Home / Archived For February 2013

Thursday, 28 February 2013

Princess Health and Kentucky's well-being ranks next to last, just above West Virginia.Princessiccia

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Kentucky ranks next to last in the annual Gallup-Healthways Well-Being index, just ahead of West Virginia. The Bluegrass State ranked last in the index's Healthy Behaviors category, which measures the percentage of residents who smoke, exercise frequently and eat healthy daily.

The chart on the left shows Kentucky's score in each of the six categories. The state's rankings haven't changed much since last year, with the exception of the Work Environment index, which fell from 8th to 31st.  The colored chart on the right shows the state's overall and category rankings for 2011 and 2012 (1 is the highest rank and 50 is the lowest). Click here for the detailed report on Kentucky.
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Left: Kentucky Well-Being Indexes     Right: Well-Being rankings of Kentucky among the states
West Virginia, with an index score of 61.3, had the lowest well-being for the fourth year in a row. The report shows West Virginians were the least likely to be thriving and also had the nation's worst emotional health. They had the lowest score in the Physical Health category, which reflects having the highest percentage of obese residents in the nation.

There were few changes from 2011 to 2012 among states with the highest and lowest well-being scores. Hawaii residents had the highest well-being for the fourth straight year, followed by Colorado, Minnesota, Utah, and Vermont.

The report shows a consistent regional pattern in well-being over the past five years. Western and Midwestern states earned seven of the 10 highest overall scores, while New England states held the other three spots. Southern states had the six lowest scores, and Southern states had eight of the 10 lowest well-being scores.
Princess Health and Health departments in N. Ky. and Franklin County are among the first 11 in the nation to be accredited, a milestone in public health .Princessiccia

Princess Health and Health departments in N. Ky. and Franklin County are among the first 11 in the nation to be accredited, a milestone in public health .Princessiccia

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Three Kentucky departments are among the first 11 in the nation to receive accreditation from the national Public Health Accreditation Board, which announced the achievements Thursday.

The Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties received five-year accreditation.

"I am proud of the departments achieving this public health milestone of national accreditation," said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health. "Before now, there has not been a national system for health departments to demonstrate accountability and quality to their community."

Scutchfield said accreditation means a department is providing a "high quality of public health service, leadership and accountability to its constituents," and is a clear indication of the departments' "passion and dedication to improving and protecting the health" of the community.

The board, funded by the federal Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, has received 128 total applications for accreditation: 112 from local health departments, 15 from state departments; and one tribal department.

In addition to the three Kentucky departments that have received accreditation, other Kentucky departments have applied and are awaiting site visits. Those are the Lexington-Fayette County, Barren River District, Madison County and Christian County health departments, said Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services.

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year. (Click here to learn more about accreditation)
Princess Health and House sends Senate pill-mill and Medicaid managed-care fixes.Princessiccia

Princess Health and House sends Senate pill-mill and Medicaid managed-care fixes.Princessiccia

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The state House yesterday approved without dissent two bills aimed at improving Kentucky's health care.

House Bill 217 addresses some "unintended consequences" of last year's "pill mill bill" by easing some of the bills regualtions. The bill also tightens restricitions on prescription drugs, reports Ryan Alessi of cn|2.

The other measure, House Bill 5, deals with payment problems of the Medicaid managed care system. Itl would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints and disputes to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Both bills are expected to see action in the Senate.

Princess Health and Lack of statewide smoking ban represents one part of Kentucky's struggle to deal with tobacco use and the health issues it creates.Princessiccia

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By Molly Burchett
Kentucky Health News

As the bill for a statewide smoking ban lies on its deathbed in the General Assembly, new federal data show Kentucky still has the highest percentage of smokers (29 percent) of any state, leads the nation in the share of smoking high school students (24 percent) and spends only a minuscule portion of their tobacco revenues to fight tobacco use. Those figures come from the federal Centers for Disease Control and Prevention's Tobacco Control State Highlights 2012 report. (For county-by-county figures, click here.)

The lack of a statewide smoking ban, which nevertheless has become popular among Kentuckians, represents only a small part of the struggle to address Kentuckians' tobacco use and resulting health problems. Kentucky's program to discourage tobacco use has been severely underfunded for years, contributing to the state's lack of or slow progress in reducing its smoking and tobacco use rates and subsequent health problems, said Dr. Ellen Hahn, director of the Kentucky Center for Smoke-Free Policy at the University of Kentucky.

State tobacco revenue (left bar) and spending (right bar)
The CDC says Kentucky should spend $57.2 million a year to have an effective, comprehensive tobacco-prevention program, but the state allocates only $2.1 million a year to such programs -- 3.7 percent of the recommended amount.

By another measure, the amount is only 0.6 percent of the estimated $381 million the state gets from tobacco taxes and the 1998 national settlement with cigarette manufacturers, according to a tobacco settlement report.
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????Meanwhile, Kentucky's health-care costs attributable to smoking add up to about $1.5 billion a year, and smoking-caused productivity losses total $2.3 billion a year. These amounts do not include health costs caused by exposure to secondhand smoke, smoking-caused fires, smokeless tobacco use or cigar and pipe smoking.

Despite the known health risks that tobacco use poses, smoking in Kentucky remains a part of everyday life in most places. But that is increasingly less so around the country, so there is an increasing gap between heavy-smoking and low-smoking states; smoking in Kentucky is about twice as prevalent as in Utah and California, reports Steven Reinberg of HealthDay. Click here for an interactive map of states' tobacco prevention efforts.
There are proven, multi-pronged strategies to curb smoking. They include combinations of higher tobacco taxes, smoke-free laws, media campaigns, and restricted access to tobacco products. However, Kentucky continues to lag behind other states due to "stagnant policies" and a lack of funding, said Hahn.

Many other factors contribute to Kentucky's lack of tobacco-prevention progress. By failing to substantially reduce adult smoking, the state misses opportunities to encourage younger adults and children not to smoke, Hahn said. Kentucky needs to employ strategies that communicate the success and affordability of tobacco cessation programs, she said; people often lack the encouragement to quit smoking because they don't know how or they don't believe it is possible.

The latest tobacco report is a timely reminder that tobacco use remains a huge public health problem for Kentucky and there are proven strategies that, if implemented, could help Kentuckians live a healthier, tobacco-free life.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
Princess Health and 'Incredible Colon' to march across the state in Colon Cancer Awareness Month; more than a dozen stops scheduled.Princessiccia

Princess Health and 'Incredible Colon' to march across the state in Colon Cancer Awareness Month; more than a dozen stops scheduled.Princessiccia

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A special tour throughout the state of the Incredible Colon � an inflatable model of a human colon, large enough for visitors to walk through it � will promote education about risks and preventive measures of colon cancer during March, National Colon Cancer Awareness Month.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly, according to the federal Centers for Disease Control and Prevention. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon, and when detected early, polyps can be easily removed during a colonoscopy before they develop into cancer. When colon cancer is found early and treated, the five-year relative survival rate is 90 percent, underscoring the need for preventive health exams.

However, only 63 percent of Kentuckians who should have screening tests have had them, according to Kentucky data from the federal Behavioral Risk Factor Surveillance System, an ongoing national survey.

The colon tour is a coordinated promotion by the Kentucky Cancer Program, local cancer councils and the Kentucky Colon Cancer Prevention Project. It is free and open to the public and will take place in 13 Kentucky communities March 4-28:

� March 4: Fleming County Hospital, Flemingsburg (10:30 a.m. - 2:30 p.m.)
� March 5: Walmart, Manchester (Noon - 4 p.m.)
� March 6: Hazard ARH Medical Mall, Hazard (10 a.m. - 3 p.m.)
� March 7: Rowan County Chamber of Commerce, Morehead (members
  only, 9:30 a.m. - 3 p.m.)
� March 8: Frankfort Regional Hospital, Frankfort (9 a.m. - 4 p.m.)
� March 19: Lexmark, Lexington, (Employees only, 8:30 a.m. - 2 p.m.)
� March 20: Lawrence County High School, Louisa (8 a.m. - 5 p.m.)
� March 21: Lady of Bellefonte Health Center, Grayson (10 a.m. - 2 p.m.)
� March 23: Phillip Sharp Middle School, Butler (8-11 a.m. )
� March 25: Town Center Mall, Ashland (10 a.m. - 3 p.m.)
� March 26: Walmart, Georgetown (3-6 p.m.)
� March 27: Adron Doran University Center, Morehead (9:30 a.m. - 3 p.m.)
� March 28: Walmart, Somerset (10 a.m. - 2 p.m.)

Attendees are invited to dress in blue, the color of colon cancer awareness, and there will be door prizes, giveaways (while supplies last), refreshments and educational information about colon cancer screening, prevention and early detection. (Read more)

Wednesday, 27 February 2013

Princess Health and Your Brain on Potato Chips. Princessiccia

Princess Health and Your Brain on Potato Chips. Princessiccia

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Or, more accurately, a rat's brain on potato chips. Last week, PLoS One published a very interesting paper by Dr. Tobias Hoch and colleagues on what happens in a rat's brain when it is exposed to a highly palatable/rewarding food (1). Rats, like humans, overconsume highly palatable foods even when they're sated on less palatable foods (2), and feeding rats a variety of palatable human junk foods is one of the most effective ways to fatten them (3). Since the brain directs all behaviors, food consumption is an expression of brain activity patterns. So what is the brain activity pattern that leads to the overconsumption of a highly palatable and rewarding food?

Read more �
Princess Health and Take care with a big cold-weather killer, the space heater.Princessiccia

Princess Health and Take care with a big cold-weather killer, the space heater.Princessiccia

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Warm weather isn't far away, but winter remains, and precautions should be taken to steer clear of a big cold-weather killer -- the space heater -- for the season's remaining cold days.

The Consumer Product Safety Commission estimates that each year, space heaters cause more than 25,000 residential fires and more than 300 deaths, and more than 6,000 Americans get emergency-room care for burn injuries associated with room heaters.

An Eastern Kentucky fire started by a space heater claimed the lives of one adult and four children last month. This blaze destroyed a rural house and family and was considered by authorites to be the worst the region has seen in a long time.

Using a space heater makes sense, and many people, particularly those in rural areas, use them to stay warm; but they must be used with caution. The Burn Center at Loyola University Medical Center is warning the public about the dangers of space heaters because many of the injuries they cause are preventable if the appropriate measures are taken. Here are some general safety tips from Loyola:

� Keep space heaters at least three feet away from furniture or other combustible material
� Don't place heaters on carpets or rugs.
� Locate heaters on a hard, level surface where a child or family pet can't brush against them.
� Never leave a heater on when an adult is not present in the room.
� Never keep flammable liquids near a heater.
� Mobile homes should use only electric heaters or vented, fuel-fired heaters.

Loyola also advises to use combustion space heaters only outside your home because they release carbon monoxide and nitrogen oxide. If the heater is not properly vented, high levels of these gases are deadly. Also, when using electric space heaters, be sure to plug the heater directly into a wall outlet and use a heavy duty cord. Click here for more tips.

Tuesday, 26 February 2013

Princess Health and Bill for statewide smoking ban appears to have been extinguished.Princessiccia

Princess Health and Bill for statewide smoking ban appears to have been extinguished.Princessiccia

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The bill to enact a statewide smoking ban in Kentucky appears to be dead for this session of the General Assembly.

The House sent House Bill 190 back to committee today, and "House Speaker Greg Stumbo said he doesn't expect the bill to make it back to the full House," Sam Dick reported for WKYT-TV.

Rep. Bob Damron, D-Nicholasville, an opponent of the bill, told Kentucky Health News on Feb. 21 that he did not think it had more than 41 votes in the 100-member House.
Princess Health and House panel approves bill easing rules of 2012's pill-mill bill.Princessiccia

Princess Health and House panel approves bill easing rules of 2012's pill-mill bill.Princessiccia

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They could call it the pill they're taking to fix the pill-mill bill.

A state House committee approved a bill Tuesday that would tweak last year's legislation aimed at cracking down on prescription drug abuse through doctor shopping and "pill mills" where painkiller prescriptions are easily available for a fee.

House Speaker Greg Stumbo told the House Judiciary Committee that House Bill 217 would fix �unintended consequences� of 2012's House Bill 1 while still requiring that health-care providers use the Kentucky All Schedule Prescription Electronic Reporting system to track painkiller prescriptions.

The bill "would exempt hospitals and long-term care facilities from HB 1�s per-unit patient dosing restrictions and ensure that physicians decide when physicals are needed," the Kentucky Press News Service reported. "It would limit restricted access to narcotic pain medication for surgery patients, end-of-life patients, cancer patients and a few other categories of patients who may need increased pain management, Stumbo said." (Read more)
Princess Health and Bill to make Medicaid managed-care firms pay up, and more promptly, nears final form in House and will get attention in Senate.Princessiccia

Princess Health and Bill to make Medicaid managed-care firms pay up, and more promptly, nears final form in House and will get attention in Senate.Princessiccia

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By Molly Burchett and Al Cross
Kentucky Health News

The complaints by many health-care providers about Medicare managed-care firms' delay or denial of payment claims appears to be generating a bipartisan solution in the General Assembly. A bill on the House floor that would transfer late-payment complaints to the state Department of Insurance, which enforces Kentucky's prompt-payment laws, appears to have support in the Senate.

House Bill 5 would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Hospitals, doctors and other health care providers have complained that the cabinet is not resolving their payment disputes with managed-care firms. The bill cleared the House Health and Welfare Committee Feb. 21 and is awaiting a vote on the House floor. The bill is sponsored by House Speaker Greg Stumbo.

Sen. Julie Denton, chair of the Senate Health and Welfare Committee, told Kenny Colston of Kentucky Public Radio that she plans to give the bill a hearing and supports its intent to make managed care organizations pay providers. "I think anything we can do to have more oversight and more assistance in keeping them in compliance with their contracts is a welcome breath of fresh air," she said.

Senate President Robert Stivers said he has concerns about the bill affecting the MCOs contracts with the state. But he said his chamber will take a look at the bill, Colston reports. The cabinet has had the same concerns, and some other objections that are to be addressed by House floor amendments.

Kentucky providers report being burdened by a lack of or delayed payments from the new managed-care system. Kentuckians have called for immediate action by state government to help fix these issues on behalf of providers and patients, which has prompted this bipartisan legislative response.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Survey suggests Great Recession has harmed the health of Kentuckians.Princessiccia

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A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky�s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.


Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

�We know there is a direct relationship between income and good health, and these data reflect that,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. �While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population�s health.�

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

Monday, 25 February 2013

Princess Health andH+P at the 2013 Re-Fridgee-Eighter.Princessiccia

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The team had a great time at the 2013 Waterloo Running Series Re-Fridgee-8er!

Here are the team results:

8K results:
1st place 8KM team
Coach Sean was 2nd male overall, 1st in the 8K team, 1st in his AG
Greg won his AG, was 5th overall and 2nd on our 8K team
Kevin was 3rd in his AG, and 3rd on our team
Mike Piazza was 4th in his AG, 4th on our team (and only seconds away from Kevin- what a sprint finish- check out the pictures!)
Dragan-Ball-Zubac ran yet another PB, and placed 6th in his very competitive AG
Maria had a great 8K, finishing 3rd in her category!


8M results:
1st place 8M team
1st place spouse team (good job Mailman and Jessica!)
Luke had a great race, finishing 6th overall and 1st in his AG
Florian finished right behind him in 7th place overall, winning his AG
Dave had an awesome race, going over 2 minutes faster than his anticipated pace, finishing 9th overall and winning his AG
Jeremy had a great race, finishing second in his category (had he filled out his form properly haha!)
Jerry had a great race, coming in 4th in his category
Aaron had an awesome race, finishing 15th overall, 3rd in his AG, and winning the spouse category
Jessica was great, winning the spouse team award with Aaron!
Heidi ran very strong, finishing 3rd in her category

Here are some of our favourite pictures of the event:

















Princess Health and Salt Sugar Fat. Princessiccia

Princess Health and Salt Sugar Fat. Princessiccia

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I'd just like to put in a quick word for a book that will be released tomorrow, titled Salt Sugar Fat: How the Food Giants Hooked Us, by Pulitzer prize-winning author Michael Moss.  This is along the same lines as Dr. David Kessler's book The End of Overeating, which explains how the food industry uses food reward, palatability, and food cues to maximize sales-- and as an unintended side effect, maximize our waistlines.   Judging by Moss's recent article in New York Times Magazine, which I highly recommend reading, the book will be excellent.  I've pre-ordered it.


Princess Health and Exercise And Water Intake. Princessiccia

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How does water intake affect your health and fitness goals? Why to drink plenty of water? How much do we actually need? Why is it extremely important to drink water during exercising? What if we are not thirsty? And why is that?

Water-facts

-Water makes up nearly 60% of total body weight.
-For example: bone contains 22% water, muscle cells contain 75% water, blood contains nearly 83% water.
-Without exercising, we lose an average 1500 ml of water every day.
-Thirst is a very poor indicator of hydration status, in fact, thirst usually isn't perceived until 1-2% of body weight is lost. At that point, if you are exercising, performance decreases will already have occurred. Even if you are not exercising, mental focus and clarity may have dropped off.

Why do we need water?

-Lubricates joints
-Lessens the burden on the kidneys and liver by flushing out waste products
-Carries oxygen and nutrients to cells
-Helps dissolve minerals and other nutrients to make them accessible to the body
-Helps prevent constipation
-Regulates body temperature

It is very simple: our body needs water to function properly. 

What happens when we don't drink enough?

Here is an easy-to-understand chart about the effect of water loss on the body. (The first column shows the water loss in %, and the second column the effect of it:

0.5%Increased strain on the heart
1% Reduced aerobic endurance
3% Reduced muscular endurance
4% Reduced muscle strength, reduces motor skills, heat cramps
5% Heat exhaustion, cramping, fatigue, reduced mental capacity
6% Physical exhaustion, heatstroke, coma

How much water do we actually need?

There are different ways to estimate the fluid need. One of the easier methods is estimating according to body weight. 
As per this method, for every kilogram of body weight you would ingest 30-40 milliliters of water. So if you weigh 50 kg for example, you would need 1.5-2 liters of water per day. 
This requirement increases in warm weather conditions and during exercising.

Why do I not feel thirsty?

You might ask the question. As pointed out above, thirst itself is a sign of danger, your body has already lost a lot of water.
Our body gives different signs of being dehydrated: headache, fatigue, low blood pressure, dizziness. And one of the interesting signs could be hunger. 

So before you make your afternoon coffee, or reach for a painkiller, or think you are being hungry again, try this "trick": drink a glass of water!
Beside these, there are certain types of food- processed, sugary, fatty food - which will make you not feeling thirsty. If you eat plenty of fruit and veg, beside the fact that these foods contain higher amount of water themselves, you will feel the need of more water because of the fibers.

Can I drink any kind of fluid?

No. You can't replace water with sugary and flavored drinks. Why? There are several reasons for that. Flavored drinks usually contain high amount of unhealthy sugars and artificial additives, which do more harm than good for your body. Not to mention their weight-gain 'side-effect'.

We are talking here about mineral water. That is what your body needs. Not just plain tap water, because, especially during exercising, you do not only need to replace the lost body-water, but also the salts and minerals.

Hydration before and during exercising

As we were saying, exercising increases the amount of water our body needs. During  aerobic types of exercises, like Zumba, where we sweat a lot, it is extremely important to drink enough water.

About 500 milliliters of water is recommended approximately 30 minutes before exercise followed by approximately 250 milliliters every 15 minutes during exercise.
The way our classes are designed lets you sip a bit of water after each song, so you can make sure your body continuously gets the water so much needed.


How to start drinking more water? The best way to get used to drinking more water is to always have water somewhere around you: on your working desk, in your bag, everywhere. Seeing the glass or bottle of water all the time will remind you of drinking, and you will actually feel "thirsty" more times than usually.

Never start your Zumba class (or any other exercise) without having a bottle of water at hand. Slowly-slowly you will get to the point where you will drink enough water with no extra effort. And your body will reward that!

So grab your bottle of water, and book your next Zumba class! CLICK HERE











































































































Princess Health and Essential-benefits rule expands mental-health and substance-abuse coverage; Ky. needs more facilities to treat newly eligible.Princessiccia

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The Department of Health and Human Services has defined the 10 "essential health benefits" insurance plans must provide, and it included benefits for mental health and treatment of substance-abuse disorders..

Nearly 20 percent of Americans don't have access to mental-health services and over 30 percent have no coverage for substance-abuse treatment. This rule will expand mental health and substance-abuse treatment benefits to 62 million Americans, according to HHS.

Expanded coverage for mental health and substance abuse treatment programs in Kentucky could bring about a dramatic shift in the delivery of these services. There is already a shortage of treatment options and centers for Kentuckians, and those suffering from addiction have not had coverage for such treatment; the proposed rule will change that.

Recovery Kentucky, a public-private partnership with residential facilities, was created to help Kentuckians recover from substance abuse. It has 10 centers, in Campbellsville, Erlanger, Florence, Harlan, Henderson, Hopkinsville, Morehead, Owensboro, Paducah, and Richmond, according to the 2012 Justice & Public Safety Cabinet report, which included the map below. 

Health-insurance plans must cover the 10 essential benefits beginning in 2014, so the state must prepare for the newly insured in addition to newly covered services. The rule defines what must be covered in insurance plans and bans discrimination based on age or pre-existing conditions. Among the core package of items and services, known as �essential health benefits" are items and services in the following categories:
  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care
States are given flexibility in implementing the federal health-care reform law with a benchmark approach. The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization plan serve as the �benchmark� plan for the Kentucky Health Benefit Exchange. HHS will review the recommendation and accept public comments prior to making a final decision. (Read more)
Princess Health and Medicaid expansion brings primary care access to the forefront.Princessiccia

Princess Health and Medicaid expansion brings primary care access to the forefront.Princessiccia

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The federal health reform law will usher at least seven million more Americans into Medicaid, and as states like Kentucky debate Medicaid expansion, policymakers are struggling with the question of whether there will even be enough primary care doctors to provide care, reports Michael Ollove of Stateline.

The country is already short of primary-care doctors. Although many primary-care physicians would take on new Medicare or privately-insured patients, only two out of three primary-care physicians surveyed in 2011 were willing to accept new Medicaid patients.

Why? Poor compensation is one reason; on average, Medicaid pays physicians 59 percent of the amount Medicare pays for primary care services, reports Ollove. Many Kentucky primary-care providers are also deterred by existing Medciaid problems. Providers report being burdened by a lack of or delayed payments from the new managed-care system.

Congress hopes to lure practitioners to primary care with a provision that raises primary-care providers' Medicaid fees to Medicare levels. This is only a temporary fix, which went into effect at the beginning of the year and will remain in effect for two years, reports Ollove.

The impact in Kentucky remains uncertain. Lawrence Kissner, Kentucky's commissioner for health and family services, says the state�s Medicaid pay raise in 2005 resulted in a 36 percent increase in the number of primary care doctors accepting Medicaid patients, reports Ollove. This is precisely what the health-law authors hope will happen now.

Kentucky is addressing the health coverage issue in other ways.  The General Assembly is considering a bill that would repeal a burdensome supervision requirement and encourage more independent physician assistants to remain in Kentucky to serve medically underserved areas.

Although Kentucky already allows nurse practitioners to practice independently, the Medicaid rate increase applies only to physicians who provide primary care services. It does not apply to nurse practitioners, who have been touted as a potential solution to the primary care problem and often provide care in underserved areas of the state. (Read more)

Princess Health and Foundation for a Healthy Kentucky gives UK $1 million for endowed co-chairs in rural health policy.Princessiccia

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Tyrone "Ty" Borders in the University of Kentucky College of Public Health's Department of Health Services Management, and Brady Reynolds in the UK College of Medicine's Department of Behavioral Science, have been named the Foundation for a Healthy Kentucky endowed co-chairs in rural health policy.

A $1 million gift from the foundation to the College of Medicine was matched by the state Research Challenge Trust Fund, better known as "Bucks for Brains." The gift has the goal of enriching Kentucky's research capabilities in regards to rural health issues and rural health policy.

Reynolds earned doctoral and master's degrees in life-span developmental psychology from West Virginia University. He also holds a master's degree in general/experimental psychology and a bachelor's degree (magna cum laude and with distinction) from James Madison University. His research has focused on nicotine use by adolescents, drug use, gambling and other addictive behaviors. In recent years Reynolds has begun research to promote smoking cessation among pregnant smokers in rural Appalachia.

Borders earned doctoral and master's degrees in health administration, as well as a master's degree in epidemiology from the University of Iowa, and a bachelor's degree in psychology from the University of Kansas. His research focuses on the conduct and analysis of population-based studies to identify subgroups of persons at risk for poor health and problems obtaining health services, with an emphasis on rural populations.

�Drs. Reynolds and Borders have skills in intervention research and rural health policy expertise that can help the University remain at the forefront of rural health policy work in today�s rapidly changing healthcare environment,� said Susan Zepeda, president and CEO of the foundation.

The mission of the foundation is to addresses the unmet health care needs of Kentuckians. Mission objectives are advanced through two initiative areas: promoting responsive health policy and a new children�s initiative named �Investing in Kentucky�s Future.� Foundation work aims to improve access to health care, reduce risks and disparities, promote health equity and healthy lifestyles. Since 2001, over $22 million has been invested in health policy research and demonstration grant projects across Kentucky

Friday, 22 February 2013

Princess Health and If Republican governors are agreeing to expand Medicaid after lobbying by hospitals, can Beshear be far behind?.Princessiccia

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By Al Cross
Kentucky Health News

Florida Gov. Rick Scott's surprising announcement that he would use federal health-care reform money to expand the Medicaid program to households earning up to 138 percent of the poverty level "means the dominoes are falling," says Ron Pollack, executive director of Families USA, a consumer group that lobbied for the law. And another domino seems likely to be Democratic Kentucky Gov. Steve Beshear, without involvement by the state legislature.

Beshear has said he will expand Medicaid if Kentucky can afford it, and has mentioned that the state can reserve the right to pull out of the deal in 2017, when it must start paying a small but increasing share of the cost, reaching 10 percent in 2020. Scott used the same qualification.

Pollack told The New York Times that the message sent by seven Republican governors' acceptance of the deal is  �Even though I may not have supported and even strongly opposed the Affordable Care Act, it would be harmful to the citizens of my state if I didn�t opt into taking these very substantial federal dollars to help people who truly need it.� The GOP governors (of states outlined in Times map below) have said they will expand the program partly to protect rural hospitals and the poor.

"The change of heart for some Republican governors has come after vigorous lobbying by health industry players, particularly hospitals," the Times notes. "Hospital associations around the country signed off on Medicaid cuts under the health care law on the assumption that their losses would be more than offset by new paying customers, including many insured by Medicaid. . . . Every few days, state hospital associations and advocates for poor people issue reports asserting that the economic benefits of expanding Medicaid would outweigh the costs." (Read more)

Kentucky Hospital Association President Michael Rust said the trade group is for "universal coverage" by whatever means but is not lobbying Beshear for Medicaid expansion. "We assume he is" going to expand it, Rust said in an interview today. He said the association has not taken a position on bills that would require legislative approval of expansion and the health-insurance exchange being set up under the reform law. The legislation, Senate Bill 39 and SB40, passed the Republican-controlled Senate on party-line votes today, and are expected to die in the Democratic-majority House.

Senate Majority Floor Leader Damon Thayer said the bills were aimed at reining in "big daddy government." Here's a video from cn|2:

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Food Reward Friday. Princessiccia

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This week, Food Reward Friday is going to be a little bit different. I've received a few e-mails from people who would like to see me write about some of the less obvious examples of food reward-- foods that are less extreme, but much more common, and that nevertheless promote overeating. Let's face it, even though they're funny and they (sometimes) illustrate the principle, most people reading this blog don't eat banana splits very often, much less pizzas made out of hot dogs.

So this week's "winner" is something many of you have in your houses right now, and which was also the subject of an interesting recent study... potato chips!


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Thursday, 21 February 2013

Princess Health and Deaths by overdose, mainly of prescription drugs, hit a new record in U.S. in 2011; a huge problem in Kentucky.Princessiccia

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Drug overdose deaths in the U.S. rose for the 11th straight year and accidental deaths involving addictive prescription drugs overshadow deaths from illicit narcotics, new federal data show.

In 2010, there were 38,329 drug overdose deaths nationwide, and prescription drugs were the cause of nearly 60 percent of them.  As in recent years, opioid drugs such as OxyContin and Vicodin were the biggest problem, contributing to three-fourths of medication-overdose deaths, report Lindsey Tanner and Mike Stoppe of The Associated Press.

Anti-anxiety drugs including Valium were involved in almost 30 percent of medication-related deaths.  Most were unintentional overdoses; 17 percent were rules suicides. The data were reported Tuesday in the Journal of the American Medical Association.

In Kentucky, drug abuse is epidemic and more than 1,000 Kentuckians a year die from prescription-drug overdoses, more than the number who die in car accidents, according to a 2012 Kentucky Justice & Public Safety Cabinet report. About 85 percent of Kentucky's drug-related deaths were accidental and approximately 2 percent were suicides, according to federal Centers for Disease Control and Prevention data.

The number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010. In 2010, the record number of deaths reflected the national trend and also involved opioid painkillers, according to a study by the Kentucky Injury Prevention and Research Center. The highest rates of overdose deaths during the study period were concentrated in Eastern Kentucky and among men, reports Bill Estep of the Lexington Herald-Leader.


Many doctors and patients don't realize how addictive these prescription drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs, said Dr. Thomas Frieden, head of the CDC. He said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" -- doctor offices and pharmacies that over-prescribe addictive medicines, AP reports.

That was the aim of House Bill 1, passed in last year's legislative session. The Kentucky All-Schedule Prescription Electronic Reporting  (KASPER) system has undergone several changes since the bill's passage to help crack down on so-called pill mills.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be placed in a more restrictive drug category, which would make them harder to prescribe. Refills wouldn't be allowed without a new prescription, and faxed or called-in prescriptions wouldn't be accepted; only a handwritten prescription from a doctor would be allowed.

Tuesday, 19 February 2013

Princess Health and Body Fatness and Cardiovascular Risk Factors. Princessiccia

Princess Health and Body Fatness and Cardiovascular Risk Factors. Princessiccia

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I recently revisited a really cool paper published in the Lancet in 2009 on body fatness, biomarkers, health, and mortality (1). It's a meta-analysis that compiled body mass index (BMI) data from nearly 900,000 individual people, and related it to circulating lipids and various health outcomes. This is one of the most authoritative papers on the subject.

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Princess Health and Three Kentucky health departments in first group up for national accreditation; requires local health assessment, improvement plan.Princessiccia

Princess Health and Three Kentucky health departments in first group up for national accreditation; requires local health assessment, improvement plan.Princessiccia

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By Molly Burchett
Kentucky Health News

Three Kentucky health departments are among the first in the nation to be considered for national accreditation, a process that could help improve patient care and put the agencies in closer touch with their communities' needs.

The national Public Health Accreditation Board will make its first accreditation decisions next week. Among the first group being considered are the Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties.

The decision will be a historic one, and this is an exciting time for the board and Kentucky, said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health.

The accreditation program was launched in September 2011 after a seven-year development process aimed at advancing quality and performance and value in the departments, and their accountability to stakeholders, Scutchfield said.

Departments are assessed by rigorous standards tested in 30 diverse health departments across the country to ensure essential public health services are provided in the community, according to the board's website. Two of the 12 "domains" of the standards deal with administration and governance. In Kentucky, state law makes county health boards responsible for the health of the county. Counties served by district health departments still have county boards.

Accreditation can help a board and department identify opportunities to improve performance and management, and to improve relationships with the community, since the process requires a community health assessment, a community improvement plan and a strategic plan to address the need of the community, said Scutchfield.

The process, often called "Mobilizing for Action through Planning and Partnerships," can help boards and departments be better prepared to proactively respond to emerging and re-emerging health challenges. For a PDF of Franklin County's MAPP document, click here.

The accrediting board has received 108 applications from health departments around the nation: 13 state health departments, 94 local health departments and one tribal agency. In addition to the three Kentucky agencies being considered in the first group, the other Kentucky departments that have applied for accreditation and are awaiting site visits are Lexington-Fayette County, Barren River District, Madison County and Christian County, Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said in an email.

The accreditation process encourages departments to move away from the "silo" model to collaborate with community programs. In Christian County, it has changed the way department employees view their jobs, because they have to continuously reflect on their methods and brainstorm for ways to improve, Health Department Director Mark Pyle told Nick Tabor of the Kentucky New Era.

"Accreditation will likely open new revenue streams," Tabor writes. "But in a way, the process matters more than the status designation."

Midkiff said, "In addition to benefiting from the process itself, our federal and state resources in public health are increasingly shrinking, we are being asked to do more with less. And there is a need for transparency within agencies."

Midkiff said accreditation "may make the agency more competitive for grants in the future. We are actually seeing quality improvement and performance management requirements being written in many federal grants now, so it is being expected at the national level."

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Poll finds four out of five Kentuckians are comfortable seeing a nurse practitioner or physician assistant for routine care.Princessiccia

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New poll figures indicate the majority of Kentuckians are comfortable seeing a nurse practitioner, physician assistant or mid-level clinician for their routine care, especially if they have been treated by such clinicians. The findings come as the General Assembly considers a bill that would allow physician assistants to practice more independently.

In the Kentucky Health Issues poll last fall, 79 percent of Kentucky adults said they would be comfortable seeing a nurse practitioner for routine health care, and half of those people said they would be very comfortable. Eighty-one percent said they would be comfortable seeing a physician assistant for routine health care, and 42 percent of those respondents said they would be very comfortable.
Reported comfort was higher among people who had received care from a nurse practitioner or physician assistant in the past year; 86 percent of those people said they would be comfortable seeing an NP again for routine care. Eighty-eight percent of those who had received care from a PA in the past year said they would be comfortable doing that again.
The poll also inquired about a proposed new �mid-level� profession: advanced dental hygiene practitioners. These practitioners would provide routine dental care, including diagnostic and preventive services such as filling cavities. Although advanced dental hygiene practitioners cannot currently be licensed to practice in Kentucky, polling data indicated 73 percent of Kentucky adults would be comfortable with such a practitioner providing routine dental care.

"As providers move to create a system of care that includes a range of skill sets and training in its care teams, new strategies emerge that hold promise to increase access to affordable care � not just in urban centers but also in rural and underserved communities,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which sponsored the poll. �The data suggest that the public is very receptive to health care services from different types of clinicians.�

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points. (Read more)
Princess Health and Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads.Princessiccia

Princess Health and Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads.Princessiccia

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Last week the state Senate approved on party lines a bill that would make lawsuits against nursing homes go through a review panel first. Republicans supported the bill and Democrats voted against it in a 23-12 vote that marked the clearest partisan split in the Senate in this year's legislative session.

Senate Bill 9 would create medical review panels of three physicians and an attorney moderator to hear complaints against long-term care facilities and vote on whether the suit had enough merit to go to court.  The bill's sponsor, Senate Health and Welfare Chairwoman Julie Denton, R-Louisville, declind to answer an opposign senator's questions about the bill. She said in introducing it that the panel would be advisory but its opinion would be admissible in court and would curb such lawsuits, reports Jack Brammer of the Lexington Herald-Leader.

Bills like this have failed in years past and could have diverse implications for Kentucky communities and nursing homes. At least one Kentucky newspaper looked around and found that lawsuits are one reason Extendicare Health Services Inc. shed management responsibilities last year for all 21 of its facilities in Kentucky, reports Nick Tabor of the Kentucky New Era in Hopkinsville.

Without Extendicare management in Western Kentucky, the volume of nursing-home lawsuits in the region appears to be shrinking, Tabor reports. In recent years, nearly all the Christian County cases that have been closed were dismissed through settlements, not by judges declaring them unfounded. This suggests the bill would minimally affect the county, writes Tabor. Other Kentucky communities may be affected differently; judges differ from circuit to circuit.

Although the bill passed the Senate, it appears to be on its deathbed in the House. Rep. Tom Burch, D-Louisville, who chairs the House Health and Welfare Committee, joked about its prospects to Tabor: �I can�t make any predictions about the bill this time, but I�ve called in three priests to have the last rites ready.� If nursing homes received this new layer of protection, he said, hospitals and day-care centers would want it too.

A similar bill died in Burch's committee last year; this version is being supported by television and radio commercials urging viewers and listeners to call their legislators in support. When Extendicare announced last spring it was transferring management of all its Kentucky facilities to a Texas company, it cited Kentucky�s �worsening litigation environment� and said tort reform seemed unlikely here.

Bernie Vonderheide, director of Kentuckians for Nursing Home Reform, said most so-called �frivolous� lawsuits would cease if the state imposed minimum staffing requirements on nursing homes, his group's main legislative goal. (Read more)

Princess Health and Medically unnecessary procedures are part of culture of disability in Eastern Kentucky, professor writes.Princessiccia

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St. Joseph London Hospital is taking heat over accusations of performing medically unnecessary cardiac catheterizations and other invasive cardiac procedures, and a look at the health data by a Kentucky physician suggests that the phenomenon is broader and reflects cultural problem in Eastern Kentucky.

An examination of health data by Dr. Peter Hasselbacher, a retired internist and professor emeritus at the University of Louisville, confirmed that St. Joseph London performed a large number of invasive heart procedures for such a relatively small, rural hospital.  Many patients have sued the hospital, alleging unnecessary procedures, notes a story in The Courier-Journal.  And when the hospital came under federal supervision, the frequency of its most commonly performed stent-angioplasty procedure dropped by 37 percent, Hasselbacher reports on his Kentucky Health Policy Institute blog.

As the number of St. Joseph London procedures dropped sharply, there was a more dramatic increase in catheterizations and angioplasties statewide. From 2010 to 2011, the number of the most commonly reported angioplasties in Kentucky increased from 12,803 to 22,688, a 77 percent increase, reports Hasselbracher.

This map showing how many people living in each of Kentucky�s counties underwent a percutaneous transluminal coronary angioplasty (PTCA) in 2010. This is the most common invasive cardiac procedure in Kentucky and is used to prevent and treat heart attacks.

In this map, the darker the shade of blue, the greater percentage of people living in that county had an angioplasty in 2010. The differences among the counties is staggering. It ranges from a low of 42 people per 100,000 in a single year, all the way up to 1,700 per 100,000 � a 40-fold difference. In the counties with the highest rates, between 1 percent  and 2 percent of the county's population underwent the procedure in a single year.

These rates are based on where people live, rather than where they go to the hospital, and the counties with the highest rates are in Appalachia. Hasselbacher calls Eastern Kentucky is "an angioplasty factory" and says the phenomenon can't be be fully explained by the simple fact that people in the region are sicker than those in the rest of the state; he offers another explanation.

"It is my belief that a major, perhaps even the major segment of the economy of Eastern Kentucky revolves around the getting of disability and the keeping of disability" and its government benefits, Hasselbacher writes. "As other industries such as coal and tobacco have faded in importance, the pursuit of disability, medically justified and not, has drained away resources from medical services into an ersatz unemployment and social support program."

Hasselbacher, left, says he doesn't wish to imply that the people of Eastern Kentucky are morally distinguishable from the rest of us, or that their health-care professionals are any less professional. He acknowledges that the region has had an uphill struggle for many years, and it is easy for providers to fall into the trap of wanting to do everything and anything to help patients.

"A culture has evolved in which being sick or just having a diagnosis of being sick is a gateway to economic security for people and professionals alike," Hasselbacher writes. "Some patients, doctors, hospitals, and lawyers wittingly or unwittingly support that process. Doing medially unnecessary diagnostic testing and treatment is part of that culture. It is also good for business." (Read more)   

Monday, 18 February 2013

Princess Health and How To Beat Those Bingo Wings?. Princessiccia

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Bingo wings - who doesn't hate them? Most women would agree that the dangling fat underneath the upper arms is quite disturbing. Therefore, they don't feel confident to wear sleeveless tops or dresses, and they don't feel confident in general about how they look. The good news is that they can beat the bingo wings with the right exercises.

Why do we get bingo wings?

Bingo wings are basically excessive fat accumulated on the upper arms. Fat accumulates because the food we take in provides more energy than the energy we use. Besides belly, hips and thighs, arms are perfect spots for storing the excessive fat. So the fact of having bingo wings is a sign of being overweight.

Fighting bingo wings - Step 1.

The right exercise to start fighting bingo wings is cardiovascular (aerobic type) exercise, to use  up more energy, to burn fat. There are many choices: jogging, swimming, biking, dancing, speed walking, aerobics, Zumba� Fitness. Doing one of these exercises regularly, at least thirty minutes four times a week can help reduce body fat all over the body, including upper arms.

Fighting bingo wings - Step 2.

Besides, doing toning exercises for the arm area can speed up the result. Working with own body weight is one of the best choices, also being very easy to do the exercises in the comfort of your own home.

Back press or chair dip - The chair is behind your back, then you place your hand palms down on the chair with your arms straight and the legs in front of you as wide as your shoulder. Lower your body until your elbow is bent at a 90 degree angle and then push yourself back up.

Push ups (easy or difficult version) - You might hate push ups, but once you see the results they will become your best friend. You might want to start with the easy version, which places the knees instead of the feet on the floor so that you don�t feel much pressure when lowering your body to the floor.

These two exercises done in repetitions will make you get the best results.

It is important to remember that doing toning exercises only will not get rid of the flabby underarms. Cardiovascular exercise (outlined above) is unavoidable to get the results you want.

During our ZUMBA� classes, there are many steps when serious arm moves are added. Beside the cardiovascular and fat burning benefit of a ZUMBA� fitness class, you can tone up your arms, if you keep your upper arm muscles tight while doing the arm moves. You will feel the difference!

Good bye, bingo wings! - Hello, gorgeous sleeveless dress!

Don't hesitate, get the 2 in 1 benefit of our ZUMBA� classes, CLICK HERE to book your place!






















































































































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