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Morning Rounds

All public housing will become smoke-free this week

Public housing nationwide is set to go smoke-free this week. Under a 2017 rule issued by the Department of Housing and Urban Development, all public housing in the U.S. must have a smoke-free policy in place by July 31. That ban includes all combustible tobacco products and applies to all residences, offices, and outdoor areas within 25 feet of housing and office buildings. Public health groups have cheered the rule and HUD’s work over the past year with local housing agencies to help public housing units make the transition. But some experts have also raised concerns about whether people who live in public housing have adequate access to smoking cessation treatment.

Alzheimer's experts weigh in on health care system shortcomings

An expert council that advises HHS on Alzheimer's research, care, and services is convening today to talk about efforts to reduce the burden of dementia nationwide. The council is slated to hear from RAND researchers who found that the U.S. health care system doesn't have the capacity to quickly move a treatment for Alzheimer's disease from approval to widespread use in the clinic. That's due, in part, to a lack of specialists who could diagnose patients with early signs of Alzheimer's and determine whether they might be eligible for a therapy to slow the disease's progression.

The meeting follows news that an in-development drug from Biogen and Eisai significantly slowed patients' cognitive decline in a large clinical trial. You can tune in live here starting at 9 a.m. ET.

Inside STAT: Alzheimer’s study sparks a new round of debate over the amyloid hypothesis

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The results spurred a fresh debate about the amyloid hypothesis. (adobe)

Meanwhile, the results of that trial seem to mark a victory for one side of the long-running debate over what causes Alzheimer’s disease. At the center of the debate: the amyloid hypothesis, which suggests that Alzheimer’s disease is due to the accumulation of sticky amyloid plaques in the brain. The highest dose tested of Biogen and Eisai’s drug, BAN2401, had a dramatic effect on amyloid buildup in the brain. But some skeptics aren't convinced — and say it's impossible to draw conclusions from the study. STAT’s Damian Garde has more here.

Dashboard for doctors could boost statin prescribing

A new study suggests an automated dashboard could improve the use of statins in some cases. Researchers ran a randomized trial with primary care doctors at 32 practices. The doctors were put into one of three groups: one had access to an online dashboard that lists patients who meet national guidelines for statins but weren't taking them, one had access to the dashboard plus analysis of prescribing rates compared to peers, and one didn’t receive access to either. Among doctors who could access the dashboard and also got a "nudge" email, 25 percent submitted statin prescriptions through the dashboard and signed those orders in a patient's electronic health record. And while that marks a modest improvement, the authors say the dashboard might work better if it were integrated into an EHR. 

Debate over a U.N. tuberculosis declaration continues

Negotiations over a draft United Nations declaration that aims to address the global tuberculosis epidemic are underway again. Countries have been debating the draft proposal — which comes ahead of a U.N. meeting on tuberculosis in September — for weeks. They submitted a near-final text to the president of the U.N. General Assembly on July 20, but South Africa has since objected to that proposal. The country’s government took issue with the removal of language that spells out the rights of countries to permit public agencies or generic drug makers to copy a patented drug to create cheaper options. That agreement has been cited in past U.N. declarations on HIV, non-communicable diseases, and antimicrobial resistance.

AAP urges pediatricians to discuss infertility with patients who might be affected

The American Academy of Pediatrics is calling on physicians to start a conversation early with parents and young patients whose condition or treatment might affect their fertility or sexual function later in life. Surgery, radiation, and other treatments can impact fertility and sexual function, as can many medical conditions that occur early in life. In a report published this morning, the AAP outlines guidance for doctors to have age-appropriate conversations with patients and parents about the “sensitive, often overlooked topic.” Among the recommendations: Start counseling parents as early as it’s clear a child might be affected and come up with a plan for ongoing assessment. 

What to read around the web today

  • To keep women from dying in childbirth, look to California. NPR
  • New Ebola species is reported for first time in a decade. STAT
  • Shopping for health care simply doesn't work. So what might? New York Times
  • VCs are pouring money into digital health. Are they making smart bets? STAT Plus
  • 1,400 nursing homes get lower Medicare ratings because of staffing concerns. Kaiser Health News

Thanks for reading! More tomorrow,

Megan

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Monday, July 30, 2018

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