Download Preventing Urinary Tract Infections

PatriotLife
JO H N S H O PK I N S U S FA M I LY H E A LTH PL AN
FALL 2014
AGING
at HOME
Preventing Urinary
Tract Infections
Get Screened
When to See
Your Doctor
TO YOUR HEALTH
Preventing Urinary Tract Infections
U
rinary tract infections are the second most common type of infection in the body. They occur when
microorganisms, such as bacteria from the digestive tract, cling to the opening of the urethra—the tube
that carries urine from the bladder out of the body—and begin to multiply. Symptoms include frequent
urination and pain or burning while urinating.
Women are more susceptible than men when it comes to urinary tract infections, says Kimberly Turner, M.D., a Johns
Hopkins Community Physicians obstetrician and gynecologist who practices in Columbia, Maryland. The reason is
simple. “Women have a shorter urethra, so there is a shorter link between sterile and non sterile areas,” she says.
To help avoid urinary tract infections, follow these tips:
•Practice good hygiene by wiping from front to
back after urinating.
•Urinate after sexual intercourse to flush any bacteria out of the urinary tract.
•Urinate when you feel the need to go.
•Drink lots of water.
•Drink cranberry juice, which is acidic and contains
vitamin C, which can inhibit the growth of some bacteria.
A urinary tract infection can be diagnosed with
a urinalysis and treated with oral antibiotics. “Early
treatment is the most important, because you don’t want
this infection to spread to the kidneys,” Turner says.
She advises that you should call your health care
provider if you suspect you have a urinary tract infection
and the symptoms do not subside within the first 24
hours.
Get Screened
S
creening tests help your doctor look for certain
diseases before symptoms appear. This is important,
because, with some diseases, you may not have
symptoms right away. The disease could get worse before
you know you have it.
To learn more about screening tests, visit hopkinsmedicine.
org/usfhp/library.html or talk to your provider about the
recommended screenings for you and your family.
2 • PatriotLife • FALL 2014
www.hopkinsmedicine.org/usfhp
Doing More
to Address Military
Health Problems
M
ilitary veterans and active duty service members
have unique health issues—from traumatic brain
injury to post traumatic stress syndrome—that
have not always been adequately addressed by
the nation’s traditional funding system for medical research.
The Johns Hopkins Military and Veterans Health Institute, launched in May 2013, has been established to put
the spotlight on solving these important health problems,
thereby improving the lives of service members, veterans
and military families.
The idea for the institute was first conceived several years
ago by Mary Cooke, vice president of military and strategic
alliances and the Johns Hopkins US Family Health Plan,
whose goal was to provide the DoD and Department of
Veterans Affairs with a front door to all Johns Hopkins
entities and“to create a model for the nation.” Today, with
retired Maj. Gen. James Gilman, M.D., at the helm as
director, the Johns Hopkins Military and Veterans Health
Institute brings together a wide range of experts from Johns
Hopkins Medicine, the Applied Physics Laboratory, the
Bloomberg School of Public Health, the Whiting School of
Engineering, and other research and academic departments
across Johns Hopkins.
We spoke recently with Gilman, who came to Johns
Hopkins following a 35-year career as an Army physician,
about the institute’s work and successes.
Why is the Johns Hopkins Military and Veterans
Health Institute needed?
resources of Johns Hopkins, our commercial and academic
partners, and the best and brightest at the DoD and the Department of Veterans Affairs to take care of them and to improve their care through training, research and education so
that 10 years from now, their lives are even better than they
are now.
What successes has the institute had so far?
We were asked to fund a project at Walter Reed National
Military Medical Center involving undergraduate mechanical engineering majors from the Whiting School of Engineering. With a $12,000 grant from the institute, these four
students addressed a problem identified at the military amputee training center about how to control heat and perspiration
inside the socket of a prosthetic limb of an amputee undergoing endurance athletic activity. The students created a liner
for the prosthesis containing tubes circulating an ice water
solution and equipped the amputee with a small backpack
and peristaltic pump. They won their senior design day competition and have applied to the Technology Transfer Office
here at Johns Hopkins, and it looks like there’s going to be a
provisional patent application for their invention.
In addition, we just announced the winners of the Russell Military Scholars Program. We had 53 applications for
$100,000 in research grants, which we awarded to seven
Johns Hopkins investigators working on projects relevant
to service members, veterans and their families (see photo
below). We are hoping this work can make a difference.
Meeting the Need
Most of the seven projects being funded through the Russell Military Scholars Program cover the three biggest issues
faced by members of the armed forces today: traumatic brain
injuries, behavioral health problems and severe physical injuries caused by improvised explosive devices. “The projects
that the awardees designed indicate that they understand
what is important to our service members, our veterans and
their families,” says Gilman.
Service members, veterans and their families have a number
of fairly unique health and health care challenges that can get
underplayed. These problems, which include traumatic brain
injury; psychological health issues like PTSD, drug and alcohol abuse; homelessness; and composite tissue damage caused
by improvised explosive devices, are America’s problems, not
just the Department of Defense’s or the federal government’s
problems. Therefore, we must leverage the resources of the
entire country if we are going to take care of these young
men and women and develop better ways to take care of
them in the future.
Why is the work of the institute so important?
There are a large number of people at Johns Hopkins who
believe the institution can and should do more for veterans,
service members and their families. And I believe now is the
time, because we are going to be dealing with these young
men and women who have been to war again and again
and again for a long time. It will take all of the collective
www.hopkinsmedicine.org/usfhp
From left, Johns Hopkins Whiting School of Engineering student
Matthew Jorgensen, Maj. Gen. James Gilman, M.D., and Johns
Hopkins Whiting School of Engineering student Josh Charest.
PatriotLife • FALL 2014 • 3
COVE R STORY
Right at Home in the
Golden
Years
Most elderly people would prefer to “age in place,” in the familiarity of their family home. Fortunately, there are easy-to-adopt strategies to prevent perils and ensure well-being.
B
looming rooftop gardens. White-table-
Hospital in Washington, D.C. “They want something that’s
cloth dining rooms serving gourmet
familiar and feels more secure.”
meals. Sunny swimming pools and ten-
Nearly 90 percent of people over 65 want to continue to live
nis courts where one can swim and play
at home for as long as they can, a 2011 AARP survey found.
with visiting family members.
And about 30 percent—or 11.3 million—of older adults live
Advertisements for assisted living
alone, according to the U.S. Census.
facilities for seniors boast all of these features and more. But for
But living at home independently as a senior comes with
many people over 65, living independently in their own home is
its share of potential perils. From safely navigating the house,
a far more attractive option.
to maintaining a healthy diet, to staving off isolation and
“The majority of folks want to stay home as long as possible
depression, there are a host of issues to consider. Here are some
today,” says Jim Williams, M.D., a family practitioner with
tips on how can you help yourself, an elderly family member or
Johns Hopkins Community Physicians at Sibley Memorial
friend live at home without jeopardizing health and well-being.
4 • PatriotLife • FALL 2014
www.hopkinsmedicine.org/usfhp
Make your home safe. Each year in the U.S., one in
three people over the age of 75 has an injury-causing fall, making
falls the leading cause of injury-related death and hospitalization
among seniors. Physical changes and health conditions can make
falls more likely in older adults, Williams says, as can medications. “They might be managing medications on their own and
taking the wrong doses, or there may be side effects,” he says. To
help prevent falls, make sure hearing and vision screenings are up
to date, since certain eye or ear disorders can increase falling risk.
Also, “slip-proof” a house by making sure it is well-lit and free of
clutter, and that any rugs are secured. Finally, make a list of all
the medications being taken and bring it to the next doctor’s appointment for review.
Get out and get moving. Regular physical activity—at least 30 minutes a day—benefits an aging body and
mind. Benefits include stronger muscles and bones and a reduction in arthritis pain. Seniors who exercise regularly improve
their balance and reduce their risk of falls by 20 to 30 percent.
There’s also increasing evidence that improved blood flow to the
brain brought on by physical activity can help keep the brain
sharp, lower the risk for dementia and decrease depression, which
affects about 6 million Americans who are 65 and older.
Eat a balanced, nutritious diet. The Mediterranean diet, which is rich in fruit, vegetables, whole grains, fish
and olive oil, has been shown to help people avoid dementia
and other health risks. Yet for many seniors, “it can be a burden
to prepare fresh meals, so instead they will eat a diet of simpler
foods, like snacks, which aren’t as nourishing,” Williams says.
“That’s why prepared meals are a big difference-maker for se-
niors’ nutrition.” Cook and share healthy meals packaged in
single portions with an elderly friend. You can also use your
local agency on aging to find community partners that deliver
reduced-cost or free prepared meals to eligible seniors.
Sleep well. Between 50 million and 70 million Americans
fail to get a good night’s sleep, and many of them are over 65.
Increased restlessness, anxiety and health issues like sleep apnea
and reflux can cause seniors to miss out on sleep. The loss is
critical. Lack of quality sleep has been linked to cognitive and
functional impairment in older adults, as well as increased risks
for depression, type 2 diabetes, high blood pressure and even
biomarkers for Alzheimer’s. To increase their amount of quality
sleep, seniors should avoid caffeine and alcohol, focus on positive
thoughts at bedtime, and eschew over-the-counter sleep aids for
good sleep hygiene habits, like creating a peaceful bedroom and
establishing a bedtime routine.
Don’t go it alone. Aging well at home means staying healthy with regular screenings and doctor visits. But lack
of access to services and a changing health system can make
this difficult. “With baby boomers entering their older years, a
demand for primary care services will rise, and there’s already a
shortage of primary care physicians,” Williams says. Community
partners, like senior centers and hospital senior groups, can help
elderly patients get what they need. For example, many senior
service organizations hold blood pressure, vision and hearing
screenings, as well as flu shot clinics. “It’s not just the doctor and
the patient figuring it all out anymore. It’s the doctor, the patient,
the family and the community partner coming up with a new
model for care.”
Here are some resources that can help to locate
services that can keep elderly friends or family
members healthy and safe in their own homes:
• The Johns Hopkins Healthy Aging Web portal offers
information about aging well, and advice for getting
good medical care and navigating the medical system at
hopkinsmedicine.org/health.
• The Meals on Wheels Association of America can connect
you with a prepared meal delivery service for seniors in your
area. Visit mowaa.org or call 888-998-6325.
• The U.S. Administration on Aging’s Eldercare Locator can help
you find services for seniors in your community at eldercare.
gov/eldercare.NET/Public/index.aspx or 800-677-1116.
• Iona Senior Services is a top Washington-area resource for
delivered meals, day programs and other services for seniors.
Visit iona.org or call 202-895-9448.
www.hopkinsmedicine.org/usfhp
PatriotLife • FALL 2014 • 5
BRIE FING ROO M
TRICARE Prime Premium Increase
Johns Hopkins US Family Health Plan has been notified by the
Department of Defense that enrollment premiums will increase
effective Oct. 1, 2014, as follows:
Plan Type:
Annual
Quarterly
Monthly
Individual:
Family:
$277.92
$555.84
$69.48
$138.96
$23.16
$46.32
When to See Your Doctor
W
hen you are sick, not feeling well or injured, the best option is to call your primary care provider.
Your provider knows you, can provide you with the best advice and correct treatment, and may
make a same-day, evening or weekend appointments. If you need immediate, non life-threatening
care after normal business hours, visit an urgent care center for treatment.
Hospital emergency rooms are designed to focus on clinical emergencies, not routine health care, so in most
cases you won’t need emergency room services, which are more costly and take longer to access.
Here are some examples of when to visit your doctor, an urgent care center or the emergency room:
Your Doctor
Urgent Care
Emergency Room
• Sprains and strains
• Broken bones or sprains
• Pain – sudden and severe
• Minor cuts and burns
• Moderate abdominal pain
• Chest pain
• Colds and coughs
• Ear infections
• Severe difficulty breathing
• Fever
• Fever, flu like symptoms, colds,
allergic reactions
• Minor injuries
• Rashes or minor swelling
• Check ups and vaccinations
• Minor burns or injuries
• Animal bites
• Difficulty breathing
• Severe bleeding
• Head injury or other major
trauma
• Stroke (signs include: sudden numbness,
tingling or loss of movement in face, arms
or legs, especially on one side of the body,
sudden vision change, and sudden, severe
headache.)
• Animal bites, if directed by urgent
care provider
If you are having a true medical emergency, your doctor will direct you to the emergency room. Some problems
that seem minor can become serious if you ignore them. You can always call your doctor’s office or a nurse line for
help.
After your primary care office closes, the Nurse Chat is a free service for Johns Hopkins USFHP members that
provides immediate access to a registered nurse who can answer your questions and provide some medical advice.
Members can call 1-866-444-3008 and be connected directly with a nurse. You can also go online and chat with a
nurse to discuss your circumstances and related symptoms at nurselinechat.com/jhhcusfhp, 24 hours a day, seven
days a week. The nurse will help you to make your decision about what steps to take next.
6 • PatriotLife • FALL 2014
www.hopkinsmedicine.org/usfhp
October Is
Breast Cancer
Awareness Month
While breast cancer is the second most deadly cancer among women in the U.S., early detection
can save lives by catching the cancer early when it’s most treatable. For mammogram screening
guidelines, survivor stories and more information, visit hopkinsmedicine.org/news/stories/
october_breast_cancer_awareness_month.html.
Seal of Excellence
T
he National Committee for Quality Assurance (NCQA®) has awarded Johns
Hopkins US Family Health Plan its highest accreditation status of Excellent
for service and clinical quality that meet or exceed NCQA’s rigorous
requirements for consumer protection and quality improvement. HEDIS® and
CAHPS® results are in the highest range of national performance.
NCQA® Health Plan Accreditation evaluates how well a health plan manages
all parts of its delivery system -- physicians, hospitals, other providers and
administrative services -- in order to continuously improve the quality of
care and services provided to its members.
NCQA® Health Plan Accreditation surveys include rigorous on-site
and off-site evaluations of over 60 standards and selected HEDIS®
measures. A team of physicians and health plan experts conducts accreditation surveys. A national oversight committee of physicians analyzes the team’s findings and assigns an accreditation level based on
the performance of each plan being evaluated to NCQA’s standards.
NCQA® is a private, non-profit organization dedicated to improving
health care quality. NCQA® accredits and certifies a wide range of
health care organizations. It also recognizes clinicians and practices in
key areas of performance. NCQA® is committed to providing health
care quality information for consumers, purchasers, health care providers and researchers.
www.hopkinsmedicine.org/usfhp
PatriotLife • FALL 2014 • 7
PatriotLife
Patriot Life, the official newsletter of the Johns Hopkins US
Family Health Plan (USFHP), is published quarterly by Johns
Hopkins Medicine Marketing and Communications. For more
information, call 800-808-7347.
Mary Cooke, Vice President, USFHP
Melissa Teves, Senior Director, Administration, USFHP
Keith Langrehr, Marketing Director, USFHP
Susan Fratto, Marketing Manager, USFHP
Sue De Pasquale, Editor
Maria Blackburn, Writer
Jason Teves, Designer, USFHP Project Manager
www.hopkinsmedicine.org/usfhp
© 2014 The Johns Hopkins University and
The Johns Hopkins Health System Corporation
Johns Hopkins US
Family Health Plan
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