Posts in category: Health

As part of its private cloud strategy, Hitachi Vantara said Monday that it can reduce multi-vendor friction with a new private and hybrid cloud environment designed to upgrade hospitals’ IT backbones and better handle their data needs. 

Meanwhile, the largest rural healthcare system in the United States also announced that it is pursuing cloud modernization across its medical centers, clinics, senior living centers and other advanced care resources via a new partnership with Infor. 

And process automation company Qventus said it added real-time insights into perioperative and inpatient care platforms that could increase operating room access by three to six cases per OR per month and also automate clinicians’ bedside tasks after surgery.

VMware launches private, hybrid cloud

Hitachi pledged to lower organizations’ costs and energy consumption through a collaboration with Broadcom, which purchased VMware in November, the company said in an announcement.

In combining automation and software-defined services with enterprise infrastructure, the new private, hybrid cloud could help organizations modernize for improved data performance and scale. 

The platform deploys business and mission-critical workloads with highly available blended server-based virtualized storage – VMware vSAN – and external storage, according to Hitachi. It removes multi-vendor friction by providing a single source of truth for systems, solutions and services.

“This not only addresses the current challenges of data management and infrastructure modernization, but also aligns with organizations’ sustainability goals, making it an essential tool for businesses looking to thrive in the era of generative [artificial intelligence] and beyond,” Paul Turner, vice president of products in the Broadcom’s VMware Cloud Foundation Division, said in a statement.

Sanford Health partners with Infor

With unified processes, Sioux Falls, South Dakota-based Sanford Health will be able to break down silos and integrate core enterprise functions, according to an announcement Monday from Infor, a business cloud software vendor, about the new partnership.

Streamlining workflows across departments and gaining real-time insights could free up Sanford Health’s caregivers, the company said.

“We look forward to supporting Sanford Health in achieving greater operational efficiency and delivering exceptional healthcare services to the communities they serve,” Steve Fanning, senior vice president of Infor, said in a statement.

Last week, Infor also announced that it selected Amazon Bedrock for building and scaling embedded generative AI applications.

Qventus adds AI to ops platforms 

AI-powered digital assistants can help clinicians reduce the amount of time they spend on administrative tasks, which wastes an estimated $13 billion annually, according to Qventus.

To bridge the data-to-action gap, the company has added capabilities for analyzing complex data in real time – predicting patient needs and recommending specific actions – initially developed with providers including Ardent Health, Allina Health, HonorHealth, Northwestern Medicine and others.

With AI operational assistance, healthcare teams can practice “at the top of their license,” the company’s CEO and co-founder, Mudit Garg, said in a statement.

Frontline staff using the AI copilot in its inpatient platform to enhance bedside tasks could improve patient outcomes while the use of an AI assistant in the company’s perioperative care platform can automate procedural components of surgical and post-surgical coordination. 

The added insights could help hospitals prevent surgery cancellations, reduce manual burden on care teams and enhance productivity.

“Fragmented surgical coordination is a critical clinical challenge for our health systems partners,” Dr. David Atashroo, Qventus, chief medical officer, noted in the statement.

It has “drastically” reduced administrative burdens at HonorHealth, Kim Post, executive vice president and chief operations officer, added.

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.

The HIMSS AI in Healthcare Forum is scheduled to take place Sept. 5-6 in Boston. Learn more and register.

In May, charity representatives, campaigners and MPs gathered in parliament to hear the then Conservative MP Theo Clarke launch the UK’s first national birth trauma inquiry. More than 1,300 people had submitted evidence, including parents who had lost babies and women with lifelong injuries and post-traumatic stress disorder.

Also there that evening was Angela McConville, the chief executive of the National Childbirth Trust (NCT), a parenting charity best known for the antenatal groups it runs for expecting parents. “Genuine sadness and emotion in parliament tonight,” McConville wrote in a post on X.

Fiona Winser-Ramm of the Maternity Safety Alliance, a group of bereaved families campaigning for a public inquiry into maternity services, saw the tweet that night and says she “felt like screaming” with rage. In 2019, Winser-Ramm, a teacher and safeguarding officer, attended NCT classes while pregnant with her first child, Aliona. Aliona died on New Year’s Day 2020 due to neglectful care at her birth. Staff at Leeds General Infirmary didn’t act when there was meconium (a baby’s first faeces) in Winser-Ramm’s waters, nor when Aliona’s foetal monitor showed she was in distress, nor when Winser-Ramm and her husband repeatedly expressed concerns about how her labour was progressing.

Winser-Ramm, who is 38 and lives in Leeds, believes the NCT should have taught her information that could have saved her daughter’s life – such as the fact that she should have been informed of her daughter’s foetal monitor readings regularly. The NCT taught her, Winser-Ramm says, that “we don’t need to talk about these things [birth trauma and baby loss], because they don’t happen very often and most of the time it’s fine”.

When she saw McConville posting a selfie at the launch of the inquiry, she felt cold fury. “Watching them stand around, I felt like shouting: ‘You are the problem! You are contributing to this.’”

The NCT is the largest provider of antenatal education in the UK, running a mixture of private courses, which cost up to £299, and free-to-access classes on behalf of NHS trusts. According to the NCT, more than 75,000 people a year attend its classes to learn about childbirth and the post-birth period, as well as to make friends with other expecting parents in their area.

“It’s lovely to know other mums hitting the same hurdles as you, so you don’t feel alone,” says Sinead Knights, 38, a travel industry manager from Manchester who did NCT classes in October 2023. She describes them as “a space to share ideas and ask questions and not feel judged” and says she meets up with the mothers from her group weekly. “Hopefully, our babies will be friends for a long time, as the mums will as well,” Knights says.

For many parents, the support and camaraderie they found through the NCT is invaluable. But according to its critics, the NCT’s focus on natural birth – inherent in its original name, the Natural Childbirth Association – has contributed to real-world harm for parents and babies. When ideology enters healthcare, things can – and do – go wrong. Over the past decade, three independent, government-commissioned reports have identified natural birth philosophy, including a reluctance to perform caesareans, as a contributing factor in maternity scandals. So how did the NCT’s founding values come to have such an influence on UK maternity services?

The NCT was established in 1956 by Prunella Briance, inspired by the teachings of the British obstetrician Grantly Dick-Read. Childbirth, said Dick-Read, is not inherently painful. It hurt when women – usually educated women in western countries – felt fear, through what he called the “fear‑tension-pain syndrome”. If women relaxed and stopped worrying about childbirth, they could have painless, unmedicated births. Dick-Read became the NCT’s first president and his teachings were enthusiastically promoted by middle-class women, who met at antenatal groups in each other’s homes.

It is easy to see why these messages about natural birth became popular. Who wouldn’t want a painless, straightforward, unmedicated birth? In the 1950s, most women gave birth in hospital, where they were subjected to dehumanising treatment by doctors. They were shaved and given enemas; the unmerited use of forceps and episiotomies – cutting the perineum to widen the opening of the vagina – were routine. Many of the pioneers of the NCT endured traumatic hospital births. Briance’s first daughter was stillborn. The prolific writer and NCT tutor Sheila Kitzinger’s doctor gave her a “husband stitch”, an unnecessary suture to reduce the size of the opening to her vagina for the benefit of future sexual partners.

Over the coming decades, natural-birth activists rebranded childbirth from a degrading medical procedure to a life-affirming experience. Outcomes such as prolapses, haemorrhages and death often weren’t discussed, lest women become frightened and activate the fear-tension-pain syndrome.

At its earliest inception, an anti-medical agenda underpinned the NCT’s philosophy of birth. “As childbirth is not a disease it should take place in the home wherever possible,” read its founding statement. “If impossible the maternity units should be homely and unfrightening and in no way connected with ‘hospital’.” Reclaiming birth from male doctors – who would try to force medical interventions such as inductions, epidurals, forceps and C-sections on women – was seen as a feminist act.

Even by 2002, the NCT’s stance had not changed much from its original aims. “We would argue that the medical model of care, in which the perspective of doctors dominates the way services are run and developed, is a key contributory cause [to the rising caesarean rate],” read an NCT response to the health select committee. “The medical model of care concentrates on looking for pathology and intervening to treat pathology when it occurs. The model fails to understand that birth is a physiological process which needs to be protected and promoted.”

The NCT helped to popularise the term “cascade of intervention”: the idea that one intervention during birth, such as an induction or an epidural, begets another. In her 2013 book Do Birth, Caroline Flint, a former NCT teacher and trustee, provided women with a script to help them “negotiate” with doctors if they recommended unwanted medical interventions. “Many doctors find it almost impossible not to intervene unnecessarily,” Flint wrote. “They must always be doing something to help things along. When midwives are experienced and strong, they keep doctors away from women in normal labour … The tragedy of modern times is that doctors don’t see that their presence is an intervention in itself.”

One retired NHS obstetrician I speak to recalls getting a Christmas card from the NCT. It showed a male doctor scowling at a pregnant woman. “A normal birth?” he said. “You’re making life very difficult for us.” Behind his back, he held a folder titled “Caesarean”.

When contacted for comment, Flint said that she had “deep gratitude” for doctors and that modern medicine had saved her life on more than one occasion. However, regarding childbirth, she said she believes that the “modern invasive and pro-active approach” is “not appropriate”: “A woman who is infused with oxytocin during a normal labour is more ready to fall in love with her baby – this is really important. The love of a mother for her baby ensures the safety of that baby.”

The NCT has always been a campaign group. The fact that partners can support women during labour and that breastfeeding is legally protected is largely down to the work of its members. But the NCT has also lobbied for policies that now appear at best ill-judged, and at worst, dangerous.

In 1999, the NCT set up the Maternity Care Working Party (MCWP), a group that included members of the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG). One of the MCWP’s objectives was to reduce the rate of C-sections being performed in hospitals, which had “reached unacceptable levels”, according to the NCT’s then chief executive, Belinda Phipps. The NCT was not alone in raising this as a concern. The World Health Organization says there “is no evidence showing the benefits of caesarean delivery for women or infants who do not require the procedure” and that, since 1985, “the international healthcare community” has considered the ideal rate to be between 10% and 15%.

In the 12 years to July 2003, the C-section rate in the UK doubled. In 2000, the health department commissioned an audit of all births to determine why the rate had increased and found that one in five births in the UK were performed by caesarean. Compared with vaginal births, C-sections cost the NHS more, have a longer recovery time and higher maternal mortality rates, and carry risks of infection. For babies, they have been linked to increased rates, albeit very small, of obesity and asthma.

But despite these risks, a C-section is often the only way to deliver a baby safely. Had Winser-Ramm been given a caesarean earlier in her labour, her daughter would have survived. “These interventions can mean the difference between your baby being born alive and dead,” she says.

The NCT argued that most women preferred to have vaginal births, but were often denied the choice – and that, overall, “normal” births were much cheaper for the NHS. It argued that women should be supported to have home births or give birth in midwife-led units, where they were more likely to have a positive birth experience. It also argued that doctors were performing C-sections unnecessarily. By the early 2000s, the NCT had jettisoned the term “natural birth” in favour of “normal birth”, meaning a vaginal birth without interventions such as epidurals and C-sections.

If these “normal” births were painful, what of it? As Phipps told the Telegraph in 2008: “If we just dropped babies like eggs without noticing, what would that say about the responsibilities we’re taking on for the next 20 years? Birth marks you out as a mother and a carer for a very long time.”

Today, Phipps says: “It’s devastating to see the NHS has learned almost nothing and is still failing to provide women with a service which enables them to have a safe and empowering birth. Women want to be listened to and be taken seriously.”

Kim Thomas, the CEO of the Birth Trauma Association, freelanced for the NCT from 2009 to 2014. “We were always talking about the importance of evidence,” she says. “And yet there was this very clear ideological position in favour of normal birth and reducing the number of C-sections.” Her former colleagues, she says, were well-intentioned people, who sincerely wanted to make birth better for women. “They thought that promoting normality was the way to do it,” she says.

An academic who worked with the NCT in the 2000s, but prefers not to speak publicly, says that the NCT “did not have the power to change government policy themselves. There was a widespread recognition at the time that maternity services needed to be more women-centred. Their input was a response to hearing women’s stories of unconsented treatment and lack of autonomy.”

Over the 2000s, the NCT, through the MCWP, formed alliances with parliamentarians. In 2007, the NCT secured its greatest achievement, drafting a Normal Birth Consensus Statement with the RCM and the RCOG. The statement called for NHS trusts to promote and support normal birth, reduce interventions and publish statistics on how many women were having C-sections.

In 2010, the National Institute for Health and Care Excellence (Nice) published a toolkit, welcomed by the NCT in a foreword to the report, urging hospitals to aim for a C-section rate below 20% and ideally below 15%. Two years later, the NCT helped draft guidance for NHS clinical commissioning groups in England, in partnership with the royal colleges, that pressed them to aim for a C-section rate of 20%.

More than a decade of concerted lobbying had come to fruition. Normal birth was now official NHS policy.

In 2012, the same year that English hospitals were urged to aim for a C-section rate of no more than 20%, a pregnant woman was admitted to Shrewsbury and Telford hospital. She didn’t want a vaginal birth. She had already had one C-section and told staff she wanted another. But they persuaded her to have a vaginal birth. About one in 200 women who have a vaginal birth after one C-section will suffer a uterine rupture, which is when the uterus tears apart. It can be fatal for mothers and babies. The mother was given an oxytocin drip, also known to increase the risk of uterine rupture, and doctors failed to notice that her baby was stuck. The mother had a uterine rupture and her baby died. Shrewsbury and Telford NHS trust never apologised or identified any failings in her care.

A decade later, Donna Ockenden, a midwife, published her landmark report on maternity failings at the trust. The report found that 12 mothers and at least 124 babies died after receiving poor care.

Throughout the 2000s and the 2010s, Shrewsbury and Telford NHS trust was seen as a poster child for exemplary maternity care. Its C-section rate was just 16.3% in 2013-14, compared with an average in England’s NHS hospitals of 26.2%. The trust was extremely proud of its low C-section rate. “We have to do everything to get a vaginal delivery and we’ve got to keep the section rate low,” one member of staff told Ockenden’s investigators.

Ockenden found that women were talked into having vaginal births despite the fact that they had babies in breech position, they had previously had C-sections or their babies were in distress. C-sections were delayed unnecessarily, sometimes leading to the death of babies. Shortly before Ockenden’s report was published, NHS England told hospitals to stop pursuing normal births and that C-section targets were potentially unsafe.

Ockenden’s findings were not unique. In all three of the independent reports into the avoidable deaths of mothers and babies in English NHS maternity units over the past few years, a reluctance to perform caesareans and a push for natural births is identified as a contributing factor. In his 2015 report on failings at Morecambe Bay NHS trust, Bill Kirkup found that midwives pursuing “normal childbirth ‘at any cost’” had contributed to the deaths of three women and 16 babies shortly after birth. Kirkup’s 2022 report on what he described as the “deplorable and harrowing” deaths of dozens of babies at East Kent hospitals university NHS trust’s maternity services also found that normal birth was the “ideal that staff and women should strive to achieve”.

The NCT released statements in response to each of these reports. None of them make reference to the C-section targets it pushed for in the consensus statement or to the promotion of normal birth. The organisation did point to staffing and investment issues within NHS maternity services. An NCT response to Ockenden’s report read: “The report is clear in its recommendations. We wholeheartedly support the call for major investment to ensure a safe, skilled maternity workforce who feel valued and supported in their roles.” The RCM and the RCOG, who signed up to the normal birth consensus statement, have each apologised for their role in promoting normal births.

Four days before the publication of Ockenden’s report, however, the i paper found that the NCT had deleted some of the content on its website promoting normal birth. “Try to avoid stimulating the rational part of your brain [in labour],” read one deleted post. In another post that was taken down, the organisation advised women that a vaginal birth after four previous C-sections was as safe as a planned C-section. In reality, says Kenga Sivarajah, a senior obstetrician at King’s College hospital in south London, the risk of uterine rupture is so high that we don’t even have figures for it.

“My biggest issue with the NCT and other organisations in this space is that they have never taken real responsibility for their role in what happened to some mothers and babies,” says Pauline McDonagh Hull, who advocates for better access to elective C-sections.

According to the academic who worked closely with the NCT in the 2000s, “the NCT was working with others in good faith to improve wellbeing for mothers and babies. If there is a lesson, I guess it would be: ‘Consider longer-term unintended consequences of the changes you seek.’”

When contacted for comment, the NCT’s McConville said she wanted to start “by acknowledging the bereaved and traumatised parents at the centre of this story, who deserve immense compassion and empathy. Every parent has a fundamental right to a safe and supported birth.” She added that “some of NCT’s historical policy positions do not align with the needs of new parents today and do not reflect the current context in which parents are giving birth. We believe there is no such thing as a normal birth and today our charity’s vision, mission and strategy strongly reflects that.”

The NCT says its courses are evidence-based and do not favour normal over medicalised births, adding that its course materials were refreshed in 2019 to cover all the ways women can give birth, without promoting one way or another.

“Our mission is to support everyone who becomes a parent, regardless of their circumstances or the birth and feeding decisions they make,” says McConville. However, this message does not appear to have filtered through to all NCT trainers on the ground.

One NCT tutor recently shared a post advising women to lie to their doctors about their due date, implying that women shouldn’t listen to male doctors amid what she described as an “epidemic of induction” because “no uterus, no opinion”. Last month, a senior NCT policy adviser, Elizabeth Duff, was forced to apologise after a post on X that read: “Some women – not all – think of their about-to-be born baby in the same way as they will soon do of their newborn. And would consider carefully about giving powerful analgesics [painkillers] to their new baby, when perhaps cuddling, rocking, soothing strategies might help too.”

Conversations with multiple recent NCT attenders who responded to a Guardian callout reveal that natural birth is still foregrounded in classes, even after the 2019 changes.

Chelsea Fawcett, 32, a nurse from York, attended an NCT course during her pregnancy in 2023. She remembers her tutor saying that if she had an epidural, she was more likely to have a C-section. “She kept saying: ‘What we tell you is evidence-based.” (Epidurals do not increase the likelihood of having a C-section.) Fawcett had planned for an epidural, but, after attending the classes, “all these things I was open to before I was suddenly terrified of”, she says.

Her labour was excruciating, but Fawcett refused an epidural. “I was so scared of the ‘cascade of interventions’,” she says. “I thought it was better to push through the pain. Next time, I am definitely having an epidural.”

Sivarajah has encountered women in extreme distress who were rejecting epidurals due to misinformation about their risks. When she questioned where this misinformation came from, “I started to realise: they’ve been told this in their antenatal classes.”

Sivarajah had a positive experience attending NCT when she was pregnant. However, she wonders if the public understands “that NCT is run by non-medical professionals”. NCT tutors take a one-year course. There is no requirement for them to have medical or midwifery qualifications. “As an obstetrician, I’ve trained since I was 18,” says Sivarajah. “I’m 41. It’s taken me a long time to understand why some women are high-risk, why some women are low-risk.

“Doctors don’t intervene because we want to medicalise birth. I don’t go into a labour ward thinking: ‘I want to do a C-section on every woman here.’ But, unfortunately, there are some scenarios where that is the only way we can safely deliver a baby.”

Thomas says she often encounters women who “feel like failures if they haven’t had a ‘normal’ birth”. The historian Hilary Marland, who analysed the NCT’s campaign work from its formation in 1956 to the 1980s, found that its “model of idealised natural birth [may] have contributed to, rather than reduced, mothers’ mental distress”.

Helena, 39, works in change management and lives in south London. She started NCT classes in July 2021. Her trainer emailed the group, stating that men did not need to attend the session on pregnancy complications. (The trainer later said men could attend; some men were at the session.) “Surely that is the one where you really need your partner to know what is going on?” Helena says.

Many feel the problem is that NCT tutors are subject to very little oversight. “Historically, there’s been a lack of centralised quality control,” says Thomas. “Some NCT teachers did a good job. But others didn’t. And that’s where the problem lies.”

McConville says: “Over the last four years, we have been working to transform and modernise our charity to respond to this crisis in the UK’s maternity system, and to equip parents with comprehensive, accurate and impartial education, content and services. Of course, there is still more for us to do.”

Despite recent changes, a subtle pro-normal-birth approach remains on the NCT website. The risks of vaginal birth are downplayed: it describes the risk of urinary and faecal incontinence after a vaginal birth as “very small”. According to an evidence review by Nice, up to 49% of women who plan vaginal births will have urinary incontinence and up to 15.1% will have faecal incontinence for at least a year after birth.

Obstetric medicine has made childbirth safer than ever, but you need only to look at the curving steel of a pair of forceps, and feel the weight of them, to realise that birth can still be medieval. “Risk in labour can change from minute to minute,” says Sivarajah.

The birth trauma inquiry recommended that all NHS trusts provide antenatal classes. “We should treat women as adults,” says Clarke, who led the inquiry. “And we should allow them to make up their own minds. And we should give them the information so they can make an informed choice during childbirth.”

The former Conservative MP attended NCT classes when she was pregnant in 2022. “I was quite disappointed with the course content,” she says. “I feel there was very much a focus on natural birth. I was told: ‘We’ll be having a water birth, they’ll be following your birth plan.’ When I did try to raise risks in the group classes, they were dismissed and I was told we didn’t need to discuss that, because the likelihood was very low.” Clarke had a traumatic birth. “Given the NCT is the largest provider in the UK for antenatal education, they need to do a better job of informing women,” she says.

Clarke would like the NHS to run antenatal courses. But after the launch of the birth trauma report, the NCT put out a response that ended with it pitching to provide these classes. It already runs antenatal classes on behalf of five NHS trusts.

“We obviously don’t want to scare mothers who are about to give birth,” says Clarke. “At the same time, we must allow adults to have an informed choice. And I do not believe that’s currently the case in the UK.”

The NCT is not the only provider of information for pregnant women. The RCOG’s president, Ranee Thakar, admitted to the birth trauma inquiry that doctors don’t give women full information, “because we think that women will be frightened and they will want to have a caesarean section if we tell them about birth trauma”.

But we are at a turning point. The website birthfacts.org was compiled by an independent researcher after their partner had a traumatic birth injury. All of the information comes from official statistics or systematic reviews, meta-analyses and large, peer-reviewed studies. The author of the website, who is anonymous to protect their partner’s privacy, hopes that it will be a principal source of information for women.

At the University of Cambridge’s Winton Centre, researchers are working on a decision-making tool that will provide pregnant women with facts about different modes of childbirth, to be given out by NHS trusts. “Particularly within maternity, there has been a lot of paternalistic behaviour and not wanting to give people the full information,” says Alexandra Freeman, one of the tool’s authors. “We want to inform and not persuade, to give people information so that they can apply their own values to it, not to give them information that has already been filtered through a values set.” Freeman is horrified by the term “the cascade of interventions”: “We would never use that kind of language.”

The decision-making aid uses numbers wherever possible. “Language is really subtle,” Freeman says. “People slip in words like ‘fewer’, ‘only’, ‘less’, ‘more’. If you are saying ‘less’, how much less? We try to give numbers. We’d never say ‘only’. That turns a number into a persuasive form.”

What all this comes down to is information. What are antenatal classes for? Are they to educate or to persuade? Is something “evidence-based” if the evidence has been selected to reinforce a worldview? Should women be trusted with the fullest science available – acknowledging, of course, that science is never final? Will the truth frighten them or empower them to make better decisions?

“It’s awful to make a decision and find out you were basing it not on the full information and regretting that decision all your life,” says Freeman. “If you make a decision based on all the information and it doesn’t turn out well for you, it’s very different.”

People with postvaccine myocarditis did not share the typical mid-term complications associated with conventional myocarditis, based on a population-based study from France.

With 18-month follow-up of people who had been hospitalized for myocarditis during the COVID-19 pandemic, it appeared that composite clinical outcomes were more favorable if people had developed myocarditis soon after COVID-19 mRNA vaccination rather than conventional myocarditis (weighted HR 0.55, 95% CI 0.36-0.86).

Meanwhile, the risk of poor composite outcomes — counting hospital readmission for myopericarditis, other cardiovascular events, and all-cause death — was comparable between post-COVID-19 myocarditis and conventional myocarditis groups (weighted HR 1.04, 95% CI 0.70-1.52), according to Laura Semenzato, MSc, a statistician at Saint-Denis Cedex France in Paris, and colleagues.

These findings applied to young people and older myocarditis patients alike. “However, affected patients, mainly healthy young men, may require medical management up to several months after hospital discharge,” Semenzato’s group maintained in JAMA.

The authors added that their results, based on the French National Health Data System, are consistent with past data associating postvaccine myocarditis with a lower short-term risk of heart failure compared with other types of myocarditis.

“These data do confirm the largely favorable prognosis of patients with post-vaccine myocarditis. The extended follow-up provides additional reassuring evidence that while this is a real entity, very few patients suffer long term clinical consequences from this,” commented James de Lemos, MD, cardiologist at UT Southwestern Medical Center in Dallas.

The results support the notion that “vaccine associated myocarditis is fundamentally different, and much lower risk, than COVID myocarditis and non-COVID, non-vaccine myocarditis,” he told MedPage Today.

Indeed, although the preponderance of evidence points to a causal relationship between the first mRNA COVID-19 vaccines and myocarditis — occurring more often in young men and adolescent boys — postvaccine myocarditis has been rare and fairly mild. Reports show a few days of hospitalization being typical for recovery, and the fear of excess sudden cardiac deaths among affected people has yet to become reality.

“Given the effectiveness of vaccines, these facts point to the unmistakable conclusion that [coronavirus] vaccines remain a safe and crucial part of dealing with this now-endemic virus,” according to cardiologist James Januzzi Jr., MD, of Massachusetts General Hospital and Harvard Medical School, both in Boston.

Indeed, mainstream public health officials continue to endorse COVID vaccines for prevention among children and adults.

Last week, the FDA approved and granted emergency use authorization to the updated vaccines from Moderna (Spikevax) and Pfizer-BioNTech (Comirnaty) for people ages 6 months and older. These new vaccines target the KP.2 strain of SARS-CoV-2 to better target currently circulating variants.

CDC Director Mandy Cohen, MD, MPH, quickly endorsed giving these vaccines to every individual ages 6 months and older.

“I tell my patients on a routine basis they should be vaccinated when appropriate. Since a new variant is out there, rates of COVID are rising quite substantially. The good news is that a new version of the vaccine is now available, which is tailored for the current variant that is circulating,” Januzzi wrote in an email.

For their French cohort study, Semenzato’s group used a database that covered all individuals, ages 12-49 years, who were hospitalized for myocarditis between Dec. 27, 2020 and June 30, 2022.

These were 4,635 people included in total: 12% with postvaccine myocarditis (within 7 days after COVID-19 mRNA vaccine), 6% post-COVID-19 myocarditis (within 30 days of SARS-CoV-2 infection), and 82% conventional myocarditis (remainder of cases).

Patients with postvaccine myocarditis were younger and more frequently men compared with the other groups. Two-thirds of postvaccine myocarditis cases occurred after a second vaccine dose.

Trends in medical management of people after hospitalization were similar across the three myocarditis groups.

The authors noted that one patient with postvaccine myocarditis had required extracorporeal membrane oxygenation. After hospital discharge, the person died, and myocarditis was judged the most likely cause of death.

Semenzato and colleagues said 18-month follow-up was complete for 99% of the population.

Despite the large sample, they nevertheless cautioned that they were unable to capture cases of myocarditis that did not require hospitalization, and results may vary depending on how postvaccine myocarditis is defined.

One important question that remains unanswered in this field is why some people develop myocarditis after getting a COVID-19 mRNA vaccine and not others.

“The mechanisms producing myocardial injury after administration of a COVID-19 mRNA vaccine are not well understood, with various hypotheses such as an altered gene expression, direct immune activation by mRNA, molecular mimicry, immune dysregulation, or aberrant cytokine expression,” Semenzato and colleagues wrote.

Experts, including psychologists who specialize in body image, agree — making comments on someone’s appearance can be harmful, even if you think you have good intentions. 

Since you may not know what someone is going through, making comments about a person’s body, whether it’s the size, shape, or just about anything else, is not only inappropriate but also can be triggering, Rachel Goldman, a licensed psychologist based in NYC and Clinical Assistant Professor at NYU Grossman School of Medicine, told BuzzFeed News. 

“Unfortunately we don’t always see what people are struggling with. Like Ariana Grande, she wasn’t sharing that she was on antidepressants and eating unhealthy, nor should she have to, but people just assumed she was in a healthy place solely on her appearance,” Goldman said. “Further, Grande is a public figure, and although it may seem like her entire life is on display, it is not. She too has feelings, emotions, struggles, and it’s important that people remember that.”

Other celebrities, including actor and singer Selena Gomez, have also discussed body-shaming comments that have been made about their appearance. Gomez, who has spoken about having bipolar disorder and the autoimmune condition lupus, and has had a kidney transplant, discussed her experience in detail in a TikTok Live. 

“When I’m off of [medication(s)], I tend to kind of lose weight,” Gomez said. “I just wanted to say and encourage anyone out there who feels any sort of shame for exactly what they’re going through and nobody knows the real story.” (Immune system–suppressing medications are well known for causing weight gain as a side effect.)

People who have questions and concerns about Grande and Gomez may comment on their bodies, thinking they have the best of intentions. However, it’s better to keep any kind of comments on people’s bodies to yourself, experts told BuzzFeed News. In some cases, it can have a negative mental health impact or even trigger disordered eating. 

We asked experts who specialize in body image about the potential damage that can be caused by comments, and what you could say instead. 

Comments and body image issues

Body image refers to how you feel and think about your body, said Keri Gans, a registered dietitian and nutritionist based in New York City. 

Even positive comments might emphasize the importance of how someone looks, which is called appearance orientation. 

Research suggests that social comparison, even to one’s own body, can be associated with body dissatisfaction. 

“Negative comments can lead them to feel even more negative about themselves, possibly causing them to engage in unhealthy behaviors,” Gans said. “Even positive comments can be damaging because they may feel that they were not good enough before.”

People on social platforms were quick to add that comments were coming from a place of concern. However, comments of concern were being made through comparisons of Grande’s body throughout the years. Bodies do change over time, including fluctuations in weight and body composition, especially as we age. 

“Even if a comment comes from a good place, one should stay quiet. You never know what a person is going through,” Gans said. “Most importantly a person should listen, and only offer support if asked.” 

Weight-related comments can actually encourage disordered eating behaviors and be triggering, Goldman told BuzzFeed News. 

“If someone is struggling and/or participating in unhealthy behaviors to be at that weight, and they get comments like ‘you look so good,’ this can actually reinforce the negative or unhealthy behavior,” Goldman said. “Further, someone could internalize this and now question ‘what was wrong with me before,’ which also impacts someone’s body image, self-worth, self-esteem, which could also reinforce and lead to additional unhealthy thoughts and behaviors.” 

Here’s what you can comment instead

“There is a way to show support and concern without commenting on one’s body, weight, or shape,” Goldman said. “I always encourage people to pause and think about the words they are going to use, before they use them. Words matter and words can impact someone’s mental health.”

Model Bella Hadid, who has previously talked about comments about her appearance and body image issues in a Vogue interview, posted an Instagram post highlighting some compliments that are not appearance oriented. In her caption, she wrote, “There is so much more to you than the eyes can see…” 

Breast milk is universal — always has been. Whether it’s a poor woman in Africa breastfeeding her baby or a busy career woman in New York City expressing her milk with a pump so she can feed her baby when she gets home from work, mothers everywhere value breast milk for the nutritional benefits it offers to their infants — and also for its other important health attributes.

According to UNICEF, an agency of the United Nations, breastfeeding reduces the risk of sudden infant death syndrome (SIDS), childhood diabetes, heart disease, and obesity.

This August, the U.S. Breastfeeding Committee (USBC) is recognizing National Breastfeeding Month (https://www.usbreastfeeding.org/national-breastfeeding-month.html), by highlighting the reasons why protecting, promoting, and supporting lactation is so important for the human life cycle.

Yet not so long ago, women in “modern” times thought of breast feeding as “primitive” and were more than happy to switch to formula and bottles. In the United States, new moms left the hospital armed with information about bottle feeding but with nary a word about breast feeding. It was as though it was a thing of the past.

But times have changed and in recent years, breast feeding has seen a resurgence now that people are more aware of how important it is for the health of infants.

Currently, the World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life. The U.S. Dietary Guidelines for Americans recommend that infants be exclusively breastfed for about the first six months and then continuing breastfeeding while introducing appropriate complementary foods until the child is 12 months old or older.

Globally, the percentage of infants younger than six months exclusively breastfed has reached 48 percent, a 10 percent increase on the last decade.

Not just the baby
Surprisingly, breast milk isn’t food just for babies. It’s also food for the trillions of microbes that live in babies’ digestive systems and has evolved to promote the growth of microbes that help keep babies healthy, according to recent research.

Microbiologist David Mills, University of California-Davis, says that the third-largest constituent in breast milk is not there to feed the babies — it’s there to feed the microbes. 

In saying that, he’s referring to human milk oligosaccharides, complex chains of sugars found in breast milk. These complex sugars bolster the kinds of intestinal bacteria that can digest the compounds into short-chain fatty acids — ones that babies need to thrive.

However, there’s still more to learn about babies’ digestive systems and the microbes involved.

What about breast pumps?
A breast pump is a mechanical device that lactating women use to extract milk from their breasts so it can be stored for later use.. They may be manual devices or automatic devices powered by electricity.

Women who breastfeed often resort to using a breast pump for times when they’ll be away from their baby. Going to school or to work are examples of that. By using a breast pump, a mother can use the milk at a later time to feed her baby. Breast milk pumped from a mother’s breasts is called expressed milk.

Food safety and breast milk
Pregnant women, babies and young children are among those at highest risk for foodborne illnesses, which means that food handling is especially important for them. And that’s doubly true when it comes to breastfeeding.

Here are some food-safety tips for breast feeding or feeding expressed milk:

Before expressing your breast milk, wash your hands with soap and water or with an alcohol-based hand sanitizer that contains at least 60 percent alcohol. 

Make sure the area where you are expressing your milk is clean. That also goes for the pump parts and bottles.

Breasts and nipples do not need to be washed before pumping.

Date your milk when you freeze it. Store breast milk in the back of the freezer, not in the freezer door. That’s because the door is the warmest spot in the freezer and you don’t want to defrost the milk unintentionally.

Follow the manufacturer’s recommendations for preparing bottles before filling them with breast milk or formula.

 Transport bottles in an insulated cooler when traveling. Perishable items (milk, formula, or food) left out of the refrigerator or without a cold source for more than two hours should not be used. Cold temperatures keep most harmful bacteria from multiplying.

Breast milk can be stored in an insulated cooler with frozen ice packs for up to 24 hours when traveling. But as soon as you reached your destination, either use the milk right away, store it in the refrigerator, or freeze it.

Don’t put a bottle back in the refrigerator if the baby doesn’t finish it. Harmful bacteria from a baby’s mouth can be introduced into the bottle during feeding; they can grow and multiply even after refrigeration (some bacteria can grow at refrigerator temperatures) and reheating. The temperature that’s needed to kill harmful bacteria is extremely high for consumption by a baby.

Heating breast milk
Breast milk does not need to be warmed. It can be served room temperature or cold. But to warm it, use hot water by by putting the bottle under running tap water until the desired temperature is reached. This should take one-to-two minutes.

Or heat water in a pan but don’t put the bottle in the pan while heating the water.  Remove the pan from the heat and set the bottle in it until it’s warm. 

When heating the milk, always shake the liquid to even out the temperature and test on top of your hand — not the wrist as this is one of the areas least sensitive to heat — before feeding. Milk that’s “baby-ready” should feel lukewarm.

Heating breast milk in the microwave is not recommended. That’s because studies have shown that microwaves heat baby’s milk and formula unevenly. This results in “hot spots” that can scald a baby’s mouth and throat.

How to store breast milk after expressing it
Use breast milk storage bags or clean, food-grade containers to store expressed breast milk. Make sure the containers are made of glass or plastic and have tight fitting lids.

Never store breast milk in disposable bottle liners or plastic bags that are not intended for storing breast milk.

Freshly expressed or pumped milk can be stored:

•At room temperature (77 degrees F or colder) for up to 4 hours.

• In the refrigerator for up to 4 days.

• In the freezer for about 6 months is best; up to 12 months is acceptable. Recommended storage times are important to follow for best quality.

If you don’t think you will use freshly expressed breast milk within 4 days, freeze it right away. This will help to protect the quality of the breast milk.

When freezing breast milk, store small amounts to avoid wasting milk. Store in 2 to 4 ounces or the amount offered at one feeding.

Leave about one inch of space at the top of the container because breast milk expands as it freezes.

Go here (https://www.cdc.gov/breastfeeding/php/guidelines-recommendations/faqs.html) to learn more about storing and using breast milk.

Cleaning pumping equipment
Carefully clean, sanitize, and store pump equipment, baby bottles, and other feeding items to protect your breast milk from contamination. 

Go here (https://www.cdc.gov/hygiene/faq/index.html) to see Centers for Disease Control guidance on how to safely clean and store pump equipment and infant feeding items.

(To sign up for a free subscription to Food Safety News,click here)

A hard-won provision of the Affordable Care Act allows young adults to stay on their family’s health insurance until age 26. But after that, those without employer-sponsored insurance face an array of complicated choices, including whether to shop on the insurance plan exchange, apply for Medicaid, or roll the dice and go uninsured.

Are you a young adult confused about navigating the exchanges used to pick plans? Have you bought a plan on an ACA exchange and found that it didn’t cover care? Have you married or taken a job just to get insurance? Did you decide to go without coverage?

Whatever your story, we want to hear from you for a project we are doing with The New York Times.

We’ll read every response to this questionnaire, and we’ll reach out to you if we’d like to learn more about your story. We won’t publish any part of your response without following up with you first, verifying your information, and hearing back from you. And we won’t use your contact information for any reason other than to get in touch with you.

Have you found it difficult to pay for health insurance?(Required)Do you currently have health insurance, and, if so, what type?(Required)If you are uninsured, why? If you’ve had a medical issue while uninsured, what happened?

Please provide your name and contact information so we can reach out to talk further.

Name(Required)

First

Last

What is your date of birth?(Required)

Month

Day

Year

Email (will not be shared and will be used only by KFF Health News and the New York Times)(Required)

Enter email

Confirm email

Phone number (will not be shared and will be used only by KFF Health News and the New York Times)(Required)What is the best way for a reporter to contact you? (Select all that apply)

Email

Text

Call
Where do you live?(Required)

City

State / Province / Region

Would you be open to recording a short video sharing your experience?(Required)

Yes

No
What is your race/ethnicity? NameThis field is for validation purposes and should be left unchanged.

Δ

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

USE OUR CONTENT

This story can be republished for free (details).

We encourage organizations to republish our content, free of charge. Here’s what we ask:

You must credit us as the original publisher, with a hyperlink to our kffhealthnews.org site. If possible, please include the original author(s) and KFF Health News” in the byline. Please preserve the hyperlinks in the story.

It’s important to note, not everything on kffhealthnews.org is available for republishing. If a story is labeled “All Rights Reserved,” we cannot grant permission to republish that item.

Have questions? Let us know at KHNHelp@kff.org

Italian meatballs

Serves 6

Tip: Weekend cooking project: Make meatballs and chill in fridge. Freeze up to 3 months. Thaw in fridge overnight and bake, when ready.

1. Add 1/3 large onion.
2. Add 2 1/2 teaspoons minced garlic.
3. Saute 5 to 7 minutes.
4. Remove from heat.
5. Add 6 tablespoons grated parmesan cheese.
6. Add 1/3 cup chopped Italian parsley.
7. Add 1 1/2 tablespoons egg substitute.
8. Add 1 teaspoon kosher salt and 1/8 teaspoon ground black pepper.
9. Add 1 1/2 pounds lean ground beef.
10. Gently mix with hands until combined.
11. Form 1-inch meatballs.
12. Bake 10 to 15 minutes at 350 F.

Created by the executive wellness chef and registered dietitians at the Mayo Clinic Healthy Living Program.

A new report from the IBM Institute for Business Value makes the case that chief information officers need to understand that the technology landscape has changed fundamentally in recent years – and that a new era of artificial intelligence requires honing new skills and core competencies.

“IT as a standalone function is dead,” IBM researchers write. “Technology is the business.”

In the new age of generative AI – a fast-evolving landscape of ubiquitous digital tools – technology leaders in healthcare need to stay agile, adaptable, assertive and proactively communicative with their CEOs and CFOs in order to help drive competitive advantage for their organizations.

The report – which polled more than 2,500 CIOs, CTOs and CDOs across industries worldwide – pointed to a half-dozen potential “blind spots” that need addressing for modern day IT leaders in the AI era.

For instance, IBM research has shown that CEOs prize “product and service innovation” as their top priority in the next few years. But just 43% of the IT leaders surveyed said their organizations are effective at delivering differentiated products and services, and 53% said their own execs see technology “as no more than moderately important to product and service innovation,” according to the report. “This disconnect between technology and the business suggests a massive change is needed.”

Among some other stats:

• While almost 75% of CEOs are gung-ho about emerging tech and its ability to drive innovation, 43% of CIOs and IT execs report that their own concerns about their technology infrastructure have increased over the past six months because of gen AI.”

• Nearly 67% CFOs, meanwhile, say their leadership has the data necessary to capitalize on new technologies. But IT pros have a different view. “Only 29% of tech leaders strongly agree their enterprise data meets the quality, accessibility, and security standards that support the efficient scaling of generative AI.”

• More than half (58%) of IT leaders say they’re struggling to find the right talent to fill key roles.

• Fewer than 50% of those same execs say they’re adequately delivering on responsible AI practices such as explainability, transparency, and fairness

“Despite the evolution and emergence of enterprise technology roles, ‘technology’ has not consistently been a part of strategic decision-making for the business,” said IBM researchers in the report.

“The absence or ineffective participation of tech leaders has resulted in organizational blind spots that are making it difficult for organizations to seize today’s opportunities in artificial intelligence in all its guises – traditional AI, gen AI, machine learning, and automation,” said IBM researchers.

THE LARGER TREND
Healthcare IT News has long charted the evolution of the CIO job over the past decade-plus.

Way back in 2014, we were noting that the one-time “IT guy” was now a “skilled strategist at the executive table, with more demands on the role than ever.”

And that was before cloud-based AI and automation had infiltrated and transformed every corner of the health system.

Since then, other profiles have shown how the healthcare CIO’s mission and mandate are “shifting quickly toward innovation, transformation and revenue generation.”

We’ve also tracked the emergence of new C-suite roles, such as the entity information officer and – starting with a new feature series that kicked off just this week – the chief AI officer.

ON THE RECORD
“Tech CxOs must courageously expose the six blind spots that are preventing their organizations from achieving AI advantage,” said IBM researchers. “To overcome the barriers, tech executives need to command the honest, must-have discussions about the readiness of their organization to deliver breakthrough innovation and business outcomes.

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.

The HIMSS AI in Healthcare Forum is scheduled to take place Sept. 5-6 in Boston. Learn more and register.