Month: February 2021

Marianne Huff: This is what real care integration looks like

From MHAM: For Complete Post, Click Here…

Integrated care has been a topic in the health care environment for years, but it became more relevant with the signing of the Affordable Care Act in 2010.

The idea that mental health and physical health professionals should “talk to each other” about their shared clientele has become an emotionally charged topic for individuals with Medicare and Medicaid, their families, their supporters and for disability rights advocates.

One of the services that developed through the community mental health centers is case-management services. Case management is designed to help individuals with more severe mental illnesses navigate the community by linking them to services such as housing and health care and by helping with the application for governmental programs such as food stamps, Social Security Disability and/or SSI and Medicaid.

Case management IS integrated care, and it is far more personal than having an electronic health record that can talk to another EHR.

The solution is simple and does not involve making an overly bureaucratic and hard-to-navigate system more overly bureaucratic and hard to navigate. Integration simply means to communicate and to collaborate with community resources.

True integration focuses on the individual who needs assistance in navigating complex community systems including physical health care. And case management is a service that is uniquely tied to the community mental health system, because the core function has always been to keep individuals out of state and community psychiatric hospitals and in the community.

Our all-new TalkBack screen reader

By Brian Kemler: For Complete Post, Click Here…

To blind traveling bluesman Joshua Pearson, songwriting is more than just a good melody. “Songwriting gave me a language to talk about my frustrations. And by putting my music out there, I could hopefully let somebody else feel some of what I was feeling.” For Joshua, TalkBack is his main pen and paper for writing songs; it lets him dictate lyrics into his phone and hear them told back to him.

Screen readers, such as Android’s TalkBack, are the primary interface through which Joshua and many other people who are blind or low vision read, write, send emails, share social media, order delivery and even write music. TalkBack speaks the screen aloud, navigates through apps, and facilitates communication with braille, voice and keyboard input. And today we’re releasing an all-new version of TalkBack that includes some of the most highly requested features from the blind and low vision community.

FCC approves $50 monthly internet subsidies for low-income households during pandemic

By Brian Fung: For Complete Post, Click Here…

The Federal Communications Commission on Thursday approved final rules for a new broadband subsidy program that could help struggling families pay for internet service during the pandemic.

The agency’s $3.2 billion Emergency Broadband Benefit Program provides eligible low-income households with up to a $50 per month credit on their internet bills through their provider until the end of the pandemic. In tribal areas, eligible households may receive up to $75 per month.

The program also provides eligible households up to $100 off of one computer or tablet.

ALS Neuron Damage Reversed With New Compound

From Neuroscience News: For Complete Post, Click Here…

ngd- Here’s hoping it proves out in bigger studies…

So far, there has been no drug or treatment for the brain component of ALS, and no drug for HSP and PLS patients.

“Even though the upper motor neurons are responsible for the initiation and modulation of movement, and their degeneration is an early event in ALS, so far there has been no treatment option to improve their health,” said senior author Hande Ozdinler, associate professor of neurology at Northwestern University Feinberg School of Medicine. “We have identified the first compound that improves the health of upper motor neurons that become diseased.”

The study will be published in Clinical and Translational Medicine on February 23.

The study was initiated after Silverman identified a compound, NU-9, developed in his lab for its ability to reduce protein misfolding in critical cell lines. The compound is not toxic and crosses the blood brain barrier.

The NU-9 compound addresses two of the important factors that cause upper motor neurons to become diseased in ALS: protein misfolding and protein clumping inside the cell. Proteins fold in a unique way to function; when they misfold they become toxic to the neuron. Sometimes proteins aggregate inside the cell and cause pathology as in the TDP-43 protein pathology. This happens in about 90% of all ALS patient brains and is one of the most common problems in neurodegeneration.

Grade retention: Will it help?

By Howard Margolis: For Complete Post, Click Here…

Retention rarely helps struggling learners, especially those with reading disabilities. I’ll say it again: It rarely helps.

It often backfires. Combinations of negative feelings abound: Humiliation, bewilderment, anger, despondency, resentment, despair, and so on. Magnify this by the widespread isolation and anxiety caused by COVID-19 and you have a formula for continued despair, resentment, and turmoil.

Around the turn of the century, Chicago enforced an aggressive policy of retaining students, a policy examined by Dr. Mary Abbott and her colleagues. Regrettably, the results were not surprising.

“The academic future of the students who were actually retained was poor. The academic performance of the Chicago third graders who were retained was similar to that of third graders who were not retained, retained sixth graders performed more poorly than their counterparts who were not retained, and retained eighth graders were far more likely to drop out and to do so at a younger age than students who were not retained. Furthermore, 78% of the students retained in eighth grade had dropped out by the time they turned 19…. These results mirror those of past retention studies (italics added) that have reported that retained students either show declines in achievement over several years after retention or have academic outcomes that are no better after repeating a grade than those of low-achieving promoted students. In addition, students who have been retained have higher dropout rates than their promoted low-achieving peers.”

Similarly, Dr. Amy Reschly noted that retention sharply increased the odds that children would drop out of school:

“Failure to achieve grade-level expectations in reading is the primary reason students in the early grades are retained … Research on grade retention clearly points to a connection between retention and dropout. … Grade retention was the most powerful predictor of later dropout, with retained students being 11 times more likely to drop out of school.”

Today, grade retention continues to backfire.

“Our results indicate that grade retention has a neutral effect on academic achievement in the short run. In the long run, grade retention, just like forced downgrading, has adverse effects on schooling outcomes and, more so, for less able pupils.”

New study finding success in supporting parents of neurodiverse kids

By Kathleen O’Grady: For Complete Post, Click Here…

ngd- Involvement of those affected in design and implementation. Gosh, what a concept!…

Encouraging response from early participants of a Canada-wide study looking at the value of personalized online training for parents of neurodiverse children have researchers excited to recruit more families.

‘Neurodiverse’ refers to children with brain-based or neuro-developmental disabilities such as Autism, Epilepsy, Down Syndrome, Fetal Alcohol Spectrum Disorder (FASD), Global Developmental Delay and significant learning disorders.

The study offers a welcome helping hand for parents during the pandemic.

The destabilizing impact of COVID-19, with sudden lockdowns, restrictions and program and school closures, has forced parents to scramble and adapt.  Many parents have suffered anxiety, overload and burnout.

Families affected by disability have been particularly hard hit.

“Parents Empowering Neurodiverse Kids” is led by Dr. Patrick McGrath at the IWK Health Centre and Dalhousie University in Halifax and Dr. Lucyna Lach from McGill University in Montreal and focuses on assessing an online parenting program. The program is designed to teach parents how to tackle challenging behaviours with a positive parenting approach to improve the quality of life for families affected by neurodevelopmental disabilities.

“Early feedback from participants and previous related studies show that providing parents with coaching skills may lighten their load and allow them to focus on the positive aspects of being parents,” says Dr. McGrath.

Dr. Sarah Tremblay, mother of a seven-year-old girl with cognitive disability says, “When I initially got involved with the program, I wasn’t sure what to expect.  But from the very first week of implementing the simple strategies for connecting and communicating with my child, I saw some pretty amazing changes in her and myself.”

The 2016 CDC Opioid Prescribing Guideline for Chronic Pain: Unintended Consequences and a Revision on the Horizon

By Beth Darnall, PhD: For Complete Post, Click Here…

ngd- This is an important policy critique and should be read by everyone involved in the chronic pain community…

In 2016, the U.S. Centers for Disease Control (CDC) issued its Guideline for Prescribing Opioids1and cautioned physicians and clinicians about starting new opioid prescriptions, as well as increasing the dose of existing opioid prescriptions. One year after it was published, national retail pharmacy data revealed that opioid prescribing had decreased by 57% each month in the United States over the preceding year.2

At their core, these rigid opioid dose policies violate the basic principles of patient-centered pain care while deeply undermining physician autonomy in medical decision-making for the individual patients they treat.

This same study showed that while decreased opioid prescribing preceded the 2016 CDC Guideline, the slope of prescribing decreased substantially afterward. Indeed, the guideline emboldened opioid reduction practices and policies in ways that its authors never intended. Since 2016, opioid prescribing decreases have been attributable to fewer new opioid prescriptions and the tapering of opioids among people who had been taking them long term. This last point is of particular relevance as the CDC Guideline included no language about opioid tapering indications or implementation.

At their core, these rigid opioid dose policies violate the basic principles of patient-centered pain care while deeply undermining physician autonomy in medical decision-making for the individual patients they treat.

Curiously, improving patient safety through opioid reduction is a primary justification cited for policies that mandate opioid tapering. Indeed, data suggest that higher doses of opioids are directly associated with risk for opioid overdose and overdose death. However, for many patients, the consequence of the misapplication of the CDC Guideline has been direct harm. Reports of iatrogenic tapering harms spurred colleagues and me to submit to U.S. Health and Human Services (HHS) a letter calling for federal action to protect patients from abrupt and forced opioid tapering harms (subsequently published in Pain Med3).

Accessibility of COVID-19 Vaccine Pages and Barriers to Individuals with Disabilities

By Jared Smith: For Complete Post, Click Here…

WebAIM contributed to an article authored by Kaiser Health News and republished in the LA Times regarding the accessibility barriers posed by vaccine registration pages in the US. Our automated WAVE analysis of vaccine information and registration web sites for all 50 state (plus DC) sites discovered that most sites may pose notable barriers to users with disabilities. All but 13 of the 94 pages tested had detectable accessibility issues.

On average the 94 state-level COVID-19 vaccine pages averaged 18.9 detectable errors. The most common error was low contrast text. Other common issues were images missing alternative text, empty links and buttons, and missing form input labels (text that would describe the purpose or function of form fields). While automated tools, such as WAVE, cannot detect all or even most accessibility issues, the issues detected tend to be highly impactful for users with disabilities. These potential barriers may be considered discriminatory and thus put the page owners at risk.

A Rally to Lift the Lockdown – Friday, March 12th

From National Long-Term Care Ombudsman Resource Center: For Complete Post, Click Here…

Join Consumer Voice Friday, March 12th at 12:00pm ET  for a rally commemorating the one year anniversary of the nursing home visitation ban.  The rally will honor those we’ve lost and provide an opportunity to hear directly from residents and family members about their experiences during the lockdown.  It will include a call to action – mobilizing family members, residents of long-term care, and advocates to ask their state and federal policymakers and the Centers for Medicare & Medicaid Services (CMS) to safely “open nursing home doors.”

Register to Attend

COVID-19 Nursing Home Lawsuit Protections: Early 2021 State Updates

From MedTruth: For Complete Post, Click Here…

Last year MedTruth covered the controversial enactment of state laws and regulations protecting nursing homes from COVID-19 related lawsuits. Roughly half of all states filed some form of nursing home protection law, or a more general business protection law that covers nursing homes in 2020, Law.com reports.

Now, at the beginning of the pandemic’s second year, MedTruth is providing updated information about these protections.

In the first two weeks of 2021, Alaska, Florida, Indiana, Kentucky, Montana, Nebraska, and Wisconsin all introduced bills designed to extend or renew previous COVID-19 lawsuit protections put in place last year, as reported by Law360.