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March 2014 Briefing - Neurology

Here are what the editors at HealthDay consider to be the most important developments in Neurology for March 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Topamax Approval for Migraines Expanded to Younger Users

MONDAY, March 31, 2014 (HealthDay News) -- U.S. Food and Drug Administration approval of the drug Topamax (topiramate) to prevent migraine headaches has been expanded to include adolescents 12 years to 17 years, the agency said Friday.

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'White Coat Effect' Is Smaller for Nurses Than Doctors

FRIDAY, March 28, 2014 (HealthDay News) -- Doctors' readings of blood pressure are often higher than measurements made by nurses at the same visit, according to research published in the April issue of the British Journal of General Practice.

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Better Outcomes With Consistent BP Control Post-Stroke

FRIDAY, March 28, 2014 (HealthDay News) -- For individuals with stroke, consistency of blood pressure (BP) control during two years of follow-up affects outcomes, according to a study published online March 27 in Stroke.

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CDC: U.S. Autism Estimates Rise by 30 Percent for Children

THURSDAY, March 27, 2014 (HealthDay News) -- One in 68 American children are now diagnosed with autism or a related disorder, according to a report published in the March 28 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report. That's a 30 percent increase from just two years ago when the estimate was one in 88 children.

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NCHS Estimates Health Insurance Coverage for 2013

THURSDAY, March 27, 2014 (HealthDay News) -- In the first nine months of 2013, 6.7 percent of children and 20.5 percent of adults were uninsured, according to a study published online March 27 by the National Center for Health Statistics (NCHS).

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Interferon Beta Tied to Spike in Thrombotic Microangiopathy

THURSDAY, March 27, 2014 (HealthDay News) -- There has been an unusually high number of cases of thrombotic microangiopathy associated with severe or malignant hypertension in patients with multiple sclerosis who were receiving therapy with recombinant interferon beta, according to a letter to the editor published in the March 27 issue of the New England Journal of Medicine.

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Brain Stimulation Improves QoL in Fibromyalgia Patients

THURSDAY, March 27, 2014 (HealthDay News) -- Repetitive transcranial magnetic stimulation (rTMS) may improve quality of life (QoL) in patients with fibromyalgia, according to research published online March 26 in Neurology.

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Galanin System Genes Linked to Risk of Depression in Stress

THURSDAY, March 27, 2014 (HealthDay News) -- Variants of the stress-inducible neuropeptide and cotransmitter in serotonin and norepinephrine neurons, galanin, and its receptors confers increased risk of depression and anxiety among highly stressed individuals, according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

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1 in 25 Inpatients Has Health Care-Associated Infection Daily

WEDNESDAY, March 26, 2014 (HealthDay News) -- There were an estimated 648,000 patients with 721,800 health care-associated infections in U.S. acute care hospitals in 2011, according to research published in the March 27 issue of the New England Journal of Medicine.

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White House Extends Affordable Care Act Enrollment Deadline

WEDNESDAY, March 26, 2014 (HealthDay News) -- Americans who've started applying for health insurance under the Affordable Care Act but can't complete the process by the March 31 enrollment deadline will be given an extension.

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Focal Disruption of Cortical Laminar Architecture in Autism

WEDNESDAY, March 26, 2014 (HealthDay News) -- Most young children with autism have focal disruption of cortical laminar architecture, according to a study published in the March 27 issue of the New England Journal of Medicine.

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WHO: Air Pollution Claimed Seven Million Lives in 2012

WEDNESDAY, March 26, 2014 (HealthDay News) -- Air pollution killed about seven million people worldwide in 2012, and more than half of those deaths were caused by indoor smoke from cook stoves, a World Health Organization report says. The U.N. health agency said that heart disease, stroke, lung cancer, and chronic obstructive pulmonary disease were the leading causes of air pollution-related deaths, CNN reported.

Health Highlights: March 25, 2014

AAN Releases Alternative Medicine Guide for MS

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Academy of Neurology (AAN) has released evidence-based recommendations for complementary and alternative medicine (CAM) for multiple sclerosis (MS). The guideline was published in the March 25 issue of Neurology.

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AMA Introduces Medical Education Initiative

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Medical Association's (AMA) Accelerating Change in Education initiative is being introduced in 11 medical schools in an effort to shift the focus of education toward real-world practice and competency assessment, according to an AMA report.

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Americans Seem Unprepared for Health Insurance Exchanges

WEDNESDAY, March 26, 2014 (HealthDay News) -- Individuals in the United States seem not to be sufficiently informed about the health insurance exchanges established by the Affordable Care Act (ACA), according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

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JC Virus Detectable in Natalizumab-Treated MS Patients

TUESDAY, March 25, 2014 (HealthDay News) -- Mononuclear cells from natalizumab-treated multiple sclerosis (MS) patients harbor JC virus (JCV), according to a study published online March 24 in JAMA Neurology.

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USPSTF: Evidence Lacking for Cognitive Impairment Screening

MONDAY, March 24, 2014 (HealthDay News) -- The United States Preventive Services Task Force (USPSTF) has found that evidence is currently insufficient to weigh the benefits and harms of universal screening for cognitive impairment in older adults. These findings are presented in a final recommendation statement published online March 25 in the Annals of Internal Medicine.

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Valproic Acid Use May Reduce Incidence of Head, Neck Cancer

MONDAY, March 24, 2014 (HealthDay News) -- Long-term use of valproic acid (VPA) is associated with a reduced risk of smoking-related cancers of the head and neck, according to a study published online March 24 in Cancer.

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Patient Request Impacts Doc Prescribing Behavior

MONDAY, March 24, 2014 (HealthDay News) -- Patients requesting specific medications are more likely to be prescribed those medications, according to research published in the April issue of Medical Care.

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Cervical Spine Clearance Protocols Vary Considerably

MONDAY, March 24, 2014 (HealthDay News) -- Cervical spine clearance protocols for level-1 trauma centers are highly variable, according to a study published in the March 1 issue of Spine.

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Practices Can Take Steps to Improve Care Transitions

FRIDAY, March 21, 2014 (HealthDay News) -- Implementation of a rigorous process can improve transitions of care, according to an article published March 10 in Medical Economics.

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Older Drivers More Susceptible to the Effects of Alcohol

FRIDAY, March 21, 2014 (HealthDay News) -- Older adults' driving performance may be more susceptible to the effects of alcohol, according to a study published in the February issue of Psychopharmacology.

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Hemicraniectomy Also Beneficial for Older Patients

FRIDAY, March 21, 2014 (HealthDay News) -- For older patients with middle-cerebral-artery infarction, early decompressive hemicraniectomy increases survival without severe disability, according to a study published in the March 20 issue of the New England Journal of Medicine.

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Human Nose Can Distinguish One Trillion Odor Combos

FRIDAY, March 21, 2014 (HealthDay News) -- Humans can discriminate an estimated one trillion olfactory stimuli, according to a study published in the March 21 issue of Science.

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Stress-Linked Protein May Play Major Role in Alzheimer's

FRIDAY, March 21, 2014 (HealthDay News) -- Dysfunction in the brain's stress response system may be an important factor in the memory and thinking problems experienced by people with Alzheimer's disease and other dementias, according to a report published online March 19 in Nature.

Health Highlights: March 20, 2014
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Midlife Diabetes May Contribute to Later Cognitive Decline

THURSDAY, March 20, 2014 (HealthDay News) -- Midlife onset of diabetes and hypertension each may contribute to cognitive impairment later in life, according to research published online March 19 in Neurology.

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Marker in Spinal Fluid Predicts Course in Parkinson's Disease

THURSDAY, March 20, 2014 (HealthDay News) -- Levels of α-synuclein in cerebrospinal fluid (CSF) might predict cognitive decline in patients with Parkinson's disease, according to research published online March 13 in the The American Journal of Pathology.

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Alzheimer's Strikes Women Harder Than Men: Report

THURSDAY, March 20, 2014 (HealthDay News) -- A 65-year-old American woman has a one in six chance of developing Alzheimer's disease later in life, while a man the same age has about a one in 11 chance, according to a report published in the March issue of Alzheimer's & Dementia, the journal of the Alzheimer's Association.

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2014 Alzheimer's Disease Facts and Figures

Simvastatin Might Help Slow Multiple Sclerosis Progression

WEDNESDAY, March 19, 2014 (HealthDay News) -- High-dose simvastatin appears to slow brain shrinkage in patients with multiple sclerosis, according to a small, early study from England, published online March 19 in The Lancet.

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COPD Tied to Development of Cognitive Impairment

WEDNESDAY, March 19, 2014 (HealthDay News) -- Chronic obstructive pulmonary disease (COPD) is associated with an increased risk for mild cognitive impairment (MCI), particularly nonamnestic MCI (NA-MCI), according to a study published online March 17 in JAMA Neurology.

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Neuroimaging Ordered for >12 Percent of Headaches

WEDNESDAY, March 19, 2014 (HealthDay News) -- Neuroimaging is frequently ordered for patients with headache, according to a research letter published online March 17 in JAMA Internal Medicine.

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Same Meningitis Strain Behind Drexel, Princeton Outbreaks: CDC

TUESDAY, March 18, 2014 (HealthDay News) -- The strain of bacterial meningitis that killed a Drexel University student earlier this month is the same strain behind a Princeton University outbreak last year, federal health officials said Tuesday. This suggests that the outbreak strain might still be present in the Princeton community and that the situation requires close monitoring, according to the U.S. Centers for Disease Control and Prevention.

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Elevated Levels of Brain Injury Biomarkers in Concussion

TUESDAY, March 18, 2014 (HealthDay News) -- Ice hockey players with sports-related concussion have elevations in the axonal injury biomarker total tau and the astroglial injury biomarker S-100 calcium-binding protein B, according to a study published online March 13 in JAMA Neurology.

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Oxytocin Seems Beneficial for Patients With Anorexia

MONDAY, March 17, 2014 (HealthDay News) -- For females with anorexia nervosa, oxytocin attenuates attentional vigilance to eating and fat shape stimuli and affects attentional processes to social emotional stimuli, according to two studies published online in Psychoneuroendocrinology and PLOS ONE.

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Insurers Must Offer Same-Sex Couples Spousal Benefits

MONDAY, March 17, 2014 (HealthDay News) -- Health plans that offer benefits for heterosexual couples must do the same for same-sex married couples, the Obama administration says.

Other Health Highlights: March 17, 2014

Rx Expenditures Expected to Rise in 2014

MONDAY, March 17, 2014 (HealthDay News) -- Drug costs are projected to rise 3 to 5 percent across all care settings in 2014, according to a study published in the March 15 issue of the American Journal of Health-System Pharmacy.

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Weaker Brain Network Connectivity in Abstinent Smokers

MONDAY, March 17, 2014 (HealthDay News) -- Abstinent smokers show weaker brain inter-network connectivity between the salience, executive control, and default modes, according to a study published online March 12 in JAMA Psychiatry.

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Animal Protein May Slow Functional Decline in Older Men

MONDAY, March 17, 2014 (HealthDay News) -- Among older men, higher intake of protein, particularly animal protein, is associated with lower risk of decline in higher-level functional capacity, according to research published in the March issue of the Journal of the American Geriatrics Society.

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NATA: Recommendations Issued for Sport Concussion Management

MONDAY, March 17, 2014 (HealthDay News) -- Recommendations have been developed for management of sport-related concussion. The recommendations have been published online March 7 in the Journal of Athletic Training as a National Athletic Trainers' Association Position Statement.

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Ischemic Stroke Outcomes Worse for Mexican-Americans

FRIDAY, March 14, 2014 (HealthDay News) -- Mexican-Americans (MAs) experience worse stroke outcomes than non-Hispanic whites, according to a study published online March 13 in Stroke.

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Improving EHR Interoperability Is a National Priority: HHS

FRIDAY, March 14, 2014 (HealthDay News) -- Interoperability of electronic health record (EHR) systems is a national priority of the Office of the National Coordinator for Health Information Technology, according to an article published March 4 in Medical Economics.

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Benefits of Faster Thrombolysis Time Quantified

FRIDAY, March 14, 2014 (HealthDay News) -- Faster thrombolysis treatment is associated with improved stroke outcome, with each minute of onset-to-treatment time saved correlating with an additional 1.8 days of healthy life, according to a study published online March 13 in Stroke.

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CDC: Most Alcohol-Linked Deaths Occur Among Working-Age Adults

FRIDAY, March 14, 2014 (HealthDay News) -- Americans' excessive alcohol use contributes to thousands of deaths each year, and the majority who die are working-age adults, according to a report published in the March 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Prehypertension Linked With Increased Risk of Stroke

THURSDAY, March 13, 2014 (HealthDay News) -- Prehypertension is associated with increased risk of stroke, according to research published online March 12 in Neurology.

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IOM Recommends Definitions for 'Gulf War' Multisymptom Illness

THURSDAY, March 13, 2014 (HealthDay News) -- Two definitions for chronic multisymptom illness should be used to identify cases of Gulf War illness among Gulf War veterans, according to a report published by the Institute of Medicine.

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Health Education Not Routinely Provided to Patients

THURSDAY, March 13, 2014 (HealthDay News) -- For patients with chronic disease, health providers do not routinely provide health education, according to a study published March 6 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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AMA: CMS Wants Physician Input on Practice Transformation

WEDNESDAY, March 12, 2014 (HealthDay News) -- Physicians are being given the opportunity to describe what resources they need in order to transition to value-based models of care, according to a report published by the American Medical Association (AMA).

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Prehospital Stroke Alerts Speed Door-to-CT Times

WEDNESDAY, March 12, 2014 (HealthDay News) -- Emergency medical services (EMS) prenotification regarding the arrival of patients who have had a stroke allows patients to bypass the emergency department and undergo computed tomography (CT) in a timely manner, according to a study published in the March issue of Neurosurgery.

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About One-Quarter of Patients With MCI Progress to Dementia

WEDNESDAY, March 12, 2014 (HealthDay News) -- About 22 percent of patients with mild cognitive impairment (MCI) progress to dementia within three years, and depression symptoms modify the prognosis, according to a study published in the March/April issue of the Annals of Family Medicine.

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White House: More Than Four Million Have Signed Up for ACA

TUESDAY, March 11, 2014 (HealthDay News) -- More than four million Americans have signed up for health coverage through state and federal insurance marketplaces established by the Affordable Care Act, the Obama administration announced Tuesday.

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FDA Approves First Device to Prevent Migraines

TUESDAY, March 11, 2014 (HealthDay News) -- The U.S. Food and Drug Administration on Tuesday approved the first device aimed at preventing migraines. The device, called Cefaly, is also the first transcutaneous electrical nerve stimulation device specifically authorized for use prior to the onset of pain, according to the FDA.

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Discrepancies ID'd in Studies on ClinicalTrials.gov, Journals

TUESDAY, March 11, 2014 (HealthDay News) -- Nearly all clinical trials reported on ClinicalTrials.gov and published in high-impact journals report at least one discrepancy in cohort, intervention, or results, according to a research letter published in the March 12 issue of the Journal of the American Medical Association.

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Medicare Drug Plan Changes Withdrawn by White House

TUESDAY, March 11, 2014 (HealthDay News) -- Proposed changes to the Medicare prescription drug program have been withdrawn by the Obama administration after strong opposition from patient groups.

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Blood Test May Have Power to Predict Alzheimer's Disease

MONDAY, March 10, 2014 (HealthDay News) -- A blood test has been developed that can predict with 90 percent certainty whether a senior will suffer from dementia such as Alzheimer's disease within the next few years, according to a study published online March 9 in Nature Medicine. The test relies on levels of 10 lipids in the bloodstream to estimate the chances of either mild cognitive impairment or the beginnings of Alzheimer's disease.

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Consultant Offers Tips for Evaluating Staff Pay

MONDAY, March 10, 2014 (HealthDay News) -- Setting salaries and dealing with raises for a practice's staff can be tricky, according to an article published Feb. 24 in Medical Economics.

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Keeping Salaries Secret Harms Worker Performance

MONDAY, March 10, 2014 (HealthDay News) -- Keeping salaries secret hurts worker performance and increases turnover of top talent, according to a study published online Jan. 13 in the Academy of Management Journal.

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AMA Grants Curriculum Efforts to Address Health Disparities

FRIDAY, March 7, 2014 (HealthDay News) -- Medical schools are beginning to change their curriculum to address ways to eliminate health disparities, according to the American Medical Association (AMA).

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Gender Gap Exists in Domestic Duties of Working Physicians

FRIDAY, March 7, 2014 (HealthDay News) -- Gender differences exist in domestic activities among career-oriented academic physicians with children, according to a study published online March 3 in the Annals of Internal Medicine.

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Relative Value Units Useful In Evaluating Practice Finances

THURSDAY, March 6, 2014 (HealthDay News) -- The Relative Value Unit (RVU) is a useful tool for managing practice finances, according to an article published Feb. 25 in Medical Economics.

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Drop in Compensation Gap for Primary Care Docs, Specialists

THURSDAY, March 6, 2014 (HealthDay News) -- From 2012 to 2013, there was a 5.7 percent increase in the median total cash compensation for primary care physicians, with a smaller gap seen for medical and surgical specialists, according to the results of a recent survey from SullivanCotter.

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Web-Based Mental Health Screening Feasible, Acceptable

THURSDAY, March 6, 2014 (HealthDay News) -- For patients in general hospital settings, a routine web-based mental health screening is feasible and acceptable, according to a study published in General Hospital Psychiatry.

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Assay Has High Specificity for Variant Creutzfeldt-Jakob Disease

THURSDAY, March 6, 2014 (HealthDay News) -- A prototype blood-based assay shows high specificity for variant Creutzfeldt-Jakob disease (vCJD), according to a study published online March 3 in JAMA Neurology.

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Increased Use-Dependent Plasticity With Chronic Insomnia

THURSDAY, March 6, 2014 (HealthDay News) -- People with chronic insomnia (CI) have increased use-dependent plasticity (UDP) relative to age-matched good sleepers, according to a study published in the March issue of SLEEP.

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Alzheimer's Disease Deaths May Be More Than Reported

WEDNESDAY, March 5, 2014 (HealthDay News) -- About half a million deaths in the United States may be attributable to Alzheimer's disease (AD), more than five times as many as previously reported and similar to the number of deaths from heart disease and cancer, according to a study published online March 5 in Neurology.

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Value-Based Insurance Plans Can Up Rx Adherence

WEDNESDAY, March 5, 2014 (HealthDay News) -- Value-based insurance design (VBID) plans with certain features aside from solely lowering cost sharing can increase medication adherence, according to a study published in the March issue of Health Affairs.

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WHO Program Improves U.S. Medical Facility Hand Hygiene

WEDNESDAY, March 5, 2014 (HealthDay News) -- For U.S. health care facilities, participation in the World Health Organization (WHO) global campaign to improve hand hygiene practices is associated with improved hand hygiene, according to a study published in the March issue of the American Journal of Infection Control.

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Gap in Regulatory Coverage Affects 5 to 16 Percent of Trials

WEDNESDAY, March 5, 2014 (HealthDay News) -- Human subjects protections (HSP) policies do not provide regulatory coverage for all clinical trials, while up to about a quarter of trials are considered overlap trials, according to a research letter published in the March 5 issue of the Journal of the American Medical Association.

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Women-Specific Research Is Still Inadequate

MONDAY, March 3, 2014 (HealthDay News) -- Women are still underrepresented in medical science and research, and sex differences are often ignored, according to a report published March 3 by the Brigham and Women's Hospital.

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Catastrophizing Can Predict Low Back Pain, Disability

MONDAY, March 3, 2014 (HealthDay News) -- For patients treated for low back pain, catastrophizing may predict the degree of pain and disability, according to a review published in the Feb. 1 issue of Spine.

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CMS: No More Delays to ICD-10 Implementation Deadline

MONDAY, March 3, 2014 (HealthDay News) -- There will be no more delays to the Oct. 1, 2014, deadline for implementation of the International Classification of Diseases, 10th Revision (ICD-10), according to an article published Feb. 27 in Medical Economics.

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