New website explores and outs of Affordable Care Act; useful tool for reporters

One of the most complex and far-reaching pieces of legislation to pass in recent years is the Patient Protection and Affordable Care Act, the federal health-care reform law that, among other provisions, requires Americans to buy health insurance or pay a penalty.

But because of its complexity, journalists can shy away from delving into stories about it. With state insurance exchanges and Medicaid expansion sure to be hot topics during the election season and the legislative session, it’s important to have reliable sources of information about the law. The American Public Health Association has a website that answers many if not most of the questions reporters, and the public, often have.

The website:
• Reviews the fundamentals about the Affordable Care Act and links to information about Medicaid expansion, insurance exchanges and the individual mandate.

• Looks at the implementation timeline of the law.

• Includes fact sheets about the ACA’s prevention funding program, which allows seniors and others to get free preventive care including mammograms and other screenings.

• Breaks down the U.S. Supreme Court’s decision to uphold the law.

The website is a useful tool in any health reporter’s arsenal and is worth a look. (Read more)

One of the most complex and far-reaching pieces of legislation to pass in recent years is the Patient Protection and Affordable Care Act, the federal health-care reform law that, among other provisions, requires Americans to buy health insurance or pay a penalty.

But because of its complexity, journalists can shy away from delving into stories about it. With state insurance exchanges and Medicaid expansion sure to be hot topics during the election season and the legislative session, it’s important to have reliable sources of information about the law. The American Public Health Association has a website that answers many if not most of the questions reporters, and the public, often have.

The website:
• Reviews the fundamentals about the Affordable Care Act and links to information about Medicaid expansion, insurance exchanges and the individual mandate.

• Looks at the implementation timeline of the law.

• Includes fact sheets about the ACA’s prevention funding program, which allows seniors and others to get free preventive care including mammograms and other screenings.

• Breaks down the U.S. Supreme Court’s decision to uphold the law.

The website is a useful tool in any health reporter’s arsenal and is worth a look. (Read more)

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41 percent of the time, Americans go to specialists instead of primary-care doctors for basic health needs, study finds

More than 40 percent of the time, Americans are turning to higher-paid specialists instead of primary-care doctors to deal with their basic health needs, including colds and fever, a new study has found.

Researchers at Mount Sinai Hospital in New York looked at data from more than 20,000 doctor visits in 1999 and 2007 that included information about why the patient had come to the doctor’s office. “Fifty-nine percent of those with primary care needs, the runny-nose group, were seen by a primary care doctor,” reports Sarah Kliff for The Washington Post. “Forty-one percent sought out care at a specialist.”

Researchers included gynecologists and internal medicine physicians in the specialists group, though they tend to have heavy primary care loads. But even without those two specialties, 27 percent of primary care appointments happened in specialists’ offices.

A 2010 study found primary care doctors earn a $69 hourly rate, compared to $92 per hour and $85 per hour that surgeons and ob-gyns earn, respectively. (Read more)

More than 40 percent of the time, Americans are turning to higher-paid specialists instead of primary-care doctors to deal with their basic health needs, including colds and fever, a new study has found.

Researchers at Mount Sinai Hospital in New York looked at data from more than 20,000 doctor visits in 1999 and 2007 that included information about why the patient had come to the doctor’s office. “Fifty-nine percent of those with primary care needs, the runny-nose group, were seen by a primary care doctor,” reports Sarah Kliff for The Washington Post. “Forty-one percent sought out care at a specialist.”

Researchers included gynecologists and internal medicine physicians in the specialists group, though they tend to have heavy primary care loads. But even without those two specialties, 27 percent of primary care appointments happened in specialists’ offices.

A 2010 study found primary care doctors earn a $69 hourly rate, compared to $92 per hour and $85 per hour that surgeons and ob-gyns earn, respectively. (Read more)

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Hospitals can learn from revealing account of the attack of a superbug; sequencing germ's DNA seems to be key

Dr. Tara Palmore, deputy hospital epidemiologist at the
National Institutes of Health Clinic Center, left, and Dr.
Julie Segre, a geneticist with the National Human
Genome Research Institute. Both were integral in
pinpointing the spread of a superbug at NIH.
Associated Press photo by Patrick Semansky.

A candid account of how a superbug was contained at one of the nation's leading research hospitals indicates that fast sequencing of a germ’s full DNA can make all the difference.

Over a six-month period, Klebsiella pneumonia, or KPC, a germ that cannot be treated by most antibiotics, sickened 18 people at the National Institutes of Health. Six of them died and another five, though they survived the effects of the germ, died from the disease that originally brought them to the facility.

Infections at health-care facilities kill about 100,000 Americans each year. But, fearful of lawsuits, hospitals generally don’t reveal to the public when infections outfox control measures, reports Lauran Neergaard for The Associated Press. That changed this week when government researchers published the story of what happened at NIH.

Dr. Julie Segre, a senior investigator at NIH’s National Human Genome Research Institute, was in charge of the “genetic sleuthing that found the bug hiding in sink drains and, most chilling, even in a ventilator that had been cleaned with bleach,” Neergaard reports. A multidrug-resistant strain of Klepsiella bacteria has emerged that spreads easily between patients who are very ill, and it kills half of whomever it sickens.

On June 13, 2011, a research nurse checked the medical records of a study participant who was being transferred from a New York City hospital and was critically ill with a rare lung disease. She found the patient had KPC, prompting the hospital to put her in strict isolation. “Everyone entering her room donned a protective gown and gloves and rigorously washed their hands,” Neergaard reports. “Her medical equipment got special decontamination. All other patients in the intensive care unit had their throats and groins tested regularly to see if the bug was spreading.” All seemed to be clear and the woman was sent home two days later.

But three weeks later, a patient with cancer was found to have KPC, though he was never in the presence of the first patient. Ten days later, a woman with an immune disease also got sick with KPC. Both died from the infection.

Researchers wondered if the cases were related or if the patients were arriving already infected with KPC. Segre turned to DNA for answers. "As bacteria multiply, mistakes appear and are repaired in their genetic codes," Neergaard reports. "Sequencing that genome allowed Segre to follow differences in single genetic letters like a trail of the germ’s transmission and evolution." Using this method, Segre discovered the KPC appearing at NIH was the same strain that came from the New York patient. "Testing bacteria from the 17 additional patients who ultimately caught it shows the KPC was transmitted three separate times from Patient No. 1 and then spread more widely," Neergaard reports.

NIH completely overhauled its decontamination practices, but the bacteria continued to spread. By November, the bacteria appeared in two patients who were not even in intensive care. Finally, the hospital built a new isolation room and all 200-plus patients in the hospital were subject to rectal testing.

The contamination is now contained, but the account of it is giving pause to infection-control specialists around the country. “Absolutely this could happen in any hospital,” said Dr. Deverick Anderson, co-director of a Duke Universityinfection control network. (Read more)

Dr. Tara Palmore, deputy hospital epidemiologist at the
National Institutes of Health Clinic Center, left, and Dr.
Julie Segre, a geneticist with the National Human
Genome Research Institute. Both were integral in
pinpointing the spread of a superbug at NIH.
Associated Press photo by Patrick Semansky.

A candid account of how a superbug was contained at one of the nation's leading research hospitals indicates that fast sequencing of a germ’s full DNA can make all the difference.

Over a six-month period, Klebsiella pneumonia, or KPC, a germ that cannot be treated by most antibiotics, sickened 18 people at the National Institutes of Health. Six of them died and another five, though they survived the effects of the germ, died from the disease that originally brought them to the facility.

Infections at health-care facilities kill about 100,000 Americans each year. But, fearful of lawsuits, hospitals generally don’t reveal to the public when infections outfox control measures, reports Lauran Neergaard for The Associated Press. That changed this week when government researchers published the story of what happened at NIH.

Dr. Julie Segre, a senior investigator at NIH’s National Human Genome Research Institute, was in charge of the “genetic sleuthing that found the bug hiding in sink drains and, most chilling, even in a ventilator that had been cleaned with bleach,” Neergaard reports. A multidrug-resistant strain of Klepsiella bacteria has emerged that spreads easily between patients who are very ill, and it kills half of whomever it sickens.

On June 13, 2011, a research nurse checked the medical records of a study participant who was being transferred from a New York City hospital and was critically ill with a rare lung disease. She found the patient had KPC, prompting the hospital to put her in strict isolation. “Everyone entering her room donned a protective gown and gloves and rigorously washed their hands,” Neergaard reports. “Her medical equipment got special decontamination. All other patients in the intensive care unit had their throats and groins tested regularly to see if the bug was spreading.” All seemed to be clear and the woman was sent home two days later.

But three weeks later, a patient with cancer was found to have KPC, though he was never in the presence of the first patient. Ten days later, a woman with an immune disease also got sick with KPC. Both died from the infection.

Researchers wondered if the cases were related or if the patients were arriving already infected with KPC. Segre turned to DNA for answers. "As bacteria multiply, mistakes appear and are repaired in their genetic codes," Neergaard reports. "Sequencing that genome allowed Segre to follow differences in single genetic letters like a trail of the germ’s transmission and evolution." Using this method, Segre discovered the KPC appearing at NIH was the same strain that came from the New York patient. "Testing bacteria from the 17 additional patients who ultimately caught it shows the KPC was transmitted three separate times from Patient No. 1 and then spread more widely," Neergaard reports.

NIH completely overhauled its decontamination practices, but the bacteria continued to spread. By November, the bacteria appeared in two patients who were not even in intensive care. Finally, the hospital built a new isolation room and all 200-plus patients in the hospital were subject to rectal testing.

The contamination is now contained, but the account of it is giving pause to infection-control specialists around the country. “Absolutely this could happen in any hospital,” said Dr. Deverick Anderson, co-director of a Duke Universityinfection control network. (Read more)

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Hopkinsville council, absent a proponent, narrowly replaces smoking ban idea with plan to require posted smoking policies

The effort to pass a smoking ban in the largest Kentucky town without one may have hit a roadblock Thursday night. The Hopkinsville City Council forwarded a smoking ordinance that would merely require businesses to decide whether to allow smoking and post signs at every entrance announcing its policy. The council's vote as a committee of the whole was 6-5, and the one absent council member favors a typical smoking ban.

Mayor Dan Kemp, who can vote to break council ties and does not sit on the committee of the whole, "said after the meeting that he could not support the proposal because it leaves the current law unchanged," Carla Jimenez reports for the Kentucky New Era. The alternative ordinance is scheduled for first reading Sept. 18; a tie vote would block it, and a tie vote in favor of a smoking ban could be broken by Kemp to pass it.

As first presented to the committee, the ordinance would ban smoking in public places, with exemptions for private clubs, age-restricted establishments and businesses with 12 employees or fewer. The small-business exemption was removed on a vote of 10-1. "That left the ordinance as it originally came before the council for its first reading in June," Jimenez reports. But then the committee voted 6-5 for the alternative ordinance, proposed by Councilman Paul Henson, who argued, “We’re not abusing anybody’s rights. We’re not the bad guy, and yet we have the smoking ban, a smoking ordinance, on the books.”

Councilwoman Peggy Rogers-Everett disagreed, saying smoking is a hazard to everyone, and “Murder is illegal.” Henson and Councilwoman Ann Cherry and Henson laughed, and "Everett was not amused," Jimenez reports. Everett said, “I don’t find that funny. I don’t take that lightly.” (Read more)

The effort to pass a smoking ban in the largest Kentucky town without one may have hit a roadblock Thursday night. The Hopkinsville City Council forwarded a smoking ordinance that would merely require businesses to decide whether to allow smoking and post signs at every entrance announcing its policy. The council's vote as a committee of the whole was 6-5, and the one absent council member favors a typical smoking ban.

Mayor Dan Kemp, who can vote to break council ties and does not sit on the committee of the whole, "said after the meeting that he could not support the proposal because it leaves the current law unchanged," Carla Jimenez reports for the Kentucky New Era. The alternative ordinance is scheduled for first reading Sept. 18; a tie vote would block it, and a tie vote in favor of a smoking ban could be broken by Kemp to pass it.

As first presented to the committee, the ordinance would ban smoking in public places, with exemptions for private clubs, age-restricted establishments and businesses with 12 employees or fewer. The small-business exemption was removed on a vote of 10-1. "That left the ordinance as it originally came before the council for its first reading in June," Jimenez reports. But then the committee voted 6-5 for the alternative ordinance, proposed by Councilman Paul Henson, who argued, “We’re not abusing anybody’s rights. We’re not the bad guy, and yet we have the smoking ban, a smoking ordinance, on the books.”

Councilwoman Peggy Rogers-Everett disagreed, saying smoking is a hazard to everyone, and “Murder is illegal.” Henson and Councilwoman Ann Cherry and Henson laughed, and "Everett was not amused," Jimenez reports. Everett said, “I don’t find that funny. I don’t take that lightly.” (Read more)

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Central Baptist takes over Russell County Hospital

Russell County Hospital in Russell Springs will be managed by Lexington's Central Baptist Hospital, at least for the next three years. The deal announced this week is the latest in a growing consolidation of rural hospitals with larger, urban facilities, expected to accelerate under federalhealth reform.

"The three-year agreement creates an opportunity to provide greater accessibility to a wider range of health services in Russell County, while exploring ways to reduce costs and maintain affordability of services," the hospitals said in a press release. "The management agreement will allow creation of a broader continuum of care, including enhanced alignment of physicians and hospital services."

Russell County Hospital has 25 beds and 170 employees. It is a critical-access hospital, meaning it limits admissions and patient stays in return for slightly higher reimbursements from Medicare and Medicaid. Chris McQueary, chairman of the hospital's board, said in the press release, “This strategic partnership will allow us to work more closely with a leading health care system to provide high levels of care in the most cost-effective way.”

Central Baptist named Robert Ramey the CEO of Russell County Hospital. He has worked at Central Baptist for 17 years, most recently as administrator of Baptist-Physicians’ Surgery Center, the release said.

Russell County Hospital in Russell Springs will be managed by Lexington's Central Baptist Hospital, at least for the next three years. The deal announced this week is the latest in a growing consolidation of rural hospitals with larger, urban facilities, expected to accelerate under federalhealth reform.

"The three-year agreement creates an opportunity to provide greater accessibility to a wider range of health services in Russell County, while exploring ways to reduce costs and maintain affordability of services," the hospitals said in a press release. "The management agreement will allow creation of a broader continuum of care, including enhanced alignment of physicians and hospital services."

Russell County Hospital has 25 beds and 170 employees. It is a critical-access hospital, meaning it limits admissions and patient stays in return for slightly higher reimbursements from Medicare and Medicaid. Chris McQueary, chairman of the hospital's board, said in the press release, “This strategic partnership will allow us to work more closely with a leading health care system to provide high levels of care in the most cost-effective way.”

Central Baptist named Robert Ramey the CEO of Russell County Hospital. He has worked at Central Baptist for 17 years, most recently as administrator of Baptist-Physicians’ Surgery Center, the release said.

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Laurel County man talks about bout with West Nile; one of few diagnosed with disease in Kentucky

A Laurel County man has shared his story after contracting the West Nile Virus, which, though rare in Kentucky, has been more common nationwide this year than it has been since it was first discovered in 1999.

Kelly Curens spent three weeks at the University of Kentucky medical center, much of which was spent in an induced coma. He started feeling sick after a camping trip at Lake Cumberland, reports Phil Penderton for WKYT-TV. The illness started with a headache and graduated to feeling dizzy, which were symptoms to similar to ones he experienced a few years ago when he was diagnosed with a brain tumor. When he went to the emergency room at St. Joseph London hospital, he had a seizure. 

Curens was one of the first in Kentucky to be positively diagnosed with the virus, which has affected more than 1,100 people nationwide this year. About half of the cases have been in Texas. Four horses have been diagnosed with the disease in Kentucky since Aug. 2. Craig Carter, director of the UK Veterminary Diagnostic Lab, said Kentucky is "still in the high-risk part of the season for West Nile infection."

Curens has been treated and is feeling much better now. "From what I was told, I'm very lucky," he said. "My blood sugar and blood pressure has always been good. Had I not been healthy I probably wouldn't be here today."

The elderly, infants and babies at the most risk, said Marion Pennington, regional epidemiologist at the Cumberland Valley District Health Department.

To protect oneself from the West Nile Virus, officials advise to:
• Dispose of tin cans, plastic containers, ceramic pots and other containers that could collect water.
• Remove discarded tires from properties. They are the most common mosquito breeding grounds in the country.
• Drill holes in recycling containers.
• Drain gutters properly and clean gutters in the spring and fall.
• Turn over swimming pools and wheelbarrows when they aren't in use.
• Change the water in birdbaths on a regular basis.
• Clean and chlorinate swimming pools and hot tubs.
• Make sure screens on windows don't have holes in them.
• Wear long-sleeve shirts and long pants when outside in the early morning and late evening. (Read more)

A Laurel County man has shared his story after contracting the West Nile Virus, which, though rare in Kentucky, has been more common nationwide this year than it has been since it was first discovered in 1999.

Kelly Curens spent three weeks at the University of Kentucky medical center, much of which was spent in an induced coma. He started feeling sick after a camping trip at Lake Cumberland, reports Phil Penderton for WKYT-TV. The illness started with a headache and graduated to feeling dizzy, which were symptoms to similar to ones he experienced a few years ago when he was diagnosed with a brain tumor. When he went to the emergency room at St. Joseph London hospital, he had a seizure. 

Curens was one of the first in Kentucky to be positively diagnosed with the virus, which has affected more than 1,100 people nationwide this year. About half of the cases have been in Texas. Four horses have been diagnosed with the disease in Kentucky since Aug. 2. Craig Carter, director of the UK Veterminary Diagnostic Lab, said Kentucky is "still in the high-risk part of the season for West Nile infection."

Curens has been treated and is feeling much better now. "From what I was told, I'm very lucky," he said. "My blood sugar and blood pressure has always been good. Had I not been healthy I probably wouldn't be here today."

The elderly, infants and babies at the most risk, said Marion Pennington, regional epidemiologist at the Cumberland Valley District Health Department.

To protect oneself from the West Nile Virus, officials advise to:
• Dispose of tin cans, plastic containers, ceramic pots and other containers that could collect water.
• Remove discarded tires from properties. They are the most common mosquito breeding grounds in the country.
• Drill holes in recycling containers.
• Drain gutters properly and clean gutters in the spring and fall.
• Turn over swimming pools and wheelbarrows when they aren't in use.
• Change the water in birdbaths on a regular basis.
• Clean and chlorinate swimming pools and hot tubs.
• Make sure screens on windows don't have holes in them.
• Wear long-sleeve shirts and long pants when outside in the early morning and late evening. (Read more)

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At least 50 Kentuckians sick from salmonella, likely from cantaloupes; best to wash them with a diluted bleach solution

Photo by Richard North for Gristmill

Health officials have zeroed in on a farm in southwestern Indiana responsible for at least some of the cantaloupe that were contaminated with salmonella, an outbreak that has sickened at least 50 Kentuckians and 178 people nationwide. It has also been associated with the death of two Kentuckians.

There is disagreement between state and federal officials whether melons from the region are safe to eat, The Associated Press reports. The Food and Drug Administration says to discard any cantaloupes grown in the area that were bought on or after July 7. Amy Reel, Indiana Department of Health spokeswoman, says melons from other farms in the area are safe to eat.

The 100-acre Chamberlain Farms, 20 miles north of Evansville, seems to be at least one source of the outbreak. It stopped producing and distributing the melons Aug. 16. They sold cantaloupe to four grocery stores in Southwestern Indiana, as well as to wholesale purchasers in St. Louis; Owensboro, Ky.; Peru, Ill.; and Durant, Iowa. (Read more)

Salmonella is a bacterium that is found in the intestines of animals and is contracted from eating raw eggs or raw poultry or having those products touch other food. It can occasionally be found on produce, so the Kentucky Cabinet for Health and Family Services recommends washing all fruit and vegetables thoroughly and scrubbing the rinds of cantaloupes and other melons before cutting or slicing them. As Tim Wright, the acting health director in Anderson County, told The Anderson News,  "People use a clean knife and cut through the melon, and that can shove the salmonella right into its meat" if any remains on the rind. He recommends washing all melons in a solution of one cup of bleach to a gallon of water, because melon rinds get salmonella when rodents urinate on them.

Photo by Richard North for Gristmill

Health officials have zeroed in on a farm in southwestern Indiana responsible for at least some of the cantaloupe that were contaminated with salmonella, an outbreak that has sickened at least 50 Kentuckians and 178 people nationwide. It has also been associated with the death of two Kentuckians.

There is disagreement between state and federal officials whether melons from the region are safe to eat, The Associated Press reports. The Food and Drug Administration says to discard any cantaloupes grown in the area that were bought on or after July 7. Amy Reel, Indiana Department of Health spokeswoman, says melons from other farms in the area are safe to eat.

The 100-acre Chamberlain Farms, 20 miles north of Evansville, seems to be at least one source of the outbreak. It stopped producing and distributing the melons Aug. 16. They sold cantaloupe to four grocery stores in Southwestern Indiana, as well as to wholesale purchasers in St. Louis; Owensboro, Ky.; Peru, Ill.; and Durant, Iowa. (Read more)

Salmonella is a bacterium that is found in the intestines of animals and is contracted from eating raw eggs or raw poultry or having those products touch other food. It can occasionally be found on produce, so the Kentucky Cabinet for Health and Family Services recommends washing all fruit and vegetables thoroughly and scrubbing the rinds of cantaloupes and other melons before cutting or slicing them. As Tim Wright, the acting health director in Anderson County, told The Anderson News,  "People use a clean knife and cut through the melon, and that can shove the salmonella right into its meat" if any remains on the rind. He recommends washing all melons in a solution of one cup of bleach to a gallon of water, because melon rinds get salmonella when rodents urinate on them.

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Feline oral squamous cell carcinoma

Final report, Winn grant W09-032
Molecular pathology of feline oral squamous cell carcinoma
Investigators: Susan M. LaRue, E.J. Ehrhart
Colorado State University

Oral squamous cell carcinoma (OSCC) is a devastating disease in cats and accounts for approximately 10% of all feline tumors. The goal of the study’s investigators was to establish protocols for molecular biomarkers and to characterize the nature of this tumor so a better treatment protocol could be developed in the future.
They first developed protocols for immune staining of tissues and antibodies against three different biological markers. 

One important detail learned was that sample processing is one of the most important factors affecting immunoreactivity of feline tissues. Due to this important finding, immunohistochemical techniques will be used only in formalin-fixed and paraffin-embedded tissues that do not undergo bone decalcification. The study results also noted that cats with high epidermal growth factor receptor (EGFR) expression had a tendency toward a shorter overall survival. This may suggest a possible usefulness for anti-EGFR therapy in future studies. 

Finally, there was statistically significant correlation between one biomarker score, Ki67, and another marker, mitotic indexes. This relationship has not been reported previously in feline OSCC and suggests that these particular cancer cells with Ki67 can keep proliferating without going into a rest or dying phase. Such a result could go a long way to explaining the impression that feline OSCC is a fast-growing cancer. [VT]

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

Final report, Winn grant W09-032
Molecular pathology of feline oral squamous cell carcinoma
Investigators: Susan M. LaRue, E.J. Ehrhart
Colorado State University

Oral squamous cell carcinoma (OSCC) is a devastating disease in cats and accounts for approximately 10% of all feline tumors. The goal of the study’s investigators was to establish protocols for molecular biomarkers and to characterize the nature of this tumor so a better treatment protocol could be developed in the future.
They first developed protocols for immune staining of tissues and antibodies against three different biological markers. 

One important detail learned was that sample processing is one of the most important factors affecting immunoreactivity of feline tissues. Due to this important finding, immunohistochemical techniques will be used only in formalin-fixed and paraffin-embedded tissues that do not undergo bone decalcification. The study results also noted that cats with high epidermal growth factor receptor (EGFR) expression had a tendency toward a shorter overall survival. This may suggest a possible usefulness for anti-EGFR therapy in future studies. 

Finally, there was statistically significant correlation between one biomarker score, Ki67, and another marker, mitotic indexes. This relationship has not been reported previously in feline OSCC and suggests that these particular cancer cells with Ki67 can keep proliferating without going into a rest or dying phase. Such a result could go a long way to explaining the impression that feline OSCC is a fast-growing cancer. [VT]

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

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Brushing teeth twice a day, two minutes at a time, is the way to prevent cavities, a new campaign advises

Kids should brush their teeth twice a day for two whole minutes at a time, a new public-service campaign urges. The “Kids’ Healthy Mouths” campaign includes TV spots, print ads, a website, social media messages and other materials, reports Jennifer LaRue Huget for The Washington Post.

Campaign materials point out that “dental decay is the most common chronic childhood disease.” More than 16 million children across the United States suffer from it. In Kentucky, nearly 35 percent of third-grade students had untreated tooth decay, the Centers for Disease Control and Prevention's State Oral Health Profile shows.

“The mouth is the gateway to a person’s overall health, and an unhealthy mouth can be linked to diabetes and even heart disease,” the campaign says. “In the U.S., oral disease causes kids to miss 51 million school hours and their parents to lose 25 million work hours annually. Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.”

The campaign includes a YouTube video channel on which there are videos that are each 120 seconds long. The goal is for kids to watch the videos while they’re brushing.

Research has shown brushing two minutes at a time, twice a day, is the “optimal prevention brushing regimen,” because it “takes two minutes for the tooth enamel to uptake the fluoride” in toothpaste, said Maria Lopez Howell, consumer adviser for the American Dental Association. When enamel absorbs fluoride it makes the surface harder and more resistant to bacteria. Brushing for two minutes additionally removes plaque on teeth. (Read more)

Kids should brush their teeth twice a day for two whole minutes at a time, a new public-service campaign urges. The “Kids’ Healthy Mouths” campaign includes TV spots, print ads, a website, social media messages and other materials, reports Jennifer LaRue Huget for The Washington Post.

Campaign materials point out that “dental decay is the most common chronic childhood disease.” More than 16 million children across the United States suffer from it. In Kentucky, nearly 35 percent of third-grade students had untreated tooth decay, the Centers for Disease Control and Prevention's State Oral Health Profile shows.

“The mouth is the gateway to a person’s overall health, and an unhealthy mouth can be linked to diabetes and even heart disease,” the campaign says. “In the U.S., oral disease causes kids to miss 51 million school hours and their parents to lose 25 million work hours annually. Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.”

The campaign includes a YouTube video channel on which there are videos that are each 120 seconds long. The goal is for kids to watch the videos while they’re brushing.

Research has shown brushing two minutes at a time, twice a day, is the “optimal prevention brushing regimen,” because it “takes two minutes for the tooth enamel to uptake the fluoride” in toothpaste, said Maria Lopez Howell, consumer adviser for the American Dental Association. When enamel absorbs fluoride it makes the surface harder and more resistant to bacteria. Brushing for two minutes additionally removes plaque on teeth. (Read more)

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West Nile outbreak light in Ky. but 'one of the largest' in nation

U.S. health officials reported Wednesday three times the usual number of West Nile cases for this time of year and one expert told the Associated Press it was “one of the largest” outbreaks since the virus appeared in this country in 1999.

So far, 1,118 illnesses have been reported, about half of them in Texas, according to the Centers for Disease Control and Prevention. Kentucky has reported few cases.

In an average year, fewer than 300 cases are reported by mid-August. There have also been 41 deaths this year. Most infections are usually reported in August and September, so it’s too early to say how bad this year will end up, CDC officials said. AP reports that West Nile virus peaked in 2002 and 2003, when severe illnesses reached nearly 3,000 and deaths surpassed 260.

 The best way to prevent West Nile disease, say experts, is to avoid mosquito bites. Insect repellents, screens on doors and windows and wearing long sleeves and pants are some of the recommended strategies. Also, empty standing water from buckets, kiddie pools and other places to discourage breeding. (Read more)

U.S. health officials reported Wednesday three times the usual number of West Nile cases for this time of year and one expert told the Associated Press it was “one of the largest” outbreaks since the virus appeared in this country in 1999.

So far, 1,118 illnesses have been reported, about half of them in Texas, according to the Centers for Disease Control and Prevention. Kentucky has reported few cases.

In an average year, fewer than 300 cases are reported by mid-August. There have also been 41 deaths this year. Most infections are usually reported in August and September, so it’s too early to say how bad this year will end up, CDC officials said. AP reports that West Nile virus peaked in 2002 and 2003, when severe illnesses reached nearly 3,000 and deaths surpassed 260.

 The best way to prevent West Nile disease, say experts, is to avoid mosquito bites. Insect repellents, screens on doors and windows and wearing long sleeves and pants are some of the recommended strategies. Also, empty standing water from buckets, kiddie pools and other places to discourage breeding. (Read more)

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Medicare is a hot topic on the presidential campaign trail; federal agency says reform has saved seniors money

Republican presidential candidate Mitt Romney and running
mate Paul Ryan talk health care in New Hampshire. Photo
by Aram Boghosian for The Boston Globe.

The federal health reform law continues to be a major point of contention in the presidential campaign. Yesterday, Republican vice presidential candidate Paul Ryan said, "Medicare should not be a piggybank for Obamacare," while at a rally in New Hampshire yesterday and blasted President Obama "for using $716 billion in savings from Medicare and applying it to his health care law," reports Matt Viser for The Boston Globe.

Most of that amount was taken from reductions to Medicare Advantage, a category of Medicare plans that are run by private insurance companies. The idea behind the program "was that competition among the private insurers would reduce costs," reports Politifact.com, a Tampa Bay Times project that fact-checks statements on public policy. "But in recent years the plans have actually cost more than traditional Medicare. So the health-care law scales back the payments to private insurers."

Ryan has proposed his own fix, a voucher program for Medicare, which Obama sharply criticized Saturday: "Now you think they'd avoid talking about Medicare, considering both of them have proposed to voucherize the Medicare system," he said. "They want seniors to get a voucher to buy their own insurance, which would force seniors to pay an additional $6,400 for their health care."

Meanwhile, the Centers for Medicare and Medicaid Services released a press release detailing how much the Patient Protection and Affordable Care Act has saved seniors. Kentucky seniors and those with disabilities have saved $78.4 million on prescription drugs since 2010. In 2012, seniors in Kentucky saved an average of $579 because of the Patient Protection and Affordable Care Act. The law covers the prescription drug coverage gap known as the "donut hole."

In the first seven months of 2012, 477,235 Kentuckians with Medicare also got at least one preventive service for free because of a provision in the law, a CMS reports.

"The health care law has saved people with Medicare over $4.1 billion on prescription drugs, and given millions access to cancer screenings, mammograms and other preventive services for free," said Kathleen Sebelius, secretary for the Department of Health and Human Services. "Medicare is stronger thanks to the health care law, saving people money and offering new benefits at no cost to seniors."

Republican presidential candidate Mitt Romney and running
mate Paul Ryan talk health care in New Hampshire. Photo
by Aram Boghosian for The Boston Globe.

The federal health reform law continues to be a major point of contention in the presidential campaign. Yesterday, Republican vice presidential candidate Paul Ryan said, "Medicare should not be a piggybank for Obamacare," while at a rally in New Hampshire yesterday and blasted President Obama "for using $716 billion in savings from Medicare and applying it to his health care law," reports Matt Viser for The Boston Globe.

Most of that amount was taken from reductions to Medicare Advantage, a category of Medicare plans that are run by private insurance companies. The idea behind the program "was that competition among the private insurers would reduce costs," reports Politifact.com, a Tampa Bay Times project that fact-checks statements on public policy. "But in recent years the plans have actually cost more than traditional Medicare. So the health-care law scales back the payments to private insurers."

Ryan has proposed his own fix, a voucher program for Medicare, which Obama sharply criticized Saturday: "Now you think they'd avoid talking about Medicare, considering both of them have proposed to voucherize the Medicare system," he said. "They want seniors to get a voucher to buy their own insurance, which would force seniors to pay an additional $6,400 for their health care."

Meanwhile, the Centers for Medicare and Medicaid Services released a press release detailing how much the Patient Protection and Affordable Care Act has saved seniors. Kentucky seniors and those with disabilities have saved $78.4 million on prescription drugs since 2010. In 2012, seniors in Kentucky saved an average of $579 because of the Patient Protection and Affordable Care Act. The law covers the prescription drug coverage gap known as the "donut hole."

In the first seven months of 2012, 477,235 Kentuckians with Medicare also got at least one preventive service for free because of a provision in the law, a CMS reports.

"The health care law has saved people with Medicare over $4.1 billion on prescription drugs, and given millions access to cancer screenings, mammograms and other preventive services for free," said Kathleen Sebelius, secretary for the Department of Health and Human Services. "Medicare is stronger thanks to the health care law, saving people money and offering new benefits at no cost to seniors."

Read More

Aetna buying Coventry, which manages some Medicaid care

Aetna will buy Coventry Health Care for about $5.6 billion as the third-largest health insurance company poises itself for more Medicare and Medicaid patients under the federal health-care reform law.

Coventry Cares is one of four managed care organizations that supervise care for Kentucky's Medicaid patients. But since being put in place last November, the company reports it has been beleaguered by shortfalls and has threatened to end many contracts with hospitals.

"It's a deal that almost had to happen," said thomas Carroll, a Stifel Nicolaus & Co. analyst in Baltimore. "For Aetna to really compete effectively amongst the other large national managed care companies, they have to do more in terms of gaining market share in the commercial business as well as getting a bigger foothold in Medicare and Medicaid, which are the growth areas in managed care over the next decade."

The health care law "seeks to add as many as 17 million patients under Medicaid, the insurance program for the poor, while individuals states have increasingly turned to insurers to help them manage existing programs at lower costs," reports the Bloomberg News. "Medicare managed-care plans are among the fastest-growing products for health insurers as Americans age." (Read more)

Aetna will buy Coventry Health Care for about $5.6 billion as the third-largest health insurance company poises itself for more Medicare and Medicaid patients under the federal health-care reform law.

Coventry Cares is one of four managed care organizations that supervise care for Kentucky's Medicaid patients. But since being put in place last November, the company reports it has been beleaguered by shortfalls and has threatened to end many contracts with hospitals.

"It's a deal that almost had to happen," said thomas Carroll, a Stifel Nicolaus & Co. analyst in Baltimore. "For Aetna to really compete effectively amongst the other large national managed care companies, they have to do more in terms of gaining market share in the commercial business as well as getting a bigger foothold in Medicare and Medicaid, which are the growth areas in managed care over the next decade."

The health care law "seeks to add as many as 17 million patients under Medicaid, the insurance program for the poor, while individuals states have increasingly turned to insurers to help them manage existing programs at lower costs," reports the Bloomberg News. "Medicare managed-care plans are among the fastest-growing products for health insurers as Americans age." (Read more)

Read More

CadenceMed Announces Top Ten Chiropractic Facebook Pages of 2012

After reviewing countless Facebook pages, we have identified our Top Ten Chiropractic Facebook Pages for 2012. These Facebook pages have unique strengths that deserve special recognition, so instead of ranking them #1 through #10, we decided it would be best to simply pinpoint what they do best.

So without further adieu, here are the chiropractic Facebook pages that we “Like” the most and why. Learn, share and enjoy!

Best Status Updates
BodyWise Chiropractic

What we like
Unlike most businesses on Facebook, these guys are rarely pushing their products and services. Instead, they are posting content that is thought-provoking, funny, educational and graphical. The end result? A large and engaged community of fans.

Most Likes
Goodlettsville Chiropractic Clinic

What we like
Isn’t it obvious? We like their “Likes.” Although the number of Likes a page has can be a vanity metric (what really matters when it comes to investing time and money on social media is if you are able to generate business, improve patient outcomes or increase patient satisfaction), it can be a decent indicator that the business is doing something correct. With over 23,000 Likes and status updates that fans are positively responding to, these guys appear to be doing more than just racking up a high Like number.

Best Design
Live Well Chiropractic and Lifestyle

What we like
This Louisville chiropractor just opened up shop earlier in the year, but he is making a splash with his practice’s attractive website and growing Facebook page. The combination of their aesthetically-pleasing profile picture and personal Timeline Banner image evokes a professional and emotional first impression.

Best YouTube Integration
Executive Express Chiropractic

What we like
Facebook Timeline Tabs often go underutilized, but not in this case. The team at Executive Express Chiropractic are integrating YouTube with their Facebook page in a wonderful way: by presenting patient testimonials. Third-party social proof is one of the most effective ways for an individual or business to validate the quality of its products and services. Video testimonials are among the most potent forms of social proof because they are more personal than written or audio testimonials; nice work!

Best E-Commerce Integration
Dr. Kevin Lau

What we like
Dr. Kevin Lau is the author of a number of books on scoliosis. He gives his Facebook visitors the opportunity to buy products right from his Facebook page. All his visitors need to do is visit his “Online Store” tab, which is powered by Amazon.

Best Engagement
Belleville Chiropractic practice: LiveWell Wellness Centers

What we like
Probably the best sign of a healthy Facebook business presence is a highly engaged fan-base. Few chiropractic practices do a better job at posting content that gets their contacts “Liking,” commenting and sharing as well as LiveWell Wellness Centers do on their Facebook page. As of posting this article, 1,178 people were talking about LiveWell Wellness Centers – now that is what we call a thriving community of fans!

Best Use of Facebook Tabs
Maui Spa & Wellness Center

What we like
We like how these folks are using their Facebook tabs to share more information about their spa, services and upcoming events. It makes a strong first impression and answers most of the key questions a prospective patient might have.

Best Patient Education
Portland Chiropractic Neurology

What we like
Pay special attention to their page’s “Patient Resources” tab. It is chocked full of rich information about health disorders that their prospective or existing patients would likely find interesting and valuable. The layout of the information – with a header, a short passage of content and then a “Learn More” button is brilliant. This provides a Facebook visitor with just enough information to become interested before referring them where most practices really want their traffic to go: their websites.

So that’s it: our ten favorite chiropractic Facebook pages? Do you agree? Disagree? Share with us on Twitter or Facebook.

Also, don’t forget to subscribe below. Next week we will be announcing our Top Ten Dental Facebook Pages of 2012!

To the health of your practice and its patients,
The CadenceMed Team

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

After reviewing countless Facebook pages, we have identified our Top Ten Chiropractic Facebook Pages for 2012. These Facebook pages have unique strengths that deserve special recognition, so instead of ranking them #1 through #10, we decided it would be best to simply pinpoint what they do best.

So without further adieu, here are the chiropractic Facebook pages that we “Like” the most and why. Learn, share and enjoy!

Best Status Updates
BodyWise Chiropractic

What we like
Unlike most businesses on Facebook, these guys are rarely pushing their products and services. Instead, they are posting content that is thought-provoking, funny, educational and graphical. The end result? A large and engaged community of fans.

Most Likes
Goodlettsville Chiropractic Clinic

What we like
Isn’t it obvious? We like their “Likes.” Although the number of Likes a page has can be a vanity metric (what really matters when it comes to investing time and money on social media is if you are able to generate business, improve patient outcomes or increase patient satisfaction), it can be a decent indicator that the business is doing something correct. With over 23,000 Likes and status updates that fans are positively responding to, these guys appear to be doing more than just racking up a high Like number.

Best Design
Live Well Chiropractic and Lifestyle

What we like
This Louisville chiropractor just opened up shop earlier in the year, but he is making a splash with his practice’s attractive website and growing Facebook page. The combination of their aesthetically-pleasing profile picture and personal Timeline Banner image evokes a professional and emotional first impression.

Best YouTube Integration
Executive Express Chiropractic

What we like
Facebook Timeline Tabs often go underutilized, but not in this case. The team at Executive Express Chiropractic are integrating YouTube with their Facebook page in a wonderful way: by presenting patient testimonials. Third-party social proof is one of the most effective ways for an individual or business to validate the quality of its products and services. Video testimonials are among the most potent forms of social proof because they are more personal than written or audio testimonials; nice work!

Best E-Commerce Integration
Dr. Kevin Lau

What we like
Dr. Kevin Lau is the author of a number of books on scoliosis. He gives his Facebook visitors the opportunity to buy products right from his Facebook page. All his visitors need to do is visit his “Online Store” tab, which is powered by Amazon.

Best Engagement
Belleville Chiropractic practice: LiveWell Wellness Centers

What we like
Probably the best sign of a healthy Facebook business presence is a highly engaged fan-base. Few chiropractic practices do a better job at posting content that gets their contacts “Liking,” commenting and sharing as well as LiveWell Wellness Centers do on their Facebook page. As of posting this article, 1,178 people were talking about LiveWell Wellness Centers – now that is what we call a thriving community of fans!

Best Use of Facebook Tabs
Maui Spa & Wellness Center

What we like
We like how these folks are using their Facebook tabs to share more information about their spa, services and upcoming events. It makes a strong first impression and answers most of the key questions a prospective patient might have.

Best Patient Education
Portland Chiropractic Neurology

What we like
Pay special attention to their page’s “Patient Resources” tab. It is chocked full of rich information about health disorders that their prospective or existing patients would likely find interesting and valuable. The layout of the information – with a header, a short passage of content and then a “Learn More” button is brilliant. This provides a Facebook visitor with just enough information to become interested before referring them where most practices really want their traffic to go: their websites.

So that’s it: our ten favorite chiropractic Facebook pages? Do you agree? Disagree? Share with us on Twitter or Facebook.

Also, don’t forget to subscribe below. Next week we will be announcing our Top Ten Dental Facebook Pages of 2012!

To the health of your practice and its patients,
The CadenceMed Team

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

Read More

Several hundred, including Sens. McConnell and Paul, attend tea-party rally to express displeasure about health reform law

By Tara Kaprowy
Kentucky Health News

Hundreds of tea-party activists showed up at a midday rally at the state Capitol to protest the Patient Protection and Affordable Care Act and Kentucky's involvement in its implementation. Both are issues in the Nov. 6 elections. (Photo by Pablo Alcala, Lexington Herald-Leader)

In a rare appearance at a tea-party event, U.S. Senate Republican Leader Mitch McConnell encouraging those in the crowd "to make Barack Obama a one-term president."

Sen. Rand Paul, who was elected in large measure on his tea-party identity, repeated his riposte to the 5-4 court decision upholding the law: "Just because a couple of people on the Supreme Court declares something to be 'constitutional' does not make it so," he said. "I still think the whole damn thing is unconstitutional."

Scott Wartman of The Cincinnati Enquirer estimated that 300 to  500 people attended the event, which was organized by the Louisville Tea Party. Some who attended came in support of the health care law and carried placards expressing their sentiments. "The rally also drew dozens of counter-protesters who favor Obama and the health care act," Jack Brammer reported for the Lexington Herald-Leader.

One reason for the rally was to influence legislators to fight the implementation of the state health insurance exchange that Democratic Gov. Steve Beshear has created under the law. Before the rally, the Bluegrass Institute for Public Policy Solutions encouraged participants to ask their legislators what will happen to cost of the state-run health exchange if a huge number of Kentucky players decide not to offer health insurance to their employees.

The Bowling Green-based group also questioned the cost of expanding the Medicaid program to 138 percent the federal poverty level, which is up to individual states under the Supreme Court decision.

McConnell called the law the worst piece in modern times and the "single biggest step in the direction of Europeanizing America, because if the government ever gets its clutches on all the health care of all 306 million Americans, which it will have if Obamacare stands, the government controls the most important concern all of us in the end have — our own health and the health of our family handed over to a centralized government."

McConnell said repealing the law would be top on the agenda if Republicans win a majority of the U.S. Senate in November. But as he alluded earlier, Obama would need to be defeated to prevent a presidential veto of repeal legislation.

Debra Harper of Louisville told the Herald-Leader she suffered a mild stroke last February due to a congenital heart problem, and welcomes the law. “Our president finally gave this nation a blueprint for health care,” she said. “It’s like a blueprint for a house. There may be some changes you want in it, but it’s a sound structure, and people who want to discard all of it are being cruel.”

Kentucky Health News is a service of the University of Kentucky's Institute for Rural Journalism and Community Issues, with support from the Foundation for a Healthy Kentucky.

By Tara Kaprowy
Kentucky Health News

Hundreds of tea-party activists showed up at a midday rally at the state Capitol to protest the Patient Protection and Affordable Care Act and Kentucky's involvement in its implementation. Both are issues in the Nov. 6 elections. (Photo by Pablo Alcala, Lexington Herald-Leader)

In a rare appearance at a tea-party event, U.S. Senate Republican Leader Mitch McConnell encouraging those in the crowd "to make Barack Obama a one-term president."

Sen. Rand Paul, who was elected in large measure on his tea-party identity, repeated his riposte to the 5-4 court decision upholding the law: "Just because a couple of people on the Supreme Court declares something to be 'constitutional' does not make it so," he said. "I still think the whole damn thing is unconstitutional."

Scott Wartman of The Cincinnati Enquirer estimated that 300 to  500 people attended the event, which was organized by the Louisville Tea Party. Some who attended came in support of the health care law and carried placards expressing their sentiments. "The rally also drew dozens of counter-protesters who favor Obama and the health care act," Jack Brammer reported for the Lexington Herald-Leader.

One reason for the rally was to influence legislators to fight the implementation of the state health insurance exchange that Democratic Gov. Steve Beshear has created under the law. Before the rally, the Bluegrass Institute for Public Policy Solutions encouraged participants to ask their legislators what will happen to cost of the state-run health exchange if a huge number of Kentucky players decide not to offer health insurance to their employees.

The Bowling Green-based group also questioned the cost of expanding the Medicaid program to 138 percent the federal poverty level, which is up to individual states under the Supreme Court decision.

McConnell called the law the worst piece in modern times and the "single biggest step in the direction of Europeanizing America, because if the government ever gets its clutches on all the health care of all 306 million Americans, which it will have if Obamacare stands, the government controls the most important concern all of us in the end have — our own health and the health of our family handed over to a centralized government."

McConnell said repealing the law would be top on the agenda if Republicans win a majority of the U.S. Senate in November. But as he alluded earlier, Obama would need to be defeated to prevent a presidential veto of repeal legislation.

Debra Harper of Louisville told the Herald-Leader she suffered a mild stroke last February due to a congenital heart problem, and welcomes the law. “Our president finally gave this nation a blueprint for health care,” she said. “It’s like a blueprint for a house. There may be some changes you want in it, but it’s a sound structure, and people who want to discard all of it are being cruel.”

Kentucky Health News is a service of the University of Kentucky's Institute for Rural Journalism and Community Issues, with support from the Foundation for a Healthy Kentucky.

Read More

Most Medicaid recipients can switch their managed care company from now through Oct. 19

Medicaid recipients in 104 counties who want to change who provides their managed care will have an opportunity to do so during open enrollment now through Oct. 19.

Letters are being sent out by the Kentucky Department of Medicaid Services to inform recipients about the open enrollment option. These recipients can choose from three companies: Coventry Cares, Kentucky Spirit Health Plan and WellCare of Kentucky. There is no cost to switch coverage. Those who want to keep their current coverage do not need to take action.

Recipients who want more information about their coverage options and provider networks can reach their managed care organization by phone. The numbers are:

• Coventry Cares: 855-300-5528

• Kentucky Spirit Health Plan: 866-643-3153

• WellCare of Kentucky: 877-389-9457

The open enrollment does not apply to people who live in the region of the state covered by Passport Health Plan, which includes Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington counties.

All changes will take effect Nov. 1. Once enrolled, the member will have 90 days to change to a different MCO, but after that period will have to wait until the next open enrollment period. (Read more)

Medicaid recipients in 104 counties who want to change who provides their managed care will have an opportunity to do so during open enrollment now through Oct. 19.

Letters are being sent out by the Kentucky Department of Medicaid Services to inform recipients about the open enrollment option. These recipients can choose from three companies: Coventry Cares, Kentucky Spirit Health Plan and WellCare of Kentucky. There is no cost to switch coverage. Those who want to keep their current coverage do not need to take action.

Recipients who want more information about their coverage options and provider networks can reach their managed care organization by phone. The numbers are:

• Coventry Cares: 855-300-5528

• Kentucky Spirit Health Plan: 866-643-3153

• WellCare of Kentucky: 877-389-9457

The open enrollment does not apply to people who live in the region of the state covered by Passport Health Plan, which includes Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington counties.

All changes will take effect Nov. 1. Once enrolled, the member will have 90 days to change to a different MCO, but after that period will have to wait until the next open enrollment period. (Read more)

Read More

Exercises for scoliosis in teens

Adolescent idiopathic scoliosis (AIS) is a rare (2% to 3% of the general population) spinal deformity affecting young people aged 10 through the end of the growth period. The deformity may continue into adulthood. AIS is characterised by one or more three-dimensional spinal curves. Disability, cosmetic deformity, pain, activity limitation, quality of life issues, breathing problems and the possibility of the scoliosis remaining with the person into and throughout adulthood are commonly associated with this condition. The cause of AIS is unknown.

Treatment for AIS varies according to the degree of severity of the curves. Just the same, exercise is almost always a part of the treatment plan. In milder cases, exercise may be the main treatment, and in more severe cases it may serve as an adjunct. In the UK and the US, physical therapy for scoliosis consists mainly of general strengthening and stretching exercises, along with exercise protocols with which the treating therapist is familiar. There is a corresponding feeling among practitioners in these geographical locations that physical therapy for scoliosis is not effective.

Scoliosis specific exercises (SSEs) are individualised exercises aimed at reducing the deformity. SSEs are taught in clinics that specialize in scoliosis. The exercises work by changing the soft tissue that affects the spine. SSEs are also thought to work by altering control of spinal movement. There are no known side effects or risks to using SSEs .

The purpose of this review was to evaluate the effectiveness of SSEs in reducing curve progression and postponing or avoiding invasive treatment such as surgery in adolescents with AIS. Two studies involving 154 patients total were included. The review found no evidences for or against SSE. The two included studies yielded very low quality evidence that SSEs added to other treatments are more effective than electrical stimulation, traction and posture training for avoiding curve progression, and that SSEs as a standalone treatment yield almost the same results as general physiotherapy.

Possible limitations of this review included the small number of studies that met the inclusion criteria and a high risk of bias, particularly selection bias. More randomised controlled trials are needed in this area, along with a deeper understanding of the types of SSEs useful for the adolescent with AIS.

Comment from Dr. Kevin Lau: I have seen time and time again that therapies that merely focus on the physical deformity and imbalance to be ineffective... Treating scoliosis at its source involves diet and lifestyle changes which can affect how genes are expressed. For more info read my book.

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

Adolescent idiopathic scoliosis (AIS) is a rare (2% to 3% of the general population) spinal deformity affecting young people aged 10 through the end of the growth period. The deformity may continue into adulthood. AIS is characterised by one or more three-dimensional spinal curves. Disability, cosmetic deformity, pain, activity limitation, quality of life issues, breathing problems and the possibility of the scoliosis remaining with the person into and throughout adulthood are commonly associated with this condition. The cause of AIS is unknown.

Treatment for AIS varies according to the degree of severity of the curves. Just the same, exercise is almost always a part of the treatment plan. In milder cases, exercise may be the main treatment, and in more severe cases it may serve as an adjunct. In the UK and the US, physical therapy for scoliosis consists mainly of general strengthening and stretching exercises, along with exercise protocols with which the treating therapist is familiar. There is a corresponding feeling among practitioners in these geographical locations that physical therapy for scoliosis is not effective.

Scoliosis specific exercises (SSEs) are individualised exercises aimed at reducing the deformity. SSEs are taught in clinics that specialize in scoliosis. The exercises work by changing the soft tissue that affects the spine. SSEs are also thought to work by altering control of spinal movement. There are no known side effects or risks to using SSEs .

The purpose of this review was to evaluate the effectiveness of SSEs in reducing curve progression and postponing or avoiding invasive treatment such as surgery in adolescents with AIS. Two studies involving 154 patients total were included. The review found no evidences for or against SSE. The two included studies yielded very low quality evidence that SSEs added to other treatments are more effective than electrical stimulation, traction and posture training for avoiding curve progression, and that SSEs as a standalone treatment yield almost the same results as general physiotherapy.

Possible limitations of this review included the small number of studies that met the inclusion criteria and a high risk of bias, particularly selection bias. More randomised controlled trials are needed in this area, along with a deeper understanding of the types of SSEs useful for the adolescent with AIS.

Comment from Dr. Kevin Lau: I have seen time and time again that therapies that merely focus on the physical deformity and imbalance to be ineffective... Treating scoliosis at its source involves diet and lifestyle changes which can affect how genes are expressed. For more info read my book.

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.hiyh.info.

Read More

Some doctors find law to fight pill mills confusing and overreaching, and some say they will stop writing prescriptions

Dr. Kathy Nieder, with patient charts
(C-J photo by Michael Clevenger)

Dr. Ralph Alvarado’s medical practice in Winchester has prescribed controlled substances to 1,800 patients in Central Kentucky over the past three years. But he and other doctors in the practice decided to put down their pens four weeks ago. That’s because, Mike Wynn of The Courier-Journal reports, "The standards imposed under a new Kentucky law designed to crack down on prescription drug abuse are so strict and complex that he would go bankrupt in a month -- or worse -- if he were to continue prescribing controlled substances."

Alvarado, who has made two unsuccessful campaigns for the state Senate, told Wynn, "I’m not going to be threatened with jail time or criminal charges and lose my career." He said he would refer patients to specialists to get pain-pill prescriptions.

Proponents argue that the new prescribing standards in House Bill 1, passed by the 2012 General Assembly "in hopes of combating an epidemic of drug abuse that kills nearly 1,000 Kentuckians each year were intended only to root out pill mills and crooked doctors and should not hamper legitimate physicians or prevent patients from receiving needed drugs," Wynn writes. However, "Some doctors contend the legislation is excessive, confusing and time-consuming, and across Kentucky, many have been seeking advice from attorneys about following the law, and warning patients about potential cutbacks to common drugs for pain, anxiety and other conditions. Some doctors are even talking about leaving the state. . . . Others say they have sent patients home in tears or in pain because they lack the time and resources to comply with the law."

"Patients who have never been a problem are bound up in all of this," Greg Hood, Kentucky chapter governor of the American College of Physicians, told Wynn. "There are so many unintended consequences." Hood's group and the Kentucky Medical Association are trying to determine how many clinics are declining to write prescriptions, but neither is advocating that approach. According to state offices of the Drug Enforcement Administration, only three in-state doctors have voluntarily surrendered their DEA registration — required for prescribing controlled substances — in recent weeks for reasons related to the new law. Still, the Greater Louisville Medical Society held a meeting with about 200 members recently in which attorneys tried to explain the law’s details. Doctors cited nearly two dozen areas of concern stemming from what they call vague and ambiguous legal language, the group reported. (Read more)

Dr. Kathy Nieder, with patient charts
(C-J photo by Michael Clevenger)

Dr. Ralph Alvarado’s medical practice in Winchester has prescribed controlled substances to 1,800 patients in Central Kentucky over the past three years. But he and other doctors in the practice decided to put down their pens four weeks ago. That’s because, Mike Wynn of The Courier-Journal reports, "The standards imposed under a new Kentucky law designed to crack down on prescription drug abuse are so strict and complex that he would go bankrupt in a month -- or worse -- if he were to continue prescribing controlled substances."

Alvarado, who has made two unsuccessful campaigns for the state Senate, told Wynn, "I’m not going to be threatened with jail time or criminal charges and lose my career." He said he would refer patients to specialists to get pain-pill prescriptions.

Proponents argue that the new prescribing standards in House Bill 1, passed by the 2012 General Assembly "in hopes of combating an epidemic of drug abuse that kills nearly 1,000 Kentuckians each year were intended only to root out pill mills and crooked doctors and should not hamper legitimate physicians or prevent patients from receiving needed drugs," Wynn writes. However, "Some doctors contend the legislation is excessive, confusing and time-consuming, and across Kentucky, many have been seeking advice from attorneys about following the law, and warning patients about potential cutbacks to common drugs for pain, anxiety and other conditions. Some doctors are even talking about leaving the state. . . . Others say they have sent patients home in tears or in pain because they lack the time and resources to comply with the law."

"Patients who have never been a problem are bound up in all of this," Greg Hood, Kentucky chapter governor of the American College of Physicians, told Wynn. "There are so many unintended consequences." Hood's group and the Kentucky Medical Association are trying to determine how many clinics are declining to write prescriptions, but neither is advocating that approach. According to state offices of the Drug Enforcement Administration, only three in-state doctors have voluntarily surrendered their DEA registration — required for prescribing controlled substances — in recent weeks for reasons related to the new law. Still, the Greater Louisville Medical Society held a meeting with about 200 members recently in which attorneys tried to explain the law’s details. Doctors cited nearly two dozen areas of concern stemming from what they call vague and ambiguous legal language, the group reported. (Read more)

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Blood glucose monitoring in cats

Hoenig M, Pach N, Thomaseth K, DeVries F and Ferguson DC. Evaluation of long-term glucose homeostasis in lean and obese cats by use of continuous glucose monitoring. Am J Vet Res. 2012; 73: 1100-6.
Diabetes mellitus is of increasing concern in both humans and cats. Obese cats are found to be at higher risk of developing diabetes mellitus. Information has not been available on whether glucose concentrations in obese cats differ from those in lean cats throughout the course the course of a day during their regular activities, including consuming food. 

This study evaluated intra-day and inter-day variations in glucose concentrations in lean and long-term (>5 years) obese cats during a 156-hour period and tested the utility of a continuous glucose monitoring system (CGMS). A CGMS is used frequently in humans with diabetes. The investigators did not detect differences in glucose concentrations between lean and obese cats during the study periods. They also did not detect differences in daily variations in glucose concentrations between lean and obese cats. The results indicate that the CGMS can be useful in evaluating the long term effects of drugs or diet on glucose homeostasis in cats. [VT]

See also: Dietiker-Moretti S, Müller C, Sieber-Ruckstuhl N, et al. Comparison of a continuous glucose monitoring system with a portable blood glucose meter to determine insulin dose in cats with diabetes mellitus. J Vet Intern Med. 2011; 25: 1084-8.

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Hoenig M, Pach N, Thomaseth K, DeVries F and Ferguson DC. Evaluation of long-term glucose homeostasis in lean and obese cats by use of continuous glucose monitoring. Am J Vet Res. 2012; 73: 1100-6.
Diabetes mellitus is of increasing concern in both humans and cats. Obese cats are found to be at higher risk of developing diabetes mellitus. Information has not been available on whether glucose concentrations in obese cats differ from those in lean cats throughout the course the course of a day during their regular activities, including consuming food. 

This study evaluated intra-day and inter-day variations in glucose concentrations in lean and long-term (>5 years) obese cats during a 156-hour period and tested the utility of a continuous glucose monitoring system (CGMS). A CGMS is used frequently in humans with diabetes. The investigators did not detect differences in glucose concentrations between lean and obese cats during the study periods. They also did not detect differences in daily variations in glucose concentrations between lean and obese cats. The results indicate that the CGMS can be useful in evaluating the long term effects of drugs or diet on glucose homeostasis in cats. [VT]

See also: Dietiker-Moretti S, Müller C, Sieber-Ruckstuhl N, et al. Comparison of a continuous glucose monitoring system with a portable blood glucose meter to determine insulin dose in cats with diabetes mellitus. J Vet Intern Med. 2011; 25: 1084-8.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

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New tool allows analysis of nursing-home deficiencies across the country; Kentucky seems to rank high in serious problems

Reporters now have a tool at their fingertips that will allow them to find nursing home problems in facilities across Kentucky, which appears to ranks high in serious problems.(iStock photo)

The tool was launched this week by ProPublica, a nonprofit, investigative news group, and allows "anyone to easily search and analyze the details of recent nursing home inspections, most completed since January 2011," report Charles Ornstein and Lena Groeger.

The tool has features that the federal government's Nursing Home Compare doesn't have, including the ability to search using any keyword. Results can also be sorted according to the severity of the violation and by state.

About 1.5 million people still live in nursing homes nationwide, though more seniors are living at home or in assisted-living facilities. The reports show there were almost 118,000 deficiencies cited against 14,565 homes. According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven.

ProPublica's analysis shows Kentucky ranked fourth nationwide for the most "K" and "L" deficiencies, considered the most serious kind. The state had 45 in the analysis, as did South Carolina. Texas had the most in the country by far, however, with 183. 

While ProPublica does rank the states, nursing home industry officials say "inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state's homes appear worse than another's," Ornstein and Groeger report. (Read more)

Reporters now have a tool at their fingertips that will allow them to find nursing home problems in facilities across Kentucky, which appears to ranks high in serious problems.(iStock photo)

The tool was launched this week by ProPublica, a nonprofit, investigative news group, and allows "anyone to easily search and analyze the details of recent nursing home inspections, most completed since January 2011," report Charles Ornstein and Lena Groeger.

The tool has features that the federal government's Nursing Home Compare doesn't have, including the ability to search using any keyword. Results can also be sorted according to the severity of the violation and by state.

About 1.5 million people still live in nursing homes nationwide, though more seniors are living at home or in assisted-living facilities. The reports show there were almost 118,000 deficiencies cited against 14,565 homes. According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven.

ProPublica's analysis shows Kentucky ranked fourth nationwide for the most "K" and "L" deficiencies, considered the most serious kind. The state had 45 in the analysis, as did South Carolina. Texas had the most in the country by far, however, with 183. 

While ProPublica does rank the states, nursing home industry officials say "inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state's homes appear worse than another's," Ornstein and Groeger report. (Read more)

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