Life spans of the least educated are shrinking; steepest decline among white women, biggest gap among white men

Here's some bad news for states like Kentucky, which are overwhelmingly white and have large shares of the population that did not graduate from high school: A new study "that looks separately at Americans lacking a high school diploma found disturbingly sharp drops in life expectancy for whites," and four previous studies support that case, reports Sabrina Tavernise of The New York Times.

"The reasons for the decline remain unclear," writes Tavernise, "but researchers offered possible explanations, including a spike in prescription-drug overdoses among young whites, higher rates of smoking among less-educated white women, rising obesity, and a steady increase in the number of the least-educated Americans who lack health insurance."

Dr. S. Jay Olshansky

White women without high-school diplomas are at particular risk, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. They lost a whopping five years of life expectancy between 1990 and 2008, he said.

That's big. To understand just how big: The average life expectancy for white women without a high-school diploma was 73.5 years, compared with 83.9 years for white women with a college degree or more. For white men, the gap was even bigger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

The slump is now the subject of an inquiry by the National Academy of Sciences. “There’s this enormous issue of why,” said David Cutler, an economics professor at Harvard University. “It’s very puzzling and we don’t have a great explanation.” And it is yet another sign of distress in one of the country’s most vulnerable groups during a period when major social changes are transforming life for less educated whites. (Read more)

Here's some bad news for states like Kentucky, which are overwhelmingly white and have large shares of the population that did not graduate from high school: A new study "that looks separately at Americans lacking a high school diploma found disturbingly sharp drops in life expectancy for whites," and four previous studies support that case, reports Sabrina Tavernise of The New York Times.

"The reasons for the decline remain unclear," writes Tavernise, "but researchers offered possible explanations, including a spike in prescription-drug overdoses among young whites, higher rates of smoking among less-educated white women, rising obesity, and a steady increase in the number of the least-educated Americans who lack health insurance."

Dr. S. Jay Olshansky

White women without high-school diplomas are at particular risk, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. They lost a whopping five years of life expectancy between 1990 and 2008, he said.

That's big. To understand just how big: The average life expectancy for white women without a high-school diploma was 73.5 years, compared with 83.9 years for white women with a college degree or more. For white men, the gap was even bigger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

The slump is now the subject of an inquiry by the National Academy of Sciences. “There’s this enormous issue of why,” said David Cutler, an economics professor at Harvard University. “It’s very puzzling and we don’t have a great explanation.” And it is yet another sign of distress in one of the country’s most vulnerable groups during a period when major social changes are transforming life for less educated whites. (Read more)

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Government says health-reform law to save average Kentuckian with Medicare coverage $5,000 through 2022

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

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Study estimates that secondhand smoke kills 42,000 Americans a year, and 900 of those are babies

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

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Doctor complaints about bill aimed at reducing prescription drug abuse largely based on misconceptions, health officials say

State health officials say doctors' complaints about House Bill 1, which cracks down on pill mills and doctors who supply the illegal prescription pill trade, result from misunderstandings and misconceptions about the law's language and intent, Mike Wynn of The Courier-Journal reports. Doctors say the bill's regulations are excessive and restrict their ability to write common prescriptions.

Assistant deputy inspector general Stephanie Hold, of the Cabinet for Health and Family Services, said doctors have at least 19 misconceptions about the state's drug tracking system, Kentucky All Schedule Prescription Electronic Reporting, and said checking KASPER before writing prescriptions "should not impede them in any way," Wynn reports. Mike Rodman, director of the Kentucky Board of Medical Licensure, said there's nothing in the law that prevents doctors from prescribing controlled substances. He said many doctors have for years practiced prescription standards similar to those in the bill, but feel uncomfortable with them being written as law.

The co-chair of the state oversight committee, Democratic Rep. John Tilley, said there are some legitimate concerns about the bill "that need discussion after we can distill what is fact and what is myth," but lawmakers could likely address all of them without changing the statute. (Read more)

State health officials say doctors' complaints about House Bill 1, which cracks down on pill mills and doctors who supply the illegal prescription pill trade, result from misunderstandings and misconceptions about the law's language and intent, Mike Wynn of The Courier-Journal reports. Doctors say the bill's regulations are excessive and restrict their ability to write common prescriptions.

Assistant deputy inspector general Stephanie Hold, of the Cabinet for Health and Family Services, said doctors have at least 19 misconceptions about the state's drug tracking system, Kentucky All Schedule Prescription Electronic Reporting, and said checking KASPER before writing prescriptions "should not impede them in any way," Wynn reports. Mike Rodman, director of the Kentucky Board of Medical Licensure, said there's nothing in the law that prevents doctors from prescribing controlled substances. He said many doctors have for years practiced prescription standards similar to those in the bill, but feel uncomfortable with them being written as law.

The co-chair of the state oversight committee, Democratic Rep. John Tilley, said there are some legitimate concerns about the bill "that need discussion after we can distill what is fact and what is myth," but lawmakers could likely address all of them without changing the statute. (Read more)

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Republicans reject governor's executive order creating health benefits exchange; move is only symbolic for now

Republican legislators voted yesterday against Gov. Steve Beshear's executive order creating the Kentucky Health Benefits Exchange, required by federal health reform. Sen. David Givens of Greensburg offered a motion to the legislative Health and Welfare Committee that said Beshear doesn't have authority to create new agencies, but only to rearrange existing agencies with the legislature's approval, Nick Storm of cn|2 Pure Politics reports.

Democrats at the meeting were caught off guard and ultimately walked out after raising objections, Storm reports. They claimed Beshear was following federal law, and said the legislature should consider the matter when it reconvenes in January. Legislators hoped they would get answers from the Cabinet for Health and Family Services about costs and operations of the exchange, which they didn't get at their meeting last month.

The exchange will match up the uninsured with private health insurance companies, and is designed to serve those who make too much to qualify for Medicaid but don't have employer-sponsored insurance. After Democrats left the meeting, Republicans voted to report the committee's findings to the Legislative Research Commission and the governor. The vote remains symbolic unless it is cited in a lawsuit challenging the exchange, which now seems likely. (Read more)

Republican legislators voted yesterday against Gov. Steve Beshear's executive order creating the Kentucky Health Benefits Exchange, required by federal health reform. Sen. David Givens of Greensburg offered a motion to the legislative Health and Welfare Committee that said Beshear doesn't have authority to create new agencies, but only to rearrange existing agencies with the legislature's approval, Nick Storm of cn|2 Pure Politics reports.

Democrats at the meeting were caught off guard and ultimately walked out after raising objections, Storm reports. They claimed Beshear was following federal law, and said the legislature should consider the matter when it reconvenes in January. Legislators hoped they would get answers from the Cabinet for Health and Family Services about costs and operations of the exchange, which they didn't get at their meeting last month.

The exchange will match up the uninsured with private health insurance companies, and is designed to serve those who make too much to qualify for Medicaid but don't have employer-sponsored insurance. After Democrats left the meeting, Republicans voted to report the committee's findings to the Legislative Research Commission and the governor. The vote remains symbolic unless it is cited in a lawsuit challenging the exchange, which now seems likely. (Read more)

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Acromegaly in cats

Greco DS. Feline acromegaly. Top Companion Anim Med. 2012; 27: 31-5.

From Dr. Mark Peterson: endocrinevet.blogspot.com

Acromegaly (or hypersomatotropism) is a disease that derives its name from two Greek words: ‘acro’ (meaning extremity) and ‘megale’ (meaning great). The disease has been known in humans for at least 100 years, and has been identified in cats starting in the 1980s. The disease is caused by a tumor (adenoma) of the pituitary gland in the brain that leads to excessive secretion of growth hormone. The effects of excessive growth hormone include the development of diabetes mellitus and increase in size of certain parts of the body (e.g., jaw, skull, limbs). Internal organs (e.g., heart, liver, kidney) may also be increased in size. 

The typical feline patient is an older male cat with diabetes mellitus that is difficult to manage. The disease is diagnosed by finding increased blood levels of growth hormone and/or insulin-like growth factor as well as demonstration of a pituitary mass using magnetic resonance imaging or computed tomography. Few treatments are available for this disease in cats; to date, the most effective approach has been radiation therapy. Most affected cats eventually die of congestive heart failure, chronic kidney failure, or complications of the growing pituitary tumor. [SL]

See also: 

• Niessen SJM. Feline acromegaly: An essential differential diagnosis for the difficult diabetic. J Feline Med Surg. 2010; 12: 15-23.
• Final report, Winn grant W10-017: Evaluation of a long-acting somatostatin receptor ligand for the treatment of feline acromegaly
• Insights into veterinary endocrinology: Dr. Mark E. Peterson

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

Greco DS. Feline acromegaly. Top Companion Anim Med. 2012; 27: 31-5.

From Dr. Mark Peterson: endocrinevet.blogspot.com

Acromegaly (or hypersomatotropism) is a disease that derives its name from two Greek words: ‘acro’ (meaning extremity) and ‘megale’ (meaning great). The disease has been known in humans for at least 100 years, and has been identified in cats starting in the 1980s. The disease is caused by a tumor (adenoma) of the pituitary gland in the brain that leads to excessive secretion of growth hormone. The effects of excessive growth hormone include the development of diabetes mellitus and increase in size of certain parts of the body (e.g., jaw, skull, limbs). Internal organs (e.g., heart, liver, kidney) may also be increased in size. 

The typical feline patient is an older male cat with diabetes mellitus that is difficult to manage. The disease is diagnosed by finding increased blood levels of growth hormone and/or insulin-like growth factor as well as demonstration of a pituitary mass using magnetic resonance imaging or computed tomography. Few treatments are available for this disease in cats; to date, the most effective approach has been radiation therapy. Most affected cats eventually die of congestive heart failure, chronic kidney failure, or complications of the growing pituitary tumor. [SL]

See also: 

• Niessen SJM. Feline acromegaly: An essential differential diagnosis for the difficult diabetic. J Feline Med Surg. 2010; 12: 15-23.
• Final report, Winn grant W10-017: Evaluation of a long-acting somatostatin receptor ligand for the treatment of feline acromegaly
• Insights into veterinary endocrinology: Dr. Mark E. Peterson

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

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UK study will try to stem high-risk, health-damaging risks in drug-using rural women in Appalachian Kentucky

Researchers at the University of Kentucky have embarked on a five-year study that aims to lower behavioral risks of HIV/AIDS and hepatitis C among disadvantaged, rural women in Appalachian Kentucky. With the help of a $2.7 million grant from the National Institute on Drug Abuse, investigators will examine the effectiveness of a brief intervention in reducing high-risk behaviors, including sexual practices and use of injected drugs.

Michele Staton-Tindall, right, associate professor in the College of Social Work, is the principal investigator. "Our intervention will focus on an individualized plan for enhancing each woman's motivation to reduce risk behaviors and to utilize existing health services," Staton-Tindall said. "The long-term goal of this study is to increase access to health and behavioral-health services in order to improve the quality of health for high-risk rural women."

According to co-investigator Jennifer Havens, HIV is not a high risk for Appalachian drug users, but hepatitis C is. Caused by a virus that attacks the liver, it is the leading cause of liver cancer in the United States. Currently, more Americans die each year from diseases related to hepatitis-C infection than from HIV-related causes, according to data from the Centers for Disease Control and Prevention. Like HIV, hepatitis C is spread through contact with contaminated blood, often through the use of needles shared by intravenous drug users.

Researchers at the University of Kentucky have embarked on a five-year study that aims to lower behavioral risks of HIV/AIDS and hepatitis C among disadvantaged, rural women in Appalachian Kentucky. With the help of a $2.7 million grant from the National Institute on Drug Abuse, investigators will examine the effectiveness of a brief intervention in reducing high-risk behaviors, including sexual practices and use of injected drugs.

Michele Staton-Tindall, right, associate professor in the College of Social Work, is the principal investigator. "Our intervention will focus on an individualized plan for enhancing each woman's motivation to reduce risk behaviors and to utilize existing health services," Staton-Tindall said. "The long-term goal of this study is to increase access to health and behavioral-health services in order to improve the quality of health for high-risk rural women."

According to co-investigator Jennifer Havens, HIV is not a high risk for Appalachian drug users, but hepatitis C is. Caused by a virus that attacks the liver, it is the leading cause of liver cancer in the United States. Currently, more Americans die each year from diseases related to hepatitis-C infection than from HIV-related causes, according to data from the Centers for Disease Control and Prevention. Like HIV, hepatitis C is spread through contact with contaminated blood, often through the use of needles shared by intravenous drug users.

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Report: Two-thirds of Kentuckians obese by 2030 if trends continue; cost to nation's future unquestionably high

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here. 

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here. 

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Some strategies for seniors as Kentucky observes Fall Prevention Awareness Day Saturday, Sept. 22

Kentucky has joined 45 other states in proclaiming Saturday, Sept. 22 as Fall Prevention Awareness Day. In 2011, fall-related injuries among the elderly in the Bluegrass were associated with $266 million in hospital charges, according to Julie Lasslo, Kentucky Safe Aging Coalition coordinator at the Kentucky Injury Prevention and Research Center.

"Falls come at an immeasurable impact on the quality of life for many seniors," Lasslo writes in the Lexington Herald-Leader, noting that the Centers for Disease Control and Prevention estimate that one-third of Americans are hospitalized due to falls. She says such falls are not an inherent part of the aging process and some simple strategies can prevent them:

# Engage in a physical activity regime that includes balance, strength training, and flexibility.
# Consult with a health professional about getting a falls risk assessment.
# Have medications periodically reviewed.
# Get an annual eye exam.
# Store frequently used items at waist level.
# Remove clutter from stairwells, hallways and walking paths.
# Install and use handrails in stairwells and bathrooms.
# Remove throw rugs.
# Place double-sided tape under area rugs and loose carpet.
# Keep your home well-lit and consider using a night light.

For more information, go to Nofalls.org.

Kentucky has joined 45 other states in proclaiming Saturday, Sept. 22 as Fall Prevention Awareness Day. In 2011, fall-related injuries among the elderly in the Bluegrass were associated with $266 million in hospital charges, according to Julie Lasslo, Kentucky Safe Aging Coalition coordinator at the Kentucky Injury Prevention and Research Center.

"Falls come at an immeasurable impact on the quality of life for many seniors," Lasslo writes in the Lexington Herald-Leader, noting that the Centers for Disease Control and Prevention estimate that one-third of Americans are hospitalized due to falls. She says such falls are not an inherent part of the aging process and some simple strategies can prevent them:

# Engage in a physical activity regime that includes balance, strength training, and flexibility.
# Consult with a health professional about getting a falls risk assessment.
# Have medications periodically reviewed.
# Get an annual eye exam.
# Store frequently used items at waist level.
# Remove clutter from stairwells, hallways and walking paths.
# Install and use handrails in stairwells and bathrooms.
# Remove throw rugs.
# Place double-sided tape under area rugs and loose carpet.
# Keep your home well-lit and consider using a night light.

For more information, go to Nofalls.org.

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Governor names board to guide creation of insurance exchange

Gov. Steve Beshear today appointed the board to make recommendations for the state health-insurance marketplace required by federal health reform.

The Health Benefit Exchange Advisory Board, originally planned to include 11 members, was expanded to 19. Beshear explained in a news release, “We need the insight and experience of a variety of Kentuckians to ensure that the exchange not only meets the requirements of the law, but also meets the needs of Kentuckians who will be looking for affordable health insurance.”

"The Health Benefit Exchange will facilitate the purchase and sale of health plans in the individual market; assist small employers in facilitating the enrollment of their employees in health plans; provide one-stop shopping by helping individuals enroll in health plans Medicaid and KCHIP; enable individuals to receive premium tax credits and premium subsidies; and qualify small businesses for tax credits," the release said.

Three public officials will serve as ex-officio representatives, including Insurance Commissioner Sharon Clark, whom Beshear named chair of the board. The other ex-officio members are Medicaid Commissioner Lawrence Kissner and Stephen R. Hall, commissioner of the Department for Behavioral Health and Developmental and Intellectual Disabilities. The other appointees represent various private interests and "will serve for staggered term limits of two or three years as designated by the governor, to ensure the board maintains an experienced membership," the release said.

Consumer advocates or representatives are represented by:
• David Allgood of Louisville, director of advocacy at the Center for Accessible Living.
• Andrea Bennett of Louisville, deputy director of Kentucky Youth Advocates.
• Tihisha Rawlins of Louisville, associate state director of AARP.

Providers based in health-care facilities are represented by:
• Ruth Brinkley of Louisville, president of KentuckyOne Health.
• Julie Paxton of Prestonsburg, an attorney for Mountain Comprehensive Care Center.
• Ed Erway of Lexington, chief revenue officer at  University of Kentucky Healthcare.
• Donna Ghobadi of Lexington, vice president of revenue cycle at Central Baptist Hospital.
Providers not based in health-care facilities are represented by:
• Connie Hauser of Barbourville, a physical therapist.
• John Thompson of Lexington, a dentist.
• Dr. Michael Huang of Lexington, a general internal medicine physician at Kentucky Clinic South, part of UK Healthcare.

Insurers are represented by:
• Deborah Moessner of Louisville, president and general manager at Anthem Blue Cross & Blue Shield.
• Jeff Bringardner of Louisville, president of Humana Inc. Kentucky.
• Carl Felix of Frankfort, chief operating officer at Bluegrass Family Health.

Other representatives are:
• Marcus Woodward of Ashland, a Democratic activist and health-insurance broker, representing insurance agents.
• Gabriela Alcalde of Louisville, a health policy officer at the Foundation for a Healthy Kentucky, representing individual purchasers of health benefit plans.
• Joe Ellis of Benton, an optometrist, representing small employers.

Gov. Steve Beshear today appointed the board to make recommendations for the state health-insurance marketplace required by federal health reform.

The Health Benefit Exchange Advisory Board, originally planned to include 11 members, was expanded to 19. Beshear explained in a news release, “We need the insight and experience of a variety of Kentuckians to ensure that the exchange not only meets the requirements of the law, but also meets the needs of Kentuckians who will be looking for affordable health insurance.”

"The Health Benefit Exchange will facilitate the purchase and sale of health plans in the individual market; assist small employers in facilitating the enrollment of their employees in health plans; provide one-stop shopping by helping individuals enroll in health plans Medicaid and KCHIP; enable individuals to receive premium tax credits and premium subsidies; and qualify small businesses for tax credits," the release said.

Three public officials will serve as ex-officio representatives, including Insurance Commissioner Sharon Clark, whom Beshear named chair of the board. The other ex-officio members are Medicaid Commissioner Lawrence Kissner and Stephen R. Hall, commissioner of the Department for Behavioral Health and Developmental and Intellectual Disabilities. The other appointees represent various private interests and "will serve for staggered term limits of two or three years as designated by the governor, to ensure the board maintains an experienced membership," the release said.

Consumer advocates or representatives are represented by:
• David Allgood of Louisville, director of advocacy at the Center for Accessible Living.
• Andrea Bennett of Louisville, deputy director of Kentucky Youth Advocates.
• Tihisha Rawlins of Louisville, associate state director of AARP.

Providers based in health-care facilities are represented by:
• Ruth Brinkley of Louisville, president of KentuckyOne Health.
• Julie Paxton of Prestonsburg, an attorney for Mountain Comprehensive Care Center.
• Ed Erway of Lexington, chief revenue officer at  University of Kentucky Healthcare.
• Donna Ghobadi of Lexington, vice president of revenue cycle at Central Baptist Hospital.
Providers not based in health-care facilities are represented by:
• Connie Hauser of Barbourville, a physical therapist.
• John Thompson of Lexington, a dentist.
• Dr. Michael Huang of Lexington, a general internal medicine physician at Kentucky Clinic South, part of UK Healthcare.

Insurers are represented by:
• Deborah Moessner of Louisville, president and general manager at Anthem Blue Cross & Blue Shield.
• Jeff Bringardner of Louisville, president of Humana Inc. Kentucky.
• Carl Felix of Frankfort, chief operating officer at Bluegrass Family Health.

Other representatives are:
• Marcus Woodward of Ashland, a Democratic activist and health-insurance broker, representing insurance agents.
• Gabriela Alcalde of Louisville, a health policy officer at the Foundation for a Healthy Kentucky, representing individual purchasers of health benefit plans.
• Joe Ellis of Benton, an optometrist, representing small employers.

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Volunteer emergency medical squads becoming less numerous

Belfry Fire and EMS responds to an accident.
(Rachel Dove-Baldwin, Williamson Daily News)

Volunteer emergency medical service squads appear to be dying out around the nation as rural populations change and EMS evolves, and Kentucky is no exception.

Volunteer squads have long been the sole emergency responders in many rural areas, reports Candi Helseth of the health-oriented Rural Assistance Center, but according to a 2010 study, "Rural Volunteer EMS: Reports from the Field," 69 percent of 49 local EMS directors in 23 states reported problems recruiting and retaining volunteers.

The North Carolina Rural Health Research and Policy Analysis Center study reported three main reasons for loss of EMS volunteers: high numbers of retirees or elderly in rural areas are unlikely to have physical strength required for EMS, many working-age individuals leave rural areas to find jobs elsewhere, and volunteers have too many obligations to cover weekends. Almost three-quarters of the all-volunteer EMS agencies hosted fundraising events to get necessary funding, requiring further time commitments. (Read more)

Volunteer fire departments have reported similar problems, but volunteer firefighters are called out less often and often receive stipends for attending meetings and training, said Michael Poynter, executive director of the Kentucky Board of Emergency Medical Services. He told Kentucky Health News that that state is part of the national trend away from volunteer EMTs, but still has 17 services that are fully volunteer and 35 that use a mixture of paid EMTs and volunteers. Kentucky has more than 250 licensed emergency medical services.

Belfry Fire and EMS responds to an accident.
(Rachel Dove-Baldwin, Williamson Daily News)

Volunteer emergency medical service squads appear to be dying out around the nation as rural populations change and EMS evolves, and Kentucky is no exception.

Volunteer squads have long been the sole emergency responders in many rural areas, reports Candi Helseth of the health-oriented Rural Assistance Center, but according to a 2010 study, "Rural Volunteer EMS: Reports from the Field," 69 percent of 49 local EMS directors in 23 states reported problems recruiting and retaining volunteers.

The North Carolina Rural Health Research and Policy Analysis Center study reported three main reasons for loss of EMS volunteers: high numbers of retirees or elderly in rural areas are unlikely to have physical strength required for EMS, many working-age individuals leave rural areas to find jobs elsewhere, and volunteers have too many obligations to cover weekends. Almost three-quarters of the all-volunteer EMS agencies hosted fundraising events to get necessary funding, requiring further time commitments. (Read more)

Volunteer fire departments have reported similar problems, but volunteer firefighters are called out less often and often receive stipends for attending meetings and training, said Michael Poynter, executive director of the Kentucky Board of Emergency Medical Services. He told Kentucky Health News that that state is part of the national trend away from volunteer EMTs, but still has 17 services that are fully volunteer and 35 that use a mixture of paid EMTs and volunteers. Kentucky has more than 250 licensed emergency medical services.

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Former health secretary is CEO of Kentucky Health Cooperative, a new type of insurance firm created by health reform

Former health and family services secretary Janie Miller, who resigned in February, has become chief executive of the Kentucky Health Cooperative, a new type of health-insurance organization established by the federal health-care reform law.

The Patient Protection and Affordable Care Act requires the cooperatives to be "directed by their customers and designed to offer people and small businesses affordable health insurance options," Tom Loftus explains for The Courier-Journal, noting that the co-op got a $59 million loan from the U.S. Department of Health and Human Services in June. The co-op "is sponsored by a coalition of business leaders, health providers and community organizations," Loftus reports.

The co-op declined to reveal Miller's salary. She was state insurance commissioner from 2001 to 2003, when Republican Gov. Ernie Fletcher was elected. When Democrat Steve Beshear became governor in December 2007, he named Miller secretary of the Cabinet for Health and Family Services. She is a naive of McCreary County.

Miller said in a news release, “The co-op will be governed and run by its members and will provide individuals and small businesses a viable alternative for quality, affordable health insurancec coverage. Unlike traditional insurance, however, any profits earned by the co-op must be used to improve benefits or lower premiums.” The C-J story is here.

Former health and family services secretary Janie Miller, who resigned in February, has become chief executive of the Kentucky Health Cooperative, a new type of health-insurance organization established by the federal health-care reform law.

The Patient Protection and Affordable Care Act requires the cooperatives to be "directed by their customers and designed to offer people and small businesses affordable health insurance options," Tom Loftus explains for The Courier-Journal, noting that the co-op got a $59 million loan from the U.S. Department of Health and Human Services in June. The co-op "is sponsored by a coalition of business leaders, health providers and community organizations," Loftus reports.

The co-op declined to reveal Miller's salary. She was state insurance commissioner from 2001 to 2003, when Republican Gov. Ernie Fletcher was elected. When Democrat Steve Beshear became governor in December 2007, he named Miller secretary of the Cabinet for Health and Family Services. She is a naive of McCreary County.

Miller said in a news release, “The co-op will be governed and run by its members and will provide individuals and small businesses a viable alternative for quality, affordable health insurancec coverage. Unlike traditional insurance, however, any profits earned by the co-op must be used to improve benefits or lower premiums.” The C-J story is here.

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KET talks with experts on heart disease and health reform tonight

Some nationally recognized heart specialists will speak directly to Kentuckians about heart disease tonight on the season premiere of Health Three60 on KET. Cardiovascular disease, the leading cause of death in the United States -- and, perhaps surprisingly, in women -- will get a thorough examination. The show will take on the history of the disease, what women should know about the disease and what the future looks like for all of us. Host Renee Shaw will explore the history of cardiac surgery and the development of the artificial heart with Dr. Laman Gray, Jr. cardiovascular surgeon and medical director at the Cardiovascular Innovation Institute. Gray will also discuss how the death rate from heart disease has decreased even as the increase has gone up.

Guests will also include Dr. Joey Maggard, executive director of the Central Kentucky Chapter of the American Heart Association; Dr. Melissa Walton-Shirley, cardiologist with Cardiology Associates in Glasgow; Mark Rucker, recipient of the American Heart Association Lifestyle Change Award; Dr. Paula Hollingsworth, cardiologist at Central Baptist Hospital in Lexington; and, James B. Hoving, Ph.D., division chief of cardiosvascula therapeutics at the Cardiovascular Innovation Institute. Health Three60 airs at 9 p.m. EDT.

Immediately preceding Health Three60, on this week's edition of Kentucky Tonight, host Bill Goodman and guests will discuss health care and health care reform.  Scheduled guests include State Sen. Tom Buford, R-Nicholasville, chair of the Senate Banking and Insurance Committee; State Rep. Mary Lou Marzian, D-Louisville, vice chair of the House Budget Review Subcommittee on Human Resources; Dr. Ralph Alvarado, a Winchester internist and pediatrician; and Dr. Barbara Casper, an internist and University of Louisville professor of medicine. Kentucky Tonight airs at 8 EDT.

Some nationally recognized heart specialists will speak directly to Kentuckians about heart disease tonight on the season premiere of Health Three60 on KET. Cardiovascular disease, the leading cause of death in the United States -- and, perhaps surprisingly, in women -- will get a thorough examination. The show will take on the history of the disease, what women should know about the disease and what the future looks like for all of us. Host Renee Shaw will explore the history of cardiac surgery and the development of the artificial heart with Dr. Laman Gray, Jr. cardiovascular surgeon and medical director at the Cardiovascular Innovation Institute. Gray will also discuss how the death rate from heart disease has decreased even as the increase has gone up.

Guests will also include Dr. Joey Maggard, executive director of the Central Kentucky Chapter of the American Heart Association; Dr. Melissa Walton-Shirley, cardiologist with Cardiology Associates in Glasgow; Mark Rucker, recipient of the American Heart Association Lifestyle Change Award; Dr. Paula Hollingsworth, cardiologist at Central Baptist Hospital in Lexington; and, James B. Hoving, Ph.D., division chief of cardiosvascula therapeutics at the Cardiovascular Innovation Institute. Health Three60 airs at 9 p.m. EDT.

Immediately preceding Health Three60, on this week's edition of Kentucky Tonight, host Bill Goodman and guests will discuss health care and health care reform.  Scheduled guests include State Sen. Tom Buford, R-Nicholasville, chair of the Senate Banking and Insurance Committee; State Rep. Mary Lou Marzian, D-Louisville, vice chair of the House Budget Review Subcommittee on Human Resources; Dr. Ralph Alvarado, a Winchester internist and pediatrician; and Dr. Barbara Casper, an internist and University of Louisville professor of medicine. Kentucky Tonight airs at 8 EDT.

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New state web portal eases non-emergency reporting of child and adult abuse and neglect

The state Department for Community Based Services has launched a web-based portal for reporting child and adult abuse and neglect in non-emergency situations. According to DCBS Commissioner Teresa James, the new system should enhance the current intake system, especially for those situations that do not require an immediate response from the department's staff.

Law enforcement and judicial officials, medical professionals, educators, child and senior caregivers and other advocates have been using the program since July, giving feedback to DCBS staff to help refine the system for the general public. According to the Cabinet for Health and Family Services press release, "Users of the portal are required to enter an email contact and will receive an immediate, automated response that their online report has been made. Centralized intake staff will review reports as they are submitted. Users will receive a response message within 48 hours only if their report has not been accepted because it doesn’t meet criteria for investigation. Reports that are accepted do not generate a follow-up email message. The reporting portal has several mandatory input fields so that intake staff can get adequate information about the incident, the alleged victim, the alleged perpetrator and any safety issues in order to screen reports effectively."

The site, https://prd.chfs.ky.gov/ReportAbuse/home.aspx, will be monitored from 8 a.m. to 4:30 p.m. ET Monday through Friday. Reports will not be reviewed during evenings, weekends or state holidays.

If situations arise during these times indicating a child or adult is at risk of immediate harm, these should be reported to 911, local law enforcement or 877-KY SAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour. Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

 

The state Department for Community Based Services has launched a web-based portal for reporting child and adult abuse and neglect in non-emergency situations. According to DCBS Commissioner Teresa James, the new system should enhance the current intake system, especially for those situations that do not require an immediate response from the department's staff.

Law enforcement and judicial officials, medical professionals, educators, child and senior caregivers and other advocates have been using the program since July, giving feedback to DCBS staff to help refine the system for the general public. According to the Cabinet for Health and Family Services press release, "Users of the portal are required to enter an email contact and will receive an immediate, automated response that their online report has been made. Centralized intake staff will review reports as they are submitted. Users will receive a response message within 48 hours only if their report has not been accepted because it doesn’t meet criteria for investigation. Reports that are accepted do not generate a follow-up email message. The reporting portal has several mandatory input fields so that intake staff can get adequate information about the incident, the alleged victim, the alleged perpetrator and any safety issues in order to screen reports effectively."

The site, https://prd.chfs.ky.gov/ReportAbuse/home.aspx, will be monitored from 8 a.m. to 4:30 p.m. ET Monday through Friday. Reports will not be reviewed during evenings, weekends or state holidays.

If situations arise during these times indicating a child or adult is at risk of immediate harm, these should be reported to 911, local law enforcement or 877-KY SAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour. Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

 

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Cyclosporine in cats

Final report, Winn grant W09-028
Pharmacokinetics of cyclosporine after intravenous and subcutaneous administration in cats
Investigators: Sandra Diaz, David Panciera, James Meldrum; Virginia_Maryland Regional College of Veterinary Medicine

Cyclosporine A (CsA) is an immune-modulating drug that has traditionally been used for kidney transplantation in cats. In recent years, CsA has been reported to be effective in the management of several skin diseases, including allergic skin disease. CsA is typically given by mouth, but absorption of the drug is variable and not all owners can give oral medication to their cats long term. The objective of this study was to determine if subcutaneous administration of CsA would give predictable blood concentrations of the drug. If so, this route of drug administration could be easier for some cat owners, and may reduce side effects and reduce the need for blood monitoring of drug levels.

This study looked at the pharmacokinetic profile of CsA after intravenous (IV) and subcutaneous (SQ) administration. Five healthy adult cats were given a single IV bolus of CsA. After two weeks, they received a dose of CsA SQ every 48 hours for 14 days. Blood samples were taken and measured. No adverse effects were observed in any cat. The results indicated that SQ CsA bioavailability is very good. The SQ route could represent a promising route of administration in cats in the future. [VT]

See also: Heinrich NA, McKeever PJ and Eisenschenk MC. Adverse events in 50 cats with allergic dermatitis receiving ciclosporin. Vet Dermatol. 2011; 22: 511-20.

More on cat health: Winn Feline Foundation Library
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Final report, Winn grant W09-028
Pharmacokinetics of cyclosporine after intravenous and subcutaneous administration in cats
Investigators: Sandra Diaz, David Panciera, James Meldrum; Virginia_Maryland Regional College of Veterinary Medicine

Cyclosporine A (CsA) is an immune-modulating drug that has traditionally been used for kidney transplantation in cats. In recent years, CsA has been reported to be effective in the management of several skin diseases, including allergic skin disease. CsA is typically given by mouth, but absorption of the drug is variable and not all owners can give oral medication to their cats long term. The objective of this study was to determine if subcutaneous administration of CsA would give predictable blood concentrations of the drug. If so, this route of drug administration could be easier for some cat owners, and may reduce side effects and reduce the need for blood monitoring of drug levels.

This study looked at the pharmacokinetic profile of CsA after intravenous (IV) and subcutaneous (SQ) administration. Five healthy adult cats were given a single IV bolus of CsA. After two weeks, they received a dose of CsA SQ every 48 hours for 14 days. Blood samples were taken and measured. No adverse effects were observed in any cat. The results indicated that SQ CsA bioavailability is very good. The SQ route could represent a promising route of administration in cats in the future. [VT]

See also: Heinrich NA, McKeever PJ and Eisenschenk MC. Adverse events in 50 cats with allergic dermatitis receiving ciclosporin. Vet Dermatol. 2011; 22: 511-20.

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

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