Researchers at Yale University are testing whether a humorous card game can help young, black women reduce their chances of contracting HIV and AIDS—part of a new but growing trend examining whether games can spur health behavior changes. Played among three to five people, “One Night Stan” has players draw cards to establish sexual scenarios and then prompts players to discuss how they would react in those settings. The game, developed by play2PREVENT, a gaming lab within the Yale School of Medicine, is still a prototype, but designers are hoping to launch a video game version eventually and bring it to a broader audience. “It’s really about evaluating sexual situations and encounters,” said Kimberly Hieftje, a developer of the game who is an associate research scientist at Yale School of Medicine and deputy director of the play2PREVENT Lab. A growing number of developers, in Connecticut and nationally, are testing whether card, video, online and mobile games are effective tools for getting people to make healthier choices.
The Centers for Medicare and Medicaid Services has backed off a controversial plan that would have changed the way it determines Medicare coverage for advanced prosthetics - a plan critics said would have affected tens of thousands of veterans nationwide. CMS had issued a draft proposal, known as a Local Coverage Determination for Lower Limb Prostheses, that critics feared would limit access to prosthetics for amputees, including veterans. Following a public comment period that ended in August and a review of those comments, CMS on Monday announced it would not finalize the draft policy. “Both CMS and its contractors have heard concerns about access to prostheses for Medicare beneficiaries,” according to a statement provided by CMS spokeswoman Helen Mulligan. CMS said it would convene a work group in 2016 to examine the lower limb prostheses issue.
Federal investigators have found that Medicare officials rarely enforce rules for private insurance plans intended to make sure beneficiaries will be able to see a doctor when they need care. It's a problem many Connecticut seniors know too well. In 2013, UnitedHealthcare, the nation's largest health insurance company, dropped hundreds of health care providers from its Connecticut Medicare Advantage plan, including 1,200 doctors at the Yale Medical Group and Yale-New Haven Hospital. Medicare Advantage beneficiaries scrambled to find new insurance or new doctors while the Fairfield and Hartford counties medical associations went to court to try to stop the terminations. The report by the Government Accountability Office, the investigative arm of Congress, said that Medicare did not check provider networks to ensure that doctors were available to beneficiaries and cited Connecticut as a “case study” in what can go wrong.
Declines in several key cancer-screening procedures among the elderly can be linked to shifts in screening guidelines issued by major public health organizations, according to recently released findings by Yale researchers. James Yu, associate professor of therapeutic radiology at the Yale School of Medicine, and Sean Maroongroge, a third-year medical student, gleaned data from Medicare billing records from 2000 to 2012, analyzing more than 230 million screenings for prostate, breast, and colorectal cancers. Yu, a member of the Yale COPPER Center (Cancer Outcomes, Public Policy, and Effectiveness Research Center), and Maroongroge, also tracked evidence-based screening guidelines issued by five prominent organizations: the U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the American College of Obstetricians and Gynecologists (ACOG), the American College of Gastroenterology (ACG), and the American Urological Association (AUA). They found that the rates for mammography, which is the primary means of screening for breast cancer, declined 7.4 percent overall during the period studied; prostate screening rates rose 16 percent during the first seven years studied then declined to 7 percent less than the 2000 rate by 2012. Colorectal cancer screening rates also dropped overall.
In Hartford around the time of the Revolutionary War, one Dr. William Jepson owned a home near where South Church stands now. The doctor was better known as an apothecary, as a nod to his main function of dispensing medicine, but for the most part in those days health care was delivered by the women of the family. Only when herbs and home remedies didn’t work were “bone-setters,” or surgeons and physicians such as Jepson, summoned. Treatment might involve bloodletting, which is exactly as it sounds. Preventive care—the standard for today’s medicine—has a spotty history in this country.
Doctors and clinicians from a wide array of specialties will offer their insights about the importance of preventive care at an upcoming community health forum in Hartford, featuring a keynote address by Dr. Jewel Mullen, commissioner of the Connecticut Department of Public Health. “Get Health Wise: The Benefits of Preventive Care” on Oct. 7, hosted by the Conn. Health I-Team, will give attendees the opportunity to hear presentations from doctors and clinicians at various health care stations. A panel discussion – with a question and answer period - will follow.
Connecticut has made strides in identifying and helping children who have experienced trauma – with more than 50,000 undergoing trauma screenings since 2007 – but more must be done to ensure all children’s needs are met, according to a report released today. Those who work with at-risk youths have placed a growing emphasis on providing trauma-based care, with some encouraging results, according to the Child Health and Development Institute’s (CHDI) Impact report titled “Advancing Trauma-Informed Systems for Children.”
Giving trauma-informed care means professionals – such as child welfare workers, behavioral health specialists, those in the juvenile justice system and pediatricians - are knowledgeable about childhood trauma, its warning signs and its repercussions. While many children in general are exposed to at least one traumatic event, trauma disproportionately impacts the lives of children involved with services such as juvenile justice and child welfare, according to CHDI. Thanks to efforts statewide since 2007, according to the CHDI report:
• More than 8,600 professionals have been trained to understand childhood trauma. • At least 35 community agencies or programs at 79 sites have implemented trauma screening.
Ayesha Clarke, of Hartford, ran track in middle and high school. She was a sprinter, and especially enjoyed relay races. She also ran track in the Junior Olympics. Clarke is 31 now, an auditor with the state Department of Revenue Services, and the mother of two children, ages 4 and 3. Like many young mothers her age, she doesn’t exercise as much as she used to, but she has noticed a difference between women who exercised as teenagers, and women who didn’t.
Experts are focusing more money and attention on the health of young children in Connecticut in an effort to prepare them to be successful in school later on. The efforts include developmental screenings at child care centers, home visits and information hotlines for parents, better collaboration with pediatricians and more support for preschool staff members dealing with emotional and behavioral issues. The idea is that if a child's basic health needs aren't met, he or she won't be able to keep up with academic and social expectations in school. "There's been a huge interest in addressing early childhood development with the understanding that's where we get the most bang for the buck," said Lisa Honigfeld, the vice president for health initiatives at The Child Health and Development Institute of Connecticut. In the last 10 years, there has been "an explosion" of federal funding for early childhood initiatives to get children on track early and prevent spending on remediation down the road, Honigfeld said.
What are the warning signs of teen depression? How do you talk to your child about his or her mood swings? How do you know when it’s the right time to consult a social worker? Kimberly Nelson, a licensed clinical social worker at the Wheeler Clinic, has provided answers to various questions regarding how to both spot and treat teen depression. In May, C-HIT hosted a forum on teen depression: Uncovering Our Kids: Towards A Better Understanding Of Teen Mental Health.