Prescribing and Drug Costs in the Province of Ontario

The Report of the Pharmaceutical Inquiry of Ontario documented dramatic increases in the cost of the Ontario Drug Benefit (ODB) program. This article demonstrates that the rise in ODB costs for those 65 and over is due to two factors: more intensive prescribing—physicians prescribing to the elderly more often and writing more prescriptions each time they see an elderly patient—and physicians writing prescriptions for more expensive drugs. Neither of these two changes in prescribing behavior has resulted in any demonstrable improvement in the health of the elderly. Efforts to control costs through some form of copayment or by eliminating some drugs from the ODB formulary should not be undertaken since they probably will result in a reduction in the use of medically necessary drugs. Ultimately, drug costs will only be controlled by improving the appropriateness of physicians' prescribing.

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The Unusual Cruelty of Nursing Homes Behind Bars

Federal Sentencing Reporter ◽

10.1525/fsr.2020.32.5.264 ◽

2020 ◽

Vol 32 (5) ◽

pp. 264-271

Author(s):

Rachel E. López

Keyword(s):

Nursing Homes ◽

Human Dignity ◽

Prison Population ◽

Financial Burden ◽

The Elderly ◽

The United States ◽

Term Care ◽

Trained Staff ◽

State Prisons ◽

The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

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Perspectives on the Therapeutic Benefits of Arginine Supplementation in Cancer Treatment

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190116121451 ◽

2019 ◽

Vol 19 (7) ◽

pp. 913-920

Author(s):

Fabiani L. R. Beal ◽

Pedro R. Beal ◽

Juliana R. Beal ◽

Natan Carvalho-Neves ◽

Octávio L. Franco ◽

...

Keyword(s):

Amino Acid ◽

Side Effects ◽

Cancer Treatment ◽

Treatment Strategies ◽

Endothelial Permeability ◽

The Elderly ◽

Therapeutic Benefits ◽

Cell Growth And Differentiation ◽

The Cost ◽

Arginine Supplementation

Background: Arginine is considered a semi-essential amino acid in healthy adults and the elderly. This amino acid seems to improve the immune system, stimulate cell growth and differentiation, and increase endothelial permeability, among other effects. For those reasons, it has been theorized that arginine supplementation may be used as an adjuvant to conventional cancer therapy treatments. Objective: This review aims to evaluate the existing knowledge of the scientific community on arginine supplementation in order to improve the efficacy of current cancer treatment. Results: Despite the continued efforts of science to improve treatment strategies, cancer remains one of the greatest causes of death on the planet in adults and elderly people. Chemo and radiotherapy are still the most effective treatments but at the cost of significant side effects. Conclusion: Thus, new therapeutic perspectives have been studied in recent years, to be used in addition to traditional treatments or not, seeking to treat or even cure the various types of cancer with fewer side effects.

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Creating a Safer Patient Room Environment: The Contribution of Patient Bed Height

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101163 ◽

2021 ◽

Vol 10 (1) ◽

pp. 180-184

Author(s):

Dorothy Taylor ◽

Janice Morse ◽

Andrew Merryweather

Keyword(s):

Elderly Patient ◽

Fall Risk ◽

The Elderly ◽

Lower Leg ◽

Patient Specific ◽

Leg Length ◽

Patient Room ◽

Patient Falls ◽

Sit To Stand ◽

Bed Height

Elderly patient falls are expensive and may cause serious harm. Studies have identified the sit-to-stand-and-walk (STSW) task as the task where the greatest number of elderly patient falls occur. There is a great need to identify the particular movement and environmental conditions that lead to these elderly patient falls. This study begins to address this gap by evaluating the elderly patient during self-selected hospital bed egress. Using an observed fall risk episode (FRE) as a fall proxy, statistically significant parameters were identified which include bed height, pausing prior to initiating gait, level of fall risk, and Stand phase. Low bed height was identified as the least safe bed height. Patient-specific bed height (PSBH) using the patient’s lower leg length (LLL) is recommended. In addition, suggested guidelines are presented for clinical application in setting PSBH without measuring the patient’s LLL.

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