Medicare announced is it reviewing whether seniors should receive spine surgeries at same-day surgery centers, five months after a USA Today Network - Kaiser Health News investigation detailed a spate of deaths following the procedures, reports Kaiser Health News . The investigation found more than 260 people have died since 2013 after in-and-out procedures at surgery centers across the country. There have been more than 12 fatalities after routine operations, such as colonoscopies and tonsillectomies. Moreover, in 2015 and 2017, Medicare approved same-day spine operations for seniors even though at least 14 individuals had died since 2008 after such surgeries. The report also noted some medical professionals urging Medicare to pay surgery centers to operate on seniors' spines did not mention recent incidents of death at their own or an affiliated center. In the wake of these revelations, Medicare said officials will examine whether these procedures "pose a significant safety risk" to recipients and continue to "meet the criteria" for Medicare coverage. The proposal seeks to review 38 procedures added since 2015, of which 25 involve spine surgery, and create an ongoing plan to continually review approved procedures. Medicare says because "beneficiaries tend to be frailer and exhibit a higher number of comorbidities than other populations, we believe it may be appropriate to reevaluate recently-added procedures."

A new drug holds promise in the battle against Alzheimer's disease, lowering the plaques in patients' brains and slowing the progression of dementia, researchers said Wednesday. The study—presented at the Alzheimer's Association International Conference in Chicago—involved a study of 856 participants from the United States, Europe, and Japan with early symptoms of cognitive decline, reports the New York Times . According to the data, patients taking the highest of five doses of a drug known as BAN2401 (Eisai and Biogen) had lower amyloid levels and slowed cognitive decline compared with placebo recipients. Among 161 individuals taking the highest dose—an injection every 2 weeks of 10 mg per kilogram of a person's weight—81 percent had such substantial reductions in amyloid levels that they "converted from amyloid positive to amyloid negative," said Lynn Kramer, MD, chief medical officer of Eisai. Furthermore, on a set of cognitive and functional tests assessing memory and skills like reasoning, the high-dose group declined at a rate that was 30 percent slower than the rate of decline seen in among placebo recipients. Kramer noted the findings from the Phase II study were statistically significant 18 months after the study began, though some improvement was seen at 6 months. However, some experts urged caution with the results, noting that more work needs to be done. Reisa Sperling, MD, director of the Center for Alzheimer Research and Treatment at Brigham and Women's Hospital in Boston, noted: "It's important not to over-conclude on the data. But as a proof of concept, I feel like this is very encouraging."

An increasing number of companies are making broad pay adjustments after delving deep into worker pay data, auditing payrolls for gaps between men and women's salaries, altering wages that are not competitive with rival companies, and amending compensation programs to prevent potential bias, reports the Washington Post . However, there are risks for businesses, raising questions about previous unfair pay practices, misconceptions concerning the adjustments, or budget pressures. This week Nike sent a memo to employees that it would adjust the pay of about 10 percent of its 74,000 workers and overhaul its bonus system, noting its compensation program is designed to "support a culture in which employees feel included and empowered." The new bonus system will still account for individual performance, but also will be based on company performance and targets and reward people more consistently across different geographies or corporate roles, potentially reducing disparities or potential bias. Pay consultants and attorneys note companies are doing pay audits in response to pressure from activist shareholders, reforms to state laws, and increasing public interest in the issue. However, some firms may be unsure that they have the budget to close any identified pay gaps, while others may be reluctant to audit because finding and admitting unfair pay in the past could have legal ramifications.

The Collaborative Aging (In Place) Research Using Technology (CART) Initiative is a national study involving researchers monitoring seniors' daily activities using motion sensors and other technology installed in their residences, reports the Wall Street Journal . The sensors feed real-time data on participants' movements throughout the day, measuring how often they enter different rooms, how often they enter and exit their home, their computer use, and their walking speed. The point of CART is to determine whether researchers can monitor and detect health changes in older adults so they can live independently longer. For example, early symptoms of cognitive decline may be detected through changes in computer use or driving. The National Institutes of Health and Department of Veterans Affairs are financing the study, with researchers having installed the technology in about 50 homes with an ultimate goal of equipping about 250 homes. Participants have software set up to measure how much time they spend on their computers, while a sensor is placed under the vehicle dashboard to monitor how often participants drive. Aging in Place Technology Watch founder Laurie Orlov says systems such as CART could offer a big opportunity for managing persons sent home from the hospital who need monitoring. "It's not just alerting that someone has fallen down, but it's looking at behavior change," she notes.

A U.S. study presented at the Alzheimer's Association International Conference found aggressively reducing blood pressure can significantly cut the risk of mild cognitive impairment (MCI) and dementia among people with hypertension, reports Reuters . The investigators analyzed data from the 2015 SPRINT clinical trial involving more than 9,300 participants with hypertension, which demonstrated significant cardiovascular benefits in people whose systolic blood pressure was lowered aggressively to below 120, compared to a higher target of less than 140. The study explored the implications of aggressive blood pressure lowering on symptoms of dementia from any cause, and MCI. People whose blood pressure was reduced to below 120 had a 19 percent lower rate of new cases of MCI and a 15 percent reduction in MCI and dementia combined. The research did not indicate an overall reduction in dementia alone. The Alzheimer's Association's Keith Fargo says the results most likely affect the impact of blood pressure reduction on vascular dementia, but he notes many people with Alzheimer's also have some degree of vascular disease, and reducing the total dementia risk could delay the onset of memory problems.

A study published in Nature Communications and presented at the Alzheimer's Association International Conference involved people with Alzheimer's undertaking an experiment to determine whether focused ultrasound can safely perforate the blood-brain barrier, reports the Associated Press . The researchers injected microscopic bubbles into the bloodstream, targeted at a precise brain region through a magnetic resonance imaging (MRI) scanner. They then beamed ultrasound waves through a helmet-like device to that point, causing the microbubbles to vibrate. The researchers tested to see whether participants' fragile blood vessels could withstand the breach without bleeding or other side effects, in the hope that eventually anti-Alzheimer's drugs and other treatments could access the brain instead of being blocked by the barrier. The appearance of a medical dye on the MRIs demonstrated that the barrier opened, and a follow-up scan one day later showed the breach had sealed. "What is remarkable is that they could do it in a very focused way, they can target a very specific brain region," says Eliezer Masliah with the National Institute on Aging.

New Zealand's government on Wednesday passed world-first legislation granting victims of domestic violence 10 days paid leave so they can leave their partners, find new homes, and protect themselves and their children, reports The Guardian . The law is the result of Green MP Jan Logie's seven-year-long diligence. New Zealand has one of the highest rates of domestic violence in the developed world, with family violence estimated to cost the country up to $7 billion annually. "Part of this initiative is getting a whole-of-society response," Logie said. "We don't just leave it to police but realize we all have a role in helping victims. It is also about changing the cultural norms and saying 'we all have a stake in this and it is not OK.'" The law is slated to go into effect in April 2019 and mandates that anyone experiencing domestic violence will be entitled to 10 days paid leave from work, in addition to standard holiday and sick leave entitlements. Victims are not required to provide proof of their circumstances, and also will be entitled to fast-tracked flexible work conditions to ensure their safety, such as changing their work location, changing their email address, and having contact details taken off the business' website. "A huge amount of research tells us a large number of abusive partners bring the violence into the workplace," Logie noted.

A study published in Health Communication found co-workers' support is essential for new mothers who want to continue breast-feeding after going back to work, reports HealthDay News . Michigan State University Professor Joanne Goldbort notes in the workplace, a breast-feeding woman "has to work collegially with co-workers, gain their support to assist with the times she's away from her desk, and ultimately try to lessen the 'you get a break and I don't' stigma." The study involved more than 330 new mothers who continued breast-feeding after returning to their jobs, more than half of whom stopped breast-feeding within six months. Returning to work was a key factor in a woman's decision to stop breast-feeding, but co-worker support was important for those who continued breast-feeding. More than 25 percent of mothers who tried to continue breast-feeding after returning to work did so because their workplace offered a supportive environment. About 15 percent said they kept breast-feeding because they had co-workers or supervisors who encouraged them. "If women know that co-workers and supervisors will support them in their breast-feeding efforts, it can make a big difference," Goldbort says.

Many leading companies are employing virtual reality (VR) in their content-marketing strategies to connect with their target audience, reports Entrepreneur . One VR approach from Ikea is a try-before-buy strategy, where customers can use a VR-based app to virtually "place" furniture in their home as they shop online. North Face's VR deployment lets the company give its target customers appealing interactive experiences designed to connect with its brand. Its VR app allows shoppers to virtually climb the Himalayas with an expedition and "test out" products. Another application of VR for brand awareness serves to create emotional links with target audiences. Toms Shoes gives a pair of shoes to a child in need for every pair sold. The firm also sponsors year-long "giving trips" where employees and partners can give children their donated shoes in person and witness first-hand how the company is improving health and education programs in different countries. Their VR app allows customers to share that experience and boost their connectivity to the program.

Massachusetts' four medical schools are taking innovative measures to improve education about end-of-life care, reports Next Avenue . In terms of palliative care, UMass Memorial Medical Center's Dr. Jennifer Reidy cites the importance of having dialogues about what matters most and "being able to treat people's pain and other distressing symptoms that affect their quality of life are all things that any doctor should be able to do in their field." She notes students at each participating school will receive training on complex communication procedures for breaking difficult news and having conversations about prognoses and end-of-life planning. Dr. Atul Gawande encourages students to investigate areas to determine what will promote well-being. These include a person's understanding of their illness; their fears and worries for the future; their priorities if time becomes short; what sacrifices they are and are not willing to make; and what their good days are like. UMass Medical Center's Tiffany Chen says the new curriculum is designed to make students "better equipped at baseline to have these conversations," noting they will need to improve their proficiency at reading people's cues and better communicators "by first listening." A simulation lab and new training methods, including role-playing actors, are essential to this process at Chen's school.