Category Archives: Health Care

Rethink Powerful Strategies for Cancer Prevention in 2017

By Hui Xie-Zukauskas

LoveHope 2017_Std.The holiday season is over and the new year started. Many of you probably have set some exciting goals or resolutions already. In reality, early or later, some folks would probably fall “off the wagon”? How would you do differently?

CancerPreventionDaily has provided plenty of practical advice, resources, and useful links on powerful strategies for cancer prevention over the years. Instead of reiterating those strategies here, I’d like to highlight a tool of “RETHINK”.

First, let’s cherish HOPE by celebrating recent scientific and medical advances in cancer treatment! Cancer Immunotherapy has been put on the spotlight – a therapy based on the principle of unleashing the body’s immune system to attack cancer. In addition, remarkable advances in other therapies (e.g. chemotherapy, targeted therapy, surgery and radiation therapy) all improved clinical outcomes, especially lives of people battling cancers.

Equally significant is advance in cancer prevention, specifically, HPV vaccine. As the human papillomavirus (HPV) is the major cause of cervical cancer – infected by passing the virus during sex, and the disease is preventable.

Now let me dive in a bit deeper on “Rethink”.

Consider Uber or Zipcar. Whether through Uber (providing you with a car and a driver) or Zipcar (providing you with a car), you can reach your desired destinies – a different approach from using traditional or old fashion rental cars. Note: These are good examples of innovation or rethinking, not paid Ads! :)

Next, how to rethink with regard to health?

Take weight loss as an example. Maintaining a healthy weight is one of the top powerful strategies for cancer prevention, as scientific evidence clearly indicate that obesity is a risk factor for several types of cancer in both men and women, needless to say risk for diabetes and heart disease.

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So, get motivated, get rid of all unhealthy baggage in all possible ways – dispose of fats, throw away junk foods, abandon extra sugar and extra salt, dispense or burn off some calories, thereby getting rid of “unwanted” pounds, consequently you will reach your goal of weight management. Certainly, you can discover creative ways that work best for you along the journey.

Rethink about cancer and prevention: Instead of fearing “Big C”, treat it as a life or health project with “small pieces”. This is because cancer is the mass (of tissues) on the surface but a collection of complex and multiple diseases in the hub, therefore, you need to tackle it with multiple approaches from genetic medicine, lifestyle to environment and early detection.

So, you got the idea.

In summary –

Rethink, Re-envision, Re-tweak, Re-evaluate and/or Re-calibrate, whatever works for you, so that you gain new perspectives and new approaches, which will help your new year’s resolutions stick, and reap your health benefits in the long run.

May more happiness and better health be all of yours throughout the year 2017!

 

Image credit: mozakdesign.com and CancerPreventionDaily

The Power of Participation in Patient Surveys

By Hui Xie-Zukauskas

Survey-Feedback_CPD w-otherAfter a trip to the doctor, you or a family member may be requested to fill in a “patient satisfaction survey” or “patient experience survey.” Many folks, questioning what difference it would make whether they complete the survey or not, simply ignore it, as if there were more urgent issues in life at the moment. Sound familiar?

In a recent post, I talked about the issue of improving patient safety and quality of care. Well, participating in a patient experience survey is a key part of that issue. Here, I’m going to dive in a little deeper.

First, let’s start with difference between a “patient satisfaction survey” and a “patient experience survey”

Though wordings of the two are similar, a careful assessment reveals striking differences. Understanding these differences can help you collaborate with your providers effectively.

The essential difference between the two is that a patient satisfaction survey concentrates on making patients happy, while a patient experience survey focuses on making people well – beyond making them happy!

A patient satisfaction survey reflects perceptions or preferences of quality of care received, so it’s more subjective. In contrast, a patient experience survey exposes what happened during the care, so is more objective.

Experience reporting is a more reliable instrument because it tells about the patient’s actual experience of a specific service, clinician, or hospital incident. Questions are designed to be more meaningful to patients and more measurable for providers’ care, and the answers can be transformed into actions.

On the other hand, a satisfaction rating is merely a judgment on meeting one’s expectations. As you can understand, people’s expectations vary, and what matters to one person is different for another.

Take a particular example of waiting time:

When asked “How satisfied are you with the waiting time for your appointment” (e.g. setting up time for your visit, finally seeing your doctor), the results from a satisfaction survey could range from excellent through good, fair, and finally poor.

But in a patient experience survey, when asked “How long did you wait for an appointment when you needed care”, the choices are more concrete (e.g., 1 day, 2-3 days, 4-7 days, or longer than 7 days). To the question “How long did you wait to see your doctor”, the answers are specific (e.g., 15 minutes, 15-30 minutes, 30 minutes or longer).

In sum, to steer towards patient-centered care, it is better to ask patients to report their real experience rather than to put down their satisfaction ratings.

Next, how do patients benefit from patient experience surveys?

Patient experience is important because it not only stimulates a strong patient-provider relationship but also is a critical step toward improving quality of care.

In particular,

  1. Patient experience surveys communicate the best way to improve quality of care. Research indicates that improving patient satisfaction has not been linked to improving quality of care.
  2. Emphasizing patient experience means putting patients first, with healthcare providers being concerned more about “what matters to you” rather than “how are we doing”.
  3. Patient experience surveys value patients’ voices. With your voice, an actionable change can begin because your input reveals key indicators for delivering quality of care.

Eventually, greater patient experience will lead to greater quality of care, which will translate into greater patient satisfaction.

Good news for cancer patients ! – CAHPS for Cancer Care

The Agency for Healthcare Research and Quality (AHRQ) has advanced Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to assess quality of care from the patient’s point of view in various healthcare settings.

CAHPS for Cancer Care has been developed by AHRQ to consistently measure and compare cancer care delivered by different providers and ultimately to provide information for quality improvement. CAHPS for Cancer Care includes three separate sets of questionnaires for surgical, radiation, and medical oncology respectively.

Although CAHPS® is the best tool for healthcare providers, patient engagement and participation are important parts of the process. More reasons for this survey, according to Dr. Caren Ginsberg, director of CAHPS® at AHRQ are:

  • CAHPS surveys are featured to capture information about patient experience rather than patient satisfaction;
  • The surveys are scientifically and statistically sound, thus the results are valid and reliable;
  • CAHPS is flexible to use and easily incorporated into any hospital existing surveys. 

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Overall, CAHPS® also serves as a massive database that offer measurable and actionable information, as the surveys have been implemented for over 20 years.

How can you participate and cooperate?

As a final point, remember: one survey cannot change health care or save a life, but it represents one voice and constitutes a worthy part of a large set of valuable data. So, when requested next time, please complete the survey (via innovative technology, direct mail, or telephone), because your voice will be heard, and you can help improve healthcare and save lives!

 

Image credit: http://earlylearningwa.org/ and http://knswb.org.au/

5 Reasons for a Higher Awareness of Zika

By Hui Xie-Zukauskas

Zika_Pt.2_CPDZika virus continuously poses a public health threat in the U.S.. Since my last post “Zika Virus Infection and Cancer Care Indication”, as of August 24th, 29 people in Florida have been infected with Zika virus through local mosquito transmission, along with 2,487 travel-related cases across the country, according to the CDC.

This is a more alarming reality than that presented three months ago when all 544 Zika cases in the U.S. were travel-related. Regions along the Gulf Coast are at an elevated risk for Zika outbreak, especially Louisiana, because of recent devastating flooding.

Pregnant women are particularly vulnerable to the Zika crisis. Of importance is to avoid traveling to Zika outbreak areas and stay self-protected to prevent mosquito bites. I won’t get into details here because plenty of information or guidance is available elsewhere.

Based on some new research and clinical findings, I’d like to emphasize FIVE reasons why we need a higher alert and responsiveness to Zika infection. Here goes:

1.      There are various ways for Zika virus transmission.

A person who has acquired the Zika infection could pass virus along through mosquito bites, maternal-fetal and/or sexual transmission. Unmistakably, blood transfusion also becomes a major concern as Zika-positive blood donation is evident. That’s why the FDA recently recommended nationwide screening of blood donations for Zika virus. Thank about it – why is it necessary to run such a costly and time-consuming testing for a massive blood donation system? Remember that people infected with Zika virus could be symptomless.

2.      Zika virus can damage not only a baby’s brain but also an adult’s brain cells.

Painful scan images have shown that Zika infects a fetus, causes brain calcification, and destroys a baby’s brain. Severe brain damage may bring about long-term developmental problems or neurological complications affecting vision, movement and epilepsy. On the other hand, new research reveals that Zika virus impacts a different area of adult mice’s brain, such as a specific neural cell, and it could affect long-term memory in some adults.

This thing does not allow reproductive system to receive sufficient blood to cause an cheap levitra canada try that store erection. You just need your debit or credit card in order cialis djpaulkom.tv order to complete the transaction and pay using the same. Myth – ED is a curable disorder Fact – ED is actually an incurable disorder; however, it can be brought upon by years of unhealthy cialis pills canada diet and lifestyle. Discover the rush that you will only get from their doctor.When it comes to certain things a person does not have firm erections in his life then it can drift away all the desirable love, happiness and pleasurable moments and may fill his life only with depression, canadian viagra sales inability and regret feelings. 3.      Zika virus affects the immune response, particularly in those whose immune system has been compromised due to a chronic disease or cancer therapy.

Infections by viruses can suppress the immune system. Moreover, a person’s inflammatory response to mosquito bites may augment the severity of arbovirus infection (e.g. Zika). Studies suggest that mosquito bites, especially in individuals hypersensitive to mosquito bites, may be linked to cancer development through activating cancer cellular pathways by mosquito-feeding, and/or through influencing human metabolic pathways leading to the initiation of cancer.

4.      It’s challenging to control mosquitoes.

Mosquito population is measured in the millions, and usually in the hundreds of millions. There is no way to distinguish Zika-infected mosquitoes from the rest uninfected. It’s virtually impossible to eradicate them all. But it doesn’t mean we should give up our effort.

Aerial spraying and backpack fogging carried out by the professionals can help reduce mosquito populations in epidemic areas. There are also effect measures that individual citizens can take right at home or the backyard with little or no cost. For instance, the best ways to control local mosquito population is to eliminate the places where mosquitoes breed, such as water-filled buckets, flowerpots, containers, puddles or pools of standing water outdoors.

Using pesticides to kill mosquitoes is delicate. Be cautious about unintended consequence, because pesticides often contain some toxic chemicals that can be harmful to human health if inhaled or ingested. 

5.      Finally, keep in mind those young women whose newborns suffering from microcephaly, neurological abnormalities and birth defects. What would their hardship be? – raising their ill babies, caring for the infants with various disabilities, and likely dealing with their own stress, anxiety, depression or quality of life.

 

Image credit: physio-pedia.com and CPD

Aging, Cancer, and Age-associated Illnesses

By Hui Xie-Zukauskas

Happy Aging_No magic pill_CPDAging is inevitable. Aging is a complex process through a progressive loss of physiological integrity, which has a negative impact on various body systems and their functions.

Aging is also a major risk factor for cancer. Why cancer risk increases as you age is not completely clear. Because cancer doesn’t develop overnight, one explanation could be – that genetic mutations of DNA (i.e. the root of developing cancerous cells) occur over a long period of time through prolonged, accumulated exposure to carcinogens (e.g. sun/UV rays, environmental toxins or contaminants in the air, the water or the food). Additionally, the aging-weakened immune system is less vigilant to detect and less effective to attack those cancerous cells.

As you age, accumulated damage to the cells put an increased burden on your immune response. Chronically stimulated inflammation, along with genetic, lifestyle and environmental risk factors, all intensify in your body and speed up the deleterious process. 

How well we age depends on many factors, including what we eat, how physically active we are, and how often and how long we are exposed to health risks such as smoking, over-consumption of alcohol, or harmful, toxic chemicals/substances.

In a parallel way, cancer is a disease of aging. Cancer is multifaceted and each one varies; but all cancers develop over time.

Interactions between aging and cancer occur at cellular, molecular, biological and physical levels via various intricate pathways. Along with “degenerative dysfunctions”, an initial cellular change becomes cumulative and collaborative to facilitate the accumulation of more or further alterations, thereby contributing to an exponential increase in age-associated cancer. Thus, cancer is a common health challenge among aging and especially elderly people. What could make this process worse are conditions like obesity and diabetes.

The good news: Cancer and other age-associated chronic diseases such as heart disease, stroke, and diabetes are mostly preventable! Prevention can be enhanced by lifestyle modifications, which is documented by both Western medicine and Traditional Chinese Medicine.

In the years we cialis viagra australia have always notice that somehow Google discriminates or just doesn’t “force” all websites into following their own guidelines and what for many websites would be an instant ban is the success of others. It must be taken orally and must be swallowed whole with a glass sildenafil canada pharmacy of water 1-3 hours before you plan to have sex (many men take about 2-4 hours before sexual activity). cheap cialis professional The hormones that control physical functions and gender hormones are mainly and prolactin. Strength and flexibility must levitra generika be built up gradually – on a gradient level. Traditional Chinese Medicine emphasizes human vitality. One principle in regard to aging is that Qi—your life energy—is crucial to longevity. Longevity is not about mere length of life. It is also about quality of life, i.e. living a life without suffering pain, distress, and diseases. Injury, physical suffering, and lack of proper nutrition cause Qi deficiency. Qi can be increased or decreased, replenished or drained, and balanced Qi promotes blood circulation, reduces inflammation, and regulates hormones. 

Here are some key strategies that keep your vital Qi protected and replenished:

  1. Maintain a healthy weight and avoid abdominal obesity. Excessive calorie intake and a sedentary lifestyle cause abdominal obesity.
  2. Have a diet rich in nutrients and antioxidants, such as fruits, vegetables, fish, beans, whole grains, nuts, and seeds.
  3. Avoid or limit high-fat, high-sugar foodstuffs and excessive salt intake from packaged or processed foods.
  4. Participate in physical activities regularly, age actively.
  5. Watch your numbers (cholesterol, blood pressure, blood sugar, etc), keep your blood pressure normal, and schedule routine cancer screenings.
  6. Remember to get a good night’s sleep.
  7. Practice gratitude. Gratitude is a secret to happiness, so keep counting your blessings.
  8. Love your age and love more. In addition to the love you show to your family, there are many ways to show your love, such as pursuing your passion, giving to your community, and caring and helping others. 

Let’s face it. You cannot help aging, but you don’t have to get “old”. Hopefully, at the end, you will achieve one of humanity’s greatest dreams, which is to have a long, productive, and happy life in a healthy body.

So, happy aging through vibrant well-being!

Links between Obesity, Diabetes, and Colon Cancer

By Hui Xie-Zukauskas

Links 3 conditions_CPDColorectal cancer remains the 3rd most common cancer and is the 2nd leading cause of cancer-related deaths in the United States.

The causes of colon cancer are multi-factorial. They include cellular, molecular, and genetic factors, as well as dietary and lifestyle factors. Today, I’m going to focus on one significant yet modifiable risk factor, obesity.

We start with a glimpse at the numbers.

The incidence rate of obesity is alarmingly high among U.S. adults based on CDC data. Rates for different age groups include middle-aged (40.2%), older (37.0%), and younger (32.3%). Also, about 17% of children and adolescents (age 2-19) are obese.

More than 29 million adults and children in the U.S. have diabetes. 86 million Americans have pre-diabetes, a condition that can lead to type-2 diabetes. Note that an estimated one in two seniors has pre-diabetes.

Obesity may be a factor in approximately 300,000 deaths each year. Diabetes will cause an estimated 75,578 deaths and colorectal cancer, an expected 49,190 deaths in 2016.

A look beyond the numbers

Obesity is a leading cause of diabetes, a disease for which the body fails to control blood sugar levels. High blood sugar levels are characteristic of both obesity and diabetes. What is less well known is that diabetes and obesity are also linked to an increase in cancer risk.

In fact, obesity is linked to many types of cancer (colon, esophageal, thyroid, breast, prostate, uterine, kidney, pancreas, gallbladder and non-Hodgkins lymphoma) and, needless to say, heart disease, stroke, and other chronic illnesses.

Research shows that obesity and diabetes are associated with an increased risk of developing colon cancer.

Intrinsic links between obesity, diabetes, and colon cancer are vastly complicated. One clear tie is sugar. High levels of blood sugar are a characteristic in both obesity and diabetes. High blood sugar also makes us predisposed to cancer by increasing the activity of a gene involved in cancer progression. Apparently, dietary sugar is a link tying together obesity, diabetes, and colon cancer, and thus excess sugar has an impact on our risk for cancer.
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Certainly, other links play a causal role. For instance, chronic inflammation is a central process that likely leads obese individuals to an elevated risk of diabetes and colon cancer, which all three conditions share a common inflammatory loop participated by multiple cell signaling molecules, growth and nuclear factors.

Highlighted Call for Actions

1. Colon Cancer screening

If you or your loved ones turn 50, you all should begin screening for colorectal cancer and then continue getting screened at regular intervals. This is because colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colorectal polyps can be found by screening and then removed before they develop into cancers. Plus, any developing cancer can be found earlier by screening when treatment works best.

2. Diabetes Control

Early intervention is critical to preventing or delaying the onset of type-2 diabetes. Good news for our nation’s seniors is that Medicare will extend coverage for pre-diabetes care. Check out the National Diabetes Prevention Program, a preventive health initiative via the Center for Medicare & Medicaid Innovation.

3. Healthy Weight Management

Nutrition and balance diet, weight loss, daily physical activity and healthy lifestyle are all beneficial for keeping weight down. Look for further details in CancerPreventionDaily earlier posts.

In brief, obese people are at a higher risk for developing cancer. Also, an obese condition is often resistant to chemotherapy regimens. The bottom line is that obesity prevention is a key life-saving approach.

 

Image source: CancerPreventionDaily

Care for Deadly Diseases: 10 Strategies to Help You Embrace Your Role

By Hui Xie-Zukauskas

Did you know …

Patient_involve_scripps.orgMore than 560,000 Americans die from cancer each year – more than 1,500 Americans each day.

More than 2,150 Americans die of cardiovascular disease each day – 1 death every 40 seconds.

Nearly 800,000 Americans suffer from a new or recurrent stroke annually – someone has a stroke every 40 seconds and someone dies of a stroke every 4 minutes.

Imagine if you or your loved one had one of these deadly diseases, what kind of care and outcome would you desire?

The Good news is that much effort has been shifting to patient-centered care, with its focus on individual needs. This is different from evidence-based practice that tends to focus on populations. Therefore, high-quality care and a good outcome must now be defined in terms of what is meaningful and valuable to the individual patient.

The Institute of Medicine has identified six areas for quality of care: safety, effectiveness, efficiency, patient-centered care, timely care, and equitable care. As a patient, you are the center of care. That means you need to take an active role in prevention and get involved in your care.

Because we’ve previously covered a great deal about prevention, today I’ll touch on a patient’s role in a high-quality care. And these strategies can extend to many other diseases, including diabetes, Alzheimer’s, obesity and rare diseases.

Here are 10 strategies for getting involved in your healthcare:

1.      Know your critical numbers and results of your screening tests.

These important results include checks for blood pressure, blood sugar and cholesterol levels, mammogram, colonoscopy, bone density scan, and even genetic analysis. These results are valuable for your primary care doctor too.

2.      Tell your story.

Inform the doctor what’s going on with you, in addition to simply answering probing questions from the doctor. Some details of your pain or discomfort may shed light for a correct diagnosis.

3.      Obtain a good primary doctor and a specialist.

Find doctors who have not only reputable professional expertise but also compassion, and who take time to listen to you instead of rushing through routines.

4.      Always have a list of questions in hand when visiting your physician or specialist.
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In case you don’t know where to start, WebMD provides essential questions about different conditions. You can also use Question Builder (by Agency for Healthcare Research & Quality) to generate your own questions at http://www.ahrq.gov/apps/qb/  – an excellent tool!

During your visit, if you don’t understand why a particular question is relevant to your situation, ask about it or let a family member do so. You may find that the doctor is only asking the question out of routine. Conversely, you may find out that issues you ignored might actually be very important to your case.

5.      Avoid medical errors, misdiagnoses, and unnecessary tests.

Hospital infections and medical errors kill 400 people each day. So, take safety initiatives to avoid being a victim. Communicate with your doctor if you have questions or concerns. Understand why your procedures or medications are necessary, and understand what will happen if you need surgery. Always keep with you a list of medications you are taking.

6.      Personalized medicine starts with individuals and reflects the patient’s needs, preferences and values.

Let’s face it – different cancers need different treatments; likewise, different patients have different needs. Personalized medicine is characterized as the right treatment for the right person at the right time. It may also encompass a biological therapy that targets specific cells or an interactive approach that requires patients and their physicians to develop customized diet plans and exercise regimes or change unhealthful habits. Remember, you play a key role in transforming your health. So make sure to have proper preventative care.

7.      Be vigilant for new symptoms or concerns, e.g., the occurrence of fever, fall, pain, or swelling.  If you suffer from a serious chronic illness like cancer and have a weak immune system, you are very vulnerable to any infections or inflammations that may worsen your situation. So, take care of your immunizations, and of food and hand hygiene.

8.      Be proactive and active.

This includes choosing a cost-effective health insurance plan and understanding your coverage. It could also be checking out where the nearest Primary Stroke Center is in town in case of a stroke emergency, because time is critical for surviving a stroke! Or volunteer to enroll a clinical trial.

9.      Self-educate, but be mindful of information sources and respect the opinions of your medical team.

Reliable and accurate medical advice can be difficult to determine sometimes on the Internet. Medical issues can involve life and death! Respect and trust your physicians, because as in life, sometimes what you think you want may not be what you really need. For instance, maybe what you want is an unnecessary drug, but what you really need is the right information or modification of your behavior. So, don’t measure good care by merely meeting your desires.

10.  Get family and friends involved.

Remember: Your health care is teamwork. Although you need to take ownership and get in the “driver’s seat,” you are not alone; your physicians, care professionals and care givers, the healthcare system, and your loved ones all take the ride with you.

Finally, being empowered with these principles and embracing your active role will facilitate the high-quality, patient-centered care that your medical professionals strive for. And they will help you achieve a desirable clinical outcome, leading to better health and more happiness for you and your family.

 

Image credit: scripps.org