Tuesday, 29 April 2014

Princess Health and Fat vs. Carbohydrate Overeating: Which Causes More Fat Gain?. Princessiccia

Princess Health and Fat vs. Carbohydrate Overeating: Which Causes More Fat Gain?. Princessiccia

Two human studies, published in 1995 and 2000, tested the effect of carbohydrate vs. fat overfeeding on body fat gain in humans. What did they find, and why is it important?

We know that daily calorie intake has increased the US, in parallel with the dramatic increase in body fatness. These excess calories appear to have come from fat, carbohydrate, and protein all at the same time (although carbohydrate increased the most). Since the increase in calories, carbohydrate, fat, and protein all happened at the same time, how do we know that the obesity epidemic was due to increased calorie intake and not just increased carbohydrate or fat intake? If our calorie intake had increased solely by the addition of carbohydrate or fat, would we be in the midst of an obesity epidemic?

The best way to answer this question is to examine the controlled studies that have compared carbohydrate and fat overfeeding in humans.

Horton et al.

Read more �

Monday, 28 April 2014

Princess Health and Princess Health andStates and their congressmen battling new painkiller that is easier to crush and inject.Princessiccia

Some states are restricting the use of the new painkiller Zohydro, "setting up a showdown with the federal government over who gets to decide the best way to protect public health," Michael Ollove reports for Stateline.

Rogers (Herald-Leader photo)
Though millions of chronic pain sufferers could benefit from the drug, some officials worry that abusers will crush and inject it for a big high, will significantly worsen the painkiller abuse crisis they have been battling. Combating prescription drug abuse has been a focus in Kentucky for the past few years. U.S. Reps. Hal Rogers of Somerset and Stephen Lynch of Massachusetts have introduced a bill to withdraw the Food and Drug Administration's approval, done though an advisory board voted 11-2 against it.

A federal judge told Massachusetts officials that they cannot ban a drug that the FDA has declared safe and effective, but Gov. Deval Patrick is restricting its use. Vermont Gov. Peter Shumlin has taken similar measures, and the Ohio legislature is debating similar action. Twenty-nine state attorneys general, including Kentucky's Jack Conway, have requested that the FDA rethink its approval of Zohydro.

"We're in the context of a very serious epidemic of opioid drug addictions and opioid deaths, and that's a public health crisis that has been growing over the last decade and half," said Michael Carome, director of the Health Research Group at the consumer organization Public Citizen. "The last thing we needed was another extended release opioid for treating chronic pain."

According to Trust for America's Health's 2013 report, "6.1 million Americans abuse or misuse prescription drugs," and "Overdose deaths involving prescription painkillers have quadrupled since 1999, and now outnumber those from heroin and cocaine combined, Ollove reports. Zohydro is an opioid, and opioids are not only easily abused but are also unfortunately gateway drugs, influencing people to use heroin, which isn't as expensive. One advantage to Zohydro is that it is a single-ingredient, long-acting product, unlike other painkillers that were combined with acetaminophen, which can be injurious to the liver.

Opponents are frustrated that the FDA not only approved the drug but also did not force the manufacturer, Zogenix, to create a version that isn't so easy to abuse. The company has said it is making such a version. "In the meantime, it said it has implemented other safeguards, such as compensating sales representatives for educating doctors, pharmacists and patients on the risks and benefits of extended-release opioids," Ollove writes.

Sherry Green, chief operating officer of The National Alliance for Model State Drug Laws, agreed withZohydro maker Zogenix "that taking action against selective prescription drugs is the wrong approach," Ollove reports. Green said, "When we focus almost solely on an individual drug, we tend not to put as much attention on the underlying problem, which is the abuse and addiction. Obstructing illicit routes to one medication only creates pathways to another one." (Read more)

Princess Health and Princess Health andHealth reform law isn't as sweeping when it comes to dental coverage, but Appalachian dentists say it should help.Princessiccia

Dr. Heather Whitt explains costs to Anita Slone at the Eula Hall
Health Center in Floyd County. (C-J photo by Jessica Ebelhar)
In Floyd County, almost 40 percent of adults have lost six or more teeth to decay or gum disease, more than 50 percent of adults have had at least one tooth pulled, and 25 percent of people older than 65 have lost all of their teeth. But "When it comes to dental care, the Affordable Care Act's reach is limited," Laura Ungar reports for The Courier-Journal.

The Patient Protection and Affordable Care Act requires health plans to cover children's oral health, but adult coverage is optional. Kentucky's Medicaid benefits only cover certain services, such as oral exams, emergency visits, X-rays, fillings and extractions, and rural areas are dealing with a shortage of dentists who increasingly do not accept Medicaid.

Despite these obstacles, Dr. Heather Whitt, director of dental services for a network of health centers called Big Sandy Health Care, said she thinks the reform law will help people who live in Central Appalachia, a hotbed of bad oral health. She said the number of uninsured�which for a long time was almost 75 percent of her patients�is finally beginning to decrease. "Now, there are more adults having Medicaid. It's definitely improved the patients we see here. . . . We stay very busy," she said. "I'm excited more people have benefits."

"She and other dentists said Medicaid, which is covering most of the area residents newly insured through the ACA, does not cover every service they might need," Ungar writes. Whitt noted that Medicaid doesn't cover costs for dentures or root canals for patients older than 21, and some dentists said Medicaid managed-care organizations do not send reimbursements quickly enough.

Whitt said that she and her staff try to teach patients about brushing, flossing and regular checkups. They also teach those things in schools, encouraging children to visit dentists. Dentists say that if the law and Medicaid can get more people to visit the dentist, they'll learn to take better care of their teeth. "A lot of our patients just kind of fall through the cracks," said Dr. James Stambaugh, another dentist at the clinic. "Small problems just grow exponentially." (Read more)

Sunday, 27 April 2014

Princess Health and Princess Health andIn Floyd County, opinions about health care reform depend on whom you ask, and in some cases they are surprising.Princessiccia

At the Eula Hall Health Center in Grethel,
nurse Stephanie Clark takes vitals of Mary
Murphy, 54, whose leg blood clot wasn't
treated for 15 years because she couldn't
afford it. (C-J photo by Jessica Ebelhar)
"A team of journalists from USA Today and The Courier-Journal has found that in Floyd County, Obamacare is a neither a train wreck nor a cure-all. It's a work in progress; widely misrepresented and misunderstood, it's helped some people and hurt others, while a handful seem unaffected." So write Chris Kenning and Laura Ungar of The C-J, with Jayne O'Donnell and Rick Hampson of the national newspaper of C-J owner Gannett Co. Inc.

Newly insured people are being treated for ailments that they long ignored or tried to treat with inadequate resources, and people who couldn't get or afford insurance because of pre-existing conditions have been able to get it. "Yet, also because of Obamacare, insurance customers in this Appalachian community complain about higher deductibles and insuring those who don't work. Many say they can't afford even subsidized plans on the state's insurance exchange," the writers report. "Some small business owners say they may cut workers' hours. And hospital leaders say the law has exacerbated health-care trends, leading them to lay off workers and shut down an entire floor of Floyd County's largest hospital."

Advocates say the health-reform law will improve Kentucky's health by bringing care to those who haven't had it, but "Obamacare so far shows scant promise of being able to heal Floyd County, where generations of poor health habits and attitudes testify to poverty's victory" despite the "war" on it that President Lyndon Johnson declared in the region 50 years ago. "Real change, many say, will take decades, given the county's poor health: 35 percent of adults smoke, and the overall death rate is 42 percent above the national average. Many lack reliable transportation, have trouble taking time off from low-wage jobs for medical appointments or just don't believe in going to the doctor."

Some say the law didn't go far enough, and worry about its effect on hospitals. "It's insurance reform," said Bud Warman, president of Highlands Regional Medical Center in Prestonsburg, the Floyd County seat. "It's not health care reform.''

Princess Health and Princess Health andKy. leads U.S. in emphysema (COPD), but study shows fewer COPD hospitalizations in Ky. places with smoke-free laws.Princessiccia

Click on image for larger version
People who live in smoke-free communities are less likely to be hospitalized for emphysema, according to a study by the University of Kentucky's College of Nursing and College of Public Health and recently published in the American Journal of Public Health.

The study found that people who live in communities with comprehensive smoke-free workplace laws are 22 percent less likely to be hospitalized for chronic obstructive pulmonary disease (COPD), or emphysema. Living in a community with an established law also resulted in a 21 percent lower likelihood of experiencing hospitalization due to emphysema.

Kentucky has the nation's highest rate of chronic obstructive pulmonary disease, 9.3 percent of the population, according to the federal Centers for Disease Control and Prevention. Tobacco use is the primary cause of emphysema, but air pollution and genetics can also play a role.

The study matched 2003 and 2001 data on hospital discharges with communities that were part of the Smoke-free Ordinance database from the Kentucky Center for Smoke-free Policy, Ann Blackford reports for UKnow.

Dr. Ellen Hahn (Herald-Leader photo by Matt Goins)
�Smoke-free public policies, particularly when they cover all workplaces with no exceptions and have been in place for at least one year, may provide protection against exacerbation of COPD that lead to hospitalizations, with potential to save lives and decrease health care costs,� said Nursing Professor Ellen J. Hahn, director of the center and lead author of the study. �Given that such a high percentage of Kentuckians live in at-risk rural areas and lack the protective factor of income or smoke-free laws, the state faces a higher risk of COPD."

Lexington was the first Kentucky city to pass a smoking ban. "Lexington's smoking ordinance, which bans smoking in most indoor public spaces, doesn't specify that smokers be caught in the act. But that has become the default standard since the ban went into effect 10 years ago," Mary Meehan reports for the Lexington Herald-Leader. "As the smoking ban in Lexington has aged, the challenges have lessened. In many cases, Hahn said, the ban has been self-enforcing. Patrons at restaurants complain to management about smokers, or bar employees take it upon themselves to keep people from lighting up. Gradually, she said, smoking just isn't accepted or expected anymore. Non-smoking in most places has become the 'new normal.' There are now only a handful of businesses that receive citations. Most are small bars and strip clubs."

Read more here: http://www.kentucky.com/2014/04/26/3214347/10-years-after-it-became-law-fayette.html#storylink=cpy
Read more here: http://www.kentucky.com/2014/04/26/3214347/10-years-after-it-became-law-fayette.html#storylink=cpy

Friday, 25 April 2014

Princess Health and Princess Health andInsurance companies will be allowed to add one more year to policies that don't comply with reforms; decisions due May 5.Princessiccia

Princess Health and Princess Health andInsurance companies will be allowed to add one more year to policies that don't comply with reforms; decisions due May 5.Princessiccia

Kentucky�s health insurance companies may extend through Oct. 1, 2016, individual and small-group policies that don't comply with federal health reform, the state Department of Insurance announced Friday. This means some consumers can continue these policies until Oct. 1, 2017.

Insurance companies are supposed to notify the Insurance Department of their decisions by May 5.

This is the second �transitional relief� option offered to states by the federal government. The earlier one came in November 2013 and offered a one-year extension of existing policies; the most recent adds two more years. The latest relief does not affect �grandfathered� plans (those in existence prior to March 23, 2010, the date the law took effect) or newly issued policies.

The Patient Protection and Affordable Care Act requires 10 essential health benefits and includes other provisions that were not part of many old policies.

�We know that health insurance needs are personal,� Insurance Commissioner Sharon P. Clark said in a press release. �This choice would give individuals and small employers the flexibility to make the decision that best fits their needs at this time while planning for full implementation of the Affordable Care Act.�

Thursday, 24 April 2014

Princess Health and Princess Health andPoll: Kentuckians still oppose Obamacare, but favor fixes, not repeal, and think state insurance exchange works well.Princessiccia

Most Kentuckians still oppose the federal health-reform law, but think it should be changed rather than repealed, and most think the state health-insurance exchange created under the law is working well. So says a poll taken for The New York Times and the Kaiser Family Foundation in four Southern states with key U.S. Senate races this year: Arkansas, Kentucky, Louisiana and North Carolina.

"Debate over the law is expected to dominate the midterm elections. Attacks on the law are featuring prominently in campaigns across the country, and Republican lawmakers have continued to push for the law�s replacement," Sabrina Tavernise and Allison Kopicki write. "Questions about it may evoke associations with an unpopular president, the remoteness of Washington from ordinary Americans and extra costs in family budgets. But majorities say they do not want it taken away, even in states that lean Republican in presidential elections."

Among the four states, Kentucky is the only one that is running its own exchange, and the only one in which a majority said it is working well. In Arkansas, which has a combined state-federal exchange, a plurality said it was working well. The other two states use the federal exchange, which had a troubled rollout.

Kentucky is the only Southern state that created its own exchange and expanded Medicaid to include people in households with incomes up to 138 percent of the federal poverty level. The poll found support for Medicaid expansion in all four states, and 55 percent in Kentucky gave Gov. Steve Beshear, who made both decisions, a positive job rating.

The poll, done with landline and cellphone interviews April 8-15, has a margin of sampling error of plus or minus 4 percentage points in each state. (Read more)

Wednesday, 23 April 2014

Princess Health and Princess Health andAt National Prescription Drug Abuse Summit, Beshear cites Kentucky's successes.Princessiccia

Gov. Steve Beshear told attendees at the 2014 National Prescription Drug Abuse Summit in Atlanta on Wednesday about the progress Kentucky has made in the last two years in its battle to combat abuse of prescription drugs.

"Prescription drug abuse was wasting away the future of Kentucky... and collectively, as a state, we decided it was past time to take aggressive action," Beshear said.

Two years ago, Beshear attended the summit  and described a plan; what Kentucky was going to do about prescription drug abuse. Since then, not only has Kentucky implemented an aggressive, strategic plan, it has data showing significant progress.

The plan included increased monitoring of prescriptions, tighter regulations for painkillers, closing pain clinics that did not meet tougher requirements, collecting and disposing of leftover drugs and educating prescribers and the public about the dangerous, addictive nature of these drugs.

The state also set up an electronic prescription drug monitoring system, called KASPER and increased coordination among health regulators and law enforcement both inside Kentucky and with other states.

As for the progress, the evidence is in the numbers. From August 2012 to July 2013, Kentucky saw an 8.5 percent drop in the prescription of controlled substances, Beshear reported, adding that there must have been " a lot of unnecessary prescribing going on."

He also noted the closure of 36 pain clinics that did not meet the new requirements: "They packed up and left, essentially in the dark of the night."

Beshear reported the third area of improvement as less reported abuse of prescription drugs by teen-agers, based on every-other-year surveys of Kentucky 10th graders by Kentucky Incentives for Prevention.

In 2008, 19.3 percent of 10th graders said they had used prescription drugs for non-medical purposes at some point in their lives. In 2012, that number had dropped to 10.4 percent. In 2008, 14.1 percent said they had illegally used prescription drugs in the last month; in 2012, that number dropped to 7.6 percent.

Getting rid of old, unused drugs, whose presence in medicine cabinets can lead to abuse and theft, has also been a strategy of success in Kentucky, Beshear said. He said 172 permanent drop-off sites have been established, with at least one site in 110 of Kentucky's 120 counties.

Beshear also stressed the importance of educating both prescribers and the public. Kentucky's medical community has access to a free, on-line education program and students in Kentucky participate in Keep Kentucky Kids Safe program which has reached 40,000 students so far.

The governor said increased availability of substance abuse treatment is important, and mentioned his expansion of Medicaid under federal health reform. "Access to treatment is at an all-time high in Kentucky, thanks to expanded Medicaid programs and the Affordable Care Act," he said. "There are many addicts who want to get clean, and we�re helping them." For a copy of the speech, click here.

Princess Health and Princess Health andBeshear says Kynect signups show importance of health-care reform to Kentucky's health; Republican foes keep attacking it.Princessiccia

By Al Cross
Kentucky Health News

Opponents of federal health reform kept up their drumbeat Tuesday as Gov. Steve Beshear announced the latest, but still not quite final, signup figures from Kynect, the state health-insurance exchange.

Kynect Executive Director Carrie Banahan listened to Beshear.
(Lexington Herald-Leader photo by Pablo Alcala)
Beshear held a news conference to announce that 413,410 Kentuckians enrolled for coverage via the exchange through April 11, when most enrollment in private insurance plans closed until Nov. 15. he said "A significant number" of paper enrollments are still being processed. Enrollment is open year-round for the Medicaid program and for people who experience a major event such as change of jobs or birth of a child.

So far, 68 percent of those who signed up for a private insurance policy through the exchange have paid their premiums, according to a state press release. About three-fourths of the policies are from the Kentucky Health Cooperative, a non-profit insurance company created under the Patient Protection and Affordable Care Act, known as Obamacare. The rest of the market was about equally divided between Humana Inc. and Anthem, the only for-profit company offering exchange policies statewide.

Beshear said state officials estimate that three-fourths of exchange enrollees did not have health insurance when they signed up, and Health and Family Services Secretary Audrey T. Haynes estimated that the number of uninsured Kentuckians has dropped to around 200,000, from an estimated 640,000. She said an unknown number of the uninsured obtained insurance outside the exchange.

About three-fourths of the exchange enrollees are in Medicaid, which Beshear expanded to cover people with household incomes up to 138 percent of the federal poverty threshold. The previous income limit was only 69 percent of poverty. The federal government will pay the entire cost of covering the newly eligible people through 2016, when the state will have to start picking up a small share, reaching a cap of 10 percent in 2020.

The federal government pays about 71 percent of benefits for previously eligible Medicaid recipients in Kentucky. Some who had been eligible but never enrolled signed up through the exchange; Haynes said she didn't know the number, but said she still feels good about the estimate of 17,000, made before the exchange opened Oct. 1.

Beshear reiterated his belief, based on a study by the international accounting firm PriceWaterhouseCoopers, that expansion of Medicaid will pay for itself by expanding the health-care industry and creating 17,000 jobs. Republicans in the General Assembly have expressed skepticism about that but have offered no countervailing information.

The leading Republican attacker has been U.S. Sen. Mitch McConnell, who sent Kentucky newspapers his latest column on the subject Monday, saying claims that the law has been successful are refuted by the experiences of those who had their policies canceled despite President Obama's promise that they could keep them, and have had to pay higher premiums and deductibles, "often for a plan that offers less access to hospitals and their favorite doctor."

McConnell called "shocking" the signup of inmates by jails and prisons, which he said could limit access to care because the demand for it may outstrip the supply of doctors, nurse practitioners and other health-care providers. Officials have said the signups save the state money by transferring costs to the federal government.

Asked about McConnell's criticism, Beshear said, "These critics continue, apparently, to sit in their own echo chambers and talk to each other, because when you get out and talk to these 413,000 people, they are very thankful that we have moved forward both in expanding the Medicaid program and in setting up our own health-benefits exchange." Haynes said the program has been "overwhelmingly successful by all measures."
Read more here: http://www.kentucky.com/2014/04/22/3207241/beshear-says-more-than-413000.html?sp=/99/322/&ihp=1#storylink=cpy

Tea party activist David Adams, who is appealing initial adverse rulings in two lawsuits he filed to challenge Beshear's actions, disputed the estimate that three-fourths of the exchange enrollees had been uninsured, "arguing that enrollment questions on the Kynect website prompted people to falsely claim that they lacked insurance when submitting applications," Mike Wynn reports for The Courier-Journal.

Beshear said the reform law is "a tool to improve people's health, to help those who are vulnerable to to remove lack of health coverage as the determining actor in a family's financial security." He said the nearly-final enrollment figure is "a milestone that shows just how important health-care reform is to our families and our future. . . . We're going to keep enrolling people until everybody in Kentucky who needs health coverage has health coverage."

Skeptics of the law say research has shown that enrollment in Medicaid doesn't improve enrollees' health, but defenders say that study didn't last long enough. Beshear said, "It'll probably take several years to see a change in our rankings, but you will see a change in our rankings over the next generation." He said the reform law's emphasis on prevention and wellness will give the state a healthier workforce that will attract more jobs.

Republicans are making Obamacare the centerpiece of their campaigns for the Nov. 6 elections, but Beshear told The Washington Post in January that by Election Day the law will be a net plus for Democrats. Asked yesterday if he would recommend to Democrats in the legislature that they use the reform law in their campaigns, he said candidates will have to make their own decisions, but "The Affordable Care Act, some next November, is going to be looked at a lot differently than it was looked at last November," when the national rollout was very troubled.

"The 80 percent of Americans and Kentuckians whom the Affordable Care Act will not affect at all are gonna know that it's not gonna affect them, so it's not gonna be a big issue for them one way or the other," Beshear said, and the 20 percent who are affected "like what they're getting. . . . I would say to those who think they're gonna make this the crowning issue and defeat somebody on it, have at it, because I don't think they're gonna get to first base by next November."

Reminded that Republicans use the law's nickname to run against a president who is unpopular in Kentucky, and asked when the tipping point in public opinion might come, Beshear suggested that he will find a way to gain political advantage.

"Whether you see a big change in the polling numbers when you use the phrase Obamacare or not, I don't think is gonna be all that relevant come next November, because people out here in Kentucky are gonna hear a lot about Kynect and the Affordable Care Act and the successes that we've had," he said. "I think you are seeing the polling now, when you talk about Kynect and what is going on in Kentucky, that people are very favorably disposed to it."

Democrat Elisabeth Jensen, running for Congress in the 6th District, has run a radio ad embracing "Kentucky Kynect" and said, "It polled well." (Read more)

Monday, 21 April 2014

Princess Health and Princess Health andBerea students' second health fair tackles touchy topics.Princessiccia

Della Walters tries to walk straight while wearing "drunk goggles" at
the Berea health fair. (Richmond Register photo by Crystal Wylie)
Student-run health fairs are becoming more popular across Kentucky, and some of them are touching on touchy topics. At their second health fair recently, for middle- and high-school students, Berea Community High School health students "handled more mature issues" than at their first, for elementary-school students. reports Crystal Wylie of The Richmond Register.

"Although students had their pick of topics ranging from sexually transmitted diseases, drunk driving, smoking, mental health, sugary drinks, learning disabilities and fitness," health teacher Cathy Jones said some students wanted to include 'sexting,' sexually oriented text messages. She allowed their presentation to pair the topic with cyber-bullying; students asked their classmates to sign a pledge against doing both.

�It�s a hot topic and something teenagers encounter,� Jones told Wylie. �They thought it was important to cover.� Jones said she plans to hold a fair twice a year. Meanwhile, Eastern Kentucky University professor Laurie Larkin and her public-health students conducted a health fair at Clark-Moores Middle School, Wylie reports. (Read more)
Princess Health and Princess Health andGeneral Assembly's failure to pass heroin bill incites wrath, calls for local action and a special session.Princessiccia

Princess Health and Princess Health andGeneral Assembly's failure to pass heroin bill incites wrath, calls for local action and a special session.Princessiccia

In the final hours of the 2014 legislative session, the House failed to pass Senate Bill 5, which would have helped combat heroin abuse. Some heroin-recovery advocates and community leaders are outraged, and now people are searching for local solutions to the problem while waiting for the General Assembly to act.

Senate Bill 5 would have allowed prosecutors to charge drug traffickers with homicide if someone died from an overdose of drugs sold by a trafficker, and allocated savings from a 2011 prison reform to fund drug-treatment programs. It would have permitted first responders and addicts' family members to give naloxone, a life-saving drug, to someone who overdosed. Amendments to the bill would have begun an program for addicts to exchange used needles for new ones, decreasing the prevalence of hepatitis C and HIV, and making Zohydro, a powerful painkiller, illegal�until it is changed into a tamper-resistant variety, Scott Wartman and Terry DeMio write for The Kentucky Enquirer.

"During a meeting in Campbell County Thursday night, many who are involved in heroin treatments predicted that a delay in passing the bill will result in more deaths and heartache throughout the commonwealth�and specifically in Northern Kentucky, which has been the most affected area by the deadly drug," Don Weber reports for cn|2's "Pure Politics." 

Charlotte Wethington, who works as a recovery advocate at the residential treatment center the Grateful Life Center, lost her son Chad 12 years ago because of an overdose. "I've been fighting this battle for well over a decade, and it is long overdue, past overdue, that we address the heroin epidemic," Wethington said, Weber writes. Dr. Mike Kalfas, a Northern Kentucky physician who treats heroin addicts, says Senate Bill 5 could have stopped what he says might be HIV or Hepatitis C epidemics in the near future. "Everywhere else there's been an IV drug problem, over time, the drug problem builds, then the Hepatitis C problem builds, and not far behind them is HIV," he said.

Because the bill didn't pass, communities are looking for local solutions, even if resources are limited. Dr. Bonnie Hedrick of the Northern Kentucky Agency for Drug Abuse reported that her organization is not only working on needle cleanup projects but also encouraging local doctors to prescribe the antidote to those who are addicted, Rae Hodge of The Associated Press reports. "Northern Kentucky Drug Strike Force director Bill Mark said that unless Gov. Steve Beshear calls the legislature into a special session to consider the bill, his organization has few tools to fight the state's growing heroin problem."

Beshear hasn't decided whether to call a session. "He argued that every session produces worthy bills that die, and 'it's too early to determine if a special session on any topic is prudent or needed,'" Beshear said, Mike Wynn writes for The Courier-Journal. Republican Senate President Robert Stivers has urged Beshear to call a session. He said, "This isn't political. This is about real people; this is about real problems; this is about real people losing their lives."

Sunday, 20 April 2014

Princess Health and Princess Health andCEO of Somerset hospital, rated by Consumer Reports as clearly the least safe in Kentucky, is resigning.Princessiccia

Mark Brenzel (Photo via Somerset Commonwealth Journal)
The CEO of the Kentucky hospital with by far the lowest safety rating from Consumer Reports magazine is resigning. Lake Cumberland Regional Hospital is one of 61 owned in 20 states by LifePoint Hospitals of Brentwood, Tenn.

In an April 14 message to the hospital staff, Mark Brenzel wrote, �A few weeks ago, I informed Scott Raplee, President of LifePoint�s Central Group, about my decision to step down  . . . I have struggled managing some health problems since last year that have required me to limit some activities including work hours. While these lifestyle changes have been helpful, they have made it difficult for me to keep up with the demands of this job.�

Brenzel concluded, �I have greatly enjoyed the last four years and am glad to be ending my hospital management career where it began in 1976 when I first visited LCRH [soon after it opened]. We have made great progress in improving patient care and implementing new strategies that will help LCRH be successful in the new healthcare reform environment. My wife and I are planning to stay in the community for the long term and look forward to supporting LCRH in any way that we can.�

Raplee told the Somerset Commonwealth Journal that LifePoint is doing national search to find a replacement for Brenzel, who will remain as CEO during the search. �We are discussing the possibility of Mark taking a new role with LCRH once the new CEO is hired,� Raplee said in a press release.

Thursday, 17 April 2014

Princess Health and Princess Health andHigh school students in Bourbon County campaign for indoor smoking ban, also against teenagers' use of e-cigarettes.Princessiccia

From left: LaShana Harney, Tyler Boyle
and Jessica Jones
(
Cori� Bowen photo)
By Cori� Bowen
Kentucky Health News

A group of young people in a Bluegrass county with a strong tobacco tradition is trying to make the county's indoors smoke-free.

Students Making a Change in our Community started at Bourbon County High School in the late 1990s and was revamped in 2013 by several students and Cyndi Steele of the Bourbon County Health Department. SMACC members said they felt it was time for the voices of youth to be heard again on smoking issues.

�Our main idea is to try to establish a smoke-free ordinance in Bourbon County,� senior Lashana Harney said.

The group has been busy this year collaborating with other youth in Paris at events such as the 2013 National Kick Butts Day � a youth rally against tobacco use and secondhand smoke � as well as attending a recent Kentucky Supreme Court hearing on an anti-smoking ordinance enacted by the Bullitt County Board of Health.

�It was interesting to be at an actual case,� Harney said. �It could go either way with this case.�

Jessica Jones, a junior, said that while SMACC targets adults, it also educates and trains elementary students on how to say no to tobacco, and about the harms of smoking. �We�ve been traveling and training fifth-graders,� she said.

SMACC members are working towards a school regulation against electronic cigarettes, which they think are deceptive. They don�t believe their peers realize the harmful effects associated with them.

�E-cigarettes are becoming more popular than traditional cigarettes,� junior Tyler Boyle said. ��The best way to get to youth is other youth.�

The Kentucky Tobacco Policy Research Program lists chemicals in e-cigarettes that can have negative effects on health including acetone (nail polish remover) and formaldehyde. The legislature recently banned sales of e-cigarettes to people under 18.

Harney, Jones and Boyle say they have seen a decrease in their parents� smoking since each student has become an anti-smoking advocate.

With Steele�s guidance, SMACC plans to keep educating and making its presence known in the community. Members will launch a group-written and directed YouTube video at the end of April that addresses secondhand smoke, titled, �It Could Be You.�

Steele said the road to banning smoking in public places for Bourbon County has been a work in progress for a long time: �I knew 20 years ago that when I chose to do this � it would be my career.� Now she has more help.

Wednesday, 16 April 2014

Princess Health and Princess Health andPoll: most Kentuckians support tobacco-free campuses, school nutrition standards and student physical activity requirements.Princessiccia

Kentuckians overwhelmingly support several school policies than can influence student health but are not all embraced by Kentucky schools, according to the latest Kentucky Health Issues Poll, taken in October and November.

The poll showed that 84 percent of Kentuckians�and 72 percent of smokers�support tobacco-free campus policies, which have been adopted by only about a third of Kentucky school districts. The survey also found that 72 percent strongly favor the tobacco-free policies, while 12 percent said they favored it somewhat.

The survey found that 57 percent of Kentucky adults strongly supported, and 21 percent somewhat supported, the U.S. Department of Agriculture's new standards for school nutrition, which reduced salt and saturated fat, increased offerings of whole-grain foods, fruit and vegetables, and put stricter controls on calories and portion size.

Because the U.S. Department of Health and Human Services recommends that young people exercise for 60 minutes per day, KHIP's survey asked Kentucky adults if they think Kentucky schools should offer 30 minutes of physical activity per day for students. It found that 88 percent strongly agreed and 9 percent somewhat agreed with the policy. Physical activity is an important topic for Kentucky because 18 percent of Kentucky children are obese, according to the Kaiser Family Foundation.
Democrats were more likely to be supportive of tobacco-free campuses and the new school menus, but there was no partisan difference on physical activity. "Poll findings show that support for the health of our children cuts across party lines," said Susan Zepeda, President/CEO of the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health of Cincinnati. It is conducted by researchers at the University of Cincinnati.
Princess Health and Princess Health andUK's advanced ventricular-assist device program for heart patients saves and improves lives.Princessiccia

Princess Health and Princess Health andUK's advanced ventricular-assist device program for heart patients saves and improves lives.Princessiccia

Two years ago, John Doty was diagnosed with walking pneumonia, and though antibiotics originally helped, the pneumonia came back with a vengeance, and he went to see a cardiologist. He found out his heart was severely weakened with an ejection fraction of less than 10 percent. "The ejection fraction is a measure of how effectively the heart can pump blood volume into the body, and in a healthy heart, that number falls between 50-65 percent," Allison Perry writes for the University of Kentucky, where Doty received a left ventricular assist device (LVAD) because his heart was so weak.

UK Chandler Hospital is Lexington's only hospital, and one of two in the state, that can perform emergency VAD procedures. "When Mr. Doty was transferred to UK, he was very sick, on a ventilator and requiring two medications to support his blood pressure," said Dr. Navin Rajagopala, a heart failure cardiologist at the UK Gill Heart Institute. "He was going into kidney and liver failure. It was clear that he needed an assist device as soon as possible before the damage to his body was irreversible."

VADs partially take the place of the function of a failing heart. They're more often used for the left ventricle, but some patients need the device for the right ventricle or even two devices to help both ventricles (BiVAD). Because VADs can help the heart rest and heal, some patients receive them after a heart attack or a surgery. People suffering from congestive heart failure might need a VAD for the rest of their lives.

A viral infection damaged Andy Baker's heart, and though he originally resisted the idea of a VAD, now he says he's "happy to keep the device and has no interest in getting a heart transplant," Perry writes. "I had mixed feelings about it," Baker said about getting the VAD, "but it's given me life again."

VAD treatment can save money for the both the patient and the hospital and allow at-home recovery. VADs can allow people to return to their normal lives, participating in many of the same activities they did previously. in about 5 to 10 percent of cases, the VAD even helps the heart to heal to the point that the device can be removed. That was the situation for Doty, whose device was removed 16 weeks after he got it. "I almost feel like I never had it," Doty said. "It wasn't that great of an imposition, considering that it was keeping you alive."

UK performs about 20 to 30 VAD procedures per year, and recently received its third straight biannual Certificate of Distinction from The Joint Commission, the leading accreditor of U.S. health-care organizations. That "shows just what an outstanding job our physicians, nurses and support staff are doing when it comes to treating patients who require these assist devices," said Dr. Maya Guglin, director of UK's Mechanical Assisted Circulation Program. (Read more)

Tuesday, 15 April 2014

Princess Health and2014 TYS10K.Princessiccia

For the 2014 Toronto Yonge Street 10K, H+P decided to put some of our faster runners together to see how quick we could go as a team.

If you didn't check it out before, here is our full team roster.

We were treated with great racing conditions, and without a doubt, a very fast course.  Here is how we did.

Men's Team


The men's team had an amazing experience!  The top 5 runners finished with an average time of 34:53, good enough to come in 1st out of 17 men's team.  CLICK HERE for the full results.

Individual Results CLICK


Coach Sean came in with a time of 33:17.
Runner Rob had an AMAZING H+P debut, coming home with a massive new PB of 33:37.

Coming back from a stress fracture, Brendan Hancock showed that his fitness is coming along nicely, putting in a very solid 35:35.


Ahmed Ahmed had an amazing performance.  He hammered a new personal best of 35:53!

Coming off a winter of volunteering and ultimate frisbee, Jordan Schmidt still managed a massive personal best, coming in at 36:04!


Pat, the best looking runner on the team, also hammered a huge personal best, coming in at 37:26!


Women's Team

Gill had an AMAZING performance.  Despite just coming back form a knee injury, she still managed to crush a new personal best of 40:38!  She also placed 3rd in her AG which included 324 runners!












Jessica (right) also had quite the race!  Just coming back from injury, she still managed a massive PB of 42:01, placing 5th in a very competitive AG!

Princess Health and2014 ENDURrace 5K.Princessiccia

One of these days, the PB train is going to slow down as H+P runners start to reach their maximum ability.  Well...today was not that day!

The team had an AMAZING experience at the 2014 ENDURrace 5K.  Our hard winter grind has really paid off.  Here's a breakdown of how we did:

Individual 5K results CLICK:

Luke "Ironman" Ehgoetz had an outstanding performance.  He covered the 5K in 18:12, coming in first for the team, and winning his AG.











Mike Piazza was next and had a HUGE break through performance.  Last year, Mike was struggling to break 20 minutes for 5K.  At this race, he ran a massive PB of 18:34!  He also placed 5th overall and won his AG!










Aaron Mailman was in next for the team.  Once again- the Mailman delivered (*Note, this line will never get old).  He ran a NEW PB of 18:49, won his AG and  placed 7th OA.










Holger (aka MileageMan) also had an outstanding performance.  He achieved a new personal best of 19:15 and also won his AG! (are you starting to sense a trend here?)









Nick Burt also had a great performance for the team.  Coming off of limited training because of school, he still managed to comfortably break 20 minutes and win his AG!







Vicki was in next for the team, and was our first female finisher.  YES, you guessed it- new PB (22-low), and first in her AG!  She was also 4th place OA!











Dragan was in next for the team with a MASSIVE personal best of 21:39!








Will also had an outstanding performance.  Putting his winter of speed work to use, he put a huge dent in his previous PB, setting a new mark at 26-low.










Cari had an outstanding H+P debut.  Despite just recently joining the club, she had an amazing performance, and also achieved a new personal best!








Sam also ran for the team...while running with his wife and pushing two kids in a stroller!  That is what H+P is all about.  Sometimes running as fast as we can, other times just about enjoying the experience and striving toward a better, healthier life!





Davey Rutherford also has an impressive performance.  Currently rehabbing a rather serious injury, he ran/walked the 5K in 3:1min intervals just to enjoy the experience.  Nice work Dave!









Team Results and Parent/Child Results:


  • Overall, the 5K team finished with an AVERAGE time of 18:51!  
  • In Parent/Child race, Luke and his son Holden were first out of 5 teams, winning by almost 2 minutes!




Princess Health and Garden Update: A Banner Year. Princessiccia

Things are warming up here in Seattle and the flowers are blooming. I just planted my first crops of the year-- potatoes and strawberries.

2013 was a banner year for my 500-square-foot urban vegetable garden, including my first experience growing and processing a grain. I never got around to posting about it last year-- so here it is.

Interbay mulch technique

The bed on the right has been mulched with leaves, spent coffee
grounds, and burlap sacks ($1/sack at the local hardware store).
The beds on the left were planted with a rye-clover-vetch-pea
cover crop. Paths are mulched with wood chips.
In the fall of 2012, I tried a new technique for improving the soil called "Interbay mulching". This is a variation on sheet mulching, which involves placing uncomposted organic matter directly onto the garden soil in fall and letting it compost until the next growing season. To Interbay mulch, you simply cover your sheet mulch with burlap. This keeps everything moist, protects earthworms from bird predation so they can munch freely, and suppresses weeds. I used leaves (carbon) and spent coffee grounds from a local coffee shop (nitrogen) for my organic matter.

When I pulled back the burlap last spring, I was initially disappointed. The coffee grounds had disappeared completely, but there was still a lot of leaf matter left on the soil, indicating that it had only partially composted. However, I later decided that it had worked well, because the soil structure underneath was improved and it seemed to be enriched with significant organic matter as well as a large population of fat earthworms. The mulch suppressed weeds remarkably well, and the beds remained mostly clean for the rest of the season.

Those observations, combined with huge yields from the mulched beds, convinced me that it was worthwhile.

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Monday, 14 April 2014

Princess Health and Princess Health andEar, nose and throat doctor at UK aims to reduce state's high rate of hearing loss among children.Princessiccia

Princess Health and Princess Health andEar, nose and throat doctor at UK aims to reduce state's high rate of hearing loss among children.Princessiccia

Dr. Matthew Bush, an otolaryngologist at the University of Kentucky, is working to reduce the state's high rate of hearing loss, especially in Appalachia and among children. He was born in Charleston, W.Va., and attended medical school at Marshall University in Huntington. "In the course of his extensive training, Bush 'fell in love' with hearing health care, ear surgery and technologies like cochlear implants that offer revolutionary opportunities for people who are deaf or hard of hearing to rejoin or enter the hearing world," Mallory Powell writes for UK. 

"It was the clinic setting that informed and fueled my efforts and interests because the patients that we see have some tear-jerking stories," Bush said. "They didn't have access to services, or they were totally unaware that there were options to help their hearing impaired child. So they show up at the clinic very delayed, well past the optimal age for intervention, and the child has already lost a lot of language development potential."

About 1 in 1,000 children experience pediatric hearing loss, and Bush said the rate is much higher in Kentucky, 1.7 out of 1,000 in Kentucky. Though hearing loss isn't life-threatening, it can greatly impact the quality of life, influencing speech, language and cognitive development in children. Early detection is important for successful treatment. "The consequences of delaying care in the first few years of life are amplified dramatically," Bush said.

Rural residents deal with many health disparities, and "delays in pediatric hearing health care are unfortunately common," Powell writes. "Children with hearing loss in rural areas are diagnosed later than children in urban areas and subsequently receive interventions like hearing aids and cochlear implants at a later age."

This rural hearing-health disparity results from factors such as distance from health-care facilities and inadequate knowledge of the importance of timely care for pediatric hearing loss. Bush says he hopes to employ telemedicine to reduce the effects of distance from facilities, with "diagnostic testing, patient counseling and hearing loss rehabilitation with hearing aids and implants. These services have not been offered before in Appalachia."

Bush is also working to increase parental knowledge about pediatric hearing loss and educate rural primary-care physicians in diagnosing and treating pediatric hearing loss. "This is not something that they're seeing on a daily basis, so provider knowledge about next steps and resources is limited," Bush said. He and his colleagues have created online educational modules that will be circulated to providers.

"In an ideal world . . . there would be a seamless transition from the birthing hospital to resources for hearing testing and treatment, whether face-to-face or via telemedicine. We'd like the quality of care and access to care to be the same for all children. That's really what our passion is," Bush said. (Read more)

Saturday, 12 April 2014

Princess Health and Princess Health andFactCheck.org takes apart attacks on Obamacare.Princessiccia

Princess Health and Princess Health andFactCheck.org takes apart attacks on Obamacare.Princessiccia

FactCheck.org is a non-profit, non-partisan center in the Annenberg Center at the University of Pennsylvania. It blows the whistle on misleading advertising and other statements of political figures. The center tries to balance its analyses between the parties, but the Republican attacks on federal health-care reform have been so strong and subjective, and Democrats have mounted so little defense or so few counterpunches, that the center's latest "Party Lines" report is all about Republican advertising against Obamacare. Here are capsules provided by FactCheck, with the label linking to each report:

Government-Run Health Care: Republican congressional candidates claim the health care law puts the government between you and your doctor. But the law boosts private insurance, and it doesn�t create a government-run system.

ACA �Hurting� Families: Ads criticizing the Affordable Care Act make the general claim that it�s �hurting� families. Some families could pay more for insurance, but millions of the uninsured will gain coverage. And millions will get subsidies to help pay for coverage.

�Skyrocketing� Premiums: Several ads make the misleading claim that premiums and health care costs are �skyrocketing� under the Affordable Care Act. Overall, both are growing at historically low rates. Some who buy their own insurance will pay more, but others will pay less.

�Millions� Lost Insurance: Anti-Obamacare ads have claimed that �millions� lost their health insurance and their doctors because of the law. But policyholders weren�t denied coverage, and there�s evidence that far more gained insurance than had their plans canceled.

Friday, 11 April 2014

Princess Health andToronto Yonge Street 10K: H+P Men's Team.Princessiccia

On Sunday April 13th the TYS10K, one of Canada's fastest 10Ks, will be flying through Toronto!  H+P is very excited to be entering a men's team for the event which includes some of our fastest runners.  We will be hammering, chasing some PB's, and having a lot of fun along the way!   CLICK here to follow along and see our results on race day.  We will also set up live tweets.  Race starts at 9AM sharp.

Here is the full men's team roster:

Name: Ahmed Ahmed
Age: 19
Height: 5'6
Weight: 120lbs
Current PBs: 17:18 5K (but has crushed many other xc races)
Interesting Facts: Known as the Kenyan Stallion.  Crushes all the guys during hill repeats.




Name: Rob Brouilette
Age: 21
Height: 6'0
Weight: 135lbs
Current 10K PB: 34:02
Interesting Facts: Loves running...like a lot.  Is the king of social media.











Name: Brendan Hancock
Age: 23
Height: 6'0
Weight: 165lbs
Current PBs: 16:47 5K, 1:15:15 half
Interesting Facts:  Current H+P TT record holder.  Throws up more often then any other men's team  member.












Name: Pat Mulherin
Age: 24
Height: 6'1
Weight: 160lbs
Current PBs: 17:37 5K (2008)
Interesting Facts: Most recent H+P signing.  Never does half  workouts.



Name: Jordan Schmidt
Age: 26
Height: 5'10
Weight: 160lbs
Current 10K PB: 37:30 and dropping!
Interesting Facts: Will have a new 10K PB after this race.
Name: Sean Delanghe
Age: 28
Height: 5'8
Weight: 155lbs
Current 10K PB: 34:05
Interesting Facts: Lacks the ability to keep up to Ahmed going up hills.

WOMEN'S TEAM UPDATE

Unfortunately we do not have a complete women's team this year.  We DO, however, have two great women running: Gillian Willard and Jessica Kuepfer.  Don't forget to watch for their results and cheer them on.  Good luck girls!!

 

Princess Health and Princess Health andSeason has arrived for poison ivy, oak and sumac; here's plenty of advice on how to deal with them and their rashes.Princessiccia

Leaves of three, let them be.

This old childhood rhyme still holds true today,well at least for poison oak and poison ivy. Poison sumac has seven to 13 leaflets on each leaf. But the result is the same: If you come into contact with the oil from their leaves, you are likely to end up with a an itchy rash that can last from one to three weeks.

About 85 percent of people will develop an itchy, blistering rash when they come in contact with the oil from these plants, says the American Academy of Dermatology in a news release.

The rash itself isn't contagious, but the oil is, and it can linger on just about any surface: skin, clothes, under fingernails, tools, pets -- you get the picture. It can even come through the air if someone is burning brush. So, you can get poison ivy, poison sumac or poison oak without stepping one foot into nature.
Avoiding the plants and wearing protective clothing are the two proven ways to avoid getting a rash from these plants.

�If you are absolutely certain that your rash is due to poison ivy, poison oak, or poison sumac, and if the rash appears on a small section of your skin, you may be able to treat the rash at home,� Seemal R. Desai, dermatologist from Texas, said in the news release. �However, if you have difficulty breathing or swallowing, you experience swelling, or you have many rashes or blisters, go to the emergency room right away.�

The association also recommends going to the emergency room if the rash covers most of your body, if your eyelid swells shut, if the rash develops anywhere on your face or genitals, if much of your skin itches, or nothing seems to ease the itch.

Fortunately, there are simple steps people can take to safely treat a mild rash at home. Here are the association's recommendations for treating mild cases of poison ivy, poison oak or poison sumac:

1. Immediately rinse your skin with lukewarm, soapy water. Initially take a shower, not a bath, to get the oil off of your body.
2. Wash your clothing.
3. Wash everything that may have come in contact with the oil from the leaves.
4. Do not scratch. Scratching can cause infection.
5. Leave blisters alone. If blisters open, do not remove the overlying skin, as the skin can protect the raw wound underneath and prevent infection.
6. Take short, lukewarm baths to relieve the itch. Add colloidal oatmeal from the drugstore or one cup of baking soda to the running water for additional relief.
7. Consider using calamine lotion or hydro-cortisone cream.
8. Apply cool compresses to the itchy skin.
9. Consider taking antihistamine pills. These pills can help reduce itching, however use with caution. Call your doctor if you are uncertain if you should take an antihistamine.
10. Do not apply a topical antihistamine to your skin; doing so can worsen the rash and the itch.
11. See a dermatologist if the rash has not improved within 10 days.

Princess Health and Princess Health andHere are spring-cleaning tips to help allergy sufferers.Princessiccia

Spring cleaning often stirs up dust and pet dander, and can leave a strong scent of cleaning supplies in the air. All can cause those with allergies to reach for a tissue and dread the task. But stirring up a little dust and dander is worth a few extra sneezes, the American College of Allergy, Asthma and Immunology says in a news release, because a thorough spring cleaning will ultimately help you avoid allergy symptoms.

�Thoroughly cleaning your home can help eliminate allergens and keep new ones from easily entering,� James Sublett, president-elect of the ACAAI, said in Newswise, a research-reporting service.  �Allergy season can last all year for those sensitive to indoor allergens, but it can worsen in the spring months when pollen becomes an issue. It�s important to remove allergens from the home so you can lead a healthy and active lifestyle.�

The ACAAI  offers tips to remove allergens from your home as well as ways to prevent more from entering.

The best way to prevent allergens from building up in your home is to stay on top of certain chores, such as vacuuming regularly to get rid of dust mites using a cyclonic vacuum or HEPA filter, changing air filters every three months using filters with a MERV rating of 11 or 12, and washing bedding and stuffed animals weekly.

It is also important to resist the urge to open the windows as the weather gets warmer, because this lets unwanted pollen into the house.Those with allergies also have to be careful to avoid air fresheners and candles because chemicals in these items can spur asthma attacks.

A top allergen target in spring cleaning is mold, paying special attention to mold-prone areas like bathrooms, basements and tiled areas, says the release. Make sure bathroom fans are functioning and usable, and always make sure not to leave any standing water in these areas. Use detergent and water to remove any visible mold, and to prevent further mold from growing, keep the humidity in your house below 60 percent.

Because pets spend so much more time indoors over the winter, chances are there is an increased amount of fur, saliva and dander in your house. Remove these allergens by vacuuming frequently and washing upholstery, including your pet's bed, the release says. Also, don't allow your pet in your bedroom.

Those with allergies should avoid being outdoors in noonday and afternoon, because pollen counts are highest then. Wear gloves and a N95 pollen mask when mowing or gardening, and make sure to wash your hands, hair and clothing when finished. Also, make sure to take your medication before going outside.