Kentucky's well-being ranks next to last, just above West Virginia

Kentucky ranks next to last in the annual Gallup-Healthways Well-Being index, just ahead of West Virginia. The Bluegrass State ranked last in the index's Healthy Behaviors category, which measures the percentage of residents who smoke, exercise frequently and eat healthy daily.

The chart on the left shows Kentucky's score in each of the six categories. The state's rankings haven't changed much since last year, with the exception of the Work Environment index, which fell from 8th to 31st.  The colored chart on the right shows the state's overall and category rankings for 2011 and 2012 (1 is the highest rank and 50 is the lowest). Click here for the detailed report on Kentucky.


Left: Kentucky Well-Being Indexes     Right: Well-Being rankings of Kentucky among the states

West Virginia, with an index score of 61.3, had the lowest well-being for the fourth year in a row. The report shows West Virginians were the least likely to be thriving and also had the nation's worst emotional health. They had the lowest score in the Physical Health category, which reflects having the highest percentage of obese residents in the nation.

There were few changes from 2011 to 2012 among states with the highest and lowest well-being scores. Hawaii residents had the highest well-being for the fourth straight year, followed by Colorado, Minnesota, Utah, and Vermont.

The report shows a consistent regional pattern in well-being over the past five years. Western and Midwestern states earned seven of the 10 highest overall scores, while New England states held the other three spots. Southern states had the six lowest scores, and Southern states had eight of the 10 lowest well-being scores.

Kentucky ranks next to last in the annual Gallup-Healthways Well-Being index, just ahead of West Virginia. The Bluegrass State ranked last in the index's Healthy Behaviors category, which measures the percentage of residents who smoke, exercise frequently and eat healthy daily.

The chart on the left shows Kentucky's score in each of the six categories. The state's rankings haven't changed much since last year, with the exception of the Work Environment index, which fell from 8th to 31st.  The colored chart on the right shows the state's overall and category rankings for 2011 and 2012 (1 is the highest rank and 50 is the lowest). Click here for the detailed report on Kentucky.


Left: Kentucky Well-Being Indexes     Right: Well-Being rankings of Kentucky among the states

West Virginia, with an index score of 61.3, had the lowest well-being for the fourth year in a row. The report shows West Virginians were the least likely to be thriving and also had the nation's worst emotional health. They had the lowest score in the Physical Health category, which reflects having the highest percentage of obese residents in the nation.

There were few changes from 2011 to 2012 among states with the highest and lowest well-being scores. Hawaii residents had the highest well-being for the fourth straight year, followed by Colorado, Minnesota, Utah, and Vermont.

The report shows a consistent regional pattern in well-being over the past five years. Western and Midwestern states earned seven of the 10 highest overall scores, while New England states held the other three spots. Southern states had the six lowest scores, and Southern states had eight of the 10 lowest well-being scores.

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Health departments in N. Ky. and Franklin County are among the first 11 in the nation to be accredited, a milestone in public health

Three Kentucky departments are among the first 11 in the nation to receive accreditation from the national Public Health Accreditation Board, which announced the achievements Thursday.

The Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties received five-year accreditation.

"I am proud of the departments achieving this public health milestone of national accreditation," said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health. "Before now, there has not been a national system for health departments to demonstrate accountability and quality to their community."

Scutchfield said accreditation means a department is providing a "high quality of public health service, leadership and accountability to its constituents," and is a clear indication of the departments' "passion and dedication to improving and protecting the health" of the community.

The board, funded by the federal Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, has received 128 total applications for accreditation: 112 from local health departments, 15 from state departments; and one tribal department.

In addition to the three Kentucky departments that have received accreditation, other Kentucky departments have applied and are awaiting site visits. Those are the Lexington-Fayette County, Barren River District, Madison County and Christian County health departments, said Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services.

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year. (Click here to learn more about accreditation)

Three Kentucky departments are among the first 11 in the nation to receive accreditation from the national Public Health Accreditation Board, which announced the achievements Thursday.

The Franklin County Health Department, the Three Rivers District Health Department in Carroll, Gallatin, Owen and Pendleton counties, and the Northern Kentucky Independent District Health Department, in Boone, Grant, Kenton and Campbell counties received five-year accreditation.

"I am proud of the departments achieving this public health milestone of national accreditation," said board Chair Dr. Douglas Scutchfield, professor of health services research and policy at the University of Kentucky College of Public Health. "Before now, there has not been a national system for health departments to demonstrate accountability and quality to their community."

Scutchfield said accreditation means a department is providing a "high quality of public health service, leadership and accountability to its constituents," and is a clear indication of the departments' "passion and dedication to improving and protecting the health" of the community.

The board, funded by the federal Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, has received 128 total applications for accreditation: 112 from local health departments, 15 from state departments; and one tribal department.

In addition to the three Kentucky departments that have received accreditation, other Kentucky departments have applied and are awaiting site visits. Those are the Lexington-Fayette County, Barren River District, Madison County and Christian County health departments, said Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services.

Although accreditation is completely voluntary, it is being encouraged for local health departments by the state Department for Public Health, which is in the process of applying for its own accreditation in 2014. Midkiff said the department just completed its state health assessment, which is now being reviewed, and is beginning to assemble partners to write a state health improvement plan, which should take about a year. (Click here to learn more about accreditation)

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House sends Senate pill-mill and Medicaid managed-care fixes

The state House yesterday approved without dissent two bills aimed at improving Kentucky's health care.

House Bill 217 addresses some "unintended consequences" of last year's "pill mill bill" by easing some of the bills regualtions. The bill also tightens restricitions on prescription drugs, reports Ryan Alessi of cn|2.

The other measure, House Bill 5, deals with payment problems of the Medicaid managed care system. Itl would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints and disputes to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Both bills are expected to see action in the Senate.

The state House yesterday approved without dissent two bills aimed at improving Kentucky's health care.

House Bill 217 addresses some "unintended consequences" of last year's "pill mill bill" by easing some of the bills regualtions. The bill also tightens restricitions on prescription drugs, reports Ryan Alessi of cn|2.

The other measure, House Bill 5, deals with payment problems of the Medicaid managed care system. Itl would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints and disputes to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Both bills are expected to see action in the Senate.

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Lack of statewide smoking ban represents one part of Kentucky's struggle to deal with tobacco use and the health issues it creates

By Molly Burchett

Kentucky Health News

As the bill for a statewide smoking ban lies on its deathbed in the General Assembly, new federal data show Kentucky still has the highest percentage of smokers (29 percent) of any state, leads the nation in the share of smoking high school students (24 percent) and spends only a minuscule portion of their tobacco revenues to fight tobacco use. Those figures come from the federal Centers for Disease Control and Prevention's Tobacco Control State Highlights 2012 report. (For county-by-county figures, click here.)

The lack of a statewide smoking ban, which nevertheless has become popular among Kentuckians, represents only a small part of the struggle to address Kentuckians' tobacco use and resulting health problems. Kentucky's program to discourage tobacco use has been severely underfunded for years, contributing to the state's lack of or slow progress in reducing its smoking and tobacco use rates and subsequent health problems, said Dr. Ellen Hahn, director of the Kentucky Center for Smoke-Free Policy at the University of Kentucky.

State tobacco revenue (left bar) and spending (right bar)

The CDC says Kentucky should spend $57.2 million a year to have an effective, comprehensive tobacco-prevention program, but the state allocates only $2.1 million a year to such programs -- 3.7 percent of the recommended amount.

By another measure, the amount is only 0.6 percent of the estimated $381 million the state gets from tobacco taxes and the 1998 national settlement with cigarette manufacturers, according to a tobacco settlement report.



Meanwhile, Kentucky's health-care costs attributable to smoking add up to about $1.5 billion a year, and smoking-caused productivity losses total $2.3 billion a year. These amounts do not include health costs caused by exposure to secondhand smoke, smoking-caused fires, smokeless tobacco use or cigar and pipe smoking.

Despite the known health risks that tobacco use poses, smoking in Kentucky remains a part of everyday life in most places. But that is increasingly less so around the country, so there is an increasing gap between heavy-smoking and low-smoking states; smoking in Kentucky is about twice as prevalent as in Utah and California, reports Steven Reinberg of HealthDay. Click here for an interactive map of states' tobacco prevention efforts.

There are proven, multi-pronged strategies to curb smoking. They include combinations of higher tobacco taxes, smoke-free laws, media campaigns, and restricted access to tobacco products. However, Kentucky continues to lag behind other states due to "stagnant policies" and a lack of funding, said Hahn.

Many other factors contribute to Kentucky's lack of tobacco-prevention progress. By failing to substantially reduce adult smoking, the state misses opportunities to encourage younger adults and children not to smoke, Hahn said. Kentucky needs to employ strategies that communicate the success and affordability of tobacco cessation programs, she said; people often lack the encouragement to quit smoking because they don't know how or they don't believe it is possible.

The latest tobacco report is a timely reminder that tobacco use remains a huge public health problem for Kentucky and there are proven strategies that, if implemented, could help Kentuckians live a healthier, tobacco-free life.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

By Molly Burchett

Kentucky Health News

As the bill for a statewide smoking ban lies on its deathbed in the General Assembly, new federal data show Kentucky still has the highest percentage of smokers (29 percent) of any state, leads the nation in the share of smoking high school students (24 percent) and spends only a minuscule portion of their tobacco revenues to fight tobacco use. Those figures come from the federal Centers for Disease Control and Prevention's Tobacco Control State Highlights 2012 report. (For county-by-county figures, click here.)

The lack of a statewide smoking ban, which nevertheless has become popular among Kentuckians, represents only a small part of the struggle to address Kentuckians' tobacco use and resulting health problems. Kentucky's program to discourage tobacco use has been severely underfunded for years, contributing to the state's lack of or slow progress in reducing its smoking and tobacco use rates and subsequent health problems, said Dr. Ellen Hahn, director of the Kentucky Center for Smoke-Free Policy at the University of Kentucky.

State tobacco revenue (left bar) and spending (right bar)

The CDC says Kentucky should spend $57.2 million a year to have an effective, comprehensive tobacco-prevention program, but the state allocates only $2.1 million a year to such programs -- 3.7 percent of the recommended amount.

By another measure, the amount is only 0.6 percent of the estimated $381 million the state gets from tobacco taxes and the 1998 national settlement with cigarette manufacturers, according to a tobacco settlement report.



Meanwhile, Kentucky's health-care costs attributable to smoking add up to about $1.5 billion a year, and smoking-caused productivity losses total $2.3 billion a year. These amounts do not include health costs caused by exposure to secondhand smoke, smoking-caused fires, smokeless tobacco use or cigar and pipe smoking.

Despite the known health risks that tobacco use poses, smoking in Kentucky remains a part of everyday life in most places. But that is increasingly less so around the country, so there is an increasing gap between heavy-smoking and low-smoking states; smoking in Kentucky is about twice as prevalent as in Utah and California, reports Steven Reinberg of HealthDay. Click here for an interactive map of states' tobacco prevention efforts.

There are proven, multi-pronged strategies to curb smoking. They include combinations of higher tobacco taxes, smoke-free laws, media campaigns, and restricted access to tobacco products. However, Kentucky continues to lag behind other states due to "stagnant policies" and a lack of funding, said Hahn.

Many other factors contribute to Kentucky's lack of tobacco-prevention progress. By failing to substantially reduce adult smoking, the state misses opportunities to encourage younger adults and children not to smoke, Hahn said. Kentucky needs to employ strategies that communicate the success and affordability of tobacco cessation programs, she said; people often lack the encouragement to quit smoking because they don't know how or they don't believe it is possible.

The latest tobacco report is a timely reminder that tobacco use remains a huge public health problem for Kentucky and there are proven strategies that, if implemented, could help Kentuckians live a healthier, tobacco-free life.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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'Incredible Colon' to march across the state in Colon Cancer Awareness Month; more than a dozen stops scheduled

A special tour throughout the state of the Incredible Colon — an inflatable model of a human colon, large enough for visitors to walk through it — will promote education about risks and preventive measures of colon cancer during March, National Colon Cancer Awareness Month.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly, according to the federal Centers for Disease Control and Prevention. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon, and when detected early, polyps can be easily removed during a colonoscopy before they develop into cancer. When colon cancer is found early and treated, the five-year relative survival rate is 90 percent, underscoring the need for preventive health exams.

However, only 63 percent of Kentuckians who should have screening tests have had them, according to Kentucky data from the federal Behavioral Risk Factor Surveillance System, an ongoing national survey.

The colon tour is a coordinated promotion by the Kentucky Cancer Program, local cancer councils and the Kentucky Colon Cancer Prevention Project. It is free and open to the public and will take place in 13 Kentucky communities March 4-28:

• March 4: Fleming County Hospital, Flemingsburg (10:30 a.m. - 2:30 p.m.)
• March 5: Walmart, Manchester (Noon - 4 p.m.)
• March 6: Hazard ARH Medical Mall, Hazard (10 a.m. - 3 p.m.)
• March 7: Rowan County Chamber of Commerce, Morehead (members
  only, 9:30 a.m. - 3 p.m.)
• March 8: Frankfort Regional Hospital, Frankfort (9 a.m. - 4 p.m.)
• March 19: Lexmark, Lexington, (Employees only, 8:30 a.m. - 2 p.m.)
• March 20: Lawrence County High School, Louisa (8 a.m. - 5 p.m.)
• March 21: Lady of Bellefonte Health Center, Grayson (10 a.m. - 2 p.m.)
• March 23: Phillip Sharp Middle School, Butler (8-11 a.m. )
• March 25: Town Center Mall, Ashland (10 a.m. - 3 p.m.)
• March 26: Walmart, Georgetown (3-6 p.m.)
• March 27: Adron Doran University Center, Morehead (9:30 a.m. - 3 p.m.)
• March 28: Walmart, Somerset (10 a.m. - 2 p.m.)

Attendees are invited to dress in blue, the color of colon cancer awareness, and there will be door prizes, giveaways (while supplies last), refreshments and educational information about colon cancer screening, prevention and early detection. (Read more)

A special tour throughout the state of the Incredible Colon — an inflatable model of a human colon, large enough for visitors to walk through it — will promote education about risks and preventive measures of colon cancer during March, National Colon Cancer Awareness Month.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly, according to the federal Centers for Disease Control and Prevention. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon, and when detected early, polyps can be easily removed during a colonoscopy before they develop into cancer. When colon cancer is found early and treated, the five-year relative survival rate is 90 percent, underscoring the need for preventive health exams.

However, only 63 percent of Kentuckians who should have screening tests have had them, according to Kentucky data from the federal Behavioral Risk Factor Surveillance System, an ongoing national survey.

The colon tour is a coordinated promotion by the Kentucky Cancer Program, local cancer councils and the Kentucky Colon Cancer Prevention Project. It is free and open to the public and will take place in 13 Kentucky communities March 4-28:

• March 4: Fleming County Hospital, Flemingsburg (10:30 a.m. - 2:30 p.m.)
• March 5: Walmart, Manchester (Noon - 4 p.m.)
• March 6: Hazard ARH Medical Mall, Hazard (10 a.m. - 3 p.m.)
• March 7: Rowan County Chamber of Commerce, Morehead (members
  only, 9:30 a.m. - 3 p.m.)
• March 8: Frankfort Regional Hospital, Frankfort (9 a.m. - 4 p.m.)
• March 19: Lexmark, Lexington, (Employees only, 8:30 a.m. - 2 p.m.)
• March 20: Lawrence County High School, Louisa (8 a.m. - 5 p.m.)
• March 21: Lady of Bellefonte Health Center, Grayson (10 a.m. - 2 p.m.)
• March 23: Phillip Sharp Middle School, Butler (8-11 a.m. )
• March 25: Town Center Mall, Ashland (10 a.m. - 3 p.m.)
• March 26: Walmart, Georgetown (3-6 p.m.)
• March 27: Adron Doran University Center, Morehead (9:30 a.m. - 3 p.m.)
• March 28: Walmart, Somerset (10 a.m. - 2 p.m.)

Attendees are invited to dress in blue, the color of colon cancer awareness, and there will be door prizes, giveaways (while supplies last), refreshments and educational information about colon cancer screening, prevention and early detection. (Read more)

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How the leopard hides its spots

Schneider A, David VA, Johnson WE, et al. How the leopard hides its spots: ASIP mutations and melanism in wild cats. PLoS ONE. 2012; 7: e50386. (free, full text article) 

Melanism (dark-colored pigmentation in the skin or pelage) is common in the cat family (Felidae), being reported in 13 of 37 extant felid species. Melanism can reach high frequencies in some cat species, e.g., Panthera pardus a.k.a. black leopard and Pardofelis temminckii a.k.a. Asian golden cat, suggesting this phenotype may be adaptive. However, little is known about the evolutionary history and ecological/behavioral significance of melanism in any felid. Two different genes whose products interact in the regulation of melanin production influence felid melanism. Melanocortin-1 receptor (MC1R) activation by binding alpha melanocyte stimulating hormone leads to eumelanin (dark pigment) synthesis. In contrast, binding the agouti signalling protein (ASIP) can inhibit MC1R activation, which causes a switch to pheomelanin (light pigment) synthesis.

In this study, DNA analysis of blood or skin samples from P. pardus and P. temminckii collected from captive animals of Asian origin identified two different variants of the ASIP gene implicated in melanistic phenotype. Experiments revealed that non-synonymous mutations involving any of 10 cysteine residues of the C-terminal Cys-rich domain adversely affected ASIP activity, suggesting these residues are critical for protein activity and receptor binding to MC1R. In P. temminckii, a change in the 9^th normally conserved cysteine residue to tryptophan led to melanism. In P. pardus, a mutation was identified that led to the elimination of most of the C-terminal domain from the 4^th normally conserved cysteine onward. Identification of these two novel mutations associated with melanism in wild felids, taken together with three previously reported mutations in either MC1R or ASIP, leads to the conclusion that this mutant phenotype arose at least five times independently in the cat family. Interestingly, three of these mutations are located in ASIP, suggesting that this gene is equally or more often involved in felid melanism than MC1R. [GO]

See also: Eizirik E, Yuhki N, Johnson WE, Menotti-Raymond M, Hannah SS and O'Brien SJ. Molecular genetics and evolution of melanism in the cat family. Curr Biol. 2003; 13: 448-53. 

More on cat health:
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Schneider A, David VA, Johnson WE, et al. How the leopard hides its spots: ASIP mutations and melanism in wild cats. PLoS ONE. 2012; 7: e50386. (free, full text article) 

Melanism (dark-colored pigmentation in the skin or pelage) is common in the cat family (Felidae), being reported in 13 of 37 extant felid species. Melanism can reach high frequencies in some cat species, e.g., Panthera pardus a.k.a. black leopard and Pardofelis temminckii a.k.a. Asian golden cat, suggesting this phenotype may be adaptive. However, little is known about the evolutionary history and ecological/behavioral significance of melanism in any felid. Two different genes whose products interact in the regulation of melanin production influence felid melanism. Melanocortin-1 receptor (MC1R) activation by binding alpha melanocyte stimulating hormone leads to eumelanin (dark pigment) synthesis. In contrast, binding the agouti signalling protein (ASIP) can inhibit MC1R activation, which causes a switch to pheomelanin (light pigment) synthesis.

In this study, DNA analysis of blood or skin samples from P. pardus and P. temminckii collected from captive animals of Asian origin identified two different variants of the ASIP gene implicated in melanistic phenotype. Experiments revealed that non-synonymous mutations involving any of 10 cysteine residues of the C-terminal Cys-rich domain adversely affected ASIP activity, suggesting these residues are critical for protein activity and receptor binding to MC1R. In P. temminckii, a change in the 9^th normally conserved cysteine residue to tryptophan led to melanism. In P. pardus, a mutation was identified that led to the elimination of most of the C-terminal domain from the 4^th normally conserved cysteine onward. Identification of these two novel mutations associated with melanism in wild felids, taken together with three previously reported mutations in either MC1R or ASIP, leads to the conclusion that this mutant phenotype arose at least five times independently in the cat family. Interestingly, three of these mutations are located in ASIP, suggesting that this gene is equally or more often involved in felid melanism than MC1R. [GO]

See also: Eizirik E, Yuhki N, Johnson WE, Menotti-Raymond M, Hannah SS and O'Brien SJ. Molecular genetics and evolution of melanism in the cat family. Curr Biol. 2003; 13: 448-53. 

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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Most People Can Skip Calcium Supplements, Prevention Panel Says

Women have been told for years that if they don't take calcium supplements religiously, they're putting themselves at risk of crippling hip fractures in old age. Now the word from a major government panel: Why bother? There's no evidence that taking calcium supplements reduces the risk of fractures for most people, the U.S. Preventive Services Task Force said. The recommendations were published online Monday by the Annals of Internal Medicine. That applies to postmenopausal women, the target audience for calcium supplements. "We're not saying don't use it," says Linda Baumann, a member of the task force and a professor emerita of nursing at the University of Wisconsin-Madison. "But think about it, because we're not sure it has the benefit you think it has." The task force said that taking up to 1,000 milligrams a day of calcium supplements and up to 400 international units of vitamin D daily did nothing to prevent fractures in healthy people, while slightly increasing the risk of kidney stones.

That's just a bit less than the 1,200 milligrams of calcium a day recommended for postmenopausal women by a 2011 Institute of Medicine report. More might be better, the USPSTF panel concluded, but there's no evidence that's true. The panel gives independent recommendations to the federal government on the risks and benefits of treatments. Reports like this always come with caveats, so here goes: The recommendations don't apply to people who already have osteoporosis or vitamin D deficiency. And the advice doesn't apply to people over 65 who are at risk of falls. The task force members would have loved to review data on whether taking calcium and vitamin D supplements earlier in life would be useful, Baumann tells Shots. Teenagers' calcium intake is pathetically low, even though they're still growing. "The other thing that's really unclear is the appropriate dose and dosing regimen," Baumann says. The studies the panel relied on were all over the map on how much people took — and when. And because most studies have looked at calcium and bone health in white women, there's no good data on men or minority groups. Vitamin D supplements have become trendy of late, promoted as preventing cancer, heart disease, and diabetes. Some doctors recommending up to 50,000 IU in a week.The USPSTF is looking at whether D influences cancer, so stay tuned for that. An accompanying editorial concludes, "While we wait for the results of further research, the USPSTF's cautious, evidence-based advice should encourage clinicians to think carefully before advising calcium and vitamin D supplementation for healthy individuals." Calcium supplements aren't as trendy, but some women are "taking three, four, five calcium pills a day," says Cliff Rosen, an author of the 2011 IOM report, and an osteoporosis researcher at the Maine Medical Center Research Institute. Taking that much can up the risk of kidney stones by 17 percent, he says. And there's also evidence that calcium supplements may contribute to heart disease. The calcium in food doesn't seem to cause those problems, Rosen says. So the best advice for everyone, from teens to their grandmas, is get calcium from food. "A glass of milk is 300 milligrams. Three glasses of milk a day, and you get there without a problem."

About Dr Kevin Lau

Dr Kevin Lau DC is a Singapore chiropractor and 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:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

Women have been told for years that if they don't take calcium supplements religiously, they're putting themselves at risk of crippling hip fractures in old age. Now the word from a major government panel: Why bother? There's no evidence that taking calcium supplements reduces the risk of fractures for most people, the U.S. Preventive Services Task Force said. The recommendations were published online Monday by the Annals of Internal Medicine. That applies to postmenopausal women, the target audience for calcium supplements. "We're not saying don't use it," says Linda Baumann, a member of the task force and a professor emerita of nursing at the University of Wisconsin-Madison. "But think about it, because we're not sure it has the benefit you think it has." The task force said that taking up to 1,000 milligrams a day of calcium supplements and up to 400 international units of vitamin D daily did nothing to prevent fractures in healthy people, while slightly increasing the risk of kidney stones.

That's just a bit less than the 1,200 milligrams of calcium a day recommended for postmenopausal women by a 2011 Institute of Medicine report. More might be better, the USPSTF panel concluded, but there's no evidence that's true. The panel gives independent recommendations to the federal government on the risks and benefits of treatments. Reports like this always come with caveats, so here goes: The recommendations don't apply to people who already have osteoporosis or vitamin D deficiency. And the advice doesn't apply to people over 65 who are at risk of falls. The task force members would have loved to review data on whether taking calcium and vitamin D supplements earlier in life would be useful, Baumann tells Shots. Teenagers' calcium intake is pathetically low, even though they're still growing. "The other thing that's really unclear is the appropriate dose and dosing regimen," Baumann says. The studies the panel relied on were all over the map on how much people took — and when. And because most studies have looked at calcium and bone health in white women, there's no good data on men or minority groups. Vitamin D supplements have become trendy of late, promoted as preventing cancer, heart disease, and diabetes. Some doctors recommending up to 50,000 IU in a week.The USPSTF is looking at whether D influences cancer, so stay tuned for that. An accompanying editorial concludes, "While we wait for the results of further research, the USPSTF's cautious, evidence-based advice should encourage clinicians to think carefully before advising calcium and vitamin D supplementation for healthy individuals." Calcium supplements aren't as trendy, but some women are "taking three, four, five calcium pills a day," says Cliff Rosen, an author of the 2011 IOM report, and an osteoporosis researcher at the Maine Medical Center Research Institute. Taking that much can up the risk of kidney stones by 17 percent, he says. And there's also evidence that calcium supplements may contribute to heart disease. The calcium in food doesn't seem to cause those problems, Rosen says. So the best advice for everyone, from teens to their grandmas, is get calcium from food. "A glass of milk is 300 milligrams. Three glasses of milk a day, and you get there without a problem."

About Dr Kevin Lau

Dr Kevin Lau DC is a Singapore chiropractor and 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:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

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Take care with a big cold-weather killer, the space heater

Warm weather isn't far away, but winter remains, and precautions should be taken to steer clear of a big cold-weather killer -- the space heater -- for the season's remaining cold days.

The Consumer Product Safety Commission estimates that each year, space heaters cause more than 25,000 residential fires and more than 300 deaths, and more than 6,000 Americans get emergency-room care for burn injuries associated with room heaters.

An Eastern Kentucky fire started by a space heater claimed the lives of one adult and four children last month. This blaze destroyed a rural house and family and was considered by authorites to be the worst the region has seen in a long time.

Using a space heater makes sense, and many people, particularly those in rural areas, use them to stay warm; but they must be used with caution. The Burn Center at Loyola University Medical Center is warning the public about the dangers of space heaters because many of the injuries they cause are preventable if the appropriate measures are taken. Here are some general safety tips from Loyola:

• Keep space heaters at least three feet away from furniture or other combustible material
• Don't place heaters on carpets or rugs.
• Locate heaters on a hard, level surface where a child or family pet can't brush against them.
• Never leave a heater on when an adult is not present in the room.
• Never keep flammable liquids near a heater.
• Mobile homes should use only electric heaters or vented, fuel-fired heaters.

Loyola also advises to use combustion space heaters only outside your home because they release carbon monoxide and nitrogen oxide. If the heater is not properly vented, high levels of these gases are deadly. Also, when using electric space heaters, be sure to plug the heater directly into a wall outlet and use a heavy duty cord. Click here for more tips.

Warm weather isn't far away, but winter remains, and precautions should be taken to steer clear of a big cold-weather killer -- the space heater -- for the season's remaining cold days.

The Consumer Product Safety Commission estimates that each year, space heaters cause more than 25,000 residential fires and more than 300 deaths, and more than 6,000 Americans get emergency-room care for burn injuries associated with room heaters.

An Eastern Kentucky fire started by a space heater claimed the lives of one adult and four children last month. This blaze destroyed a rural house and family and was considered by authorites to be the worst the region has seen in a long time.

Using a space heater makes sense, and many people, particularly those in rural areas, use them to stay warm; but they must be used with caution. The Burn Center at Loyola University Medical Center is warning the public about the dangers of space heaters because many of the injuries they cause are preventable if the appropriate measures are taken. Here are some general safety tips from Loyola:

• Keep space heaters at least three feet away from furniture or other combustible material
• Don't place heaters on carpets or rugs.
• Locate heaters on a hard, level surface where a child or family pet can't brush against them.
• Never leave a heater on when an adult is not present in the room.
• Never keep flammable liquids near a heater.
• Mobile homes should use only electric heaters or vented, fuel-fired heaters.

Loyola also advises to use combustion space heaters only outside your home because they release carbon monoxide and nitrogen oxide. If the heater is not properly vented, high levels of these gases are deadly. Also, when using electric space heaters, be sure to plug the heater directly into a wall outlet and use a heavy duty cord. Click here for more tips.

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Pink Slime and Ammonia in your blood? Natural News Connection has ANSWERS!

Ammonium hydroxide, a bad and unhealthy option for all

According to Natural News, awareness associated with “pink slime” has caused a great stir all over the U.S.One of the biggest manufacturers of this stuff, BPI, has shut down all their factories, except one. Burgers and other food items laden with pink slime are still available all over the world and BPI vehemently refuses to disclose the end users. Companies try to pacify consumers saying that it’s only in processed meat but this is just not the truth and we all know that.

Exposure to ammonia gas is highly dangerous for the respiratory tract but may not be that harmful for the digestive system as it is only a gas. But when this gas comes in contact with water present within the meat, it produces ammonium hydroxide which is also known as ammonia water. This can wreak havoc on the human body and can lead to some disastrous side effects.

http://www.naturalnews.com/035517_pink_slime_ammonium_hydroxide_burgers.html

As reported by Natural News, ammonium hydroxide is mainly used as a floor cleaner, window cleaner and also as a source of food, mainly associated with slime and  when this is consumed, it can have disastrous effects on the human body. According to Material Safety Data Sheet, ammonium hydroxide can be quite harmful if it comes in direct contact with the skin as it can damage the soft tissue.

According to the FDA, ammonium hydroxide is safe but the safety levels of such chemical products depend upon the amount used. the presence of excess ammonium hydroxide  can not only damage the acid-base balance of our body but can also kill the good bacteria that are present in our digestive system.  Since no study has been conducted to establish the harmful levels of ammonium hydroxide so that the levels can be mentioned in the packaging, as the end consumers we should be completely aware of what we are buying and from where.

SUPERFOOD SOLUTIONS RECOMMENDED BY THE HEALTH RANGER:

 

http://www.truthpublishing.com/naturalhealthsolutions_p/yprint-cat21391.htm

 

http://store.naturalnews.com/

 

http://store.naturalnews.com/Chlorella_c_51.html 

 

Mike Adams says: "The only thing that stands between a person and their own perfect health is information. Empowered with the right information, anyone can improve their health, reduce their dependence on prescription drugs, enhance their quality of life and expand their mental awareness and creativity.”

Learn more: http://www.naturalnews.com/039178_free_antibiotics_pharmacy_superbugs.html#ixzz2LTD1CRlm 

 

http://www.naturalnews.com/About.html

Learn more: http://www.naturalnews.com/039145_chlorella_heavy_metals_lab_tests.html#ixzz2LTAfO2r1

 

Ammonium hydroxide, a bad and unhealthy option for all

According to Natural News, awareness associated with “pink slime” has caused a great stir all over the U.S.One of the biggest manufacturers of this stuff, BPI, has shut down all their factories, except one. Burgers and other food items laden with pink slime are still available all over the world and BPI vehemently refuses to disclose the end users. Companies try to pacify consumers saying that it’s only in processed meat but this is just not the truth and we all know that.

Exposure to ammonia gas is highly dangerous for the respiratory tract but may not be that harmful for the digestive system as it is only a gas. But when this gas comes in contact with water present within the meat, it produces ammonium hydroxide which is also known as ammonia water. This can wreak havoc on the human body and can lead to some disastrous side effects.

http://www.naturalnews.com/035517_pink_slime_ammonium_hydroxide_burgers.html

As reported by Natural News, ammonium hydroxide is mainly used as a floor cleaner, window cleaner and also as a source of food, mainly associated with slime and  when this is consumed, it can have disastrous effects on the human body. According to Material Safety Data Sheet, ammonium hydroxide can be quite harmful if it comes in direct contact with the skin as it can damage the soft tissue.

According to the FDA, ammonium hydroxide is safe but the safety levels of such chemical products depend upon the amount used. the presence of excess ammonium hydroxide  can not only damage the acid-base balance of our body but can also kill the good bacteria that are present in our digestive system.  Since no study has been conducted to establish the harmful levels of ammonium hydroxide so that the levels can be mentioned in the packaging, as the end consumers we should be completely aware of what we are buying and from where.

SUPERFOOD SOLUTIONS RECOMMENDED BY THE HEALTH RANGER:

 

http://www.truthpublishing.com/naturalhealthsolutions_p/yprint-cat21391.htm

 

http://store.naturalnews.com/

 

http://store.naturalnews.com/Chlorella_c_51.html 

 

Mike Adams says: "The only thing that stands between a person and their own perfect health is information. Empowered with the right information, anyone can improve their health, reduce their dependence on prescription drugs, enhance their quality of life and expand their mental awareness and creativity.”

Learn more: http://www.naturalnews.com/039178_free_antibiotics_pharmacy_superbugs.html#ixzz2LTD1CRlm 

 

http://www.naturalnews.com/About.html

Learn more: http://www.naturalnews.com/039145_chlorella_heavy_metals_lab_tests.html#ixzz2LTAfO2r1

 

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Bill for statewide smoking ban appears to have been extinguished

The bill to enact a statewide smoking ban in Kentucky appears to be dead for this session of the General Assembly.

The House sent House Bill 190 back to committee today, and "House Speaker Greg Stumbo said he doesn't expect the bill to make it back to the full House," Sam Dick reported for WKYT-TV.

Rep. Bob Damron, D-Nicholasville, an opponent of the bill, told Kentucky Health News on Feb. 21 that he did not think it had more than 41 votes in the 100-member House.

The bill to enact a statewide smoking ban in Kentucky appears to be dead for this session of the General Assembly.

The House sent House Bill 190 back to committee today, and "House Speaker Greg Stumbo said he doesn't expect the bill to make it back to the full House," Sam Dick reported for WKYT-TV.

Rep. Bob Damron, D-Nicholasville, an opponent of the bill, told Kentucky Health News on Feb. 21 that he did not think it had more than 41 votes in the 100-member House.

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House panel approves bill easing rules of 2012's pill-mill bill

They could call it the pill they're taking to fix the pill-mill bill.

A state House committee approved a bill Tuesday that would tweak last year's legislation aimed at cracking down on prescription drug abuse through doctor shopping and "pill mills" where painkiller prescriptions are easily available for a fee.

House Speaker Greg Stumbo told the House Judiciary Committee that House Bill 217 would fix “unintended consequences” of 2012's House Bill 1 while still requiring that health-care providers use the Kentucky All Schedule Prescription Electronic Reporting system to track painkiller prescriptions.

The bill "would exempt hospitals and long-term care facilities from HB 1’s per-unit patient dosing restrictions and ensure that physicians decide when physicals are needed," the Kentucky Press News Service reported. "It would limit restricted access to narcotic pain medication for surgery patients, end-of-life patients, cancer patients and a few other categories of patients who may need increased pain management, Stumbo said." (Read more)

They could call it the pill they're taking to fix the pill-mill bill.

A state House committee approved a bill Tuesday that would tweak last year's legislation aimed at cracking down on prescription drug abuse through doctor shopping and "pill mills" where painkiller prescriptions are easily available for a fee.

House Speaker Greg Stumbo told the House Judiciary Committee that House Bill 217 would fix “unintended consequences” of 2012's House Bill 1 while still requiring that health-care providers use the Kentucky All Schedule Prescription Electronic Reporting system to track painkiller prescriptions.

The bill "would exempt hospitals and long-term care facilities from HB 1’s per-unit patient dosing restrictions and ensure that physicians decide when physicals are needed," the Kentucky Press News Service reported. "It would limit restricted access to narcotic pain medication for surgery patients, end-of-life patients, cancer patients and a few other categories of patients who may need increased pain management, Stumbo said." (Read more)

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Bill to make Medicaid managed-care firms pay up, and more promptly, nears final form in House and will get attention in Senate

By Molly Burchett and Al Cross
Kentucky Health News

The complaints by many health-care providers about Medicare managed-care firms' delay or denial of payment claims appears to be generating a bipartisan solution in the General Assembly. A bill on the House floor that would transfer late-payment complaints to the state Department of Insurance, which enforces Kentucky's prompt-payment laws, appears to have support in the Senate.

House Bill 5 would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Hospitals, doctors and other health care providers have complained that the cabinet is not resolving their payment disputes with managed-care firms. The bill cleared the House Health and Welfare Committee Feb. 21 and is awaiting a vote on the House floor. The bill is sponsored by House Speaker Greg Stumbo.

Sen. Julie Denton, chair of the Senate Health and Welfare Committee, told Kenny Colston of Kentucky Public Radio that she plans to give the bill a hearing and supports its intent to make managed care organizations pay providers. "I think anything we can do to have more oversight and more assistance in keeping them in compliance with their contracts is a welcome breath of fresh air," she said.

Senate President Robert Stivers said he has concerns about the bill affecting the MCOs contracts with the state. But he said his chamber will take a look at the bill, Colston reports. The cabinet has had the same concerns, and some other objections that are to be addressed by House floor amendments.

Kentucky providers report being burdened by a lack of or delayed payments from the new managed-care system. Kentuckians have called for immediate action by state government to help fix these issues on behalf of providers and patients, which has prompted this bipartisan legislative response.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

By Molly Burchett and Al Cross
Kentucky Health News

The complaints by many health-care providers about Medicare managed-care firms' delay or denial of payment claims appears to be generating a bipartisan solution in the General Assembly. A bill on the House floor that would transfer late-payment complaints to the state Department of Insurance, which enforces Kentucky's prompt-payment laws, appears to have support in the Senate.

House Bill 5 would apply the prompt-payment laws to managed-care organizations and would move Medicaid late-payment complaints to the insurance department; those are now handled by the Cabinet for Health and Family Services, which administers Medicaid.

Hospitals, doctors and other health care providers have complained that the cabinet is not resolving their payment disputes with managed-care firms. The bill cleared the House Health and Welfare Committee Feb. 21 and is awaiting a vote on the House floor. The bill is sponsored by House Speaker Greg Stumbo.

Sen. Julie Denton, chair of the Senate Health and Welfare Committee, told Kenny Colston of Kentucky Public Radio that she plans to give the bill a hearing and supports its intent to make managed care organizations pay providers. "I think anything we can do to have more oversight and more assistance in keeping them in compliance with their contracts is a welcome breath of fresh air," she said.

Senate President Robert Stivers said he has concerns about the bill affecting the MCOs contracts with the state. But he said his chamber will take a look at the bill, Colston reports. The cabinet has had the same concerns, and some other objections that are to be addressed by House floor amendments.

Kentucky providers report being burdened by a lack of or delayed payments from the new managed-care system. Kentuckians have called for immediate action by state government to help fix these issues on behalf of providers and patients, which has prompted this bipartisan legislative response.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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Survey suggests Great Recession has harmed the health of Kentuckians

A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky’s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.

Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

“We know there is a direct relationship between income and good health, and these data reflect that,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. “While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population’s health.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

A recent poll shows continuation of a trend threatening Kentucky's overall health: as the number of Kentuckians living in poverty goes up, the percentage of adults who report their health as excellent or very good goes down.

Just over four in 10 Kentucky adults in the latest Kentucky Health Issues Poll described their health as excellent or good. In 2008, almost half used those descriptions.

People with higher incomes have consistently reported better health since the poll began tracking the health status of Kentucky adults 2008. Since research has shown a strong link between higher income and better health, the Great Recession and the resulting increases in unemployment, underemployment and poverty appear to be harming the overall health of Kentucky’s population.

In the accompanying graph, showing responses by income categories, FPL stands for federal poverty level, which in 2011 was a yearly household income of $22,350. Among the categories, 58 percent in the highest category said their health is excellent or good, but only 25 percent of those living in poverty used those descriptions.

Although the health status for each income category has remained fairly constant, the poll reflects federal data that show more people living in poverty. More than 33 percent in the latest poll were earning less than the federal poverty level; in 2008, that was only 19 percent. The polls, which used self-reporting of income and survey methods that differ from federal methods, showed much higher poverty rates than federal data.

“We know there is a direct relationship between income and good health, and these data reflect that,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, a sponsor of the poll. “While changes in our health-care delivery system may provide more health-care opportunities for low-income Kentuckians, these results show how vital a strong economy, and jobs that pay well, are to our population’s health.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

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Essential-benefits rule expands mental-health and substance-abuse coverage; Ky. needs more facilities to treat newly eligible

The Department of Health and Human Services has defined the 10 "essential health benefits" insurance plans must provide, and it included benefits for mental health and treatment of substance-abuse disorders..

Nearly 20 percent of Americans don't have access to mental-health services and over 30 percent have no coverage for substance-abuse treatment. This rule will expand mental health and substance-abuse treatment benefits to 62 million Americans, according to HHS.

Expanded coverage for mental health and substance abuse treatment programs in Kentucky could bring about a dramatic shift in the delivery of these services. There is already a shortage of treatment options and centers for Kentuckians, and those suffering from addiction have not had coverage for such treatment; the proposed rule will change that.

Recovery Kentucky, a public-private partnership with residential facilities, was created to help Kentuckians recover from substance abuse. It has 10 centers, in Campbellsville, Erlanger, Florence, Harlan, Henderson, Hopkinsville, Morehead, Owensboro, Paducah, and Richmond, according to the 2012 Justice & Public Safety Cabinet report, which included the map below. 

Health-insurance plans must cover the 10 essential benefits beginning in 2014, so the state must prepare for the newly insured in addition to newly covered services. The rule defines what must be covered in insurance plans and bans discrimination based on age or pre-existing conditions. Among the core package of items and services, known as “essential health benefits" are items and services in the following categories:

1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care

States are given flexibility in implementing the federal health-care reform law with a benchmark approach. The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization plan serve as the “benchmark” plan for the Kentucky Health Benefit Exchange. HHS will review the recommendation and accept public comments prior to making a final decision. (Read more)

The Department of Health and Human Services has defined the 10 "essential health benefits" insurance plans must provide, and it included benefits for mental health and treatment of substance-abuse disorders..

Nearly 20 percent of Americans don't have access to mental-health services and over 30 percent have no coverage for substance-abuse treatment. This rule will expand mental health and substance-abuse treatment benefits to 62 million Americans, according to HHS.

Expanded coverage for mental health and substance abuse treatment programs in Kentucky could bring about a dramatic shift in the delivery of these services. There is already a shortage of treatment options and centers for Kentuckians, and those suffering from addiction have not had coverage for such treatment; the proposed rule will change that.

Recovery Kentucky, a public-private partnership with residential facilities, was created to help Kentuckians recover from substance abuse. It has 10 centers, in Campbellsville, Erlanger, Florence, Harlan, Henderson, Hopkinsville, Morehead, Owensboro, Paducah, and Richmond, according to the 2012 Justice & Public Safety Cabinet report, which included the map below. 

Health-insurance plans must cover the 10 essential benefits beginning in 2014, so the state must prepare for the newly insured in addition to newly covered services. The rule defines what must be covered in insurance plans and bans discrimination based on age or pre-existing conditions. Among the core package of items and services, known as “essential health benefits" are items and services in the following categories:

1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care

States are given flexibility in implementing the federal health-care reform law with a benchmark approach. The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization plan serve as the “benchmark” plan for the Kentucky Health Benefit Exchange. HHS will review the recommendation and accept public comments prior to making a final decision. (Read more)

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Medicaid expansion brings primary care access to the forefront

The federal health reform law will usher at least seven million more Americans into Medicaid, and as states like Kentucky debate Medicaid expansion, policymakers are struggling with the question of whether there will even be enough primary care doctors to provide care, reports Michael Ollove of Stateline.

The country is already short of primary-care doctors. Although many primary-care physicians would take on new Medicare or privately-insured patients, only two out of three primary-care physicians surveyed in 2011 were willing to accept new Medicaid patients.

Why? Poor compensation is one reason; on average, Medicaid pays physicians 59 percent of the amount Medicare pays for primary care services, reports Ollove. Many Kentucky primary-care providers are also deterred by existing Medciaid problems. Providers report being burdened by a lack of or delayed payments from the new managed-care system.

Congress hopes to lure practitioners to primary care with a provision that raises primary-care providers' Medicaid fees to Medicare levels. This is only a temporary fix, which went into effect at the beginning of the year and will remain in effect for two years, reports Ollove.

The impact in Kentucky remains uncertain. Lawrence Kissner, Kentucky's commissioner for health and family services, says the state’s Medicaid pay raise in 2005 resulted in a 36 percent increase in the number of primary care doctors accepting Medicaid patients, reports Ollove. This is precisely what the health-law authors hope will happen now.

Kentucky is addressing the health coverage issue in other ways.  The General Assembly is considering a bill that would repeal a burdensome supervision requirement and encourage more independent physician assistants to remain in Kentucky to serve medically underserved areas.

Although Kentucky already allows nurse practitioners to practice independently, the Medicaid rate increase applies only to physicians who provide primary care services. It does not apply to nurse practitioners, who have been touted as a potential solution to the primary care problem and often provide care in underserved areas of the state. (Read more)

The federal health reform law will usher at least seven million more Americans into Medicaid, and as states like Kentucky debate Medicaid expansion, policymakers are struggling with the question of whether there will even be enough primary care doctors to provide care, reports Michael Ollove of Stateline.

The country is already short of primary-care doctors. Although many primary-care physicians would take on new Medicare or privately-insured patients, only two out of three primary-care physicians surveyed in 2011 were willing to accept new Medicaid patients.

Why? Poor compensation is one reason; on average, Medicaid pays physicians 59 percent of the amount Medicare pays for primary care services, reports Ollove. Many Kentucky primary-care providers are also deterred by existing Medciaid problems. Providers report being burdened by a lack of or delayed payments from the new managed-care system.

Congress hopes to lure practitioners to primary care with a provision that raises primary-care providers' Medicaid fees to Medicare levels. This is only a temporary fix, which went into effect at the beginning of the year and will remain in effect for two years, reports Ollove.

The impact in Kentucky remains uncertain. Lawrence Kissner, Kentucky's commissioner for health and family services, says the state’s Medicaid pay raise in 2005 resulted in a 36 percent increase in the number of primary care doctors accepting Medicaid patients, reports Ollove. This is precisely what the health-law authors hope will happen now.

Kentucky is addressing the health coverage issue in other ways.  The General Assembly is considering a bill that would repeal a burdensome supervision requirement and encourage more independent physician assistants to remain in Kentucky to serve medically underserved areas.

Although Kentucky already allows nurse practitioners to practice independently, the Medicaid rate increase applies only to physicians who provide primary care services. It does not apply to nurse practitioners, who have been touted as a potential solution to the primary care problem and often provide care in underserved areas of the state. (Read more)

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Foundation for a Healthy Kentucky gives UK $1 million for endowed co-chairs in rural health policy

Tyrone "Ty" Borders in the University of Kentucky College of Public Health's Department of Health Services Management, and Brady Reynolds in the UK College of Medicine's Department of Behavioral Science, have been named the Foundation for a Healthy Kentucky endowed co-chairs in rural health policy.

A $1 million gift from the foundation to the College of Medicine was matched by the state Research Challenge Trust Fund, better known as "Bucks for Brains." The gift has the goal of enriching Kentucky's research capabilities in regards to rural health issues and rural health policy.

Reynolds earned doctoral and master's degrees in life-span developmental psychology from West Virginia University. He also holds a master's degree in general/experimental psychology and a bachelor's degree (magna cum laude and with distinction) from James Madison University. His research has focused on nicotine use by adolescents, drug use, gambling and other addictive behaviors. In recent years Reynolds has begun research to promote smoking cessation among pregnant smokers in rural Appalachia.

Borders earned doctoral and master's degrees in health administration, as well as a master's degree in epidemiology from the University of Iowa, and a bachelor's degree in psychology from the University of Kansas. His research focuses on the conduct and analysis of population-based studies to identify subgroups of persons at risk for poor health and problems obtaining health services, with an emphasis on rural populations.

“Drs. Reynolds and Borders have skills in intervention research and rural health policy expertise that can help the University remain at the forefront of rural health policy work in today’s rapidly changing healthcare environment,” said Susan Zepeda, president and CEO of the foundation.

The mission of the foundation is to addresses the unmet health care needs of Kentuckians. Mission objectives are advanced through two initiative areas: promoting responsive health policy and a new children’s initiative named “Investing in Kentucky’s Future.” Foundation work aims to improve access to health care, reduce risks and disparities, promote health equity and healthy lifestyles. Since 2001, over $22 million has been invested in health policy research and demonstration grant projects across Kentucky

Tyrone "Ty" Borders in the University of Kentucky College of Public Health's Department of Health Services Management, and Brady Reynolds in the UK College of Medicine's Department of Behavioral Science, have been named the Foundation for a Healthy Kentucky endowed co-chairs in rural health policy.

A $1 million gift from the foundation to the College of Medicine was matched by the state Research Challenge Trust Fund, better known as "Bucks for Brains." The gift has the goal of enriching Kentucky's research capabilities in regards to rural health issues and rural health policy.

Reynolds earned doctoral and master's degrees in life-span developmental psychology from West Virginia University. He also holds a master's degree in general/experimental psychology and a bachelor's degree (magna cum laude and with distinction) from James Madison University. His research has focused on nicotine use by adolescents, drug use, gambling and other addictive behaviors. In recent years Reynolds has begun research to promote smoking cessation among pregnant smokers in rural Appalachia.

Borders earned doctoral and master's degrees in health administration, as well as a master's degree in epidemiology from the University of Iowa, and a bachelor's degree in psychology from the University of Kansas. His research focuses on the conduct and analysis of population-based studies to identify subgroups of persons at risk for poor health and problems obtaining health services, with an emphasis on rural populations.

“Drs. Reynolds and Borders have skills in intervention research and rural health policy expertise that can help the University remain at the forefront of rural health policy work in today’s rapidly changing healthcare environment,” said Susan Zepeda, president and CEO of the foundation.

The mission of the foundation is to addresses the unmet health care needs of Kentuckians. Mission objectives are advanced through two initiative areas: promoting responsive health policy and a new children’s initiative named “Investing in Kentucky’s Future.” Foundation work aims to improve access to health care, reduce risks and disparities, promote health equity and healthy lifestyles. Since 2001, over $22 million has been invested in health policy research and demonstration grant projects across Kentucky

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Jaw disorders in cats

Arzi B, Cissell DD, Verstraete FJ, Kass PH, DuRaine GD and Athanasiou KA. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011). J Am Vet Med Assoc. 2013; 242: 69-75.

There are very few studies published on temporomandibular joint (TMJ) disorders in cats and dogs. These disorders are often painful and debilitating, with a detrimental impact on quality of life. In humans, the most common cause of TMJ disorders is osteoarthritis, but less in known for cats and dogs. The standard diagnostic tool in humans is magnetic resonance imaging (MRI), but computed tomography (CT) remains an important tool for TMJ disorders in small animals.
 
In this study, the investigators evaluated CT findings in 41 dogs and 17 cats with TMJ disorders. Medical records and CT images of the skull were examined from a dentistry and oral surgery practice for a 5-year period. In the 17 cats with evidence of a TMJ disorder, a fracture of the condylar process of the mandible was the most common finding (9 cats). Osteoarthritis (8 cats), luxation (4 cats), ankylosis (2 cats), and a tumor (1 cat) were the other findings on CT. Animals with TMJ disorders generally have multiple joint abnormalities and the most common signs are pain or decreased range of motion of the joint. All the cats with a TMJ fracture had signs of pain while resting along with fractures of bones in the maxillofacial region and soft tissue trauma. The study found no association between the presence and severity of TMJ osteoarthritis and age or body weight. CT is valuable for evaluating osseous (boney) lesions and the spatial positioning of the TMJ, and should be considered essential as part of a diagnostic workup of suspected TMJ disorders. [VT]

See also: Schwarz T, Weller R, Dickie AM, Konar M and Sullivan M. Imaging of the canine and feline temporomandibular joint: a review. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association. 2002; 43: 85-97. 

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Arzi B, Cissell DD, Verstraete FJ, Kass PH, DuRaine GD and Athanasiou KA. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011). J Am Vet Med Assoc. 2013; 242: 69-75.

There are very few studies published on temporomandibular joint (TMJ) disorders in cats and dogs. These disorders are often painful and debilitating, with a detrimental impact on quality of life. In humans, the most common cause of TMJ disorders is osteoarthritis, but less in known for cats and dogs. The standard diagnostic tool in humans is magnetic resonance imaging (MRI), but computed tomography (CT) remains an important tool for TMJ disorders in small animals.
 
In this study, the investigators evaluated CT findings in 41 dogs and 17 cats with TMJ disorders. Medical records and CT images of the skull were examined from a dentistry and oral surgery practice for a 5-year period. In the 17 cats with evidence of a TMJ disorder, a fracture of the condylar process of the mandible was the most common finding (9 cats). Osteoarthritis (8 cats), luxation (4 cats), ankylosis (2 cats), and a tumor (1 cat) were the other findings on CT. Animals with TMJ disorders generally have multiple joint abnormalities and the most common signs are pain or decreased range of motion of the joint. All the cats with a TMJ fracture had signs of pain while resting along with fractures of bones in the maxillofacial region and soft tissue trauma. The study found no association between the presence and severity of TMJ osteoarthritis and age or body weight. CT is valuable for evaluating osseous (boney) lesions and the spatial positioning of the TMJ, and should be considered essential as part of a diagnostic workup of suspected TMJ disorders. [VT]

See also: Schwarz T, Weller R, Dickie AM, Konar M and Sullivan M. Imaging of the canine and feline temporomandibular joint: a review. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association. 2002; 43: 85-97. 

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