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New Mums At Rotherham Hospital Were Given Goody Bags This Week To Help Promote Breastfeeding Awareness Week, UK
The hospital"s maternity unit provides year-round support for all mothers, whatever their chosen method of feeding, but the maternity team is committed to increasing the support for breastfeeding.
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Washington Post Examines Lack Of Information About Stillbirths, Bill To Expand Data Collection
Centers for Disease Control and Prevention data show that stillbirth occurs in about one in every 160 pregnancies in the U.S., but physicians rarely warn pregnant women or their partners about the possibility, Washington Post staff writer Alan Goldenbach writes in an article discussing his experience when his wife"s pregnancy ended in stillbirth. In the U.S., the clinical definition for stillbirth is the death of a fetus after 20 weeks" gestation or weighing 350 grams if the age is unknown.There are about 26,000 stillbirths annually in the U.S., according to CDC. Goldenbach writes that this is "10 times the number of deaths attributed to sudden infant death syndrome, which has been identified as a key public health issue, and four times the incidence rate of Down syndrome, for which prenatal testing has become almost ritual." He continues that many doctors told him and his wife "that they don"t see any point in discussing stillbirth, that it"s a catch-all term for an event, and one that is frequently unexplained." Doctors contend that if they knew the causes or signs of stillbirth, they would warn patients or take preventive action, he adds. Noting that awareness of SIDS spurred research into preventive measures, Goldenbach writes that "[w]e can"t know if improved technology or more stringent standards of monitoring can lower stillbirth rates unless we do the research."Ruth Fretts, an assistant professor of obstetrics and gynecology at Harvard Medical School and chair of the scientific committee for the International Stillbirth Alliance, said, "It"s a trade-off -- you are going to frighten a lot of people" by discussing stillbirths. According to Fretts" research, the leading cause of fetal death after 28 weeks" gestation is an unexplained . Goldenbach writes, "Several doctors told us privately that many ob-gyns fear charges of malpractice following a stillbirth, leading them to avoid citing a cause of death."Stillbirth Legislation in Development Sen. Frank Lautenberg (D-N.J.) is drafting legislation similar to a stillbirth prevention bill that then-Sen. Barack Obama (D-Ill.) introduced in June 2008. According to s familiar with the bill, it will be brought to the Senate floor before the August recess. The legislation will expand stillbirth registries already in operation in Iowa and metropolitan Atlanta. The bill"s supporters hope to have as many as 12 states participating in the registry and installing a standard protocol for data collection after each stillbirth. Another provision would create a campaign to increase public awareness and strengthen grief support services, Goldenbach writes (Goldenbach, Washington Post, 7/6).
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G8 Addresses Developing Nation Economic Assistance, Reforming African Aid, Establishing Farming Investment, Food Security, Climate Change
G8 Addresses Developing Nation Economic Assistance, Reforming African Aid, Establishing Farming Investment, Food Security, Climate Change
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Kaiser Permanente Project Proves Electronic Health Information And Care Coordination Improve Chronic Disease Management

Specialty care physicians can improve the health of high-risk patients by reviewing electronic health records and proactively providing e-consultations and treatment plan recommendations with primary care physicians, according to a Kaiser Permanente paper published online in the British Medical Journal. The quality improvement project at Kaiser Permanente demonstrated that specialists can take a more active role in managing the health of populations with chronic illness - in this case, kidney disease - by using electronic health records to coordinate care among primary and specialty care providers. In the project, nephrologists (kidney specialists) proactively consulted remotely with primary care doctors to help manage patients at risk for end-stage renal disease. Using a new system developed by the paper"s lead author, Brian J. Lee, MD, and his colleagues at Kaiser Permanente, nephrologists in Hawaii used electronic laboratory results to rank more than 10,000 kidney patients not yet referred to a specialist by their risk for kidney failure. Then, they monitored the patients who were most at risk to make sure they were getting care in line with evidence-based treatment recommendations. After identifying the at-risk patient population, the nephrologists relied on Kaiser Permanente HealthConnect(R), an electronic health record system, to evaluate next steps. The nephrologists used the EHR to review the patients" electronic medical record and to provide an e-consult to the patients" primary care physicians. In many cases, the nephrologists recommended referral for more intensive specialty care. In others, the primary care physician was given the treatment plan necessary to prevent the need for referral. Results of the five-year project showed it increased early intervention for high-risk patients and reduced by two-thirds the number of late specialist referrals - those occurring within four months of the onset of end-stage renal disease. "The goal with kidney disease is to detect it early enough to make changes that will slow the disease down. If you"re more likely to end up with kidney failure, we want to reach you in time to help prepare you for successful dialysis treatment," said Lee, a nephrologist with Kaiser Permanente Hawaii. "Patients who have a chance to consult with a nephrologist well before the onset of kidney failure are less likely to be hospitalized and more likely to survive longer. Our patients are more successful in starting dialysis when they are able to choose the type of dialysis or transplant with their physician, have a dialysis access implanted, start treatment outside of the hospital before becoming very ill, and be educated and psychologically prepared for it." While the vast majority of chronic kidney disease patients can be successfully managed by primary care doctors, some patients are better off cared for by a nephrologist, particularly those at highest risk of worsening kidney disease. Many people with chronic kidney disease don"t even know they have it, and yet it is critical to reach people before their kidney disease progresses too far. The most common risk factors are obesity, diabetes and hypertension - all controllable through healthy lifestyle changes and medication. "We want to provide the best and most comprehensive care that we can to our patients," said Geoffrey Sewell, MD, president and executive medical director of the Hawaii Permanente Medical Group, whose 410 physicians exclusively provide care for 222,594 Kaiser Permanente members in Hawaii. "Our integrated system of primary and specialty care physicians working together provides complete care - from the prevention of disease to the management of acute and chronic illness. This coordinated care program is made possible by KP HealthConnect, a system that supports the decisions we as physicians make with our patients every day." "This pilot illustrates the benefits of leveraging technology and the expertise within a multi-specialty group practice," said Lee, the paper"s lead author. "In the past, specialists have been limited to helping only those patients who were referred to them. Now that we can use databases to identify disease trends and populations, and electronic health information to provide data on individual patients, our specialists can proactively find and recommend treatments for patients who could really use their help." The paper was co-authored by Ken Forbes, a care management analyst with the Kaiser Permanente Care Management Institute. About Kaiser Permanente Hawaii Kaiser Permanente Hawaii has provided total health to the people of Hawaii for more than 50 years. Today it has the largest medical group with over 410 physicians supported by 4,400 nurses and other staff. Care for members is focused on their total health guided by our personal physicians, specialists, and team of caregivers. Our expert care and medical teams are supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America"s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. Kaiser Permanente


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