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Continuous changes in the healthcare reimbursement criteria require executives across the industry to focus on enterprise-wide changes that have a positive effect on supply chain savings. It's a complex problem and it's easy to get distracted on one issue when having the ability to see a clear BIG picture of your entire supply chain is what can lead to the most dramatic results and return on investments. Register for MHS' webinar on November 01 (2:00pm EST) to learn about how their customers experience an average 4:1 ROI with continual savings into the millions and a positive financial impact to their bottom line through inventory reduction, avoidance of obsolete and expired inventory, improved charge capture for each patient, and physician preference card optimization. Click on http://bit.ly/UvD3nq Presenters *Michael Ferris: Co-Founder, MHS with over 30 years of supply chain management experience *Steve Basiliere: Former Director of Supply Chain Services at Saints Medical Center, Lowell, MA *Art Kozyrovicius: Finance and Procurement Systems Support at New York-Presbyterian Hospital, New York, NY WHY ATTEND? Join a unique discussion with healthcare supply chain thought leaders and understand how to drive significant and sustainable supply chain operational improvements. Get a jump on making an immediate and positive impact on your bottom line as you head into 2013. Register by clicking on http://bit.ly/UvD3nq Note: Event will be online, through WebEx Please Register at http://bit.ly/UvD3nq

The Standing Committee of European Doctors (CPME) is preparing a vitamin D policy paper it hopes can influence European national associations considering vitamin D medical recommendations. PA International Foundation is hosting an event on the topic in Bruges, Belgium, on October 6, its 14th workshop to be held on the matter. The CPME draft paper will be presented at the convention attended by doctors, scientists, patient groups, media representatives and politicians.

Vitamin D treatment in multiple sclerosis. Myhr KM. J Neurol Sci. 2009 Jun 22. [Epub ahead of print] PMID: 19549608 doi:10.1016/j.jns.2009.05.002 Epidemiological evidence combined with clinical and laboratory analyses, and experimental animal models, suggest a possible influence of vitamin D on MS susceptibility as well as clinical disease activity. Supplement with vitamin D may reduce the risk of developing MS. An intervention may also reduce the risk of conversion from a first clinical event suggestive of MS to clinical definite MS, as well as reduce the relapse rate among patients with relapsing remitting MS. More studies are, however, needed to determine optimal dose and serum level for vitamin D, as well as target populations and optimal timing for intervention.

Effectiveness and safety of vitamin D in relation to bone health. Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D, Fang M, Yazdi F, Garritty C, Sampson M, Barrowman N, Tsertsvadze A, Mamaladze V. Evid Rep Technol Assess (Full Rep). 2007 Aug;(158):1-235. Review. PMID: 18088161 CONCLUSIONS: The results highlight the need for additional high quality studies in infants, children, premenopausal women, and diverse racial or ethnic groups. There was fair evidence from studies of an association between circulating 25(OH)D concentrations with some bone health outcomes (established rickets, PTH, falls, BMD). However, the evidence for an association was inconsistent for other outcomes (e.g., BMC in infants and fractures in adults). It was difficult to define specific thresholds of circulating 25(OH)D for optimal bone health due to the imprecision of different 25(OH)D assays. Standard reference preparations are needed so that serum 25(OH)D can be accurately and reliably measured, and validated. In most trials, the effects of vitamin D and calcium could not be separated. Vitamin D(3) (>700 IU/day) with calcium supplementation compared to placebo has a small beneficial effect on BMD, and reduces the risk of fractures and falls although benefit may be confined to specific subgroups. Vitamin D intake above current dietary reference intakes was not reported to be associated with an increased risk of adverse events. However, most trials of higher doses of vitamin D were not adequately designed to assess long-term harms.

Effectiveness and safety of vitamin D in relation to bone health. Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D, Fang M, Yazdi F, Garritty C, Sampson M, Barrowman N, Tsertsvadze A, Mamaladze V. Evid Rep Technol Assess (Full Rep). 2007 Aug;(158):1-235. Review. PMID: 18088161 CONCLUSIONS: The results highlight the need for additional high quality studies in infants, children, premenopausal women, and diverse racial or ethnic groups. There was fair evidence from studies of an association between circulating 25(OH)D concentrations with some bone health outcomes (established rickets, PTH, falls, BMD). However, the evidence for an association was inconsistent for other outcomes (e.g., BMC in infants and fractures in adults). It was difficult to define specific thresholds of circulating 25(OH)D for optimal bone health due to the imprecision of different 25(OH)D assays. Standard reference preparations are needed so that serum 25(OH)D can be accurately and reliably measured, and validated. In most trials, the effects of vitamin D and calcium could not be separated. Vitamin D(3) (>700 IU/day) with calcium supplementation compared to placebo has a small beneficial effect on BMD, and reduces the risk of fractures and falls although benefit may be confined to specific subgroups. Vitamin D intake above current dietary reference intakes was not reported to be associated with an increased risk of adverse events. However, most trials of higher doses of vitamin D were not adequately designed to assess long-term harms.

Vitamin D Status and the Risk of Cardiovascular Disease Death. Kilkkinen A, Knekt P, Aro A, Rissanen H, Marniemi J, Heliövaara M, Impivaara O, Reunanen A. Am J Epidemiol. 2009 Sep 17. [Epub ahead of print] PMID: 19762371 doi:10.1093/aje/kwp227 A low vitamin D level may be associated with higher risk of a fatal CVD event, particularly cerebrovascular death. These findings need to be replicated in other populations. To demonstrate a causal link between vitamin D and CVD, randomized controlled trials are required.

The American diet circa 2007 is a disaster - but positive change has begun. Those were the twin themes of the "Fourth Annual Nutrition and Health Conference" held in San Diego, Calif., May 14-16, 2007. The conference was sponsored by the University of Arizona's College of Medicine in conjunction with the Program in Integrative Medicine (PIM); PIM was founded and is co-directed by Dr. Weil. \n\nThe three-day event brought together leading nutrition researchers from around the world, bearing plenty of both bad and good news. Some highlights:

What can high-vitamin D foods do for you? * Help prevent a growing list of chronic diseases, including type 2 diabetes, heart disease, hypertension, osteoporisis, breast cancer, colon cancer, and ovarian cancer * Help keep your bones and teeth strong and healthy * Regulate the growth and activity of your cells * Reduce inflammation What events can indicate a need for more foods rich in vitamin D? * Bone pain and/or soft bones * Frequent bone fractures * Bone deformities or growth retardation in children

Low vitamin D status, high bone turnover, and bone fractures in centenarians. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M, Franceschi C. J Clin Endocrinol Metab. 2003 Nov;88(11):5109-15. PMID: 14602735 We conclude that the extreme decades of life are characterized by a pathophysiological sequence of events linking vitamin D deficiency, low serum calcium, and secondary hyperparathyroidism with an increase in bone resorption and severe osteopenia. These data offer a rationale for the possible prevention of elevated bone turnover, bone loss, and consequently the reduction of osteoporotic fractures and fracture-induced disability in the oldest olds through the supplementation with calcium and vitamin D.

Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Engelsen O, Brustad M, Aksnes L, Lund E. Photochem Photobiol. 2005 Nov-Dec;81(6):1287-90. PMID: 16354110 Vitamin D production in human skin occurs only when incident UV radiation exceeds a certain threshold. From simulations of UV irradiances worldwide and throughout the year, we have studied the dependency of the extent and duration of cutaneous vitamin D production in terms of latitude, time, total ozone, clouds, aerosols, surface reflectivity and altitude. For clear atmospheric conditions, no cutaneous vitamin D production occurs at 51 degrees latitude and higher during some periods of the year. At 70 degrees latitude, vitamin D synthesis can be absent for 5 months. Clouds, aerosols and thick ozone events reduce the duration of vitamin D synthesis considerably, and can suppress vitamin D synthesis completely even at the equator. A web page allowing the computation of the duration of cutaneous vitamin D production worldwide throughout the year, for various atmospheric and surface conditions, is available on the Internet at http://zardoz.nilu.no/~olaeng/fastrt/VitD.html and http://zardoz.nilu.no/~olaeng/fastrt/VitD-ez.html. The computational methodology is outlined here.

Vitamin D and cardiovascular disease risk. Michos ED, Melamed ML. Curr Opin Clin Nutr Metab Care. 2008 Jan;11(1):7-12. Review. PMID: 18090651 doi: 10.1097/MCO.0b013e3282f2f4dd Summary: Vitamin D deficiency is easy to screen for and easy to treat with supplementation. Further larger observational studies and randomized clinical trials are, however, needed to determine whether vitamin D supplementation could have any potential benefit in reducing future cardiovascular disease events and mortality risk.

"DALLAS, Jan. 8 - The same vitamin D deficiency that can result in weak bones now has been associated with an increased risk of cardiovascular disease, Framingham Heart Study researchers report in Circulation: Journal of the American Heart Association. "Vitamin D deficiency is associated with increased cardiovascular risk, above and beyond established cardiovascular risk factors," said Thomas J. Wang, M.D., assistant professor of medicine at Harvard Medical School in Boston, Mass. "The higher risk associated with vitamin D deficiency was particularly evident among individuals with high blood pressure." In a study of 1,739 offspring from Framingham Heart Study participants (average age 59, all Caucasian), researchers found that those with blood levels of vitamin D below15 nanograms per milliliter (ng/mL) had twice the risk of a cardiovascular event such as a heart attack, heart failure or stroke in the next five years compared to those with higher levels of vitamin D."

"With daily news reports warning of a swine flu pandemic, members have besieged our health advisors with questions about what they should do to protect themselves against the H1N1 (swine flu) virus. The good news is that Life Extension® members obtain a considerable amount of immune support via the supplements they already use, especially those taking high-dose vitamin D. An important question, however, is what one should do if they develop symptoms of a viral infection? As the days grow colder, the risks of contracting common flu and cold viruses increase. Each year, flu virus infections kill around 36,000 Americans and cause miseries for millions.1 An outbreak of the swine flu virus is expected this winter. While certain supplements (and drugs) purport to shorten the duration of a viral infection, most of them fail to provide significant relief. Over the past 28 years, Life Extension® personnel have experimented with various nutrients, hormones, and drugs in order to minimize the impact of the common cold and typical flu viruses. In this article, I will reveal what has worked for me personally to ward off common cold/flu viruses and what has been validated in the scientific literature to be effective. I will also elaborate on some aggressive prescription drug strategies to consider in the event that you contract a severe form of swine flu or other type of influenza."

Dear Colleague: What public health action could you take today that could possibly stop breast cancer and colon cancer, prevent type 1 diabetes and multiple sclerosis, and reduce the incidence of infectious diseases? What would be the economic impact of this action? A group of physicians and researchers in the vitamin D field are presenting information at this conference to look at the current research and practice with vitamin D to enable everyone to take action today based on what's known to solve the deficiency epidemic, and, to start the prevention of many diseases.