maternal health
Making doula services more affordable
Adobe
Having a doula during and after childbirth can improve health outcomes, research has shown. Just ask Kendra Berger, who after the traumatic birth of her second child was grateful for a doula's help with her third. "My birth experiences between my second and third were like night and day," she said. "The third birth was peaceful and beautiful and I loved it." Berger's doula services were covered by Medicaid through a New York state program with the goal of reducing maternal mortality, which disproportionately affects Black women, and other racial disparities involving maternal health.
Eleven states currently reimburse doula services through Medicaid, but that coverage limits the number of visits and the amount it pays doulas. "The reimbursement rates are too low. Our organization relies on funding in addition to the reimbursement to pay our doulas," said Julissa Vazquez-Coplin of the Priscilla Project Manager at Jericho Road Community Health Center in Erie County. STAT contributor Anika Nayak has more.
cancer
Patients with certain types of cancer have higher risk of substance use disorders
Researchers have long known that heavy users of alcohol, tobacco, and some other substances face greater risks of developing certain types of cancer. The corollary is that some cancer patients may also be struggling with addictions. A team of researchers led by Devon Check at Duke University sought to estimate what proportion of cancer patients have a substance use disorder by cancer type.
Their study, published in JAMA Oncology on Thursday, found a lot of variation, with the highest prevalence of substance use disorder among people with melanoma, head and neck, cervical, esophageal, and gastric cancers. Clinicians may want to guide health services for substance use disorder towards these populations, Check told STAT's Angus Chen. In general, understanding how to integrate addiction care with cancer care is crucial for patient outcomes. "There are a few consequences you might be concerned about. One might be about prescribing opioids for pain, which can be indicated even with substance use disorder. Undertreated pain has all sorts of consequences, including someone's ability to tolerate life- saving or prolonging cancer treatment," Check said.
first opinion
A key aspect of the nurse staffing crisis is being overlooked
The exodus of nurses from the health care workforce has been bemoaned for some time. But another crucial role is also increasingly hard to fill: the nurse manager. "Think of nurse managers as the CEO of their respective unit," write Toby Bressler and Lauren Ghazal in First Opinion. They work directly with patients and their families, but are also responsible for setting the standards and work culture for their whole nursing unit.
Some organizations are adopting solutions to try to reduce turnover, including four-day work weeks, more tangible career advancement opportunities, and supportive mentorship programs. Bressler and Ghazal add that organizations also need to focus on attracting and retaining diverse nurse managers, particularly because it's a nurse manager's job to address inappropriate and discriminatory behavior — both within the teams they supervise and with patients. Read more.
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