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Thursday, 27 March 2014

Princess Health and Princess Health andTelemedicine can help delay Alzheimer's, especially in rural areas, where it starts sooner, Appalachian health conference is told.Princessiccia

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By Melissa Landon
Kentucky Health News

Telemedicine is a strategy that can be used to help prevent and treat Alzheimer's disease, especially in rural areas, where the disease comes sooner in life, Dr. Gregory Jicha, clinical-core director of the University of Kentucky's Disease Center, said today at the fourth annual Appalachian Translational Research Network Summit in Lexington.

Dr. Gregory Jicha
While mortality rates for prostate cancer, breast cancer, heart disease and HIV are going down, the rates for Alzheimer's are going up, and by 2020, it is estimated that 5.6 million Americans could be affected by it. Rural areas have higher incidents of the condition, and the onset of dementia averages four years younger in rural areas than in urban areas, Jicha said.

The university's Telemedicine Cognition Clinic offers appointments that involve video interaction with patients and caregivers in remote areas. In rural areas in general, telemedicine can be particularly helpful for patients who live great distances from the nearest specialist. "I cannot drive to Paducah and fill an entire clinic every week," Jicha said. But he explained that he can "travel" to a different city every hour and provide care to patients. "Telemedicine really is the wave of the future," he said. 

During telemedicine appointments, medical experts can talk about the patients' history, administer cognitive tests, and even observe patients walking or performing tasks to diagnose them. The goal of the program is to provide high level care and cognitive evaluations in rural areas by partnering with primary care physicians and clinics in rural areas, Jicha said.

Another important aspect of the growing program is education, both for patients and for physicians. Alzheimer's disease has no sure, but some risk factors associated with it�such as hypertension, alcohol use and depression�are treatable. If rural residents had better access to specialists who can detect the early symptoms of the disease, its onset could be delayed.

The conference was a forum for hundreds of research efforts. Among the topics discussed during the conference were the connection between physical fitness and academic performance in children, and environmental enrichment to promote healthy aging brains.

Todd Gress, a professor at Marshall University in Huntington, W.Va., presented a study about a pilot test of a text-message reminder system to advance diabetes awareness, compliance, and education�particularly in remote areas where cell phone service might be unreliable.

The advancing telemedicine strategy and these other research agendas should serve as a reminder that gifted researchers are searching for ways to improve rural health.

Such conferences "represent the best of what's happening out there in the world of universities and the world of communities," UK Provost Christine Rirodan told one session. She said the Appalachian gathering "represents the passion of people who are dedicated to solving these problems" in the region, "which require a great deal of collaboration to solve. . . . They're not small problems."
Princess Health and Princess Health andOne of every three Kentucky adults didn't see a dentist last year; key factors are overall health, insurance and income.Princessiccia

Princess Health and Princess Health andOne of every three Kentucky adults didn't see a dentist last year; key factors are overall health, insurance and income.Princessiccia

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More than a third of Kentucky adults say they didn't go to a dentist last year, and one in six said they hadn't in five years or more, according to the latest Kentucky Health Issues Poll.

The results show the challenges Kentucky adults who are lower income, uninsured or living in rural areas face in getting dental care, said the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health, formerly the Health Foundation of Greater Cincinnati. �Oral health is critical to overall health,� said Dr. Susan Zepeda, president of the foundation.

The poll, taken Oct. 25 through Nov. 26, found that 64.4 percent of Kentucky adults went to the dentist in the past year. Another 8.5 percent said they had been in the previous year, 10.4 percent said their last visit was three to five years ago, and 14.6 percent said it has been more than five years. Two percent of Kentuckians polled said they had never been to a dentist.

Among those who defines their overall health as very good or excellent, 73 percent had a dental visit in the previous year while only half of those who said their overall health is fair or poor said they did.

Only 24 percent said their physician has asked about their oral or dental health. Those whose physicians did ask about their oral health (73%) were more likely to visit a dentist than those who were not asked (62%).

Dental insurance is relatively rare, so income is a major factor in seeing after oral health. Among Kentucky adults with incomes at or below 138 percent of the federal poverty threshold, making them eligible for Medicaid, 48 percent reported seeing a dentist in the past year. Among those with incomes more than double the threshold, the figure was 81 percent. Among those who said they had insurance, 70 percent reported a dental visit, while only 43 percent of the uninsured said they did.

Just over half (51%) of adults who live in Appalachian Kentucky visited a dentist in the past year compared to seven in ten (71%) of adults living outside Appalachia.

The poll surveyed a random sample of 1,551 adults from throughout Kentucky by telephone, including landlines and cell phones. The poll has a margin of error of plus or minus 2.5 percentage points.

Wednesday, 26 March 2014

Princess Health and Princess Health andChildren 8-12 can submit a healthy lunch recipe by April 5 to get chance for trip to Kids' 'State Dinner' at White House.Princessiccia

Princess Health and Princess Health andChildren 8-12 can submit a healthy lunch recipe by April 5 to get chance for trip to Kids' 'State Dinner' at White House.Princessiccia

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First Lady Michelle Obama is again teaming up with the Education and Agriculture departments to run a nationwide recipe contest to promote cooking and healthy eating by young people.

"Teaching kids to cook is a great way to ensure our children learn healthy habits early in life," a white House press release said. "Research shows that children who help with cooking and meal preparation are more likely to consume fruits and vegetables, and they are more aware of the importance of making healthier food choices.'

The third annual Healthy Lunchtime Challenge & Kids' �State Dinner� encourages students across the country to come up with healthy, original creations. It invites parents or guardians and their children, ages 8 through 12, to create and submit an original lunch recipe that is healthy, affordable and tasty.

The recipe must follow the guidance that supports USDA�s MyPlate to ensure that the criteria of a healthy meal are met. Entries must include each major food group, either in one dish or as parts of a lunch meal, including fruits, vegetables, whole grains, lean proteins and low-fat dairy foods, with fruits and veggies making up roughly half of the plate or recipe.

Recipes can be submitted through April 5, online at www.recipechallenge.epicurious.com, or via mail to The Healthy Lunchtime Challenge c/o Epicurious.com, 1166 Ave. of the Americas, 15th Floor, New York NY 10036.

This summer, Delta Air Lines will fly 56 children and their parent/guardian (one pair from each of the 50 states, plus the U.S. territories, D.C., and Puerto Rico) to the nation�s capital where they will have the opportunity to attend a Kids� �State Dinner� at the White House hosted by Mrs. Obama. A selection of the winning healthy recipes will be served. Winners will be notified in May. For more information and contest rules visit www.recipechallenge.epicurious.com.
Princess Health and Corrections to the New Review Paper on Dietary Fat and Cardiovascular Risk. Princessiccia

Princess Health and Corrections to the New Review Paper on Dietary Fat and Cardiovascular Risk. Princessiccia

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The meta-analysis by Chowdhury et al. raised quite a furor from certain segments of researchers and the popular media. I find this reaction interesting. I usually write about obesity, which is a topic of great interest to people, but my post about the review paper received more than twice my usual traffic. People whose findings or opinions are questioned by the paper are aggressively denouncing it in the media, even calling for retraction (1). This resembles what happens every time a high-profile review paper is published that doesn't support the conventional stance on fatty acids and health (e.g., Siri-Tarino et al. [2], which despite much gnashing of teeth is still standing*). I'm not sure why this issue in particular arouses such excitement, but I find it amusing and disturbing at the same time. This kind of reaction would be totally out of place in most other fields of science, where aggressive public media outbursts by researchers are usually frowned upon.

As it turns out, the critics have a point this time. Significant errors were uncovered in the original version of the meta-analysis, which have been corrected in the current version (3). These include the following two errors, one of which alters the conclusion somewhat:
  • The outcome of one observational study on omega-3 fatty acids was reported as slightly negative, when it was actually strongly positive. This changes the conclusion of the meta-analysis, making it somewhat more favorable to omega-3 consumption for cardiovascular protection.
  • The authors left out two studies on omega-6 fatty acids. These didn't change the overall conclusions on omega-6.

Read more �
Princess Health and Princess Health andUK hospital tells 1,079 former patients that a laptop computer with their medical records was stolen in early February.Princessiccia

Princess Health and Princess Health andUK hospital tells 1,079 former patients that a laptop computer with their medical records was stolen in early February.Princessiccia

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The University of Kentucky reported Wednesday that personal health information of 1,079 people who had been patients at its hospital was on a laptop computer that was stolen in early February.

UK HealthCare said the computer, which was password-protected, belonged to one of its pharmacy billing management vendors. The computer contained dates of birth, medical records and perhaps some patients' insurance carriers and ID numbers, but not Social Security numbers or bank information, UK said.

"We have no reason to believe at this time that any data has been compromised, but under federal privacy regulations we are required to notify people whose information was on the computer in question," UK spokesman Jay Blanton said. "We are also notifying those individuals directly about what has occurred. In that communication, we provide information about where people can contact UK HealthCare for further information." For coverage from WKYT-TV, click here.

Princess Health and Princess Health andNew County Health Rankings report shows same counties at top and bottom, but many have shown moves in the rankings this year.Princessiccia

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By Melissa Patrick
Kentucky Health News

The fifth annual County Health Rankings report shows that some Kentucky counties have made great improvements in their rankings over the last five years, while others have significantly dropped or remained stuck at the bottom.

The report estimates each county's overall health outcomes (length and quality of life) and its overall health factors (determinants of health). These categories are broken down into eight different areas that are measured and calculated to rank each county relative to the other counties in the same state.

Local communities can use the data "to see how they compare to other Kentucky counties on several health dimensions," said Susan Zepeda, president/CEO of the Foundation for a Healthy Kentucky. "We hope local leaders will use this information to identify both health challenges and policy opportunities." The foundation operates a complementary data website, kentuckyhealthfacts.org, with detailed information on each county's health status.

The last five years have shown some great improvements in the health outcomes and health factors in some of Kentucky's counties. The factors used in the rankings have changed somewhat over the years, some statistical modeling is involved, and statistical differences among closely ranked counties are so small that they may not be significant.

Thus, the rankings should be viewed more as a general categorization of a county's health status than be used to make specific comparisons with counties that are relatively close in the rankings. To emphasize that, the University of Wisconsin's Population Health Institute, which compiles the data, groups counties in quartiles, or fourths of the whole. Kentucky has 120 counties, in quartiles of 30.


McLean County (ML on the map, southwest of Owensboro) is the only one that showed major improvement in both measures, moving up to 45th now from 85th in health outcomes, and up to 51st now from 79th in health factors.

Other counties that showed the most improvement in health outcomes are Hickman, moving up to 56th from 95th; Grant, moving up to 58th from 89th; Elliott, moving up to 66th from 93rd; and Simpson, moving up to 27th from 54th.

A video on Grant County is part of this year's national presentation, also funded by the Robert Wood Johnson Foundation. To watch it, click here.

Grant County was spotlighted because community members used its low ranking as a motivation for improvement. One goal of the project is to provide specific health information to counties that can be evaluated and used to improve their health status.

The counties that showed the most improvement in health factors are Bracken, moving up to 40th from 74th; Meade, moving up to 49th from 83rd; Hart, moving up to 62nd from 91st; and Graves, moving up to 42nd from 73rd. Four other counties, besides McLean, moved up 28 spots in this category: Union (to 43rd from 71st), Marion (to 36th from 64th), Christian (to 66th from 94th) and Carlisle (to 21st from 49th).

Because the rankings are relative, within the state, as many counties must move down as move up, and some counties have shown significant drops in the last five years.

Morgan and Carlisle counties both plummeted 48 spots in the rankings for health outcomes over the five-year period. Morgan fell from 14th to 62nd and Carlisle dropped from 25th to 73rd. These counties were followed by Bath, moving from 67th to 99th; Harrison, from 47th to 77th; and two that dropped 29 spots: Union, which fell from 45th to 74th, and and Robertson, which went from 57th to 86th.

Larger drops were seen in health factors. Fulton County showed a whopping 61-place decline in the last five years, from 48th to 109th. Robertson dropped to 91st from 37th; Lincoln dropped to 95th from 45th; Harrison dropped to 50th from 16th; and Clinton dropped to 89th from 60th.

The top and bottom counties in the rankings have showed very little variation over the last five years. This year the top five counties for health outcomes are: Oldham, Boone, Shelby, Calloway and Scott. The top five for health factors are Oldham, Woodford, Boone, Fayette and Scott.

All five are some of the state's wealthiest and most educated counties, and the five at the bottom are some of the poorest and least educated.

The bottom five counties for health outcomes this year are Lee, Breathitt, Wolfe, Floyd and Perry, at 120th. The bottom five for health factors are Leslie, Magoffin, Wolfe, Martin and Clay, at 120th. These overlapping groups of counties form a contiguous area in the middle of Eastern Kentucky.

Year-to-year changes are subject to more statistical doubt, but some counties showed big movements in their rankings form last year. Carlisle County showed the single greatest drop in health outcomes, dropping 29 spots, from 44th to 73rd. Adjoining Harrison County dropped 22 spots in health outcomes, moving from 55th to 77th. Trimble County dropped 26 spots in health factors, moving from 21st to 47th.

It will be interesting  to watch Bracken County, whose improvement of 30 spots to 40th from 70th this year might reflect in better health outcomes in the future.

Morgan County is also one to watch. Its dismal health factors scores over the last five years, ranging from 96th to 111th, may have contributed to a drop in health outcomes, from 14th in 2010, to 23rd 2011, to 29th in 2012, to 69th in 2013 and to 62nd in 2014.

The downward trend in Nelson County's health-factor ranking, from 25th in 2013 to 46th in 2014, is also worth watching to see if this will reduce its consistently high ranking in health outcomes, ranging from 17th to 25th over the last five years.

The report uses data from the federal Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, which constantly surveys Americans about their health. Because of small sample sizes for small counties, their figures are calculated through statistical modeling and comparison with counties of similar demographics.

Tuesday, 25 March 2014

Princess Health and Princess Health andFeds, state will allow mid-April enrollment for people who start but don't complete Obamacare applications by March 31.Princessiccia

Princess Health and Princess Health andFeds, state will allow mid-April enrollment for people who start but don't complete Obamacare applications by March 31.Princessiccia

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"The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health-care plans through the federal insurance marketplace by the March 31 deadline," The Washington Post reports. "Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on www.HealthCare.gov, but who do not finish by Monday, will have until about mid-April to ask for an extension."

The announcement will not change the policies and procedures of the Kentucky Health Benefits Exchange (branded as Kynect), said its executive director, Carrie Banahan. She said the exchange was already planning to enroll by April 15 people who had filed an application but not selected a plan by March 31, and will also enroll people who can show they tried to apply by March 31 but were prevented from doing so by a technical difficulty.

Here is more background from the Post.
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