The GOP has abandoned its plans to revamp Medicare as new forecasts indicate Medicare's trust fund is in poor shape partly due to Republican tax cuts, reports Politico Pro . A Medicare board of trustees' report says those cuts will add $1.5 trillion to the deficit, slowing the flow of Medicare funding and further destabilizing the program. Furthermore, the decision to eliminate the Independent Payment Advisory Board will put additional pressure on Medicare's finances, with its hospital trust fund currently projected to run out by 2026, three years earlier than predicted. The GOP also must weigh President Trump's likely antipathy toward a proposed overhaul of Medicare. Some Republicans still believe a resurgent economy will alleviate financial pressure on the program's trust funds. The trustees' report anticipated that the GOP tax cuts would lower the income taxes people pay on Social Security benefits, part of which are channeled into Medicare. The tax law's repeal of the Affordable Care Act penalty for lacking insurance will drive up the uninsured rate, hiking Medicare payments for uncompensated care. Medicare's Paul Spitalnic says lower-than-expected tax returns account for the "vast majority" of this year's funding shortage, and the trustees found payroll and income taxes cannot cover Medicare's budget gap, partly because of the tax law. Rep. Steve Womack (R-Ark.) argues that the report highlights the need for the House to unite behind a fiscal plan that includes entitlement reform.

A survey published on HealthITSecurity.com found most healthcare workers share sensitive medical data via non-secure email, with 87 percent admitting to doing so, reports the National Law Review . The poll determined healthcare workers are 36 percent more likely to share regulated data using non-secure methods than financial service professionals, and 10 percent of healthcare employees admit they do not comply with their employer's security rules. In addition, more than 25 percent of respondents share sensitive data, documents, and information externally using personal sync and share services like Dropbox. Moreover, 29 percent of respondents across industries admit to sharing intellectual property via non-secure email externally. When deciding how to send sensitive documents, 60 percent of respondents across industries said they choose the least difficult option. Although a majority of healthcare employees understand their employers' information security policies and how to use the secure communications tools provided, they also indicated that they do whatever is easiest when they need to transfer data; 64 percent said when it comes to sharing data, email is the easiest option. The survey outcomes suggest organizations should have programs to create a culture of information security, with components such as reminders of why the security measures have been put in place, ways to make secure communication systems easier to use, soliciting employee feedback on ways to boost efficiency of secure communications, and audits of use of non-secure communication.

A study published in Cancer found more older adults are coming down with human papillomavirus (HPV)-positive oropharyngeal cancers, reports Medical Xpress . The researchers retrospectively studied 239 cases of oropharyngeal squamous cell carcinoma (OPSCC) diagnosed at two National Comprehensive Cancer Network-designated cancer centers from 1995 to 2013. P16 immunohistochemistry and in situ hybridization (ISH) for HPV-16, high-risk DNA, and/or E6/E7 RNA were conducted. Age at diagnosis was compared by p16 and ISH tumor status. The team determined 60 percent of participants were p16-positive. Over the study period the average age rose among p16-positive individuals from 53 to 58 years, but not among p16-negative cases. The proportion of OPSCCs that were p16-positive climbed among those 65 or older, from 41 percent during 1995 to 2000 to 75 percent during 2007 to 2013. Irrespective of age, a p16-positive tumor status improved overall survival. "The median age at diagnosis for HPV-related OPSCC is increasing as the proportion of OPSCCs caused by HPV rises among older adults," the researchers note.

Data from Japan's National Police Agency estimated that a record 15,863 people with dementia were reported missing in 2017, according to the Japan Times . A total of 227 were still not located by the end of the year. The number of missing person reports rose to 431 from 2016 and represented a 65 percent rise from 2012, when comparable data became available. Local police have been working with municipal authorities to find wandering persons with dementia faster, and some debuted new methods such as the prior registration of the pattern of veins in an individual's palm and other information, as well as the compiling of databases of those with dementia for quick and accurate identification. About 14 percent of Japan's senior population are age 75 or older, and the number of seniors with dementia is expected to reach 7 million in 2025, according to a government calculation. Including those reported missing in earlier years, the locations of 10,129 people were discovered by the police in 2017, 5,037 came home by themselves or were found by their families, and 470 were found deceased. The poll indicated that 72.7 percent were found on the day their disappearance was reported to police. Some 99.3 percent were found within a week. The overall total who went missing last year, including those without dementia, was 84,850. Osaka was the prefecture with the most people with dementia reported missing last year at 1,801.

A computed tomography (CT) imaging study published in Radiology of people with memory problems found smoking and diabetes are associated with calcium buildup in the brain's hippocampus, reports Medical News Today . The researchers say their findings could be significant because they support the idea that the "calcifications may be of vascular origin." They note the multiplanar brain CT scan "makes it possible to see the hippocampus in different anatomical planes; for example, from top to bottom, right to left, and front to back." Their analysis of multiplanar brain CT scans of about 2,000 people who had attended a hospital memory clinic from 2009 to 2015 sought to investigate any associations between risk factors known to cause vascular problems and hippocampal calcifications; and to learn whether calcium buildup in the hippocampus affects cognitive function. They determined 19 percent of study participants had hippocampal calcifications, and that "older age," smoking, and diabetes "were associated with the presence of hippocampal calcifications." However, the team observed no connections between calcium accumulation in the hippocampus and cognitive function.

A report from the Pennsylvania Patient Safety Authority treats misunderstandings involving end-of-life documents as medical errors, according to the Washington Post . The report estimates that in 2016, Pennsylvania hospitals reported nearly 100 events relating to persons' "code status" — their wish to be resuscitated or not. Individuals were resuscitated against their wishes in 29 cases, while in two cases they were not resuscitated despite making it clear they wanted this to happen. Authority Executive Director Regina Hoffman says doctors and nurses receive little, if any, training in understanding and interpreting living wills, do-not-resuscitate (DNR) orders, and Physician Orders for Life-Sustaining Treatment (POLST) forms, either on duty or in medical or nursing school. Research suggests the potential for confusion concerning end-of-life documents is broad. The Medical College of Wisconsin's Arthur Derse recommends people ensure they have ongoing discussions about their end-of-life preferences with their physician, surrogate decision-maker, and family. A living will is designed to express preferences for end-of-life care but is not a binding medical order. Medical staff will instead interpret it based on the situation at hand, with input from the subject's family and surrogate decision-maker. Living wills are invoked only when a person is terminally ill and unconscious or in a permanent vegetative state. DNRs are binding medical orders, signed by a doctor, that apply specifically to cardiopulmonary resuscitation and instruct staff not to administer chest compressions if someone stops breathing or their heart stops beating. A POLST form is a set of medical orders for someone expected to die within a year, signed by a physician, physician assistant, or nurse practitioner; they are meant to be prepared after a detailed conversation about the person's prognosis, goals, and values, and the potential benefits and harms of various treatment options.

A study published in the European Heart Journal estimated that systolic blood pressure as low as 130 at age 50 raises the risk for dementia, reports the New York Times . The investigators measured blood pressure in 8,639 men and women in 1985, when they were age 35 to 55, and repeated the measurements in 1991, 1997, and 2003. Through March 2017, 385 cases of dementia were recorded. After controlling for various risk factors, the researchers found a systolic blood pressure at age 50 of 130 or higher was independently tied to a 38 percent increased risk of dementia. "The 140 threshold has been considered beneficial for the heart for a long time, but it might not work for the brain," notes Inserm Professor Archana Singh-Manoux. "The problem with hypertension is that people don't take their meds because they have no symptoms. I would encourage people to use their hypertensive medications."

A study from the Transamerica Center for Health Studies and the Interdisciplinary Center for Healthy Workplaces found most employers say their wellness programs have had a good effect on job satisfaction, workplace commitment, turnover, and absenteeism, reports Employee Benefit Adviser . However, 62 percent of employers say they offer wellness programs, yet just 40 percent of employees with employer-based coverage say they work for an employer who does so. The organizations have jointly issued an evidence-based, workplace wellness program employer guide. The document concentrates on effective wellness programs for small and medium businesses especially, offering a step-by-step process for identifying one or more wellness programs that fit each employer's unique characteristics. The guide highlights eight different wellness program types, including education programs, employee-directed social community building, organization-directed social community building, "lite" preventive care programs, "lite" healthy habit development, "enhanced" healthy habit development, "enhanced" preventive care programs, and disease management. The guide also can help human resources in identifying wellness program facilitators and impediments, and approaches to augment or overcome those facilitators/barriers and external resources, including assessments, toolkits, planning guides, educational articles, wellness technology, and webinars. "We help company leadership understand how the organization will benefit from employee wellness and how they can find a wellness program that fits their specific circumstances," says Interdisciplinary Center for Healthy Workplaces Director Cristina Banks.

A study published in the Journal of the American Geriatrics Society found short and long daily sleep duration, as well as hypnotics, are risk factors for dementia and death in Japanese seniors, reports Healio . The researchers examined the link between self-reported daily sleep duration and dementia and mortality risk in community-dwelling adults 60 years and older without dementia. The investigators grouped participants into categories based on their daily sleep duration, including less than five hours per day, five to 6.9 hours, seven to 7.9 hours, eight to 9.9 hours, and 10 hours or more. In general, 294 participants developed dementia and 282 died during follow-up. There were significantly higher incidence rates of dementia and all-cause mortality in seniors who reported sleeping less than five hours per day and 10 hours or more per day compared with those who reported daily sleep duration of five to 6.9 hours. These associations were consistent when adjusting for other confounders in those who reported daily sleep duration of less than five hours and in those who reported 10 hours or more. Moreover, older adults who used hypnotics and had any sleep duration had a 1.66 times higher risk for developing dementia and a 1.83 times higher risk for mortality versus non-hypnotics users who reported five to 6.9 hours of daily sleep. The story, which appeared in yesterday's edition, incorrectly said that "hypnosis" was a risk factor for dementia. It should have said "hypnotics."

The Association for the Advancement of Retired Persons (AARP) is urging the Security and Exchange Commission (SEC) to offer tougher proposed investment advice to investors, reports Politico Pro . The agency expressed concern that the rules would be confusing to savers and risk exposing them to conflicted advice. "The current SEC proposal does not clearly define a 'best interest standard,' and we believe it must do so," says AARP's David Certner. "Investors also do not understand the different legal standards, or the disclosure forms that apply to different types of financial professionals." Two months ago, the SEC voted to propose rules requiring brokers to act in their customers' best interest when making investment recommendations. They proposed requiring investment professionals to disclose their relationship with customers in a four-page document, and to ban certain financial advisers from describing themselves as advisers. Investment advisers are held to a higher fiduciary standard of care than brokers, who must comply with a suitability standard when offering customers advice. AARP sees itself as the biggest nonprofit, nonpartisan organization committed to people over 50, and it supported the Obama administration's fiduciary rule for brokers, which was jettisoned by an appeals court in March.