introduction of the supine sleep position to reduce the prevalence of Sudden
Infant Death Syndrome has not altered the timing or sequence of infant rolling
abilities, say authors of an article published
online in Early Human Development. This information is valuable to health care
providers involved in the surveillance of infants' development, they add.
Original normative age estimates for these 2 motor abilities are still
The aim of this study was to compare the order and age
of emergence of rolling prone to supine and supine to prone before the
introduction of back to sleep guidelines and 20 years after their introduction.
The original normative data for the Alberta Infant Motor Scale (AIMS) were
collected just prior to the introduction of back to sleep guidelines in 1992.
Currently these norms are being reevaluated. Data of rolling patterns of
infants 36 weeks of age or younger from the original sample (n=1,114) and the
contemporary sample (n=351) were evaluated to compare the sequence of
appearance of prone to supine and supine to prone rolls (proportion of infants
passing each roll) and the ages of emergence (estimated age when 50% of infants
passed each roll).
According to the results, the sequence of emergence
and estimated age of appearance of both rolling directions were similar between
the 2 time periods.
conjunction with the Therapy Cap Coalition, is launching a national grassroots
campaign to "Stop the Therapy Cap" on Monday, December 3. The patient impact of the cap is the theme of Monday's
campaign. Almost 50 associations, organizations and patient groups will
be sending action alerts to their members. With about 30 days left until
expiration of the therapy cap exceptions process, the goal is to create a
significant surge in Congressional e-mails and phone calls urging members of
Congress to stop the therapy cap from taking effect in 2013.
provided association members form letters and e-mails in its Legislative Action Center. To access the materials, log in
to the website, click "Take Action" under "Stop the Medicare Therapy Cap and
Prevent SGR Payment Cuts," and follow the instructions. If you have time,
personalize the e-mail and let Congress know how the cap impacts your patients.
has been very clear: it will not take action without input from constituents.
If you only send 1 advocacy e-mail or make 1 advocacy phone call this year, do
it on Monday.
will send out an Action Alert Monday morning with talking
points and instructions for contacting your legislators. Also, ask your
patients to e-mail or call their members of Congress on Monday using APTA’sPatient Action Center.
For more information on APTA's advocacy efforts, visit the Medicare Therapy Cap website.
running out! Take 5 minutes on Monday and contact your legislators. You can
make a difference and help prevent a hard Medicare therapy cap of $1,900 from
being implemented in 2013.
patients to e-mail their clinicians and access their records online is
associated with more, not fewer, telephone calls, office visits, and clinical
services in general, says a Medscape
Medical News article based on a study published in the
November 21 issue of JAMA.
Researchers studied the effect of an online Web
portal for patients enrolled in Kaiser Permanente (KP) Colorado. The portal,
called My Health Manager (MHM), connects to KP's electronic health record
system. MHM allows patients access test results, request medicine refills,
schedule nonurgent appointments, and exchange messages with their clinicians on
nonurgent health issues.
The authors measured the use of health care services by 44,321 users of MHM
before and after KP Colorado adopted the system compared with health care use
by an equal number of nonusers. All patients in the study were continuously
enrolled in KP Colorado for at least 2 years from March 2005 through June 2010.
Lead author Ted Palen, MD, PhD, MSPH, and
coauthors found that the number of office visits by MHM users increased by 0.7
per member per year compared with nonusers. Telephone encounters rose at a
smaller rate of 0.3 per member per year. The rates of after-hours clinic
visits, emergency department encounters, and hospitalizations per 1,000 members
per year rose significantly, by 18.7, 11.2, and 19.9, respectively. These
patterns held true whether the patients were younger or older than 50 years,
says the article.
In contrast, a 2007 KP study of this issue in the organization's Northwest
region reported that office visits decreased between 7% and 10% for patients
using the patient portal. At that time, however, only 6% of KP Northwest
patients were signed up for it. Today, roughly 50% of all KP patients, and
about 60% of those in Colorado, are logging on.
Online access might have helped patients take more responsibility for their
health care, which led them to use more services, Palen told Medscape
Medical News. Or perhaps patients who signed up for MHM were already likely
to use more services because of clinical characteristics that the study failed
to control for. Future research will try to tease out cause and effect, he
An even more important question to answer, said Palen, is the effect of the
online clinician–patient relationship on clinical outcomes. If virtual visits
lead to more face-to-face visits, does a patient's health necessarily improve
as a result?
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