Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN)

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions—for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of ‘common carriage’ or ‘public calling,’ the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.     

Cluster analysis and food group consumption in a national sample of Australian girls

Background: Food preferences develop early in life and track into later life. There is limited information on food consumption and dietary patterns in Australian girls. The present study aimed to: (i) determine the frequency of food groups consumed over 1 day; (ii) identify dietary clusters based on food group consumption; and (iii) compare dietary intakes and activity variables between clusters. Methods: A cross‐sectional analysis of 9–16‐year‐old girls (n = 1114) from the 2007 Australian National Children’s Nutrition and Physical Activity Survey was performed. Results: Over the whole day, 30% of all girls consumed carbonated sugar drinks, 46% consumed take‐away food, 56% consumed fruit, 70% consumed at least one vegetable, and 19% and 30% consumed white and/or red meat, respectively. K‐means cluster analysis derived four clusters. Approximately one‐third of girls were identified in a Meat and vegetable cluster; these girls had the highest intakes of red meat and vegetables, and tended to have higher intakes of fruit, whole grain breads, low fat yoghurt, and lower intakes of take‐away foods and soft drinks. They also had the highest intakes of protein, fibre and micronutrients; and tended to perform more physical activity, compared to girls in the remaining clusters. Conclusions: Girls identified in the Meat and vegetable cluster, on average, consumed more lean red meat, vegetables, fruits, and low‐fat dairy products, and had a higher intakes of many nutrients. The high percentage of girls not identified in this cluster suggests the need to inform them on how to make healthy, nutrient dense food choices, and why they require increased nutrient intakes at this time.     

CyberEx Internet-Based Group Exercise for Rural Older Adults: A Pilot Study

The purpose of this study was to examine satisfaction with and outcomes of a real-time Internet-based group exercise program for older adults. Men and women age 50 and older (mean = 66.5) were recruited to participate in a 10-week distance group exercise program. Paired sample t-tests revealed that Sit-To-Stand (STS) repetitions increased significantly (p = .009), while Timed Up-and-Go(TUG) time decreased significantly (p = .000). Connectivity, visibility, and communication emerged as themes related to the use of technology; but overall, real-time Internet-based technology was shown to be an effective way to present group exercise programs for older adults in this rural setting.