U of L and KentuckyOne Health announce partnership that keeps women's health services intact at University Hospital

The University of Louisville and KentuckyOne Health have reached a partnership agreement that will leave the resolution of any "moral roadblocks" up to a higher authority. U of L President James Ramsey said the partnership will allow the hospital board to continue its control over the public entity, a principle that scuttled an earlier deal with Catholic Health Initiatives, which then formed KentuckyOne with Jewish Hospital. Gov. Steve Beshear signed on to the agreement, after killing the first one.

The goals of a public institution that provides all women's health services -- including reproductive and end-of-life care -- were not the same goals of those espoused by the Roman Catholic Church. The new agreement seems to have solved that issue by continuing to allow the hospital's pharmacy and Center for Women and Infants and to provide the same services as they did before, reports Laura Ungar of The Courier-Journal. The services will be provided by the same people as currently, the partners said. This includes all reproductive services.

The Archdiocese of Louisville said in a statement that it was not part of the negotiations but that there were no more “moral roadblocks” to its continued official recognition of KentuckyOne as a Catholic entity. The archdiocese said the partners involved “have committed to respecting one another’s traditions, missions, and values, including our own Ethical and Religious Directives for Catholic Health Care Services.” (Read more)

No-Hit zones in place in pediatric wards of Kosair and U of L children's hospitals

Health professionals and other employees at Kosair Children's Hospital and the University of Louisville pediatrics unit were given an unusual tool this week when it was announced that their facilities are now No-Hit Zones. A program developed to maintain a calm, safe and caring environment for children and their parents, the No-Hit Zone initiative works to educate staffers on how to keep everyone on the ward safe from those who would lose their tempers while everyone around them is already in a stressful situation.

The policy is quite clear. No adult shall hit another adult. No adult shall hit a child. No child can hit an adult. And no child can hit another child while in the hospital environment.

The Kosair Children's, Kosair Children's-Brownsboro and U of L hospitals are now among only 30 children’s hospitals nationwide to implement the No-Hit Zone program. The Louisville effort has been led by Erin Frazier, M.D., FAAP, associate professor of pediatrics at the Uof L Children & Youth Project, and the Kosair Children’s Hospital Child Abuse Task Force, which Dr. Frazier chairs.

To learn about the No-Hit Zone, go here.

Kentucky is No. 1 state in overuse of antibiotics, a problem that poses wide dangers to the drugs' effectiveness

In 2010 the average number of dispensed outpatient antibiotic
prescriptions was 801 per 1,000 Americans. In Kentucky it was
1,197. The darker the state, the higher the rate. (CDC map)

Americans, especially Kentuckians, are taking too many antibiotics and that is contributing to the decline in the drugs' effectiveness, says a study by a group associated with the Centers for Disease Control and Prevention.

The study found that, in 2010, the five states with the highest antibiotic use were Kentucky, West Virginia, Tennessee, Mississippi and Louisiana. Such misuse is already showing up, reports USA Today, as lab reports show urinary tract infections were 30 percent more likely to resist antibiotic treatment in 2010 than in 1999.

Dr. Robert Salley, executive director of cardiovascular services for KentuckyOne Health in the Lexington market, told Cheryl Truman of the Lexington Herald-Leader that the overuse of antibiotics might reflect the state's problem with prescription pain pills. Many Kentuckians are used to "that culture of availability, that culture of not making appropriate use of the physician-patient relationship," he said. Experts have also noted that states that have lower rates of antibiotic use have spent money and time educating their residents about the dangers of overuse. Kentucky has not done that. (Read more)

Meanwhile, the Pew Health Group has released a study showing that 87 percent of Americans have a basic understanding of what antibiotics do, but many did not understand that antibiotic resistance was a major health issue and will only become more problematic in the future. Forty-one percent of Americans said they have never heard of the issue. For more information on that study, go here.

U.S. preterm birth rate goes down but Kentucky's maternal smoking rate still second highest, putting preterm babies at risk

For the fifth year in a row, the preterm birth rate in the United States has dropped. Which is great news. But Kentucky again had a significantly high smoking rate for expectant mothers -- at 32.2 percent, putting us behind only West Virginia (at 36 percent) of pregnant women who gave birth preterm and smoked.

Being born before full term puts babies at undue risk. Still, nearly half a million babies in the United States are born prematurely, many unnecessarily, according to the March of Dimes' 2012 Premature Birth Report Card. Serena Gordon of HealthDay reports that "those risks include breathing difficulties, heart defects and bleeding in the brain. Some conditions are only temporary while others can persist." A premature birth is anything that occurs before 37 weeks gestation. Maternal smoking is a major factor respiratory difficulties for the child and in an inability for the mother to go full term.

It is also been found that women without health insurance also have a higher incidence of preterm birth. Texas had the worst rates of uninsured women with 34.2 percent without insurance. Florida and New Mexico had rates of uninsured women of about 30 percent. Kentucky had rates of uninsured women of 21.7 percent. (Read more)

To see the full report and to see how Kentucky fared compared to other states in a number of other categories, go here.

Japan approves a high-fiber version of Pepsi as a fat blocker

Let's start here: Way too much of Kentucky is way too fat. And, let's add this, we drink lotsa sugary beverages. Why, our intake of Mountain Dew alone is legendary. So, here comes some news out of Japan which may have particular interest to Kentuckians: This week, Pepsi will start marketing a new product called Pepsi Special that is special indeed, since it has the blessing of that country's National Institute of Health and Nutrition as a "food for specified health use." That use, you ask? Fat blocking. Let me at it, you say? Hold up, we caution. Pepsi Special is, in a nutshell, Benefiber Pepsi.

According to reporters at the The Atlantic magazine, wheat dextrin is the same additive in Pepsi Special as the one that's sold as Benefiber in the U.S. It's a soluble fiber that "absorbs water as it moves through our intestines and promotes movement of food through the bowel, and contraction of the bowel wall itself." In a 2006 Japanese study, rats that ate wheat dextrin absorbed less fat from their food because, notes the magazine, "It essentially moved right through them."

So, is any of this actually good for you? Dextrin "may increase micronutrient absorption, stabilize blood glucose, lower serum lipids, may prevent several gastrointestinal disorders, and have an accepted role in prevention of cardiovascular disease," experts say. But you still have to restrict your soda intake for any of this to matter. (Read more)

State officials appear to be overstating successes of new prescription-drug law, The Courier-Journal reports

There's new criticism from Kentucky's doctors in an analysis of the state's four-month old prescription drug law, showing that a lot of what state officials have touted as the law's successes were already in the works before the law went into effect.

The Courier-Journal of Louisville reviewed state records after Gov. Steve Beshear released figures last month that showed the Kentucky Board of Medical Licensure had disciplined 33 physicians for violating professional prescription standards. Reporter Mike Wynn writes that he "found that 16 of the cases were resolved before the new law took effect on July 20, and 13 others involved investigations or actions that were well under way before the law’s implementation. The administration also reported last month that 18 of the 44 known pain-management clinics in Kentucky have closed or discontinued pain management services, including 10 after House Bill 1. Still, state records are unclear if all the clinics were suspected of illegal prescribing."

“They’ve taken a situation that required a scalpel to cut out the disease and instead they have used a machete,” Gregory Hood, governor of the Kentucky chapter of the American College of Physicians, told Wynn.

Beshear's announcement last month about the bill's almost overnight success also included crediting it for drops in prescriptions being written for pain killers, most notably for oxymorphone, which had a 38 percent falloff.  But, writes Wynn, "Critics of the law say that at least part of those declines are due to doctors denying needed prescriptions to patients because of problems with HB 1." Experts told the paper that oxymorphone, commonly prescribed as Opana, was not readily available in the market during the applicable period because of a reformulation by its manufacturer. (Read more)

Electric cooperatives' monthly magazine looks at the poor health of our state's children

Courtney Cagle, 14, of Clinton learns
how to cook healthy spaghetti in UK's
Cooperative Extension nutrition program

The November issue of Kentucky Living magazine, published monthly for member-customers of the state's electric cooperatives, focuses on children's health. Editor Paul Wesslund writes that the stories and statistics on the current state of the state's kids are "scary."

Reporter James Nold Jr. writes that when experts were asked about their concerns for the state, childhood obesity was front and center. The state ties Georgia and Arkansas for the second highest share of children (37 percent) who are obese, and it trails only Mississippi among children 10 to 17. That’s more than one in three kids who are grossly unfit.

Also of concern are Kentucky children's high rates of asthma, abuse, neglect, and cigarette smoking. The numbers for these are so bad and so seemingly out of control now that health professionals would be happy just to see them remain stable in the future, instead of continuously rising.

Nold writes that the experts' urgency on these matters was palpable. A lot of them talked about the way poor nutrition can harm children now and throughout the rest of their lives.  They also expressed deep concern for the lack of dental education and care, the need for more exercise and for more parent involvement in all of their children's choices.

The magazine, which has a Health Club for children, notes that the University of Kentucky's Cooperative Extension Service provides nutrition education to students in all 120 counties. For more information on the club, or to join, go to www.KentuckyLiving.com and click on "KL Health Club." (Read more)

U of L doctor tells American Heart Association that cardiac stem-cell research shows a lot of promise

Dr. Roberto Bolli

Promising results are coming from research that uses patients’ own cardiac stem cells to heal their hearts, a Louisville doctor told colleagues this week at an American Heart Association meeting in Los Angeles.

Laura Ungar of The Courier-Journal reports that Dr. Roberto Bolli, lead author of the clinical trial and chief of cardiovascular medicine and director of the Institute of Molecular Cardiology at the University of Louisville, said cardiac stems cells may someday be used to treat heart failure caused by muscle scarring after a heart attack.

Bolli, who partnered with Dr. Piero Anversa of Brigham and Women’s Hospital in Boston on the research, explained that their research showed that hearts in patients treated with their stem cells had greater pumping power, and benefits continued to increase as long as two years after receiving the cells.  Heart failure afflicts about 6.6 million Americans. (Read more)

New, 4-volume veterans' health handbook reflects UK expertise

It is not just about post-traumatic stress and re-entry into the job market anymore, as if it ever was. In topics as diverse as how to best get electronic medical records to how to treat the severely injured who would not have survived earlier wars, The Praeger Handbook of Veterans Health: History, Challenges, Issues and Developments has plumbed the expertise of 65 professionals -- many with ties to the University of Kentucky -- to teach anyone who cares how it's done.

Mary Meehan of the Lexington Herald-Leader reports that the editor of the four-volume set is Dr. Thomas Miller, professor emeritus and senior research scientist in psychiatry at UK, who began working on the handbook in 2006. The book makes wide use of Miller's many decades of work with veterans as well his network of experts from other countries.
 
 Miller told the Herald-Leader that he hopes the book will not only show people the scope of services available and how to get the help they need, but help shape the future of veteran care and by extension health care in the United States. The set is designed as a resource for libraries, health care offices and universities. It is available at online bookstores for $257. (Read more)

Poll: A quarter of Cincinnati and Northern Kentucky residents skip doctor visits and are behind on their medical bills

Nearly one-quarter of adults throughout Greater Cincinnati and Northern Kentucky did not always go to the doctor when they needed to during the past year, according to a Cincinnati Enquirer poll. And of those that did seek medical attention last year, a little more than one-quarter (27.5 percent) said they were not able to pay all of their medical bills. The results may not be all that surprising but do highlight health care costs’ impact on the average American. “It’s very common to see people making decisions between food and medicine,” said Kate Keller, senior program officer at the local policy group the Health Foundation of Greater Cincinnati.

Local doctors say they’re seeing all sorts of ruses from patients to try to avoid even a $25 co-pay. Rob Tracy, a family doctor at St. Elizabeth Physicians in Cold Spring (left, with patient Kathy Schneider), said some patients call and ask him to call in a prescription to the pharmacy without a visit. That allows them to avoid a co-pay on the office visit. He said delaying such visits only deepens the impact of chronic conditions and ups the costs when those patients are forced to local emergency rooms when their symptoms fail to improve. (Enquirer photo by Carrier Cochran)

Peale notes that these issues are intrinsically involved with the Patient Protection and Affordable Care Act, which was cemented by President Barack Obama's victory Tuesday. It is set to go into full effect in 2014. "The law will help insure as many as 30 million more people by requiring every American to buy insurance or pay a penalty, requiring employers to offer benefits or pay a penalty, and requiring insurers to accept anyone who applies," Peale writes. With the new law in place, the average person will likely be paying $4,775 out of pocket, including premiums and co-pays. (Read more)

Study: Grandparent caregivers aren't up on latest safety standards for babies and children

Grandparents might be more quick to say yes to grandkids but they might also be a little behind the times on the the new safety guidelines that could better protect them. A new study finds that many grandparent caregivers don't know about those new health suggestions and, in some cases, laws for babies -- such as appropriate sleep position, crib safety and car seat use. This is particularly critical in a country where 2.8 million grandparents are primary caregivers to their grandchildren, an increase of nearly 20 percent since 2000, according to the the 2011 American Community Survey.

In this study, reporter Robert Preidt of HealthDay writes that 56 percent of grandparents asked got the question about the safest sleep position of babies wrong. (The correct answer is on their backs, according to the American Academy of Pediatrics.) "Another question addressed correct car seat positioning, and 24.5 percent of the participants said that a 9-month-old, 22-pound child should be facing forward. The AAP recommends, however, that children remain in rear-facing car seats until age 2 years." It doesn't get much better. Almost half of those grandparents questioned thought it was OK to have bumpers, stuffed animals and blankets in cribs. It's not.

We know it's difficult but maybe it time to have the talk. (Read more)

National Rural Health Day to be celebrated Nov. 15 with free week-long issue-based webinar series

Those almost 60 million Americans who live in rural America do not have as much ready access to health care or to the vast number of health care providers than those who live in more urbanized America. Rural Americans are more likely to arrive on the doorstep of health care facilities without insurance, and that number is growing. These challenges and more have prompted the National Organization of State Offices of Rural Health (NOSORH) to designate Thursday, Nov. 15 as National Rural Health Day. The day, explains NOSORH director Teryl Eisinger, is an effort to increase awareness of rural health-related issues. The event has stretched to a week of activities, celebrations and a daily webinar series on rural health-care issues accessible to anyone interested nationwide.

Here's a schedule of free webinars. All times are Eastern Standard.
Monday, Nov. 12, 3-4 p.m., Basics of Rural Health, with Kristine Sande, program director, Rural Assistance Center; Rebecca David, executive director, National Cooperation of Health Networks; Mike Shimmens, executive director, Rural Recruitment and Retention Network.
Tuesday, Nov. 13, 1-2 p.m., Cultural Awareness While Serving Rural Veterans with Jay H. Shore, MPH, Associate Professor, University of Colorado, Denver.
Wednesday, Nov. 14, 2:30-3:15 p.m., Health Resources and Services Administration Rural Health Update with Mary Wakefield, HRSA administrator.
Thursday, Nov. 15, 3-4 p.m., HRSA's Office of Rural Public Health Policy, Celebrating 25 Years.
Friday, Nov. 16, 3 p.m. Looking Towards the Future of Rural Health Care with Randall Longenecker, MD, Rural Training Track Technical Assistance Program and Jim DeTienne, Montana EMS and Trauma Systems.

All webinars will be recorded and made available to the public at www.celebratepowerofrural.org.(Read more)