Forget Ringing the Button for the Nurse. Patients Now Stay Connected by Wearing One.
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HOUSTON — Patients admitted to Houston Methodist Hospital get a monitoring device about the size of a half-dollar affixed to their chest — and an unwitting role in the expanding use of artificial intelligence in health care.
The slender, battery-powered gadget, called a BioButton, records vital signs including heart and breathing rates, then wirelessly sends the readings to nurses sitting in a 24-hour control room elsewhere in the hospital or in their homes. The device’s software uses AI to analyze the voluminous data and detect signs a patient’s condition is deteriorating.
Hospital officials say the BioButton has improved care and reduced the workload of bedside nurses since its rollout last year.
“Because we catch things earlier, patients are doing better, as we don’t have to wait for the bedside team to notice if something is going wrong,” said Sarah Pletcher, system vice president at Houston Methodist.
But some nurses fear the technology could wind up replacing them rather than supporting them — and harming patients. Houston Methodist, one of dozens of U.S. hospitals to employ the device, is the first to use the BioButton to monitor all patients except those in intensive care, Pletcher said.
“The hype around a lot of these devices is they provide care at scale for less labor costs,” said Michelle Mahon, a registered nurse and an assistant director of National Nurses United, the profession’s largest U.S. union. “This is a trend that we find disturbing,” she said.
The rollout of BioButton is among the latest examples of hospitals deploying technology to improve efficiency and address a decades-old nursing shortage. But that transition has raised its own concerns, including about the device’s use of AI; polls show the public is wary of health providers relying on it for patient care.
In December 2022 the FDA cleared the BioButton for use in adult patients who are not in critical care. It is one of many AI tools now used by hospitals for tasks like reading diagnostic imaging results.
In 2023, President Joe Biden directed the Department of Health and Human Services to develop a plan to regulate AI in hospitals, including by collecting reports of patients harmed by its use.
The leader of BioIntelliSense, which developed the BioButton, said its device is a huge advance compared with nurses walking into a room every few hours to measure vital signs. “With AI, you now move from ‘I wonder why this patient crashed’ to ‘I can see this crash coming before it happens and intervene appropriately,’” said James Mault, CEO of the Golden, Colorado-based company.
The BioButton stays on the skin with an adhesive, is waterproof, and has up to a 30-day battery life. The company says the device — which allows providers to quickly notice deteriorating health by recording more than 1,000 measurements a day per patient — has been used on more than 80,000 hospital patients nationwide in the past year.
Hospitals pay BioIntelliSense an annual subscription fee for the devices and software.
Houston Methodist officials would not reveal how much the hospital pays for the technology, though Pletcher said it equates to less than a cup of coffee a day per patient.
For a hospital system that treats thousands of patients at a time — Houston Methodist has 2,653 non-ICU beds at its eight Houston-area hospitals — such an investment could still translate to millions of dollars a year.
Hospital officials say they have not made any changes in nurse staffing and have no plans to because of implementing the BioButton.
Inside the hospital’s control center for virtual monitoring on a recent morning, about 15 nurses and technicians dressed in scrubs sat in front of large monitors showing the health status of hundreds of patients they were assigned to monitor.
A red checkmark next to a patient’s name signaled the AI software had found readings trending outside normal. Staff members could click into a patient’s medical record, showing patients’ vital signs over time and other medical history. These virtual nurses, if you will, could contact nurses on the floor by phone or email, or even dial directly into the patient’s room via video call.
Nutanben Gandhi, a technician who was watching 446 patients on her monitor that morning, said that when she gets an alert, she looks at the patient’s health record to see if the anomaly can be easily explained by something in the patient’s condition or if she needs to contact nurses on the patient’s floor.
Oftentimes an alert can be easily dismissed. But identifying signs of deteriorating health can be tough, said Steve Klahn, Houston Methodist’s clinical director of virtual medicine.
“We are looking for a needle in a haystack,” he said.
Donald Eustes, 65, was admitted to Houston Methodist in March for prostate cancer treatment and has since been treated for a stroke. He is happy to wear the BioButton.
“You never know what can happen here, and having an extra set of eyes looking at you is a good thing,” he said from his hospital bed. After being told the device uses AI, the Montgomery, Texas, man said he has no problem with its helping his clinical team. “This sounds like a good use of artificial intelligence.”
Patients and nurses alike benefit from remote monitoring like the BioButton, said Pletcher of Houston Methodist.
The hospital has placed small cameras and microphones inside all patient rooms enabling nurses outside to communicate with patients and perform tasks such as helping with patient admissions and discharge instructions. Patients can include family members on the remote calls with nurses or a doctor, she said.
Virtual technology frees up on-duty nurses to provide more hands-on help, such as starting an intravenous line, Pletcher said. With the BioButton, nurses can wait to take routine vital signs every eight hours instead of every four, she said.
Pletcher said the device reduces nurses’ stress in monitoring patients and allows some to work more flexible hours because virtual care can be done from home rather than coming to the hospital. Ultimately it helps retain nurses, not drive them away, she said.
Sheeba Roy, a nurse manager at Houston Methodist, said some members of the nursing staff were nervous about relying on the device and not checking patients’ vital signs as often themselves. But testing has shown the device provides accurate information.
“After we implemented it, the staff loves it,” Roy said.
Serena Bumpus, chief executive officer of the Texas Nurses Association, said her concern with any technology is that it can be more burdensome on nurses and take away time with patients.
“We have to be hypervigilant in ensuring that we are not leaning on this to replace the ability of nurses to critically think and assess patients and validate what this device is telling us is true,” Bumpus said.
Houston Methodist this year plans to send the BioButton home with patients so the hospital can better track their progress in the weeks after discharge, measuring the quality of their sleep and checking their gait.
“We are not going to need less nurses in health care, but we have limited resources and we have to use those as thoughtfully as we can,” Pletcher said. “Looking at projected demand and seeing the supply we have coming, we will not have enough to meet demand, so anything we can do to give time back to nurses is a good thing.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Science of HIIT – by Ingrid Clay
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We previously reviewed another book in this series, Science of Yoga. This one’s about HIIT: High Intensity Interval Training!
We’ve written about HIIT before too, but our article doesn’t have the same amount of room as a book, so…
This one lays out 90 key HIIT exercises that you can do at home without special equipment. By “without special equipment”, we mean: there are a few exercises that use dumbbells, but if you don’t want to get/use dumbbells, you can improvize (e.g. with water bottles as weights) or skip those. All the rest require just your body!
The illustrations are clear and the explanations excellent. The book also dives into (as the title promises) the science of HIIT, and why it works the way it does to give results that can’t be achieved with other forms of exercise.
Bottom line: if you’ve been wanting to do HIIT but have not yet found a way of doing it that suits your lifestyle, this book gives many excellent options.
Click here to check out Science of HIIT, and level-up yours!
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Women’s Strength Training Anatomy – by Frédéric Delavier
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Fitness guides for women tend to differ from fitness guides for men, in the wrong ways:
“Do some squats and jumping jacks, and here’s a exercise for your abs; you too can look like our model here”
In those other books we are left wonder: where’s the underlying information? Where are the explanations that aren’t condescending? Where, dare we ask, is the understanding that a woman might ever lift something heavier than a baby?
Delavier, in contrast, delivers. With 130 pages of detailed anatomical diagrams for all kinds of exercises to genuinely craft your body the way you want it for you. Bigger here, smaller there, functional strength, you decide.
And rest assured: no, you won’t end up looking like Arnold Schwarzenegger unless you not only eat like him, but also have his genes (and possibly his, uh, “supplement” regime).
What you will get though, is a deep understanding of how to tailor your exercise routine to actually deliver the personalized and specific results that you want.
Pick Up Today’s Book on Amazon!
Not looking for a feminine figure? You may like the same author’s book for men:
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Toothpastes & Mouthwashes: Which Help And Which Harm?
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Toothpastes and mouthwashes: which kinds help, and which kinds harm?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
For today, let’s look at toothpastes and mouthwashes, to start!
Toothpaste options
Toothpastes may contain one, some, or all of the following, so here are some notes on those:
Fluoride
Most toothpastes contain fluoride; this is generally recognized as safe though is not without its controversies. The fluoride content is the reason it’s recommended not to swallow toothpaste, though.
The fluoride in toothpaste can cause some small problems if overused; if you see unusually white patches on your teeth (your teeth are supposed to be ivory-colored, not truly white), that is probably a case of localized overcalcification because of the fluoride, and yes, you can have too much of a good thing.
Overall, the benefits are considered to far outweigh the risks, though.
Baking soda
Whether by itself or as part of a toothpaste, baking soda is a safe and effective choice, not just for cosmetic purposes, but for boosting genuine oral hygiene too:
- Enhanced plaque removal to improve gingival health: 3-month randomized clinical study of the effects of baking soda toothpaste on plaque and gingivitis
- The effects of two baking-soda toothpastes in enhancing mechanical plaque removal and improving gingival health: A 6-month randomized clinical study
- The efficacy of baking soda dentifrice in controlling plaque and gingivitis: A systematic review
Activated charcoal
Activated charcoal is great at removing many chemicals from things it touches. That includes the kind you might see on your teeth in the form of stains.
A topical aside on safety: activated charcoal is a common ingredient in a lot of black-colored Halloween-themed foods and drinks around this time of year. Beware, if you ingest these, there’s a good chance of it also cleaning out any meds you are taking. Ask your pharmacist about your own personal meds, but meds that (ingested) activated charcoal will usually remove include:
- Oral HRT / contraceptives
- Antidepressants (many kinds)
- Heart medications (at least several major kinds)
Toothpaste, assuming you are spitting-not-swallowing, won’t remove your medications though. Nor, in case you were worrying, will it strip tooth enamel, even if you have extant tooth enamel erosion:
Source: Activated charcoal toothpastes do not increase erosive tooth wear
However, it’s of no special extra help when it comes to oral hygiene itself, just removing stains.
So, if you’d like to use it for cosmetic reasons, go right ahead. If not, no need.
Hydrogen peroxide
This is generally not a good idea, speaking for the health. For whitening, yes, it works. But for health, not so much:
To be clear, when they say “alter”, they mean “in a bad way”. It increases inflammation and tissue damage.
If buying commercially-available whitening toothpaste made with hydrogen peroxide, the academic answer is that it’s a lottery, because brands’ proprietorial compounding processes vary widely and constantly with little oversight and even less transparency:
Is whitening toothpaste safe for dental health?: RDA-PE method
Mouthwash options
In the case of fluoride and hydrogen peroxide, the same advice (for and against) goes as per toothpaste.
Alcohol
There has been some concern about the potential carcinogenic effect of alcohol-based mouthwashes. According to the best current science, this one’s not an easy yes-or-no, but rather:
- If there are no other cancer risk factors, it does not seem to increase cancer risk
- If there are other cancer risk factors, it does make the risk worse
Read more:
- Does the use of alcohol mouthwash increase the risk of developing oral cancer?
- Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review
Non-Alcohol
Non-alcoholic mouthwashes are not without their concerns either. In this case, the potential problem is changing the oral microbiome (we are supposed to have one!), and specifically, that the spread of what it kills and what it doesn’t may result in an imbalance that causes a lowering of the pH of the mouth.
Put differently: it makes your saliva more acidic.
Needless to say, that can cause its own problems for teeth. The research on this is still emerging, with regard to whether the benefits outweigh the problems, but the fact that it has this effect seems to be a consensus. Here’s an example paper; there are others:
Effects of Chlorhexidine mouthwash on the oral microbiome
Flossing, scraping, and alternatives
These are important (and varied, and interesting) enough to merit their own main feature, rather than squeezing them in at the end.
So, watch this space for a main feature on these soon!
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Tahini vs Hummus – Which is Healthier?
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Our Verdict
When comparing tahini to hummus, we picked the tahini.
Why?
Both are great! But tahini is so nutritionally dense, that it makes even the wonder food that is hummus look bad next to it.
In terms of macros, tahini is higher in everything except water. So, higher in protein, carbs, fats, and fiber. In terms of those fats, the fat breakdown is similar for both, being mostly polyunsaturated and monounsaturated, with a small percentage of saturated. Tahini has the lower glycemic index, but both are so low that it makes no practical difference.
In terms of vitamins, tahini has more of vitamins A, B1, B2, B3, B5, B9, E, and choline, while hummus is higher in vitamin B6.
This is a good reason to embellish hummus with some red pepper (vitamin A), a dash of lemon (vitamin C), etc, but we’re judging these foods in their most simple states, for fairness.
When it comes to minerals, tahini has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Meanwhile, hummus is higher in sodium.
Note: hummus is a good source of all those minerals too! Tahini just has more.
In short… Enjoy both, but tahini is the more nutritionally dense by far. On the other hand, if for whatever reason you’re looking for something lower in carbs, fats, and calories, then hummus is where it’s at.
Want to learn more?
You might like to read:
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Stop Sabotaging Your Weight Loss – by Jennifer Powter, MSc
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This is not a dieting book, and it’s not a motivational pep talk.
The book starts with the assumption that you do want to lose weight (it also assumes you’re a woman, and probably over 40… that’s just the book’s target market, but the same advice is good even if that’s not you), and that you’ve probably been trying, on and off, for a while. Her position is simple:
❝I don’t believe that you have a weight loss problem. I believe that you have a self-sabotage problem❞
As to how this sabotage may be occurring, Powter talks about fears that may be holding you back, including but not limited to:
- Fear of failure
- Fear of the unknown
- Fear of loss
- Fear of embarrassment
- Fear of your weight not being the reason your life sucks
Far from putting the reader down, though, Powter approaches everything with compassion. To this end, her prescription starts with encouraging self-love. Not when you’re down to a certain size, not when you’re conforming perfectly to a certain diet, but now. You don’t have to be perfect to be worthy of love.
On the topic of perfection: a recurring theme in the book is the danger of perfectionism. In her view, perfectionism is nothing more nor less than the most justifiable way to hold yourself back in life.
Lastly, she covers mental reframes, with useful questions to ask oneself on a daily basis, to ensure progressing step by step into your best life.
In short: if you’d like to lose weight and have been trying for a while, maybe on and off, this book could get you out of that cycle and into a much better state of being.
Get your copy of “Stop Sabotaging Your Weight Loss” from Amazon today!
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The Alzheimer’s Gene That Varies By Race & Sex
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The Alzheimer’s Gene That Varies By Race & Sex
You probably know that there are important genetic factors that increase or decrease Alzheimer’s Risk. If you’d like a quick refresher before we carry on, here are two previous articles on this topic:
- Genetic Testing: Health Benefits & Methods (about personal genomics and health, including Alzheimer’s)
- The Surprising Link Between Type 2 Diabetes & Alzheimer’s (about the APOE-ε4 allele that is implicated in both)
A Tale of Two Alleles
It has generally been understood that APOE-ε2 lowers Alzheimer’s disease risk, and APOE-ε4 increases it.
However, for reasons beyond the scope of this article, research populations for genetic testing are overwhelmingly white. If you, dear reader, are white, you may be thinking “well, I’m white, so this isn’t a problem for me”, you might still want to read on…
An extensive new study, published days ago, by Dr. Belloy et al., looked at how these correlations held out per race and sex. They found:
- The “APOE-ε2 lowers; APOE-ε4 increases” dictum held out strongest for white people.
- In the case of Hispanic people, there was only a small correlation on the APOE-ε4 side of things, and none on the APOE-ε2 side of things per se.
- East Asians also saw no correlation with regard to APOE-ε2 per se.
- But! Hispanic and East Asian people had a reduced risk of Alzheimer’s if and only if they had both APOE-ε2 and APOE-ε4.
- Black people, meanwhile, saw a slight correlation with regard to the protective effect of APOE-ε2, and as for APOE-ε4, if they had any European ancestry, increased European ancestry meant a higher increased risk factor if they had APOE-ε4. African ancestry, on the other hand, had a protective effect, proportional to the overall amount of that ancestry.
And as for sex…
- Specifically for white people with the APOE-ε3/ε4 genotype, especially in the age range of 60–70, the genetic risk for Alzheimer’s was highest in women.
If you’d like to read more and examine the data for yourself:
APOE Genotype and Alzheimer Disease Risk Across Age, Sex, and Population Ancestry
Want to reduce your Alzheimer’s risk?
We have just the thing for you:
How To Reduce Your Alzheimer’s Risk: It’s Never Too Early To Do These 11 Things
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