Monthly Archives: January 2015

Turkey Vegetable Soup

ChickenSOUP2

Turkey Vegetable Soup

“Soup is good food!”

 

 

 

Ingredients

  • 4 medium carrots, cut into 1/2-inch slices
  • 2 medium stalks celery, cut into 1/2-inch slices
  • 1 cup green beans
  • 6 cups Homemade or store bought chicken or vegetable broth - regular or low-sodium
  • 2 cups cooked pasta noodles of choice
  • 2 cups (1/2-inch strips or chunks) skinless freshly cooked or leftover cooked turkey
  • 1/2 cup fresh parsley leaves, chopped

Directions

  1. In 4-quart saucepan, pour in broth then stir in carrots, celery, beans; heat to boiling on high. Reduce heat to low and simmer 5 minutes or until vegetables are tender.
  2. Stir in turkey and heat through. Add cooked pasta noodles and continue to simmer for five minutes, remove saucepan from heat; stir in parsley. Makes approx. 12 cups.
  3. To store: cover bowl and refrigerate. Refrigerate safely up to three days or freeze soup in 1-quart portions to use within 5 months. With permanent marker, place the date the soup was prepared on the outside of the container for safe storage.
  4. **** There may be times when it is too challenging to digest the ingredients in this meal, All is not lost. Consider placing serving in a blender/food processor to quickly blend all ingredients together creating a smoother consistency. Maintaining nutrition and hydration is very important when the body is fighting any infection. When a patient is unable to maintain adequate hydration or nutrition please contact and report symptoms to the healthcare provider and/or visit the local clinic/hospital for assessment and treatment. Dehydration and malnutrition can be life-threatening - do not delay in receiving treatment.

 

Nutritional Information Per 8 oz. serving:

Calories 435
Total Fat 9g
Saturated Fat 2g
Cholesterol 62mg
Sodium 970mg
Total Carbohydrate 58g
Dietary Fiber 7g
Sugars 0
Protein 32g

President Obama Will Announce Launch of $215M Precision Medicine Initiative

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President Obama today will announce the launch of a $215 million precision medicine initiative to leverage advances in genomics, informatics, and health information technology to accelerate biomedical discoveries in the hopes of yielding more personalized medical treatments for patients in the US.

The public-private initiative, which will be included in the President’s 2016 budget proposal to be released next week, will provide new funding to the National Institutes of Health, the National Cancer Institute, the US Food and Drug Administration, and the Office of the National Coordinator for Health Information.

That funding will help those agencies to, among other things, develop a voluntary national research cohort of more than 1 million people, obtain sequencing data for as many of those individuals as possible, identify genomic drivers of cancer, improve how next-generation sequencing-based tests are evaluated and marketed, and develop methods for managing and analyzing large patient data sets while protecting individual privacy.

“Precision medicine is about moving beyond this one-size-fits-all kind of approach to medicine and instead approaching disease prevention and treatment by taking into account individual differences in people’s genes, their microbiomes, their environments, and their lifestyles,” Jo Handelsman, associate director for science at the White House Office of Science and Technology Policy, said yesterday in a press briefing previewing today’s announcement. “The idea is to give clinicians tools to better understand the mechanisms underlying a patient’s condition, and to better predict which treatments will be most effective and safe.”

The largest part of the initiative will provide $130 million to the NIH to help develop a national research cohort of a million or more volunteers whose data — including medical records, genetic and metabolomic profiles, microbiomes, and environmental and lifestyle information — will contribute to a further understanding of disease and help establish a new way of doing research through engaged participants and open, responsible data sharing, the White House said.

In addition, the NCI will be budgeted for $70 million to scale up efforts to understand the genetic basis of cancer by expanding genetically based clinical trials, exploring fundamental aspects of cancer biology, and establishing a national “cancer knowledge network” that will generate and share new knowledge.

Meantime, $10 million will be earmarked for the FDA to help it acquire additional tools and expertise to develop high-quality, curated databases that will be used in its efforts to evaluate next-generation sequencing technologies and ensure their accuracy, reliability, and safety for patients.

And, finally, the initiative calls for a $5 million investment in the ONC to support the development of interoperability standards and requirements that address patient privacy and enable the secure exchange of data across systems.

“This concept of precision medicine – that is, prevention and treatment strategies that take individual differences into account – is not entirely new,” NIH Director Francis Collins said during the briefing. “But for much of medicine, this kind of personalizing just has not been possible. We just didn’t know enough. That’s all changing now, and at an unprecedented pace, which makes now the right time to launch this initiative.”

Collins pointed to advances over the past several years in basic research, data science, mobile connectivity, use of electronic medical records, and “perhaps most dramatic of all in terms of the scale, the decline in the cost of DNA sequencing. It cost us $400 million for that first genome, and now a genome can be sequenced for a cost approximating $1,000. That’s more than 100,000-fold drop in 15 years.”

Regarding the NIH’s plan to create a longitudinal cohort of more than 1 million patients, Collins noted that the agency and its partners will not need to start from scratch, but will instead tap into already-established cohorts, both public and private.

“We are aware that there is something like 200 cohorts that have already been put in place that have at least 10,000 participants,” Collins said. “They’re in different sorts of shape as far as the kind of information that’s already been collected. But there is a wealth of potential there.”

Collins noted that a large part of this cohort effort will be trying to piece together many of these existing cohorts, and he said that this could be aided by existing projects such as the Electronic Medical Records and Genomics (eMERGE) program, which aims to combine electronic medical records technologies with DNA biorepositories for use in large-scale, high-throughput genomics research projects.

In terms of the types of existing cohorts that could be tapped into, Collins mentioned the attractiveness of the cohorts generated so far under Kaiser Permanente’s Research Program on Genes, Environment, and Health, which includes more than 430,000 adult members of Kaiser’s system in Northern California and has generated a 100,000-individual cohort in partnership with the University of California, San Francisco. However, Collins stressed that the NIH will be encouraging new participants to volunteer to help build the national cohort.

Another large part of the cohort effort will be attempting to obtain sequencing data for as many of the participants as possible. Although the cost of sequencing has dropped dramatically in recent years, this component of the initiative remains a major hurdle.

“We would love to have whole-genome sequence [data] on all the participants in the cohort, but the expense has to be considered, and where are we going to find those funds?” Collins said. Although it now costs about $1,000 to sequence a whole genome, “that curve is coming down, and that is actually quite reassuring,” Collins added. “It will take us, of course, a matter of some time to assemble this cohort. Our expectation would be that, as it’s being assembled, the cost [of sequencing] would be coming down, and so ultimately the goal would be to have a full-genome sequence on as many of the cohort as are comfortable.”

Another important aspect of the national cohort project will be its interactive nature. “The precision medicine initiative is not just about scale,” Collins said. “It’s also intended to be a new model of research, one in which people who participate are true partners – not subjects, not even patients – partners.”

To that end, the ONC is charged with developing new and better ways to ensure secure data exchange with patients’ consent, and the initiative overall will be committed to protecting patients’ privacy by launching a “multi-stakeholder process” that will solicit input from patient groups, bioethicists, privacy and civil liberties advocates, technologists, and other experts to identify legal and technical issues.

Summarizing, Collins noted that although the cohort initiative will likely yield its greatest benefits many years into the future, “there should be some successes in the relatively near future, as well, especially in the areas of cancer, and the field called pharmacogenomics – how to provide the right drug at the right dose to the right patient at the right time. This initiative will provide a wonderful platform for finding out how to apply that strategy to more and more people.”

On the regulatory side, FDA Commissioner Margaret Hamburg noted during the briefing that the agency’s funding would primarily be used to improve the way it oversees the marketing of new types of precision medicine technologies, particularly NGS.

“Our current market review approaches for evaluating a test’s analytical and clinical performance are designed around a more traditional one test-one disease paradigm,” Hamburg said. “In contrast, next-generation sequencing produces a massive amount of data, potentially bearing on a huge range of diseases, conditions, and risk factors that will be better handled using a new approach.”……………………………………….

…………. the FDA is currently in the process of considering what that approach should be, referring to the fact that the agency has scheduled a public meeting on Feb. 20 to discuss the challenges of regulating NGS technologies. Ahead of the meeting, last year the agency issued a white paper to lay out its current thinking and provide the basis for future discussion.

President Obama plans to fully announce the precision medicine initiative at an 11:00 AM event at the White House today.

 

To read the article in its entirety please click on the following link:

https://www.genomeweb.com/policy-legislation/president-obama-launch-215m-precision-medicine-initiative?utm_source=SilverpopMailing&utm_medium=email&utm_campaign=Daily%20News:%20President%20Obama%20to%20Launch%20$215M%20%27Precision%20Medicine%27%20Initiative%20-%2001/30/2015%2011:10:00%20AM

C. diff. and Crohn’s & Colitis; Improving Quality Of Life - Crohn’s & Colitis Foundation of America

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Crohn’s & Colitis Foundation of America
Established in 1967, the Crohn’s & Colitis Foundation of America (CCFA) is a non-profit, volunteer-driven organization whose mission is to cure Crohn’s disease and ulcerative colitis, and to improve the quality of life of children and adults affected by these diseases.

Since its founding, CCFA has remained at the forefront of research in Crohn’s disease and ulcerative colitis. Today, it funds cutting-edge studies at major medical institutions, nurtures investigators at the early stages of their careers, and finances underdeveloped areas of research.

In addition, CCFA provides a comprehensive series of education programs and support services to members of the IBD community, including patients and caregivers.

Website: www.ccfa.org
Email: info@ccfa.org
Phone: 888.MY.GUT.PAIN (888.694.8872)
Address: Crohn’s & Colitis Foundation of America, 733 Third Avenue, Suite 510, New York, NY 10017

Irwin M. and Suzanne R. Rosenthal IBD Resource Center (IBD Help Center)
The Crohn’s & Colitis Foundation of America’s IBD Help Center is a free service designed to provide members of the inflammatory bowel disease (IBD) community with disease-specific information, guidance and support. The IBD Help Center is staffed by caring Master’s degree-level specialists who provide education on IBD management, available treatment options and coping strategies, as well as referrals to helpful resources and programs.

Hours: Monday through Friday, 9am to 5pm Eastern
Email: info@ccfa.org
Phone: 888-MY-GUT-PAIN (888-694-8872)

Healthcare - Associated Infections (HAI’s) Patient Safety Addressed by Vice-President Joe Biden

Vice-President Joe Biden targets patient safety at hospitals

“Up until now, our health care system – in my humble opinion – hasn’t sufficiently linked quality … with safety,” the Vice President said.

"Up until now, our health care system -- in my humble opinion -- hasn't sufficiently linked quality … with safety," the Vice President said.

“Up until now, our health care system — in my humble opinion — hasn’t sufficiently linked quality … with safety,” the Vice President said.

Hospitals need to focus more on reducing preventable errors and infections and the government must create more economic incentives to improve patient safety, Vice President Joe Biden said at a conference in Irvine, Calif. over the weekend.

“Up until now, our health care system – in my humble opinion – hasn’t sufficiently linked quality … with safety,” he said. “Not enough time has been focused on keeping bad things from happening.”

But Biden said the paradigm is starting to change. Hospitals are now penalized for unnecessary re-admissions and new technology alerts nurses of possible problems and reduces the reliance on handwritten doctors’ orders.

Gains have been made in improving hand hygiene and reducing central line infections, he said. And a recent government report by the Agency for Healthcare Research and Quality found that 1.3 million fewer hospital-acquired conditions occurred – and 50,000 fewer deaths – in 2013 compared to 2010.

“This is the time to double down on your commitment to patient safety,” he told the crowd of doctors, nurses, hospital executives and patient advocates. “We’ve gone from accepting the inevitable to showing what’s absolutely within our wheelhouse to be able to change.”

The conference was sponsored by the Patient Safety Movement, an organization aimed at reaching “zero preventable patient deaths by 2020.” There were panels on patient involvement, on lessons learned from Ebola and on measuring hospital efforts to improve safety.

Alicia Cole, who attended and spoke at the conference, has spent years recovering from multiple hospital-acquired infections. She went into a Burbank hospital in 2006 for a simple surgery to remove small fibroid and ended up with a staph infection, sepsis and flesh-eating disease.

“Instead of getting better I deteriorated,” Cole said. She has had numerous additional surgeries, had to stop working and still sees a doctor weekly. “My life completely changed.”

Jim Bialick, president of the Patient Safety Movement Foundation, said it’s critical to bring together patients, doctors and technology companies to create solutions. “Traditional methods aren’t working,” he said.

patientsafetymovement.org

Bialick said he appreciates the government’s renewed focus on the issue. For instance, its Partnership for Patients program is working with 3,700 hospitals across the nation to reduce preventable infections and re-admissions.

Much of the discussion at the conference focused on sepsis, a blood infection that costs the health care system more than $20 billion annually and has a mortality rate of up to 50 percent. Several hospitals, including UC San Francisco, have programs aimed at identifying victims early.

Chris Fee, associate professor of emergency medicine at UCSF, said reducing sepsis deaths is about recognizing symptoms in patients and getting treatment started as soon as possible. Technology can be key in alerting hospital staff of abnormal vital signs and lab tests he said.

www.sepsisalliance.org

“We have to remember that patients can be very ill and look quite well,” Fee said.

The UCSF project started as a pilot and has since expanded to the entire hospital. Fee said it is credited with reducing mortality from 18 percent in 2012 to 12 percent in 2014 and saving more than 100 lives.

To read the article in its entirety:

http://www.healthcarefinancenews.com/news/joe-biden-targets-patient-safety-hospitals

Evaluation of a Pulsed Xenon Ultraviolet (PX-UV) Disinfection System for Reduction of Healthcare-Associated Pathogens in Hospital Rooms

“Evaluation of a Pulsed Xenon Ultraviolet (PX-UV) Disinfection System for Reduction of Healthcare-Associated Pathogens in Hospital Rooms”

A study conducted by Dr. Curtis Donskey, and a team of researchers with the objective to determine the effectiveness of pulsed xenon ultraviolet (PX-UV) disinfection device for reduction in recovery of healthcare-associated pathogens was recently published in Infection Control & Hospital Epidemiology (ICHE).

Michelle M. Nerandzica1 c1, Priyaleela Thotaa2, Thriveen Sankar C.a2, Annette Jencsona1, Jennifer L. Cadnuma2, Amy J. Raya2a3, Robert A. Salataa2a3, Richard R. Watkinsa4 and Curtis J. Donskeya2a3a5

a1 Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio

a2 Case Western Reserve University School of Medicine, Cleveland, Ohio

a3 Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio

a4 Akron General Medical Center, Akron, Ohio

a5 Geriatric Research, Education and Clinical Center, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio

Abstract

OBJECTIVE To determine the effectiveness of a pulsed xenon ultraviolet (PX-UV) disinfection device for reduction in recovery of healthcare-associated pathogens.

SETTING Two acute-care hospitals.

METHODS We examined the effectiveness of PX-UV for killing of Clostridium difficile spores, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) on glass carriers and evaluated the impact of pathogen concentration, distance from the device, organic load, and shading from the direct field of radiation on killing efficacy. We compared the effectiveness of PX-UV and ultraviolet-C (UV-C) irradiation, each delivered for 10 minutes at 4 feet. In hospital rooms, the frequency of native pathogen contamination on high-touch surfaces was assessed before and after 10 minutes of PX-UV irradiation.

RESULTS On carriers, irradiation delivered for 10 minutes at 4 feet from the PX-UV device reduced recovery of C. difficile spores, MRSA, and VRE by 0.55±0.34, 1.85±0.49, and 0.6±0.25 log10 colony-forming units (CFU)/cm2, respectively. Increasing distance from the PX-UV device dramatically reduced killing efficacy, whereas pathogen concentration, organic load, and shading did not. Continuous UV-C achieved significantly greater log10CFU reductions than PX-UV irradiation on glass carriers. On frequently touched surfaces, PX-UV significantly reduced the frequency of positive C. difficile, VRE, and MRSA culture results.

CONCLUSIONS The PX-UV device reduced recovery of MRSA, C. difficile, and VRE on glass carriers and on frequently touched surfaces in hospital rooms with a 10-minute UV exposure time. PX-UV was not more effective than continuous UV-C in reducing pathogen recovery on glass slides, suggesting that both forms of UV have some effectiveness at relatively short exposure times.

Infect Control Hosp Epidemiol 2014;00(0): 1–6

(Received July 11 2014)

(Accepted October 14 2014)

To access the report in its entirety please click on the following link:

http://dx.doi.org/10.1017/ice.2014.36

C Diff Foundation Welcomes Dr. David Cook, Ph.D.

Welcome cloud

We are pleased to welcome

Dr. David Cook,Ph.D.

joining the C Diff Foundation’s Research and Development Committee and Research Community.

David Cook is a scientist and entrepreneur who has held senior operating and management positions in the biotechnology industry over his 20-year career. Before joining Seres Health, he was the chief operating officer for the International AIDS Vaccine Initiative (IAVI), a global R&D organization whose mission is to develop a safe, globally accessible vaccine for HIV. Prior to IAVI, David was the founding CEO at Anza Therapeutics, a biotechnology start-up developing a novel microbial vaccine platform to induce cellular immune responses to fight or prevent diseases such as cancer, hepatitis C, malaria and tuberculosis. Before launching Anza, David held positions of increasing responsibility at the biotechnology corporations Cerus and Eligix, with oversight over R&D, program management, manufacturing, and clinical and regulatory affairs. He has led teams to develop and commercialize several biotech products and has been directly responsible for obtaining marketing authorization from the European Union for four novel medical products. He is also a co-inventor on over twenty-five patents. He received his undergraduate degree from Harvard College and his Ph.D. in chemistry from the University of California, Berkeley.

C. diff. CDC Reports On Major Healthcare-Associated Infections - Progress Being Made In Infection Control In U.S. Hospitals

Progress Being Made in Infection Control in U.S. Hospitals; Continued Improvements Needed

Progress has been made in the effort to eliminate infections that commonly threaten hospital patients, including a 46 percent decrease in central line-associated bloodstream infections (CLABSI) between 2008 and 2013, according to a report released today by the Centers for Disease Control and Prevention. However, additional work is needed to continue to improve patient safety.

CDC’s Healthcare-Associated Infections (HAI) progress report is a snapshot of how each state and the country are doing in eliminating six infection types that hospitals are required to report to CDC. For the first time, this year’s HAI progress report includes state-specific data about hospital lab-identified methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections and Clostridium difficile (C. difficile) infections (deadly diarrhea).

Preventing infections in the first place means that patients will not need antibiotics to treat those infections. This can help to slow the rise of antibiotic resistance and avoid patient harm from unnecessary side-effects and C. difficile infections, which are associated with antibiotic use. Continued progress and expanded efforts to prevent HAIs will support the response to the threat of antibiotic resistance

The annual National and State Healthcare-associated infection Infection Progress Report expands upon and provides an update to previous reports detailing progress toward the goal of eliminating HAIs. The report summarizes data submitted to CDC’s National Healthcare Safety Network (NHSN), the nation’s healthcare-associated infection tracking system, which is used by more than 14,500 health care facilities across all 50 states, Washington, D.C., and Puerto Rico. Healthcare-associated infections are a major, yet often preventable, threat to patient safety. On any given day, approximately one in 25 U.S. patients has at least one infection contracted during the course of their hospital care, demonstrating the need for improved infection control in U.S. healthcare facilities.

“Hospitals have made real progress to reduce some types of healthcare-associated infections - it can be done,” said CDC Director Tom Frieden, M.D., M.P.H. “The key is for every hospital to have rigorous infection control programs to protect patients and healthcare workers, and for health care facilities and others to work together to reduce the many types of infections that haven’t decreased enough.”

This report focuses on national and state progress in reducing infections occurring within acute care hospitals.

Although not covered by the report released today, the majority of C. difficile infections and MRSA infections develop in the community or are diagnosed in healthcare settings other than hospitals.

Other recent reports on infections caused by germs such as MRSA and C. difficile suggest that infections in hospitalized patients only account for about one-third of all the healthcare-associated infections.

Tracking National Progress On the national level, the report found a:

  • 46 percent decrease in central line-associated bloodstream infections (CLABSI) between 2008 and 2013. A central line-associated bloodstream infection occurs when a tube is placed in a large vein and either not put in correctly or not kept clean, becoming a highway for germs to enter the body and cause deadly infections in the blood.
  • 19 percent decrease in surgical site infections (SSI) related to the 10 select procedures tracked in the report between 2008 and 2013. When germs get into the surgical wound, patients can get a surgical site infection involving the skin, organs, or implanted material.
  • 6 percent increase in catheter-associated urinary tract infections (CAUTI) since 2009; although initial data from 2014 seem to indicate that these infections have started to decrease. When a urinary catheter is either not put in correctly, not kept clean, or left in a patient for too long, germs can travel through the catheter and infect the bladder and kidneys.
  • 8 percent decrease in MRSA bloodstream infections between 2011 and 2013.
  • 10 percent decrease in C. difficile infections between 2011 and 2013.

Research shows that when healthcare facilities, care teams, and individual doctors and nurses, are aware of infection control problems and take specific steps to prevent them, rates of targeted HAIs can decrease dramatically.

Data for Local Action The report provides data that can be used by hospitals to target improvements in patient safety in their facilities. For example, together with professional partners, CDC, the Centers for Medicare & Medicaid Services (CMS) Quality Improvement Organizations and Partnership for Patients initiative, and the Agency for Healthcare Research and Quality’s (AHRQ) Comprehensive Unit-based Safety Program (CUSP) increased attention to the prevention of catheter-associated urinary tract infections, resulting in a reversal of the recent increase seen in these infections. CAUTI data for early 2014 demonstrating these improvements will be publicly available on the CMS Hospital Compare website in 2015. CDC is also working to use HAI data to help identify specific hospitals and wards that can benefit from additional infection control expertise.

“Healthcare-associated infection data give healthcare facilities and public health agencies knowledge to design, implement and evaluate HAI prevention efforts,” said Patrick Conway, Deputy Administrator for Innovation and Quality and Chief Medical Officer of the Center for Medicare & Medicaid Services. “Medicare’s quality measurement reporting requires hospitals to share this information with the CDC, demonstrating that, together, we can dramatically improve the safety and quality of care for patients.”

“Successful programs such as CUSP demonstrate that combining sound HAI data with effective interventions to prevent these infections can have enormous impact,” said AHRQ Director Richard Kronick, Ph.D.

State Data Not all states reported or had enough data to calculate valid infection information on every infection in this report. The number of infections reported was compared to a national baseline.

In the report, among 50 states, Washington, D.C., and Puerto Rico, 26 states performed better than the nation on at least two of the six infection types tracked by state (CLABSI, CAUTI, MRSA, C. difficile, and SSI after colon surgery and abdominal hysterectomy). Sixteen states performed better than the nation on three or more infections, including six states performing better on four infections. In addition, 19 states performed worse than the nation on two infections, with eight states performing worse on at least three infections.

The national baseline will be reset at the end of 2015. Starting in 2016, HAI prevention progress from 2016-2020 will be measured in comparison to infection data from 2015.

The federal government considers elimination of healthcare-associated infections a top priority and has a number of ongoing efforts to protect patients and improve healthcare quality.

CDC provides expertise and leadership in publishing evidence-based infection prevention guidelines, housing the nation’s healthcare-associated infection laboratories, responding to health care facility outbreaks, and tracking infections in these facilities.

Other federal and non-federal partners are actively working to accelerate the ongoing prevention progress across the country. In collaboration with CDC, these agencies use data and expertise to mount effective prevention programs and guide their work.

Source: CDC

January 14, 2015