Tuesday, January 17, 2012

Dr. White Talks About Getting More Sleep

As a mother of 3 young children this post from Dr. White about healthy amounts of sleep really struck home. There are many factors that affect the amount of sleep we get on a regular basis. In many cases simple lifestyle changes could make a real positive impact. In other cases, a discussion with your physician may be an appropriate next step.

One New Year's Resolution Worth Keeping: Get More Sleep

Dr. David White, M.D.

Chief Medical Officer for Philips Home Healthcare Solutions

It's no secret that today's nonstop lifestyle is detrimental to our sleep. Whether due to work, television, stress or any number of other reasons, more Americans are staying up late and getting up early. The average American sleeps only six hours and 55 minutes per night during the week, according to the National Sleep Foundation. Additionally, 15 percent of adults and 7 percent of adolescents regularly sleep less than six hours per night. A lack of sleep is taking its toll. What's the price you pay for sleeping less than the currently recommended amount? Poor concentration. One early indicator of sleep deprivation is a loss of the ability to maintain attention or stay focused on a given task. Most of us can rise to the occasion and concentrate for a short period of time with generally good results. But, for activities like driving, or any task requiring over five to 10 minutes of serious concentration, inadequate sleep leads to poor outcomes. And, your cognitive impairment will get steadily worse for at least two weeks if you don't sleep longer at night. Many of us have jobs that do not require sustained attention, so we appear to function well with relatively little sleep. However, this does not mean that our brains are working optimally. It simply means that many of us are "on auto-pilot" at jobs that may not constantly challenge our minds. Memory loss. Another casualty of shortened sleep is your ability to retain memories and learn new skills. Memory consolidation (encoding or firmly implanting a memory in the brain) occurs the night after you learn something while you are sleeping. If you don't get a good night's rest after learning a motor task (like typing) or grasping an intellectual concept, your ability to perform that task or remember that concept is impaired. Bad choices and bad mood. Your ability to inhibit some risky behaviors is hampered by lack of sleep. Sleep deprivation is also well known to have a negative effect on emotions. Losing sleep flattens your mood and makes you a more dour, irritable and negative individual. Plus, the negative influence on your mood carries over to your ability to address personal or moral decisions effectively. Sleep experts are currently investigating whether inadequate sleep affects complex brain functions such as decision making, planning and goal-oriented activities. Certainly, a diminished ability to concentrate degrades cognitive ability. However, there is mixed evidence as to whether sleep loss specifically influences complex cognition apart from this loss of attention. It seems that some mental functions are more affected than others by sleep deprivation. Basic decision making, logical deduction and reading comprehension seem to be minimally affected by sleep loss. However, creativity and the innovative aspects of cognition decline. Whether sleep duration affects athletic performance is not as well studied. It seems quite clear that reaction time deteriorates with reduced sleep. To the extent reaction speed is important in an athletic event, worsening performance can be predicted. Most evidence suggests that short sleep reduces athletic prowess and that extending sleep duration may improve your performance in sports. Research addressing sleep and athletic performance indicates that: • Four hours' less sleep (eight to four hours) on a single night decreases accuracy and consistency in throwing darts. • One whole night without sleep yields slower times for short distance sprints, while an afternoon nap following a night of partial sleep deprivation improves sprint times. • Increasing sleep for 110 minutes per night for several weeks in college basketball players improves free throw and three-point goal percentage and results in faster sprint times. It seems pretty clear that there is lot of upside to getting enough sleep. A good night's rest goes a long way toward improving your reaction time, memory, complex cognition and probably athletic prowess. This year, resolve to create an effective nighttime routine and a positive sleep environment. Unplug from the TV or mobile devices before bed and limit your caffeine intake as it gets later in the day. Make sure you get those Zzzs; an adequate nightly sleep has a lot to offer. Article from Huffpost Healthyliving http://www.huffingtonpost.com/dr-david-white-md/need-sleep_b_1194893.html

Friday, January 6, 2012

Impact of Competitve Bidding Reported

Check out this survey reported on in HMENews. Patient access to diabetic supplies and patient choice has been drastically impacted by Competitive Bidding. Sadly, the results of this survey don't come as a surprise to many in our industry, but we're glad these groups have taken the time to bring this information to the forefront.

Survey: Bidding program really does limit access
By Theresa Flaherty, Managing Editor 12.23.2011 CHICAGO - Beneficiaries in Round 1 competitive bid areas have limited access to the most widely used diabetes testing supplies, says the American Association of Diabetes Educators (AADE). A survey by the association found that mail order contract suppliers, on average, offered only 38% of the product brands that are listed on www.medicare.gov. Of the nine brands identified by the Office of Inspector General in a 2010 report as the top mail order brands by market share, contractor suppliers offered, on average, only 1.44 of the brands, or 16%. "We were getting all of these stories from our educators who were hearing about problems, or having their patients tell them they don't have a certain meter any more," said Martha Rinker, chief advocacy officer for the AADE. "When we talked to CMS about it, or any other party, they'd say it was just anecdotal. We thought this was the best way to get concrete information." With an average reimbursement cut of 56% for mail order diabetes supplies, it's not all that surprising that many suppliers are offering lesser-known--and less expensive--brands. Dr. Peter Cramton, a vocal critic of the current competitive bidding program, predicted providers would cherry pick and switch patients to different brands to try and squeeze out a profit. "It's in line with what I expected to see based on the current design of the program and the type of behavior it creates," said Tom Milam, a member of the Program Advisory and Oversight Committee (PAOC) and former CEO of mail-order diabetes supply firm AmMed Direct. For Round 2, which expands the mail order diabetes bid to all 50 states and several U.S. territories, CMS has implemented changes it believes will prevent low-ball bids: Contract winners must provide, at minimum, 50% of all the different types of diabetes testing supplies on the market by brand names; and contract winners are prohibited from influencing or providing incentives to beneficiaries to switch their brands. But unless CMS plans to police suppliers, stakeholders don't believe the provisions will work. "It's easy to bid and give a low bid and say you're going to do something and not do it," said Rinker. "I think it's going to be up to us who work with the patient community to get some congressional interest in this to make CMS take an interest."

Article from HMENews http://www.hmenews.com/?p=article&id=hm201112nviNI0