Obese Kids More Likely to Have Asthma, With Worse Symptoms

WEDNESDAY, Aug. 7 (HealthDay News) -- Overweight and obese kids are more likely to struggle with asthma than kids of normal weight, according to a new review of more than 623,000 children.

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New Report Shows Most States Fall Behind on Asthma and Allergy School Policies

With millions of children heading back to classrooms in the coming weeks, asthma and food allergies at school present serious concerns, but some states are better than others when it comes to supporting students with these chronic diseases.  A new report by the Asthma and Allergy Foundation of America (AAFA) shows that most states still don't have core policies in place to protect kids and adults in schools nationwide. In fact only 7 states and the District of Columbia currently meet the Foundation's criteria to be listed on the "State Honor Roll™ of Asthma and Allergy Policies for Schools." The report, at www.StateHonorRoll.org, is an annual look at how states compare on 18 core policy issues that affect kids and adults with asthma and allergies while they spend the day learning or working in America's schools.

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How to best prepare and adapt for shared risk and value-based payment: Tips for practice managers

UAS president and CEO, Nick Hollis, was quoted in the most recent Medical Group Management Association (MGMA) members magazine. The article was an industry roundtable on valuable tips for practice managers. Please see the page in the magazine below where Nick is quoted.

MGMA Connexion pg 57

When Allergies Attack! Asthma and Allergies in America (Infographic)

Seeing how combating unhealthy air quality and allergies are the main factors Oransi builds our high quality HEPA air purifiers, we have compiled the most recent statistics on allergies and asthma in the U.S. to show you how important fresh, clean air is to millions of Americans. Some of the facts in this infographic may surprise you. For instance, most Americans believe the air in their home is clean. In reality, indoor air can be up to 100 times more polluted than outdoor air, which is why having air purifiers for allergies can be a huge benefit to your health. Click the infographic to learn more about common triggers, risk factors, and the costs of asthma, allergies and poor indoor air quality in the United States.

Feature Our Asthma & Allergy Infographic on Your Site
You are free to display this infographic on your own website or blog. All you have to do is copy and paste our embed code below to attribute the graphic back to Oransi with a link. It’s really that simple!

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Case Report: Allergic Rhinitis (AR)

Learning Objectives:

1. ) Better understand the seasonal and perennial allergies that Louisianans face, particularly in the summer.
2. ) Learn more about allergy treatment options in the family practice setting.
3. ) Understand the need for primary care providers to provide allergy care.Draft Article:

Allergic Rhinitis (AR) is the fifth leading cause of chronic disease among all Americans1 and a major concern for Louisianans year round. As many as 30 percent of all adults and 40 percent of children suffer from AR nationwide.2 In Louisiana in particular, the humid weather often causes patients to experience more severe symptoms than in other parts of the country. While in other areas summertime is often associated with reduced pollen counts and allergy symptoms, Louisiana’s hot humid, summers foster spikes in mold, grasses and other airborne allergens.

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Providers Prep for New Models of Care

Like it or not, a new healthcare landscape is taking shape that runs counter to just about every convention the industry has ever known.

Instead of furnishing services and automatically getting paid, providers must demonstrate their value through outcomes. Rather than being hospital-centric, healthcare must be shared by a network of post-acute care providers. It is a different mindset that the industry is trying to come to grips with, experts say.

"It is about providers understanding their market, their strengths and their capabilities," says Gary Anthony, head of technology business development and sales operations for Hartford, Conn.-based Aetna Accountable Care. "The market seems to be embracing it, but the pace with which they accept that change is different for different reasons."

Whether the new business model is called an accountable care organization, value-based purchasing or medical home, the goal is the same: to provide cost-effective health services that meet a high standard of quality. And while that may cause some executives to freeze in anticipation of a complex, convoluted transformation, the process is actually simpler than it appears, says Brenda Radke, CEO of the Brevard Physicians Care Network, a group of 270 independent physicians on Florida's Space Coast.

"It is really pretty basic stuff," said Radke, who also serves as executive director at Medical Practitioners of Care ACO, an organization with 150 physicians. "I wish I could say it was a stroke of genius, but it really isn't."

In the months following the organization's launch of an electronic medical record last October, Radke says the physicians are realizing that "they belong to each other" and that "all the focus is on why the patient is there."

Critical to the success of this ACO model is communication, Radke says, because that connection through the EMR enables all physicians to share the same patient data so that they know symptoms, test results and diagnosis before the face-to-face encounter.

"There was a disconnect about the appointments between primary care and specialists - maybe a piece of paper from the primary care that said the patient has an abnormal EKG," she said. "The specialists would then perform the same lab work and diagnostics that the patient already had. There was also a lot of faxing going on back and forth, which was very inefficient."

'Volume to value'

Katherine Schneider, MD, executive vice president and chief medical officer for Wayne, Pa.-based Medecision, characterizes the new healthcare landscape as "the journey from volume to value." In other words, it is shifting from basing revenues on the number of patients treated to becoming invested in how patients are cared for.

The transformation has been slow and gradual for the industry so far, but Schneider says that is a natural part of the evolution.

"The lights don't come on all at once," she said. "It's building blocks. But once you gain momentum, it is hard to put the brakes on. The business model and care model should progress at the same pace, not letting them get ahead of each other. At some point, however, it will have to accelerate so that the revenue part takes over."

As a consultant to providers on ACO formation, Schneider says she wants to instill trust and confidence in her clients by getting them to envision their own futures.

"All our conversations are around 'how are you doing things now, how will you be doing them next year, what will things look like in 2016 and how we can be their partner," she said.

Maximizing health

Physician Jeff Bullard's healthcare philosophy is summed up in the name of his Colleyville, Texas, practice - MaxHealth Family Medicine. As a primary care practitioner, Bullard serves as the anchor for a litany of services provided in his 10,000 square-foot complex, including allergy treatment, mental health and wellness services, physical medicine and rehabilitation, sports medicine, weight loss and cosmetic medicine.

Realizing that the healthcare model was ripe for change, Bullard and his associates set up a "medical home" model five years ago that laid out a roadmap of service extensions.

"When we examined the medical home idea for us, it amounted to a documentation of processes that are already in place," he said. "As a primary care physician, it is quite intimidating to be involved in an ACO where you give up responsibility depending on what measures you are trying to achieve. Our hope is that we can demonstrate cost effectiveness by focusing on prevention. We are in contact with employers on the importance of workplace wellness and our role in addressing it."

Finding a balance

Providers need to study the impact on their service levels as they move away from fee-for-service to a value-based system, added Frank Flosman, vice president and West regional leader for Aetna Consulting.

"They need to look at improving utilization patterns and finding a balance," he said. "As an organization you may see your top line revenue decrease, so what investments can you make in infrastructure for care management capabilities? Some organizations can manage within four walls, but that isn't the real challenge - it is to coordinate and deliver care across the continuum."

Providers must also take greater interest in the population outside the realm of service delivery, Flosman said, such as population health.

"This gives them information about the appropriate level of services," he said. "They need to utilize the data and use it for provision of services. It is a critical shift."


By John Andrews
June 1, 2013

Healthy Memphis: Know difference between seasonal allergies and cold symptoms

What you should know

Spring and summer open up the enjoyment of outdoor activities and scenery. Yet a runny nose, stuffiness, and itchy eyes can ruin the experience. Relief methods depend on whether you have an allergy or a cold.

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Half of nasal allergy sufferers have sleep issues

More than half of U.S. nasal allergy sufferers report sleep issues as a result of their allergy symptoms, but 35 percent treat their symptoms, a survey says.

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Respiratory Symptoms And Exacerbations In COPD Worsened By Allergic Disease

Patients with chronic obstructive pulmonary disease (COPD) who also have allergic disease have higher levels of respiratory symptoms and are at higher risk for COPD exacerbations, according to a new study from researchers at Johns Hopkins University in Baltimore.

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Blurry vision and allergic shiners? How to treat eye allergies

Up to 40 percent of the U.S. population suffers from itchy and watery eyes. Seasonal allergy symptoms experienced in the eye area can result in practical problems such as extreme sensitivity to bright light, blurry vision and an annoying desire to rub your eyes.

Many allergy patients also experience darkness and/or swelling underneath one or both eyes. This is known as “allergic shiners,” and is simply the result of congestion in the sinuses that slightly affect ones blood flow. Some of the smaller blood vessels beneath the skin may enlarge and show up as darkness (often purplish) right under the eyes.

My female patients try to remedy this situation by using facial cosmetics, such as concealers and foundation, as a cover-up to the puffiness and dark circles.

But, upon medical examinations, we often find that our patients’ have allergic sensitivities to the very eye make-up they are using to try and look better. Mascara and eyeliner in particular make the allergic shiner worse, rather than fixing the problem.

Other hygienic products that may worsen one’s allergic shiner include hair care products, facial moisturizers and products containing fragrances.

In-office allergy patch tests can easily identify if contact dermatitis, or skin allergies, are present, and may explain the puffiness, redness and irritated eyelids.

The next step, after removing irritant eye make-ups and creams, is to look for specific solutions to treat the allergy or sinus disease. Of course, dehydration, lack of sleep and familial facial characteristics may contribute to ones unfavorable physical appearance. Many of us tend to have more puffiness around the eyes upon wakening, as a result of the horizontal or recumbent sleeping position in which fluid has accumulated, and will subsequently diminish during the day.

Another indicator may be one’s amount of salt intake, which can contribute to the retention of fluid within and around your lids. Low-tech treatments such as “cool” compresses around your eyelids will help reduce swelling and residual daytime puffiness.

Bottom-line: Visit your doctor to have a diagnosis confirmed. A simple in-office allergy test can help pinpoint whether you have seasonal or indoor allergies. Second, many allergy patients benefit from prescription antihistamine eye drops as well as oral antihistamines. Last, a sinus evaluation can also detect inflamed or blocked sinus passages that require appropriate remedies.

After you complete these steps you will be on your way to feeling better and having younger-looking eyes.


By Dr. Clifford Bassett
Published April 29, 2013