CIENCIASMEDICASNEWS

Ebola Vaccine Tests on Monkeys Show Promise
Tests of an experimental Ebola vaccine have shown positive results, protecting healthy monkeys from contracting the virus, the National Institutes of Health announced, as West Africa grapples with the epidemic that has killed around 2,000. Five weeks after giving them a shot of the experimental vaccine, called ChAd3, researchers exposed four macaque monkeys to high levels of the Ebola virus, and all the monkeys were protected, the NIH National Institute of Allergy and Infectious Diseases said. The protection decreased over time, it said: Ten months after receiving a shot of the vaccine, two of four monkeys were protected. Researchers also tried giving monkeys the experimental vaccine and then, eight weeks later, a booster vaccine. Ten months after the initial dose, all four monkeys were fully protected from being infected with Ebola, the institute said.

Source: http://www.latimes.com/

U.S., Britain to Send Troops to Help Fight Ebola in West Africa
The United States and Britain are sending troops and equipment to West Africa to help curb the spread of Ebola, officials said Monday, as the World Health Organization warned that the outbreak is outstripping the capacity to respond in one of the worst-hit countries. The military forces will build treatment facilities in Liberia and Sierra Leone to help care for victims of the virus, which has killed more than 2,000 people since it was detected in March. Thousands more could become infected before the worst outbreak on record is brought under control, the WHO has warned. The outbreak began in Guinea and spread to Liberia, Sierra Leone, Nigeria and Senegal. In Liberia, the number of new cases is increasing far faster than the number of beds, the WHO said Monday

after conducting an assessment with local government representatives. As soon as a new care facility opens, it is immediately filled to overflowing. “When patients are turned away at Ebola treatment centers, they have no choice but to return to their communities and homes, where they inevitably infect others,” the WHO said in a statement. Those who care for patients are among those hardest-hit by Ebola, which is spread through contact with the bodily fluids of its victims. In Liberia alone, about 152 healthcare workers have contracted the virus and 79 have died, according to the WHO.

Source: http://www.latimes.com/

Virus Hospitalizes Hundreds of Kids in Midwest and South
Hospitals in Colorado, Missouri and potentially eight other states are admitting hundreds of children for treatment of an uncommon but severe respiratory virus. The virus, called Enterovirus D68, causes similar symptoms to a summer cold or asthma: a runny nose, fever, coughing and difficulty breathing. But the illness can quickly escalate and there are no vaccines or antiviral medications to prevent or treat it. Though only Missouri has confirmed cases of EV-D68, cases with similar symptoms have been reported throughout the Midwest and South. According to news reports, Missouri, Colorado, Georgia, Illinois, Iowa, Kansas, Kentucky, North Carolina, Ohio and Oklahoma have sent samples to the Centers for Disease Control for identification.

Source: http://www.washingtonpost.com/

Laboratory Testing / Diagnostics

Pap Proficiency Testing—for Whom, When, and Why
It has been almost 10 years since gynecologic cytology proficiency testing, or Pap PT, was implemented in the United States. Has Pap PT prevented unqualified cytologists from practicing gynecologic cytopathology? Approximately 10,000 to 12,900 people have taken Pap PT annually since 2005, the first year the test was introduced. From 2006 to 2013, of participants in the CAP Pap PT program, six physicians (0.016 percent) (no cytotechnologists) failed two or three retests. Over time, the first-time individual failure rate for the test has plateaued at about three percent annually, and most of those who fail initially will pass on the second attempt. Has Pap PT further reduced the rate of cervical cancer? In 2006, the age-adjusted incidence of invasive cervical cancer was 6.93 per 100,000, and in 2011, the last year for which complete SEER data exist, it was 6.73 per 100,000. The incidence of cervical cancer has declined steadily across all age groups since 1975, when it was 14.79 in 100,000, largely owing to cervical cancer screening. Although there continues to be a slight overall decline in the incidence since 2006, this may be attributable to advances in Pap test technology, the introduction of HPV tests, and the development of new screening algorithms rather than proficiency testing.

Source: http://www.captodayonline.com/

The Pap Test Under Fire
The humble Pap test is perhaps one of the most lauded and disdained laboratory tests, lauded because it is the lab test with the best track record of preventing cancer and disdained because the test is labor-intensive, the results are operator dependent, and the regulations are burdensome. Recently the Pap test has come under fire, threatened to be replaced with HPV tests and maligned by patients and physicians for its sometimes unexpected high cost.

Source: http://www.captodayonline.com/

The Current Way of Diagnosing Type 2 Diabetes Needs to be Revised
The current way of diagnosing type-2 diabetes using blood glucose levels needs to be revised, research by scientists from The University of Manchester and King's College London suggests. The findings, published in the journal PLOS ONE, show the current method of diagnosis - using blood glucose levels - means patients are diagnosed too late so that their blood vessels may already be damaged. The study focused on young, previously pregnant women followed up in Greater Manchester after being identified as at increased, intermediate and low risk of developing type-2 diabetes. Researchers examined biochemical markers in the blood before glucose became elevated - so before the patients reached the pre-diabetes stage. Professor Cruickshank said: "We found that several groups of fat metabolites, also linked to body fat, were changed in the blood, as were others including some amino acids and to some extent vitamin D, before glucose levels increased. The team says more work is now needed to validate this alternative approach to diagnosing, treating and preventing diabetes.

New Sickle Cell Test Could Be Lifesaver in Developing World
A new low-cost, rapid blood test for sickle cell anemia could someday save the lives of thousands children in developing countries. An estimated 300,000 children are born with the genetic blood disorder each year in Africa alone. Writing in the journal Proceedings of the National Academy of Sciences, Harvard University researchers describe a new blood test that tells doctors within 12 minutes whether a child has the disorder. If and when it finally becomes available, after more clinical trials, the test could cost as little as 50 cents each. The researchers tested 50 blood samples, half of which contained sickle-shaped cells, and were able to accurately identify those blood samples from whole blood from individuals without the disease. The test takes advantage of the fact that sickle cells are heavier than healthy red blood cells.

Source: http://www.voanews.com/

Researcher Urges Wider Genetic Screening for Breast Cancer
A prominent scientist has started a big new debate about breast cancer. Geneticist Mary-Claire King of the University of Washington, who identified the first breast cancer gene, is recommending that all women get tested for genetic mutations that can cause breast cancer. "My colleagues and I are taking a really bold step," King said. "We're recommending that all adult women in America, regardless of their personal history and regardless of their family history, be offered genetic testing for the breast cancer genes." But others say that one study is far from enough evidence to know if these women face a higher risk of getting cancer, and that universal testing could lead women to undergo unnecessary surgery, doing more harm than good.

Source: http://www.npr.org/

Case Study Illustrates Benefits, Complexities of NGS Panel Testing for Cancer Risk
A case study of a 38-year-old woman referred for genetic counseling due to a family history of breast cancer illustrates the benefits of screening multiple genes when estimating cancer risk. Researchers from the Center for Genomic Medicine at the University of Copenhagen in Denmark described the case in a study published online last month in Familial Cancer. Running a six-gene hereditary breast and ovarian cancer panel, the study authors identified likely pathogenic mutations in two genes, one of which would have been missed using standard BRCA1 and BRCA2 screening.

Source: http://www.genomeweb.com/

Inexpensive Lab Test Identifies Resistant Infections in Hours
Researchers from Oregon State Public Health Lab have modified the protocol for a relatively new test for a dangerous form of antibiotic resistance, increasing its specificity to 100 percent. Their research, confirming the reliability of a test that can provide results in hours and is simple and inexpensive enough to be conducted in practically any clinical laboratory was presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy, an infectious disease meeting of the American Society for Microbiology. The test, called Carba NP, originally developed by Patrice Nordmann and Laurent Poirel at the University of Fribourg, Switzerland, and Laurent Dortet of the University Hospital of the South-Paris Medical School, France, allows for rapid identification of carbapenem-resistant Enterobacteriaceae (CRE), often referred to in the media as "super bugs" for their ability to resist most major antibiotics. Polymerase chain reaction (PCR), a DNA-based test, is currently the gold standard for detecting CRE, but it is expensive and requires equipment that many labs just do not have, especially in low-income countries that are large reservoirs for CRE. Carba NP is a much less expensive test that most labs should be able to afford.

Source: http://www.sciencedaily.com/

Noninvasive Prenatal Testing: This New Methodology Has Its Limitations; Should be Considered for Screening Purposes Only
Noninvasive prenatal testing (NIPT) has limitations in determining the risk of fetal aneuploidy, according to an article published Aug. 7 in Genetics in Medicine, the Journal of the American College of Medical Genetics and Genomics. The test method has produced strong results in some instances. In one study by Quest Diagnostics, NIPT demonstrated 100% sensitivity for trisonomy 21 and 18, yielding a specificity of greater or equal to 99.7% for each. Data from several independent groups, however, prompted the review of “the concordance of results among cases with positive or negative NIPT results referred to Quest Diagnostics for confirmation with cytogenic studies,” the article explains. Researchers looked at results from more than 100 consecutive specimens that were either prenatally and/or postnatally studied by fluorescence in situ hybridization, karyotyping, and/or oligo–single-nucleotide polymorphism microarray. True-positive rates varied among the cytogenic results. As an example, 38 of the 41 noninvasive prenatal testing cases for trisomy 21 were positive, yielding a true-positive rate of 93%. However, for trisomy 18, the true-positive rate was only 64%. For trisomy 13 and sex chromosome aneuploidy, the true-positive rates were only 44% and 38%, respectively. “These findings raise concerns about the limitations of noninvasive prenatal testing and the need for analysis of a larger number of false-positive cases to provide true positive predictive values for noninvasive testing and to search for potential biological or technical causes,” the article states.

Source: http://www.aacc.org/

A Bar Code Devised for the Bacteria That Causes Tuberculosis
Doctors and researchers will be able to easily identify different types of tuberculosis (TB) thanks to a new genetic barcode devised by scientists from the London School of Hygiene & Tropical Medicine. The bacteria that cause the deadly respiratory disease have evolved into families of strains, or lineages, which may affect people differently. According to the study - published in Nature Communications - the researchers found that just 62 mutations are needed to code the global family of strains.

Cepheid Xpert TB Test Gets CLIA 'Moderately Complex' Rating
[The] US Food and Drug Administration has categorized Cepheid's Xpert MTB/RIF test as "moderate complexity" under CLIA guidelines. Xpert MTB/RIF runs on Cepheid's GeneXpert system and is designed for the rapid molecular detection of Mycobacterium tuberculosis complex DNA and rifampin-resistance associated mutations of the rpoB gene. The assay provides results in two hours, compared to up to three months with traditional methods of detecting drug-resistant TB, according to Cepheid.

Source: http://www.genomeweb.com/

FDA Greenlights Early AKI Test
The FDA has approved a urine-based biomarker test that can tell if a hospitalized patient is at immediate risk of developing acute kidney injury (AKI), the agency announced. The quantitative NephroCheck test detects insulin-like growth factor binding protein-7 (IGFBP7) and tissue inhibitor of metalloproteinases (TIMP-2) in urine. Based on levels of these proteins, the test provides a score indicating whether a critically ill hospitalized patient is likely to develop moderate-to-severe AKI within 12 hours.

Source: http://www.medpagetoday.com/

Classification of Early Growth Response 1 Gene Fluorescence In-Situ Hybridization Test System for Specimen Characterization
The Food and Drug Administration (FDA) is classifying early growth response 1 (EGR1) gene fluorescence in-situ hybridization (FISH) test system for specimen characterization into class II (special controls). The special controls that will apply to this device are identified in this order and will be part of the codified language for the early growth response 1 (EGR1) gene fluorescence in-site hybridization (FISH) test system for specimen characterization classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. An early growth response1 (EGR1) gene fluorescence in-situ hybridization (FISH) test system for specimen characterization is a device intended to detect the EGR1 probe target on chromosome 5q in bone marrow specimens from patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). The assay results are intended to be interpreted only by a qualified pathologist or cytogeneticist. These devices do not include automated systems that directly report results without review and interpretation by a qualified pathologist or cytogeneticist.

Source: http://www.gpo.gov/

Diabetes: Abbott Wins E.U. Approval for Wearable Glucose Sensor
The Libre blood glucose sensing system gathers blood glucose data every minute via a coin-sized sensor worn on the back of the upper arm. The device doesn't even require preliminary finger-prick-based calibration, Abbott said. Libre analyzes glucose levels in the interstitial fluid with a filament inserted and held just under the skin. The system includes a scanner that collects results when in close proximity, even when the sensor is beneath clothing. The sensor is water-resistant and disposable after being worn for up to 14 days as it constantly takes measurements that can then be captured and recorded by the handheld scanner.

Source: http://www.massdevice.com/

Research and Development

Powerful anti-HIV Antibody Found
The search for a preventive vaccine against HIV, the virus that causes AIDS, has taken a major step forward with identification of a new vulnerable site on the virus, researchers reported. An international project to develop a vaccine plans to start clinical trials in two years. The site was found by studying an antibody that is unusually powerful in neutralizing a broad range of HIV strains. It is the seventh weak spot in HIV found so far — and the third discovered this year.

Source: http://www.utsandiego.com/

New Protein Family Discovery May Lead to Improved Staph Therapy
Scientists at Kansas State University say they have discovered a family of proteins that could lead to better treatments for Staphylococcus aureus, a pathogenic bacterium that can cause more than 60,000 potentially life-threatening infections each year. While S. aureus is typically a harmless commensal organism found in the nose and skin of 30% of the human population, it can cause serious and deadly infections if it invades deeper tissues. In their latest research study ("Staphylococcus aureus secretes a unique class of neutrophil serine protease inhibitors"), published in PNAS, Brian Geisbrecht, Ph.D., professor of biochemistry and molecular biophysics, and Kasra Ramyar, Ph.D., his research associate, and collaborators discovered that S. aureus secretes a family of proteins that prevent neutrophil serine proteases, or NSPs, from functioning, which is an important finding for understanding how infections are established. Neutrophils help prevent serious infections from occurring. "Neutrophils are like the fire department of the immune system," said Dr. Geisbrecht. "They are the first on the scene when a microbial infection tries to take hold."

Source: http://www.genengnews.com/

Novel Chip-based Platform Could Simplify Measurements of Single Molecules
A nanopore-gated optofluidic chip combines electrical and optical measurements of single molecules onto a single platform. Researchers at UC Santa Cruz have developed a new approach for studying single molecules and nanoparticles by combining electrical and optical measurements on an integrated chip-based platform. In a paper published July 9 in Nano Letters, the researchers reported using the device to distinguish viruses from similarly-sized nanoparticles with 100 percent fidelity. Biological nanopores, a technology developed by coauthor David Deamer and others at UC Santa Cruz, can be used to analyze a DNA strand as it passes through a tiny pore embedded in a membrane. Researchers apply voltage across the membrane, which pulls the negatively charged DNA through the pore. Current fluctuations as the DNA moves through the pore provide electrical signals that can be decoded to determine the genetic sequence of the strand.

Source: http://www.technologynetworks.com/

Protein in Plasma May One Day Change Transfusions
In injured mice, the naturally occurring protein fibronectin is instrumental in stopping bleeding but interestingly also at preventing life-threatening blood clots - according to new research published inJournal of Clinical Investigation. When someone is bleeding, a blood clot is a positive response - the body forms the clot as a plug to stop bleeding. But when blood clots form in the absence of an injury, those clots can be life-threatening. Excessive blood clots in arteries and the brain are the main cause of heart attack and stroke. Researchers found that fibronectin can actually switch its function from stopping bleeding to stopping overactive blood clots.
More clinical studies are required to determine whether fibronectin - one of many proteins found in blood - plays a similar role in people. Dr. Ni's research shows that fibronectin may actually be the body's first response to prevent bleeding at an injured blood vessel.

Hidden Infection Route of Major Bacterial Pathogen Uncovered
Pseudomonas aeruginosa is usually harmless to humans, but in people with cystic fibrosis (CF) or who have weakened immune systems - such as those who have had an operation or treatment for cancer - it can cause infections that are resistant to antibiotics. In CF patients in particular, infections can be impossible to eradicate from the lungs. The team from the University made their discovery by studying the bacteria in a newly developed model, which closely reflected the human disease condition. By using this model, they showed for the first time that Pseudomonas aeruginosa colonised the nasopharynx - the part of the body which connects the back of the nose to the back of the mouth - long term and then subsequently migrated down into the lungs to cause chronic infection. Joint first author of the study, microbiologist Dr Jo Fothergill said: "We have discovered that the nasopharynx acts as a silent reservoir for bacteria from which more serious infections in the lungs can develop."

Why do More Women get Alzheimer’s? Research Points to Genetics Other Factors
It has long been known that more women than men get the deadly neurodegenerative disease, and an emerging body of research is challenging the common wisdom as to why. Although the question is by no means settled, recent findings suggest that biological, genetic and even cultural influences may play heavy roles. Of the more than 5 million people in the United States who have been diagnosed with Alzheimer’s, the leading cause of dementia, two-thirds are women. Because advancing age is considered the biggest risk factor for the disease, researchers largely have attributed that disparity to women’s longer life spans. The average life expectancy for women is 81 years, compared with 76 for men. Yet “even after taking age into account, women are more at risk,” said Richard Lipton, a physician who heads the Einstein Aging Study at Albert Einstein College of Medicine in New York.

Source: http://www.wpost.com/

Public Health and Patient Safety

Millions of Children Not Getting Recommended Preventive Care
Millions of infants, children and adolescents in the United States did not receive key clinical preventive services, according to a report published by the Centers for Disease Control and Prevention (CDC) in today’s Morbidity and Mortality Weekly Report (MMWR) Supplement.
Clinical preventive services are various forms of important medical or dental care that support healthy development. They are delivered by doctors, dentists, nurses and allied health providers in clinical settings. These services prevent and detect conditions and diseases in their earlier, more treatable stages, significantly reducing the risk of illness, disability, early death, and expensive medical care.
The CDC report focuses on 11 clinical preventive services: prenatal breastfeeding counseling, newborn hearing screening and follow-up, developmental screening, lead screening, vision screening, hypertension screening, use of dental care and preventive dental services, human papillomavirus vaccination, tobacco use screening and cessation assistance, chlamydia screening and reproductive health services. The findings offer a baseline assessment of the use of selected services prior to 2012, before or shortly after implementation of the Affordable Care Act. Sample findings include:

In 2007, parents of almost eight in 10 (79 percent) children aged 10-47 months reported that they were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.
In 2009, more than half (56 percent) of children and adolescents did not visit the dentist in the past year and nearly nine of 10 (86 percent) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.
Nearly half (47 percent) of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.
Approximately one in three (31 percent) outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; eight of 10 (80 percent) of those who screened positive for tobacco use did not receive any cessation assistance.
Approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement.

Source: http://www.cdc.gov/

Risk of Drug-resistant Infections Increases 1% for Each Day in Hospital
There's a strong relationship between time in the hospital and time to infection from a multidrug resistant pathogen, according to a new study presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Researchers from the Medical University of South Carolina analyzed 949 incidents of documented Gram-negative infection, such as pneumonia, bloodstream infections or surgical site infections, between 1998 and 2011 to check for the relationship between the number of days in the hospital from admission to day of infection, according to the study. Multidrug resistance (MDR) was defined as a resistance to more than one drug within three antibiotic classes. Each hospitalization day increased the likelihood of infection with an MDR pathogen by 1 percent, and hospitals should consider these findings in selection of empiric antibiotic treatment for such infections, the study found.

CDC Consolidates HPV Vaccine Recommendations
The U.S. Centers for Disease Control and Prevention published consolidated guidelines on human papilloma virus (HPV) vaccination in the August 29 Morbidity and Mortality Weekly Report. The CDC's Advisory Committee on Immunization Practices makes the following recommendations: For children ages 11 or 12, girls should be vaccinated with either of the two vaccines available in the U.S., HPV4 or HPV2. Boys should be vaccinated with HPV4. If they have been not vaccinated earlier, females ages 13 to 26 years should be vaccinated, and so should males ages 13 to 21 years. Males ages 22 to 26 may also be vaccinated if they have not before.

Source: http://www.medscape.com/

CMS Reverses Decision, Will Publish Hospital Error Data
The Centers for Medicare & Medicaid Services reversed its August decision to stop publicly reporting data on several hospital-acquired conditions (HACs) and will resume public reporting of data on HACs such as foreign objects left in patients' bodies, according to USA Today. CMS told the publication it will publish data on eight more HACs on its website. "We are working to make it available as a public-use file for researchers and others who are interested in the data," CMS spokesman Aaron Albright told USA Today. "It's been requested, so we will make it available."

Johnson & Johnson to Accelerate Ebola Vaccine Development
Johnson & Johnson said it will fast-track the development of a new combination vaccine regimen against Ebola amid a race to combat the worst outbreak of the deadly disease on record. The company will collaborate with Denmark-based biotech company Bavarian Nordic (BAVA) and the National Institute of Allergy and Infectious Diseases, it said in a statement. They will work toward starting a clinical trial in humans in early 2015.

Source: http://www.businessweek.com/

Health IT

Nations Should Learn From Each Other on Health IT Strategies
The use of health information and communications technologies (ICTs) to improve chronic care "is still in its early days," according to research at Health Affairs comparing approaches used in Australia, Canada, Denmark and the U.S. The study looked at four types of solutions: electronic health records (EHRs), health information exchange (HIE), telehealth, and patient self-management tools. The next five years will be critical in addressing common issues, the authors say, adding that common challenges present the opportunity for nations to learn from each other. Australia has comparatively high EHR adoption (92 percent) and moderate health information exchange adoption (27 percent). The U.S. and Canada have comparatively moderate EHR adoption (around 50 percent) and low levels of HIE. Denmark, meanwhile, has high EHR adoption (more than 80 percent among primary care providers) as well as high HIE adoption (90 percent).

Source: http://www.fiercehealthit.com/

HIT Groups Applaud CMS Telemedicine Expansion Proposal
Expansion to telemedicine coverage for Medicare beneficiaries recommended by the Centers for Medicare & Medicaid Services in its proposed update to the Medicare Physician Fee Schedule for 2015 generally was praised in comments recently submitted by industry stakeholders, including the American Telemedicine Association (ATA) and the American Hospital Association (AHA).

Source: http://www.fiercehealthit.com/

DeSalvo: America 'waiting for us to get interoperability right'
Calling it a “changing of the horizon,” national coordinator Karen DeSalvo, MD, said that her office is working to refresh the Federal Health IT Strategic Plan. “It’s an opportunity to look at HIT beyond the EHR and policy levers beyond meaningful use,” DeSalvo said of the forthcoming plan. The Office of the National Coordinator for Health IT, in fact, has been reshaping itself for the future and is currently working on its strategic plan alongside a 10-year roadmap for interoperability — and that is against the backdrop of health IT reports put out by other federal entities, notably JASON and PCAST.

Source: http://www.govhealthit.com/

Other News

Australian Researchers Develop Lens to Transform Smartphones into Microscopes with Enough Resolution to Diagnose Skin Cancers; Goal is to Improve Access to Microscopy in Developing Countries
Pathologists will soon have multiple low-cost devices that allow their smartphones and notebook computers to function as microscopes. Microscopy is going mobile and becoming accessible to people beyond pathologists. Researchers and entrepreneurs have invented lenses to transform smartphones and tablets into flat microscopes. Researchers at the Australian National University in Canberra, Australia, (ANU) have developed an optical lens that can be combined with a smartphone camera to create a microscope for diagnosing skin cancer, reported Physics World in a story published this spring. Other mobile microscope products have gone to market over the past year. They vary in purpose, magnification strength, and cost. But they have one thing in common: they all fit in a pocket or a flat case and are relatively inexpensive.

Source: http://www.darkdaily.com/

US Hospitals Have Highest Administrative Spending Costs in the World
Hospitals in the United States have the highest administrative costs in the world, according to a study published in Health Affairs. Researchers analyzed data from eight countries with various types of healthcare systems: Canada, England, Scotland, Wales, the U.S., Germany, France and the Netherlands. They found administrative costs, which researchers say include the costs of a clinic receptionist and employee benefits, in the U.S. made up a greater percentage of total hospital expenditures than all other countries analyzed--25.2 percent. That was more than twice the percentages in Canadian and Scottish hospitals, which were tied for last.

US Must Produce 1.1 Million Nurses by 2022 to Meet Demand
The United States will need to produce 1.1 million new registered nurses by 2022 to fill jobs and replace retirees, according to an announcement from the American Nurses Association (ANA). About one in five nurses is set to retire soon, according to statistics from ANA. To deal with the aging population, increased access to care after healthcare reform and the new value-based healthcare model, the ANA recommended actions on federal funding, nurse education and hiring practices to make sure the industry meets demand and focuses on quality.