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Thursday, 19 May 2016

Princess Health and At forum on opioid abuse in Corbin, people say they need more treatment services, community education and coalitions. Princessiccia

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Image from Lauren Osborne, WYMT-TV Mountain News
By Melissa Patrick
Kentucky Health News

CORBIN, Ky. � After a day of learning and talking about opioid prevention, treatment and mobilization, people at a forum in Corbin agreed on three things: Access to substance abuse and mental health services remains a huge barrier in southeastern Kentucky; more community education is needed; and drug-prevention programs should form coalitions to better use their limited resources.

Substance abuse affects almost every family in Kentucky, and four Kentuckians die every day from a drug overdose. That was part of the opening message from Dr. Allen Brenzel, medical director of the state Department for Behavioral Health, Development and Intellectual Disabilities.

"This is, in my opinion, one of the most pressing health-care issues facing our commonwealth today," Brenzel said. "If 1,000 people a year were dying from measles in the state of Kentucky, think about the public response that we would have. ... We would be on red-alert, we would have a complete, public-health, massive intervention to solve that problem."

Van Ingram, executive director at the Governor's Office of Drug Control Policy, said that next year's drug overdose report, which will be released in a few weeks, will show the problem is getting worse.

About 125 people, most of them health-care providers, attended the "Cumberland River Forum on Opioid Use Disorders: A Time for Community Action" May 17 at the Corbin Technology Center. It was sponsored by The Kentucky Cabinet for Health and Family Services, the Hazelden Betty Ford Foundation, and Cumberland River Behavioral Health. Similar forums were held in Lexington May 16 and Louisville May 13.

John Tilley
John Tilley, secretary of the Kentucky Cabinet for Justice and Public Safety, said he hoped the forum would "light a fire under this community" to talk to their neighbors and friends, community leaders and legislators about the value of treatment over incarceration for substance abuse and mental health issues.

Tilley, who chaired the House Judiciary Committee when he was a state representative from Hopkinsville, acknowledged that some abusers should be in prison, but said society must distinguish between "who we are mad at and who we are afraid of. ... I promise you the way to get out of this mess is not to over-criminalize addiction and mental illness."

Tilley said "The solution is right before our eyes," using for treatment some of the billions of dollars now used to incarcerate drug users.

Tim Feeley, deputy secretary for the CHFS and a former legislator from Oldham County, agreed: "We are not going to incarcerate our way out of this." He said the state needs more treatment programs and said the cabinet was fully committed to addressing the state's addiction problems to the best of its abilities.

William Hacker
Kentucky has moved away from treating mental health and substance abuse issues criminally, said Dr. William Hacker, chair of Shaping Our Appalachian Region's Health and Wellness Advisory Committee and former state health commissioner. He said other successful anti-drug efforts include grassroots advocacy groups, the online prescription-drug tracking program, needle-exchange programs, a move toward medication assisted treatments for opioid addiction, and the SMARTS initiative, which provides addiction care for pregnant and parenting women for up to two years.

Hacker also mentioned Operation UNITE, a Kentucky non-profit created by U.S. Rep. Hal Rogers that leads education, treatment and law enforcement initiatives in 32 counties in Southern and Eastern Kentucky. UNITE has held a national drug abuse conferences for the past five years, with this year's summit in Atlanta including President Barack Obama. The acronym stands for Unlawful Narcotics Investigations, Treatment and Education.

A former pediatrician in Corbin, Hacker also noted that SOAR recently held a Substance Abuse Roundtable to discuss research and emerging opportunities associated with substance abuse and intravenous drug use in Appalachian Kentucky. He said SOAR works to create a network across the region to share best practices and money opportunities and to create community level empowerment.

"Substance abuse is not a failure of moral character, it is a disease," Hacker said. "Don't give up. Never give up."

At the end of the meeting, the attendees broke into groups that represented schools, community leaders, health-care professionals, parents and the faith community to discuss what actions they could take to address opioid abuse in their communities.

Most groups reported that lack of access to substance abuse and mental health treatment is a barrier in their communities. And while it was noted that some communities offer more services than others, several groups said they did not have enough counselors to support medication-assisted therapies or enough doctors willing to prescribe it. Lack of transportation was also mentioned as a barrier toward getting treatment in several groups.

Also, most groups said community members often aren't aware of the resources, so more community education is needed. They listed schools, churches and county Extension offices as possible sources of education, and noted that a community resource website would be helpful. They also said parents would benefit from a class to learn how to talk to their children about drugs.

The groups agreed that all sectors of the community were needed to combat substance abuse and suggested that drug prevention programs in each community should form coalitions to better use resources and information.

Princess Health and Slicing your way to an apple a day: Americans' apple consumption is on the rise because we're eating them in small pieces. Princessiccia

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Photo from livestrong.com
By Danielle Ray
Kentucky Health News

Presentation is everything. Apple consumption is on the rise, and researchers at Cornell University think pre-sliced apples are the cause.

The 2013 Cornell study explored why so many whole apples served in school lunches ended up uneaten in the trash. Researchers found that eating whole apples can be difficult for young children with small mouths and for kids with missing teeth or braces. The study also noted that older girls find whole fruits messy and unattractive to eat.

The study found that consumption jumped by more than 60 percent when apples were served sliced. These findings back up U.S. Department of Agriculture statistical data about overall apple consumption. Data show that Americans ate more than 510 million pre-sliced apples in 2014, up from fewer than 150 a decade before.

Likewise, overall apple consumption has grown by 13 percent percent since 2010, according to USDA data. Americans ate about 17.5 pounds per capita in 2013, the most in nearly a decade.

Why does simply slicing an apple matter? The difference between a whole apple and apple slices may seem silly or superficial, especially to an adult, but the inconvenience is a barrier nonetheless, David Just, a professor of behavioral economics at Cornell and one of the researchers behind the study, told Roberto Ferdman of The Washington Post.

"It sounds simplistic, but even the simplest forms of inconvenience affect consumption," Just said. "Sliced apples just make a lot more sense for kids."

The rise of mass-produced pre-sliced apples probably has a lot to do with the fast food industry. McDonald's added apple slices to its menu in 2004 in an effort to give parents healthier options. The company began automatically serving apple slices with Happy Meals in 2012, causing apple sales to skyrocket.

McDonald's has served more than 2 billion packages since first offering apple slices as a side, a representative for the company told the Post. In 2015 alone, the company served nearly 250 million packages of sliced apples, which amounts to more than 60 million apples, or about 10 percent of all fresh sliced apples sold in the United States, the Post noted.

The USDA, which oversees school lunch programs, can't be sure of how many schools offer pre-sliced apples versus whole apples, as local school districts make that decision. However, the agency does make recommendations and encourages schools make fruit appealing in presentation.

The problem with the pre-sliced apple trend? It may lessen food waste, but it increases plastic waste, which puts a strain on the environment. McDonald's apple slices, for example, are served in plastic wrappers. These wrappers are recyclable, yes, but two important differentials exist. First, "recyclable" does not mean it was made of recycled materials, only that it has the potential to be recycled. Second, just because consumers can recycle the wrappers does not mean they will.

Wednesday, 18 May 2016

Princess Health and May 18th, 2016 The Morning Deal. Princessiccia

Princess Health and May 18th, 2016 The Morning Deal. Princessiccia

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May 18th, 2016 The Morning Deal

My "Morning Deal" is proving to be a wonderful addition to my early routine. It's fast and easy and I want to keep it that way. On the other hand, I realize it's much easier to do those two sets of ten push-ups opposed to when I first started this before coffee-daily thing over two months ago. The squats are always simple for me. The issue? I'm currently pondering how to maintain the progress--build upon it, without increasing the time commitment so early in the morning. I've pretty well decided to find a set of dumbbells in different weights--at least then I could increase the resistance without lengthening the routine. 

The water part of that deal is super fast--I pretty much down it in a couple seconds, while snapping the "fresh out of bed" selfie. By the way, I haven't heard a peep from the person who zeroed in on my vanity by saying I only shared the most flattering pictures of myself. I honestly don't care-and I don't take things like that personally-my response in posting the daily "straight from the pillow" pics was simply a humorous response to the criticism. Let's be honest--some of these pictures have been super rough! It's fun--and for whatever reason, it lifts my mood.

I suppose the whole #morningdeal adds to the strengthening of my daily foundation. This strengthening starts with meditation and prayer before anything else. Then I start the coffee--then I hit the water, push-ups and squats. As far as the strength exercises go-on days when I'm super rushed, I at least finish the water and push-ups, that's the minimum requirement before the coffee hits the bottom of the cup.

Today was challenging. I did get more sleep--but obviously not enough, because it was a challenge most of the day. I agree with those that contend the body keeps track--and not getting enough sleep has a cumulative effect.

I made it through today fairly well, considering everything. I stayed in good contact with support connections, maintained the integrity of my maintenance calorie budget, remained abstinent from refined sugar and met my water goal.

Now--more sleep.

Today's Live-Tweet Stream:


































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Feds strengthen anti-discrimination health rules. Princessiccia

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Photo from mdxipe.wordpress.com
By Danielle Ray
Kentucky Health News

The Department of Health and Human Services issued rules Friday in an effort to ensure equality in health care for women, the disabled and people who speak English as a second language.

The new provisions protect women from discrimination not only in the health coverage they obtain but in the health services they seek from providers. They also prohibit denial of health care or health coverage based on a person's sex, including discrimination based on pregnancy, gender identity and sex stereotyping.

The rule also requires providers to take reasonable steps to provide communication access to people with limited English proficiency. In addition, it requires that providers make electronic information and newly constructed or altered facilities accessible to individuals with disabilities, including providing auxiliary aids and services.

HHS Secretary Sylvia Burwell called the rule "a key step toward realizing equity within our health care system." She said in an agency news release that it reinforces the central goal of the Patient Protection and Affordable Health Care Act, to improve access to quality health care.

The rule covers any health program or activity that receives federal funding, such as providers who accept Medicare or Medicaid; any health program that HHS administers; and federal- and state-based health insurance marketplaces and insurers that participate in them.

The new rule implements Section 1557 of the 2010 health-reform law, which is the first federal civil-rights law to prohibit discrimination based on sex in federally-funded health programs. Previously, civil rights laws enforced by the agency's civil rights office barred discrimination based only on race, color, national origin, disability, and age.

The rule does not resolve whether discrimination on the basis of an individual�s sexual orientation status alone is a form of sex discrimination under the reform law. However, the provisions leave room for the agency's civil-rights office to evaluate complaints that allege sex discrimination related to a person�s sexual orientation to determine if they can be considered sex stereotyping, which the rule prohibits. In cases where religious freedom would be violated, health-care providers are not required to follow the regulation.

A summary of the new rule can be accessed here.

Princess Health and House Republicans want to make it harder for schools to get free meals for all students; could affect more than 350 Ky. schools. Princessiccia

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Photo from npr.org
By Danielle Ray
Kentucky Health News

Kentucky school officials are concerned about a proposal by Republicans in the U.S. House that would make it harder for schools to offer free meals to all students using federal money.

The House is considering changes to the 2010 Hunger-Free Kids Act, now in its second year, which allows schools who serve a high-poverty population to offer free meals to every student.

Instead of collecting individual applications for free or reduced-price meals, the Community Eligibility Provision uses data that illustrates how many students in a given school may be "food-vulnerable": how many students live in households that receive government assistance, live in foster care, are homeless, and other similar criteria.

Under current CEP rules, schools with greater than 40 percent of students who qualify as food-vulnerable are eligible to offer free meals to all students. A bill approved May 18 by the House Education and Workforce Committee would raise the threshold to 60 percent, forcing schools between 40 and 59 percent range off the program.

"Proponents of community eligibility say it spares schools from paperwork and administrative burdens, and that it allows low-income children to eat free meals without the stigma or red tape of particpation in the free meal program, which is often a barrier for participation," Evie Blad reports for Education Week. "But Republicans on the committee said the provision is wasteful, potentially allowing children from higher-income families access to free meals."

The change could affect more than 350 Kentucky schools. Kentucky has 804 schools eligible to offer free meals under current CEP rules, according to the Center on Budget and Policy Priorities. Under the proposed bill, only 441 would qualify, according to the center.

More than 10,000 students at 17 public schools in Lexington alone would be affected, according to the Lexington Herald-Leader reported. More than 190,000 students statewide could be affected, the Herald-Leader said.

Nick Brake, superintendent of Owensboro schools, told Keith Lawrence of The Messenger-Inquirer that he is hopeful that his district will be spared cuts.

"I have been working with Congressman (Brett) Guthrie�s office on this issue," Brake said. "We are still looking at the overall numbers, but our district average is 63 percent, so it looks favorable that we will be able to continue to provide the benefit of this vital program in the future."

Muhlenberg County Supt. Randy McCarty told Lawrence he thought his district would still qualify. "Once a district goes CEP, it stays in place for four years," he said.

Hopkins County, which recently expanded its use of free meals to all public schools, faces uncertainty if the changes are passed.

"I have no idea if school districts will be grandfathered in, or how Congress will write everything, but I am afraid that if we don't jump on this now, we may not get this opportunity again," Michael Dodridge, food services director of Hopkins County schools, told Laura Buchanan of The Messenger in Madisonville. "I would hate to pass this up."

UPDATE, May 26: The Harlan Independent School Board voted to join the program, Joe Asher reports for the Harlan Daily Enterprise.

The proposed CEP changes are part of House Resolution 5003, the child nutrition reauthorization bill introduced by Indiana Republican Rep. Todd Rokita. For more information on the proposed changes, click here.

Tuesday, 17 May 2016

Princess Health and May 17th, 2016 Support Instead Of The Fork. Princessiccia

Princess Health and May 17th, 2016 Support Instead Of The Fork. Princessiccia

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May 17th, 2016 Support Instead Of The Fork

Last night was involved. Just as I was dropping into bed, I checked the radar and realized, I had work to do. Severe weather season means weather coverage at any time-night or day. Even when the weather isn't considered severe--as broadcasters in a state known for tornadoes, it's important to be a voice of calm, especially when a storm looks and feels dangerous, but isn't. This coverage translated to roughly two hours sleep. Not good for me.

I made it through the day by remaining in contact with support and staying focused on getting what I needed--while keeping an eye toward getting something else I needed--a nap! I did eventually grab a one hour nap--still not enough, so I'm making it a priority to go to bed much much earlier tonight. No weather coverage tonight, thank goodness!

Tonight is a great night to republish some thoughts on consistency. The following excerpt is from the September 23rd, 2014 archived blog post:

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The topic of consistency has come up a few times of late. Consistency is key, for sure. This road isn't about perfection. Striving for perfection is the quickest detour to disappointment. Consistency is the goal along this road. If we can be consistent, we can accomplish amazing things. But how do we remain consistent?

In my opinion, it starts with narrowing our focus. Not once have I sat down with a calendar to try to figure out when I'll arrive at some predetermined number. I haven't even stated a particular goal weight, opting instead for a "healthy weight." Who knows what that will be? It doesn't matter how long it takes or when I'll get there because my focus is on today. My goal is to make it through this day with the integrity of my food plan intact and if it's an exercise day, that too. Today is the day. I'm not obsessing about how much time it will take. It will take however long it takes. If I focus on how long it will take to "arrive," I'm suggesting that my efforts will end at some point. And making my food and fitness a big priority in my life is something I do not plan on ending, ever. 

Keeping it simple is important in keeping us consistent. It's super easy to make this really difficult. You can quickly overwhelm yourself with a multitude of numbers, rules, self-imposed requirements and rock solid expectations. Keep it as simple as you need, to fit where you are. If you're planning on waking up tomorrow as a completely different person with completely different habits and behaviors--it could become very difficult, really fast.

I recommend setting a calorie budget or points budget, whatever you prefer, and making the limit you set, sacred. Sacrificing the integrity of this budget shouldn't be something taken lightly. Treat it with the highest importance level. Then, find an exercise of some sort that works for you and your body and do it. Worry less about content and more about maintaining the integrity of your budget and exercise schedule. As you progress and you become more comfortable, you can get fancy all you want!!

Allow your food to become a natural evolution of good choices. My choices today look very different than when I first started losing weight six years ago. I wouldn't categorize myself as a "clean eater," but I'm at least 80% clean and that's a big difference for me.  Had I tried eating like this on Day 1, September 15th, 2008, it likely wouldn't have gone very well.

And that brings me to the "joy factor." I believe we must enjoy what we're doing in order to maintain consistency. If we don't enjoy--and I mean truly enjoy what we're eating, how do we expect to keep doing it? I eat what I like and nothing I don't. This doesn't mean I'm not willing to try new things. It simply means if I don't like it, it will not be on my regular "foods I enjoy" list. 

Somewhere over the years, someone decided that losing weight had to be about eating things you choked down as a means to an end. And as soon as the weight loss goal was reached, you could go back to eating what you like. I say nonsense!! Why not eat what you like and enjoy from day 1? Then, if they're not the best for you, gradually and naturally improve your choices. But never sacrifice by eating things you can't stand!!

My first food question isn't "Will this help me lose weight?" My first question about any particular food is: "Do I enjoy eating this?" If the answer is yes, then the second question is, "Will this food help me lose weight as a regular part of my day to day selections?" If the answer to that question is "No," then like it or not, it goes. An automatic "no" for me is sugar. I enjoy eating deep fried egg rolls, fried anything, really, and plenty of other things that if consumed regularly, would have a negative effect on my efforts. The key is finding foods that give you a "yes" to both questions.

The same "joy factor" applies to exercise. Find what you enjoy! If all you can do is walk slowly for short distances, do that. But make it enjoyable. Listen to music, an audio book, or carry on a conversation with someone--whatever you got to do to make it fun and enjoyable. When you're ready to make it something more intense--again, make sure it's something you truly enjoy doing.

Narrow the focus to one day at a time, set your limits and maintain the integrity of your limits, enjoy what you're eating and love what you're choosing to do for exercise.

And a big one: Develop a support system that focuses on accountability. Don't remain all hush about your efforts--share it, tell your friends and family--make some declarations and ask for support from those you're confident will give it. Keep a MyFitnessPal food diary or something similar and make it accessible by the friends you accept.

And another big one: Write, write, write--how you're feeling, what you're doing, describe your challenges, write about what you plan on doing to overcome these challenges, and write about how determined you are to succeed once and for all. Get it out on paper, in your personal diary--or on a blog, on your facebook--somewhere, anywhere--just write for you and your own personal clarity. There is no right or wrong. It doesn't matter if you fancy yourself a good writer or not--that isn't the point. If the only person who understands what you're writing is you, mission accomplished.

Consistency brings results. If the results aren't to your liking, change the elements of your consistent efforts until you find the balance you desire.
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That was a fun little trip back to a year and a half ago. An additional thought:

Here's the thing-- If we give ourselves this simplified approach, it allows mental space to face the bigger issues of emotional and stress eating. I can't count the number of times in past weight loss attempts where I made the basics bigger than I could handle--and then, at the slightest bend emotionally or in my stress level, I'd release the plan completely. I was looking for some kind of magic emotional and stress pattern of stability. Instead, I eventually realized stress and emotions are a part of life--so instead of hoping and praying for a pattern of stability long enough for me to succeed--I realized how I needed to learn ways of changing my pattern of perspective.

This is where the benefits of accountability and support have the best chance of changing things. Reaching for support instead of the fork can give us life changing shifts in perspective.

I'm hitting the pillow softly, with gratitude, confidence and certainty. I maintained the integrity of my maintenance calorie budget, I remained abstinent from refined sugar and I exceeded my daily water goal. And in the face of a challenging schedule over the last 24 hours, I increased my awareness--understanding how I might not make the best choices under these conditions--so I brought in additional support to help carry me through to a wonderful finish. This kind of day--in all its challenges, feels amazing once I'm on the pillow and giving thanks for having made it through. I'm grateful.  

Today's Live-Tweet Stream:


































Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Effects of new vaping regulations won't be felt immediately; American and British researchers have differing views of e-cigs. Princessiccia

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By Danielle Ray
Kentucky Health News

A long time coming, the U.S. Food and Drug Administration released new regulations this month for all tobacco products, including electronic cigarettes, vape pens, hookahs, dissolvables, and pipes. But the effects might not be felt for as long as two years.

Photo: excusemyvapes.com
The regulations require health warnings on packages and advertisements and ban sales to minors. Other regulations include reporting ingredients to the FDA, requiring photo identification to buy, banning free samples and banning the labeling of products as moderate, with words such as "light" or "mild,"

The FDA called the regulations a milestone in consumer protection. It believes the new rules will help prevent misleading claims by manufacturers moving forward and allow for review of new products not yet on the market. The agency already regulated traditional cigarettes, smokeless tobacco, and roll-your-own tobacco prior to the decision.

The new rules will take effect in stages. The ban on sales to minors begins Aug. 8, but according to Phil Galewitz of The Washington Post, the ban will primarily affect Michigan and Pennsylvania, as the other 48 states already ban sales of e-cigarettes to minors. Warning labels will take effect May 2018. The labels will read: �WARNING: This product contains nicotine. Nicotine is an addictive chemical.�

Don't expect changes overnight. Manufacturers have two years to submit products for review and another year for the agency to perform evaluations.

Why did the FDA take on vaping? For one thing, because the market has so far been unregulated, the ingredients in vaping liquid are largely a mystery. However, a 2015 Harvard University study found several dangerous chemicals present in these liquids. The chemicals can destroy tiny passageways in lungs, leading to scar tissue buildup and eventually respiratory disease, according to the study.

For another thing, adolescents and teenagers are vaping at unprecedented rates. More than 3 million middle and high school students used e-cigarettes in 2015, up more than 500,000 from the year before, according to the FDA.

E-cigarettes have been the most commonly used tobacco products among youth for two consecutive years. Sixteen percent of high schoolers and about 5 percent of middle schoolers were vapers of e-cigarettes in 2015, according to the FDA. More than 80 percent of them cited appealing flavors, which include "gummy bear" and "cotton candy," as their primary reason for use.

The science is still out on whether the harmful qualities of vaping negate any potential benefits. Some studies have found e-cigarettes to be less harmful than traditional cigarettes. For example, a 2015 Public Health England review concluded that e-cigarettes are about 95 percent less harmful than traditional cigarettes.

"E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm," said Professor Kevin Fenton, director of health and well-being at PHE, said in a news release. "The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting."

As noted in the Harvard study, e-cigarettes are not harmless. The question remains if vaping can be a tool to help current smokers quit, if they lure in kids who otherwise would not become smokers or if it's a little of both.

According to the British study, there is no evidence that vaping attracts non-smokers. Fewer than 1 percent of either adults or young people who have never smoked are becoming regular e-cigarette users, the study noted.

As for fears that vaping leads to traditional smoking, Linda Bauld, a cancer prevention expert at Cancer Research United Kingdom, said in a news release that those claims are unfounded.

"Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realized," Bauld said. "In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco."

Attitudes toward vaping have been much more favorable overall in the UK. Public health officials there seem more willing to accept e-cigarettes as a safer alternative and even a stop smoking tool than do U.S. officials.

For more background information on the FDA's new regulations, click here.
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