Thursday, April 17, 2014

High school students in Bourbon County campaign for indoor smoking ban, also against teenagers' use of e-cigarettes

From left: LaShana Harney, Tyler Boyle
and Jessica Jones
(
Coriá Bowen photo)
By Coriá Bowen

A group of young people in a Bluegrass county with a strong tobacco tradition is trying to make the county's indoors smoke-free.

Students Making a Change in our Community started at Bourbon County High School in the late 1990s and was revamped in 2013 by several students and Cyndi Steele of the Bourbon County Health Department. SMACC members said they felt it was time for the voices of youth to be heard again on smoking issues.

“Our main idea is to try to establish a smoke-free ordinance in Bourbon County,” senior Lashana Harney said.

The group has been busy this year collaborating with other youth in Paris at events such as the 2013 National Kick Butts Day – a youth rally against tobacco use and secondhand smoke – as well as attending a recent Kentucky Supreme Court hearing on an anti-smoking ordinance enacted by the Bullitt County Board of Health.

“It was interesting to be at an actual case,” Harney said. “It could go either way with this case.”

Jessica Jones, a junior, said that while SMACC targets adults, it also educates and trains elementary students on how to say no to tobacco, and about the harms of smoking. “We’ve been traveling and training fifth-graders,” she said.

SMACC members are working towards a school regulation against electronic cigarettes, which they think are deceptive. They don’t believe their peers realize the harmful effects associated with them.

“E-cigarettes are becoming more popular than traditional cigarettes,” junior Tyler Boyle said. ““The best way to get to youth is other youth.”

The Kentucky Tobacco Policy Research Program lists chemicals in e-cigarettes that can have negative effects on health including acetone (nail polish remover) and formaldehyde. The legislature recently banned sales of e-cigarettes to people under 18.

Harney, Jones and Boyle say they have seen a decrease in their parents’ smoking since each student has become an anti-smoking advocate.

With Steele’s guidance, SMACC plans to keep educating and making its presence known in the community. Members will launch a group-written and directed YouTube video at the end of April that addresses secondhand smoke, titled, “It Could Be You.”

Steele said the road to banning smoking in public places for Bourbon County has been a work in progress for a long time: “I knew 20 years ago that when I chose to do this … it would be my career.” Now she has more help.

Wednesday, April 16, 2014

Poll: most Kentuckians support tobacoo-free campuses, school nutrition standards and student physical activity requirements

Kentuckians overwhelmingly support several school policies than can influence student health but are not all embraced by Kentucky schools, according to the latest Kentucky Health Issues Poll, taken in October and November.

The poll showed that 84 percent of Kentuckians—and 72 percent of smokers—support tobacco-free campus policies, which have been adopted by only about a third of Kentucky school districts. The survey also found that 72 percent strongly favor the tobacco-free policies, while 12 percent said they favored it somewhat.

The survey found that 57 percent of Kentucky adults strongly supported, and 21 percent somewhat supported, the U.S. Department of Agriculture's new standards for school nutrition, which reduced salt and saturated fat, increased offerings of whole-grain foods, fruit and vegetables, and put stricter controls on calories and portion size.

Because the U.S. Department of Health and Human Services recommends that young people exercise for 60 minutes per day, KHIP's survey asked Kentucky adults if they think Kentucky schools should offer 30 minutes of physical activity per day for students. It found that 88 percent strongly agreed and 9 percent somewhat agreed with the policy. Physical activity is an important topic for Kentucky because 18 percent of Kentucky children are obese, according to the Kaiser Family Foundation.
Democrats were more likely to be supportive of tobacco-free campuses and the new school menus, but there was no partisan difference on physical activity. "Poll findings show that support for the health of our children cuts across party lines," said Susan Zepeda, President/CEO of the Foundation for a Healthy Kentucky, which sponsors the poll with Interact for Health of Cincinnati. It is conducted by researchers at the University of Cincinnati.

UK's advanced ventricular-assist device program for heart patients saves and improves lives

Two years ago, John Doty was diagnosed with walking pneumonia, and though antibiotics originally helped, the pneumonia came back with a vengeance, and he went to see a cardiologist. He found out his heart was severely weakened with an ejection fraction of less than 10 percent. "The ejection fraction is a measure of how effectively the heart can pump blood volume into the body, and in a healthy heart, that number falls between 50-65 percent," Allison Perry writes for the University of Kentucky, where Doty received a left ventricular assist device (LVAD) because his heart was so weak.

UK Chandler Hospital is Lexington's only hospital, and one of two in the state, that can perform emergency VAD procedures. "When Mr. Doty was transferred to UK, he was very sick, on a ventilator and requiring two medications to support his blood pressure," said Dr. Navin Rajagopala, a heart failure cardiologist at the UK Gill Heart Institute. "He was going into kidney and liver failure. It was clear that he needed an assist device as soon as possible before the damage to his body was irreversible."

VADs partially take the place of the function of a failing heart. They're more often used for the left ventricle, but some patients need the device for the right ventricle or even two devices to help both ventricles (BiVAD). Because VADs can help the heart rest and heal, some patients receive them after a heart attack or a surgery. People suffering from congestive heart failure might need a VAD for the rest of their lives.

A viral infection damaged Andy Baker's heart, and though he originally resisted the idea of a VAD, now he says he's "happy to keep the device and has no interest in getting a heart transplant," Perry writes. "I had mixed feelings about it," Baker said about getting the VAD, "but it's given me life again."

VAD treatment can save money for the both the patient and the hospital and allow at-home recovery. VADs can allow people to return to their normal lives, participating in many of the same activities they did previously. in about 5 to 10 percent of cases, the VAD even helps the heart to heal to the point that the device can be removed. That was the situation for Doty, whose device was removed 16 weeks after he got it. "I almost feel like I never had it," Doty said. "It wasn't that great of an imposition, considering that it was keeping you alive."

UK performs about 20 to 30 VAD procedures per year, and recently received its third straight biannual Certificate of Distinction from The Joint Commission, the leading accreditor of U.S. health-care organizations. That "shows just what an outstanding job our physicians, nurses and support staff are doing when it comes to treating patients who require these assist devices," said Dr. Maya Guglin, director of UK's Mechanical Assisted Circulation Program. (Read more)

Monday, April 14, 2014

Ear, nose and throat doctor at UK aims to reduce state's high rate of hearing loss among children

Dr. Matthew Bush, an otolaryngologist at the University of Kentucky, is working to reduce the state's high rate of hearing loss, especially in Appalachia and among children. He was born in Charleston, W.Va., and attended medical school at Marshall University in Huntington. "In the course of his extensive training, Bush 'fell in love' with hearing health care, ear surgery and technologies like cochlear implants that offer revolutionary opportunities for people who are deaf or hard of hearing to rejoin or enter the hearing world," Mallory Powell writes for UK. 

"It was the clinic setting that informed and fueled my efforts and interests because the patients that we see have some tear-jerking stories," Bush said. "They didn't have access to services, or they were totally unaware that there were options to help their hearing impaired child. So they show up at the clinic very delayed, well past the optimal age for intervention, and the child has already lost a lot of language development potential."

About 1 in 1,000 children experience pediatric hearing loss, and Bush said the rate is much higher in Kentucky, 1.7 out of 1,000 in Kentucky. Though hearing loss isn't life-threatening, it can greatly impact the quality of life, influencing speech, language and cognitive development in children. Early detection is important for successful treatment. "The consequences of delaying care in the first few years of life are amplified dramatically," Bush said.

Rural residents deal with many health disparities, and "delays in pediatric hearing health care are unfortunately common," Powell writes. "Children with hearing loss in rural areas are diagnosed later than children in urban areas and subsequently receive interventions like hearing aids and cochlear implants at a later age."

This rural hearing-health disparity results from factors such as distance from health-care facilities and inadequate knowledge of the importance of timely care for pediatric hearing loss. Bush says he hopes to employ telemedicine to reduce the effects of distance from facilities, with "diagnostic testing, patient counseling and hearing loss rehabilitation with hearing aids and implants. These services have not been offered before in Appalachia."

Bush is also working to increase parental knowledge about pediatric hearing loss and educate rural primary-care physicians in diagnosing and treating pediatric hearing loss. "This is not something that they're seeing on a daily basis, so provider knowledge about next steps and resources is limited," Bush said. He and his colleagues have created online educational modules that will be circulated to providers.

"In an ideal world . . . there would be a seamless transition from the birthing hospital to resources for hearing testing and treatment, whether face-to-face or via telemedicine. We'd like the quality of care and access to care to be the same for all children. That's really what our passion is," Bush said. (Read more)

Saturday, April 12, 2014

FactCheck.org takes apart attacks on Obamacare

FactCheck.org is a non-profit, non-partisan center in the Annenberg Center at the University of Pennsylvania. It blows the whistle on misleading advertising and other statements of political figures. The center tries to balance its analyses between the parties, but the Republican attacks on federal health-care reform have been so strong and subjective, and Democrats have mounted so little defense or so few counterpunches, that the center's latest "Party Lines" report is all about Republican advertising against Obamacare. Here are capsules provided by FactCheck, with the label linking to each report:

Government-Run Health Care: Republican congressional candidates claim the health care law puts the government between you and your doctor. But the law boosts private insurance, and it doesn’t create a government-run system.

ACA ‘Hurting’ Families: Ads criticizing the Affordable Care Act make the general claim that it’s “hurting” families. Some families could pay more for insurance, but millions of the uninsured will gain coverage. And millions will get subsidies to help pay for coverage.

‘Skyrocketing’ Premiums: Several ads make the misleading claim that premiums and health care costs are “skyrocketing” under the Affordable Care Act. Overall, both are growing at historically low rates. Some who buy their own insurance will pay more, but others will pay less.

‘Millions’ Lost Insurance: Anti-Obamacare ads have claimed that “millions” lost their health insurance and their doctors because of the law. But policyholders weren’t denied coverage, and there’s evidence that far more gained insurance than had their plans canceled.

Friday, April 11, 2014

Season has arrived for poison ivy, oak and sumac; here's plenty of advice on how to deal with them and their rashes

Leaves of three, let them be.

This old childhood rhyme still holds true today,well at least for poison oak and poison ivy. Poison sumac has seven to 13 leaflets on each leaf. But the result is the same: If you come into contact with the oil from their leaves, you are likely to end up with a an itchy rash that can last from one to three weeks.

About 85 percent of people will develop an itchy, blistering rash when they come in contact with the oil from these plants, says the American Academy of Dermatology in a news release.

The rash itself isn't contagious, but the oil is, and it can linger on just about any surface: skin, clothes, under fingernails, tools, pets -- you get the picture. It can even come through the air if someone is burning brush. So, you can get poison ivy, poison sumac or poison oak without stepping one foot into nature.
Avoiding the plants and wearing protective clothing are the two proven ways to avoid getting a rash from these plants.

“If you are absolutely certain that your rash is due to poison ivy, poison oak, or poison sumac, and if the rash appears on a small section of your skin, you may be able to treat the rash at home,” Seemal R. Desai, dermatologist from Texas, said in the news release. “However, if you have difficulty breathing or swallowing, you experience swelling, or you have many rashes or blisters, go to the emergency room right away.”

The association also recommends going to the emergency room if the rash covers most of your body, if your eyelid swells shut, if the rash develops anywhere on your face or genitals, if much of your skin itches, or nothing seems to ease the itch.

Fortunately, there are simple steps people can take to safely treat a mild rash at home. Here are the association's recommendations for treating mild cases of poison ivy, poison oak or poison sumac:

1. Immediately rinse your skin with lukewarm, soapy water. Initially take a shower, not a bath, to get the oil off of your body.
2. Wash your clothing.
3. Wash everything that may have come in contact with the oil from the leaves.
4. Do not scratch. Scratching can cause infection.
5. Leave blisters alone. If blisters open, do not remove the overlying skin, as the skin can protect the raw wound underneath and prevent infection.
6. Take short, lukewarm baths to relieve the itch. Add colloidal oatmeal from the drugstore or one cup of baking soda to the running water for additional relief.
7. Consider using calamine lotion or hydro-cortisone cream.
8. Apply cool compresses to the itchy skin.
9. Consider taking antihistamine pills. These pills can help reduce itching, however use with caution. Call your doctor if you are uncertain if you should take an antihistamine.
10. Do not apply a topical antihistamine to your skin; doing so can worsen the rash and the itch.
11. See a dermatologist if the rash has not improved within 10 days.

Here are spring-cleaning tips to help allergy sufferers

Spring cleaning often stirs up dust and pet dander, and can leave a strong scent of cleaning supplies in the air. All can cause those with allergies to reach for a tissue and dread the task. But stirring up a little dust and dander is worth a few extra sneezes, the American College of Allergy, Asthma and Immunology says in a news release, because a thorough spring cleaning will ultimately help you avoid allergy symptoms.

“Thoroughly cleaning your home can help eliminate allergens and keep new ones from easily entering,” James Sublett, president-elect of the ACAAI, said in Newswise, a research-reporting service.  “Allergy season can last all year for those sensitive to indoor allergens, but it can worsen in the spring months when pollen becomes an issue. It’s important to remove allergens from the home so you can lead a healthy and active lifestyle.”

The ACAAI  offers tips to remove allergens from your home as well as ways to prevent more from entering.

The best way to prevent allergens from building up in your home is to stay on top of certain chores, such as vacuuming regularly to get rid of dust mites using a cyclonic vacuum or HEPA filter, changing air filters every three months using filters with a MERV rating of 11 or 12, and washing bedding and stuffed animals weekly.

It is also important to resist the urge to open the windows as the weather gets warmer, because this lets unwanted pollen into the house.Those with allergies also have to be careful to avoid air fresheners and candles because chemicals in these items can spur asthma attacks.

A top allergen target in spring cleaning is mold, paying special attention to mold-prone areas like bathrooms, basements and tiled areas, says the release. Make sure bathroom fans are functioning and usable, and always make sure not to leave any standing water in these areas. Use detergent and water to remove any visible mold, and to prevent further mold from growing, keep the humidity in your house below 60 percent.

Because pets spend so much more time indoors over the winter, chances are there is an increased amount of fur, saliva and dander in your house. Remove these allergens by vacuuming frequently and washing upholstery, including your pet's bed, the release says. Also, don't allow your pet in your bedroom.

Those with allergies should avoid being outdoors in noonday and afternoon, because pollen counts are highest then. Wear gloves and a N95 pollen mask when mowing or gardening, and make sure to wash your hands, hair and clothing when finished. Also, make sure to take your medication before going outside.

McConnell continues attack on Obamacare as Washington Post gives him 'four Pinocchios' for misleading article in C-J

U.S. Sen. Mitch McConnell took the resignation of Health and Human Services Secretary Kathleen Sebelius as an opportunity to repeat his criticism of the Patient Protection and Affordable Care Act.

"Regardless of the administration’s public explanation for the secretary’s exit, Obamacare has been a rolling disaster and her resignation is cold comfort to the millions of Americans who were deceived about what it would mean for them and their families," McConnell said in a press release. "Countless Americans have unexpectedly been forced out of the plans they had and liked, are now shouldering dramatically higher premiums, and can no longer use the doctors and hospitals they choose. Beyond that, virtually everyone who has come into contact with this law has had new reason to worry about what it means for the government to control their health care."

McConnell has been perhaps the leading critic of the law, which led New Yorker magazine cartoonist Barry Blitt to make him the focal point of his artwork on this week's cover, which shows President Obama administering medicine to McConnell as House Speaker John Boehner moves on and Rep. Michelle Bachman and Sen. Ted Cruz await their spoonful. For Blitt's brief explanation of his work, click here.

The point of the cartoon is that despite criticism and a troubled national rollout, the administration exceeded its goal of 7 million people signing up for Obamacare by the original March 31 deadline. In Kentucky, enrollment on the Kynect exchange is now more than 402,000, with several thousand more having been determined eligible for a subsidy to buy private insurance. In an April 10 press release, the state said 79,580 people have bought private policies and 322,827 have qualified for coverage under the federal-state Medicaid program.

McConnell bases part of his criticism on the state's initial report that 285,000 people "might be affected if they had substandard plans," The Courier-Journal said in an editorial. "A month later—in December 2013—Kentucky revised the figure to 168,000 and the [Washington] Post said the number could be as low as 100,000." The Post's Glenn Kessler, in his Fact Checker column, recently gave McConnell the maximum "four Pinocchios" for a misleading op-ed piece in the Louisville newspaper attacking the reform law.

The senator wrote, “Only approximately 64,000 Kentuckians enrolling in Obamacare have enrolled in a private plan in Kentucky’s own Obamacare exchange, far fewer than the 280,000 who received cancellation notices of plans they had and liked.” Kessler says that number is nowhere near correct.

Kessler writes that the 64,000 number (now up to almost 80,000; see above) "can be related only to the 130,000 individual plan policies. Adding in small-group policies inflates the total. . . . When the state made the announcement, it did not know how many plans might actually comply with the law; it just described the size of the individual and small-group markets." Also, he notes, not all the cancellation notices are going out at once: "We have no idea what the flow would be, but just taking a simple average over 12 months yields 11,000 individual policies a month. That adds up to only 55,000 individual policies since November, yet McConnell assumed that all of the notices had been mailed and received."

Finally, Kessler writes, "The 280,000 figure is out of date. In December, the state said it had determined that more than 48,000 plans were grandfathered in under ACA and that nearly 64,000 qualified for transitional relief under an administrative fix announced by the Obama administration. (The state did not distinguish between individual and small-group plans in its announcement, but overall that’s a 40 percent reduction.) That brought the total down to 168,000, a figure that was reported." McConnell spokesman Don Stewart said the fundamental point of the letter, that Democrats were touting Obamacare's successes and ignoring its pitfalls, was still correct.

Louisville jails sign up inmates for health coverage to save the state money; other jails around state may follow suit

Louisville jails are holding daily health insurance sign-ups for released inmates, Chris Kenning reports for The Courier-Journal.

Most inmates qualify for expanded Medicaid under the Patient Protection and Affordable Care Act, and Medicaid applications can be made at any time, not just during the annual sign-up period. Officials told Kenning that after the first four days, they had processed 18 applications, mostly for Medicaid.

The benefit to prisons and jails is twofold: Inmate hospitalizations lasting more than 24 hours can be billed to Medicaid, and getting coverage for released inmates provides insurance to a population that has a high rate of chronic disease, substance abuse and mental illness -- conditions that often bring them back to prison, Kenning writes.

This treatment is often only a temporary fix, because repeat offenders fail to continue their treatment when released because of a lack of health insurance, officials acknowledged.

"I know some people will think, 'I can't afford health insurance myself. Now a person in jail gets access to health care?'" Mark Bolton, director of Metro Corrections, told Kenning. "But taxpayers are paying for these people anyway."

Kenning reports that in Louisville, "Metro Corrections' health care costs make up $9 million of its $52 million budget — a result of treating medical conditions including diabetes, heart disease, infections and drug problems." The jails house an average of about 2,000 people.

U.S. Sen. Mitch McConnell does not support the signups, telling The Courier-Journal that it adds burdens to an already strained Medicaid program that is hard-pressed to find enough doctors willing to accept Medicaid patients. "This is yet another disturbing aspect of a profoundly troubling piece of legislation," he told Kenning.

Plans to expand to other jails and other parts of the state are in the works, said Barbara Gordon of the Kentuckiana Regional Planning and Development Agency, a Louisville-area government clearinghouse that provides "Kynectors" to help people sign up on Kynect, the state health-insurance exchange. They now spend two hours a day at the jail and hope to eventually have someone there full time, Bolton told Kenning.

About a third of people going in or out of prisons and jails would qualify for expanded Medicaid, and 24 percent would qualify for subsidized private insurance, estimates Dr. Fred Osher, director of health systems and services policy for the nonpartisan Council of State Governments Justice Center.

The state Department of Corrections projects that by shifting the costs of those 24-hour hospital stays to Medicaid, the state prison system would save more than $5 million a year, Kenning reports. The system has seen health costs rise to more than $54 million this year, from $34 million in 2004.

New law bans sales of electronic cigarettes to minors

Sales of electronic cigarettes to people under 18 are now illegal in Kentucky, following Gov. Steve Beshear's signing into law Thursday of a bill that had support from cigarette manufacturers, many of whom are also getting into the e-cigarette business.

Senate Bill 109, sponsored by Republican Paul Hornback of Shelbyville and Dennis Parrett of Vine Grove, took effect immediately because it contained an emergency clause. A House committee had approved a similar bill, but it did not contain an emergency clause and never came to a vote in the full House.

The law bans the sale to minors of "alternative nicotine products," defined as "a noncombustible product containing nicotine that is intended for human consumption, whether chewed, absorbed, dissolved, or ingested by any other means," but "does not include any tobacco product, vapor product, or any other product regulated as a drug or device by the United States Food and Drug Administration." It also adds to state law more detailed definitions of "tobacco product" and "vapor product," and also bans the sale of the latter to minors.

KET's 'Safe and Sound: Raising Emotionally Healthy Children in a Stressful World' premieres April 17, first airs April 21

Though new parents often have access to many resources of information on how to care for their children physically, they are usually not as well-informed about raising them to be strong and healthy emotionally, and esearch shows that children who grow up stressed can face brain development  and long-term health issues, KET "Be Well Kentucky" reports.

The state network will present a special report, "Safe and Sound: Raising Emotionally Health Children in a Stressful World," designed to teach parents to be the best they can be, in various locations across the state.

The program will be aired Monday, April 21 at 9/8 p.m. It was produced partly with funding from the Foundation for a Healthy Kentucky.

A public screening and panel discussion of the program will be held Thursday, April 17 at 5:30 p.m. at the Kentucky Science Center in Louisville.

Guests are invited to a 4:30 p.m. reception at the Leadership Louisville Center at 732 W. Main St. The event is free, but registration is required, and seats are limited. Click here to register.

Beshear signs bill allowing limited use of oil extracted from marijuana to treat children's seizures

Gov. Steve Beshear has signed into law a bill allowing doctors at the University of Kentucky and the University of Louisville, or those conducting a clinical trial approved by the U.S. Food and Drug Administration, to prescribe a marijuana extract to treat seizures in young people.

Denton (Herald-Leader photo)
Senate Bill 124 was sponsored by retiring Sen. Julie Denton, R-Louisville, who said its passage was unimaginable a decade ago, according to the Lexington Herald-Leader. The General Assembly rejected legislation to authorize medical use of marijuana, but legislators and the Beshear administration agreed to SB 124 because tearful parents testified for the bill and cannabidiol contains none of marijuana's psychoactive ingredient.

"Both our law enforcement leaders and our drug policy director worked with the legislators on this bill, and they gave the bill their support," Beshear said in a press release. "Because the bill has been carefully constructed to require that any prescriptive recommendation for the oil can come only from physicians at the state’s research universities or through an FDA clinical trial, I am confident that this law will provide the relief that these families seek, without creating complications for our law enforcement community.”