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Anchor lead: If you’re a fan of artificial sweeteners you may want to consider other options, Elizabeth Tracey reports

Artificial sweeteners seem like such a good idea, since they don’t have any calories, but a lot of evidence is turning up that they have a substantial downside. Now a new study from the European Association for the Study of Diabetes meeting adds more. Rita Kalyani, a diabetes expert at Johns Hopkins, said researchers gave subjects artificial sweeteners, then looked at metabolism of sugar, or glucose.

Kalyani: They gave them in a very high quantity, the equivalent of 1.5 liters of diet beverage per day. That’s a lot but what they wanted to do was to see after two weeks, whether glucose measures were higher in those who took the artificial sweeteners. They did find that there was an exaggerated glucose response. Maybe those who take artificial sweeteners every day might be more likely to have high blood sugars in the long term. It was a very small pilot study, only 27 people but it had some really great physiological measures to look at the effects of sweeteners after just a few weeks. :33

Kalyani says high blood sugars put someone on the path to diabetes. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How does your neighborhood affect your risk of diabetes? Elizabeth Tracey reports

Do you walk around your neighborhood, or does it lack sidewalks, lighting, and safety, rendering it essentially unwalkable? That factor turns out to have a lot to do with whether you develop prediabetes or diabetes, a study presented at the recent European Association for the Study of Diabetes meeting found. Rita Kalyani, a diabetes expert at Johns Hopkins, explains the findings.

Kalyani: They looked at walkability in neighborhoods and the relationship to the development of prediabetes and diabetes. Though there were differences in ethnicities, non-Western populations versus Western populations, in terms of their incidence of prediabetes, this difference was most marked in the least walkability areas. What this means is that for some reason, having areas that were less walkable resulted in more prediabetes in some of these minority populations.  :28

Kalyani says the minority populations were largely immigrants, and right now no one knows why they are disproportionately affected by neighborhoods that aren’t walkable. For now, she recommends that everyone strive for 10,000 steps each day to reduce their risk of diabetes. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can design thinking improve people’s experiences in the hospital? Elizabeth Tracey reports

Patient experiences in the hospital should be the best they can be, and to that end, Johns Hopkins chief patient experience officer Lisa Allen and colleagues are using ‘design thinking,’ a process that is creative, human centered and empathetic, to solve problems and test solutions, described in a recent Harvard Business Review article. Allen says it’s a win-win for patients.

Allen: A patient who is having a better experience requires less time because hopefully they’re getting engaged in their care, they’re being activated about their care, and an activated engaged patient we know lowers readmission rates, healthcare costs. I read a lot of patient comments and patients that feel cared for, feel healed. Patients who feel that their emotions were not taken into consideration really feel hurt or harmed. We consider it like an infection might be, it’s a harm if you don’t feel that you’ve had that emotional connection.   :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can studying the experience of patients in the hospital help improve things? Elizabeth Tracey reports

If you’ve been a patient in a hospital lately, you’ve likely been given a questionnaire to evaluate your experience. Fill it out. That’s the advice of Lisa Allen, chief patient experience officer at Johns Hopkins, who says these surveys really do matter and result in scientific scrutiny of how to improve things. In a recent Harvard Business Review article, she cites such a study of people’s negative experiences in the emergency department.

Allen: Sometimes it was as simple as I didn’t alert people I was here, so needing to make a phone call. What we did was we put advocates into the emergency department so anybody who is getting ready to be admitted they try to make them as comfortable as possible while they’re waiting for a bed in the hospital, and then after they settle into their unit the same individuals go up and see them and they do what we’ve called a warm welcome, getting them settled into their room. By studying what happens when you go from needing to be in an emergency room to needing to be in the hospital we put in this human intervention.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Cigarettes Tied With Rope And Wick Over Blue Background

This week’s topics include how the Zika virus changed, outcomes after surgery and health literacy, e-cigarettes and healthcare costs, and a reaction to tattooing.

Program notes:
0:36 Case report of an outcome after a tattoo
1:32 Reaction to the tattoo ink but not cancer
2:32 Not cancer just a reaction
2:46 Mutations in the Zika virus
3:44 More likely to have brain malformation
4:46 Lot of controversy over this study
5:00 Health literacy and outcomes after surgery
6:01 No correlation with readmission
7:02 Very few minority patients
7:15 E-cigarettes and cost savings
8:15 People still had exposure to nicotine
9:15 How to quantify e-cigarette safety
10:39 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/10/09/e-cigarette-benefits/
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Anchor lead: Are food challenges safe? Elizabeth Tracey reports

Food challenges done in allergist's offices are generally quite safe, a recent study of about 6000 such tests concluded. Corrine Keet, an allergist at Johns Hopkins, describes the results.

Keet: Food challenge is where we feed someone the food they're allergic to, or we suspect they may be allergic to. In that study, which reviewed 6000 challenges that were done in an allergist's office, it showed that it was generally very low risk in having any kind of an allergic reaction, there were no deaths reported in that. I think it's important that allergists do take a lot of steps to make sure that food challenges are safe that include having medications available, making sure that their staff are medically trained, that's there's easy access to emergency medical care. :31

Keet says the study was done after the death of a three year old boy following a food challenge was reported in August. She says this study should help parents feel confident that safety is paramount when a food challenge is done in an allergist's office. At Johns Hopkins, I'm Elizabeth Tracey.

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Anchor lead: Why are food challenges needed? Elizabeth Tracey reports

In the wake of the recent death of a three year old following a food challenge test, a new study of over six thousand such tests done in allergist's offices found the safety profile very reassuring. Corrine Keet, an allergist at Johns Hopkins, explains why such testing is necessary at all.

Keet: Food challenges are really a mainstay of food allergy diagnosis and that's because our testing is not that great. So we have skin tests and blood tests for food allergy and we know that there are a lot of false positives with skin tests and blood tests and so in many cases we do have to do a food challenge when the diagnosis is in doubt. We know that there are many people who are walking around with diagnoses of food allergy that are really not true or are no longer true so we do food challenges when we're not sure that somebody is truly allergic to a food or we're wondering if they may have outgrown that food allergy.  :30

Keet notes that supposed food allergy can compromise someone's quality of life because of the vigilance needed around food choices. At Johns Hopkins, I'm Elizabeth Tracey.

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