06Jun

As if clinical researchers and managers didn’t already have enough to worry about, now add activity trackers to the list.

Smartwatches, Fitbits and similar trackers have the potential to influence behavior, which matters in studies where physical activity is a study endpoint. (An endpoint in a clinical study is an event used to objectively measure the effect of a drug or other intervention.)

If the level of activity is an endpoint in a study of, say, a drug to improve fatigue, researchers need to be able to say that it is the drug that has made the difference. But anyone who has ever used a Fitbit or other activity tracker know how engaging – addicting, even – they can be. They prod you to get in that 10,000 steps with encouraging messages like, “Only 789 steps to reach your goal.”

As an article on the Clinical Research News website says, “Use of the devices could result in ‘activity peaks’ and ‘activity plateaus’ driven not by drug efficacy but as a response to the smartwatch/fitness tracker targets.”

In other words, who’s to say the increased physical activity was the result of the drug or the tracker prodding?

Before commercial trackers became so ubiquitous, researchers gave study volunteers devices that accumulated the data, but without making it visible to them. Commercial trackers make everything visible.

Besides simply counting steps, sophisticated wearables measure all sorts of activity related variables like heart rate, duration, intensity, distance, sleep and more. Because participants in studies of physical activity are able to see this data they can skew the results by working to reach targets and earn badges.

The authors of the article – “The Potential Of Activity Trackers To Bias Study Results” – suggest a number of measures researchers can take to mitigate the influence of these devices including prohibiting participants from wearing them, establishing baseline physical activity levels and choosing endpoints less likely to be influenced by the trackers.

Ultimately, the writers say, “Additional research is needed in this arena… More certain is that the unblinding of study data could have far-reaching if unintended consequences by introducing bias into the data analysis process.”

Photo by Andres Urena on Unsplash

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Jun 6, 2023

Virus Is Causing Surge In Healthcare Hiring

As the number of coronavirus cases continues to grow, the demand for healthcare workers is surging.

Glassdoor analysis well before the outbreak was declared a pandemic, said, “Dozens of job postings for health care workers, scientists and data specialists are popping up as organizations prepare for the outbreak.”

More recently, the report’s author Daniel Zhao told public media’s Marketplace, “There is a wide mix of skills needed… [including] epidemiologists or virologists to registered nurses, down to call center or front-desk workers who are helping handle the influx of community questions.”

Here at Green Key Resources we’re experiencing an even greater increase in calls for healthcare workers, especially from nursing homes and medical centers.

“We are seeing a huge uptick in requests from our hospitals for staff to work in all different departments,” says Brett Braterman, Principal within Green Key’s healthcare division in New York City.

“The requests are ranging from registered nurses to lab technologists and medical assistants, where hospitals are preparing for a combination of increase in patients and their own staff unable to work. In addition, our nursing homes have also hit panic mode and gone on a hiring frenzy trying to cover their own staff calling out.”

Even before the coronavirus outbreak, nurses and many other healthcare professionals were in short supply. The situation now has become so critical that New York Governor Andrew Cuomo and Colorado Governor Jared Polis called on former and retired healthcare workers to help.

Cuomo asked that nurses and doctors contact their past employer to “reconnect” with the workforce. New York is sending letters to retired health care professionals and all schools of nursing, public health and medicine encouraging qualified health care personnel to sign up for on-call work.

Healthcare workers anywhere in the nation can also call us at 212.683.1988 or simply upload a resume here. You can also review our open healthcare positions here.

Because of the nature of their job, healthcare workers are particularly at risk of contracting Covid-19. Cuomo said it’s critical to create a reserve of professionals who can fill-in for workers who may fall ill or be ordered quarantined. The Washington Post reported last week that 160 employees of a Massachusetts medical center were quarantined after coming into contact with patients who tested positive. The hospital issued a call for nurses to replace the quarantined professionals.

Nurse.org said Washington State hospitals are hiring hundreds of nurses to help with the influx of cases that have hit the state particularly hard. The report said the Seattle metro area has issued a call for travel nurses from throughout the country to replace nurses who are or will become quarantined and to conduct testing and monitor quarantined individuals.

Quoting the head of a local healthcare staffing firm, Nurse.org says pay rates for these temporary nurses is as high as $2,600 a week. “We really need travel nurses, especially public health nurses, to come work here for at least 13-weeks,” Mona Veiseh, president of the staffing agency told the publication. “These are urgently needed, with crisis pay.”

In particularly hard hit Northern California, San Francisco Mayor London Breed issued an emergency order to expedite the hiring of as many as 100 nurses and health care workers. Special, invitation-only hiring events will be scheduled with job offers made on the spot.

Photo by Ashkan Forouzani on Unsplash

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Jun 6, 2023

In-Home Colon Screening Is Rising as a COVID Alternative

The sharp decline in cancer screenings due to the suspension of elective medical procedures has prompted doctors to turn to alternatives, and none have seen a greater increase than in-home colon screening tests.

Screening for colorectal cancer has typically meant a trip to an outpatient surgical center for a colonoscopy or for a somewhat less invasive sigmoidoscopy. During the initial months of the pandemic when COVID disrupted medical care, there was an 86% decline in colon cancer screening, according to the Epic Health Research Network.

Decades ago, medical researchers found testing for the presence of blood in stool could be an effective indicator for potential colon cancer. Patients with abnormal fecal immunochemical test (FIT) results are referred for colonoscopies.

Despite the ready availability of FIT and a second type that detects cancer biomarkers, most doctors continued to recommend colonoscopies for all their over 50 year old patients. Many doctors never even discuss other options, so few patients are aware there are alternatives.

“Some patients are definitely surprised that there are options for colon cancer screening other than colonoscopy,” Lisa Ravindra, MD, an assistant professor of medicine at Rush University Medical Center in Chicago, said in an article on the JAMA Network.

Yet the in-home tests are as good at early detection as a colonoscopy, said Dr. Alex Krist, chairman of the U.S. Preventive Services Task Force. “The data show the tests are equally effective at saving lives,” he told The New York Times.

Because of the rising incidence of colon cancer, the Task Force is expected to recommend lowering the age at which screening should begin to 45. Colonoscopies should be done every 10 years, annually for FIT and every 3 years for Cologuard, the biomarker test.

While routine screenings have increased, Michael Sapienza, chief executive officer of the Colorectal Cancer Alliance, said, “I’m still hearing from a lot of people that we’re not seeing a ton of [routine] screening colonoscopies.”

As a result of the COVID-caused delay in diagnostic testing and the consequent delay in treatment, the National Cancer Institute predicts 4,500 more deaths from colorectal cancers over the next decade. A Lancet study estimated a 15.3–16.6% increase.

Speaking to The Times, Dr. Rachel Issaka, a gastroenterologist at the University of Washington and the Fred Hutchinson Cancer Research Center, said colon cancer screenings, of any type, “are considered non-urgent, but they’re not optional.”

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