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Clostridium Difficile Infection: Strategic Approaches For Better Outcomes
In recent years, the epidemiology of Clostridium difficile infection (CDI) has been changing. This trend may be the result of antimicrobial use, infection control practices, or other factors. It is critical for healthcare professionals to be aware of the epidemiology of this virulent pathogen and apply evidence-based principles for diagnosis, treatment, and prevention.
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Massachusetts Health Insurance Law Has Increased Access To Care, Though Residents' Ability To Obtain Treatment Hampered By Provider Supply, Study Find
Since the implementation of the Massachusetts health insurance law in 2006, more residents have health coverage and increased access to care, but rising health care costs combined with the current economic recession could undermine some of the law"s successes, according to the third annual "Update on Health Reform in Massachusetts" report by the Urban Institute, the Boston Globe reports. The study was funded by the Blue Cross and Blue Shield of Massachusetts Foundation, the Robert Wood Johnson Foundation and the Commonwealth Fund, and published in the journal Health Affairs.For the report, Sharon Long of the Urban Institute and colleagues surveyed about 4,000 Massachusetts adults in 2007 and 2008 and compared their health care habits with those of residents surveyed in 2006 -- just after the law went into effect. Researchers found that although there were initial gains in health care affordability, there are now some signs that an increasing number of state residents are reporting problems paying for medical bills, and an increasing number of people -- especially lower-income residents -- not seeking care because of costs (Lazar, Boston Globe, 5/28). One in five adults reported being told in the past 12 months that a physician or clinic was not accepting new patients or would not see patients with their type of insurance (Sack, New York Times, 5/28). Lower-income residents had more difficulties finding a physician than higher-income residents, with 24% of residents enrolled in state-subsidized health plans, saying they were told that a physician did not accept their insurance, compared with 7% of residents with private coverage (Boston Globe, 5/28). Additional Findings
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Earlier Commencement Of Antiretroviral Therapy Yields Better Clinical Outcomes
A clinical trial has demonstrated that HIV-infected adults in a re-limited setting are more likely to survive if they start antiretroviral therapy (ART) before their immune systems are severely compromised.
Diagnostics

Back-to-School Health: Are Your Child's Eyes Ready For The Classroom?

Good vision can be directly correlated with a child"s learning ability. As much as 80% of the learning a child does occurs through his eyes and approximately 1 in 4 school-age children have some type of vision impairment. Does your child have normal, healthy vision needed for classroom learning, or is there a problem that requires treatment by a pediatric ophthalmologist, optometrist or pediatrician? "Generally, the earlier we diagnose vision issues, the better the outcome for the child," said Dr. Mark Borchert, a pediatric ophthalmologist and the director of The Vision Center at Childrens Hospital Los Angeles and associate professor of ophthalmology and neurology at the Keck School of Medicine of the University of Southern California. "Professional eye examination tests not only measure distance of vision, but also how accurately the eyes focus and how well the eye muscles are working," he said. Below are four suggestions from The Vision Center for parents concerned about their child"s eyesight. 1. Don"t wait until your child enters kindergarten for his first complete eye exam. Pediatricians should perform a dilated eye exam to detect any serious eye problems within the first two months of life. Children are often more responsive to treatment when diagnosed early, so every child should have a comprehensive eye exam by age three. Some of the more serious eye diseases like amblyopia (lazy eye) or strabismus (crossed eyes) are correctable with eye patches or surgery if caught early. Once a child is seven or eight years old, the opportunity to correct the problem may have been lost, resulting in permanent vision problems. 2. Children that avoid books or reading may have a vision problem. Generally, preschoolers are eager to look at books and try and figure out words. Most children are reading by first grade. In general, most reading problems are not caused by vision problems. For instance, the child may have dyslexia, ADHD, or other learning differences and this may not be the result of poor vision. In these cases glasses, while helpful, will not fully solve the problem. However, if a child is having trouble learning to read, a comprehensive vision examination by a pediatric ophthalmologist or optometrist should be one of the tools used in making a diagnosis. 3. If your child is resistant to wearing glasses, point out those with familiar faces who also wear them. Defeating the stereotype that glasses are "dorky" is half the battle with school-aged children. Getting your child to wear glasses, without tearing them apart is the other. When children see relatives, cartoons or classmates wearing glasses, they are typically drawn to the attractiveness of someone they admire wearing them. If your child needs to wear glasses, you should allow the child to pick out the frames as it gives them a sense of ownership and pride. 4. Children age 10 and above can usually manage contact lenses. Children of all ages, even infants, can be fitted with contact lenses if their vision requires it. Under the age of 10, an adult will usually need to insert, remove and clean the lens. Many children over 10 can handle wearing and cleaning the contact lenses themselves. The Vision Center at Childrens Hospital Los Angeles is an international referral center known for its family friendly environment of children afflicted with all forms of eye disease and provides a full range of inpatient and outpatient services. It is the largest pediatric ophthalmology program in the nation with multiple subspecialty programs that are considered to be among today"s finest res for diagnosis, treatment and research. Founded in 1901, Childrens Hospital Los Angeles has been treating the most seriously ill and injured children in Los Angeles for more than a century, and it is acknowledged throughout the United States and around the world for its leadership in pediatric and adolescent health. Childrens Hospital is one of America"s premier teaching hospitals, affiliated with the Keck School of Medicine of the University of Southern California since 1932. It is a national leader in pediatric research. Since 1990, U.S. News & World Report and its panel of board-certified pediatricians have named Childrens Hospital Los Angeles one of the top pediatric facilities in the nation. Childrens Hospital Los Angeles is one of only 10 children"s hospitals in the nation - and the only children"s hospital on the West Coast - ranked in all 10 pediatric specialties in the U.S. News & World Report rankings and named to the magazine"s "Honor Roll" of children"s hospitals. Vision Center at Childrens Hospital Los Angeles


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