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Friday, 29 May 2015

Princess Health and Kentucky's seniors rank 48th in insurance firm's health rankings.Princessiccia

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Kentucky seniors ranked in the bottom 10 states for 23 of the 35 measures ranked by the 2015 America's Health Ranking Seniors Report, placing Kentucky in 48th place for the second year in a row.

�The report is a call to action. We believe you can�t improve what you don�t measure,� Dr. Julie Daftari, market medical director for United Health Care of Kentucky told Alyssa Harvey of the Bowling Green Daily News. �It may start with seniors taking individual action. If we live long enough, we�ll be part of these statistics in the future."

Kentucky seniors ranked last in two areas, total health outcomes and preventable hospitalizations; next to last in premature deaths and education and in the bottom three states for smoking, seniors who are considered underweight, and poor mental health days.

The report notes that smoking is the leading cause of preventable death in the U.S. and "older smokers are at an increased risk of smoking-related illness as they tend to be heavy smokers with an average smoking duration of 40 years" and "are less likely than younger smokers to believe that smoking harms their health." Kentucky, with 11.8 percent of its seniors regularly smoking, ranked third highest in senior smoking, behind Nevada and Mississippi.

The report is intended to point out the health challenges facing today's seniors and offer a starting point to help states determine what needs to change. That being said, Kentucky ranks very low in an area that could help improve these outcomes: community support, where it ranks 45th.

The report did say that Kentucky seniors do have some strengths. They have a low prevalence of chronic drinking, low percentage of adults needing pain management, high flu vaccination coverage and a low percentage of low-care nursing home residents.

More Kentucky seniors also reported very good or excellent health since last year's report, up to 33.7 percent from 31.2 percent.

The report noted that a decrease in physical inactivity is a nationwide problem for seniors, with 33.1 percent of seniors nationwide reporting they did not get enough physical activity. This percentage was even higher in Kentucky at 40.2 percent, which is higher than the previous two years (34.5 percent in 2014 and 17 percent in 2013).

The report notes that today, one in seven Americans are aged 65 and older, and in the next two decades the rest of the 77 million baby boomers will move into this demographic. The report also projected the increase in Kentucky's senior population between 2015 to 2030 will be 41.8 percent.

�The fact that we were able to identify key strengths and challenges gives Kentucky an opportunity to address those specific issues,� Daftari told Harvey. �If these challenges aren�t addressed, there may be a significant strain on health care in the future.�

The rankings were based on 35 measures of senior health including behavior determinants like smoking and dental visits; micro and macro community and environmental determinants like poverty and social support; policy issues like percentage of seniors on SNAP; and measures of clinical care like the percentage of seniors who receive home health.; and outcomes like the percentage of seniors who have fallen. It also included measures like education and cognition.

Princess Health and University of Kentucky rural health expert, Ty Borders, appointed to national advisory committee on rural health.Princessiccia

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University of Kentucky College of Public Health Professor Ty Borders was recently appointed to the National Advisory Committee on Rural Health and Human Services.
Ty Borders


This committee is part of the Health Resources and Services Administration and includes a 21-member panel of nationally recognized rural health experts that is responsible for making recommendations to the Department of Health and Human Services on issues related to rural health. Borders's appointment will continue until April 2019.

�This appointment is an honor not only for Dr. Borders and his family, but also for Kentucky,� Rep. Andy Barr, R-Ky., said in a UK news release. �Dr. Borders possesses a broad and deep understanding of the health care challenges facing rural Kentucky and America. His unique insight about evidence-based strategies that could improve rural health and health care delivery will greatly benefit the committee.�

Borders is the chair of the Department of Health Services Management and the Foundation for a Healthy Kentucky endowed chair in Rural Health Policy. He also serves as a founding co-director of the UK Institute for Rural Health Policy and is the editor of the Journal of Rural Health, an academic publication devoted to rural health research.
Princess Health and Insulin Resistance Strongly Predicts Cardiovascular Disease Risk. Princessiccia

Princess Health and Insulin Resistance Strongly Predicts Cardiovascular Disease Risk. Princessiccia

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I recently came across a very interesting paper by the research team of Gerald Reaven, an endocrinologist at Stanford. He has long been one of the leading researchers studying insulin resistance, the metabolic syndrome, and their association with obesity. Reaven's research, and that of many others, suggests that insulin resistance is a central part of the constellation of metabolic disturbances that are so common in affluent nations*. We also have good reason to believe that it contributes to cardiovascular risk.

All the way back in 1998, Reaven's group published a paper that should raise the eyebrows of anyone interested in cardiovascular health (1).

Read more �

Thursday, 28 May 2015

Princess Health and Feeling exhausted and not sure why? Ask your health-care provider to check your vitamin B12.Princessiccia

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Some doctors are adding a vitamin B check to their standard "baseline" workup, especially vitamin B12, the one most commonly deficient, Dr. Leigh Erin Connealy reports for Newport Natural Health.

"By some estimates, up to 40 percent of the population does not have sufficient levels of B12," Connealy writes.

The B vitamins work together as a family to  perform many important functions throughout the body, such as helping to convert our food to fuel, allowing us to stay energized through the day, helping maintain heart health, preventing birth defects, creating red blood cells or assisting with the production and repair of DNA, to name a few.

Vitamin B12, or cobalamin, keeps our blood, nervous system and heart healthy. It is found primarily in animal-sourced foods�all meats, dairy products, eggs, and shellfish. Liver, sardines, and salmon contain the greatest amount.

Image from webmd.com
While it is not uncommon for vegetarians and vegans to have low levels of B12, Connealy says that even meat eaters can lack it, usually because of poor absorption.

Absorption issues in younger people are often caused by acid-blocking medications, disorders such as Crohn's disease, leaky gut, diarrhea and other gastrointestinal problems.  Older people with a condition called hypocholorhydria, where the stomach does not produce enough acid to help with the absorption of nutrients, can have low levels as well, Connealy notes.

B12 deficiency can cause a wide variety of debilitating symptoms ranging from exhaustion and lethargy to depression, anxiety, memory loss, confusion, and other Alzheimer�s-like symptoms.

WebMD adds rapid heartbeat and breathing, pale skin, sore tongue, bleeding gums, stomach upset and weight loss and diarrhea or constipation to the list of symptoms.

Connealy notes that there are differing recommendations for the amount of B12 that should be in a supplement. The Dietary Reference Intake recommends between 2-3 micrograms daily, while the Center for Food Safety and Applied Nutrition recommends 6 mcg daily, based on a 2,000-calorie diet.

Connealy recommends the higher dosage, especially since "absorption problems are so common with age" and "it's nearly impossible to overdose." She also recommends B12 injections for severe deficiencies. In particular, she says that vegetarians, vegans and those age 50 and older should take an oral B12 supplement every day.
Princess Health and In-school health clinics not only meet the health-care needs of students and staff, but also their families.Princessiccia

Princess Health and In-school health clinics not only meet the health-care needs of students and staff, but also their families.Princessiccia

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School-based health clinics in Kentucky could become a trend,  especially as the state searches for solutions to meet the health care needs of schools as budgets for school nurses continue to be slashed.

Southern Kentucky has Cumberland Family Medical, based in Burkesville, which has clinics at the five schools in Russell County and a deal to do likewise with the four in adjoining Adair County.

Western Kentucky has three such clinics, with two more likely to open next year, Genevieve Postlethwait reports for The Paducah Sun. 

The clinics are at McCracken County's Reidland Middle School, Lone Oak Elementary School, and Paducah's Morgan Elementary. Next school year a full-time clinic will open in McCracken County High School, hopefully followed by a clinic at McNabb Elementary.

These clinics exist as a partnership between Mercy Medical Associates and the local public school districts; the school districts supply the space, Mercy supplies and staff and the Lourdes Foundation helps with funding, Postlethwait reports.

An advanced practice registered nurse with Mercy Medical, Julie Higdon, said she has seen well over 30 patients at the Lone Oak clinic since it opened in mid-April. "That's not busy by ER standards," she said, "but that's busy for a little clinic that's just softly opened."

The clinics serve the entire "school family," from the students and their parents and siblings to the districts' teachers, staff and administrators, regardless of their ability to pay. "Their goal is to give the community the preventive, acute and critical health care it needs while reducing students' and teachers' time away from school, and parents' time away from work," Postlethwait writes.

"It's a big deal when you start talking about dollars and cents, too," Tennille Rushing, director of clinical operations for Mercy, told Postlethwait.  "Not only in the impact for the schools to have kids staying in the classroom and helping with attendance numbers, but for parents. If you only have a limited number of days that you can take off, and you have to take off half a day to go sit in a lobby somewhere with your child, you've missed a half day of pay."

These clinics will also help those without a primary-care provider, which are in short supply in the Paducah area. The Lone Oak clinic will remain open by appointment only this summer.

"I feel like these clinics really have the potential to meet a need for the community," Higdon told Postlethwait. "I feel like it has great potential to grow, I really do." (This story is behind a paywall.)
Princess Health and Free overdose-reversal kits are given to Kentucky hospitals with the highest recent rates of heroin-overdose deaths.Princessiccia

Princess Health and Free overdose-reversal kits are given to Kentucky hospitals with the highest recent rates of heroin-overdose deaths.Princessiccia

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Kentucky hospitals with the highest rates of heroin overdose deaths are receiving funding for heroin/opiate overdose reversal kits, which will be provided free of charge to every treated and discharged overdose victim at the pilot project hospitals, according to a state press release.

The funding for these kits is through the Substance Abuse Treatment Advisory Committee, which oversees the distribution of a $32 million pharmaceutical settlement fund that is used to expand treatment in Kentucky. The committee has allocated $105,000 to purchase these kits for the pilot hospitals: the University of Louisville Hospital, the University of Kentucky Medical Center in Lexington, and the St. Elizabeth Healthcare in Northern Kentucky.

In 2013, 230 Kentuckians died from heroin overdoses. Final numbers for heroin overdoses in 2014 are not yet available, but the Office of Drug Control Policy estimates heroin was involved in 30 percent of all drug-overdose deaths, according to the release.

Attorney General Jack Conway chairs the committee and First Lady Jane Beshear serves on it. They announced recently that about 500 of these kits will be made available to the St. Elizabeth system, which treated 545 people in 2013 and 745 people in 2014 for heroin overdoses.

�There is evidence the collaborative efforts in our community are having an effect,� St. Elizabeth interim president and CEO Garren Colvin said in the release. �A report earlier this month indicated that heroin-related overdose deaths are down in Northern Kentucky. ... To continue to battle heroin issues in our community and throughout Kentucky, it is going to take education and collaboration at the local and state levels.�

Naloxone, which is also known as Narcan, is the drug in the free Naloxone Rescue kits and "has no potential for abuse and immediately reverses the effects of heroin overdose by physiologically blocking the effects of opiates," says the release.

One of the challenges for access to these kits is that they are not covered by Medicaid or many private insurance companies and are too expensive for most people to purchase. Health experts anticipate that when the U.S. Food and Drug Administration approves the nasal mist form of the drug, most insurance companies and Medicaid will cover it.

�As Kentuckians expand access to mental health treatment, including addiction recovery, it�s more important than ever to have community access to tools like Narcan,� Jane Beshear said in the release. �Often, an overdose experience is what finally drives people suffering from addiction to seek help.�

Wednesday, 27 May 2015

Princess Health and Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children.Princessiccia

Princess Health and Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children.Princessiccia

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The University of Kentucky recently partnered with over 100 fourth and fifth grade students in two Clay County schools to study the relationship between circadian rhythms and weight in children.

Sydney Sester, a fifth grade student at Manchester Elementary School, said in a UK news release that in addition to learning more about science and helping others by contributing to research, participating in the study showed her the importance of maintaining a healthy weight and eating well.

"It made me want to be more responsible with food and be patient with what I eat and only eat when I'm hungry," she said.

The project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," also known as the Clay County Clock Study, is led by Dr. Jody Clasey, associate professor of kinesiology and health promotion, and Dr. Karyn Esser, professor of physiology.

The research team says it hopes to learn about the relationship between circadian rhythms, eating, and activity behaviors and the incidence of overweight and obesity in children.

And while the team is in the process of analyzing the data, Esser told a group at the 10th annual Center for Clinical and Translational Science conference in March that early data show 33 percent of the students in the study are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

The data was gathered through electronic devices that the students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their sleep and eating activities each day.

Previous studies have shown that disrupting an adult's circadian rhythm is associated with increased risk for metabolic disease, which is a combination of chronic health conditions that puts a person at a higher risk of heart disease and diabetes. Similar research with children has been limited.

Esser noted that "Clay County and many of the counties in Appalachia have a much higher rate of these chronic diseases."

She also said that while it is known that light exposure affects the body clock, recent findings show that the time that we do activities, like exercising and eating, also contribute to circadian health, and that this is also likely true in children.

This research "could not only influence an individual, but school start times, activity intervention, just so many different areas from personal practice or behavioral choices to public policy, all for the metabolic or physiological good of the individual or collective body," Clasey said.
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