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Eating clean also means exercising discipline even a person are are endeavouring to gain excess. Avoid junk food and eating elsewhere! Limit your cheat meals to a few times a week.

Cause why frequently have changed it, were to make it less complicated to remember. I mean, come on, Keto BodyTone Cyclical Keto BodyTone guidelines? That is a little slight tongue twister that created sure. And Go visit Calorie shifting, or Carb Cycling absolutely much for you to remember.

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Not only did I lower my carbohydrate intake, but as i ate carbohydrates, I only ate complex carbohydrates and i ate them fat.and point that, I eliminated all refined foods from my diet, all simple and starchy carbohydrates, sugars, caffeine and alcoholic beverage. Not eating these things is fundamental to you getting Reactive Hypoglycemia under supervision.

What exactly helps make fat burning diets complete the task? Successful diets are the correct associated with healthful proteins healthy carbs along with healthier bad fats. They will restrict or remove adverse fats and basic sugars realistically.

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    4994 (togel tang keluar kemarin)
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    Setelah itu anda terus hasil masing-masing angka perolehan dari larutan angka togel tadi adalah 3+1=4 serta 4+4=8.

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    4995 (togel yang keluar kemarin) 4+9+9 +4= 26

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  • Q: Rebuilding The Tower Of Babel - A CEO's Perspective On Health Information Exchanges AshleyRotton47323993 07.08.2019
    Defining a Health Information Exchange

    The United States is facing the largest shortage of healthcare practitioners in our country's history which is compounded by an ever increasing geriatric population. In 2005 there existed one geriatrician for every 5,000 US residents over 65 and only nine of the 145 medical schools trained geriatricians. By 2020 the industry is estimated to be short 200,000 physicians and over a million nurses. Never, in the history of US healthcare, has so much been demanded with so few personnel. Because of this shortage combined with the geriatric population increase, the medical community has to find a way to provide timely, accurate information to those who need it in a uniform fashion. Imagine if flight controllers spoke the native language of their country instead of the current international flight language, English. This example captures the urgency and critical nature of our need for standardized communication in healthcare. A healthy information exchange can help improve safety, reduce length of hospital stays, cut down on medication errors, reduce redundancies in lab testing or procedures and make the health system faster, leaner and more productive. The aging US population along with those impacted by chronic disease like diabetes, cardiovascular disease and asthma will need to see more specialists who will have to find a way to communicate with primary care providers effectively and efficiently.

    This efficiency can only be attained by standardizing the manner in which the communication takes place. Healthbridge, a Cincinnati based HIE and one of the largest community based networks, was able to reduce their potential disease outbreaks from 5 to 8 days down to 48 hours with a regional health information exchange. Regarding standardization, one author noted, "Interoperability without standards is like language without grammar. In both cases communication can be achieved but the process is cumbersome and often ineffective."

    United States retailers transitioned over twenty years ago in order to automate inventory, sales, accounting controls which all improve efficiency and effectiveness. While uncomfortable to think of patients as inventory, perhaps this has been part of the reason for the lack of transition in the primary care setting to automation of patient records and data. Imagine a Mom & Pop hardware store on any square in mid America packed with inventory on shelves, ordering duplicate widgets based on lack of information regarding current inventory. Visualize any Home Depot or Lowes and you get a glimpse of how automation has changed the retail sector in terms of scalability and efficiency. Perhaps the "art of medicine" is a barrier to more productive, efficient and smarter medicine. Standards in information exchange have existed since 1989, but recent interfaces have evolved more rapidly thanks to increases in standardization of regional and state health information exchanges.

    History of Health Information Exchanges

    Major urban centers in Canada and Australia were the first to successfully implement HIE's. The success of these early networks was linked to an integration with primary care EHR systems already in place. Health Level 7 (HL7) represents the first health language standardization system in the United States, beginning with a meeting at the University of Pennsylvania in 1987. HL7 has been successful in replacing antiquated interactions like faxing, mail and direct provider communication, which often represent duplication and inefficiency. Process interoperability increases human understanding across networks health systems to integrate and communicate. Standardization will ultimately impact how effective that communication functions in the same way that grammar standards foster better communication. The United States National Health Information Network (NHIN) sets the standards that foster this delivery of communication between health networks. HL7 is now on it's third version which was published in 2004. The goals of HL7 are to increase interoperability, develop coherent standards, educate the industry on standardization and collaborate with other sanctioning bodies like ANSI and ISO who are also concerned with process improvement.

    In the United States one of the earliest HIE's started in Portland Maine. HealthInfoNet is a public-private partnership and is believed to be the largest statewide HIE. The goals of the network are to improve patient safety, enhance the quality of clinical care, increase efficiency, reduce service duplication, identify public threats more quickly and expand patient record access. The four founding groups the Maine Health Access Foundation, Maine CDC, The Maine Quality Forum and Maine Health Information Center (Onpoint Health Data) began their efforts in 2004.

    In Tennessee Regional Health Information Organizations (RHIO's) initiated in Memphis and the Tri Cities region. Carespark, a 501(3)c, in the Tri Cities region was considered a direct project where clinicians interact directly with each other using Carespark's HL7 compliant system as an intermediary to translate the data bi-directionally. Veterans Affairs (VA) clinics also played a crucial role in the early stages of building this network. In the delta the midsouth eHealth Alliance is a RHIO connecting Memphis hospitals like Baptist Memorial (5 sites), Methodist Systems, Lebonheur Healthcare, Memphis Children's Clinic, St. Francis Health System, St Jude, The Regional Medical Center and UT Medical. These regional networks allow practitioners to share medical records, lab values medicines and other reports in a more efficient manner.

    Seventeen US communities have been designated as Beacon Communities across the United States based on their development of HIE's. These communities' health focus varies based on the patient population and prevalence of chronic disease states i.e. cvd, diabetes, asthma. The communities focus on specific and measurable improvements in quality, safety and efficiency due to health information exchange improvements. The closest geographical Beacon community to Tennessee, in Byhalia, Mississippi, just south of Memphis, was granted a $100,000 grant by the department of Health and Human Services in September 2011.

    A healthcare model for Nashville to emulate is located in Indianapolis, IN based on geographic proximity, city size and population demographics. Four Beacon awards have been granted to communities in and around Indianapolis, Health and Hospital Corporation of Marion County, Indiana Health Centers Inc, Raphael Health Center and Shalom Health Care Center Inc. In addition, Indiana Health Information Technology Inc has received over 23 million dollars in grants through the State HIE Cooperative Agreement and 2011 HIE Challenge Grant Supplement programs through the federal government. These awards were based on the following criteria:1) Achieving health goals through health information exchange 2) Improving long term and post acute care transitions 3) Consumer mediated information exchange 4) Enabling enhanced query for patient care 5) Fostering distributed population-level analytics.

    Regulatory Aspects of Health Information Exchanges and Healthcare Reform

    The department of Health and Human Services (HHS) is the regulatory agency that oversees health concerns for all Americans. The HHS is divided into ten regions and Tennessee is part of Region IV headquartered out of Atlanta. The Regional Director, Anton J. Gunn is the first African American elected to serve as regional director and brings a wealth of experience to his role based on his public service specifically regarding underserved healthcare patients and health information exchanges. This experience will serve him well as he encounters societal and demographic challenges for underserved and chronically ill patients throughout the southeast area.

    The National Health Information Network (NHIN) is a division of HHS that guides the standards of exchange and governs regulatory aspects of health reform. The NHIN collaboration includes departments like the Center for Disease Control (CDC), social security administration, Beacon communities and state HIE's (ONC).11 The Office of National Coordinator for Health Information Exchange (ONC) has awarded $16 million in additional grants to encourage innovation at the state level. Innovation at the state level will ultimately lead to better patient care through reductions in replicated tests, bridges to care programs for chronic patients leading to continuity and finally timely public health alerts through agencies like the CDC based on this information.12 The Health Information Technology for Economic and Clinical Health (HITECH) Act is funded by dollars from the American Reinvestment and Recovery Act of 2009. HITECH's goals are to invest dollars in community, regional and state health information exchanges to build effective networks which are connected nationally. Beacon communities and the Statewide Health Information Exchange Cooperative Agreement were initiated through HITECH and ARRA. To date 56 states have received grant awards through these programs totaling 548 million dollars.

    History of Health Information Partnership TN (HIPTN)

    In Tennessee the Health Information Exchange has been slower to progress than places like Maine and Indiana based in part on the diversity of our state. The delta has a vastly different patient population and health network than that of middle Tennessee, which differs from eastern Tennessee's Appalachian region. In August of 2009 the first steps were taken to build a statewide HIE consisting of a non-profit named HIP TN. A board was established at this time with an operations council formed in December. HIP TN's first initiatives involved connecting the work through Carespark in northeast Tennessee's s tri-cities region to the Midsouth ehealth Alliance in Memphis. State officials estimated a cost of over 200 million dollars from 2010-2015. The venture involves stakeholders from medical, technical, legal and business backgrounds. The governor in 2010, Phil Bredesen, provided 15 million to match federal funds in addition to issuing an Executive Order establishing the office of eHealth initiatives with oversight by the Office of Administration and Finance and sixteen board members. By March 2010 four workgroups were established to focus on areas like technology, clinical, privacy and security and sustainability.

    By May of 2010 data sharing agreements were in place and a production pilot for the statewide HIE was initiated in June 2011 along with a Request for Proposal (RFP) which was sent out to over forty vendors. In July 2010 a fifth workgroup,the consumer advisory group, was added and in September 2010 Tennessee was notified that they were one of the first states to have their plans approved after a release of Program Information Notice (PIN). Over fifty stakeholders came together to evaluate the vendor demonstrations and a contract was signed with the chosen vendor Axolotl on September 30th, 2010. At that time a production goal of July 15th, 2011 was agreed upon and in January 2011 Keith Cox was hired as HIP TN's CEO. Keith brings twenty six years of tenure in healthcare IT to the collaborative. His previous endeavors include Microsoft, Bellsouth and several entrepreneurial efforts. HIP TN's mission is to improve access to health information through a statewide collaborative process and provide the infrastructure for security in that exchange. The vision for HIP TN is to be recognized as a state and national leader who support measurable improvements in clinical quality and efficiency to patients, providers and payors with secure HIE. Robert S. Gordon, the board chair for HIPTN states the vision well, "We share the view that while technology is a critical tool, the primary focus is not technology itself, but improving health". HIP TN is a non profit, 501(c)3, that is solely reliant on state government funding. It is a combination of centralized and decentralized architecture. The key vendors are Axolotl, which acts as the umbrella network, ICA for Memphis and Nashville, with CGI as the vendor in northeast Tennessee.15 Future HIP TN goals include a gateway to the National Health Institute planned for late 2011 and a clinician index in early 2012. Carespark, one of the original regional health exchange networks voted to cease operations on July 11, 2011 based on lack of financial support for it's new infrastructure. The data sharing agreements included 38 health organizations, nine communities and 250 volunteers.16 Carespark's closure clarifies the need to build a network that is not solely reliant on public grants to fund it's efforts, which we will discuss in the final section of this paper.

    Current Status of Healthcare Information Exchange and HIPTN

    Ten grants were awarded in 2011 by the HIE challenge grant supplement. These included initiatives in eight states and serve as communities we can look to for guidance as HIP TN evolves. As previously mentioned one of the most awarded communities lies less than five hours away in Indianapolis, IN. Based on the similarities in our health communities, patient populations and demographics, Indianapolis would provide an excellent mentor for Nashville and the hospital systems who serve patients in TN. The Indiana Health Information Exchange has been recognized nationally for it's Docs for Docs program and the manner in which collaboration has taken place since it's conception in 2004. Kathleen Sebelius, Secretary of HHS commented, "The Central Indiana Beacon Community has a level of collaboration and the ability to organize quality efforts in an effective manner from its history of building long standing relationships. We are thrilled to be working with a community that is far ahead in the use of health information to bring positive change to patient care." Beacon communities that could act as guides for our community include the Health and Hospital Corporation of Marion County and the Indiana Health Centers based on their recent awards of $100,000 each by HHS.

    A local model of excellence in practice EMR conversion is Old Harding Pediatric Associates (OHPA) which has two clinics and fourteen physicians who handle a patient population of 23,000 and over 72,000 patient encounters per year. OHPA's conversion to electronic records in early 2000 occurred as a result of the pursuit of excellence in patient care and the desire to use technology in a way that benefitted their patient population. OHPA established a cross functional work team to improve their practices in the areas of facilities, personnel, communication, technology and external influences. Noteworthy was chosen as the EMR vendor based on user friendliness and the similarity to a standard patient chart with tabs for files. The software was customized to the pediatric environment complete with patient growth charts. Windows was used as the operating system based on provider familiarity. Within four days OHPA had 100% compliance and use of their EMR system.

    The Future of HIP TN and HIE in Tennessee

    Tennessee has received close to twelve million dollars in grant money from The State Health Information Exchange Cooperative Agreement Program.20 Regional Health Information Organizations (RHIO) need to be full scalable to allow hospitals to grow their systems without compromising integrity as they grow.21and the systems located in Nashville will play an integral role in this nationwide scaling with companies like HCA, CHS, Iasis, Lifepoint and Vanguard. The HIE will act as a data repository for all patients information that can be accessed from anywhere and contains a full history of the patients medical record, lab tests, physician network and medicine list. To entice providers to enroll in the statewide HIE tangible value to their practice has to be shown with better safer care. In a 2011 HIMSS editor's report Richard Lang states that instead of a top down approach "A more practical idea may be for states to support local community HIE development first. Once established, these local networks can feed regional HIE's and then connect to a central HIE/data repository backbone. States should use a portion of the stimulus funds to support local HIE development."22 Mr. Lang also believes the primary care physician has to be the foundation for the entire system since they are the main point of contact for the patient.

    One piece of the puzzle often overlooked is the patient investment in a functional EHR. In order to bring together all the pieces of the HIE puzzle patients will need to play a more active role in their healthcare. Many patients do not know what medicines they take every day or whether they have a living will. Several versions of patient EHR's like Memitech's 911medical id card exist, but very few patients know or carry them.23 One way to combat this lack of awareness is to use the hospital as a catch-all and discharge each patient with a fully loaded USB card via case managers. This strategy also might lead to better compliance with post in patient therapies to reduce readmissions.

    The implementation of connecting qualified organizations began earlier this year. To fully support organizations to move toward qualification the Office of National Coordinator for HIE (ONC) has designated regional education centers (TN rec) who assist providers with educational initiatives in areas like HIT, ICD9 to ICD10 training and EMR transition. Qsource, a non-profit health consulting firm, has been chosen to oversee TNrec. To ensure sustainability it is critical that Tennessee build a network of private funding so that what happened with Carespark won't happen to HIP TN. The eHealth Initiatives 2011Survey Report states that of the 196 HIE initiatives, 115 act independently of federal funding and of those independent HIE's, break even through operational revenue. Some of these exchanges were in existence well before the American Recovery and Reinvestment Act in 2009. Startup funding from grants is only meant to get the car going so to speak, the sustainable fuel, as observed in the case of Carespark, has to come from value that can be monetized. KLAS research reports that 54% of public HIE's were concerned about future sustainability while only 35% of private HIE's shared this concern.

    Hospital Implications of HIP TN (A Call to Action)

    From a Financial perspective, taking our hospital into the future with EMR and an integrated statewide network has profound implications. In the short term the cost to find a vendor, establish EMR in and outpatient will be an expensive proposition. The transition will not be easy or finite and will involve constant evolution as HIP TN integrates with other state HIE's. To get a realistic idea of the benefits and costs associated with health information integration. we can look to HealthInfoNet in Portland, ME, a statewide HIE that expects to save 37 million dollars in avoided services and 15 million in productivity reduction. Specific areas of savings include paper or fax costs $5 versus $0.25 electronically, virtual health record savings of $50 per referral, $26 saved per ED visit and $17.41 per patient/year due to redundant lab tests which amounts to $52 million for a population of 3 million patients. In Grand Junction Colorado Quality Health Network lowered their per capita Medicare spending to 24% below the national average, gaining recognition by President Obama in 2009. The Santa Cruz Health Information Exchange (SCHIE) with 600 doctors and two hospitals achieved sustainability in the first year of operation and uses a subscription fee for all the organizations who interact with them. In terms of government dollars available, meaningful use incentives exist to encourage hospitals to meet twenty of twenty five objectives in the first phase (2011-2012) and adopting and implement an approved EHR vendor. ARRA specified three ways for EHR to be utilized to obtain Medicare reimbursement. These include e-prescribing, health information exchange and submission of clinical quality measures. The objectives for phase two in 2013 will expand on this baseline. Implementation of EHR and Hospital HIE costs are usually charged by bed or by the number of physicians. Fees can range from $1500 for a smaller hospital up to $12,000 per month for a larger hospital.

    Perhaps the most compelling argument to building a functional Health Information Exchange is patient and community safety. The Healthbridge reduction in disease outbreak detection of 3-5 days is a perfect example of this safety benefit. Imagine the implications in the case of a rampant virus like avian or swine flu. The goal is to avoid a repeat of the 1918 influenza outbreak and ultimately save the lives of our most at risk. Rick Krohn of Healthsense makes the case for a socially responsible HIE that serves those who are chronically ill, uninsured and homeless. As the taxpayers ultimately bear the societal burden for our country's healthcare coverage, the need to reduce redundancies, increase efficiency and provide healthcare worthy of the United States is imperative. Right now our healthcare is in the Critical Care Unit it's time to stabilize it through operational excellence starting with our hospital. Let's rebuild the Tower of Babel and enhance communication to provide our patients the healthcare they deserve!
  • Q: How Decide An E-currency Exchanger SergioDahl0863011659 07.08.2019

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  • Q: Looking For A Attorney? Look No Further! BettinaGee63800 07.08.2019
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  • Q: After All, The Debt-collection Industry Isn't Exactly Beloved Among Consumers, With The CFPB Recording 84,500 Complaints About Debt Collection In 2017, Making It One Of The Most Complained-about Financial Services MarySmalls52452262 07.08.2019
    \ubc29\ud669\ud558\ub294 Borderer :: \ubc14\uce74\ub77c\uaddc\uce59Debt collecting is an age-old business but it may soon receive a 21st-century revamp when the Consumer Financial Protection Bureau, an agency created in the wake of the financial crisis to protect consumers, proposes new rules for the industry. Among the changes may be whether debt collectors can text and email borrowers as they pursue overdue funds. 

    The idea of debt collectors adding new methods of communication to their arsenal may stir annoyance, if not fear, among some consumers. After all, the debt-collection industry isn't exactly beloved among consumers, with the CFPB recording 84,500 complaints about debt collection in 2017, making it one of the most complained-about financial services.

    Debt collection is a big business in the U.S., a $10.9 billion industry that employs almost 120,000 workers who help track down overdue payments. Since the financial crisis, American consumers have taken on more debt, and some delinquencies, such as for auto loans, have been increasing. Against this backdrop is a CFPB that critics say has lost its appetite for going after financial abuses by corporations under Trump administration appointees who favor less regulation.

    Some consumer advocates say they worry updated rules for debt collectors may lead to an unwelcome flurry of texts, emails and 카지노 바카라 calls to consumers who owe money. 

    "I'm really terrified the rule will say, 'Now you can contact them 10 times a day," every debt collector will max out on it," said Linda Jun, senior policy counsel at Americans for Financial Reform, a nonprofit group formed after the financial crisis to advocate for Wall Street regulation. 

    For its part, the CFPB argues the law that oversees debt collections -- the Fair Debt Collection Practices Act -- is long overdue for an update. The law was passed in 1977 and hasn't been updated to reflect new technologies like email and texting, said CFPB director Kathleen Kraninger in a Wednesday speech. 

    "This was the same year that Steve Jobs introduced the world to the idea of a personal computer with the design of the Apple II," Kraninger said. "Phone booths were on almost every corner and cell phones were not even imaginable."

    Right now, debt collectors don't typically rely on texting or emailing to reach consumers because the law is unclear, said Mark Neeb, the CEO of the Association of Credit and Collection Professionals, the trade group for the debt collection industry. 

    "It's not illegal but it's fraught with a lot of potential pitfalls," he said. "The rules aren't clear because there just aren't any."

    Permitting texting and emailing may improve the consumers' experience with debt collectors, Neeb said. Consumers will have more control over how they are contacted, he said, adding that debt collectors could send a "nudge" via text or email to repay a bill.

    "Debt collectors aren't looking to deluge consumers with communications," he said. 

    But there's another reason why the debt-collection industry is pushing for a regulatory green light to text and email: Smartphone-addicted millennials are more likely to text than answer or place a call. "Phone communication is going to be less and less prevalent" as younger generations come of age, Neeb noted.

    He added, "While they may not be dancing in the streets because they are getting contacted by debt collectors, their credit is at stake."
  • Q: "Of Course Israel Is More Than Willing And Has Expressed Its Agreement To Go Back To The Negotiation Table, But Apparently It's Going To Take A Little More Time." While Israel Has Balked At Palestinian Demands, The International Community H MillieBnh781332055 07.08.2019
    Updated at 7:37 a.m. Eastern

    AMMAN, Jordan After Palestinian leaders demanded further guarantees before restarting talks with Israel, U.S. Secretary of State John Kerry discussed his ideas with the chief Palestinian negotiator in Amman on Friday, and decided to continue his efforts later in the day in the West Bank with Palestinian leader Mahmoud Abbas.

    A stormy, high-level meeting of senior Palestinian leaders called to discuss Kerry's latest peace proposal ended with a decision early Friday to demand that Israel agree on the general border of a future Palestinian state, officials said.

    The demand cast a cloud of uncertainty over months of U.S. mediation efforts because Israel rejects preconditions.

    Hoping to push Israelis and Palestinians toward talks, President Obama asked Israeli Prime Minister Benjamin Netanyahu to work with Kerry "to resume negotiations with Palestinians as soon as possible," according to a statement released by the White House late Thursday.

    No details were immediately available about Kerry's meetings Friday with Erekat, the first of which lasted about an hour and the second, after a short break, an hour and 바카라 가입 머니 a half. Neither of the men spoke publicly after the meetings, but the U.S. State Department confirmed that Kerry would travel to the Palestinian territory of the West Bank to meet Erekat's boss, Palestinian Authority President Mahmoud Abbas, later Friday

    />The Palestinians demand is that the starting point for border talks must be the cease-fire line that held from 1949 until the 1967 war, when Israel captured the West Bank. Gaza Strip and east Jerusalem. Israel withdrew from Gaza in 2005

    />Palestinians claim those territories for their future state, with modifications reached through agreed land swaps that could allow major Jewish settlement blocs built in the West Bank becoming part of Israel proper, in exchange for territories in Israel

    />Previous Israeli governments twice negotiated on the basis of the 1967 lines, but no peace accord was reached

    />Palestinian official Wasel Abu Yussef said Erekat would ask for more clarifications from Kerry on what Israel expects from negotiations

    />Abu Yussef said Palestinians did not want to reject Kerry's efforts to restart negotiations outright

    />The Palestinians did not bring up their often-repeated demand that Israel stop building in Jewish settlements in the West Bank and east Jerusalem before talks could resume. One official said that if Israel accepts the 1967 lines as a basis, that would make most of the settlements illegitimate

    />CBS News correspondent Margaret Brennan reported Friday that the Israelis have come under increasing pressure -- particularly from Europe -- for their increasing settlement construction on Palestinian land

    />The European Union published new guidelines Friday explicitly banning any EU funding of Israeli institutions operating in territories occupied since the 1967 Mideast war, amid vigorous
  • Q: Tommy Chong: Legalize Marijuana To Boost U.s. Economy' AdaReay31583463320827 07.08.2019
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  • Q: Overall, Mortality Rates From Colorectal Cancer In Adults Age 20 To 54 Declined From 6.3 Per 100,000 In 1970 To 3.9 In 2004 ErnaHales083053 07.08.2019
    In recent years, reports have consistently shown colorectal cancer rates have been rising in Americans under the age of 55.

    Now, a new study finds that not only are cases increasing, but deaths from colorectal cancer are also on the rise in this age group.

    Researchers say the findings are particularly worrisome because this means the increase in diagnoses in this age group is not solely the result of more screening with colonoscopies.

    "This is not good news. We looked at adults from ages 20 to 54 and following several decades of pretty rapid declines in death rates, over the past decade deaths in this age group have been increasing," lead investigator Rebecca Siegel, strategic director of surveillance information services at the American Cancer Society, told CBS News. "This indicates that there's actually a true increase in disease. It's not just detection of disease that was there and that we're catching it earlier."

    Researchers said the increase colorectal cancer deaths in people in their 50s was particularly unexpected since screening -- which can both prevent colon cancer and detect it early -- has been recommended starting at age 50 for decades.

    Using data from the National Center for Health Statistics, the researchers analyzed colorectal cancer deaths in people aged 20 to 54 from 1970 through 2014. The analysis included more than 242,000 people who died from colorectal cancer during this time. The study is published in the Journal of the American Medical Association.

    Another striking finding was that the trend is being driven by increases in colorectal deaths among white men and women. Although African-Americans are still more likely to die from colon cancer than whites, the rate among African-Americans has declined.

    Overall, mortality rates from colorectal cancer in adults age 20 to 54 declined from 6.3 per 100,000 in 1970 to 3.9 in 2004. After 2004, death rates began to increase slightly each year, reaching 4.3 per 100,000 in 2014.

    In white individuals, death rates increased from 3.6 per 100,000 in 2004 to 4.1 in 2014. In contrast, mortality declined over time for African-Americans, from 8.1 in 1970 to 6.1 in 2014.

    These findings are consistent with an increase in the number of whites getting diagnosed with colorectal cancer, but not blacks.

    However, Siegel says it's still surprising because the findings are inconsistent with trends for major risk factors for colorectal cancer like obesity.

    "The thinking has been that the reason we're seeing the increase in this disease is because of the excess body weight we've been dealing with for the past several decades, but the obesity epidemic has affected everyone universally across races and ethnicities and if anything the increase in obesity in the black population has been higher," she said.

    So what's going on? "The answer is that no one really knows why this is happening," Siegel said.

    Obesity and the sedentary lifestyle common among many Americans are likely contributing to rising cases and deaths from colorectal cancer, but it's "unclear the extent to which these factors are contributing because of the racial disparity," Siegel said.

    While research is ongoing to look into what may be causing this, experts believe the answer may lie at least partly in the microbiome -- the bacteria that normally thrive in the body.

    "We're learning more and more all the time about how important the balance of the microbiome is, particularly in the colon and how that relates to health," Siegal said. "I think we're going to need more time for etiologic studies to try to understand this."

    In the meantime, 릴 사이트 she emphasizes that while the overall risk of colorectal cancer in young and middle aged adults is still very small, there are preventive steps doctors and patients can take to protect themselves.

    If caught in the early stages when colorectal cancer is confined to the bowel, treatment results in a cure approximately 50 percent of the time, according to the National Cancer Institute.

    Symptoms of colorectal cancer include pain in the abdomen, bloody stool, constipation, weight loss, and change in bowel patterns.

    "It probably isn't cancer for people who are young or middle aged, but it could be," Siegal said, "so if we can get earlier detection in younger age groups then we can reduce the mortality and try to turn this trend around even before we know what's causing the increased incidence."
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