Do You Really Need to Take Vitamin D Supplements? T Researchers analyzing hundreds of studies say vitamin D supplements won’t protect healthy, middle-aged adults from osteoporosis. And even worse, they say the supplements may increase the risk of death from other diseases. But make sure you aren’t deficient in vitamin D before you stop taking the supplement, say Cleveland Clinic bone health experts. “The take-home message for patients with vitamin D deficiency should not be ‘you won’t benefit from vitamin D supplementation.’ Vitamin D can have a positive impact,”   says rheumatologist  Chad Deal, MD.   Adds rheumatologist  Johnny Su, MD,  “If you are healthy and are not getting treatment for any medical problems, you don’t have to worry about starting supplements. But if you are now taking supplements, be sure to get your vitamin D levels checked before stopping.” Who still needs their D People in the following categories should keep taking vitamin D supplements, says

Many Physicians, Nurses Want Pain Removed as Fifth Vital Sign   Almost half of physicians and half of nurses strongly agree that pain should be eliminated as the fifth vital sign, according to a  Medscape survey . Medscape received more than 2100 responses to an online survey conducted in December 2016, a few months after the American Academy of Family Physicians (AAFP) Congress of Delegates  voted  to eliminate pain as a fifth vital sign. The AAFP delegates said the pain measurement — which has been used for decades — is subjective and has likely led to overprescribing of medications. Respondents to the Medscape survey were asked directly whether they supported the AAFP vote. While 47% of physicians — who were from multiple specialties — said they strongly agreed, 17% said they somewhat agreed, and 19% said they strongly disagreed. For nurses, 45% strongly agreed with the AAFP, 22% somewhat agreed, and 19% strongly disagreed. "I applaud the AAFP for this com

10 Ways to improve the quality of care in health facilities There is increasing global awareness that good quality care is key to keeping mothers and babies alive and well. Today, each year there are 303 000 deaths of women during pregnancy and childbirth, 2.6 million stillbirths, and 2.7 million deaths of babies during the first 28 days of life. Better care can prevent many of these deaths. More babies are being born in health facilities. A new UN- and partner-supported "Network for Improving Quality of Care for Maternal, Newborn and Child Health" aims to help countries improve the quality of care in those facilities and to respect the rights and dignity of those who seek care. This photo story describes some of WHO’s recommendations on how countries can improve quality of care in their health facilities and prevent maternal and newborn deaths, based on its  Standards for improving quality of maternal and newborn care in health facilities . UNICEF/Asselin Pr

A 10-step model for improving breastfeeding in NICU babies With an aim toward increasing breastfeeding among newborns in the NICU, Penn Nursing's Diane Spatz created a 10-step model especially for these families, which starts by helping them make an informed decision about breastfeeding, then guides them through the transition to doing so. Much breastfeeding emphasis and education in the United States focuses on healthy infants and their mothers rather than newborns admitted to the neonatal intensive care unit (NICU). Given  the benefits of human milk —decreasing infections and improving developmental outcomes, for example—NICU infants need it just as much, if not more, argues  Diane Spatz , a perinatal nursing and nutrition professor in the  School of Nursing and lactation program director at the Children’s Hospital of Philadelphia . They’re also less likely to breastfeed immediately due to separation from mom because of admission to the NICU. With an aim toward