Researchers at Cincinnati Children's Hospital Medical Center have successfully carried out what is believed to be the first initiative conducted exclusively among teenagers to show significant improvement in their asthma outcomes.

The quality improvement initiative, conducted in a primary care setting, dramatically improved asthma control and outcomes for high-risk adolescents.

The study is published online in the journal Pediatrics.

"Improving asthma is particularly difficult for teenagers, whose adherence to treatment is often poor and outcomes worse than those of younger patients," says Maria Britto, MD, director of the Center for Innovation in Chronic Disease Care at Cincinnati Children's and senior author of the study.

"We were able to achieve sustained improvement in patients whose chronic asthma is not well-controlled by implementing a package of chronic care interventions. These included standardized and evidence-based care; self-management support, such as self-monitoring by using diaries and journals; care coordination and active outreach among healthcare providers; linking these teens to community resources; and following-up with patients whose chronic asthma is not well-controlled."

From 2007 to 2011, Dr. Britto and her colleagues at Cincinnati Children's focused improvement efforts on 322 primary care patients, all of whom had asthma. Only 10 percent, however, had optimally well-controlled asthma. By August 2009, the proportion of these patients had increased to 30 percent and remained at that level over time.

Moreover, the initiative resulted in nearly 100 percent of patients receiving an evidence-based care bundle of tools to control their asthma. These tools included an action plan (which included goal setting and learning how to overcome barriers) and controller medications at the most recent doctor visit. Prior to the initiative, only 38 percent had received this bundle.

Ninety percent of patients also received a self-management bundle of tools, including a patient self-assessment and a personal action plan. Formal self-management support had not been in place prior to this initiative.

"Patients and parents who were confident in their ability to manage their asthma increased from 70 percent to 85 percent," says Dr. Britto. "But patients with chronically poor asthma control are likely to need additional interventions."

Asthma is the most common chronic disease of childhood, affecting seven million children in the United States, more than 9 percent of all children in the U.S. Asthma results in an estimated 10.5 million missed school days, 640,000 emergency visits, and 157,000 hospitalizations each year.

See the original post here:
Quality improvement initiative improves asthma outcomes in teens

Published: Tuesday, January 28, 2014 at 8:04 a.m. Last Modified: Tuesday, January 28, 2014 at 8:04 a.m.

Downtown Petaluma merchants concerned about a self-imposed tax meant to encourage visitors to spend money in the historic business district will have an opportunity to make their feelings known next month.

On Monday night, the City Council scheduled a public hearing for Feb. 24, when merchants will be able to voice their opinions about the 13-year-old business improvement district and how its funds are spent.

Late last year as the district's new budget was being prepared for 2014 typically a routine event each year before the City Council several business owners challenged the tax.

They said the levy, enacted in 2000 by a vote of downtown merchants, was being administered behind closed doors and wasn't benefitting many of the member merchants.

They said the money wasn't helping keep their streets and sidewalks clean, nor providing the additional security they wanted. Some pointed the finger at area bars, whose patrons often vomit or urinate in or near other businesses on weekend nights.

The tax was enacted when downtown business owners sought a way to raise funds for their special interests security, beautification and marketing and convinced the council to approve the self-imposed business improvement district.

The Petaluma Downtown Association administers the annual tax proceeds of about $50,000.

Since the merchants went public with their concerns in December even threatening to work to dissolve the district representatives from the PDA and merchants have met several times to try to resolve problems.

A proposed budget and spending details will be sent this week to the approximately 600 downtown businesses, roughly centered at Petaluma Boulevard and Western Avenue and radiating outward about a half-mile. Businesses are levied from $41 and $500 a year depending on size, location and type of business.

More:
Petaluma calls hearing on merchants' self-imposed tax

Remember the shiny spandex, neon sweatbands and bunched-up leg warmers?

Those 1980s' aerobics classes are back -- with a twist -- at the Walker Art Center on Thursday. This time exercisers won't just feel the sweat, they'll also produce sweet, creamy butter.

From the people who brought us the uber-popular Internet Cat Video Festival, the Walker is hosting two "Feel the Churn" events. A 20-minute aerobics class led by Jimmy Fusil and Mike Wait of the Los Angeles-based art duo PopSoda, "Feel the Churn" has participants making fat as they burn fat.

During the class, participants -- who are encouraged to dress in '80s-inspired garb -- get a lesson on the science of butter making during warm-up stretches. Then they follow a choreographed routine led by Fusil, with Wait providing tunes including the Cars' "Shake it Up," Elvis' "All Shook Up" and PopSoda's original churning anthem "Eat Your Fat."

While folks jog in place, they'll also get their churn on as they continuously shake jars filled with heavy whipping cream. The cream for the Walker classes is being provided by Hastings Cooperative Creamery. The jars are plastic.

"There's always that one person who drops their jar," Fusil said. "It's not without its risks, but nobody has gotten hurt so far."

While Fusil leads the class, it's Wait's job to keep the beat going, making sure to react to how the class is doing and knowing when to stop a song and start another. He also keeps an eye out to make sure people aren't overshaking, which can ruin their butter.

At the end of class, the containers are opened, contents strained and the homemade butter packaged. There's always some bread available so the butter can be enjoyed immediately.

"You'll burn 150 to 200 calories, which happens to be the number of calories on your average slice of bread with some butter on it," Fusil said. "You can burn some calories and put them right back on at the end of the class.

"The whole thing is about balance. It's actually very Zen."

See the original post here:
Walker's 'Feel the Churn' teaches exercisers to make butter during aerobics