Drewes A.M.,Aarhus University Hospital |
Drewes A.M.,University of Aalborg |
Jensen R.D.,Bernard Health |
Nielsen L.M.,Aarhus University Hospital |
And 5 more authors.
British Journal of Clinical Pharmacology | Year: 2013
Clinical studies comparing the response and side effects of various opioids have not been able to show robust differences between drugs. Hence, recommendations of the regulatory authorities have been driven by costs with a general tendency in many countries to restrict physician's use of opioids to morphine. Although this approach is recognized as cost-effective in most cases there is solid evidence that, on an individual patient basis, opioids are not all equal. Therefore it is important to have an armamentarium of strong analgesics in clinical practice to ensure a personalized approach in patients who do not respond to standard treatment. In this review we highlight differences between opioids in human studies from a pharmacological, experimental, clinical and health economics point of view. We provide evidence that individuals respond differently to opioids, and that general differences between classes of opioids exist. We recommend that this recognition is used to individualize treatment in difficult cases allowing physicians to have a wide range of treatment options. In the end this will reduce pain and side effects, leading to improved quality of life for the patient and reduce the exploding pain related costs. © 2012 The British Pharmacological Society.
Jourdan D.,University Blaise Pascal |
Stirling J.,University Blaise Pascal |
Mannix McNamara P.,University of Limerick |
Pommier J.,Bernard Health |
Pommier J.,Health Education in Schools Research Unit
Health Promotion International | Year: 2011
The objectives of the study were to identify the professional issues that teachers perceived as important in their commitment to a health promotion (HP) programme launched in their schools and to understand their perceptions of the impact of the programme on themselves as professionals, individuals, on students, on school staff and on the relationship with students' families. A mixed methods design was used. An anonymous questionnaire was distributed to 54 participating teachers exploring their practices and perceptions of the programme and 26 semi-structured interviews were conducted which examined their professional commitment to the programme. The main factors that teachers identified as shaping their commitment were (1) their perceptions of the programme, specifically, its congruence with their own role and practice and also their perceived impact of the programme upon whole staff relations and (2) the specific school environment including school organization, quality of the relationships with parents and student behaviour. If HP programmes are to be successfully developed in schools, it is necessary to anchor them within the schools' mission. HP programmes need to make sense to teachers' educational perspectives. They need to be responsive to school needs. They also need to be cognisant of the internal tensions that programme implementation can engender among the whole staff, some of whom may be committed to HP in their school, while others, may not value HP in the same way. Therefore, implementation processes that are respectful of the challenges schools encounter and of the differing ontological perspectives that teachers may hold with regard to HP is important. © The Author (2011).
Tome D.,Bernard Health
British Journal of Nutrition | Year: 2012
Dietary proteins are found in animal products, plant products and single-cell organisms. Proteins are present in variable proportions in these different food sources and the different proteins also differ in their amino acid composition, dietary indispensable amino acid content and physico-chemical properties. Different criteria can be used to define dietary protein requirements and different markers can be used to assess nutritional protein quality according to the criteria used for protein requirement estimation. The current approach to determining protein requirements is related to nitrogen balance and the dietary indispensable amino acid score approach relates protein quality to the capacity of protein to allow reaching nitrogen balance by providing nitrogen and indispensable amino acids. A second approach considers more directly protein nitrogen utilization by the body and includes measurement of protein digestibility and of the efficiency of dietary nitrogen retention at maintenance or for protein deposition at the whole body level or in more specific body areas. Another approach is related to protein turnover and protein synthesis in relation to maintenance and/or efficiency for deposition or development (growth) at the whole body level or for different and more specific target tissues such as muscle or bone. Lastly, protein quality can also be evaluated from different markers used as risk factors for metabolic dysfunction and disorders related for instance to insulin resistance, diabetes and obesity or cardio-vascular disease. The accuracy and relevance of these different approaches is discussed regarding the capacity of the different protein sources (i.e. animal as meat, milk or eggs, legume as soya or pea, or cereal as wheat or rice) to satisfy protein requirements according to these different criteria and markers. © 2012 The Author.
Bessonneau V.,Bernard Health |
Clement M.,Bernard Health |
Thomas O.,Bernard Health
International Journal of Environmental Research and Public Health | Year: 2010
Hand disinfection with alcohols-based hand rubs (ABHRs) are known to be the most effective measure to prevent nosocomial infections in healthcare. ABHRs contain on average 70% by weight of one or more alcohols. During the hand rubbing procedure, users are exposed to these alcohols not only through dermal contact, but also via inhalation, due to the physical and chemical properties of alcohols volatilizing from alcoholic solutions or gels into the air. Ethanol ingestion is well known to increase risks of several diseases (affecting the pancreas, liver, cardiovascular system...), but there is a lack of knowledge about the effects of exposure to other alcohols (including n- or isopropanol) via inhalation and dermal contact, despite the worldwide use of ABHRs. This work aims at discussing possible health effects related to unintentional alcoholization (via inhalation and dermal contact) from professional ABHR usage to suggest the need for more research in this area (but not to question the value of ABHRs). Based upon an average of 30 hand rubbings per healthcare professional per day, it can be assumed that a healthcare worker may be exposed to a maximum 5,500 mg/m3 per work shift, five times above the recommended occupational time weighted average limit. Thus, in order to answer the question posed in the title, studies on spatial and temporal variability of alcohol emission from ABHRs in real world situations and studies on certain high risk individuals are needed. © 2010 by the authors.
Rector J.L.,University of Birmingham |
Rector J.L.,University of Heidelberg |
Dowd J.B.,Bernard Health |
Loerbroks A.,University of Heidelberg |
And 10 more authors.
Brain, Behavior, and Immunity | Year: 2014
Cytomegalovirus (CMV) is a herpes virus that has been implicated in biological aging and impaired health. Evidence, largely accrued from small-scale studies involving select populations, suggests that stress may promote non-clinical reactivation of this virus. However, absent is evidence from larger studies, which allow better statistical adjustment for confounding and mediating factors, in more representative samples.The present study involved a large occupational cohort (N= 887, mean age. = 44, 88% male). Questionnaires assessed psychological (i.e., depression, anxiety, vital exhaustion, SF-12 mental health), demographic, socioeconomic (SES), and lifestyle variables. Plasma samples were analyzed for both the presence and level of CMV-specific IgG antibodies (CMV-IgG), used as markers for infection status and viral reactivation, respectively. Also assessed were potential biological mediators of stress-induced reactivation, such as inflammation (C-reactive protein) and HPA function (awakening and diurnal cortisol). Predictors of CMV infection and CMV-IgG among the infected individuals were analyzed using logistic and linear regression analyses, respectively.Confirming prior reports, lower SES (education and job status) was positively associated with infection status. Among those infected (N= 329), higher CMV-IgG were associated with increased anxiety (β= .14, p<. .05), depression (β= .11, p= .06), vital exhaustion (β= .14, p<. .05), and decreased SF-12 mental health (β= -14, p<. .05), adjusting for a range of potential confounders. Exploratory analyses showed that these associations were generally stronger in low SES individuals. We found no evidence that elevated inflammation or HPA-function mediated any of the associations.In the largest study to date, we established associations between CMV-IgG levels and multiple indicators of psychological stress. These results demonstrate the robustness of prior findings, and extend these to a general working population. We propose that stress-induced CMV replication warrants further research as a psychobiological mechanism linking stress, aging and health. © 2014.
News Article | April 23, 2015
Up to six million Americans are expected to pay a tax penalty this year for not having health insurance coverage in 2014. To help families avoid future penalties, a special enrollment period for the Health Insurance Marketplace opened on March 15, 2015, and will close April 30, 2015. This special enrollment period is an additional time outside of open enrollment during which you and your family have a right to sign up for health coverage. This will be your last chance this year to receive health coverage through the Health Insurance Marketplace and avoid a tax penalty for next year. Health coverage helps cover the cost of medical services, tests and treatments that assist you in getting and staying healthy. The required basic level of coverage includes preventive care, health screenings, well woman and prenatal care, immunizations for adults and children, treatment for pre-existing conditions, and the cost of some prescription medications. Surveys have shown that nearly half of uninsured adults are unaware of the penalty associated with not having health coverage. In 2014, the penalty for not having the required minimum level of health coverage was up to $95 per uninsured person or 1% of a household’s income. For 2015, this amount will more than double, with the penalty per uninsured person reaching $325 or 2% of a household’s income. There are exemptions available to those who cannot afford coverage or who have experienced hardship. Consult Healthcare.gov or an Bernard Health advisor to see if you qualify for an exemption. The special enrollment period is designed for the following: Macon County General Hospital can help you learn more about the special enrollment period, what tax penalties you may face for not having health coverage and what health plans are available to you. We have an advisor onsite to support you in the application process. “We’re offering this service to individuals and families. Health insurance is confusing,” said Bernard Health Team Member Mallory Jones. “It’s more like filing taxes than buying car insurance and people need help with it. We have an advisor set up at MCGH. Her name is Rachel Hesson. She is there 5 days a week to meet with either people that come through the ER, or people in the community that make an appointment with her.” “It is a free service when you come into the hospital. It’s an awesome opportunity to get this advice,” she said. Contact them today. You can call 615-666-2147. Rachel Hesson is available for phone or in-person appointments. Don’t be caught off guard by not being covered. Learn the value of health insurance and get covered today. Bernard Health was featured in the Macon County Times this past week. The article, written by Reporter Stacey Morgan, touches on the importance of having healthcare coverage and she gives the readers the basic facts about the March 15th-April 30th Special Enrollment Period for Marketplace coverage. This column originally appeared in the March 30th edition of the Macon County Times. If you enjoyed this post, you may like Top 5 Ways Hospitals are Helping Patients Find Health Insurance.
News Article | April 23, 2015
Wondering how much does it cost to have your gallbladder removed? Well, the easy answer is it depends where you live. As a healthcare consumer, it's important to know that prices in different states (and even at hospitals a mile down the road from each other) will vary drastically. Be sure to do your research in advance. If you live in New Jersey, the average cost of gallbladder removal surgery is $46,850. In Maryland? It's only $10,747! A flight from New Jersey to Maryland is only 37 minutes; the drive across state lines is just under 3 hours (depending on where you live and where the hospital is located). Traveling from New Jersey to Maryland will save you an average of $36,103! Think it's worth the trip? This is just one example. Our infographic above shows the most expensive states to have your gallbladder removed and the cheapest. California, Florida, and New Jersey rank as the most expensive; Maryland, North Dakota, and Utah rank as the least expensive. The natural next question becomes, "Why is it so much cheaper in certain states to have this surgery?" The answer has nothing to do with quality, and everything to do with the bargaining power a hosptial has with insurance companies. If a hospital has a lot of bargaining power, then it is able to negotiate higher prices. Gallbladder removal is typically not something that has to be done urgently. Some might opt to fly to a nearby state to have their gallbladder removed in order to save tens of thousands of dollars. Will you travel in order to save? If you enjoyed this post, you may also like Why you shouldn't have a C-section in New Jersey.
News Article | April 23, 2015
I'm having a baby in December. I'm wondering if my baby will be covered after she's born or how this works with insurance? Can I sign her up right away? What do I need to do to make sure she's covered? My friend told me her insurance company said her baby had to meet his own deductible. I wasn't planning on this cost and am wondering if this applies to my situation too? First of all, congratulations! This is certainly a very exciting time for you and your family. I'm guessing there are other things you'd rather worry about than health insurance. (How's the nursery coming along?) As for your questions, I'll tackle them one by one. Fortunately, you don't have to get on the phone right after you give birth (except maybe to call your mother-in-law) because you have 30 days to add your baby to your health plan. If you are on an employer-sponsored plan, contact the person at your organization responsible for the health plan and let them know you'd like to add your baby. Otherwise, call your insurance company and ask to add your baby to your health plan. You can find the number on the back of your insurance card. Because you have health insurance, your baby has automatic coverage for the first 30 days of life. How nice! Just make sure you sign your little one up within the 30-day window. Yes, after your baby is born, she will be on her own plan with her own deductible. However, if the baby is healthy, most doctors bill anything at the hospital under the mom. You'll want to contact your doctor and ask how he or she bills. However, if your baby isn't healthy, let's say she has to be in the NICU or undergo surgery, she will fall under her own deductible that will start right after birth. This newborn deductible comes as a surprise to many, as it can add another layer of financial stress. Best of luck with your upcoming arrival and let us know if we can help answer any more questions about healthcare. We're here to rescue you! Health insurance can be confusing and there is a lot of conflicting information available. Our mission is to be your most trusted advisor when you navigate these difficult scenarios. We'd love to answer your questions, so please leave a question in the comments below or email us at firstname.lastname@example.org. We look forward to hearing from you! And as our teachers told us, there are no stupid questions. If you enjoyed this post, you may also like Why you should have a baby in North Dakota.
News Article | October 28, 2016
Virsys12, an award-winning, certified Salesforce Silver Consulting Partner, continues its shift to focus on healthcare nationwide as it marks five years in business. CEO Tammy Hawes announced today a promotion and the addition of talent, including a senior solutions executive, director of consulting services, senior project manager and two consultants. “Word is spreading about Salesforce’s impact on healthcare, especially with the release of Health Cloud,” Hawes says. “The successes of our healthcare clients that are using the platform, customizing and integrating applications, and/or using one of our own V12 apps are a big part of this story. As a result, we are pleased to see our team growing with the addition of these high-caliber individuals.” Andy Harlen joins Virsys12 as Senior Solutions Executive with recent experience providing CRM solutions to healthcare providers. He was a regional account executive with Playmaker CRM and held similar positions with Ipero, Shareholder InSite and Bernard Health. He holds a BS in business administration from the University of Tennessee at Chattanooga. “The future for population health is managing the entire continuum of healthcare in one centralized place, and I know that Salesforce is the best way it can happen,” says Harlen. “When I was introduced to Virsys12, my choice was clear: I wanted to be on the team leading the charge for this game-changer technology.” Kristin Kilpatrick Johnson joined the Virsys12 team as Director, Consulting Services earlier this month with a decade of experience focused on CRM and healthcare. Johnson is a Salesforce® Certified Administrator, a Six Sigma Green Belt, is certified in Prosci Change Management methodology and has completed the Harvard Program on Negotiation. She has held senior positions with Medhost and Healthcare Management Systems. Johnson received an MA in leadership and organizational change from Belmont University and a BS in journalism from Middle Tennessee State University. “I grew to love the Virsys12 team when they were in a service provider role with my previous company,” Johnson says. “They are true partners and have your best interests in mind. I’m excited to be a part of a Salesforce A-team with so many groundbreaking projects.” Sarah McCarter joins as Senior Consultant with four Salesforce certifications, including Administrator, Advanced Administrator, Developer and Service Cloud, in addition to her ScrumMaster certification. Her experience includes positions with Eloyalty, Salesforce.com, Nelson Technology and Stream Global Services. She holds a BS in geology from the State University of New York at Fredonia. “I was introduced to Salesforce before I finished college, and it changed the course of my life,” says McCarter. “I’ve loved technology since I was in kindergarten. Now I get to use my favorite technology to impact healthcare, and it feels right.” Sara Schroeck officially begins this week as Consultant with two Salesforce certifications including Administrator and Advanced Administrator. She has served as a business and operations analyst and in other management positions with Decision Resources Group, Relias Learning and Silverchair Learning systems. She earned a BS in management, marketing and human resources with a minor in women’s studies from Boston College. Additionally, Hannah Feeley has joined Virsys12 as Associate Consultant from her position with TechTarget in Newton, MA. Feeley’s experience includes The Kraft Group and Feeley & Brown. She holds a BS in business administration from Stonehill College in Easton, MA. “A family friend works for Salesforce,” Feeley says. “Knowing my passion for the technology, he told me ‘Virsys12 is the company for you.’ I’m proud to join the team.” Tanzy Wallace, previously Technical Sales Consultant, has been promoted to Team Lead, Solutions Engineering. Wallace, who has been with Virsys12 since 2014, holds Salesforce Administrator and Service Cloud certifications. Virsys12 continues to expand, says Vice President of Client Success Paul Peterson. “Even with a highly competitive hiring environment for technology talent, we are being selective to find candidates who have a vision for healthcare and a passion for change. If you are not content with the status quo and have the skills and passion for healthcare, give us a call. Or email careers[at]virys12[dot]com.” About Virsys12 Virsys12 is an award-winning, certified Salesforce Silver Consulting Partner focused on healthcare innovation nationwide. With success providing transformative technology for large, small, public and private enterprises, the individually certified team maintains top customer satisfaction ratings and excels in lean business process. We solve your hardest problems by making the complex simple, guaranteeing our work for implementation, integrations, applications and technology strategy. More at Virsys12.com. Salesforce, Force.com, Service Cloud, Health Cloud and others are trademarks of salesforce.com Inc., and are used here with permission.