Tag Archives: Healthcare

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Groupthink and healthcare: An unhealthy alliance

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The term “groupthink” has been in popular usage since the 1970s, and its applicability to the multibillion-dollar 21st-century healthcare industry could not be more salient than it is today when we need more creative solutions to vexing problems than ever before.

Initially coined in 1974 by Irving Janis, a professor of psychology at Yale University, in reaction to terminology used by George Orwell in his seminal novel “Nineteen Eighty-Four,” it is defined by Yale Alumni Magazine as when “a group of intelligent people working together to solve a problem can sometimes arrive at the worst possible answer.”

Those firmly ensconced in the healthcare ecosystem can likely agree that groupthink plays a larger role than we would like to believe.

When Groupthink Rears Its (Misguided) Head

In the healthcare milieu, problem-solving frequently occurs from the top down, often without the valuable input of those with boots on the ground. When such changes are in the planning stages, staff members (who are often seen as nothing more than mere cannon fodder) are not consulted and typically told to suck it up and not ask questions because “this is the way we’re doing it now.”

Within nursing, when a staff nurse questions a particular accepted practice, the most dangerous words to be spoken in response are, “Well, that’s the way we’ve always done it.” In nursing, groupthink can keep nurses utilizing practices that are not evidence-based simply because change is too bothersome. Thus, in many instances, woe to the innovative nurse who has a new solution to offer.

Another form of nursing groupthink is the hazing and bullying of new nurses. In this form of groupthink, a more seasoned nurse might say, “Well, I was hazed, bullied, and sabotaged as a new nurse and now it’s my turn to get some payback; why should these new nurses get off easy?” This spurious practice is a significant driver of nurse attrition from the profession within the first few years following graduation and licensure; in terms of nursing shortages, this is a very unfortunate calculus indeed.

In medical education, groupthink occurs in the long sleepless hours worked by medical residents. Often awake for more than 24 hours at a time, the evidence is clear that such extreme lack of rest leads to mental fatigue, physical exhaustion, burnout, depression, poor judgment, and medical errors.

While some headway has been made in legislating residents’ hours, the reality is still mostly the same, with severely compromised residents populating teaching hospitals throughout the country like an army of highly educated zombies. Whoever still blindly supports such cruel and ineffective indoctrination is an obvious adherent to groupthink that absolutely endangers patients.

Ignorance Isn’t Bliss

Innovative thinking is the natural enemy of groupthink. While some may readily embrace groupthink as the modus operandi of American healthcare, others push back against such ignorance with the power of the creative mind.

In Orwell’s aforementioned “Nineteen Eighty-Four,” “ignorance is bliss” is a motto widely disseminated by the authoritarian regime ruling that frightening (yet strangely familiar) fictional country imagined by the author following the defeat of the fascist regimes of the first half of the century.

Healthcare is not an industry where groupthink, blissful ignorance, or pandering to the powerful produce any appreciably positive results. To the contrary, groupthink and its accompanying lack of knowledge or forethought are what has lent an air of inevitable dysfunction to healthcare delivery, especially in the United States, where we spend more per capita for far worse outcomes than any other industrialized country.

Historical rejection by the medical establishment of alternative/complementary therapies has kept many potential solutions out of the hands of consumers, and the death grip of insurance companies on politicians’ reelection campaigns also drives groupthink in the White House and the halls of Congress. Outright rejection of single-payer and related solutions also stymies creative approaches to our current situation, not to mention the denial of climate change, a true public health crisis of unprecedented proportions.

The Rise of Innovation

In what remains of the 21st century, we need more leaders, influencers, researchers, innovators, and rank and file clinicians to rise to the occasion and provide us with new fixes to longstanding problems.

The outright rejection of groupthink and ignorance is paramount if we are to move forward. Weak-willed and ineffective politicians, mercenary insurers, greedy pharmaceutical companies, cadres of lobbyists, and others standing in the way of innovation and positive change must be thwarted by most any means necessary.

As the millennial generation enters into full leadership of most industries worldwide over the coming decade, we must hold out hope that the younger generation can succeed where its predecessors failed. Healthcare costs are out of control, Americans continue to get sicker, and we spend more for less with each passing year.

We need creative, courageous minds to gather together, reject groupthink, swear off the status quo, and move us into a brighter future. Without such leadership, groupthink and its stalwart companion ignorance will continue to hobble our best efforts.

Who will lead the charge, dear Reader? Look no further than the face in the mirror.

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Considering giving up alcohol? You’re in good company

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For years now, people have been abstaining from alcohol during the month of January. This trend follows the typical pattern of people wanting to focus on health after holiday indulgences and failed resolutions from the previous year. Once the month is over, many return to their previous habits.

This year is different. Now, there is a major trend toward eliminating alcohol altogether. In the past few months, four people I know personally have happily announced that they’ve given up alcohol. All acknowledged that they feel better than they have in years.

So, why now?

The title of a Dec. 30, 2019, article in The Economist boldly proclaimed that “Drinking is going out of style.” Zion Market Research reported in 2018 that the global nonalcoholic beverage market will reach a record value of $1.65 trillion by 2024.

Part of the new alcohol-free language includes “sober curious” based on the best-selling book by the same name that encourages socializing without alcohol and “zero-proof” drinks, which include completely alcohol-free wine, beer and “mocktails.”

There are some deeper meanings behind these terms.

  • Sober curious doesn’t imply full abstinence, but rather supports a willingness to give sober social activities a try.
  • Zero-proof drinks allow people to still appear to be drinking because their drinks look exactly like the alcoholic versions.
  • Mocktails maintain the social enjoyment of being in a public bar or bar-like space enjoying drinks, but without the associated issues of intense inebriation, drunk driving and hangovers, among other things.

All of these reflect a strong desire to transition away from the socially accepted perception of needing alcohol to have a good time.

Even social media is reflecting this trend. According to Social Standards’ consumer analytics, there has been an 85% increase in online discussions about low‑ and no‑alcohol drinking in the past couple of years.

It’s clear that the sober lifestyle is more than just the latest fad. It appears to be here to stay. What that means is that we’re not only going to see more non-alcoholic drinks available in traditional bars, but we’ll also see more “sober bars” opening that cater exclusively to those seeking a place to socialize in which no alcohol is served.

Living a “booze-free” life used to be seen as missing out on one of life’s social customs. Now, however, as wellness has become a strong priority, sobriety is now considered a health-conscious choice.

Alcohol may be going the way of smoking. With so much awareness of the downsides of alcohol, especially in the area of addiction, viewing it through the lens of its impact on health means that we don’t have to go the way our predecessors did a hundred years ago when they tried banning alcohol altogether. We all know how that turned out.

Instead, we can each make a choice based on our own values and preferences, which makes it more likely to become integrated into an overall collective movement to improve health and well-being. Optimum health requires utilizing the best options available to maximize potential. Ultimately, this means reducing or eliminating those things which interfere with that potential. Right now, it appears that alcohol is on the outs.

Given that most of us have probably been negatively affected by the use and abuse of alcohol directly or in association with a family member, I see this as a very optimistic sign for future generations.

In the meantime, I suggest doing a Google search for sober bars or alcohol-free bars in your area and find out for yourself what this new trend is all about.

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Spotting ‘hidden’ but dangerous terms in a commercial lease

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Signing a commercial lease agreement is a huge milestone in the life of your business. It can greatly contribute to the success or failure of your business. When signing a commercial lease agreement, it is important to pay close attention to the business as well as the legal terms of the agreement, as it is usually not easy to change or get out of a commercial lease agreement once it has been signed.

On the upside, commercial leases are not based on standard forms and can be customized to the needs of your business. Generally, a standard lease will usually lean towards suiting the landlord’s needs. However, all the terms can be negotiated and you, as the tenant, can and should negotiate these terms to suit and protect your business needs as well.

You should, therefore, speak to an experienced real estate lawyer before you sign any lease agreement. A good real estate lawyer should explain all the terms of the agreement to you in layman’s terms.

He or she can assist with negotiating and making sure that the terms of the agreement are friendly to the needs of your business. A good understanding of the terms will help you to avoid unfair clauses that could be costly to you and your business a few months or years down the line.

Below are some important terms or clauses that are often overlooked, but that can be very dangerous for your business.

Permitted use clause

A restricted use clause limits how you may use the space. Ideally, you would want to avoid severe restrictions on how you may use the commercial space. To this end, a broad use clause will be much more favorable to you than a restrictive one.

Among other things, a restrictive use clause can have an impact on the future expansion and development of your business. You need to make sure that there is no clause in the lease agreement that will limit your scope or ability to expand your business activities.

For example, if you want to sublet a portion of the property to a sub-tenant who may be important to the development of your business, will the agreement allow you to do this? Or perhaps you want to start a food canteen for your staff in the future; will you be permitted to prepare and serve food on the premises?

Ask the landlord for a copy of the building’s certificate of occupation and check that your needs will not violate the use terms of the certificate.

Another example might concern parking. Depending on your type of business, client parking might be very important to you.

Will you be able to use the property’s parking lot for your clients? Can you use the parking bays in front of your area exclusively for your clients? Will your staff have allocated parking bays? A first-come, first-serve parking scenario might not suit your needs but the lease you signed might stipulate that this is how it will be.

Relocation clause

A relocation clause allows your landlord to relocate your business to a different area within the rental complex. Landlords often want the option of relocation in case another tenant wants to expand or they are willing to pay a higher rental fee.

A relocation clause puts you at a disadvantage because your customers might have become accustomed to meeting you at a specific address, and now, all of a sudden, you are no longer at that address. Not to mention the cost and time it will take to update all your marketing and sales materials to reflect the new address.

The best way to avoid this is to negotiate the relocation clause out of the lease agreement before signing. Alternatively, you need to negotiate terms that will protect you in this scenario.

For example, the new premises must be comparable to the original one, the landlord must cover the cost of relocation (this may include new business cards and new equipment fittings) and so on. You might want to add that you will have the right to terminate the lease if the new premises are not suitable.

Renewal clause

This is probably one of the most overlooked clauses in commercial leases.

An option to renew at the end of the lease term can be of great value to the tenant. It gives you the choice to move or stay on the premises and avoid the cost and inconvenience of moving. However, be very careful before accepting such a clause. It can come with significant risks. A clause that merely says that the parties “agree to agree” on renewal terms at a later stage could be dangerous.

For example, you’ve been renting the premises for $18,000 per month (escalating at a fixed % per year for the initial rental term) for 5 years. Your renewal clause states that you have the right to renew and that the new rental period and rental shall be agreed on in writing between the landlord and the tenant at the time of renewal.

When you give the landlord notice that you would like to renew, he agrees to renewal but at $120,000 per month. Where does that leave you? You could argue that it is unfair and that you could fight him in court, but will it be worth the legal cost? After all, the court might say that you expressly agreed to that clause!

Avoid an “agreement to agree” clause at all costs. Your renewal clause must be drafted with great care. At the very least, the agreement should give you a basic sense of what you can potentially expect to pay in rental fees should you decide to renew.

Compliance clause

The lease will generally require you to comply with state and federal laws. For example, the Americans With Disability Act requires all businesses that are open to the public or that employs more than 15 people to have premises that are accessible to disabled people. If this applies to your business and you signed the compliance clause, you will be responsible to make the premises compliant with the Act, and pay for any modifications such as ramps or wider doorways, if it didn’t comply before.

Make sure that the premises are indeed in compliance with all relevant laws and regulations at the commencement of the lease period, before you sign to agree to keep it in compliance with the law. Ask the landlord for a warranty that the premises are in compliance and include the warranty in your lease agreement.

Conclusion

The above-mentioned pitfalls are only a few of the issues that tenants must look out for when signing a commercial lease agreement. It is very important to understand all the legal implications of every clause in your agreement.

While you may not be able to understand many of the terms in such an agreement, this is exactly why it is always a good idea to speak with a lawyer to help you understand what you are getting into, before signing any lease agreement. The future and success of your business might depend on it.

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The return of whooping cough

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Pertussis, or whooping cough, is a highly contagious acute infectious disease caused by the bacterium Bordetella pertussis. Outbreaks were first described in the 16th century; the organism was first isolated in 1906.

Pertussis was one of the most common childhood diseases and a major cause of childhood mortality in the United States in the 20th century. The disease is more common during spring and spreads when an infected person coughs or sneezes and other people breathe in the bacteria. During the 1940s, before a vaccine was introduced, more than 200,000 cases of pertussis were reported annually.

As a result of the pertussis vaccine, used since 2000, incidence has decreased more than 80%. The vaccine targets three antigens in the bacteria.

However, despite vaccination, pertussis bacteria are becoming smarter at colonizing and feeding off unsuspecting hosts. Australia’s whooping cough epidemic from 2008 to 2012 resulted in more than 140,000 cases in 2011, revealing an alarming rise of evolving strains able to evade vaccine-generated immunity.

New studies showed that the evolving strains made additional changes to better survive in their host, regardless of that person’s vaccination status. The researchers also identified new antigens as potential vaccine targets.

Now, whooping cough is emerging as a superbug. According to microbiologist Dr. Laurence Luu, who led a team of researchers with Professor Ruiting Lan, the whooping cough strains are evolving to improve their survival, regardless of vaccination, by producing more nutrient-binding and transport proteins and fewer immunogenic proteins that are not targeted by the vaccine.

As a result, whooping cough bacteria are better at hiding and feeding — able to efficiently scavenge nutrients from the host during infection and also evade the body’s natural immune system because the bacteria are making fewer proteins that the body recognizes.

Another issue is that immunity wanes quickly after vaccination, indicating the need for a new vaccine that can better protect against the evolving strains, stop the transmission of the disease, and provide longer lasting immunity. The good news is that while the number of whooping cough cases has increased during the past decade, the incidence is nowhere near as high as what it was before whooping cough vaccines.

Vaccination is especially important for children, people who are in contact with children, and pregnant women who need the vaccine to produce antibodies to protect their newborns from developing whooping cough in the first few weeks of life.

Babies under six months have a high risk of catching the disease if they are not protected by maternal immunization or have not yet completed the three-dose primary vaccine course. Older adults who live with someone who has whooping cough and those who have not had a booster in the past 10 years are also at risk.

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Is your job affecting your sleep?

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Experts recommend seven to nine hours of sleep nightly. In fact, according to the National Sleep Foundation, not getting enough sleep could negatively impact your immune system. That’s in addition to other sleep-deprivation issues, such as a lack of focus and productivity. And let’s not forget that kids aren’t the only ones who get cranky when they’re sleepy.

But even if you sleep the recommended number of hours each night, you may not be getting “good” sleep, especially if you’re dreaming about work. A study by Health Sleep reveals that 79% of people have work-related dreams.

“Considering the significant amount of time we spend ‘on the clock,’” it makes sense for familiar places and everyday situations to creep into our dreams,” says Jennifer Martinez of Healthy Sleep. These types of dreams were more prevalent in intermediate, first-level, and mid- to senior-level management than in entry level employees who were 15% to 17% less likely to dream about work.

Types of work-related dreams

So, what type of work-related dreams are most frequent?

Making a huge mistake (34.9%) and being late to work (32.3%) topped the list. However, employees also dreamed about being unprepared, missing a deadline, facing a pile of work, and being humiliated.

Less frequent work-related dream scenarios include getting yelled at by the boss, being laid off or fired, and yelling at co-workers. Some people even dream about yelling at the boss or the company going out of business.

So, why are negative dreams so prevalent? “Nightmares and dreams can sometimes be strongly linked to our real-life experiences,” Martinez explains. “We can assume the prevalence of negative dreams may indicate how disappointing or embarrassing scenarios related to work can affect us, even while we are sleeping.”

However, not all work-related dreams are bad. A small percent of dreamers probably didn’t want to wake up. For example, 10.5% dreamed of receiving a promotion/raise, and 9.6% dreamed of getting hired for their dream job.

Also, 29.5% dreamed of having a normal day at work — although that could be negative or positive depending on the dreamer. And among the 15.75% that dreamed of being back at their first job, that could also be interpreted either way.

The salary link

“Our study found an interesting correlation between annual income and type of dream,” Martinez says.

While 41% of those earning $75,000 or more and 40.9% of those earning between $25,000 and $49,000 had negative dreams, those earning between $50,000 and $74,000 actually had fewer negative dreams (38.2%). In addition, those earning less than $25,000 had the fewest negative dreams (33.8%).

Another interesting tidbit: Those on commission were less likely to have bad dreams than those earning a salary.

In addition, remote workers had the highest percentage of positive dreams, perhaps because they have more control of their work environment and ability to maintain work-life balance.

Stress and nightmares

The study also reveals that 57% of employees reported having work-related nightmares. And as you might imagine, there’s a correlation between stress level at work and work-related nightmares. Only 46.5% of employees who were somewhat or not at all stressed had work-related nightmares, compared to 61.7% of those who were moderately stressed. However, 79.1% of employees who were extremely or very stressed reported having work-related nightmares.

The vast majority of those who had work-related nightmares (70% to 75%) listed the following sources of stress: insufficient job skills, poor relationship with co-worker(s), lack of autonomy, poor relationship with boss, inadequate work environment, and micromanagement.

Relatively high on the list (60% to 68%) were nightmares by people who were stressed about lack of job security, overwhelming workload, work-life balance, lack of proper resources, long work hours, and unfulfilling work. However, over half of respondents having nightmares were stressed over low pay or insufficient business, few promotional opportunities, and boring work.

Tips for better sleep

If you’re suffering from these negative work-related dream experiences, Martinez recommends the following tips:

  • Unplug devices (laptops, tablets, smartphones) early in the evening.
  • Go to bed at an earlier time than usual.
  • Create a distinct workspace that is separate from your sleeping space (don’t work in bed).
  • Regularly relax away your work stresses and consider real-life options on how to resolve some of those issues.

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FDA issues public safety notification after exosome treatment sickens patients in Nebraska

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In December, the Food and Drug Administration (FDA) issued a public safety notification regarding exosome products following multiple reports of serious adverse effects experienced by patients in Nebraska who received treatment with unapproved products derived from placentas.

Derived from endosomes and present in all body fluids, exosomes are a form of extracellular vesicle. Exosomes serve as carriers of different biomolecules, such as RNAs, proteins and lipids, from one cell to another to provide a means of intercellular communication and of transmission of these macromolecules.

Clinics administer exosome therapies through intravenous injection, inhalation, or injection into joints or soft tissue.

Within the past two months, several Nebraska patients developed severe infections after receiving unapproved cell-based therapies that included exosomes. Fewer than five people became seriously ill; some developed sepsis. All had received an exosome product derived from C-sectioned placentas.

Becker’s Hospital Review reports that the product is no longer available in Nebraska.

The FDA regulates stem cell therapies. The FDA has approved stem cell-based products that come from bone marrow or blood in transplant procedures, and only for limited use in patients with cancer or disorders of the blood or immune system. The FDA provides a list of approved stem cell-based products on its website. There are currently no FDA-approved exosome products.

Some clinics, including those that manufacture or market unlawful “stem cell” products, are now offering exosome products despite the lack of FDA approval. Many make unsubstantiated claims that the products can prevent, treat or cure certain conditions and treatments. Clinic workers may falsely claim that regulatory provisions for drugs and biological products do not cover the exosomes products when, in fact, the Public Health Service Act and the Federal Food Drug and Cosmetic Act subjects exosomes used as treatment to pre-market review and approval requirements.

Because they are offering exosome products outside of the regulatory process, the clinics are putting patients at risk for adverse effects. They may also be delaying care with approved and scientifically sound treatment options.

MedPage Today recently published a report on the growing trend of placenta donation programs offered by hospitals to women who are in labor or who are about to have a C-section. The report suggests that, while placental material does have legitimate applications in wound care and research, there is a large for-profit marketplace. This marketplace may have links to unapproved stem cell products.

While the patients that prompted the FDA’s public statement all resided in Nebraska, some clinics all over the country are offering exosome therapy for a number of conditions. A San Diego clinic offers exosome therapy as “the ultimate anti-aging hack,” for example, while a Delaware clinic peddles exosome therapy for the treatment of “Lyme disease, chronic inflammation, autoimmune disease and other chronic degenerative diseases.”

Care for patients with potential adverse effects with stem cell treatments

Healthcare providers and patients should be aware of the potential risks associated with unapproved stem cell treatments, and placental and umbilical cord blood derived products. The CDC and FDA describe these risks as:

  • Failure of the cells to work as expected
  • Administration site reaction
  • Growth of tumors
  • Infections
  • Potential for contamination of the product
  • The ability of cells to move from placement sites or change into inappropriate cell types and multiply

Clinicians may wish to consider the possibility of procedure-related infection following the administration of stem cell and exosome therapies. Cultures and empirical treatment may be appropriate for patients with symptoms consistent with infection. The Nebraska Department of Health and Human Services says that bacteremias caused by E.coli, Enterobacter cloacae and polymicrobial agents have been reported in such patients.

The FDA is encouraging healthcare professionals and consumers to report adverse effects associated with the use of exosome products by filling out and submitting the MedWatch Online Voluntary Reporting Form online or via fax to 1-800-FDA-0178.

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Kidney Accelerated Placement Project aims to improve transfer of hard-to-place kidneys

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The Organ Procurement and Transplantation Network (OPTN) launched the Kidney Accelerated Placement Project (KAPP) on July 18, 2019. The goal of the project is to assess whether speeding up the placement of hard-to-place kidneys could increase utilization of these organs.

OPTN developed this pilot testing program to improve placement of kidneys in response to the Executive Order on Advancing American Kidney Health and on feedback from the community.

“Hard-to-place” kidneys have a kidney donor profile index (KDPI) of 80 or higher and are offered to all transplant programs at both the local and regional level.

KAPP reflects recommendations outlined in the October 2018 National Kidney Foundation report, “Report of National Kidney Foundation Consensus Conference to Decrease Kidney Discards,” published in the journal Clinical Transplantation, the Journal of Clinical and Translational Research. The report focuses on reducing kidney discards and is the first to provide a systematic nationwide approach to decreasing the number of discarded kidneys.

The National Kidney Foundation report lists several reasons for discarded kidneys, such as poor organ quality, prolonged cold ischemic time, abnormal biopsy findings, anatomy, and increased costs of using higher kidney donor profile index (KDPI) grafts. However, data supports the use of many of these kidneys for transplant. Furthermore, kidney discard rates often vary by geography, which leads many experts to believe that variations in kidney discard rates may be the result of subjective views of organ viability on the part of individual transplant teams.

OPTN is testing accelerated placement of hard-to-place kidneys on allocations coordinated by the United Network for Organ Sharing (UNOS) Organ Center. Current OPTN policy requires that all organ procurement organizations (OPOs) transfer kidney matches for national allocation to UNOS Organ Center. KAPP will not require a change to this policy and affect only hard-to-place kidneys that UNOS already offers.

KAPP’s goal is to transplant more of these kidneys by having UNOS offer the organs to transplant centers that have accepted and transplanted medically similar kidneys in the past. If these transplant centers turn down the organ, UNOS Organ Center may extend the offer to other hospitals.

UNOS is updating qualifying acceptance patterns monthly. Members of a safety and monitoring council comprised of physicians and OPO executives is monitoring this data to determine if KAPP is resulting in more effective placement of hard-to-place kidneys.

The council monitors outcomes and discards in real time, regularly evaluates the structure of the pilot program, and will create recommendations for consideration by the OPTN Board of Directors at the end of the pilot in 2020. The council is developing criteria that will trigger an early end to the project if outcomes on national kidney offer acceptance do not meet expectations.

Transplant hospitals across the country will continue to receive national kidney offers throughout the testing period, and these institutions have the option to accept or decline these hard-to-place kidneys. The kidney accelerated placement test does not change OPO practices either, as OPTN already requires them to turn over organ allocation to UNOS Organ Center.

The council will look at the transplant program’s history of transplanting kidneys with similar or riskier donor characteristics from the prior two years. The data will refresh monthly to account for changes in kidney transplant characteristics.

Donor characteristics used in determining accelerated placement transplant programs are transplants from donors with similar or riskier donor KDPI, peak serum creatinine, age, history of diabetes or of IV drug use, and donation after circulatory death status.

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10 health hacks for 2020

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A new year is upon us and with it typically comes the desire to get healthy. Here are some health hacks to give your healthy resolutions a jump start!

1. Less is more.

With KonMari and the minimalism movement taking off, it is clear that clutter and owning too much stuff can be chaotic and overwhelming.

Selling, donating and consigning are all easier than ever and can also be fun. Collaborate with a friend to help each other downsize. Celebrate with a fun outing or dinner out afterward.

2. Water. Water. Water.

A recent survey by Quench showed that 80% of working Americans don’t drink enough water. In addition to not feeling thirsty, many people find plain water boring or bland. One way to make it more appealing is to dress it up a bit: flavor it with fresh fruit (lemons, strawberries, cucumbers) and serve it in an attractive container.

3. Get up and move!

If sitting is the new smoking, then it’s essential to find creative ways to move. Instead of setting aside time to stretch or move, double up! Stretch while waiting for your coffee to brew in the morning, take a 10-minute walk during your lunch break, do yoga while watching television or talking on the phone, dance while doing housework, etc.

4. Train your brain.

According to the American Heart Association, failing brain health is a public health epidemic with 3 out of 5 Americans developing a brain disease in their lifetime. The good news is that the brain is able to change and develop new pathways.

Some ways to strengthen your brain include: 1) learn something new such as a new language or new vocabulary words; 2) exercise your memory by not relying so much on your phone for directions or Google for information; and 3) try one of the many brain training apps available to challenge your thinking.

5. Unplug.

With time in front of a screen taking up a large portion of waking hours, it’s time for a break. As with anything else, unplugging requires planning.

Set aside a day a week, a half-day or blocks of time here and there in which you are completely away from all screens. Your eyes and your brain will thank you.

6. Sound.

Healing with sound has been around for thousands of years. In addition to listening to music, in most major metro areas, you can also attend sound healing events with crystal bowls, gongs and other instruments. Online, there are many options for sound healing in which you can listen to solfeggio frequencies or binaural beats.

7. Plant-based lifestyle.

A study by Harvard researchers found that swapping 3% of processed red meat for plant proteins reduces your chances of an early death by 34%. You don’t have to make the switch to meat-free completely; instead, try eating this way for one meal a day.

8. Sleep hygiene.

In a 2016 Consumer Reports survey 68% of U.S. adults had trouble with sleep at least once a week. To improve your sleep quickly, try listening to a guided meditation or sleep hypnosis recording. You can find them on Spotify, YouTube and other online platforms.

9. Get curious about sobriety.

There’s a movement afoot based on the 2018 book “Sober Curious” by Ruby Warrington that’s inspiring people to be social without alcohol.

Curiosity is the motivator as people discover what it feels like to engage with others without mood altering or numbing. Search for or start a Meetup group to find other sober-curious folks.

10. Rest and restore.

More emphasis than ever is being placed on the need to let the body recover after strenuous exercise. Don’t be surprised if you see more and more gyms offering “recovery fitness.”

When planning your exercise routine, not only should you leave enough time to do cool-down stretches, replenish nutrients with a smoothie or fresh juice and take some time to rest, but also fill some of your non-exercise time with activities to help your body recover. These include infrared saunas, massages, rolling, resistant bands, compression therapy, cold water therapy, and more.

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Why you need to update your hospital’s ventilation system

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As a hospital administrator, proper infection control is an incredibly important task. Nosocomial infections — the viral and bacterial illnesses that your patients may contract while at the hospital after being admitted for another reason — are a constant and vexing concern at most facilities.

Yet, taking a fresh overview of your ventilation system, making easy and effective changes to that system, and sharpening your staff’s germ control awareness can pay big dividends. This piece will incorporate the latest research to inform you of the latest technology and strategies.

Consider a system change if you’re looking to update.

According to a research team at the University of Cordoba, 90% of hospitals use a mixed ventilation system. A mixed ventilation system pushes new air into a patient’s room, where it migrates to the upper portion near the ceiling. The problem with this, of course, is that your patient’s bed is much lower, so he or she is trapped in germy air.

One way to solve this problem: look into switching to a displacement ventilation system. In a displacement system, air is sent into the room at low speeds where the patient actually is and the germy air rises so it can then go out the room’s vents.

Talk to your engineering staff about possible options in this regard, then crunch the numbers to see if a displacement option could work for your budget.

Make sure your patients’ rooms get frequent air refreshing.

CDC guidelines require patient room air to be refreshed through ventilation regularly. Have your system analyzed for lags and make sure the air is automatically changing as frequently as can be programmed — more than the minimum requirement, optimally.

Use wing sealing as an easy solution to control outbreaks.

A study published in the American Journal of Infection Control found that simply sealing off a wing and adjusting your existing vent system can dramatically cut the spread of airborne germs if a large number of patients get the same infection.

Reducing the supply of air in a unit by 60% creates a “negative pressure ward” in which air doesn’t escape into the hospital and your staff and other patients aren’t also infected. Analyzing the logistics of this idea with your engineers and gaining physician input could be a major boon to your facility.

Ensure your filter systems are effective.

Researchers at Rice University have been creating a new graphene filter that will swiftly capture fungi, spores, endotoxins, bacteria and more infectious agents. Your hospital’s two federally required filter beds should be constantly monitored and scrupulously maintained to catch and contain germs as effectively as possible. Never skimp on expense here.

Do a full sterilization inventory.

You may think your staff is doing a great job at cleaning surfaces at your facility, but aerosol droplets are a constant concern and inadequate sterilization even at small levels can create big problems.

Walk your wards for frequent quality control observation; hold monthly sterilization seminars to update and reeducate; and make sterilization training a major point for new employees. Be proactive and never take your eye off the ball when it comes to germ control.

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Infographic: The surprising effects of business vs. leisure travel on your well-being

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Whether it’s business, leisure or even bleisure, travel is something of a status symbol regardless if it’s for work or play. Exploring new places, learning about new cultures and tasting new foods are all part of the fun.

However, differences abound when we look at business vs. leisure travel, particularly in regard to personal health and well-being.

75% of business travelers report heightened levels of stress. On the contrary, a four-day vacation can actually negate the effects of perceived stress for up to 30 days. Check out the infographic below, which illustrates more of the details and statistics between these two types of travel.

Infographic courtesy Reservations.com

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