Tuesday, 25 March 2014

Princess Health and Princess Health andFDA reviews alternatives to colonoscopies to screen for colorectal cancer, including mail-in, stool-sampling kits.Princessiccia

Princess Health and Princess Health andFDA reviews alternatives to colonoscopies to screen for colorectal cancer, including mail-in, stool-sampling kits.Princessiccia

The Food and Drug Administration is examining the possibility of two alternatives to colonoscopies for identifying tumors and growths in the large intestine. Kentucky ranks high in deaths from colon cancer, partly because people resist having colonoscopies.

According to briefing documents posted online Monday, scientists are evaluating the precision of mail-in, stool-sampling kits from Epigenomics and Exact Sciences, which if approved could be on the market this summer, Matthew Perrone writes for the Minneapolis Star Tribune.

Stool tests have long been employed to help detect precancerous tumors, and colon cancer is often treatable if found early enough. So far, the two tests are more accurate than traditional blood stool tests, but they also more often reported growths when there were none.

"Colorectal cancer is the second leading cause of cancer death in the U.S., with over 50,000 deaths expected this year, according to the American Cancer Society," Perrone reports. Last year Kentucky had the fourth highest death rate for colon cancer in the nation, Dr. Amy Tiu noted in a March 15 article for the Lexington Herald-Leader.

Though colonoscopy is the most accurate screening, many people shun it because they think it will be uncomfortable or invasive, and a liquid compounds must be used to clean out the colon before the procedure. The blood-in-stool tests, though thought to be less accurate, may work just as well if employed each year, according to a federally appointed panel.

The new screenings are expected to be more expensive than traditional tests, and it is so far unclear how often people would need to be tested, Perrone reports.

"Only through a better understanding of other key factors, such as the screening interval, adherence, cost and diagnostic evaluation of positive results, can we determine the appropriate place for stool DNA testing on the screening menu," Drs. Douglas Robertson Dr. Jason Dominitz said in the briefing documents.

One of the proposed tests, Cologuard, detected colorectal cancer in 92 percent of patients who had cancerous tumors, while the traditional blood stool test only has 74 percent accuracy. "In patients with precancerous polyps the test was accurate 42 percent of the time, compared with 24 percent for the blood test," Perrone reports.

Epigenomics' Epi proColon test, however, did not meet all of the study goals. This test discovered cancer in 68 percent of patients who had cancerous tumors, but it only recognized healthy patients in 79 percent of cases. FDA scientists warned that "lower specificity could lead to an increase in the number of avoidable colonoscopies" and "adverse events associated with such invasive procedures," Perrone writes.

Princess Health and Princess Health andSmoking persists or even increases in poor, rural, working-class counties; New York Times cites Clay County as an example.Princessiccia

Clay County has a dubious distinction. It has the highest rate of smoking for any U.S. county with a population under 15,000. Researchers at the University of Washington pointed that out, and The New York Times focused on it in reporting the larger finding: Some poor, rural and working-class counties have increasingly high rates of smoking, while the smoking rates in wealthy counties continue to decline.

Ed Smith Jr.
(NYT photo by Tim Harris)
In Clay County, the smoking rate was 36.7 percent in 2012. �It�s just what we do here,� Ed Smith Jr., 51, told the Times, which reports, "Several of his friends have died of lung cancer, and he has tried to quit, but so far has not succeeded." (Institute for Health and Metrics map shows adult smoking rates by county; Clay and Knox counties are the red area in southeastern Kentucky. The interactive map shows how rates have changed since 1996, overall and among men and women. To view it, click here.)
The smoking rate among adults has decreased 27 percent since 1997, but only 15 percent among poor people, and haven't changed at all for adult smokers living in deep poverty in the South and Midwest, the study found. "The findings are particularly stark for women," Sabrina Tavernise and Robert Gebeloff write. "About half of all high-income counties showed significant declines in the smoking rate for women, but only 4 percent of poor counties did." Education also plays a role. "Americans with a high-school education or less make up 40 percent of the population, but they account for 55 percent of the nation�s 42 million smokers."

Clay County is one of the nation's poorest, and only 7 percent of its people have a college degree. The county seat, Manchester, passed an indoor smoking ban in 2012, and Manchester Memorial Hospital "runs a smoking-cessation program that offers free nicotine patches and gum in an effort to reach low-income smokers," the Times reports. �Smoking cessation is our biggest uphill battle,� Jeremy Hacker, the hospital�s community outreach coordinator, told the newspaper. Smoking is no longer a normal activity in urban places, he said, but in Clay, �It�s not viewed as a problem.� (Read more)
Princess Health and Book Review: Your Personal Paleo Code. Princessiccia

Princess Health and Book Review: Your Personal Paleo Code. Princessiccia

Chris Kresser has been a major figure in the ancestral health community for some time now. It's funny to recall that I was actually one of his first readers, back in the early days of his blog when it was called The Healthy Skeptic and the audience was small. Chris's readership rapidly eclipsed mine, and now he's in high demand for his ability to convey ideas clearly and offer practical solutions to important health concerns.

He recently published a book titled Your Personal Paleo Code, which also happens to be a New York Times bestseller. The primary goal of the book is to help you develop a diet and lifestyle that support health and well-being by starting from a generally healthy template and personalizing it to your needs. Let's have a look.

Introduction

Kresser opens with the poignant story of his own health problems, which began with an infectious illness in Indonesia and several courses of antibiotic therapy. After years of struggling with the resulting symptoms, trying a variety of diets, and finally accepting his condition, he was unexpectedly able to recover his health by adopting a personalized Paleo-like diet that included bone broth and fermented foods.

Why Paleo?

Read more �

Monday, 24 March 2014

Princess Health and Princess Health andHumana Inc. bus travels the rural roads of Mississippi, looking to enroll people in Obamacare by March 31 deadline.Princessiccia

Insurance providers have been scared off by Mississippi, one of the poorest and unhealthiest states in the country. Only nine percent of eligible residents have signed up for insurance under federal health reform, ranking Mississippi near the bottom of all states in Obamacare, with only 25,554 residents having signed up as of early March.

Politico photo by Madeline Marshall: Humana bus
Louisville-based insurance company Humana Inc. is attempting a unique way to try to get Mississippi residents signed up. The company has a bus that travels the state, having made more than 200 stops "pulling into hospital parking lots and Wal-Mart shopping centers, parking at churches large and small and hitting other obvious targets to find and convince the uninsured that President Barack Obama�s signature health achievement will benefit them," Jennifer Haberkorn reports for Politico. "Sometimes the company�s agents see dozens of people per stop. Other times, just a few individuals climb aboard."

Mississippi is the only state where Humana has a bus, Haberkorn writes. "It�s also the only state where the company is covering the co-pay for customers� first doctor�s visit before June, immediate cash savings that it hopes will get people to start a relationship with a primary-care physician. Officials declined to say exactly how much is being spent on the dual strategies."

Based on the dismal number of residents signing up, the bus hasn't exactly been a hit. Part of the problem is that rates in Mississippi are the third highest in the country, and that Humana is only one of two insurers in the state. "Despite all the political rhetoric about a government-run health program, Obamacare relies on private insurers to sell policies on the state and federal exchanges. If there�s no insurance company, then there�s really no Obamacare," Haberkorn writes. "And Mississippi is one of the last places the typical risk-averse health insurance company would choose to sell policies under the law. Statistically, it�s one of the unhealthiest states, topping the charts in all kinds of negatives such as obesity, diabetes, hypertension and cardiovascular disease � conditions that can be stabilized with treatment or kill without."

"But Humana has every incentive to sell as many policies as possible," Haberkorn writes. "The math involved is simple: Insurance works when there are more people enrolled, which spreads the risk of high costs across hundreds or thousands of customers. To succeed in a state like Mississippi, it had to go all out to get customers."

Humana originally offered policies in only four counties, but the state insurance commissioner persuaded it to go to 40. The company's Mississippi market director, told Haberkorn, �Back in August, when we added on an additional 36 counties, we had to act really quickly on how we would get to all of the people in those counties at such a last minute. Operating this mobile tour has allowed us to get to people, instead of waiting for them to come to us.� (Read more)

Princess Health and Princess Health andHigh-school health fair takes healthy messages to students.Princessiccia

Dietitians Josie Crew and Heather Schierer staffed an exhibit on
risks of sugary drinks. (Messenger photo by Melissa Mudd)  
More than 1,000 students participated in Meade County High School's sixth annual health fair, which focused on issues specific to students' health and wellness, Melissa Mudd reported for the Meade County Messenger in Brandenburg.

More than 20 booths were set up at the March 11 fair, featuring exhibits about such topics as alcohol and drug abuse, nutrition, breast cancer, dental and physical health, stress and distracted driving. Booths offered games and prizes. The fair was hosted by the Lincoln Trail District Health Department and various community organizations.

�The health fair originally started with an idea of doing something to promote health and wellness for students. We also wanted to come up with a fun way to engage students in learning the harmful effects of drugs, alcohol, smoking, poor-decision making, et cetera," Karen Cottrell, Meade County district health coordinator, told Mudd. "We are always very impressed with how engaged the students are in the various activities."

Cottrell told Mudd that the students who were asked to complete a survey after the fair said they enjoyed coming to the fair and especially loved the games. Each reported learning at least one new health fact.

Sunday, 23 March 2014

Princess Health and Princess Health andObama reminds the uninsured of March 31 signup deadline; McConnell continues to point out the pitfalls of reform.Princessiccia

Princess Health and Princess Health andObama reminds the uninsured of March 31 signup deadline; McConnell continues to point out the pitfalls of reform.Princessiccia

On the fourth anniversary of the law that has informally come to bear his name, President Obama reminded uninsured Americans that they have only one more week to sign up for coverage under open enrollment.

He also dismissed Republican calls to repeal or replace the law, first citing the relief one woman shared with him after she used her new insurance for the first time: "I felt like a human being again. I felt like I had value."

Obama said, "This is what�s at stake any time anyone, out of some outdated obsession, pledges to repeal or undermine the Affordable Care Act. And that�s why my administration will spend the fifth year of this law and beyond working to implement and improve on it." (Read more)

Senate Republican Leader Mitch McConnell took the anniversary as an opportunity to remind voters of the pitfalls of "a deeply misguided expieriment," noting in an op-ed piece that Obama "pledged that Americans could keep their health care plans and their doctors and that their coverage would be 'more secure and stable' than before" and that journalistic fact-checkers called that "the lie of the year."

McConnell cited the example of Angela Strobel of Owensboro, "a mother of five girls [who] not only lost her insurance, she also lost a trusted family doctor to Obamacare. In a perfect summary of modern liberalism, one of the billing clerks for Kentucky's Obamacare exchange told Angela that since she now qualifies for Medicaid, she'd be breaking the law if she tried to pay more out of her own pocket just to keep her old doctor. Medicaid rules forbid it. The upshot: for Angela and her family, it's either Medicaid or a monthly premium increase of nearly $1,000."

Medicaid is free, but many doctors don't treat Medicaid beneficiaries, and most insurance policies sold through the exchanges have fewer providers to choose from because some providers were not willing to limit their charges in order to be part of the insurance network.

"A recent analysis by the management consulting firm McKinsey & Co. found that only a fraction of the biggest local hospitals in a given coverage area will accept Obamacare patients," McConnell wrote. "An Associated Press study found that only four of the 19 cancer centers it surveyed would give Obamacare patients access to its cancer care through the new Obamacare exchanges in their states. This is progress?" (Read more)

Friday, 21 March 2014

Princess Health and Princess Health andOne in 13 Kentuckians have health coverage through Kynect.Princessiccia

Princess Health and Princess Health andOne in 13 Kentuckians have health coverage through Kynect.Princessiccia

Nearly 322,000 Kentuckians had enrolled for health coverage through the state's new insurance exchange through 6 p.m. Thursday, March 20, and three-fourths of them didn't have coverage before, according to the state's preliminary analysis.

Gov. Steve Beshear's office said in a news release that enrollments are expected to keep growing in the final 10 days of open enrollment, which ends March 31: "In the past seven days, nearly 3,100 Kentuckians have signed up each day for quality, affordable health insurance."

Of the 321,932 enrollees, 257,477, or 80 percent, qualified for coverage under the federal-state Medicaid program, and 64,455 bought private insurance. Another 10,096 have been found eligible for a subsidy to buy a policy but haven't bought one.

The release said 7.5 percent of Kentucky's population now has health insurance through the exchange, which the state has branded Kynect. The release said 32 percent of those in private health plans through the exchange are under 35, a key group for success of health reform.

�In these final days of open enrollment, we strongly encourage those folks to complete their applications and choose a plan,� said Carrie Banahan, executive director of Kynect. �After March 31, subsidies to help cover the cost of a private health plan won�t be available again until the fall enrollment period � and by that point, being without insurance may cost you on your taxes.�

Individuals who don't enroll by March 31 could face a financial penalty of $95 or 1 percent of income, whichever is greater, for every uninsured member of a household. Under federal health reform, the penalty will increase significantly from year to year.

With the first phase of Kynect about to end, Beshear's office reported the benefits of health reform to Kentucky health-care providers. It said they have been paid more than $45 million for treatment of people that reform made eligible for Medicaid.

The new income limit for Medicaid recipients is 138 percent of the federal poverty threshold; before reform, it was 69 percent. The newly eligible include individuals making less than $15,856 a year and families of four with annual income below $32,499.

"The vast majority of the nearly 20,000 newly insured patients seen by hospitals and reimbursed for services would have been considered indigent prior to Medicaid expansion and most likely would have been written off as uncompensated charity care by the hospitals," the news release said. "These figures don�t include reimbursements to health-care providers for patients with new private health insurance."