Cancer survivors face hardships related to medical bills: Study

Agencies
January 22,2019

Washington, Jan 22: A new study now finds that cancer survivors carry a higher burden related to medical debt payments and bills compared with individuals without a cancer history. The greatest hardships are found in younger survivors. The research, published in CANCER, a peer-reviewed journal of the American Cancer Society, the study also found that among privately insured survivors, those who enrolled in high deductible health plans and did not have health savings accounts were particularly vulnerable to medical financial hardship.

Medical financial hardship can encompass three domains: material (such as problems paying medical bills); psychological (for example, worrying about paying medical bills); and behavioural (which might include forgoing or delaying care because of cost).

Zhiyuan Zheng, PhD, of the American Cancer Society, and his colleagues analysed information from the 2013 to 2016 National Health Interview Survey. The study included nationally representative samples of 10,354 cancer survivors and 124,436 individuals without a cancer history.

Compared with those without a cancer history, cancer survivors were more likely to report any material hardship (ages 18 to 49: 43.4 per cent versus 30.1 per cent; ages 50 to 64: 32.8 per cent versus 27.8 per cent; ages 65 and older: 17.3 per cent versus 14.7 per cent), psychological hardship (ages 18 to 49: 53.5 per cent versus 47.1 per cent, with similar rates for older groups), and behavioral hardship (ages 18 to 49: 30.6 per cent versus 21.8 per cent; ages 50 to 64: 27.2 per cent versus 23.4 per cent, with similar rates for ages 65 and older).

Among privately insured survivors, having a high deductible health plan without a health savings account was also associated with greater hardship compared with low-deductible insurance. Speaking about the study, Dr. Zheng said, “Identifying patients with medical financial hardship will be important for primary care and oncology care providers.” He further added, "Developing and evaluating interventions to minimize medical financial hardship will be important for the research community. It may also require attention from health policy makers.

"According to Dr Zheng, younger cancer survivors, aged between 18 to 49 years, experience greater financial hardship than their older counterparts. He said, “It may be that they do not have the opportunity to accumulate financial assets to pay for medical expenses.

In addition, a cancer diagnosis might interrupt employment, and consequently limit access to employer-sponsored health insurance coverage.” "Although we could not identify the underlying reasons for greater hardship intensity in the younger group in this study, we believe it will be an important area for additional research," he concluded.

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Nutrition, cardiovascular disease experts urge evaluation of diet at routine healthcare check-ups

Agencies
August 11,2020

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Dallas, Aug 11: A group of nutrition and cardiovascular disease experts issued a new scientific statement which states that the time has come for routine healthcare visits to include some form of dietary assessment and counselling.

The statement issued from the American Heart Association was published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal. The experts recommend the adoption of a rapid diet screening tool that can be integrated into electronic health record platforms across all healthcare settings.

"Dietary patterns and quality are not sufficiently prioritised when addressing modifiable risk factors during regular healthcare office visits. Given the evidence that diet contributes to disease and mortality, it is a risk factor worth screening for continuously," said Maya Vadiveloo, Ph.D., RD, chair of the statement writing group and assistant professor of nutrition and health sciences in the College of Health Science at the University of Rhode Island in Kingston, Rhode Island.

Poor diet quality has surpassed all other risk factors for death, accounting for 11 million deaths and about half of the cardiovascular disease (CVD) deaths globally, according to the 2017 Global Burden of Disease Study, a comprehensive report on the health impact of diet in 195 countries around the world.

The statement authors reviewed 15 existing screening tools, assessing each to provide insight into the feasibility of incorporating an evidence-based dietary screening tool into routine practice.

The authors list numerous reasons why members of a healthcare team may not address diet quality during a routine office visit: lack of training and knowledge; lack of time and reimbursement; competing demands during the often short office visit and that nutrition services aren't integrated into many healthcare settings.

"However, these barriers can be overcome," said Vadiveloo. "We want a valid, reliable way to assess diet that reflects the best science and most of the tools assessed take under 10 minutes to use."

Three of the tools assessed to meet criteria set forth in the statement and may provide a framework to help practices incorporate diet screening into their workflow. The Powell and Greenberg Screening Tool asks two questions about fruit and vegetable consumption and sugary food and juice consumption.

The Rapid Eating Assessment for Participants-Shortened assessment and the Mediterranean Diet Adherence Screener ask more than 10 questions and cover major food groups, as well as processed foods and alcohol consumption.

The keys to an effective diet screening tool include:

-Using an evidence-based approach;
-Assessing the total dietary pattern, not just a single food or nutrient;
-Speed;
-The ability to give actionable next steps and support to patients; and
-The ability to track and monitor dietary change over time.

"There are other tools beyond what was assessed and additional tools could be developed," said Vadiveloo.

While the statement does not endorse a specific screening tool, it encourages critical conversations among clinicians, individuals with diet/lifestyle expertise, and specialists in information technology to adopt rapid diet screening tools for adults in primary care and relevant specialty care and prevention settings.

"An important component in addition to evaluating diet quality is targeting actionable changes - helping patients set achievable dietary goals - and then following up at the next visit," said Alice H. Lichtenstein, D.Sc., vice-chair of the writing group and lead and senior scientist of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.

Areas for future study include testing and validating screener tools in diverse populations, as well as among special clinical populations (paediatrics, geriatrics), and evaluating the feasibility of implementing these tools in clinical settings.

A healthy diet can improve cardiovascular disease risk and outcomes. What you eat (and how much) can affect other controllable risk factors, such as cholesterol, blood pressure, diabetes, and being overweight. 

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Biryani tops the list of most ordered dishes in India even during lockdown

Agencies
July 25,2020

The COVID-19 pandemic and the subsequent lockdown saw many people turning chefs overnight, but those who could not turned to online delivery of food. And not just any food, as per a new report, Indians "craved the most for Biryani" during the lockdown.

The "StatEATistics report: The Quarantine Edition" from food delivery platform Swiggy found that Indians ordered biryani over "5.5 lakh times" from their favourite restaurants.

The new normal might have opened a pandora's box of behavioral changes, but some old habits die hard like the love for Biryani, which took the top spot for overall orders. It was followed by butter naan and masala dosa at 3,35,185 and 3,31,423, respectively.

Biryani has topped the list of most ordered dishes for the fourth year in a row, the food delivery platform noted.

Indians didn't forget to indulge their sweet tooth in the uncertain months of lockdown. Their favourite comfort food during the lockdown period was the moist and decadent Choco Lava cake, ordered around 1,29,000 times.

"The humble Gulab Jamun (84,558) and chic Butterscotch Mousse cake (27,317) followed suit," said the report derived from Swiggy's order analysis in the past few months across cities that it is present in.

Also, as birthday parties moved to video calls, and virtual cake cutting sessions, according to the food delivery platform, it delivered nearly "1,20,000 cakes" to complete these celebrations.

According to the report, on average, "65,000 meal orders" were placed by 8 pm each day to make sure food arrived in time for dinner.

"It was the busiest hour for Swiggy delivery partners and restaurants. On average, they (customers) chose to tip Rs.23.65, with one particularly generous customer tipping Rs. 2500!," it added.

For those who only relied on home-made food during the quarantine, Swiggy delivered a whooping 323 million kgs of onions and 56 million kgs of bananas through its grocery section and hence ensured that its consumers were all stocked up.

That said, it also took care of the 'quick-fix meal' tribe -- consumers who resort to the evergreen college hacks of living on instant noodles.

"Around 3,50,000 packets of this ideal easy to cook meal were ordered during the lockdown," it said.

In all, Swiggy delivered 40 million orders across food, groceries, medicines and other household items during India's lockdowns. It also delivered over 73,000 bottles of sanitizers and hand wash along with 47,000 face masks as the definition of essentials' changed during these uncertain times.

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'Children under the age of 5 carry higher levels of Covid-19'

Agencies
August 2,2020

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Washington, Aug 2: Children under the age of five have between 10 to 100 times greater levels of genetic material of the coronavirus in their noses compared to older children and adults, a study in JAMA Pediatrics said Thursday.

Its authors wrote this meant that young children might be important drivers of Covid-19 transmission within communities -- a suggestion at odds with the current prevailing narrative.

The paper comes as the administration of US President Donald Trump is pushing hard for schools and daycare to reopen in order to kickstart the economy.

Between March 23 and April 27, researchers carried out nasal swab tests on 145 Chicago patients with mild to moderate illness within one week of symptom onset.

The patients were divided into three groups: 46 children younger than five-years-old, 51 children aged five to 17 years, and 48 adults aged 18 to 65 years.

The team, led by Dr Taylor Heald-Sargent of the Ann & Robert H. Lurie Children's Hospital, observed, "a 10-fold to 100-fold greater amount of SARS-CoV-2 in the upper respiratory tract of young children."

15 countries with the highest number of cases, deaths due to the Covid-19 pandemic

The authors added that a recent lab study had demonstrated that the more viral genetic material was present, the more infectious virus could be grown.

It has also previously been shown that children with high viral loads of the respiratory syncytial virus (RSV) are more likely to spread the disease.

"Thus, young children can potentially be important drivers of SARS-CoV-2 spread in the general population," the authors wrote.

"Behavioral habits of young children and close quarters in school and daycare settings raise concern for SARS-CoV-2 amplification in this population as public health restrictions are eased," they concluded.

The new findings are at odds with the current view among health authorities that young children -- who, it has been well established, are far less likely to fall seriously ill from the virus -- don't spread it much to others either.

However, there has been fairly little research on the topic so far.

One recent study in South Korea found children aged 10 to 19 transmitted Covid-19 within households as much as adults, but children under nine transmitted the virus at lower rates.

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