and the CFO Healthcare committee believe that without the reform the problem would have continued to deteriorate.

The meeting began by discussing the critical strategies in preparing the healthcare for the decade ahead, Marc Holland - CEO and MD for Systems Research Services outlined the need for capital budgeting, the new healthcare reform legislation, and strategic IT decision making. Bill Donato - Executive Director Supply Chain Management and Carol Harding - Senior Director Supplychain management at the Cleveland Clinic also discussed how to compete within the ‘Age of Reform.'

"The Healthcare Supply Chain, from manufacturer to provider and ultimately the patient, can no longer be ignored or counted on to contribute small incremental savings through price over price and/or inventory reductions."

The Cleveland Clinic itself has already committed to spending $100 Million in costs for strategic initiatives to continue over the next two years to excel clinically while driving operational excellence. They understand that in an era of declining revenues and spiralling costs, engineering supply chains and implementing new systems is the only way to keep up with the competition.

"In order to reduce the organizations cost basis the Supply Chain must be reengineered utilizing business practices that industry has been using for the last decade to respond to their provider customer's financial concerns. Expanding service lines, streamlining operations and reducing waste and errors will be critical to success."

Also joining the committee were representatives from Catholic Health East, Jenny Barnett - Corporate CFO, Baylor Health Care System, Michael Taylor - SVO Operations, BJC Healthcare, John Katsianis - CFO North Region and Spectrum Health Systems, Jeff Lemon - President.

The new reform will inevitably cost more money. It would be almost impossible to provide an equal service to everyone at the current price. To cover more people, costs must be controlled and some cuts will be necessary. The Affordable Care Act will save Medicare an estimated $8 billion in the next two years and almost $418 billion by 2019. Affordable care will drive down the costs for everyone, and save the Medicare system, from fraud and inefficiency. The Congressional Budget Office found that health insurance reform will reduce the deficit by over $100 billion in this decade and by more than $1 trillion over the following 10 years. It is up to the industry to carry this out now the government has settled on a decision.

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First Clinical Trial of Human Embryonic Stem-Cell Underway

Wed, 20 Oct 2010 13:52:00 +0100

After fierce ethical debates and a barrage of moral perspectives on the subject in years gone by, the first regulator-authorized clinical trial to treat humans by using embryonic stem cells began in the US last week.

Californian-based Geron Corporation announced the enrolment of the first patient in the company's clinical trial of human embryonic stem cell (hESC)-derived oligodendrocyte progenitor cells, GRNOPC1, last Monday. The primary objective of their Phase I study is to assess the safety and tolerability of GRNOPC1 in patients with complete American Spinal Injury Association (ASIA) Impairement Scale grade A thoracic spinal cord injuries - with participants in the study having to fulfil the criteria of being newly injured and receive GRNOPC1 within 14 days of the injury.

The anonymous patient was enrolled at the Shepherd Center, a 132-bed spinal cord and brain injury rehabilitation hospital and clinical research center in Atlants, GA. The Shepherd Center is one of seven potential sites in the US that have been granted permission to enrol patients in clinical trials.

"Initiating the GRNOPC1 clinical trial is a milestone for the field of human embryonic stem-cell based therapies," said Thomas B. Okarma, Geron's President and CEO. "When we started working with hESCs in 1999, many predicted that it would be a number of decades before a cell therapy would be approved for clinical trials. This accomplishment results from extensive research and development and a succession of inventive steps to enable production of cGMP master cell banks, scalable manufacture of differentiated cell product, and preclinical studies in vitro and in animal models of spinal cord injury, leading to concurrence by the FDA to initiate the clinical trial."

GRNOPC1 contains progenitor cells that have demonstrated remyelinating and nerve growth stimulating properties leading to the restoration of function in animal models with acute spinal cord injuries. Preclinical studies have already shown that the administration of GRNOPC1 significantly improved locomotive and kinetic activities of rodent models after being injected seven days after the injury.

David Apple, Shepherd Center's Medical Director Emeritus and Principle Investigator of the trial at Shepherd Center, said: "This clinical trial represents another step forward in Shepherd Center's involvement in an attempt to find a cure for paralysis in people with spinal cord injury. Shepherd Center is an ideal place to conduct this study because of our clinical expertise and the volume of patients referred here for rehabilitation care."

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Major Disease Threat to Global Health, Warns WHO

Fri, 15 Oct 2010 15:28:00 +0100

A new report by the World Health Organization (WHO) says the number of cases of a serious parasitic disease have more than doubled over the last 10 years. The warning states that unless countries act now then the situation will only get worse.

According to the report outbreaks of dengue have now become a major threat to public health.

WHO state that as many as two fifths of the world's population is at risk of the disease; and while the majority is living in the Asia Pacific region, WHO has warned of an increased number of dengue outbreaks in the Western Pacific region. In fact, the number of cases in the Western Pacific Region has more than doubled over the past decade.

A serious acute febrile disease, dengue is transmitted by mosquitoes and starts by giving victims flu-like symptoms; however it can develop into dengue hemorrhagic fever, which can be fatal.

The report suggests that an increase in outbreaks could be caused by a number of factors, such as higher temperatures and rainfall, which together make the perfect breeding conditions for the aedes aegypti mosquito, which carry the disease.

Dr Shin Young-soo, WHO's regional director for the Western Pacific, told the BBC that, "National resources need to be mobilized to sustain dengue prevention and control, and the disease's profile needs to be raised on the global health agenda to stimulate the interest of international agencies and donors.

According to WHO a concerted international effort is vital, with callings for urban planning and improving sanitation essential if the number of dengue cases are to be reduce. "The fight against this disease is everybody's problem," concluded Dr Young-soo.

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Legal Challenge of the Health Reform Goes to Next Stage

Fri, 15 Oct 2010 13:25:00 +0100

In their quest to throw out a controversial federal healthcare law, a US District Judge in Pensacola has allowed Florida and 19 other states to continue proceedings to challenge President Obama's national health reform effort.

Hearing the arguments both for and against dismissing the case last month, Judge Roger Vinson decided yesterday to rule in favor of the states, the National Federation of Independent Businesses and two individuals on two key provisions in granting them approval to continue their challenge. In a 65-page ruling, Vinson dismissed four of six counts, including arguments that law violated the states' due process rights; that the mandate amounted to coercion instead of taxation and interfered with the state's sovereignty.

"Starting in the First World War, there have been at least six attempts by the federal government to introduce some kind of universal healthcare insurance coverage," wrote Vinson. "At no point - until now - did it mandate that everyone buy insurance (although it was considered during the healthcare reform efforts in 1994). While the novel and unprecedented nature of the individual mandate does not automatically render it unconstitutional, there is perhaps a presumption that it is."

Unlike fellow US District Judge George Steeh, who dismissed a similar case in Michigan last week, Vinson agreed with the states that the healthcare law could violate the US Constitution's commerce clause and could be considered an undue expansion of Medicare. And on arguments from the US Department of Justice seeking to dismiss all counts, Vinson retorted that was a case for the court to decide.

Working against the health reform, Attorney General Bill McCollum, who filed the Florida lawsuit the same day President Obama signed the health care law in March, hailed Vinson's decision, which sets the stage for a Dec 16, asking Vinson to summarily throw the healthcare law.

"This ruling is a victory for the states, small business and the American people," McCollum stated. "It is the first step to having the individual mandate declared unconstitutional and upholding state sovereignty in our federal system and means this case will go forward to the summary judgement hearing that the court has set."

However, despite the continuation, Vinson cautioned both sides in the Florida case not to take his decision to allow the case to proceed as a final statement on the merits of the healthcare law, which will come by the end of the year according to a schedule lawyers on both sides agreed to last month.

"In this order, I have not attempted to determine whether the line between constitutional and extra constitutional government has been crossed. That will be decided on the basis of the parties' expected motions for summary judgement, when I will have the benefit of additional argument and all evidence in the record that may bear on the outstanding issues. I am only saying that (with respect to two of the particular causes of action discussed above) the plaintiffs have at least stated a plausible claim that the line has been crossed," concluded Vinson.

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EFSA maintains bisphenol A is safe, Denmark disagrees

Tue, 05 Oct 2010 14:04:00 +0100

The European Union's Food Safety Authority (EFSA) announced that it would not reduce or take any action to reduce or ban bisphenol A, a chemical widely used in plastic and food safety applications.

Both Denmark and France have maintained their own bans on bisphenol A, despite the EFSA announcement. France outlawed the substance in polycarbonate baby bottles earlier this year.

"The Danish ban was temporary because we were waiting for EFSA to provide new data that would remove these uncertainties. The EFSA opinion did not do this and therefore the ban will not be lifted in the near future," said Krestine Greve, a biochemist for the Danish food ministry.

"If the Commission imposes a Europe-wide ban on BPA in food contact materials for children aged three and under, Denmark will lift its unilateral ban. If the Commission does not do this, Denmark's ban will remain in place until such time as scientific evidence proves BPA is safe in at low doses."

"Our ban is based on a study which, according to Danish experts, shows uncertainty about the effects of even small doses of bisphenol A on the learning ability in young rats. So I stick to the temporary Danish ban," said Danish Minister of Food Henrik Høegh.

The EFSA confirmed that there is no new evidence to suggest the tolerable daily intake (TDI) for bisphenol A needs to be changed as it reconfirmed that current levels of exposure pose no threat to human health.

"Following a detailed and comprehensive review of recent scientific literature and studies on the toxicity of bisphenol A at low doses, scientists on the European Food Safety Authority's (EFSA) CEF[1] Panel conclude they could not identify any new evidence which would lead them to revise the current Tolerable Daily Intake for BPA of 0.05 mg/kg body weight set by EFSA in its 2006 opinion and re-confirmed in its 2008 opinion," the EFSA notes.

"Even human premature infants can metabolise and excrete BPA efficiently (via glucuronidation and sulfation), as supported by recent human data and data in young monkeys. The use of the standard uncertainty factor (UF) of 10 to take into account interspecies differences is therefore considered quite conservative."

Despite clearing the substance, the EFSA did acknowledge that there was dissent among some of its 21-member CEF panel. As a result, the current TDI level will be reviewed and is temporary.

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Hospital Infections Boost at Least One Area of IVD

Fri, 01 Oct 2010 14:08:00 +0100

Hospital acquired infections, or HAIs remain a problem for the healthcare system, and a problem in which new diagnostic products can play a role, according to Kalorama Information.

In its report, "The Worldwide Market for In Vitro Diagnostic Tests," the healthcare market research publisher details how sophisticated molecular tests that can quickly identify patients for isolation and treatment are being utilized despite their higher price tag. Kalorama forecasts that revenues for molecular tests that detect HAIs will grow at 25% per year for the next five years.

"They are growing at four times the rate of the average IVD products," said Shara Rosen, senior diagnostic analyst for Kalorama Information and the author of the report. "HAIs are a huge problem and this is an opportunity for the most logical tests to treat them."

Centers for Disease Control and Prevention (CDC) estimates that HAIs affect nearly 2 million Americans annually, resulting in 90,000 deaths and up to $6.5 billion in extra costs. A 2009 edition study in the Journal of the American Medical Association found that 51% of patients in nearly 1,300 intensive care units in 75 countries were suffering from some kind of hospital-acquired infection. MRSA, the most notorious of them all, accounts for about 10% of these infections. Other problem pathogens include C-difficile (an intestinal infection), Vancomycin-Resistant Enterococcus (linked with intestinal, skin and blood infections), and drug-resistant Acinetobacter (which can cause pneumonia, skin and blood infections).

Kalorama Information's report details several approaches to HAI detection. On the conservative and least expensive side are chromogenic growth media that permit the selective growth of MRSA bacteria and produce a colored colony that is easily recognizable. On the more expensive side, there has been an explosion of user-friendly molecular assays that have been widely accepted. Cephid, Becton Dickinson and Seegene are among the companies with products to test for HAIs. The advantage of these molecular tests is that they can provide highly sensitive rapid turnaround results. Their popularity, according to the report is growing but not universal.

"Screening with molecular tests has its defenders and opponents," Rosen said. "The defenders suggest that the cost of molecular screening tests, especially for MRSA, allow carrier patients to be segregated from the rest of the population. The opponents say that techniques such as chromogenic growth media identify carriers in enough time to limit the damage they can do."

Kalorama Information's Report, "The Worldwide Market for In Vitro Diagnostic Tests," takes a look at these topics and more. The book, published every two years, looks at every aspect of the in vitro diagnostic industry including molecular, hematology, immunoassays, POC and more. The report can be found here.

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From 2011 employer healthcare costs expected to rise by 9%

Tue, 28 Sep 2010 10:56:00 +0100

According to forecasts released on Monday, employers in the US can expect to pay nine percent more for their employees' healthcare costs in 2011.

The announcement could prove bad news for employees: according to the report from consulting group Hewitt Associates, an estimated 60 percent of employers will expect employees to cover around 12 percent of the increased healthcare costs. Given that the average salary raise is likely to hover in the vicinity of three percent for 2011, employees will see a subsequent decrease to their income.

According to the Hewitt report, the cause of the rise in healthcare and medical costs is due in part to America's ageing population, but also a direct result of the US healthcare reform. The latter has caused a real stir in political and non-political circles since President Obama announced the changes earlier this year, and is still a thorn in Obama's side as the November congressional elections approach and voters learn they must wait for promised savings to come into effect.

Counting the cost of reform

Reuters have calculated the fiscal effect of the report, and projected that average health care cost per employee will rise to $9,821 in 2011, up from $9,028 in 2010. Employees will pay $2,209, or 22.5 percent of the total premium, up 12.4 percent from 2010.

"After 18 months of waiting for healthcare reform to play out, employers find themselves in a very challenging cost position for 2011," Ken Sperling, Hewitt's health care practice leader, said in a statement.

In a more detailed breakdown of the growing costs, IndustryWeek confirm that other rising costs are due in part to employers moving toward pre-managed care benefit design by increasing deductibles and replacing co-pays with co-insurance, drugs representing about $26 billion in annual sales are expected to go off patent in 2011, including the world's best-selling drug, Lipitor, and COBRA subsidies passed by Congress in 2009 created a one percent increase in the medical cost trend, and costs are expected to return to more normal levels in 2011.

IndustryWeek do highlight that the biggest inflation of healthcare costs is due to the rising cost of hospital treatment and physician costs, which account for 83 percent of premium costs.

"Health reform delivers only a minor impact on the underlying medical cost trends in 2011 and introduces hundreds of changes in the healthcare system designed to reduce costs and improve efficiencies in the long-term," said Kelly A. Barnes, U.S. health industries leader at PricewaterhouseCoopers. "These changes could bring significant new cost savings opportunities for employers and payers as well as new choices and transparency for workers buying insurance."

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Viagra available on High Street without prescription

Tue, 21 Sep 2010 09:20:00 +0100

Tesco is to start selling the erectile dysfunction drug Viagra over the counter, at the ‘cheapest price'.

The UK retail giant is set to start selling Viagra in 300 of its stores to men between the ages of 40 and 65 years who don't have a GP prescription.

Tesco is the first supermarket to offer the surface. Boots currently charge £55 for four tablets; Tesco plans to undercut this by offering £52 for eight.

Tesco has stipulated that it won't be simply selling the tablet over the counter, and a number of checks will be carried out to ascertain whether the consumer is suitable for the tablets.

Amongst the checks will be a questionnaire, a blood pressure test, a cholesterol check and a test for diabetes.

"Provided that the men are suitable we will discuss their options and sell them an effective treatment," said Shona Scott, commercial manager for Tesco pharmacy services.

The idea has been lauded by Dr Nick Tomlinson of the Sexual Advice Association. ,
"Men can be very embarrassed about going to their GP for help with things like this," he said.

Buying over the counter also prevents men from purchasing fake Viagra over the Internet which could carry bigger health risks and means buyers will get a health check.

"It's now realised that for a great many men, ED is a warning sign of cardiovascular problems that need checking out. Something like a third of men with ED go on to develop some sort of cardiovascular problem within five years."

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GE Healthcare: �Smart Patient Room�

Mon, 20 Sep 2010 10:38:00 +0100

GE Healthcare has taken the initiative with its own twist on remote patient monitoring - and although not remote in the truest sense of the word, it certainly affords patients in the healthcare setting the assurance that they are, for the first time in healthcare history, being monitored remotely in-house for the greater good.

Beginning pilot trials of its Smart Patient Room health-monitoring project at New York's Bassett Medical Center, GE hopes that their next generation patient care system could transform patient monitoring while exponentially improving compliance from the caregiver perspective. As part of GE's Healthymagination Initiative, the Smart Patient Room can determine, amongst others, whether sanitizer dispensers are used by medical staff before and after seeing a patient, detecting spontaneous pain outbursts and monitoring steps medical staff take to ensure health and safety remains a top priority in protecting the patient.

Consisting of optical sensors, RFID tags, facial recognition, computer vision algorithms, cameras and speakers, the Smart Patient Room has been set up in existing hospital rooms at the inpatient teaching facility to ensure a small tester population. And with the Institute of Medicine and the Millenium Research Group both reporting that medical errors remain a leading cause of death in the US, it's an initiative that has been applauded by a large majority.

With an artificial intelligence (AI) system sitting on top of the RFID signals, the idea is that the hospital could also use the technology to detect patient delirium - particularly as a result of a medication reaction - check for ulcers and watch for signs of pain or a stroke based on facial expressions. Peter Tu, a research scientist for GE's Global Research Center, likened the Smart Patient Room platform to an iPhone running an abundance of applications. Speaking to eWeek, he explained: "Our goal here is to use this approach to sense the motion and action of individuals, and then determine whether they're within a given policy and work toward better outcomes."

GE has importantly taken the patient-centric approach to the initiative and ensured that all possible wires and cameras remain invisible within the room. "What's important is that the technology is transparent to the patient and to the care provider. It's the data that comes from the sensor technology that creates the value for the hospital," a GE spokesman said.

Up until the introduction of the Smart Patient Room to the Basset Medical Center, GE had been refining and developing their technology in a lab setup to mock a patient room. However, as Scott Gallagher, a senior consultant for GE Healthcare, said, the "chaos and uncertainty" of a live hospital setting will allow the company to finally create a completely reliable product that should be ready for commercial use by hospitals nationwide within a two year window. Tu also noted that the final product will undoubtedly uphold the "privacy of individuals", with the concept focused solely on working for its patients, not against them.

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MRI scan to check child�s brain development

Tue, 14 Sep 2010 09:58:00 +0100

A new ‘five-minute scan' to check children's brain development could become a reality in the very near future, according to a recently published study.

The team of researchers responsible for the results at Washington University's School of Medicine in St. Louis, published a study last year that looked at how brain function develops with age, using magnetic resonance imaging (MRI) to trace blood and neuron flows within the brain. The study revealed that in young children, connections within the brain appeared to be largely localized in particular regions. As the brain grows, it naturally replaces its short-range connections with longer ones, with the team believing that these latter signals are fewer but sharper in the adult brain.

Back with another step forward, the same team have now used similar techniques to map the neurological development in 238 volunteers aged between seven and 30. Each person's brain was scanned using an MRI machine, before the mass of subsequent data was put through a complex algorithmic computer program to produce a single "score" representing brain maturity.

Speaking to the BBC, Dr. Nico Dosenbach, head researcher for the study, said: "From a five-minute scan we get 13,000 measurements of functional brain connections. Then, we can take the whole pattern for a given individual and boil it down essentially to a single measure that tells us something about an individual. In our case, we were interested in how functionally mature an individual's brain is."

With the results to hand, the measures can then be plotted on a maturation curve, much like the ones already in use to determine the development of a child's height and weight, to give an indication of how quickly, or indeed slowly, relative to a median that a child's brain is developing.

Published in the journal Science, Dr. Dosenbach has high hopes for the subsequent findings from the study, convinced that the same technique could be used to test for specific conditions such as autism or schizophrenia - although comparative data and new mathematical programs would need to be collected and built to do so.

"In a young adult with schizophrenia, if you look at the anatomy of the brain, it looks totally normal whereas a clinician will clearly know this person is very ill and their brain doesn't function normally," he said. "Similarly with kids with autism, taking one look at the brain it's not obvious to a radiologist what's wrong, you have to do more advanced analysis like we're working on now to classify individuals as having autism or being at risk of having autism."

Dr. Gina Gómez de la Cuesta of the UK's National Austistic Society welcomed the Washington study, but remained cautious about the amount of work that remained ahead. "There is still a lot we need to learn about brain function and development so we welcome research such as the Washington study, which has the potential to give further insight into the neurological basis of conditions like autism. Eventually, the researchers hope that brain scans might also be a useful diagnostic tool, however this goal is still a long way off and further research is required."

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Vit B could delay onset of Alzheimer�s

Mon, 13 Sep 2010 14:29:00 +0100

The results of a UK-based study last week has revealed that high doses of B vitamins could aid in delaying the onset of Alzheimer's disease in elderly patients displaying warning signs of the life-changing disease.

Published in the journal Public Library of Science One, the study looked at 168 elderly people experiencing levels of mental decline known as mild cognitive impairment. With half of the volunteers being given a daily tablet containing levels of the B vitamins foliate, B6 and B12 well above the recommended daily amount - and the other half being given an inescapable placebo - after a drawn-out two years, the rate at which their brains shrunk was measured and analysed.

The results speak for themselves, with the team from the Oxford Project to Investigate Memory and Ageing (Optima), finding on average that those taking the vitamin B supplements had their brain shrinkage slowed by 30 percent. Indeed, in more exceptional cases, Optima recorded a slowing down of more than 50 percent, making their brain atrophy no worse than those without cognitive impairment. Prior studies have showed that the average brain shrinks at a rate of 0.5 percent a year after the age of 60, with Alzheimer's patients rapidly overtaking that figure at 2.5 percent.

The vitamin B specifics in question - folic acid, vitamin B6 and vitamin B12 - all control levels of homocysteine in the blood; the higher the levels, the faster the brain shrinks and the onset of Alzheimer's begins. The study's author, Professor David Smith, told the BBC that the results were far more significant than he expected.

"These vitamins are doing something to the brain structure," he confirmed. "They're protecting it and that's very important because we need to protect the brain to prevent Alzheimer's." Smith hopes that further research into the findings could actually work out a way to prevent the development of the disease in patients with mild cognitive impairment.

However, despite the results, experts are warning people not to take the findings into their own hands. Chris Kennard, Chair of the Medical Research Council's Neurosciences and Mental Health Board, said: "We must be cautious when recommending supplements like vitamin B as there are separate health risks if taken in too high doses. Further research is required before we can recommend the supplement as a treatment for neurodegenerative diseases, such as Alzheimer's."

With this in mind, the UK's Food Standards Agency has set out guidelines to ensure that boundaries are adhered to, highlighting the fact that taking in excess of 200 milligrams of vitamin B6 a day could lead to a loss of feeling in the arms and legs, and ingesting more than 1milligram of folic acid a day could mask signs of vitamin B12 deficiency.

Fortunately, inhibiting further ingestion of the supplements in question can reverse the symptoms with no extensive harm. Regardless, for the world of Alzheimer's understanding and treatment, it seems as though things may have just stepped up a notch.

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