Friday, 3 July 2015
Wednesday, 1 July 2015
Princess Health and Our 2015 ENDURrun Women's Team.Princessiccia
The ENDURrun is fast approaching! We had an amazing time last year, but this year is shaping up to be even better. As many of you know, H+P will have 7 relay teams with various challenges to tackle as they conquer this week-long 7-stage race. Every Wednesday in July, we will be revealing 1-2 of our teams along with their goals for the event.
TODAY we are excited to introduce our 2015 H+P ENDURrun Women's Team!
Goals:
TODAY we are excited to introduce our 2015 H+P ENDURrun Women's Team!
Goals:
- We had a great team last year, but this year our fastest women are looking better than ever before. Goal #1 will be to take down last year's women's course record time of 13:58.
- The second, and perhaps most exciting goal to follow will be very simple: take down our 2015 H+P Masters Men's ENDURrun team (roster to be announced next week).
Roster:
Stage 1: Half Marathon
Name: Kailey Haddock
Height: 5'2
Age: 27
Favourite Workout: Anything with no hills.
Favourite food: nachos with jalape�os
Spirit animal: Liger
Stage 2: 15K TT
Name: Gillian Willard
Height: 5'2
Age: 26
Favourite Workout: Recovery days
Favourite Food: Gushers (formly fruit roll-ups)
Spirit Animal: jerboa
Stage 3: 30K Cross-Country
Name: Helen Broom
Height: 5'5
Age: 29
Favourite Workout: brick
Favourite Food: watermelon
Spirit Animal: red panda
Stage 4: 10-Mile Hill Run
Name: Andrea Sweny
Height: 5'2
Age: 31
Favourite Workout: tempo run
Favourite Food: butter tarts
Spirit Animal: narwhal
Stage 5: 25.6K Alpine Run
Name: Emily Hunter
Height: 5'5
Age: 29
Favourite Workout: long run with hillz
Favourite Food: guacamole, kale
Spirit Animal: unicorn?
Stage 6: 10K TT
Name: Payton Thiel
Height: 5'4
Age: 22
Favourite Workout: cross training
Favourite Food: potatoes
Spirit Animal: killer whale
Stage 7: Marathon
Names: Val Hobson
Age: 45
Height: 5'4 (and 3/8)
Favourite Workout: modified HIIT and long runs
Favourite Food: peanuts, butter, chocolate, tomatoes cheese, fresh bread
Spirit Animal: hummingbird
Make sure to follow the action on our Facebook Page the second week of August! We will keep you up to date on stage results, full event standings, how they are stacking up against our men's masters team, and if they are on track to setting the event record!
Princess Health and Bill Clinton, Paid to Speak to Biotech Conference, Extolled $1000 Pill to Prevent "Liver Rot," Despite Lack of Evidence that It Does. Princessiccia
Clinton Foundation evidence-based medicine Gilead hepatitis c SovaldiWhat were they thinking?
Former President Clinton Talkes to Pharma and Biotech Executives
In mid June, 2015, the Philadelphia Inquirer reported that former US President
For his troubles he was apparently paid, however
It is likely he was well paid, since his going rate is very high:
Clinton Endorses the Miraculous $1000 Pill
So what would a former president say to a bunch of pharmaceutical and biotechnology executives and their friends? He chose to talk about the prices of new drugs:
Who could quarrel with more explanations and disclosures? President Clinton did not stop there, and went on to opine about prices versus drugs' purported value to patients, with a focus on new drugs for hepatitis C.
So the implications are clearly
- President Clinton thinks it is reasonable to charge $80,000 for a course of treatment with Sovaldi, but society needs to figure out who will pay
- Apparently he thinks it is reasonable because without treatment, patients with hepatitis C will get "liver rot," but the drugs will prevent that.
The Evidence Fails to Support the President
President Clinton's preparation for this talk apparently did not include speaking with someone who had critically reviewed the best evidence from clinical studies about hepatitis C, and the effects of new drugs on it, particularly, the effects of sofosbuvir (Sovaldi.) Neither did President Clinton read Health Care Renewal.
If he did, he would have found out starting in March, 2014, we have posted about the lack of good evidence from clinical research suggesting these drugs are in fact so wondrous. The drugs are now touted as "cures," at least by the drug companies, (look here), and physicians are urged to do widespread screening to find patients with asymptomatic hepatitis C so they can benefit from early, albeit expensive treatment.
However, as we pointed out (e.g., here and here)
- The best evidence available suggests that most patients with hepatitis C will not go on to have severe complications of the disease (cirrhosis, liver failure, liver cancer), and hence could not benefit much from treatment.
- There is no evidence from randomized controlled trials that treatment prevents most of these severe complications
- There is no clear evidence that "sustained virologic response," (SVR), the surrogate outcome measure promoted by the pharmaceutical industry, means cure.
- While the new drugs are advertised as having fewer adverse effects than older drugs, it is not clear that their benefits, whatever they may be, outweigh their harms.
Furthermore, health care professionals and researchers with heftier credentials in clinical epidemiology and evidence based medicine than mine have since published similar concerns. These included
- a report from the German Institute for Quality and Efficiency in Health Care (the English summary is here)
- an article in JAMA from the Institute for Clinical and Economic Review (1)
- a report from the Center for Evidence-Based Policy (link here)
- an article in Prescrire International (2)
These publications and your humble scribe noted that the clinical trials or other types of clinical research about new hepatitis C treatment published in the most prominent journals had numerous methodologic problems that all seemed likely to make the new drugs look better, perhaps intentionally. (See posts here, here, and here.)
But because, as we noted here, concerns about the lack of evidence in support of Sovaldi and its new competitors have been anechoic, it might not have been so easy for President Clinton to quickly determine if hepatits C usually causes "liver rot," and whether Sovaldi almost always prevents "liver rot," and hence might just be worth $1000 a pill.
Hype Wins, Logic and Reason Lose
Unfortunately, the problem is not merely that the BIO folks hired a celebrity to tell them what they wanted to hear. President Clinton has a lot more gravitas than a Hollywood star, even given his famous equivocation about the meaning of the word "is."
More unfortunately in this context, President Clinton is also the husband of the current front running Democratic candidate for President. Should former Senator and Secretary of State Hilary Clinton win the election, would her health policy choices be influenced by the (probably erroneous) belief that the current extremely high prices of medical treatments, particularly new drugs, are reasonable because of their magical curative properties? Furthermore, President Clinton is also the Founder and presumed current leader of the the Bill, Hilary and Chelsea Clinton Foundation whose goals include working "to improve global health and wellness,..." Is this work based also based on the assumption that the astronomical prices of new drugs are justified by their miraculous powers?
Thus President Clinton's apparent endorsement of the wonderful powers of Sovaldi, despite the lack of good evidence underlying them, may carry a lot of weight.
Conclusion
How distorted is health care these days. Misinformation, even disinformation seems to dominate evidence and logic. Concerns about health care dysfunction are suppressed by the anechoic effect. Perhaps inspired by the generic managers who now run health care organizations, everyone seems to have become a health care expert, and so the reach of viewpoints on health care seems to be more about the celebrity of their proponents rather than their knowledge, or the logic and evidence underlying their views.
As a start, true health care reform has to somehow liberate good clinical evidence from where it has been hidden, and encourage logical discourse over marketing, public relations, hype, propaganda, and disinformation.
If only someone who knows something about health care, logic and evidence could get their views heard by ex Presidents and others who dominate our 24/7 conversation.
ADDENDUM (2 July, 2015) - This post was republished on the Naked Capitalism blog
See also comments by Micky on the 1BoringOldMan blog.
References
1. Ollendorf DA, Tice JA et al. The comparative clinical effectiveness and value of simeprevir and sofosbuvir in chronic hepatitis C viral infection. JAMA Intern Med 2014. Link here.
2. Sofosbuvir (Sovaldi), active against hepatitis C virus, but evaluation is incomplete. Prescrire Int 2015; 24: 5- 10. Link here.
Former President Clinton Talkes to Pharma and Biotech Executives
In mid June, 2015, the Philadelphia Inquirer reported that former US President
Clinton was the keynote speaker at Klick Ideas Exchange, sponsored by Klick Health, a Toronto-based digital marketing agency, along with Veeva Systems and the Biotechnology Industry Organization. BIO, the Washington-based trade association, is holding its annual convention at the Pennsylvania Convention Center this week, attracting 15,000 people.
For his troubles he was apparently paid, however
his foundation did not respond to a request for information about Monday's speaking fee. Hillary Clinton's campaign also did not respond to a similar request. A spokeswoman for Klick Health declined to provide Clinton's fee.
It is likely he was well paid, since his going rate is very high:
disclosure forms indicated Bill Clinton received between $225,000 and $275,000 for each of eight speaches delivered between March 31 and May 14 of this year.
Clinton Endorses the Miraculous $1000 Pill
So what would a former president say to a bunch of pharmaceutical and biotechnology executives and their friends? He chose to talk about the prices of new drugs:
Former president Bill Clinton said Monday in Philadelphia that high prices for some medicines are hard to justify, and the biotech and pharmaceutical industries should try full explanation and disclosure to make their case.
'Explain, explain, explain and disclose, disclose, disclose,' Clinton said in a speech and question-and-answer session before about 200 biotech and health-care executives at the National Museum of American Jewish History. 'Don't expect everybody to love you, but at least they will hear your side of the story.'
Who could quarrel with more explanations and disclosures? President Clinton did not stop there, and went on to opine about prices versus drugs' purported value to patients, with a focus on new drugs for hepatitis C.
Clinton pointed to new hepatitis C drugs, Sovaldi and Harvoni, which are sold by Gilead Sciences for more than $80,000 for a 12-week program of treatment. Those medications often cure a disease that can cause liver disease and eventually lead to transplants or death, which are expensive, too. But the sticker price on the drug has caused a backlash by payers and patients.
'Who wants to let somebody's liver rot? Nobody,' Clinton said. 'Who's got $80,000 to spend? Not many. And if you're a small businessperson and you're in a small pool [of employer-based insurers], are you going to fire somebody who needs that treatment? These are all practical problems, and we can solve them.'
So the implications are clearly
- President Clinton thinks it is reasonable to charge $80,000 for a course of treatment with Sovaldi, but society needs to figure out who will pay
- Apparently he thinks it is reasonable because without treatment, patients with hepatitis C will get "liver rot," but the drugs will prevent that.
The Evidence Fails to Support the President
President Clinton's preparation for this talk apparently did not include speaking with someone who had critically reviewed the best evidence from clinical studies about hepatitis C, and the effects of new drugs on it, particularly, the effects of sofosbuvir (Sovaldi.) Neither did President Clinton read Health Care Renewal.
If he did, he would have found out starting in March, 2014, we have posted about the lack of good evidence from clinical research suggesting these drugs are in fact so wondrous. The drugs are now touted as "cures," at least by the drug companies, (look here), and physicians are urged to do widespread screening to find patients with asymptomatic hepatitis C so they can benefit from early, albeit expensive treatment.
However, as we pointed out (e.g., here and here)
- The best evidence available suggests that most patients with hepatitis C will not go on to have severe complications of the disease (cirrhosis, liver failure, liver cancer), and hence could not benefit much from treatment.
- There is no evidence from randomized controlled trials that treatment prevents most of these severe complications
- There is no clear evidence that "sustained virologic response," (SVR), the surrogate outcome measure promoted by the pharmaceutical industry, means cure.
- While the new drugs are advertised as having fewer adverse effects than older drugs, it is not clear that their benefits, whatever they may be, outweigh their harms.
Furthermore, health care professionals and researchers with heftier credentials in clinical epidemiology and evidence based medicine than mine have since published similar concerns. These included
- a report from the German Institute for Quality and Efficiency in Health Care (the English summary is here)
- an article in JAMA from the Institute for Clinical and Economic Review (1)
- a report from the Center for Evidence-Based Policy (link here)
- an article in Prescrire International (2)
These publications and your humble scribe noted that the clinical trials or other types of clinical research about new hepatitis C treatment published in the most prominent journals had numerous methodologic problems that all seemed likely to make the new drugs look better, perhaps intentionally. (See posts here, here, and here.)
But because, as we noted here, concerns about the lack of evidence in support of Sovaldi and its new competitors have been anechoic, it might not have been so easy for President Clinton to quickly determine if hepatits C usually causes "liver rot," and whether Sovaldi almost always prevents "liver rot," and hence might just be worth $1000 a pill.
Hype Wins, Logic and Reason Lose
Unfortunately, the problem is not merely that the BIO folks hired a celebrity to tell them what they wanted to hear. President Clinton has a lot more gravitas than a Hollywood star, even given his famous equivocation about the meaning of the word "is."
More unfortunately in this context, President Clinton is also the husband of the current front running Democratic candidate for President. Should former Senator and Secretary of State Hilary Clinton win the election, would her health policy choices be influenced by the (probably erroneous) belief that the current extremely high prices of medical treatments, particularly new drugs, are reasonable because of their magical curative properties? Furthermore, President Clinton is also the Founder and presumed current leader of the the Bill, Hilary and Chelsea Clinton Foundation whose goals include working "to improve global health and wellness,..." Is this work based also based on the assumption that the astronomical prices of new drugs are justified by their miraculous powers?
Thus President Clinton's apparent endorsement of the wonderful powers of Sovaldi, despite the lack of good evidence underlying them, may carry a lot of weight.
Conclusion
How distorted is health care these days. Misinformation, even disinformation seems to dominate evidence and logic. Concerns about health care dysfunction are suppressed by the anechoic effect. Perhaps inspired by the generic managers who now run health care organizations, everyone seems to have become a health care expert, and so the reach of viewpoints on health care seems to be more about the celebrity of their proponents rather than their knowledge, or the logic and evidence underlying their views.
As a start, true health care reform has to somehow liberate good clinical evidence from where it has been hidden, and encourage logical discourse over marketing, public relations, hype, propaganda, and disinformation.
If only someone who knows something about health care, logic and evidence could get their views heard by ex Presidents and others who dominate our 24/7 conversation.
ADDENDUM (2 July, 2015) - This post was republished on the Naked Capitalism blog
See also comments by Micky on the 1BoringOldMan blog.
References
1. Ollendorf DA, Tice JA et al. The comparative clinical effectiveness and value of simeprevir and sofosbuvir in chronic hepatitis C viral infection. JAMA Intern Med 2014. Link here.
2. Sofosbuvir (Sovaldi), active against hepatitis C virus, but evaluation is incomplete. Prescrire Int 2015; 24: 5- 10. Link here.
Tuesday, 30 June 2015
Princess Health and Know the signs of a heart attack and don't ignore or dismiss them; quick action can be the difference between life and death.Princessiccia
cardiac care cardiovascular disease heart disease heart health
Many people who have a heart attack initially ignore the symptoms or dismiss them. For the best chance of survival and preserving heart function, you should not ignore these symptoms, and should get help quickly.
Heart disease is the leading cause of death in the U.S. and Kentucky. Nationwide, it causes about one in four deaths. The age-adjusted death rate from heart disease in Kentucky is 208.2 per 100,000 per year, according to the federal Centers for Disease Control and Prevention.
Below are some questions and answers about the symptoms and treatment of heart attacks and narrowed aortic valves, as reported by Gina Kolata for the New York Times.
How do you know if you are having a heart attack? Most people feel pain, pressure or squeezing in their chest and about one-third of people have symptoms in addition to or instead of chest pain that include abdominal pain, heavy sweating, back pain, neck and jaw pain, nausea and vomiting, Kolata reports. WebMD adds pain that radiates down one arm, indigestion or a choking feeling, extreme weakness, anxiety or shortness of breath, and rapid or irregular heartbeats to the list.
How can you decide if symptoms other than chest pain are actually from a heart attack? If your symptoms come on suddenly, or if they worsen over a period of hours or days, call 911 and get to an emergency room. "The best time to treat a heart attack is within one to two hours of the first onset of symptoms," says WebMD. "Waiting longer increases the damage to your heart and reduces your chances of survival."
Do women have different symptoms than men? "Probably not," Dr. Mary Norine Walsh, vice president of the American College of Cardiology, told Kolata. Walsh noted that women, however, are more likely to delay seeking treatment and doctors are more likely to dismiss their symptoms, especially if the woman is younger.
The American Heart Association says women often attribute signs of a heart attack to the flu, acid reflux or the normal aging process, even though it is the number one killer of women. It also noted that symptoms in women can be subtler, like shortness of breath, upper back pressure that feels like squeezing, lightheadedness or actually fainting.
What should you do if you are having heart attack symptoms? Call 911 for an ambulance to take you to the emergency room immediately. Do not drive yourself and do not have a friend or family member drive you unless you have no other choice. Kolata notes that paramedics are trained to treat heart attacks and are less likely to get stuck in traffic.
How can you find out if your local hospital is able to treat heart attacks quickly? Don't waste time fighting with your paramedic when you are having a heart attack, they will know the best place to take you, Kolata writes.
That being said, some hospitals are faster than others in treating heart attacks, but the time to research this information is before you are in the throws of a heart attack, Kolata writes. To find out this information, she suggest you ask each hospital what its "door to balloon time" is, which will tell you how long it takes the hospital to open a blocked coronary artery with a balloon after you arrive at the emergency room. If they don't have this information, ask if they take certain steps to speed up treatment. For example ask: Do paramedics transmit a patient's electrocardiogram to the hospital en route?; Does the ER doctor read the EKG and send out a single call to summon the cardiology team?; And are the team members on call required to be within 30 minutes of the hospital?
What are the symptoms of a severely narrowed aortic valve? There are three classic symptoms of this disease of aging: shortness of breath, a feeling of heaviness and pain in the chest, and fainting, according to cardiologists. They also noted that these symptoms are often mistakenly attributed to the normal process of aging.
How can a doctor know if symptoms are caused by a narrowed aortic valve? The doctor will listen for a heart murmur in the patient�s chest and can order an echocardiogram, which will reveal the narrowed artery and the extent of the damage.
Should everyone with a severely narrowed artery have it replaced? Not everyone should undergo treatment, Kolata reports, so ask your doctor if you are a good candidate. The latest treatment is a transcatheter aortic valve replacement, or TAVR, which allows doctors to replace valves without doing open-heart surgery. High risk patients who would have been considered at too great a risk of dying from open-heart surgery have a chance to have a valve replacement, but sometimes elderly patients whose health is compromised are not good candidates.
Heart disease is the leading cause of death in the U.S. and Kentucky. Nationwide, it causes about one in four deaths. The age-adjusted death rate from heart disease in Kentucky is 208.2 per 100,000 per year, according to the federal Centers for Disease Control and Prevention.
Below are some questions and answers about the symptoms and treatment of heart attacks and narrowed aortic valves, as reported by Gina Kolata for the New York Times.
How can you decide if symptoms other than chest pain are actually from a heart attack? If your symptoms come on suddenly, or if they worsen over a period of hours or days, call 911 and get to an emergency room. "The best time to treat a heart attack is within one to two hours of the first onset of symptoms," says WebMD. "Waiting longer increases the damage to your heart and reduces your chances of survival."
Do women have different symptoms than men? "Probably not," Dr. Mary Norine Walsh, vice president of the American College of Cardiology, told Kolata. Walsh noted that women, however, are more likely to delay seeking treatment and doctors are more likely to dismiss their symptoms, especially if the woman is younger.
The American Heart Association says women often attribute signs of a heart attack to the flu, acid reflux or the normal aging process, even though it is the number one killer of women. It also noted that symptoms in women can be subtler, like shortness of breath, upper back pressure that feels like squeezing, lightheadedness or actually fainting.
What should you do if you are having heart attack symptoms? Call 911 for an ambulance to take you to the emergency room immediately. Do not drive yourself and do not have a friend or family member drive you unless you have no other choice. Kolata notes that paramedics are trained to treat heart attacks and are less likely to get stuck in traffic.
How can you find out if your local hospital is able to treat heart attacks quickly? Don't waste time fighting with your paramedic when you are having a heart attack, they will know the best place to take you, Kolata writes.
That being said, some hospitals are faster than others in treating heart attacks, but the time to research this information is before you are in the throws of a heart attack, Kolata writes. To find out this information, she suggest you ask each hospital what its "door to balloon time" is, which will tell you how long it takes the hospital to open a blocked coronary artery with a balloon after you arrive at the emergency room. If they don't have this information, ask if they take certain steps to speed up treatment. For example ask: Do paramedics transmit a patient's electrocardiogram to the hospital en route?; Does the ER doctor read the EKG and send out a single call to summon the cardiology team?; And are the team members on call required to be within 30 minutes of the hospital?
What are the symptoms of a severely narrowed aortic valve? There are three classic symptoms of this disease of aging: shortness of breath, a feeling of heaviness and pain in the chest, and fainting, according to cardiologists. They also noted that these symptoms are often mistakenly attributed to the normal process of aging.
How can a doctor know if symptoms are caused by a narrowed aortic valve? The doctor will listen for a heart murmur in the patient�s chest and can order an echocardiogram, which will reveal the narrowed artery and the extent of the damage.
Should everyone with a severely narrowed artery have it replaced? Not everyone should undergo treatment, Kolata reports, so ask your doctor if you are a good candidate. The latest treatment is a transcatheter aortic valve replacement, or TAVR, which allows doctors to replace valves without doing open-heart surgery. High risk patients who would have been considered at too great a risk of dying from open-heart surgery have a chance to have a valve replacement, but sometimes elderly patients whose health is compromised are not good candidates.
Sunday, 28 June 2015
Princess Health and More dental patients using ERs, showing lack of dental coverage, shortage of dentists and the stepchild status of oral health.Princessiccia
Affordable Care Act dental care dental health dentistry dentists emergency rooms health reform hospitals obamacare oral health
More patients are going to hospital emergency rooms for dental care, illustrating how oral health remains the stepchild of the health system despite health-care reform.
"An analysis of the most recent federal data by the American Dental Association shows dental ER visits doubled from 1.1 million in 2000 to 2.2 million in 2012, or one visit every 15 seconds, Laura Ungar reports for The Courier-Journal and USA Today.
"This is something I deal with daily," Dr. George Kushner, director of the oral and maxillofacial surgery program at the University of Louisville, told Ungar. "People still die from their teeth in the U.S."
A longstanding federal law requires ERs to treat patients regardless of their ability to pay. "Although they often provide little more than painkillers and antibiotics to dental patients, the visits cost more than three times as much as a routine dental visit, averaging $749 if the patient isn't hospitalized � and costing the U.S. health care system $1.6 billion a year," Ungar reports.
Private dental insurance is not common. "Just over a third of working-age adults nationally, and 64 percent of seniors, lacked dental coverage of any kind in 2012, meaning they had to pay for everything out of pocket," Ungar writes. The Patient Protection and Affordable Care Act "requires health plans to cover dental services for children but not adults," and "Medicare generally doesn't cover dental care at all," she notes.
In Kentucky, the expansion of Medicaid under Obamacare has increased dental visits in the program by 37 percent, but it offers "only a short list of dental services," such as extractions, which patients often choose instead of restorative work, for which they would have to pay.
Another big issue is that many dentists don't accept Medicaid, which pays them only 41 percent of private reimbursement, Ungar reports. Also, Kentucky has a shortage of dentists. "A 2013 workforce study by Deloitte Consulting found the state needs 612 more to meet demand," Ungar notes.
More dentists would encourage more preventive treatment, which dentists say would save a lot of money. "If we were going to the dentist more often, we could avoid a lot of this," Dr. Ruchi Sahota, a California dentist and consumer adviser for the ADA, told Ungar. "Prevention is priceless."
Fewer than 60 percent of Kentuckians saw a dentist in 2013, making their dental-visit frequency 43rd in the nation, according to the Kentucky Health Issues Poll.
"An analysis of the most recent federal data by the American Dental Association shows dental ER visits doubled from 1.1 million in 2000 to 2.2 million in 2012, or one visit every 15 seconds, Laura Ungar reports for The Courier-Journal and USA Today.
 |
| Christopher Smith of Jeffersonville, Ind., had a dental infection that put him in a Louisville hospital for a week. (Courier-Journal photo by Sam Upshaw Jr.) |
A longstanding federal law requires ERs to treat patients regardless of their ability to pay. "Although they often provide little more than painkillers and antibiotics to dental patients, the visits cost more than three times as much as a routine dental visit, averaging $749 if the patient isn't hospitalized � and costing the U.S. health care system $1.6 billion a year," Ungar reports.
Private dental insurance is not common. "Just over a third of working-age adults nationally, and 64 percent of seniors, lacked dental coverage of any kind in 2012, meaning they had to pay for everything out of pocket," Ungar writes. The Patient Protection and Affordable Care Act "requires health plans to cover dental services for children but not adults," and "Medicare generally doesn't cover dental care at all," she notes.
Another big issue is that many dentists don't accept Medicaid, which pays them only 41 percent of private reimbursement, Ungar reports. Also, Kentucky has a shortage of dentists. "A 2013 workforce study by Deloitte Consulting found the state needs 612 more to meet demand," Ungar notes.
More dentists would encourage more preventive treatment, which dentists say would save a lot of money. "If we were going to the dentist more often, we could avoid a lot of this," Dr. Ruchi Sahota, a California dentist and consumer adviser for the ADA, told Ungar. "Prevention is priceless."
Fewer than 60 percent of Kentuckians saw a dentist in 2013, making their dental-visit frequency 43rd in the nation, according to the Kentucky Health Issues Poll.
Princess Health and CDC says state spends less than 8% of what it should on preventing use of tobacco; companies spend 13 times as much.Princessiccia
advertising children's health federal government smoking smoking cessation state budget state budgets state governments tobacco tobacco prevention youth
Kentucky spends only 7.6 percent of what it should spend on preventing the use of tobacco, the federal Centers for Disease Control and Prevention says in its latest annual report on the subject.
The state spent $4.33 million on tobacco-control programs in 2011, the year covered by the report. The CDC said spending of $57.2 million was called for, since 29 percent of Kentuckians smoked that year. Tobacco-related illnesses are estimated to cost Kentuckians $3.3 billion a year.
South Carolina and Texas, which spent 6.5 percent and 7 percent of the recommended amounts, were also singled out for criticism by the CDC. Nationally, states spend less than 18 percent of what they should, $3.7 billion, in the agency's view. "Only Alaska and North Dakota funded programs at the CDC-recommended levels, $10.7 million and $9.3 million, respectively," Samantha Ehlinger of McClatchy Newspapers reports.
"States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased," the CDC report said. "Evidence suggests that funding tobacco prevention and control efforts at the levels recommended . . . could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality."
In contrast to the state spending of $658 million on tobacco control, tobacco companies spent more than 13 times as much on advertising and promotion in 2011: $8.8 billion, or $24 million per day, the report noted.
"During the same period, more than 3,200 youth younger than 18 years of age smoked their first cigarette and another 2,100 youth and young adults who are occasional smokers progressed to become daily smokers," the report said. "If current rates continue, 5.6 million Americans younger than 18 years of age who are alive today are projected to die prematurely from smoking-related disease. However, the tobacco-use epidemic can be markedly reduced by implementing interventions that are known to work."
For the CDC's latest comprehensive report on tobacco use in Kentucky, with data from 2012, click here. For county-by-county figures on adults smoking in Kentucky in 2011-13, click here.
The state spent $4.33 million on tobacco-control programs in 2011, the year covered by the report. The CDC said spending of $57.2 million was called for, since 29 percent of Kentuckians smoked that year. Tobacco-related illnesses are estimated to cost Kentuckians $3.3 billion a year.
South Carolina and Texas, which spent 6.5 percent and 7 percent of the recommended amounts, were also singled out for criticism by the CDC. Nationally, states spend less than 18 percent of what they should, $3.7 billion, in the agency's view. "Only Alaska and North Dakota funded programs at the CDC-recommended levels, $10.7 million and $9.3 million, respectively," Samantha Ehlinger of McClatchy Newspapers reports.
"States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased," the CDC report said. "Evidence suggests that funding tobacco prevention and control efforts at the levels recommended . . . could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality."
In contrast to the state spending of $658 million on tobacco control, tobacco companies spent more than 13 times as much on advertising and promotion in 2011: $8.8 billion, or $24 million per day, the report noted.
"During the same period, more than 3,200 youth younger than 18 years of age smoked their first cigarette and another 2,100 youth and young adults who are occasional smokers progressed to become daily smokers," the report said. "If current rates continue, 5.6 million Americans younger than 18 years of age who are alive today are projected to die prematurely from smoking-related disease. However, the tobacco-use epidemic can be markedly reduced by implementing interventions that are known to work."
For the CDC's latest comprehensive report on tobacco use in Kentucky, with data from 2012, click here. For county-by-county figures on adults smoking in Kentucky in 2011-13, click here.
Friday, 26 June 2015
Princess Health and Study finds that one dose of HPV vaccine that targets only cervical cancer is as effective as three doses, now recommended.Princessiccia
cancer cervical cancer HPV human papillomavirus immunizations research sexually transmitted diseases vaccinations
By Melissa Patrick
Kentucky Health News
A study has found that one dose of the human papillomavirus vaccine Cervarix appears to be as effective in preventing HPV infections that lead to cervical cancer as do three doses, the recommended course of vaccination. Only 25 percent of Kentucky adolescent women initiate the vaccination, and fewer than one in nine of those who do get three does, according to the Kentucky Cancer Consortium.
"Many women around the world and in the U.S. don't get the full three doses that are recommended, so this is promising news," said Elisia Cohen, an associate professor of communication at the University of Kentucky, who does extensive research on community strategies to improve adolescent and adult vaccinations. However, she cautioned that the drug Cervarix is "only 1 percent of the U.S. market" and that the findings from this study do not apply to Gardasil, the drug most commonly used in the U.S.
Dr. Diane Harper of the University of Louisville, one of the researchers, said in a news release, �Kentucky is one of the states that has not had a program in place to make Cervarix available to all of its citizens, and has very low three-dose completion rates of Gardasil.�
Most health departments and physicians choose Gardasil over Cervarix because it protects against four strains of HPV: two strains that cause 70 percent of all cervical cancers and two strains that cause genital warts and oral and anal cancers, concerns for males as well as females. Cervarix only protects against the two strains that cause cervical cancer. "Generally, the thinking is that protection against four strains is better that two," Cohen said.
She said Gardasil 9, which will protect against 90 percent of HPV strains that cause cervical cancer as well as pre-invasive cervical cancer lesions, has just been approved by the U.S. Food and Drug Administration and is going through its labeling process, and will be recommended for both boys and girls.
HPV is the most common sexually transmitted infection in the U.S., affecting an estimated 79 million individuals, according to the federal Centers for Disease Control and Prevention.
The study, published in The Lancet Oncology, analyzed data from two large trials of Cervarix. In the trials, women were randomly chosen to receive three doses of Cervarix or a control vaccine. All of the women were evaluated, regardless of how many doses of the vaccine they received, for the effectiveness of the vaccine for a period of four years. The analysis found that the protection from one dose was similar to that achieved by three doses of the vaccine.
�Knowing that Cervarix offers protection in one dose reassures public health agencies that they are not wasting money when most of their vaccines are given to those who never complete the three-dose series,� the researchers wrote.
The CDC recommends HPV vaccination for girls 11 and 12 years old, and catch-up vaccination for females from 13 to 26. The second dose should be given one to two months after the first injection; the third dose should be administered six months after the first dose.
Kentucky Health News
A study has found that one dose of the human papillomavirus vaccine Cervarix appears to be as effective in preventing HPV infections that lead to cervical cancer as do three doses, the recommended course of vaccination. Only 25 percent of Kentucky adolescent women initiate the vaccination, and fewer than one in nine of those who do get three does, according to the Kentucky Cancer Consortium.
"Many women around the world and in the U.S. don't get the full three doses that are recommended, so this is promising news," said Elisia Cohen, an associate professor of communication at the University of Kentucky, who does extensive research on community strategies to improve adolescent and adult vaccinations. However, she cautioned that the drug Cervarix is "only 1 percent of the U.S. market" and that the findings from this study do not apply to Gardasil, the drug most commonly used in the U.S.
Dr. Diane Harper of the University of Louisville, one of the researchers, said in a news release, �Kentucky is one of the states that has not had a program in place to make Cervarix available to all of its citizens, and has very low three-dose completion rates of Gardasil.�Most health departments and physicians choose Gardasil over Cervarix because it protects against four strains of HPV: two strains that cause 70 percent of all cervical cancers and two strains that cause genital warts and oral and anal cancers, concerns for males as well as females. Cervarix only protects against the two strains that cause cervical cancer. "Generally, the thinking is that protection against four strains is better that two," Cohen said.
She said Gardasil 9, which will protect against 90 percent of HPV strains that cause cervical cancer as well as pre-invasive cervical cancer lesions, has just been approved by the U.S. Food and Drug Administration and is going through its labeling process, and will be recommended for both boys and girls.
HPV is the most common sexually transmitted infection in the U.S., affecting an estimated 79 million individuals, according to the federal Centers for Disease Control and Prevention.
The study, published in The Lancet Oncology, analyzed data from two large trials of Cervarix. In the trials, women were randomly chosen to receive three doses of Cervarix or a control vaccine. All of the women were evaluated, regardless of how many doses of the vaccine they received, for the effectiveness of the vaccine for a period of four years. The analysis found that the protection from one dose was similar to that achieved by three doses of the vaccine.
The CDC recommends HPV vaccination for girls 11 and 12 years old, and catch-up vaccination for females from 13 to 26. The second dose should be given one to two months after the first injection; the third dose should be administered six months after the first dose.
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