Wednesday, 25 June 2014

Princess Health and Fat and Carbohydrate: Clarifications and Details. Princessiccia

Princess Health and Fat and Carbohydrate: Clarifications and Details. Princessiccia

The last two posts on fat and carbohydrate were written to answer a few important, but relatively narrow, questions that I feel are particularly pertinent at the moment:
  • Was the US obesity epidemic caused by an increase in calorie intake?
  • Could it have been caused by an increase in carbohydrate intake, independent of the increase in calorie intake?
  • Does an unrestricted high-carbohydrate diet lead to a higher calorie intake and body fatness than an unrestricted high-fat diet, or vice versa?
  • Could the US government's advice to eat a low-fat diet have caused the obesity epidemic by causing a dietary shift toward carbohydrate?
However, those posts left a few loose ends that I'd like to tie up in this post. Here, I'll lay out my opinions on the relationship between macronutrient intake and obesity in more detail. I'll give my opinions on the following questions:
  • What dietary macronutrient composition is the least likely to cause obesity over a lifetime?
  • What dietary macronutrient composition is best for a person who is already overweight or obese?
  • Is fat inherently fattening and/or unhealthy?
From the beginning

Read more �

Sunday, 22 June 2014

Princess Health and Princess Health andRussell Co. school board plans to make all campuses tobacco-free, renews free-lunch-for-all plan after breaking even.Princessiccia

Princess Health and Princess Health andRussell Co. school board plans to make all campuses tobacco-free, renews free-lunch-for-all plan after breaking even.Princessiccia

School districts in Kentucky often deal with health issues. The Russell County Board of Education dealt with two important ones, tobacco use and school lunch, in its meeting last week.

State officials are pushing to get schools to make their campuses tobacco-free as a way of discouraging smoking, since Kentucky has the highest percentage of smokers in the nation and ranks near the top in youth smoking.

The Russell County school board heard first reading of a policy that would ban use of tobacco products on all school campuses at any time, including events such as outdoor athletic contests. "Board Member Gerald Murray indicated that those who attended the meeting were for the complete ban, and wanted the public informed that if they had concerns, either for or against the ban, they need to attend the next board meeting to be heard," The Times Journal of Russell Springs reports. "The next reading and vote will be at a special called meeting on June 30."

June 30 was the original deadline for school districts to decide whether to participate in the federal program that makes free meals available to every student in school districts with certain levels of poverty and public assistance.

The board voted to stay in the program after Nutrition Director Susan Melton reported "the program has resulted in a 73 percent breakfast participation rate, an increase of 28 percent compared to 2012-2013 school year, and nearly double the state breakfast participation rate of 39 percent," the Times Journal reports. "The lunch participation rate was 90 percent over the last school year, up eight percent from 2012-2013."

The newspaper notes that the district has to pay only 6 percent of the cost, compared to 20 percent in the normal program, which charges some students regular or reduced prices for meals based on their family income. Some school districts have not joined the program, saying they might lose money on it, and Russell County feared likewise, but Melton said it "has been essentially 'break even' for the county" and has benefits; research has shown that hungry children are less able to learn.

�We went into this last year understanding we may lose $12,000 to $15,000,� Board Member Steve Kerr said. �But we all agreed that if we did lose that it was still well worth it. And with it being a break even situation you couldn't ask for anything better than that. And with the way it looks for the coming school year, I'm extremely pleased with it. Our students are the ones who benefit so that makes everything worth it.�

The state Department of Education expects about 100 of Kentucky's 173 public school districts to participate during the coming school year in a federal program that makes free meals available to all children in a school if at least 40 percent of its students already qualify for free meals through federal programs, Valarie Honeycutt Spears reports of the Lexington Herald-Leader reports.

Princess Health andTriathlon/Duathlon Results: June 21st-22nd.Princessiccia

Princess Health andTriathlon/Duathlon Results: June 21st-22nd.Princessiccia

This was the first big multi-sport weekend of the year for the team.  We had athletes in a number of different races and distances.  Here's how they all did:

Guelph Lake 1

Try-a-Tri

  • Mailman had a great debut in triathlon, placing 13th OA and winning his AG!
Olympic Triathlon
  • Adam had an awesome race in Guelph, finishing with a time of 2:23 and 6th in his AG.  
  • Despite limited training in the swim and bike, Jordan had a great race.  He managed a time of 2:27, good enough for 7th in his AG.  
Olympic Duathlon
  • After being plagued by injuries for a number of months, Erik had an outstanding return to the duathlon world.  He finished with a time of 2:10, and placed 3rd in his AG.
Sprint Triathlon
  • Despite just racing the day before, Jessica had a great race.  She finished in 1:21, and placed 7th in her AG.
Ironman Syracuse 70.3
  •  IronLuke CRUSHED the half in Syracuse.  He finished with a time of 4:32, good enough for 5th in a very competitive AG
  • Graham Dunn started off strong, battled some serious cramping during the run, and finished with a stellar time of just over 5 hours!  

Princess Health and2014 Heart Lake.Princessiccia


Despite not officially planning to race Heart Lake as a club race, H+P still had a solid contingent tackle this challenging, hilly course.  Here's how we did:

  • RunnerRob had a great return to trails.  He place 4th OA and 2nd in his AG with a time of 55:27 for the 14.4K.
  • Dave also had an awesome racing, cracking the top 10 OA, and placing 2nd in his AG.
  • Mike was in next for the team with a very sold 68 mins and 19th OA.
  • Craig was in next for the team, finishing 25th OA with a time of 70 minutes.
  • Jessica was in next for the team with a very solid 72minutes, placing 4th OA for females.
  • Vicki also had a great race, finishing just a few minutes after Jessica, cracking the top-10 OA for females!
  • Cari had an awesome race in the Sport race, finishing easily in the top 20 in her AG!
Team Results
  • The team results were scored based on a point system.  H+P was lucky enough to walk away with the win out of 10 total teams.  CLICK HERE for the full results.  


Thursday, 19 June 2014

Princess Health and Princess Health andState Supreme Court says county boards of health cannot enact smoking bans by regulation.Princessiccia

By Al Cross
Kentucky Health News

County health boards in Kentucky do not have the power to ban smoking in public places, the Kentucky Supreme Court ruled without dissent Thursday.

The decision was a stiff blow to health officials who see smoking as the primary factor in making Kentucky one of the least healthy states, and have sought state and local smoking bans to limit exposure to second-hand smoke. It struck down a ban in Bullitt County and presumably will do likewise for those enacted by the Clark, Madison and Woodford county health boards, which joined the case. (Click on map for larger version)

Justice Bill Cunningham, who wrote the decision, noted that the U.S. surgeon general has found "many of the chemicals inhaled through second-hand smoke are known carcinogens" and "that even short-term exposure to second-hand smoke can result in serious health consequences. In 2009-10, overall second-hand smoke exposure by Kentucky adults was 51.4 percent, with 30 percent reporting exposure in the workplace and 32.8 percent reporting exposure in public places. Given such dismal data, it is understandable that many health-care professionals and government officials have sought to curtail the prevalence of this noxious fume. Promoting a smoke-free society is a reasonable goal grounded in sound research. However, when promotion becomes enactment, even the most virtuous causes must also be grounded in law."

Health boards enacting bans have relied on a 1954 state law that gives them to power to adopt regulations "necessary to protect the health of the people." To find that law as "sufficient grounding for the regulation," Cunningham wrote, the court would have to construe the law "as delegating the totality of the Commonwealth's police power to the health boards. Nothing would remain to be ceded by the General Assembly, including the critical legislative charge of distinguishing virtue from vice."

Cunningham said such a ruling would "promote an overly broad delegation of legislative sovereignty," in violation of the state constitution. He said the authorization of regulations was limited, and was based that view on what he called the law's legislative history. In 1954, he wrote, "It would have been
commonplace for members of the General Assembly to indulge in a cigarette or cigar in their offices, committee rooms, or even on the floors of the House and Senate chambers. Most likely, the . . . legislation was debated and voted in chambers fogged with a haze of smoke."

Thursday's decision overturned a 2-1 ruling of a Court of Appeals panel that relied partly on the 1984 Supreme Court decision that upheld a Jefferson County regulation on lead paint. Cunningham said that was based on a law that "specifically addressed lead poisoning and expressly authorized and encouraged action at the local level," and "There is no similar statutory mandate" in state law for smoking bans.

Cunningham also noted that most of the Jefferson County board is appointed by local officials, while health boards in other counties are appointed by the state health secretary "and not by duly elected representatives. When regulating controversial issues traditionally within the province of state or local legislative entities, this structure is constitutionally problematic in that it does not comport with traditional notions of representative government." In this case, the Bullitt County Fiscal Court filed a lawsuit challenging the health board's authority.

The appeals court, in rejecting the fiscal court's case and overturning the local circuit court, also relied on a 1967 decision upholding a local health board's regulation of private sewage disposal systems. Cunningham said that decision was strongly based on earlier cases on the topic, and in contrast, there is no "well-established line of authority regarding the need for administrative regulation of smoking and second-hand smoke."

Finally, Cunningham said legal precedents in Kentucky say that "Where reasonable doubt exists concerning the proper scope of an administrative agency's authority, it should be resolved against the agency," and "An increase in the aggregate power of administrative agencies over the recent decades, if left unchecked, invites the ascendance of a fourth branch of government�the regulatory state."

Princess Health and2014 Waterloo Classic.Princessiccia

Another year, another great race experience at the Waterloo 10K Classic.  This year we assembled our fastest, deepest team ever.

Last year, our 3 person 10-K team had an average time of 38:31, this year we had TWO 5-athlete teams with an average time of 36-something.  Had we entered a 3-person team with our top runners, we would have beat our 2013 team by over 12 minutes total (or average 4 minutes per runner!) with an average time of 34:28.  We are improving!

#MikeVsDave

By now, everybody knows about the #MikeVsDave team challenge.  In the end, #TeamDave walked away with the victory.  Here is the full recap.

Team Results

The H+P 5K team won the open team race quite comfortably with an average time of 20:00 among the top 5 runners.

H+P Team Dave won the 10K- open team category with an average time of 36:53.  H+P Team Mike was only 2 seconds behind, finishing 2nd in the team category.

Individual Results

Another race, another set of ridiculous PB's for the team.  We are expecting this constant stream of personal bests slow sometime soon, but clearly not just yet!  Here's how we did:

5K:

  • Mailman was first for the team, with a new PB of 18:43.  This earned him 2nd in his AG.
  • Steph came in next with a stellar time of 19:12 which brought her in 6th OA and 1st in her AG.
  • Kailey finished with a new PB of 20:27, good enough for 3rd in her AG!
  • Gillian, coming off illness and injury, posted a solid  20:35, bringing in her 4th in her AG!
  • Holger came in with an awesome time of 20:43 despite just racing 50K the day before!  This was still good enough for 3rd in his AG.
  • Payton came in with a new PB of 21:00, earning her 2nd in her AG!
  • Tammy and Derek both had GREAT H+P debuts, enjoying the race, running with their kids!
10K:
  • RunnerRob took over a minute off his time from last, and won 4th OA with an outstanding time of 33:52.
  • Coach Sean came in 5th OA with a time of 34:33.
  • Brendan set a new 10K PB with a very solid 34:56, good enough for 2nd in his AG and 6th OA.
  • Coach Dyce was in next with great time of 36:11, cracking the top 10, and placing 2nd in his AG.
  • IronLuke was in next for the team with a PB time of 36:45, bringing him in as the 2nd masters runner OA!
  • Ahmed Ahmed crushed the 10K, running 37-high, and winning his AG.
  • Chris was in next, and ran a huge PB of 38:08!
  • Dave ran an excellent time of 38:18, placing 3rd in his AG.
  • Pat came in with a very solid time of 38:52, easily placing within the top-10 for the team.
  • Nick Burt ran a new PB of 39:19, coming in as the 10th H+P athlete to crack the 40-minute mark in one race!
  • Mike ran 40-something despite having difficulty recovering from a recent marathon, and still manged to place within the top-10 of a competitive AG.
  • Jessica was the first female in the H+P team to finish- she posted an outstanding 42-low despite limited running over the last number of weeks due to injury.  
  • Emily was in next for the team with a HUGE PB (by well over 3 minutes) of 45:20!
  • Vicki came in with another PB (by 2 minutes), finishing in 45:37, and 2nd in her AG!
  • Dragan was in next for the team with yet another massive PB, running 46:23.
  • Justin also posted a 10K PB, coming in just seconds after Dragan in gun time, but with the same chip time of 46:23- new rivalry? 
  • Manny was in next for the team with a very solid 46:39, good enough for 4th in her AG!
  • Dan came in with a HUGE PB, also running 46:39!
  • Howie came in with a very sold 47-low, an excellent performance in his H+P debut.  
  • Sam came in next with a very speedy 47-mid 10K
  • Mark Potvin had a great return to action, running 56:46
  • Will was yet another H+P-er to post a PB, coming in just over 58 minutes.
  • Cari finished the race off with a massive 9-minute PB of 59:19!
Looking forward to next year already!

Wednesday, 18 June 2014

Princess Health and Princess Health andFoundation for a Healthy Kentucky reports putting 24 percent more money into grants last year than in 2012.Princessiccia

Princess Health and Princess Health andFoundation for a Healthy Kentucky reports putting 24 percent more money into grants last year than in 2012.Princessiccia

The Foundation for a Healthy Kentucky made grants totaling $2,355,838 in 2013, a 24 percent increase over the 2012 total of $1,903,660, according to the annual report it released yesterday.

Last year was the first in which the foundation made grants for two major initiatives: Investing in Kentucky's Future, which it calls "a $3 million commitment to seven Kentucky communities where civic leaders have come together and committed to a process and a plan for collective impact on the future health of their children," and Promoting Responsive Health Policy, which tries to see that voices of under-represented populations are part of the health-policy conversation in Kentucky.

The first initiative's seven grantees are Fitness for Life Around Grant County, the Clinton County Schools (for the Healthy Hometown Coalition), the Foundation for Appalachian Kentucky (for the Perry County Health and Wellness Coalition), the Green River Area Development District (for the Partnership for a Healthy McLean County), the Kentucky Heart Foundation (for work in Boyd and Greenup counties), Kentucky River Community Care (for the Breathitt County Health Planning Council for Children) and the Louisville Metro Department of Health and Wellness (for the Coalition for Louisville Youth).

Under the policy initiative, the report says, grantees "are working to improve access to needed health care, support children's health, strengthen local public health and "increase the number of Kentuckians living in communities where workplaces are smoke-free." For a complete list of grants made by the foundation in 2013, click here. For a January press release about them, click here.

The foundation was established in 2001 to settle a lawsuit by then-Attorney General Ben Chandler against Anthem Inc. to recover the charitable assets that Anthem had gained in its merger with the old Kentucky Blue Cross/Blue Shield. The foundation's net assets grew to nearly $56.4 million last year, a 7.7 percent increase over the end of 2012.

The foundation is a non-profit philanthropy with a mission of addressing the unmet health-care needs of Kentuckians. It has invested more than $24 million in health-policy research and pilot-project grants that invests in communities and informs health policy through grant making, research and education. It says it is "committed to improving access to care, reducing health risks and disparities and promoting health equity."

The foundation also acts as a convener, through its annual Howard L. Bost Health Policy Forum, its "Health for a Change" workshops and webinars, funding of conferences held by others and meeting space at its new offices in eastern Jefferson County for more than 21 community and statewide organizations.

It also acts as a communicator, through its annual Kentucky Health Issues Poll and other research, and it funds independent health reporting by Kentucky Educational Television and the Institute for Rural Journalism and Community Issues in the School of Journalism and Telecommunications at the University of Kentucky, which publishes Kentucky Health News.

Princess Health and Princess Health andParents can help teens make healthy food choices this summer by strategically stocking the pantry.Princessiccia

A steady diet of junk food can be especially harmful to teens, who tend to experience a growth spurt during these years, and these poor nutritional choices as teens can affect their health in years to come, reports Newswise, a research-reporting service.

�While it�s important to eat healthy at every age and stage, the growth and physical maturation occurring during adolescence makes good nutrition all the more critical,� Kristen Kizer, a clinical dietician with Houston Methodist Wellness Services, said in the release. �Teens are growing, meaning that their cells are diving rapidly. This means increased calorie and protein needs, as well as increased need for vitamins and minerals like calcium, vitamin D, iron, and folate.�

So, as parents stock their refrigerators and pantries for the summer, it is important for you to remember to include healthy foods that are quick, easy and tasty to teens, while paying special attention to providing foods high in calcium and vitamin D.

Calcium and vitamin D intake should be of particular importance for teens because about half of peak bone mass occurs during the teen years, Kizer explains in the release. If teens don't get adequate amounts of calcium and vitamin D, they can become adults with poor bone density, setting themselves up for osteoporosis and bone fractures in later years.

The National Institute of Health says teenagers need 1,300 milligrams of calcium each day. Kidshealth.org offers a list of foods that are high in calcium that includes dairy products, veggies including broccoli and dark green, leafy vegetables, soy products, calcium-fortified foods, beans and canned fish.

Parents and teens should also remember that good eating habits and a healthy weight are important to establish during the teen years because approximately 90 percent of overweight and obese teens will remain overweight or obese as adults, Newswise reports.

�Most teens aren't thinking about chronic disease 30 years down the road, reminding them that the foods they choose now have an impact on their appearance, athletic performance, or academics can help them make healthier choices,� Kizer says in the release. �Girls especially may be struggling with body image issues, so helping them select foods that will make them physically feel well can also improve their mood and emotional health.�

Kizer's suggestions for healthy food choices:

  • Guacamole, made from a jar of salsa and avocados, and baby carrots. The vitamin C in the salsa will keep the guacamole from turning brown and the healthy monounsaturated fat from the avocado will keep your hungry teens satisfied.
  • Whole wheat rotini and veggies and pasta sauce, all mixed together and ready to heat. This meal provides fiber, magnesium, manganese and selenium.
  • Greek yogurt with fruit. The added protein from the Greek yogurt will keep your hungry teen full and he or she will also be getting fiber from the fruit, as well as vitamin C, potassium, folic acid, and calcium.
  • Cereal. Look for cereals that include no more than 6 grams of sugar.
  • Baked chips instead of full-fat chips.
  • Low-fat ice-cream sandwiches or 100 percent frozen fruit bars.
  • Whole-wheat thin crust pizza that features veggies rather than high-fat meat like sausage and pepperoni.

Princess Health and Princess Health and30 participants contribute to 'Expressions of Courage' art exhibit at UK cancer center for National Cancer Survivorship Month.Princessiccia

Princess Health and Princess Health and30 participants contribute to 'Expressions of Courage' art exhibit at UK cancer center for National Cancer Survivorship Month.Princessiccia

The University of Kentucky Markey Cancer Center held its first "Expressions of Courage" event, an art exhibit showcasing art connected to an experience with a cancer diagnosis or created in memory of a Markey patient, on June 6 as part of National Cancer Survivorship Month.

The artistic entries from the 30 participants who responded were on display in the Combs Research Building at Markey. They included paintings, drawings, photography, sculpture, and quilting as well as performing and literary art performances, Allison Perry and Abby Besson report for UKNow.

"The artwork is very moving and inspiring, and actually will bring tears to your eyes if you read some of the pieces," Cindy Robinson, a nurse practitioner at Markey and one of the organizers of the event, told the authors. " We have some pieces here from patients that are no longer with us, and we personally know those people."

Expressions of Courage was made possible by gifts from the Markey Cancer Foundation and Biological Systems Consulting, Inc.

Norton Cancer Center and Markey patient Phillip Meeks contributed a drawing created by his daughter depicting the "unlikely good fortune of his treatment."

Meeks was diagnosed with acute myeloid leukemia in 2012 and required a bone marrow transplant to survive, the authors write. As an African-American - a population that makes up around seven percent of the bone marrow registry - and an adoptee without biological siblings or parents to get tested, the odds of finding a match were against him.

Upon admission to the hospital, Meeks found a token underneath his hospital bed that said "Believe in Miracles" on one side and "Faith" on the other. He told the authors that he took this token as a sign from God that he wasn't alone and to not be afraid. This token was the inspiration for his daughters art.

Meeks received his life-saving transplant in January 2013. He told the authors that not only was Expressions of Courage a day to showcase talent, but a day survivors could show their appreciation to the staff of Markey.

"I just want to give back," Meeks said. "That's my big thing. How can you thank so many people that are involved in saving your life? There's not a gift that you can give that's big enough. Hopefully this is my one little piece to say thank you for everything that everybody has done for me."

Princess Health andRecap: #MikeVsDave.Princessiccia

The epic battle of #TeamMike vs. #TeamDave has come and gone.  Who was the victor?  Here is a breakdown of how the event transpired:


Play-By-Play:
  1. First across the line for both teams was the talented RunnerRob for #TeamDave.  He posted an excellent, sub-34 time.  First across the line for #TeamMike was Coach Sean with a time of 34:34.  This gave #TeamDave an early lead.  Time Gap: 41s, #TeamDave leading
  2. Once the second place runners on each time crossed the finish line, #TeamMike took the lead!  Coach Dyce from #TeamDave just missed his PB, running an impressive 36:14.  Brendan, from #TeamMike countered with an impressive 34:57 PB.  Time Gap: 36s, #TeamMike leading
  3. IronLuke and Ahmed Ahmed (Young Blood) were up next.  Luke managed to post an epic 36:46 PB for #TeamMike.  Ahmed countered with a great time of 37:47.  Time Gap: 1:37, #TeamMike leading
  4. Sitting 1.5 minutes behind with only 2 runners to go, #TeamDave was going to have stage a tremendous comeback to put themselves in contention.  Up next was Chris Goldsworthy for #TeamDave, posting a solid 38:09 PB to counter Pat's 38:54 for #TeamMike.  This brought to two teams closer, with only one runner to go.  Time Gap: 52s, #TeamMike leading  
  5. Captain of #TeamDave, ENDURdave himself, was the next to come in for his team.  He finished with a time of 38:20.  Now, all that needed to happen was for somebody on #TeamMike to finish with a time of 39:12 or faster.  As everybody anxiously watched the clock, we saw Nick Burt from #TeamMike sprinting his way around the track.  For a while it seemed like he might make it just in time!  But, still with 50m to go, the clock hit 39:12- Nick finished with a great time of 39:22.  Time Gap: 10s, #TeamDave WINS 
In an shocking, come-from-behind fashion, #TeamDave came out on top by a mere 10 seconds total (average 2 seconds per athlete).  HERE are the full team results.

It was a well earned win, and they did not hesitate to bask in the glory of their victory:




Other Battle Results:
#TeamDave did not leave with the team battle win, but also a number of individual battle victories.  Dan (from #TeamDave) walked away on top after his #SameVsDan battle, and Manny (again from #TeamDave) walked away with the win in the #MannyVsHowie battle.  All of the results were quite close, but #TeamDave simply seemed to have the advantage today!  

Tuesday, 17 June 2014

Princess Health and Princess Health andSome school districts reject federal offer of free lunch for all students, saying schools would lose money on the deal.Princessiccia

Princess Health and Princess Health andSome school districts reject federal offer of free lunch for all students, saying schools would lose money on the deal.Princessiccia

Some school districts are rejecting a federal program that would provide free meals to all students in districts with a certain percentage of students in poverty, Jared Nelson reports for The Times Leader in Princeton, after the Caldwell County Schools decided against joining the Community Eligibility Program.

�Right now, we are not at the economically feasible point to do that. We would lose money,� District Food Service Director Will Brown told Nelson.

Nelson writes, "The district�s food service program is largely self-sufficient, earning income based on students and teachers who pay full-price for meals, and federal reimbursement for those meals and those provided to students qualifying for free or reduced-rate lunches."

If everyone gets a free lunch, �You are losing all of your students on full paid status,� Brown said. �You�re losing that revenue.� He said the number of qualifying students is �not high enough to do that.�

In other words, Nelson writes, "Having a percentage sufficient to qualify ... is different from having a percentage that would make the program viable locally. . . . Brown said other districts have signed on to the CEP program in prior years and been adversely affected. . . . The revenue earned each year allows the food services department to be able to use its own funds to cover the costs of most repairs, new equipment, and other expenses required during the school year and in the summer.

The program "is expanding nationwide this year, after being tested in 11 states, including Kentucky," Nelson notes. Qualifications are based on students in households in the Supplemental Nutrition Assistance Program (food stamps), the Kentucky Transitional Assistance Program, certain Medicaid recipients and foster children. (Read more; subscription required)

Monday, 16 June 2014

Princess Health and Princess Health andHow to keep kids safe from traumatic brain injuries this summer.Princessiccia

Princess Health and Princess Health andHow to keep kids safe from traumatic brain injuries this summer.Princessiccia

About 1.7 million people in the U.S. suffer a traumatic brain injury each year, and nearly half a million children under 15 visit an emergency room for TBI. A brain injury is traumatic if it disrupts the normal function of the brain.

Dr. Michael Egnor, vice-chairman of neurology at New York's Stony Brook University Hospital and director of pediatric neurosurgery at Stony Brook Children's Hospital, provides ideas for how parents can help protect their children from brain injuries this summer.

Families are going on more bike rides, but not everyone knows that bicycle accidents are most likely to happen within five blocks of home. "Make sure your child wears a helmet every time he or she rides a bicycle, scooter or skateboard," Egnor said. "We're seeing the most head injuries right now in skateboarding, especially in young teens, who might think it's just not cool to wear a helmet."

Each year more than 200,000 children suffer from injuries on playgrounds in the U.S., according to the U.S. Consumer Product Safety Commission. The main cause is falls. Egnor suggested looking for shredded mulch, pea gravel, crushed stone and other loose surfaces and being extra careful on asphalt and concrete.

Parents with older children and teens should be aware of possible diving accidents. "In about 50 percent of cases of catastrophic injuries, alcohol or drugs is involved," Egnor said. "Ensure that responsible adults supervise pool parties and other events where swimming and diving are involved."

Egnor also warned of concussions during summer sports. He said, "The few serious injuries we treat from organized sports are usually accidents that probably could not have been prevented," he said, while many of the concussions he treats are mild because many sports require helmets.

Dealing with serious injuries quickly is key, Egnor said. "The full extent of the injuries may not appear immediately." (Read more)

Princess Health and Princess Health andPanel of physicians at national conference discuss future of rural primary care, how to solve doctor shortages.Princessiccia

More needs to be done to address the shortage of primary-care physicians, a big problem in rural areas and much of Kentucky, according to a panel of physicians at "Rural Health Journalism 2014," Kris Hickman writes for the Association of Health Care Journalists, which sponsored the conference.

Almost half of rural U.S. counties, 44 percent, struggle with primary care physician shortages, said Andrew Bazemore, M.D., M.P.H., director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care of the American Academy of Family Physicians. According to a presentation at the 2013 Kentucky Rural Medical Educators Conference, Kentucky had a 1,287:1 primary care physician to citizen ratio, which is 557 short of the national average.

The national shortage is expected to worsen soon because almost 27 percent of those providers are older than 60, said Mark A. Richardson, M.D., dean of Oregon Health and Science's School of Medicine.

Bazemore said the medical community needs to draw more attention to the need for more primary care physicians in rural areas. He also said that for every dollar spent on health care, only six or seven cents are spent on primary care. "States facing a shortage should remember that primary care is the logical basis of any health care system," Bazemore said.

Richardson recommended that medical schools try to recruit students who have rural backgrounds because they're more likely to return to practice in rural areas. He and Bazemore agree that students who practice in rural areas should be given loan forgiveness or scholarships. "Debt prevents many people from choosing primary care," Bazemore said.

Richardson said the most important factor for where medical students end up practicing is where they completed their training. "Rural training is one of the highest predictors of a rural practice and should be required," he said. To do this, the government-imposed cap on graduate medical education spending would have to be abolished.

"Medical care is not a free market dynamic," Richardson said. "We pay for health care transactions, rather than health." (Read more)
Princess Health and Princess Health andStudy concludes that fasting can reduce cholesterol levels for people in danger of developing diabetes.Princessiccia

Princess Health and Princess Health andStudy concludes that fasting can reduce cholesterol levels for people in danger of developing diabetes.Princessiccia

New research suggests that occasional fasting can help pre-diabetics from developing diabetes, which is more common in Kentucky than most states.

After 10 to 12 hours of fasting, the body looks for other energy sources to sustain itself, so it removes LDL (bad) cholesterol from fat cells and converts it into energyaccording to researchers at the Intermountain Heart Institute at Intermountain Medical Center in Murray, Utah.

"Fasting has the potential to become an important diabetes intervention," in addition to lifestyle changes and weight loss, said Benjamin Home, the lead researcher.

The study focused on prediabetics between the ages of 30 to 69 with at least three of the following metabolic risk factors: a large waistline, a high triglyceride (type of fat in the blood) level, a low HDL (good) cholesterol level, high blood pressure and high blood sugar after fasting.

"Over a six-week period cholesterol levels decreased by about 12 percent in addition to the weight loss," Home said. "Because we expect that the cholesterol was used for energy during the fasting episodes and likely came from fat cells, this leads us to believe fasting may be an effective diabetes intervention."

The removal of LDL cholesterol from the fat cells for energy use should help stop insulin resistance, which happens when the pancreas keeps producing more and more insulin until it can't make enough for the body, and the blood sugar rises. "The fat cells themselves are a major contributor to insulin resistance, which can lead to diabetes," he said. "Because fasting may help to eliminate and break down fat cells, insulin resistance may be frustrated by fasting."

Home noted that although fasting might be effective for protecting against diabetes, the results were not immediate. "How long and how often people should fast for health benefits are additional questions we're just beginning to examine." (Read more)

Friday, 13 June 2014

Princess Health and Princess Health andProposed waiver from school nutrition guidelines sparks debate.Princessiccia

The controversial school lunch waiver debate that began in Washington has migrated to Kentucky. While supporters claim that the proposal assists rural schools, some opponents say it defeats the purpose of years of work to fight one of the U.S.'s highest childhood obesity rates, John Moritz writes for McClatchy Newspapers, parent of the Lexington Herald-Leader.

Next week the House of Representatives is expected to vote on a measure that would let schools ask for a one-year waiver to get out of the new federal school lunch nutritional standards�if the school can show that meeting those guidelines would require them to keep operating meal programs at a loss. The measure is part of a spending bill for the Department of Agriculture passed by the House Appropriations Committee, headed by 5th District Rep. Hal Rogers, R-Somerset.

Michael Saucedo, 9, eats lunch at Russell Cave Elementary
School in Lexington. (Herald-Leader photo by Pablo Alcala)
USDA guidelines, enacted in 2012, call for schools to serve a fruit and a vegetable with each meal. "The guidelines also mandated a switch to 100 percent whole grains by this summer, required milk servings be 1 percent or fat-free and imposed calorie and sodium limitations based on age group," Moritz writes. "Standards also were set for a limited amount of saturated fats per serving, while banning the use of trans fats."

Although the Fayette County Public Schools lunch program will not likely apply for a waiver because the system's meal program is operating in the black, Director of Child Nutrition Michelle Coker told Moritz the waivers would helps smaller Kentucky school districts.

Scott County Nutritional Services Director Mitzi Marshall told Moritz the district is losing money because fewer students are buying the healthier lunches, and even some students who could get free or on-sale lunches have been bringing food from home. She said the guidelines have "gone a little overboard." Coker said cafeteria workers told her that students do not eat the healthy food, forcing the district to increase trash collection. "She estimated that as much as 75 percent of the fruits and vegetables were thrown away," Moritz writes.

"You can put the best meal out there, the most healthy meal, but if they are not eating it, they are not healthier," Coker told Moritz. Before the new guidelines, schools provided fruits and vegetables as an option for children instead of as a requirement.

Supporters of the guidelines argue that tastes can change and schools need to come up with creative strategies for that. "Our schools need to be an environment that makes the healthier and easier choice for our children," said Susan Zepeda, president of the Foundation for a Healthy Kentucky.

According to a report by the Trust for America's Health and the Robert Wood Johnson Foundation, Kentucky ranks eighth in the nation for obesity among children ages 10 to 17 and third among high-school students.

Anita Courtney, who helped the Better Bites program that aims to offer healthier food items for children at swimming pools, public parks and after-school programs, said, "Great work has been done to shift the food that our tax dollars pay for our kids. It just boggles my mind that [Congress] would consider pulling the plug on that."

Coker said a waiver wouldn't mean a school district reverts to its old ways of offering greasy, fatty and sugary foods, but would give an extra year to meet all the requirements. (Read more)
Princess Health and Princess Health andAltria, parent of Philip Morris, reports spending most on lobbying the 2014 legislature but says it didn't fight smoking ban.Princessiccia

Princess Health and Princess Health andAltria, parent of Philip Morris, reports spending most on lobbying the 2014 legislature but says it didn't fight smoking ban.Princessiccia

The parent firm of the nation's largest cigarette company again reported spending more than anyone else on lobbying the Kentucky General Assembly, but says it did not fight the bill that would have imposed a statewide smoking ban in most public places.

"Altria Group, the parent company of Philip Morris USA and U.S. Smokeless Tobacco, reported spending $156,200, "far more than any other company or group, Tom Loftus reports for The Courier-Journal. "And it got the things it wanted from Kentucky lawmakers: tobacco taxes were not increased, no new tax was put on electronic cigarettes and the tobacco-industry supported bill to ban the sale of electronic cigarettes to minors passed."

Spokesman David Sutton "said not a penny of Altria's lobbying campaign went to defeat the so-called 'smoke-free' bill, though he said the company opposes such complete smoking bans within private businesses," Loftus reports. "He said he suspected Altria's lobby spending topped the list because 'We fully disclose everything'," including research time of its legal staff and its "grassroots activation" work to rally its supporters in Kentucky.

The Campaign for Tobacco Free Kids, "which reported spending $6,284 during the session, earlier this month blamed Altria for leading the successful defeat of the bill to ban smoking in indoor public places like bars and restaurants," The Courier-Journal reports.

"They've spent a lot of money on lobbying for years," the campaign's Betsy Janes told Loftus. "They've sent their message out for so long and have relationships with legislators. It's hard for us to compete with that." (Read more)

The campaign's Amy Barkley told Kentucky Health News that Altria's assertion "is very hard to believe. That said, I don�t have any hard evidence to dispute their claim. We all know the tobacco industry�s influence is very deep in Frankfort, so perhaps they didn�t need to overtly lobby against the smoke-free bill."

The Kentucky Farm Bureau Federation, which gets funding from Altria for some of its programs, lobbied against the smoking ban. It ranked eighth in lobbying expenses, with $68,821. For The Courier-Journal's lst fo top lobbying interests, click here.
Princess Health and Princess Health andAt least one additional health-insurance company is expected to sell policies on Kynect exchange next year.Princessiccia

Princess Health and Princess Health andAt least one additional health-insurance company is expected to sell policies on Kynect exchange next year.Princessiccia

The five insurance companies that sold policies this year on Kynect, Kentucky's health-benefit exchange, want to return in 2015, and Dayton, Ohio-based CareSource wants to join as well. Officials said they believe other insurers will sign up to sell policies next year, too, which will benefit consumers, Jack Brammer writes for the Lexington Herald-Leader.

""Consumers benefit from the choices that come with more competition," Insurance Commissioner Sharon P. Clark said. Cabinet for Health and Family Services Secretary Audrey Tayse Haynes said she hopes than even more Kentucky residents will set aside time to examine the plans on Kynect when the second round of open enrollment begins Nov. 15.

Anthem, Humana, Bluegrass Family Health, United Healthcare of Kentucky and Kentucky Health Cooperative offered plans on the exchange this year, and Humana was the only one that didn't offer small group market insurance, for two to 50 people. Humana, Anthem and the cooperative offered individual coverage.

Jonathan Copley, CareSource's executive director for Kentucky, said the company's participation in Kynect is "an extension of our commitment to provide affordable coverage to Kentuckians who need it most. We are expanding our reach to one of Ohio's bordering states to offer affordable health care coverage. Kynect represents a successful model on the marketplace, and we are excited to offer CareSource."

Though the tentative deadline for insurers to request to be on the exchange was April 1, the official deadline has been extended as a result of inquiries, Brammer reports.

In Kynect's first open-enrollment period, from Oct. 1 through March 31 about 421,000 Kentuckians enrolled for coverage, and the increasing number of insurers seems to be a sign even more people will sign up next year. Last month The New York Times reported that "8 million people signed up for coverage in 2014 under the federal health care law and that estimates put next year's national enrollment near 13 million," Brammer writes.

This year monthly rates for those enrolled in Kynect ranged from $47 for older couples without dependents to $403 for families of four with a total income of $70,000 per year. Health and Family Services spokeswoman Jill Midkiff told Brammer that an average premium wasn't calculated because of the many variables such as age and family membership. (Read more)

Princess Health and Princess Health andFDA issues warning label for tanning bed use by minors; sponsor of bill for a state ban says he will try again.Princessiccia

Soon tanning beds will have a "black box" warning that those younger than 18 should not be using them, but some doctors, tanning companies and legislators do not think this will be sufficient to keep minors from tanning. "Consequently, some want a new Kentucky law prohibiting bed use by minors," Annie Garau writes for the Lexington Herald-Leader.


Lexington Herald-Leader graphic
The U.S. Food and Drug Administration announced May 29 new regulations that moved sunlamps from the category of low-risk devices�like dental floss and tongue depressors�to moderate-risk devices. Tanning beds are dangerous because they emit ultraviolet rays like the ones from the sun. These ultraviolet rays not only cause wrinkles and eye damage but also cause skin cancers, including melanoma, which is the most deadly kind of skin cancer, according to the FDA and local doctors.

"There's really no way to get a tan right now without incurring the risk of cancer," said Dr. John D'Orzio, a researcher and pediatric oncologist at Kentucky Children's Hospital. "I don't want to tell people not to go outdoors at all because that would be ridiculous, but the actual ultraviolet radiation from the beds can be up to 10 times more than from standing in the sun." D'Orazio said his biggest concern is that children under 18 have access to the tanning beds. Currently Kentucky only requires "signed parental consent for teens ages 14 to 17 and in-person parental consent for anyone younger than 14," Garau writes.

Mark Wells and Cheryl Ledford, co-owners of Southern Rays Tanning, do not think the new warnings will turn customers away. "There has always been some kind of warning on the beds," Ledford said, "and they haven't stopped people from tanning."

Wells said there are health benefits to tanning, such as increased Vitamin D, the fading of acne and getting a "base tan" indoors to prevent burning outside. D'Orazio disagreed. "A base tan is not going to help you avoid the risks," he said. "You're still getting ultraviolet radiation while you're getting that base tan. Also, it really only takes about one minute of standing in the sun to get enough vitamin D. . . . This is a multibillion-dollar industry. That's a lot of money going into downplaying the negative consequences."

American Academy of Dermatology President Dr. Brett Coldiron said that although sometimes dermatologists prescribe phototherapy as a treatment, "The difference between phototherapy and indoor tanning is that phototherapy is closely monitored and supervised by a dermatologist. This type of medical care isn't provided at an indoor tanning salon, where operators have minimal knowledge about the potential side effects of UV light, and tanning bed lamps have variable amounts of UVA and UVB light."

State Rep. David Watkins, a Democrat and retired physician from Henderson, wanted to prevent Kentucky minors from using tanning beds without a medical prescription, but the Senate Health and Welfare Committee killed his House-passed bill. "I think I'm going to have to work a little harder and make sure my colleagues in the Senate understand that I'm not trying to limit freedoms," Watkins told Garau. "I'm trying to protect some of our most vulnerable constituents." (Read more)

Princess Health and Food Reward Friday. Princessiccia

This week's lucky "winner"... kettle corn!


Read more �

Thursday, 12 June 2014

Princess Health and Princess Health andLexington auto mechanic becomes neurosurgeon; now researching traumatic brain injury diagnosis and treatment.Princessiccia

In the early 1980s, Geoff Manley was a mechanic, and some of his clients were University of Kentucky faculty. That is how he met microbiology professor Shelly Steiner and started on the road to a new career: neurosurgery and a multi-million-dollar research project.

"Some kids are polite�you know, 'Yes, yes, sir'�but disengaged. Geoff was clearly intelligent and focused," Steiner told Laura Dawahare of UKNow. "You can talk to someone for just a few minutes and know right away how bright they are. Geoff was like that."

Because no one in Manley's family had gone to college, Steiner's suggestion that he finish his GED and attend UK, was a "transformative moment," Manley said. He graduated in 1988 then earned his MD-PhD at Cornell University. Now he is the vice chair of neurosurery at the University of California-San Francisco.

"Manley's earlier work with Steiner and a colleague in the lab influenced his decision to pursue a career in the neurosciences; his particular interest is in traumatic brain injury, or TBI," Dawahare writes.

Though the public often hears about athletes' concussions, TBI results even more often from auto accidents or slips-and-falls. Every year at least 1.7 million people in the U.S. get medical attention for TBI. "I did a lot of bench work earlier in my career, but I was torn between my interest in the basic sciences and my desire to do something directly relevant for TBI patients," Manley said. "So I began to explore a new translational research approach to TBI."

The National Institutes of Health (NIH) gave him $18.8 million over five years to do worldwide research about concussion and traumatic brain injury. TBI is complex, which makes diagnosis and therapy development difficult. Dr. Manley and his colleagues want to change the current TBI measures. "Here we are in the 21st Century, and we classify TBI in one of three ways: mild, moderate or severe," Manley said. "Cancer, by comparison, can be characterized in a very precise way, and treatments are customized to each patient's needs." Therefore, Dr. Manley wants to establish a set of classifications for TBI that are as detailed as the ones used for cancer.

"We expect that our approach will permit researchers to characterize and stratify patients more effectively, will allow meaningful comparisons of treatments and outcomes and will improve the next generation of clinical trials," Manley said. "Advancing our understand of TBI will ultimately lead to successful, patient-specific treatments."

Manley said that Steiner's encouragement helped him not only finish his GED and college but also get where he is today. Steiner said, "Geoff would have made it anyway�he had the intellectual octane and the motivation. He may think others helped him, but it really was his trip." (Read more)

Wednesday, 11 June 2014

Princess Health and Princess Health andWellCare of Kentucky removes co-pays for most Medicaid members and offers to pay for GED course for many.Princessiccia

WellCare Health Plans Inc. is improving its Medicaid benefits in Kentucky by removing most members' co-pays and covering the cost of the General Educational Development test and its corresponding coursework for eligible members.

The co-pay and GED benefits will become available on July 1 and continue through the end of the year, except in Medicaid Region 3, comprising 16 Kentucky counties near Louisville. Region 3�s benefits will be determined in fall 2014 to align with its open enrollment. Region 3 is Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, LaRue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington counties.

Open enrollment for the rest of the state ends Wednesday, June 18, so WellCare is offering the new benefits as an incentive for Medicaid recipients to switch form other managed-care companies.

All WellCare of Kentucky Medicaid members will have no co-pays except for non-emergency visits to the emergency room and, only in the Louisville region, a $4 co-pay for preferred-brand medications.

Recipients  of the GED benefits must be at least 16 years old, must not be currently enrolled in high school, cannot be graduates from an accredited high school and cannot have received a high school equivalency certificate or diploma. Members need to complete the required GED coursework at an adult testing center.

For more information about these and other WellCare Medicaid benefits in Kentucky, please visit http://kentucky.wellcare.com/member or call 1-877-389-9457.
Princess Health and Princess Health andStudy finds personalized text messages helps some quit smoking.Princessiccia

Princess Health and Princess Health andStudy finds personalized text messages helps some quit smoking.Princessiccia

Smoking is a hard habit to break. A recent study, reported in the American Journal of Preventive Medicine, found that sending smokers personalized text messages was twice as effective as giving them self-help materials, Valerie DeBenedette writes for Health Behavior News Service.

Participants chose a date to quit smoking and received five text messages during that day and two per day for the rest of the week. Then the text messages decreased to three per week, then to one per week. "Encouraging texts included top health reasons to quit smoking and the amount of money saved by quitting," DeBenedette writes.

"Previously, phone texting programs to help people quit smoking have been shown to be effective in other countries, said Lorien C. Abroms, Sc.D., the lead author of the study and associate professor of prevention and community health at The George Washington University. "This is the first long-term study in the United States."

More than 500 smokers were placed in one of two groups: the group that received text messages and the group that received self-help materials. They were then surveyed about their experience with the program one, three and six months afterward. Researchers tested mailed saliva samples for cotinine to determine if participants had stopped smoking.

Of those who received texts, 11.1 percent stayed off tobacco, compared to 5 percent in the control group. When asked to self-report, "nearly 20 percent of the texting group said they had quit, compared to 10 percent of the control group," DeBenedette writes.

Abroms said texting is cost-effective. Some programs offer it along with telephone counseling. "The potential for reach is wide, and they are fairly low cost compared to more traditional types of therapy," she said.

Chris Bostic, J.D., deputy director for policy at Action on Smoking and Health, an advocacy group in Washington, told DeBenedette, "Even if something like texting only has a marginal effect on the quit rate, it should be added to [the] menu of options available to smokers who want to quit." (Read more)

Princess Health and#TeamMike and #TeamDave complete rosters.Princessiccia

Well, the day we all have been waiting for is ALMOST here.  The Waterloo Classic is only four days away, and the team couldn't more more excited.




There is a lot riding on this race for a number of different reasons.  First, we have the epic battle of #MikeVsDave.  For those of you who don't know, there is a team component to this battle.  Here is a break down of inter-team race, and the team draft results.  Today, we are very excited to announce the complete team rosters for #TeamMike and #TeamDave.  Here they are:



H+P Team Mike
Mike Piazza
Sean Delanghe
Brendan Hancock
Luke Ehgoetz 
Pat Mulherin
Nick Burt
Sam Lalonde
Harold OKrafka
Vicki Zandbergen
Emily Hunter
Cari Rastas Howard
Mark Potvin

H+P Team Dave
Dave Rutherford
Rob Brouillette
Ahmed Ahmed
Greg Dyce
Chris Goldworthy
Daniel Cook
Manuel Jones
Jessica Kuepfer
Justin Buis
Will Spaetzel
Dragan Zubac


5K Team



With so much focus being put in this 10K, we can't forget about our 5K team.  We have a solid contingent being entered in the Open 5K Team category with heavy reliance on some of our fastest female runners.  Here's how the team shapes up:

Kailey Haddock
Payton Thiel
Aron Mailman
Holger Kleinke
Derek Hergott
Tammy Hergott
Stephaney Hortian
Gillian Willard





Battle of Waterloo

Finally, we can't forget that the 10K is the 2nd of 3 stages of the Battle of Waterloo.  Click here to see the recap of Stage 1.    H+P has a number of runners in contention for the OA podium.  After stage one, we have six runners (Sean, Dave, Mike, Greg, Brendan, Pat) all in the top 11 OA.  Vicki Z is also in contention for the OA podium on the women's side as she now sits in 4th OA.





Princess Health and Has Obesity Research Failed?. Princessiccia

Princess Health and Has Obesity Research Failed?. Princessiccia

I frequently encounter the argument that obesity research has failed because it hasn't stopped the global increase in obesity rates. According to this argument, we need to re-think our approach to obesity research because the current approach just isn't working.

Grant funding for obesity research keeps increasing in the US, and the prevalence of obesity also keeps increasing*. What gives? Maybe if we just scrapped the whole endeavor we'd be better off.

Let's take a closer look at this argument and see how it holds up.

Why Do Research?

There are two fundamental reasons why we do research:
  1. To gather accurate information about the natural world. This information is intrinsically valuable because we like knowing how the world works, and it may eventually have practical value that's not immediately obvious.
  2. Practical applications. We want to solve problems and improve our lives.
If we want to determine whether or not obesity research has failed, we should evaluate it using those two metrics.

Has Obesity Research Gathered Accurate Information?

Read more �

Tuesday, 10 June 2014

Princess Health and Princess Health andSteven J. Stack will be second Lexington physician in three years to lead the American Medical Association.Princessiccia

Dr. Steven J. Stack, an emergency physician in Lexington, is the new president-elect of the American Medical Association, the nation�s largest organization for physicians

Stack, at 43, is the youngest president of the organization in a century, Laura Ungar reports for The Courier-Journal. He is the first board-certified emergency physician elected to the post, which he will fill in June 2015.

�It�s an immense honor and a total joy and a thrill,� Stack told Ungar.

Stack will be the second Lexington doctor in three years to hold the office. AMA's immdiate past president is Dr. Ardis Dee Hoven, an infectious disease specialist.

�It�s a fluke of history,� Stack told Ungar.

Stack is a practicing physician and former medical director for emergency departments at St. Joseph East in Lexington and St. Joseph Mt. Sterling.

Stack's experience as the chair of the AMA�s Health Information Technology Advisory Group from 2007 to 2013 and also as a member of the federal advisory groups for the Office of the National Coordinator for Health Information Technology puts him in a position to help further one of the many goals of the Affordable Care Act�to expand information technology.

Stack told Ungar he also plans "to work on improving medical education, reducing diabetes and pre-diabetes in the population and helping ensure doctors are satisfied with their jobs so they can better help patients."

Stack came to Lexington with his wife Tracie, a pediatric allergist, and their 9-year-old daughter in 2006, Ungar writes. He has been active in the AMA for years and has held several offices. He has also been a legislative voice for local Kentucky issues, such as prescription drug abuse and medical liability reform. (Read more)

Monday, 9 June 2014

Princess Health and Princess Health andNational poll finds many who need health coverage didn't even shop for it because they didn't think they could afford it.Princessiccia

Princess Health and Princess Health andNational poll finds many who need health coverage didn't even shop for it because they didn't think they could afford it.Princessiccia

By Melissa PatrickKentucky Health News

The top two reasons people gave for getting health insurance under the Patient Protection and Affordable Care Act were compliance with the law and a desire to see a doctor, according to a recent survey by PerryUndem Research/Communication for Enroll America, a group promoting the law.

The poll also found that many people needed health coverage but didn't even shop for it because they thought they couldn't afford it. UPDATE, June 14: "Convincing Americans that they could afford insurance was the White House's biggest challenge in making Obamacare work," Ezra Klein reports on Vox.

Four in 10 of those surveyed who did enroll that they might not have signed up if the 2010 law hadn't required them to do so. Mike Perry of PerryUndem told Louise Radnofsky of The Wall Street Journal that the poll suggested that "The mandate was a big factor even if it wasn't politically popular."

The survey also found there was a high demand for health insurance during the first open enrollment period, which ended in April. Kentucky also found this to be true, said Gwenda Bond, assistant communications director for the Cabinet For Health and Family Services.

"In Kentucky, we definitely experienced high demand from the beginning of open enrollment Oct. 1, which continued to increase right up through the end of the open enrollment period," Bond said in an e-mail.

Kentucky ended up providing coverage to about 420,000 people in the state, with about three-fourths reporting they did not have insurance before signing up through Kynect, the state's health-insurance exchange.

Despite the demand,the national poll found that 61 percent of those who did not enroll still wanted coverage and the main reason they did not even look for it was because they thought they couldn't afford it.

Some of these people may not have been aware that they could qualify for free coverage through Medicaid. Almost 25 percent of the newly enrolled cited "I qualified for Medicaid" as a reason they enrolled, and over half of that population said it was the main reason.

Kentucky is working on this issue of affordability perception, Bond said. "We will be working to make it easier for individuals and small businesses to get information or a quote up front that estimates the amount of subsidies or discounts they may qualify for, before they ever begin an application,"she said in the email.

More than eight out of 10 surveyed nationally said they will consider enrolling next time.

The poll surveyed 671 newly enrolled people and 853 who remained uninsured. It was conducted April 10-28. The margin of error for the total sample is plus or minus 2.9 percentage points.

Other key findings in the poll included: 69 percent of the newly enrolled thought the process was "easy," especially if they enrolled in person instead of the phone; 74 percent of those in private plans felt confident they can afford their premiums, and many more think their plans have enough doctors than not (56 percent vs. 13 percent). The self-reported health status of those who enrolled and those who didn't was similar.

Princess Health and Princess Health andDoctors in emergency rooms say they are busier since Obamacare began; hospitals struggle to handle extra patients.Princessiccia

Nearly half of emergency-room doctors say their ERs have seen an increase in patients since health reform went into effect, and 86 percent say they expect the increase to continue, according to a poll by the American College of Emergency Physicians. Of the 1,845 completed surveys, 9 percent said ER visits had increased greatly and 37 percent said they had increased slightly. When asked what they think will happen over the next three years, 41 percent said visits will increase greatly and 45 percent said they will increase slightly. (ACEP graphic)

"Dr. Jay Kaplan, a member of ACEP's board of directors, said he wasn't surprised by the findings given the large influx or Medicaid enrollees and the difficulty in locating primary-care doctors who will see those patients," Paul Demko reports for Modern Healthcare. Kaplan told him, �When people get insurance, they feel like they deserve healthcare. When they deserve health care, and there's nobody else they can see, they come to us.�

77 percent of respondents
said their ER is not prepared
for an increase in patients
But some hospitals say many patients are going to the ER for ailments that are not emergencies, Laura Ungar reports for The Courier-Journal. Lewis Perkins, vice president of patient care and chief nursing officer at Louisville's Norton Hospital, said the emergency room is seeing 100 more patients per month, an increase of 12 percent. "We're seeing patients who probably should be seen at our (immediate-care centers)," he told Ungar. "And we're seeing this across the system."

ER visits at the University of Louisville Hospital are up 18 percent, while Dr. Ryan Stanton of Lexington, president of the Kentucky chapter of the ER physicians' group, said ER services are up 7.5 percent in that city. He told Ungar, "It's a perfect storm here. We've given people an ATM card in a town with no ATMs." (Read more)

Phil Galewitz of Kaiser Health News reports that a study in Massachusetts following its Obamacare-like expansion showed an initial surge in ER use followed by a decline over several years. Hospital officials around the country told him that the biggest impact of the expansion of Medicaid is that patients can now go to a primary-care doctor instead of the emergency room for routine care.
Princess Health and Princess Health andIn selling proposed limits on CO2, Obama administration emphasizes health improvement, not climate-change fight.Princessiccia

Princess Health and Princess Health andIn selling proposed limits on CO2, Obama administration emphasizes health improvement, not climate-change fight.Princessiccia

By Melissa Landon and Al Cross
Kentucky Health News

As it announced its plan to reduce carbon dioxide emissions from power plants by 30 percent by 2030, the Obama administration emphasized the health angle, not climate change, which has been the driving force for the proposed regulations but is a more controversial cause than improving health.

"For the sake of our families' health and our kids' future, we have a moral obligation to act on climate," EPA administrator Gina McCarthy said in her announcement.

Juliet Eilperin and Steven Mufson note in The Washington Post that when a climate bill stalled in the Senate four years ago, environmental and public health activists began pressuring Preisdent Obama to mandate carbon limits. Opponents to the measure include coal producers, some utilities and many Republicans, who say that the EPA has not proposed a plan that can work using current technology.

Under the new rules, states would use different strategies�such as energy efficiency, shifting from coal to natural gas, investing in renewable energy and making power plant upgrades�to achieve state-by-state goals. The reductions will be measured from 2005 levels; Environmental Protection Agency data reveal that power plants in the U.S. have already diminished carbon dioxide emissions by almost 13 percent since 2005, The Associated Press reports.

EPA estimates the rules will prevent as many as 6,600 premature deaths, 150,000 asthma attacks in children, up to 490,000 missed work and school days�saving $93 billion, Connie Hedegaard writes for EurActiv. The federal Centers for Disease Control reports that "exposure to particle pollution may cause worsening asthma symptoms, breathing problems, adverse birth outcomes, lung cancer and early death," Healio reports.

The new rules are intended to assist Washington in achieving international obligations to reduce U.S. greenhouse gas emissions deemed responsible for global warming, but Obama is focusing on the human health benefits to encourage Americans to adopt the movement, Jeff Mason wres for Reuters.

Although federal law has been employed to regulate other pollutants�such as soot, mercury and lead�this is the first time it has been applied to greenhouse gases, Fox News reports, quoting Obama: "We limit the amount of toxic chemicals like mercury, sulfur and arsenic that power plants put in our air and water. But they can dump unlimited amounts of carbon pollution into the air. It's not smart, it's not safe, and it doesn't make sense."