Sunday, September 28, 2014

Claims that health-reform law is putting Kentuckians out of work don't hold up to scrutiny, economic experts say

"Key Republicans running for election Nov. 4 say the federal Affordable Care Act is putting Kentuckians out of work, but employment data and interviews with Kentucky-based economists suggest otherwise," John Cheves reports for the Lexington Herald-Leader.

The objects of Cheves's scrutiny are a television commercial for U.S. Rep. Andy Barr, R-Lexington, saying Democratic challenger Elisabeth Jensen "supports Obamacare, which has decimated Kentucky jobs," and an opinion piece, by Sen. Mitch McConnell saying "There are so many stories about businesses holding back from expanding or hiring — or even cutting back on their workforces — it's hard to even count."

McConnell's anecdotal assertion proves nothing, and Barr's appears to be false. Cheves notes that Kentucky has gained 3,600 health-care jobs during the last year and quotes experts: Manoj Shanker, an economist at the state Office of Employment and Training, who said the law "is expected to be a net gain for the economy . . . and not just for doctors and nurses. It will mean the creation of jobs in other areas, including clerical staff for processing claims, more receptionists, more pharmacy technicians and clerks, more janitors, orderlies and ambulance drivers."

Glen Mays, a University of Kentucky public-health professor who studies health economics, told Cheves, "I think the law is definitely going to stimulate the health-care segment of our local economies, especially where we've seen substantial drops in the numbers of people who are uninsured. People who were forgoing medical care because they did not have insurance now can access it."

KET will discuss asthma Monday night: living with it, its environmental affects, and available resources to deal with it

KET's current "Health Three60" program is "Easing the Burden of Asthma," discussing a disease that hospitalizes more than 6,000 Kentuckians a year. After debuting on KET Sept. 29 at 9 p.m., it will air on KETKY Sept. 30 at 2 p.m., again on KET Oct. 1 at 3 a.m., again on KETKY Oct. 1 at 9 a.m., again in KET Oct. 2 at 4 a.m. and KETKY Oct. 2 at 4 p.m. (all times EDT).

Host Renee Shaw and guests discuss what it means to live with asthma, daily asthma management and the need for better education and support. They will also explore how the environment affects asthma, both outdoors and indoors.  One segment will look at a pioneering initiative at the Ashland-Boyd County Health Department, which sends health professionals into the homes of people with asthma to help them improve their indoor air quality and reduce asthma triggers. It will also discuss how smoke-free laws help people with asthma. Another segment will look at how to access and utilize resources to help with asthma, such as the Kentucky Asthma Partnership.

Guests on the program include Beth VanCleave, asthma educator at Kosair Children's Hospital, Louisville; Connie White, deputy commissioner of the Kentucky Department for Public Health; David Mannino, professor, University of Kentucky College of Public Health; James Sublett, co-founder of Family Allergy and Asthma and president-elect of the American College of Allergy, Asthma and Immunology.

Kentucky school officials make foods look more appetizing and easier to eat, in order to decrease food waste

Some school districts are working to keep fruits and vegetables from being thrown out by students who seem to be unhappy with their school lunches that must follow stricter nutrition guidelines to get federal subsidies. "The key to getting students to eat healthier is to make the food look appetizing and easy to eat," Rich Suwanski reports for the Messenger-Inquirer in Owensboro.

A recent study by the Harvard School of Public Health in four low-income schools in Massachusetts found that while the guidelines had increased fruit and vegetable consumption, students threw away 60 percent of fresh vegetables and 40 percent of fresh fruits.

Lisa Sims, Daviess County Public Schools nutrition director, and Lisa McCarty, Owensboro Public Schools human resources and food services officer, are trying to keep that from happening in the county. Sometimes it's as simple as "like cutting up the fruit to make it easier to eat," Sims told Suwanski. "Even high school kids won't eat apples and oranges whole because it's more work, and they've got a short amount of time for their lunch break, so we slice the fruit and bag it. They could eat a whole apple if they wanted to, but that's not what their lunch break is all about. It's about socializing, too, and we realize that."

McCarty told Suwanski that the Owensboro schools don't see a lot of wasted fruit and vegetables, but they pay attention to what is being thrown out, and then figure out why. She told him they sometimes will swap out items to foods the students like better and make sure that the foods they serve look appealing.

Federal guidelines have also required schools to increase whole grains and decrease the sodium in their menus. The whole grain mandate began this year. Sims and McCarty told Suwanski that those changes have been a challenge, but by making them gradually, the students have adjusted. Shifts have been made toward offering whole-grain breads, biscuits, pizza crust, pasta and even the breading on the chicken.

"Little by little, we've been changing to whole grain and there's not a lot of reaction against it, " Simms told Suwanski. "Actually, we're kind of surprised to see them taking the whole grain pasta."

Lots of research has established that children with egg allergies can still get a flu shot; those with asthma especially should

Flu season can start as early as October, and  children with egg allergies are now encouraged to get a flu shot, especially if they have asthma, according to a news release from the American College of Allergy, Asthma and Immunology.

Children with egg allergies may have been told in the past to not get a flu shot because of a possible reaction to trace amounts of eggs in which the vaccine is produced, but recent research now says that the vaccine is safe for these kids.

“We now know administration is safe, and children with egg allergies should be vaccinated,” Michael Foggs, president of the American College of Allergy, Asthma and Immunology, said in the news release. “We recommend that, as with any vaccine, all personnel and facilities administering flu shots have procedures in place for the rare instance of anaphylaxis, a life-threatening allergic reaction.”

The release says "a large number of research studies published over the last several years have shown that thousands of egg-allergic children, including those with a severe life-threatening reaction to eating eggs, have received injectable influenza vaccine as a single dose without a reaction."

More than 21,100 children under the age of five are hospitalized annually because of the flu, with only 55 percent of children ages 5-17 getting a flu shot, according to the Centers for Disease Control and Prevention, says the release.

Foggs especially recommended that children with asthma get the vaccine, because even though they are not more likely to get the flu, it can be more serious for those with asthma, says the release.

"Children with asthma really need to get the flu vaccine," Foggs said in the release. “Asthma sufferers are among the most vulnerable because the flu compromises their airways even further than they already are.”

Saturday, September 27, 2014

State's commissioners of education and health urge Kentucky's school boards to make their campuses smoke-free

The commissioners of Kentucky’s education and health departments have jointly signed and sent letters to all 173 school superintendents in the state asking them to pass full smoking bans "to protect the health of students," Devin Katayama reports for Louisville's WFPL.

Education Commissioner Terry Holliday and Health Commissioner Stephanie Mayfield Gibson said in the letter that "only 36 school districts, including Jefferson County, have passed comprehensive smoking bans that prohibit smoking anytime on any school property, in school vehicles and during field trips," Katayama writes.

The state has decreased its student smoking rate to 18 percent, down from 24 percent in 2011, according to the most recent Youth Risk Behavior Surveillance System report, but that still leaves Kentucky near the top, ranking 6th place in youth smoking. The national average is 15.7 percent.

“Are we pleased it’s decreasing, of course. Are we resting on our laurels and said great job? Absolutely not, we have more work to do," she told Katayama.

Friday, September 26, 2014

Kentucky schools teach nutrition with hands-on-learning

Visiting dairy cows, growing food in the air and being the first school in the state to grow its own garden on school grounds are just some of the efforts Kentucky schools are making to help their students learn more about nutrition.

Shelby County's Heritage Elementary School joined schools in 40 countries in the 15th annual World School Milk Day on Sept. 24, where they learned about the nutritional importance of milk, Ashley Wilkins reports for The Sentinel-News of Shelbyville.

The students learned from the Southeast United Dairy Industry Association in the cafeteria, which was decorated in a cow-related theme while the cafeteria employees wore cow costumes and provided milk to the students. The students also enjoyed stick-on milk mustaches and were able to pet and view calves outside on the playground.

“Lots of kids don’t have a lot of opportunities to see dairy cows up close,” SUIDA's Kathy Belcher told Wilkins.

Students in the Eastern Elementary School Wellness Club in Barren County are learning about nutrition not only in this club, but with its hydroponic tower garden, adding a second one this week, Bobbie Hayse reports for the Glasgow Daily Times.

The Wellness Club meeting was led by fourth-grade teacher Cathy Bishop, who asked the students if they had talked to their parents about what they had been learning about health. They also talked about who had met their goal of not drinking any sodas that week, and also about the importance of making healthy choices such as getting plenty of sleep, drinking plenty of water, making good food choices, exercising and limiting screen time.

“We need to try to make healthy choices, and try to take care of our bodies the best we can because this is the only body we get,” Bishop said. “The habits we start today are going to make a difference for the way our body feels a long time down the road from now."

Nutritional learning in the club is reinforced with growing plants in the tower gardens, which are vertical systems that grows food hydroponically with aeroponics, a process for growing food in an air and water environment, Hayse reports.

Jennifer Turner, a dietitian who helped the students plant seeds and build the tower garden, told Hayse, "Research shows that if kids have a hand in growing and making food, they are more likely to try it."

Beaver Dam Elementary School in Ohio County is the first school in the state to have a garden on school grounds, through donations from businesses and individuals, Lisa Autry reports for WKU Public Radio.

Kindergarten teacher Becky Gaither, who helped start the garden project, told Autry that "students learn the value of hard work by maintaining the garden and they get to enjoy the harvest." She said that the students had already made pizzas in the classroom with cherry tomatoes and herbs harvested from the garden.

Kentucky Agriculture Commissioner James Comer visited the school on Thursday to recognize the school as having the state’s first certified “Ready, Set, Grow” garden and said he hoped the "concept will expand statewide," Autry reports.

UK gets historic $1.8 million grant to fight obesity in six highly obese counties: Clinton, Elliott, Lewis, Letcher, Logan, Martin

The Cooperative Extension Service at the University of Kentucky is getting $1.8 million in federal funds over the next three years to fight obesity in several of the Kentucky counties most affected by the problem.

"Researchers and extension personnel in UK's College of Agriculture, Food and Environment and College of Public Health will work in six Kentucky counties that have obesity rates higher than 40 percent ... Logan, Clinton, Lewis, Martin, Letcher and Elliott," Katie Pratt writes for UKAgNews.

The work will focus on reducing chronic disease rates, advocating healthier lifestyles, reducing of health disparities and supervising health-care spending. It will be overseen by the federal Centers for Disease Control and Prevention.

"This is the first time the CDC has directly funded a Cooperative Extension program," said Ann Vail, director of the UK School of Human Environmental Sciences, part of the College of Agriculture, Food and Environment. "The grant will support building and strengthening collaborations between extension and public health personnel at the university, community and state levels."

Extension agents, state extension professionals, local health departments, UK public-health specialists and community health coalition members will create programs designed to reduce obesity rates and improve residents' overall health. Strategies will be modified to fit the needs of each county.

The grant from the U.S. Department of Health and Human Services is part of $4.6 million that the agency "has dedicated to this program, which has resulted in awards to six land-grant universities," Pratt reports.

Researchers say aggressively treating pre-diabetes could stop or delay future diabetic complications

Treating pre-diabetes as if it is diabetes could delay or prevent future related health complications, according to doctors from three leading research institutions and the American Diabetes Association, says a press release from the University of North Carolina School of Medicine.

The researchers writes in the journal Diabetes Care that "by not devising a treatment strategy for people with pre-diabetes, doctors run the risk of creating a pool of future patients with high blood sugar who then become more likely to develop serious complications, such as kidney disease, blindness, amputations, and heart disease."

Type 2 diabetes is diagnosed with a fasting blood sugar of 126 or higher; most of these patients are treated with medication. Prediabetes is diagnosed with sugar levels between 100 and 125, and the release says such patients are usually not treated aggressively.

"Diabetes is generally diagnosed and first treated about 10 years later than it could be. We waste this critical opportunity to slow disease progression and the development of complications," lead author Lawrence Phillips of Emory University said in the release.

Kentucky ranks 17th in diabetes, according to the 2014 "State of Obesity" report. The report projects that there will be an increase of 51 percent of people with diabetes in Kentucky by 2030, going from 394,029 people with diabetes in 2010 (or 10.6 percent) to 594,058. The Kentucky Cabinet for Health and Family Services reports an estimated 233,000 adult Kentuckians have pre-diabetes.

“We need to screen and track patients with pre-diabetes to manage their blood sugar more aggressively,” John Buse, professor of medicine and director of the UNC Diabetes Care Center, said in the release. “We’re very confident this would spare our patients serious health issues down the road.”

Evidence for this study comes from clinical trials where "lifestyle changes and/or glucose-lowering medications decreased the progression of pre-diabetes to Type 2 diabetes," says the release. The future development of diabetes also remained less in those who implemented these changes and then withdrew from them compared to a pre-diabetic control group who did not get any interventions.

Patients who achieved a normal glucose level, even for a short time during the trials, showed a "substantial reduction in subsequent development of Type 2 diabetes," says the release.

The authors say in the release that based on this evidence diabetes management should change to include regular screening in adults for pre-diabetes and early Type 2 diabetes and if a patient has either one of these conditions and is determined to benefit from treatment, they should get "management that will keep their blood glucose levels as close to normal as possible."

Thursday, September 25, 2014

Study finds that early memory loss can be a predictor of dementia

Experiencing memory loss early in life could be a cause for concern about dementia later in life.

Research from the University of Kentucky's Sanders-Brown Center on Aging has found that "self-reported memory loss is a strong predictor of clinical memory impairment later in life," says a university press release. The study was published online Sept. 24 in the journal Neurology.

The research was led by Richard Kryscio, associate director of UK's Alzheimer's Disease Center. It involved 531 people with an average age of 73 and free of dementia, says the release. Participants were asked about changes in their memory in the prior year and were given an annual memory and thinking test for 10 years. After death, the participants' brains were examined for evidence of Alzheimer's disease.

The study found that 56 percent of the participants reported changes in their memory by age 82. This group was nearly three times more likely to develop memory and thinking problems. In all, about one in six participants developed dementia during the study, with 80 percent of that group reporting early changes in memory.

 "What's notable about our study is the time it took for the transition from self-reported memory complaint to dementia or clinical impairment -- about 12 years for dementia and nine years for clinical impairment -- after the memory complaints began," Kryscio said in the press release. "That suggests that there may be a significant window of opportunity for intervention before a diagnosable problem shows up."

Kryscio said in the release that while all memory issues should be reported to a doctor, there "isn't cause for immediate alarm if you can't remember where you left your keys."

Lexington is considering whether to add electronic cigarettes to its anti-smoking ordinance

The Lexington-Fayette Urban County Council will discuss whether to expand its smoking ban to include electronic cigarettes, possibly as early as Oct. 7 at the General Government Committee meeting, Beth Musgrave reports for the Lexington Herald-Leader.

Berea, Bardstown, Danville, Glasgow, Manchester and Richmond have banned included e-cigarettes in smoking bans; on Oct. 6 Versailles may do likewise. (The city is replacing a Woodford County Board of Health regulation that was ruled unconstitutional.)

Amy Barkley, chairwoman of the Smoke-Free Kentucky Coalition, told Musgrave that cities and states updating their anti-smoking ordinances to include e-cigarettes is "part of a trend," and "Lexington has always been the leader in smoke-free policy in this state."

But e-cigarettes have changed the terms of smoking-ban debates. Tony Florence, co-owner of 723 Vapor Store in Lexington, which sells e-cigarettes, told Musgrave, "It's ludicrous to try to ban something that is trying to help people kick a horrible habit," Florence said. "The way that I look at it, if you are anti e-cigarette then you are really pro-lung cancer."

Gorton, who is a registered nurse, told Musgrave that she supported an amendment to the smoking ordinance because the Fayette County Board of Health recommended it. Gorton also noted that the state now bans all tobacco products, including e-cigarettes, on most state properties and that Rupp Arena and the attached Lexington Convention Center do likewise.

Supporters of e-cigarette ordinances say the devices are not effective in helping people stop smoking and "not much is known about the effects of electronic cigarettes," Musgrave reports. Barkley also told Musgrave that because e-cigarettes look like real cigarettes it "undermines the enforceability of smoking ordinances."

The Food and Drug Administration does not regulate e-cigarettes. Smoke-free advocates, including Barkley say that "until the FDA regulates e-cigarettes, it's best to include them in smoking bans," Musgrave writes.

But Florence told Musgrave that "the federal government hasn't acted on e-cigarettes for a reason: The research is not conclusive."

Tuesday, September 23, 2014

CDC sending full-time senior staffer to E. Ky. to help health departments tackle the region's chronic, serious health problems

The federal Centers for Disease Control and Prevention will place a full-time employee in Eastern Kentucky to help public health departments battle the region's serious, chronic health problems, the area's congressman said Tuesday.

Republican Rep. Harold "Hal" Rogers of Somerset, chair of the House Appropriations Committee, said CDC Director Dr. Thomas Frieden, who spent three days with him in his Fifth Congressional District last month, told him he would assign a senior staffer to the job.

Beshear, Rogers (Melissa Newman photo)
Rogers made the announcement at a meeting of the executive committee of Shaping Our Appalachian Region, the economic-development effort he started with Democratic Gov. Steve Beshear. In a meeting at Natural Bridge State Resort Park, the panel heard reports from chairs of SOAR's working groups, which held "listening sessions" around the region this summer.

The Health Working Group "recommended pushing a statewide ban on smoking indoors in public; asking the Centers for Disease Control and Prevention to study poor health in the region and the emerging research on a correlation between mountaintop mining and health problems," Bill Estep reports for the Lexington Herald-Leader.

The working group's PowerPoint slide said, "Invite the CDC to form a task force to accurately map the current state of health in Eastern Kentucky and to create a strategic health plan for the region; start the 'Healthy 5 for the 5th' campaign for individual health in an effort to promote wellness in the region; explore Coordinated School Health programs for our entire region; ramp up oral-health efforts to encourage school-based oral health services are underway in every school district in the region."

Kentucky doctors treat an increasing number of babies suffering from drug addiction given to them by their mothers

Neonatal abstinence syndrome, or NAS, is becoming such a widespread problem that many medical professionals are calling it an epidemic and a public-health crisis. In 2001, 67 Kentucky babies were hospitalized for drug withdrawal, and in 2013, 955 were, according to the Cabinet for Health and Family Services, Justin Madden writes for The Lexington Herald-Leader.

Baby Sheena, who has neonatal abstinence syndrome, in
treatment at the University of Kentucky Children's Hospital.
(Lexington Herald-Leader photo by Mark Cornelison)
Henrietta Bada, a neonatologist at the University of Kentucky Children's Hospital, said babies born with NAS are eager to eat, "but then you give them their formula or their feedings, but they just cannot." She said they can't "coordinate their suck-swallow reflexes . . . If they are not treated, then they end up with weight loss, dehydration," and are sicker than if they had only been going through withdrawal.

Bada said she can treat the babies with medication, but she wants to make sure they go to a safe home: "Babies have to go home to a mother that is capable of taking care of him or her." There isn't enough care for mothers dealing with drug addictions, she said, "and the lack of care continues after the baby is born." She also noted that at least 80 percent of the medical bills are paid through Medicaid, "which can cost as much as $60,000."

The Kentucky Perinatal Association and the state's Department for Public Health are working together to make standardized treatments for mothers and babies, The Associated Press reported earlier this month. Officials also continue to look for ways to solve the state's drug problem.

Eric Reynolds, a neonatologist at Kosair Children's Hospital in Louisville, pointed out that NAS isn't always a result of a mother abusing drugs. "We need better treatment options for the pregnant mothers who have a legitimate medical reason to be on these types of medications," he said.

Reynolds and Bada said endeavors to fight NAS begin with education, and Reynolds added that the long term effects of NAS are not yet known because it's early in the epidemic, Madden writes.