A novel vaccine could help prevent middle ear infection in children under two years of age, according to a paper in this week's issue of The Lancet.
Otitis media (middle ear infection) accounts for nearly 20 million visits to a paediatrician every year in the USA. The bacteria Streptococcus pneumoniae and Haemophilus influenzae are the leading causes of infection. Although vaccines against S. pneumoniae exist, they are not effective enough in the age group where the disease is most prevalent--children younger than two years.
Roman Prymula (University of Defence, Hradec Kralove, Czech Republic) and colleagues tested a vaccine containing proteins from 11 different strains of S. pneumoniae attached to a protein derived from H. influenzae. 4968 infants were randomly assigned to receive the pneumococcal protein D vaccine (intervention group) or hepatitis A vaccine (control group) at the ages of 3, 4, 5 and 12-15 months. The investigators followed up the children at the end of their second year of life and found that there were 333 cases of otitis media in the pneumococcal protein D vaccine group and 499 in the control group. They also found that using the vaccine not only protected against pneumocccal otitis media, but also against middle ear infection caused by H. influenzae.
Dr Prymula states: "We found a reduction in ear, nose and throat specialist-confirmed episodes of acute otitis media by about a third in infants in the vaccine group compared with controls."
A novel vaccine could help prevent middle ear infection in children under two years of age, according to a paper in this week's issue of The Lancet.
Otitis media (middle ear infection) accounts for nearly 20 million visits to a paediatrician every year in the USA. The bacteria Streptococcus pneumoniae and Haemophilus influenzae are the leading causes of infection. Although vaccines against S. pneumoniae exist, they are not effective enough in the age group where the disease is most prevalent--children younger than two years.
Roman Prymula (University of Defence, Hradec Kralove, Czech Republic) and colleagues tested a vaccine containing proteins from 11 different strains of S. pneumoniae attached to a protein derived from H. influenzae. 4968 infants were randomly assigned to receive the pneumococcal protein D vaccine (intervention group) or hepatitis A vaccine (control group) at the ages of 3, 4, 5 and 12-15 months. The investigators followed up the children at the end of their second year of life and found that there were 333 cases of otitis media in the pneumococcal protein D vaccine group and 499 in the control group. They also found that using the vaccine not only protected against pneumocccal otitis media, but also against middle ear infection caused by H. influenzae.
Dr Prymula states: "We found a reduction in ear, nose and throat specialist-confirmed episodes of acute otitis media by about a third in infants in the vaccine group compared with controls."
Contact: Roman Prymula, Department of Epidemiology, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic. T) +420 602 488 620 prymulapmfhk.cz
Contact: Joe Santangelo
j.santangeloelsevier
Lancet
Buy Cefadroxil Without Prescription
вторник, 6 сентября 2011 г.
Health Disparities: Genetics, Society And Race Play An Important Role In Access To Healthcare
Minority individuals are much more likely to develop and die from cancer than the general U.S. population. Previous research points to lack of health insurance, poverty, language and cultural barriers, and inadequate access to early detection services and good medical care as causes. Research reported today at the 2007 Annual Meeting of the American Association for Cancer Research (AACR) suggests that genetics, in addition to socioeconomic status, are important factors accounting for the disparity of cancer incidence and mortality between African-Americans, Hispanics and Caucasians.
A survey of stomach and kidney cancer patients in Los Angeles revealed that those who were diagnosed in a late stage of disease when cancer is harder to treat successfully were likely to be older, living in an unsafe neighborhood and traveling at least 45 minutes to get to the doctor.
Researchers at the University of Southern California's Keck School of Medicine cite two general types of personal risk factors associated with late cancer diagnosis: socio-economic, or cultural, factors related to knowledge about the health care system and difficulties accessing it; and individuals' failure to give priority to medical care, despite having access to it.
While minorities have been shown to have higher rates of dying from cancer, it hasn't always been clear why, said Ann Hamilton, Ph.D., assistant professor of preventive medicine at USC. Using proportions of minorities in census tracts or income and education statistics hasn't been totally effective in identifying subgroups at higher risk.
Hamilton and USC colleague Myles Cockburn mailed a questionnaire to patients diagnosed with stomach and kidney cancer between 2000 and 2001 in Los Angeles County, which has a large Hispanic population. It asked about, among other things, access to care, acculturation, neighborhood environment, other diseases and demographic information. The acculturation scale was based on a series of questions, such as, 'What language do you speak primarily at home English, Spanish or both?'
Hamilton and Cockburn also wanted to identify "neighborhood-related" factors that could help predict population subgroups at higher risk for being diagnosed late, in addition to personal risk factors. "I wanted to identify new combinations of individual risk factors as well as ecological factors at the census tract level that could be used to better predict subgroups at higher risk," Hamilton said.
The researchers found that, at the census tract level, the percentage of people who speak a language other than English at home, the percentage of Hispanics 25 or older with less than a ninth grade education, percent unemployed and percent using public transportation were correlated with a higher percentage of cancers being diagnosed at a later stage.
"In using both ecological and personal measures, we were trying to determine how both factors may increase risk. We were assessing the effect of personal risk factors in the context of the neighborhood environment," Hamilton said. "For example, we found an indication that after taking other factors into account, a person with a lower level of acculturation who lived in an area where few others speak English was more likely to be diagnosed at a later stage of disease than the same type of person who lived in an area where most spoke English."
The results, Hamilton said, may help better target disease intervention programs for those most vulnerable and at risk.
Epidemiologists have unexpectedly found that African Americans had a higher rate of recurrence following prostate cancer surgery than did whites, regardless of whether or not patients received surgery at hospitals or by surgeons who performed a high number of such operations.
The findings were surprising as previous research has shown that, in general, patients fare better at hospitals that perform a high volume of surgeries or by surgeons who perform a large number of operations.
According to epidemiologist Kyna Gooden, Ph.D., of Shaw University, previous studies have shown that African Americans have a higher rate of prostate cancer recurrence and a greater likelihood of dying from their cancer following prostate surgery more specifically, total removal of the prostate gland compared to white men.
She and her co-investigators at Shaw University and the University of North Carolina in Chapel Hill, looked at whether the number of prostate cancer surgeries a hospital or a surgeon performed affected this disparity.
Gooden and her team hypothesized that a disproportionate number of African Americans were treated at hospitals or by physicians performing fewer surgeries. The racial differences in the prostate cancer recurrence and mortality following surgery would disappear, they assumed, once they took into account hospital and physician volume.
They examined data from the Surveillance, Epidemiology, and End-Results Medicare database for 962 African American and 7,387 white men diagnosed with prostate cancer between 1993 and 1999 who had received surgery within six months of diagnosis. They controlled for age at diagnosis, cancer stage and grade.
When the researchers looked at the outcomes after surgery in relation to volume, results were similar to previous findings patients who had surgery at high volume hospitals for prostate cancer were less likely to have cancers that returned and less likely to die from prostate cancer. But when they broke down the numbers by race for African Americans and whites, they found that surprisingly, the racial disparities persisted.
"Even for patients who went to high volume hospitals and were seen by high volume physicians, there was still a racial disparity," Gooden said. "We expected that if everyone was treated by similarly experienced doctors or hospitals, they would have had comparable outcomes. But that wasn't the case."
"These results may have less to do with access to clinical care but more to do with lifestyle factors and the physical and genetic characteristics of the tumor itself," Gooden said.
In preliminary findings, researchers have identified differences in the expression of two genes in normal breast tissue from African American and white women that could predispose the former to develop more aggressive tumors and poorer prognoses.
Postdoctoral fellow Lori Field, Ph.D., of the Windber Research Institute, and colleagues at Walter Reed Army Medical Center and Invitrogen Informatics, wanted to understand why breast cancer mortality rates are higher in African American women than in Caucasian, even though the overall incidence in white women is higher. Breast tumors in black women are larger, more aggressive, and more likely to spread to the lymph node than those in white women.
Before comparing breast cancer tumors, the scientists first examined healthy breast tissue. They obtained samples from 26 African American and 22 Caucasian women enrolled in the Clinical Breast Care Project, a federally mandated breast research program with both military and civilian centers.
Using microarray technology to examine large numbers of genes at once, they found differences in the expression of 89 genes among the two groups. Two of these genes PSPH, phosphoserine phosphatase, which is involved in forming serine, and ACSM1, acyl-CoA synthetase medium chain family member 1, which is involved in fatty acid oxidation had a higher expression in the African American women.
Serine is an intermediate in the synthesis of other amino acids, as well as DNA and lipids. If more serine is being shunted into any of these pathways, Field said, it might enhance cellular division and growth. Increased ACSM1 expression could increase the rate of fatty acid oxidation in the cell, resulting in a rise in cellular energy production.
"Both conditions could promote cell growth and could potentially provide greater growth advantage to breast cells in African Americans compared to Caucasians and could increase the likelihood to potential cancer transformation," Field said.
While the researchers continue to validate these initial findings, they currently are comparing breast tumors from African American and Caucasian women to look for differences in gene expression.
"If we see that there are differences in the breast tumors, we may find new molecular targets to which therapy can be tailored specifically to African American women," Field said.
Having a mother or sister with breast cancer significantly increases the risk for young African American women to develop breast cancer, according to the analysis of questionnaires answered by approximately 59,000 African American women enrolled in the Black Women's Health Study.
Beginning in 1995, questionnaires were given every two years to women none of whom knowingly had cancer asking about demographics, reproductive and health history, family history of breast cancer and other factors.
According to principal investigator Julie Palmer, ScD, professor of epidemiology at Boston University, few studies have examined the relationship of family history to breast cancer risk in African American women, and none have done so prospectively.
"We wanted to see if we would confirm what had been shown in white women that having a mother or sister with breast cancer would increase a woman's risk of developing breast cancer," Palmer said.
Analyzing 10 years' worth of follow-up questionnaires found there were 1,050 cases of breast cancer among those who completed questionnaires on family history. The team, found that the incidence rate-ratio for such women was 1.77, meaning that overall, African American women who had a first degree relative either a mother or a sister with breast cancer had 1.77 times the risk of getting breast cancer compared to another woman of the same age who didn't have a family member with breast cancer. Having a family history of breast cancer was a stronger risk factor in women under 35, among whom the relative risk was 2.67.
Palmer said that as the study group ages and the number of women with cancer increases, the team can begin to examine other factors in cancer risk and development. "We'd expect that relative risk of 1.77 to go up quite a bit for women who have two first-degree relatives," she said. In fact, the researchers found that the overall relative risk for breast cancer was 2.58 for having two or more first-degree relatives with breast cancer, but the figure was based on few women.
The researchers plan to examine whether having a family member with other cancers is related to heightened breast cancer risk. Palmer noted that ovarian cancer might be one such cancer because "there are some shared genes," referring to the tumor suppressor gene BRCA1, which when damaged can increase a woman's risk of both breast and ovarian cancers.
In time, Palmer said, the study will have data to report on other cancers, such as colon and lung.
Genetic variations in the body's immune system could play a role in making African Americans more susceptible to developing colon cancer, scientists have found.
Researchers led by Krista Zanetti, Ph.D., a postdoctoral fellow in the National Cancer Institute's Division of Cancer Prevention and Center for Cancer Research, looked at variations in genetic sequences of the gene that makes mannose-binding lectin (MBL), a protein that plays a role in inflammation and innate immunity. They compared 26 MBL variations, or single nucleotide polymorphisms (SNPs), in 261 colon cancer patients and 537 normal controls in the Baltimore area.
Of the 26, four SNPs were associated with a significant increase in colon cancer risk in African Americans, though not in Caucasians. African Americans who carried two copies of all four variants had an approximately six-fold higher risk of colon cancer compared to those without such variants.
The four DNA variants occur in linkage disequilibrium that is, they appear together at a higher frequency than by random chance in both African Americans and Caucasians, though they are more prevalent in the former. "It was surprising," Zanetti said, "because we wouldn't necessarily assume that any one SNP would be linked to one race more than others. It wasn't our hypothesis."
Zanetti and her team currently are attempting to validate the findings with data from the Prostate, Lung, Colorectal and Ovarian (PLCO) trial, a randomized control trial originally designed to test the effectiveness of cancer screening methods. They will screen the colorectal cancer patient subset of the study for the four SNPs, with individuals with colorectal polyps as controls. Both of the latter groups are mostly Caucasian.
"Before we validate these associations in African Americans, we first need to know whether or not they exist in Caucasians that's the number one question we want to answer," Zanetti said. "Is it possible that this is actually an African American risk factor?"
According to Zanetti, the PLCO study gives the researchers the high level of power needed to detect whether these associations really exist in Caucasians. That would then enable the team to design the rest of their study.
Zanetti noted that over the past three decades colon cancer deaths in African Americans have generally been higher than in Caucasians. "We don't know why the decline in death rates has been smaller in African Americans, but we believe it's more than one factor," she said. "These SNPs aren't necessarily the only answer. We need to keep working to uncover all the contributors to this increased risk, whether there are underlying biological issues or social determinants.
"We're doing a multitude of functional studies in the laboratory to see if we can link a phenotype to the genotype we have found," she said. "We're trying to link it to biological function I think there's more to it than just association."
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 25,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts over 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, diagnosis and treatment. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication, CR, is a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. It provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.
American Association for Cancer Research (AACR)
615 Chestnut Street, 17th Floor
Philadelphia, PA 19106
United States
aacr
Buy Metronidazole Gel Without Prescription
A survey of stomach and kidney cancer patients in Los Angeles revealed that those who were diagnosed in a late stage of disease when cancer is harder to treat successfully were likely to be older, living in an unsafe neighborhood and traveling at least 45 minutes to get to the doctor.
Researchers at the University of Southern California's Keck School of Medicine cite two general types of personal risk factors associated with late cancer diagnosis: socio-economic, or cultural, factors related to knowledge about the health care system and difficulties accessing it; and individuals' failure to give priority to medical care, despite having access to it.
While minorities have been shown to have higher rates of dying from cancer, it hasn't always been clear why, said Ann Hamilton, Ph.D., assistant professor of preventive medicine at USC. Using proportions of minorities in census tracts or income and education statistics hasn't been totally effective in identifying subgroups at higher risk.
Hamilton and USC colleague Myles Cockburn mailed a questionnaire to patients diagnosed with stomach and kidney cancer between 2000 and 2001 in Los Angeles County, which has a large Hispanic population. It asked about, among other things, access to care, acculturation, neighborhood environment, other diseases and demographic information. The acculturation scale was based on a series of questions, such as, 'What language do you speak primarily at home English, Spanish or both?'
Hamilton and Cockburn also wanted to identify "neighborhood-related" factors that could help predict population subgroups at higher risk for being diagnosed late, in addition to personal risk factors. "I wanted to identify new combinations of individual risk factors as well as ecological factors at the census tract level that could be used to better predict subgroups at higher risk," Hamilton said.
The researchers found that, at the census tract level, the percentage of people who speak a language other than English at home, the percentage of Hispanics 25 or older with less than a ninth grade education, percent unemployed and percent using public transportation were correlated with a higher percentage of cancers being diagnosed at a later stage.
"In using both ecological and personal measures, we were trying to determine how both factors may increase risk. We were assessing the effect of personal risk factors in the context of the neighborhood environment," Hamilton said. "For example, we found an indication that after taking other factors into account, a person with a lower level of acculturation who lived in an area where few others speak English was more likely to be diagnosed at a later stage of disease than the same type of person who lived in an area where most spoke English."
The results, Hamilton said, may help better target disease intervention programs for those most vulnerable and at risk.
Epidemiologists have unexpectedly found that African Americans had a higher rate of recurrence following prostate cancer surgery than did whites, regardless of whether or not patients received surgery at hospitals or by surgeons who performed a high number of such operations.
The findings were surprising as previous research has shown that, in general, patients fare better at hospitals that perform a high volume of surgeries or by surgeons who perform a large number of operations.
According to epidemiologist Kyna Gooden, Ph.D., of Shaw University, previous studies have shown that African Americans have a higher rate of prostate cancer recurrence and a greater likelihood of dying from their cancer following prostate surgery more specifically, total removal of the prostate gland compared to white men.
She and her co-investigators at Shaw University and the University of North Carolina in Chapel Hill, looked at whether the number of prostate cancer surgeries a hospital or a surgeon performed affected this disparity.
Gooden and her team hypothesized that a disproportionate number of African Americans were treated at hospitals or by physicians performing fewer surgeries. The racial differences in the prostate cancer recurrence and mortality following surgery would disappear, they assumed, once they took into account hospital and physician volume.
They examined data from the Surveillance, Epidemiology, and End-Results Medicare database for 962 African American and 7,387 white men diagnosed with prostate cancer between 1993 and 1999 who had received surgery within six months of diagnosis. They controlled for age at diagnosis, cancer stage and grade.
When the researchers looked at the outcomes after surgery in relation to volume, results were similar to previous findings patients who had surgery at high volume hospitals for prostate cancer were less likely to have cancers that returned and less likely to die from prostate cancer. But when they broke down the numbers by race for African Americans and whites, they found that surprisingly, the racial disparities persisted.
"Even for patients who went to high volume hospitals and were seen by high volume physicians, there was still a racial disparity," Gooden said. "We expected that if everyone was treated by similarly experienced doctors or hospitals, they would have had comparable outcomes. But that wasn't the case."
"These results may have less to do with access to clinical care but more to do with lifestyle factors and the physical and genetic characteristics of the tumor itself," Gooden said.
In preliminary findings, researchers have identified differences in the expression of two genes in normal breast tissue from African American and white women that could predispose the former to develop more aggressive tumors and poorer prognoses.
Postdoctoral fellow Lori Field, Ph.D., of the Windber Research Institute, and colleagues at Walter Reed Army Medical Center and Invitrogen Informatics, wanted to understand why breast cancer mortality rates are higher in African American women than in Caucasian, even though the overall incidence in white women is higher. Breast tumors in black women are larger, more aggressive, and more likely to spread to the lymph node than those in white women.
Before comparing breast cancer tumors, the scientists first examined healthy breast tissue. They obtained samples from 26 African American and 22 Caucasian women enrolled in the Clinical Breast Care Project, a federally mandated breast research program with both military and civilian centers.
Using microarray technology to examine large numbers of genes at once, they found differences in the expression of 89 genes among the two groups. Two of these genes PSPH, phosphoserine phosphatase, which is involved in forming serine, and ACSM1, acyl-CoA synthetase medium chain family member 1, which is involved in fatty acid oxidation had a higher expression in the African American women.
Serine is an intermediate in the synthesis of other amino acids, as well as DNA and lipids. If more serine is being shunted into any of these pathways, Field said, it might enhance cellular division and growth. Increased ACSM1 expression could increase the rate of fatty acid oxidation in the cell, resulting in a rise in cellular energy production.
"Both conditions could promote cell growth and could potentially provide greater growth advantage to breast cells in African Americans compared to Caucasians and could increase the likelihood to potential cancer transformation," Field said.
While the researchers continue to validate these initial findings, they currently are comparing breast tumors from African American and Caucasian women to look for differences in gene expression.
"If we see that there are differences in the breast tumors, we may find new molecular targets to which therapy can be tailored specifically to African American women," Field said.
Having a mother or sister with breast cancer significantly increases the risk for young African American women to develop breast cancer, according to the analysis of questionnaires answered by approximately 59,000 African American women enrolled in the Black Women's Health Study.
Beginning in 1995, questionnaires were given every two years to women none of whom knowingly had cancer asking about demographics, reproductive and health history, family history of breast cancer and other factors.
According to principal investigator Julie Palmer, ScD, professor of epidemiology at Boston University, few studies have examined the relationship of family history to breast cancer risk in African American women, and none have done so prospectively.
"We wanted to see if we would confirm what had been shown in white women that having a mother or sister with breast cancer would increase a woman's risk of developing breast cancer," Palmer said.
Analyzing 10 years' worth of follow-up questionnaires found there were 1,050 cases of breast cancer among those who completed questionnaires on family history. The team, found that the incidence rate-ratio for such women was 1.77, meaning that overall, African American women who had a first degree relative either a mother or a sister with breast cancer had 1.77 times the risk of getting breast cancer compared to another woman of the same age who didn't have a family member with breast cancer. Having a family history of breast cancer was a stronger risk factor in women under 35, among whom the relative risk was 2.67.
Palmer said that as the study group ages and the number of women with cancer increases, the team can begin to examine other factors in cancer risk and development. "We'd expect that relative risk of 1.77 to go up quite a bit for women who have two first-degree relatives," she said. In fact, the researchers found that the overall relative risk for breast cancer was 2.58 for having two or more first-degree relatives with breast cancer, but the figure was based on few women.
The researchers plan to examine whether having a family member with other cancers is related to heightened breast cancer risk. Palmer noted that ovarian cancer might be one such cancer because "there are some shared genes," referring to the tumor suppressor gene BRCA1, which when damaged can increase a woman's risk of both breast and ovarian cancers.
In time, Palmer said, the study will have data to report on other cancers, such as colon and lung.
Genetic variations in the body's immune system could play a role in making African Americans more susceptible to developing colon cancer, scientists have found.
Researchers led by Krista Zanetti, Ph.D., a postdoctoral fellow in the National Cancer Institute's Division of Cancer Prevention and Center for Cancer Research, looked at variations in genetic sequences of the gene that makes mannose-binding lectin (MBL), a protein that plays a role in inflammation and innate immunity. They compared 26 MBL variations, or single nucleotide polymorphisms (SNPs), in 261 colon cancer patients and 537 normal controls in the Baltimore area.
Of the 26, four SNPs were associated with a significant increase in colon cancer risk in African Americans, though not in Caucasians. African Americans who carried two copies of all four variants had an approximately six-fold higher risk of colon cancer compared to those without such variants.
The four DNA variants occur in linkage disequilibrium that is, they appear together at a higher frequency than by random chance in both African Americans and Caucasians, though they are more prevalent in the former. "It was surprising," Zanetti said, "because we wouldn't necessarily assume that any one SNP would be linked to one race more than others. It wasn't our hypothesis."
Zanetti and her team currently are attempting to validate the findings with data from the Prostate, Lung, Colorectal and Ovarian (PLCO) trial, a randomized control trial originally designed to test the effectiveness of cancer screening methods. They will screen the colorectal cancer patient subset of the study for the four SNPs, with individuals with colorectal polyps as controls. Both of the latter groups are mostly Caucasian.
"Before we validate these associations in African Americans, we first need to know whether or not they exist in Caucasians that's the number one question we want to answer," Zanetti said. "Is it possible that this is actually an African American risk factor?"
According to Zanetti, the PLCO study gives the researchers the high level of power needed to detect whether these associations really exist in Caucasians. That would then enable the team to design the rest of their study.
Zanetti noted that over the past three decades colon cancer deaths in African Americans have generally been higher than in Caucasians. "We don't know why the decline in death rates has been smaller in African Americans, but we believe it's more than one factor," she said. "These SNPs aren't necessarily the only answer. We need to keep working to uncover all the contributors to this increased risk, whether there are underlying biological issues or social determinants.
"We're doing a multitude of functional studies in the laboratory to see if we can link a phenotype to the genotype we have found," she said. "We're trying to link it to biological function I think there's more to it than just association."
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 25,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts over 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, diagnosis and treatment. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication, CR, is a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. It provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.
American Association for Cancer Research (AACR)
615 Chestnut Street, 17th Floor
Philadelphia, PA 19106
United States
aacr
Buy Metronidazole Gel Without Prescription
Differences In Treatments And Outcomes Of Patients With Second Primary Lung Cancers Versus Those With One Primary Lung Identified
Patients with second primary lung cancers (SPLC), when compared to those with one primary lung cancer (OPLC), are more likely to have localized disease at the time of diagnosis and are more likely to receive surgical treatment rather than radiation treatment. However, patients with SPLC have a 12% higher lung cancer specific mortality, Fox Chase Cancer Center researchers reported at the annual meeting of the International Association for the Study of Lung Cancer.
"We want to identify factors that can improve and prolong lung cancer survivorship," says Linna Li, M.D., resident physician in the radiation department at Fox Chase.
It is recognized that patients who were previously treated for lung cancer are at high risk of developing SPLC, but the impact of this second cancer on treatment and lung cancer specific mortality is unknown. With this study Li and her colleagues aimed to uncover some of these unknowns.
The study used the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) database and evaluated the treatment and outcomes of non-small cell lung cancer (NSCLC) survivors with SPLC. Survivors of at least 2 years, over the age of 18 and undergoing active follow-up were included. With a median follow-up of 7 years, 49,577 patient with OPLC and 2,914 patients with SPLC were identified. The incidence, tumor characteristics, treatment, and cause of death in patients with OPLC and SPLC were analyzed.
"By studying a large population database, we can get important information to guide recommendations for treatment and follow up."
The research showed that median time to develop a second cancer is 51 months with 28% diagnosed 5 years after initial diagnosis of lung cancer. When diagnosed with OPLC versus SPLC, localized disease was 45% versus 60%, loco-regional disease was 35% versus 32%, and metastatic disease was 14% versus 5%. The data also showed that treatment of OPLC versus SPLC was 68% versus 87% with surgery, 31% versus 20% with radiation therapy, and 12% versus 12% with both surgery and radiation therapy. At the time of the last follow up, 56% of OPLC and 67% of SPLC were deceased. The leading cause of death in patients with OPLC versus SPLC was 64% versus 76% from lung cancer - showing that those with SPLC have a 12% higher lung cancer specific mortality.
"Curing second primary lung cancers is crucial in the long term care of lung cancer survivors. We should continue to follow lung cancer survivors after 5 years to detect second cancers earlier. It's unclear why SPLC are more likely to die from lung cancer even though they present with earlier disease. Perhaps they have less reserve, limited treatment options for the second treatment, or simply, that they are older. We need to study this more carefully in future clinical trials." adds Li.
Source:
Diana Quattrone
Fox Chase Cancer Center
Buy Famvir Without Prescription
"We want to identify factors that can improve and prolong lung cancer survivorship," says Linna Li, M.D., resident physician in the radiation department at Fox Chase.
It is recognized that patients who were previously treated for lung cancer are at high risk of developing SPLC, but the impact of this second cancer on treatment and lung cancer specific mortality is unknown. With this study Li and her colleagues aimed to uncover some of these unknowns.
The study used the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) database and evaluated the treatment and outcomes of non-small cell lung cancer (NSCLC) survivors with SPLC. Survivors of at least 2 years, over the age of 18 and undergoing active follow-up were included. With a median follow-up of 7 years, 49,577 patient with OPLC and 2,914 patients with SPLC were identified. The incidence, tumor characteristics, treatment, and cause of death in patients with OPLC and SPLC were analyzed.
"By studying a large population database, we can get important information to guide recommendations for treatment and follow up."
The research showed that median time to develop a second cancer is 51 months with 28% diagnosed 5 years after initial diagnosis of lung cancer. When diagnosed with OPLC versus SPLC, localized disease was 45% versus 60%, loco-regional disease was 35% versus 32%, and metastatic disease was 14% versus 5%. The data also showed that treatment of OPLC versus SPLC was 68% versus 87% with surgery, 31% versus 20% with radiation therapy, and 12% versus 12% with both surgery and radiation therapy. At the time of the last follow up, 56% of OPLC and 67% of SPLC were deceased. The leading cause of death in patients with OPLC versus SPLC was 64% versus 76% from lung cancer - showing that those with SPLC have a 12% higher lung cancer specific mortality.
"Curing second primary lung cancers is crucial in the long term care of lung cancer survivors. We should continue to follow lung cancer survivors after 5 years to detect second cancers earlier. It's unclear why SPLC are more likely to die from lung cancer even though they present with earlier disease. Perhaps they have less reserve, limited treatment options for the second treatment, or simply, that they are older. We need to study this more carefully in future clinical trials." adds Li.
Source:
Diana Quattrone
Fox Chase Cancer Center
Buy Famvir Without Prescription
Altravax, Inc. Awarded $1.2 Million In Federal Funds For Vaccines For HIV/AIDS
Altravax, Inc. announced that it has been awarded two SBIR grants totaling $1.2 million from the NIH's National Institute of Allergy and Infectious Diseases for research on antibody-inducing vaccines for HIV-1. A 2009 report from the United Nations has estimated the total number of people living with AIDS is now at over 30 million. Altravax will use its proprietary MolecularBreeding™ directed evolution technology to create vaccines that provide broad protection against the various strains of HIV-1. The existence of a large number of virus strains and the continued changing nature of the virus is one of the major challenges facing the development of vaccines for HIV/AIDS.
Dr. Robert Whalen, the Chief Scientific Officer at Altravax, is one of the leaders in the development of the MolecularBreeding™ technology platform for use in the vaccine area. "Our past research activities have made significant progress in developing novel vaccine antigens to broadly target the numerous HIV-1 strains and we are pleased that the NIH is continuing to support our research on HIV vaccines," said Dr. Whalen. "This continued federal support is a critical factor in our program to develop a preventative vaccine to combat the AIDS epidemic."
Altravax also recently received a third NIH SBIR grant for $600,000 to support its research on "Improved Vaccines for Influenza B Virus" to create vaccines that provide broad protection against the two influenza B virus strains that co-circulate each flu season. Including its development of a therapeutic vaccine to treat chronic hepatitis B infection, Altravax is focusing on three areas of major importance for improving human health: hepatitis B, influenza and HIV.
In January 2010, Altravax acquired from Maxygen, Inc. (Nasdaq: MAXY) exclusive rights to the MolecularBreeding™ technology platform for the development of vaccines to infectious diseases.
Source:
Altravax, Inc.
Buy Anti-Bacterial Face Mask Without Prescription
Dr. Robert Whalen, the Chief Scientific Officer at Altravax, is one of the leaders in the development of the MolecularBreeding™ technology platform for use in the vaccine area. "Our past research activities have made significant progress in developing novel vaccine antigens to broadly target the numerous HIV-1 strains and we are pleased that the NIH is continuing to support our research on HIV vaccines," said Dr. Whalen. "This continued federal support is a critical factor in our program to develop a preventative vaccine to combat the AIDS epidemic."
Altravax also recently received a third NIH SBIR grant for $600,000 to support its research on "Improved Vaccines for Influenza B Virus" to create vaccines that provide broad protection against the two influenza B virus strains that co-circulate each flu season. Including its development of a therapeutic vaccine to treat chronic hepatitis B infection, Altravax is focusing on three areas of major importance for improving human health: hepatitis B, influenza and HIV.
In January 2010, Altravax acquired from Maxygen, Inc. (Nasdaq: MAXY) exclusive rights to the MolecularBreeding™ technology platform for the development of vaccines to infectious diseases.
Source:
Altravax, Inc.
Buy Anti-Bacterial Face Mask Without Prescription
What We "Know" May Not Be So, When It Comes To The Uninsured And ERs
The 47 million Americans who lack health insurance are the reason emergency departments are crowded all the time right? And only the uninsured visit the emergency department for minor complaints, because it's easier than going to a doctor right?
Not so fast, according to a new study published in the Journal of the American Medical Association by a University of Michigan team. In fact, the reality of what causes ED overcrowding is a lot more complicated, they find. And some widely repeated perceptions about the uninsured and emergency care may be rooted more in assumptions than in solid fact.
Those faulty perceptions, they conclude, may be getting in the way of real efforts to solve both the uninsurance crisis and the crisis in American EDs.
In truth, the uninsured do not make up a disproportionate share of ED patients, because they are the only group that faces the full cost of care, the study shows. It also demonstrates that people who have insurance are more likely to contribute to ED overcrowding and to use the ED for minor complaints or in place of a primary care doctor's visit, because primary care offices are also overcrowded.
The study is based on an exhaustive review of 127 medical research papers, and on detective work to find out whether often-repeated statements about the uninsured and emergency care were actually based in fact. Most of the papers were published in the last decade, when both the plight of the uninsured and the state of the nation's EDs captured the national spotlight.
Although it challenges some of the most-repeated mantras about the uninsured and ED care, the study does confirm that solid evidence exists for many of the things that Americans have come to believe about the uninsured and emergency care.
For instance, the study shows, the number of people without insurance visiting American EDs is rising but less quickly than the numbers of uninsured are rising. Meanwhile, patients with insurance are going to the ED more frequently.
There is also solid evidence that caring for patients insured and uninsured in an ED is more expensive than treating the same complaint in a doctor's office. Uninsured people definitely have a hard time finding primary care doctors who will see them as outpatients, but even insured patients have difficulty finding primary care.
"What we found is that there is a perception that because one of the roles of the emergency room is a safety net for the uninsured it is the uninsured who must be causing all the problems in ED care," says first author and emergency physician Manya Newton, M.D., MPH, M.S., a Robert Wood Johnson Clinical Scholar at the U-M Medical School.
"The crisis in emergency medicine and the problems of the growing uninsured population have been conflated," she adds. "While there's excellent research out there on both issues, the myths about how the uninsured use the emergency department threaten to interfere with the policy-making process. The rise in ED use has much more to do with the aging of the population, the increase in chronic diseases, and the decrease in available primary care than with the uninsured. Policies based on false assumptions risk diverting energy and money from confronting the true drivers of emergency department crowding."
Newton holds positions in internal medicine and emergency medicine at the U-M Medical School, and at the School of Public Health. The study was funded by the RWJ Clinical Scholars Program.
At the least, Newton and her co-authors conclude from their review, ED policy solutions will need to address the lack of timely access to primary care by the uninsured and insured alike.
The uninsured have a nearly impossible task in finding primary care. But both insured and uninsured have trouble getting appointments in less than two to three weeks, or finding primary care after regular business hours and on weekends which leads them to the always-open ED. A reluctance by some physicians to take on the legal liability of counseling a patient over the phone, instead of instructing them to go to the ED, may also contribute, Newton says.
Meanwhile, Newton says the evidence is very strong that the overall cause of ED overcrowding is an "input-throughput-output" problem at American hospitals.
Patients come to the ED for treatment, and under federal law the ED cannot turn them away. Some of them need at least an overnight stay in one of the hospital beds upstairs from the ED. But those beds are often full because of a lack of safe and appropriate places to discharge current patients to so patients get backed up down in the ED, making it more crowded. The closure of hospitals, EDs, and long-term skilled nursing facilities around the country makes the situation worse and worse, the researchers say. Fewer beds plus more patients equals an ED crisis.
Newton and her colleagues embarked on the study after noting a curious phenomenon in the medical literature: many papers whose introductory passages included phrases like "It is well understood that…" and other statements of conventional wisdom about the uninsured and EDs. They often appeared without direct citations of studies that could support such statements.
The researchers set out to find out what those statements, and other assumptions about this issue, were based on. They winnowed an initial pool of 586 papers down to the 127 that most directly pertained to the issue, after excluding papers that looked at children and the elderly (two groups with much different insurance coverage issues than those between the ages of 18 and 65), and papers that looked at emergency psychiatric or dental care (two types of care for which insurance coverage varies greatly even among the insured). They also excluded papers about non-patient care issues.
The resulting 127 papers received a thorough examination to tally just what they had found and what they were based on, and what types of assumptions about the uninsured they perpetuated or substantiated. One surprising finding, Newton says, is that an often-repeated statement about urban EDs being overwhelmed with uninsured patients appeared to largely stem from a paper by a plastic surgeon who saw three emergency patients in nine months two of whom had no insurance and concluded that two-thirds of all patients in urban EDs are uninsured.
In all, the authors found six commonly repeated assumptions about the uninsured and ERs, which appeared in numerous papers. A number of less common assumptions were also found. But after they had tried to track down the sources of those assumptions, only three of the most common one held any water: the rise in the number of ED visits by uninsured (and insured) people, the higher expense of caring for an uninsured (or insured) person in the ED, and the lack of primary care for uninsured people.
In addition to Newton, the authors of the paper are Carla Keirns, M.D., Ph.D., M.A., M.S., Rebecca Cunningham, M.D., Rodney Hayward, M.D. and Rachel Stanley, M.D., MHSA.
University of Michigan Health System
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
med.umich.edu
Buy Vantin Without Prescription
Not so fast, according to a new study published in the Journal of the American Medical Association by a University of Michigan team. In fact, the reality of what causes ED overcrowding is a lot more complicated, they find. And some widely repeated perceptions about the uninsured and emergency care may be rooted more in assumptions than in solid fact.
Those faulty perceptions, they conclude, may be getting in the way of real efforts to solve both the uninsurance crisis and the crisis in American EDs.
In truth, the uninsured do not make up a disproportionate share of ED patients, because they are the only group that faces the full cost of care, the study shows. It also demonstrates that people who have insurance are more likely to contribute to ED overcrowding and to use the ED for minor complaints or in place of a primary care doctor's visit, because primary care offices are also overcrowded.
The study is based on an exhaustive review of 127 medical research papers, and on detective work to find out whether often-repeated statements about the uninsured and emergency care were actually based in fact. Most of the papers were published in the last decade, when both the plight of the uninsured and the state of the nation's EDs captured the national spotlight.
Although it challenges some of the most-repeated mantras about the uninsured and ED care, the study does confirm that solid evidence exists for many of the things that Americans have come to believe about the uninsured and emergency care.
For instance, the study shows, the number of people without insurance visiting American EDs is rising but less quickly than the numbers of uninsured are rising. Meanwhile, patients with insurance are going to the ED more frequently.
There is also solid evidence that caring for patients insured and uninsured in an ED is more expensive than treating the same complaint in a doctor's office. Uninsured people definitely have a hard time finding primary care doctors who will see them as outpatients, but even insured patients have difficulty finding primary care.
"What we found is that there is a perception that because one of the roles of the emergency room is a safety net for the uninsured it is the uninsured who must be causing all the problems in ED care," says first author and emergency physician Manya Newton, M.D., MPH, M.S., a Robert Wood Johnson Clinical Scholar at the U-M Medical School.
"The crisis in emergency medicine and the problems of the growing uninsured population have been conflated," she adds. "While there's excellent research out there on both issues, the myths about how the uninsured use the emergency department threaten to interfere with the policy-making process. The rise in ED use has much more to do with the aging of the population, the increase in chronic diseases, and the decrease in available primary care than with the uninsured. Policies based on false assumptions risk diverting energy and money from confronting the true drivers of emergency department crowding."
Newton holds positions in internal medicine and emergency medicine at the U-M Medical School, and at the School of Public Health. The study was funded by the RWJ Clinical Scholars Program.
At the least, Newton and her co-authors conclude from their review, ED policy solutions will need to address the lack of timely access to primary care by the uninsured and insured alike.
The uninsured have a nearly impossible task in finding primary care. But both insured and uninsured have trouble getting appointments in less than two to three weeks, or finding primary care after regular business hours and on weekends which leads them to the always-open ED. A reluctance by some physicians to take on the legal liability of counseling a patient over the phone, instead of instructing them to go to the ED, may also contribute, Newton says.
Meanwhile, Newton says the evidence is very strong that the overall cause of ED overcrowding is an "input-throughput-output" problem at American hospitals.
Patients come to the ED for treatment, and under federal law the ED cannot turn them away. Some of them need at least an overnight stay in one of the hospital beds upstairs from the ED. But those beds are often full because of a lack of safe and appropriate places to discharge current patients to so patients get backed up down in the ED, making it more crowded. The closure of hospitals, EDs, and long-term skilled nursing facilities around the country makes the situation worse and worse, the researchers say. Fewer beds plus more patients equals an ED crisis.
Newton and her colleagues embarked on the study after noting a curious phenomenon in the medical literature: many papers whose introductory passages included phrases like "It is well understood that…" and other statements of conventional wisdom about the uninsured and EDs. They often appeared without direct citations of studies that could support such statements.
The researchers set out to find out what those statements, and other assumptions about this issue, were based on. They winnowed an initial pool of 586 papers down to the 127 that most directly pertained to the issue, after excluding papers that looked at children and the elderly (two groups with much different insurance coverage issues than those between the ages of 18 and 65), and papers that looked at emergency psychiatric or dental care (two types of care for which insurance coverage varies greatly even among the insured). They also excluded papers about non-patient care issues.
The resulting 127 papers received a thorough examination to tally just what they had found and what they were based on, and what types of assumptions about the uninsured they perpetuated or substantiated. One surprising finding, Newton says, is that an often-repeated statement about urban EDs being overwhelmed with uninsured patients appeared to largely stem from a paper by a plastic surgeon who saw three emergency patients in nine months two of whom had no insurance and concluded that two-thirds of all patients in urban EDs are uninsured.
In all, the authors found six commonly repeated assumptions about the uninsured and ERs, which appeared in numerous papers. A number of less common assumptions were also found. But after they had tried to track down the sources of those assumptions, only three of the most common one held any water: the rise in the number of ED visits by uninsured (and insured) people, the higher expense of caring for an uninsured (or insured) person in the ED, and the lack of primary care for uninsured people.
In addition to Newton, the authors of the paper are Carla Keirns, M.D., Ph.D., M.A., M.S., Rebecca Cunningham, M.D., Rodney Hayward, M.D. and Rachel Stanley, M.D., MHSA.
University of Michigan Health System
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
med.umich.edu
Buy Vantin Without Prescription
The Big Gamble - Will Stimulus Dollars Pay Off In Ways Health Information Consumers Can Use?
Shortly after the American Recovery and Reinvestment Act passed in February, there was a government affairs retreat of the eHealth Initiative to discuss concern regarding the $19 billion allocated for health information technology. A feature article in the June issue of the Journal of AHIMA examines conclusions policy makers made about the investment in health IT and how to engage healthcare consumers in productive use of it.
Primarily, the concern is whether the stimulus investment is enough to assist the electronic health records being provided to hospitals and smaller offices, thus meeting the goal of health IT to provide more efficient, less expense, and better quality health and healthcare for consumers.
The Big Gamble discusses legislative language that states one of the key purposes of ARRA is to advance the delivery of patient-centered care, and the decisions the Department of Health and Human Services will make over the next year to achieve consumer's health information needs through several strategies:
- Offer technical assistance and endorse technologies, content and best practices that facilitate proactive delivery of timely information to consumers
- Conduct focus groups and structured interviews with consumers to better understand where health IT can serve their health needs
- Translate medical language into understandable information with the use of text, graphics, audio and video, and
- Design toolkits for consumer outreach
Also discussed are the health IT provisions in ARRA that require physicians to demonstrate meaningful use of electronic health records to qualify for up to $44,000 in adoption incentives. Overall, clinicians should get credit for EHRs that provide meaningful information to consumers, therefore, if health IT tools are not helping consumers make better decisions and manage their health then the tools are not meaningfully changing healthcare.
Read the complete article in the June issue of the Journal of AHIMA or online at journal.ahima.
Source
The American Health Information Management Association
Buy Medrol Online no Prescription
Primarily, the concern is whether the stimulus investment is enough to assist the electronic health records being provided to hospitals and smaller offices, thus meeting the goal of health IT to provide more efficient, less expense, and better quality health and healthcare for consumers.
The Big Gamble discusses legislative language that states one of the key purposes of ARRA is to advance the delivery of patient-centered care, and the decisions the Department of Health and Human Services will make over the next year to achieve consumer's health information needs through several strategies:
- Offer technical assistance and endorse technologies, content and best practices that facilitate proactive delivery of timely information to consumers
- Conduct focus groups and structured interviews with consumers to better understand where health IT can serve their health needs
- Translate medical language into understandable information with the use of text, graphics, audio and video, and
- Design toolkits for consumer outreach
Also discussed are the health IT provisions in ARRA that require physicians to demonstrate meaningful use of electronic health records to qualify for up to $44,000 in adoption incentives. Overall, clinicians should get credit for EHRs that provide meaningful information to consumers, therefore, if health IT tools are not helping consumers make better decisions and manage their health then the tools are not meaningfully changing healthcare.
Read the complete article in the June issue of the Journal of AHIMA or online at journal.ahima.
Source
The American Health Information Management Association
Buy Medrol Online no Prescription
Persistent Vaccination Effect Of GRAZAX(R) After Completion Of Treatment
Breakthrough: Results
from the fourth year in a long-term clinical study prove the disease
modifying effect of GRAZAX(R). For the first time ever, it is documented
that the positive clinical effect of the tablet vaccine persists after
completion of treatment.
Today, ALK announces main results from the first follow-up year in a
long-term study (GT-08) with GRAZAX(R), the company's tablet-based vaccine
against grass pollen allergy. The clinical study documents that the effect
of GRAZAX(R) persists following completion of the recommended three-year
treatment regimen. Furthermore, blood samples from patients show a
persistent, positive effect on the immune system indicating a lasting
tolerance to grass pollen.
During the first year after completion of treatment, GRAZAX(R)
continues to provide statistically significant reductions in both hay fever
symptoms and the use of symptom-relieving medication.
In the follow-up year, hay fever symptoms were reduced by 31% while the
use of symptom-relieving medication was reduced by 52%. The reduction of
symptoms and use of medication is measured as median values relative to a
control group in which patients had unrestricted access to
symptom-relieving medication.
The patients in the study have adhered to the recommended three-year
GRAZAX(R) treatment regimen and completed treatment in the autumn of 2007.
The above-mentioned results cover the 2008 pollen season, the first season
in which the patients did not receive active treatment with GRAZAX(R).
The fourth-year results represent a major breakthrough, since ALK is
the first company ever to document a persistent disease modifying
vaccination effect of a tablet-based allergy vaccine. Patients cannot
obtain such a persistent vaccination effect with traditional
symptom-relieving allergy medication.
ALK-Abello A/S
alk-abello/Pages/CorpFrontPage.aspx
Buy Armour Without Prescription
from the fourth year in a long-term clinical study prove the disease
modifying effect of GRAZAX(R). For the first time ever, it is documented
that the positive clinical effect of the tablet vaccine persists after
completion of treatment.
Today, ALK announces main results from the first follow-up year in a
long-term study (GT-08) with GRAZAX(R), the company's tablet-based vaccine
against grass pollen allergy. The clinical study documents that the effect
of GRAZAX(R) persists following completion of the recommended three-year
treatment regimen. Furthermore, blood samples from patients show a
persistent, positive effect on the immune system indicating a lasting
tolerance to grass pollen.
During the first year after completion of treatment, GRAZAX(R)
continues to provide statistically significant reductions in both hay fever
symptoms and the use of symptom-relieving medication.
In the follow-up year, hay fever symptoms were reduced by 31% while the
use of symptom-relieving medication was reduced by 52%. The reduction of
symptoms and use of medication is measured as median values relative to a
control group in which patients had unrestricted access to
symptom-relieving medication.
The patients in the study have adhered to the recommended three-year
GRAZAX(R) treatment regimen and completed treatment in the autumn of 2007.
The above-mentioned results cover the 2008 pollen season, the first season
in which the patients did not receive active treatment with GRAZAX(R).
The fourth-year results represent a major breakthrough, since ALK is
the first company ever to document a persistent disease modifying
vaccination effect of a tablet-based allergy vaccine. Patients cannot
obtain such a persistent vaccination effect with traditional
symptom-relieving allergy medication.
ALK-Abello A/S
alk-abello/Pages/CorpFrontPage.aspx
Buy Armour Without Prescription
Yeast Finding Links Processes In Heart Disease And Cancer
By studying a little-known yeast too primitive to get diseases, Johns Hopkins researchers have uncovered a surprising
link between two processes at play in heart disease and cancer in people.
In experiments with yeast known as S. pombe, the researchers discovered that a gene that helps the organism make cholesterol
also helps it survive when oxygen is scarce. The finding, described in the March 25 issue of Cell, offers a new strategy for
killing infectious yeast, but it also suggests that cells' efforts to make cholesterol and detect oxygen levels might be
connected in people, too.
"We were simply trying to establish that this yeast could be a model for studying cholesterol-related activities in human
cells," says the study's leader, Peter Espenshade, Ph.D., assistant professor of cell biology in Johns Hopkins' Institute for
Basic Biomedical Sciences. "We certainly didn't expect to find a completely new role for this gene."
It's already well established that human cells can both make cholesterol and sense oxygen. In people, high levels of
cholesterol in the blood are a major risk factor for heart disease, and many human cancer cells are able to survive despite
being in tumors' oxygen-starved centers.
"We don't know yet whether cholesterol production and oxygen sensing are connected in human cells, but now we're trying to
find out," says Espenshade.
In people, the gene in question, known as SREBP, controls other genes whose products help make or import cholesterol.
Cholesterol-lowering drugs called statins mimic this gene's natural role by triggering cells to import more cholesterol,
clearing the artery-clogging stuff from the blood.
Despite the obvious medical relevance of SREBP, no one had ever looked at the equivalent system -- or even determined whether
there was one -- in yeast, the simple, single-celled relatives with which we share many genes. Because yeast can be easily
manipulated and studied, Espenshade figured they might be a good model for figuring out exactly how SREBP is turned on, what
it does and how it's shut off -- if the organism has an equivalent process.
Turning first to databases of the entire genetic sequences of various yeast, Espenshade sought yeast genes that looked like
SREBP and its binding partner SCAP. Nothing turned up in the well-studied S. cerevisiae, or brewer's yeast, but S. pombe
seemed to have the right stuff.
Graduate student Adam Hughes then examined the role of these similar genes to prove that they in fact duplicate the human
process. Indeed, the yeast gene they called sre1 triggered activation of cholesterol-producing genes, aided by a gene called
scp1 that behaves like SCAP.
As in humans, sre1 somehow gets turned on when cholesterol levels are low, increasing the cell's production of cholesterol.
As cholesterol builds up in the cell, sre1 is gradually turned off.
"Essentially, SREBP and sre1 both try to maintain an optimal level of cholesterol in the cells," says Espenshade.
But, based on what he now knows, Espenshade suspects that the yeast use cholesterol levels to figure out whether there's
enough oxygen around for biology as usual. Single-celled yeast can alter their biology to live without oxygen, and human
cells can do so to a certain extent. Johns Hopkins researcher Gregg Semenza, M.D., Ph.D., discovered a number of years ago
how human cells react to low oxygen levels, but that process has never been connected to cholesterol production.
"Our cells can adjust to lowered oxygen by turning on a specific set of genes when oxygen levels drop [using a gene called
HIF1-alpha]," says Espenshade. "While there's no known connection between this process and cholesterol production, our
results in the yeast suggest that perhaps SREBP itself, or something in the cholesterol pathway, might also serve as an
oxygen sensor for mammalian cells."
It makes sense, he says, that the yeast could use its cholesterol levels as an indirect measure of oxygen levels. The cell
uses a few oxygen molecules each time it makes cholesterol, so lowered cholesterol levels could signal that there's not
enough oxygen around to make it. And because low cholesterol levels automatically turn on the yeast's version of SREBP, it's
an easy solution to have the same gene sound the alarm that the cell needs to adapt to low levels of oxygen.
Espenshade says sre1's role in the yeast's production of cholesterol (actually a similar molecule called ergosterol) and
sensing of oxygen might offer a new opportunity to kill infectious yeast and fungi that share the gene with S. pombe.
"Without the sre1 gene, the yeast in our experiments died in low oxygen conditions," says Espenshade. "Because low oxygen
levels are common in infected tissues, if we can block infectious yeasts' SREBP pathway without affecting human cells'
cholesterol pathways, we might be able to treat certain infections."
Espenshade and his team have found that infection-causing yeast Aspergillus, Neurospora, Cryptococcus and Ustilago share S.
pombe's cholesterol-related genes, while S. cerevisae and the yeast Candida do not.
The researchers were funded by the National Institute of General Medical Sciences, the National Heart, Lung and Blood
Institute and the Burroughs Wellcome Fund. Authors on the paper are Hughes, Bridget Todd and Espenshade, all of Hopkins.
Hughes and Todd are both graduate students in the Biochemistry, Molecular and Cell Biology program.
On the Web:
cell
Contact: Joanna Downer
jdowner1jhmi.edu
410-614-5105
Johns Hopkins Medical Institutions
hopkinsmedicine
Buy Diflucan Without Prescription
link between two processes at play in heart disease and cancer in people.
In experiments with yeast known as S. pombe, the researchers discovered that a gene that helps the organism make cholesterol
also helps it survive when oxygen is scarce. The finding, described in the March 25 issue of Cell, offers a new strategy for
killing infectious yeast, but it also suggests that cells' efforts to make cholesterol and detect oxygen levels might be
connected in people, too.
"We were simply trying to establish that this yeast could be a model for studying cholesterol-related activities in human
cells," says the study's leader, Peter Espenshade, Ph.D., assistant professor of cell biology in Johns Hopkins' Institute for
Basic Biomedical Sciences. "We certainly didn't expect to find a completely new role for this gene."
It's already well established that human cells can both make cholesterol and sense oxygen. In people, high levels of
cholesterol in the blood are a major risk factor for heart disease, and many human cancer cells are able to survive despite
being in tumors' oxygen-starved centers.
"We don't know yet whether cholesterol production and oxygen sensing are connected in human cells, but now we're trying to
find out," says Espenshade.
In people, the gene in question, known as SREBP, controls other genes whose products help make or import cholesterol.
Cholesterol-lowering drugs called statins mimic this gene's natural role by triggering cells to import more cholesterol,
clearing the artery-clogging stuff from the blood.
Despite the obvious medical relevance of SREBP, no one had ever looked at the equivalent system -- or even determined whether
there was one -- in yeast, the simple, single-celled relatives with which we share many genes. Because yeast can be easily
manipulated and studied, Espenshade figured they might be a good model for figuring out exactly how SREBP is turned on, what
it does and how it's shut off -- if the organism has an equivalent process.
Turning first to databases of the entire genetic sequences of various yeast, Espenshade sought yeast genes that looked like
SREBP and its binding partner SCAP. Nothing turned up in the well-studied S. cerevisiae, or brewer's yeast, but S. pombe
seemed to have the right stuff.
Graduate student Adam Hughes then examined the role of these similar genes to prove that they in fact duplicate the human
process. Indeed, the yeast gene they called sre1 triggered activation of cholesterol-producing genes, aided by a gene called
scp1 that behaves like SCAP.
As in humans, sre1 somehow gets turned on when cholesterol levels are low, increasing the cell's production of cholesterol.
As cholesterol builds up in the cell, sre1 is gradually turned off.
"Essentially, SREBP and sre1 both try to maintain an optimal level of cholesterol in the cells," says Espenshade.
But, based on what he now knows, Espenshade suspects that the yeast use cholesterol levels to figure out whether there's
enough oxygen around for biology as usual. Single-celled yeast can alter their biology to live without oxygen, and human
cells can do so to a certain extent. Johns Hopkins researcher Gregg Semenza, M.D., Ph.D., discovered a number of years ago
how human cells react to low oxygen levels, but that process has never been connected to cholesterol production.
"Our cells can adjust to lowered oxygen by turning on a specific set of genes when oxygen levels drop [using a gene called
HIF1-alpha]," says Espenshade. "While there's no known connection between this process and cholesterol production, our
results in the yeast suggest that perhaps SREBP itself, or something in the cholesterol pathway, might also serve as an
oxygen sensor for mammalian cells."
It makes sense, he says, that the yeast could use its cholesterol levels as an indirect measure of oxygen levels. The cell
uses a few oxygen molecules each time it makes cholesterol, so lowered cholesterol levels could signal that there's not
enough oxygen around to make it. And because low cholesterol levels automatically turn on the yeast's version of SREBP, it's
an easy solution to have the same gene sound the alarm that the cell needs to adapt to low levels of oxygen.
Espenshade says sre1's role in the yeast's production of cholesterol (actually a similar molecule called ergosterol) and
sensing of oxygen might offer a new opportunity to kill infectious yeast and fungi that share the gene with S. pombe.
"Without the sre1 gene, the yeast in our experiments died in low oxygen conditions," says Espenshade. "Because low oxygen
levels are common in infected tissues, if we can block infectious yeasts' SREBP pathway without affecting human cells'
cholesterol pathways, we might be able to treat certain infections."
Espenshade and his team have found that infection-causing yeast Aspergillus, Neurospora, Cryptococcus and Ustilago share S.
pombe's cholesterol-related genes, while S. cerevisae and the yeast Candida do not.
The researchers were funded by the National Institute of General Medical Sciences, the National Heart, Lung and Blood
Institute and the Burroughs Wellcome Fund. Authors on the paper are Hughes, Bridget Todd and Espenshade, all of Hopkins.
Hughes and Todd are both graduate students in the Biochemistry, Molecular and Cell Biology program.
On the Web:
cell
Contact: Joanna Downer
jdowner1jhmi.edu
410-614-5105
Johns Hopkins Medical Institutions
hopkinsmedicine
Buy Diflucan Without Prescription
Cold Spring Harbor Laboratory Press Launches CSH Protocols
Cold Spring Harbor Laboratory Press launched CSH Protocols, a new, online methods journal in molecular and cell biology. Bringing powerful online functions to the Press' renowned presentation of laboratory protocols, the site offers scientists:
* A new, community-based source of trusted techniques from laboratories worldwide
* Classic and cutting edge protocols featuring the strict attention to procedure that have made Cold Spring Harbor Laboratory's methods international standards
* Step-by-step, uniformly structured formats for ease of use and printing, with clearly identified materials, cautions, recipes, and troubleshooting
* Moderated, interactive Web tools enabling users to ask questions, discuss experiences, and contribute suggestions
* Customizable features such as topic-based e-mail alerts and personal folders, where favorite protocols and searches can be stored
* Robust navigation tools including a unique taxonomy for browsing and a variety of full-text search options
* A launch archive of 500 protocols that will grow to more than 900 by year-end 2006
The Executive Editor of the journal, Dr. Michael Ronemus, heads a distinguished editorial board of international advisors. He plans monthly releases of new protocols including contributions from Cold Spring Harbor Laboratory's courses and lab manuals, as well as laboratories around the world. The protocols will cover a wide range of experimental biology, from genetics and immunology to bioinformatics and imaging. Ronemus emphasizes that CSH Protocols is a research journal that accepts submissions of protocols from the scientific community for peer-reviewed publication. Ronemus also notes that many features of the journal take advantage of Web technology, in particular the opportunity for scientists to join a conversation about protocols by adding their own comments, questions, and ideas. "Each published protocol is a citable contribution to the scientific literature, but, once put online, protocols will continue to evolve as users add their own observations. In this way, researchers will have access to the most up-to-date information available."
The community aspect of the journal is a natural extension of Cold Spring Harbor Laboratory's long-established tradition of excellence in technical education. Dr. John Inglis, the journal's publisher, points out that the scientific community has gathered for decades at Cold Spring Harbor Laboratory to discuss concepts and technologies. "Emerging methods have been explored in hands-on courses and the resulting knowledge has been conveyed to labs worldwide through carefully constructed manuals." Inglis added, "As a not-for-profit science publisher committed to research and education, our aim is to make CSH Protocols a virtual gathering place where scientists search for and store information they can rely on, annotate it, share it with colleagues, and contribute improvements and updates for the benefit of all." By registering for the site's alerting services, users will keep abreast of the latest developments in their particular fields of interest.
CSH Protocols is now available via institutional site license. Free trials are currently underway enabling librarians and scientists to explore the site and experience its outstanding utility and functions. Further details can be found at cshprotocols/
In encouraging trials of the site, Dr. Inglis said, "We realize the community has a choice in online protocol resources. We believe that a comparison of our features, subject coverage, and pricing will make CSH Protocols the first choice in online methods for molecular and cell biologists."
CSH Protocols Subject Coverage
Antibodies
Bioinformatics/Genomics
Cell Biology
Chromatography
Computational Biology
DNA Delivery/Gene Transfer
Electrophoresis
Genetics
High-Throughput Analysis
Imaging/Microscopy
Immunology
Laboratory Organisms
Molecular Biology
Neuroscience
Plant Biology
Polymerase Chain Reaction (PCR)
Proteins and Proteomics
RNA Interference (RNAi)
Small Interfering RNA (siRNA)
Stem Cells
Transgenic Technology
About Cold Spring Harbor Laboratory
Established more than a century ago, Cold Spring Harbor Laboratory, New York, is a private, non profit basic research and educational institution. Its 330 scientists conduct groundbreaking research in cancer, neurobiology, plant genetics, and bioinformatics. Their studies have won numerous awards and honors, including three Nobel Prizes. The Laboratory is recognized internationally for professional training programs that bring more than 8000 scientists to its campus each year, innovative graduate education, and outreach that enhances K-12 education and the public understanding of science.
About Cold Spring Harbor Laboratory Press
From its beginnings in 1933 as an initiative to publish an Annual Symposium in Quantitative Biology, Cold Spring Harbor Laboratory Press is now an internationally recognized science publisher. The largest of the five educational divisions of the Laboratory, with more than 200 books in print, 6 research journals, and a variety of multimedia and online resources, its publications inspire and train scientists, educate students, and explain science to the public.
COLD SPRING HARBOR LABORATORY PRESS
500 Sunnyside Boulevard
Woodbury, New York 11797
Web: cshprotocols/
Contact: Wayne Manos
Cold Spring Harbor Laboratory
Buy Differin Online no Prescription
* A new, community-based source of trusted techniques from laboratories worldwide
* Classic and cutting edge protocols featuring the strict attention to procedure that have made Cold Spring Harbor Laboratory's methods international standards
* Step-by-step, uniformly structured formats for ease of use and printing, with clearly identified materials, cautions, recipes, and troubleshooting
* Moderated, interactive Web tools enabling users to ask questions, discuss experiences, and contribute suggestions
* Customizable features such as topic-based e-mail alerts and personal folders, where favorite protocols and searches can be stored
* Robust navigation tools including a unique taxonomy for browsing and a variety of full-text search options
* A launch archive of 500 protocols that will grow to more than 900 by year-end 2006
The Executive Editor of the journal, Dr. Michael Ronemus, heads a distinguished editorial board of international advisors. He plans monthly releases of new protocols including contributions from Cold Spring Harbor Laboratory's courses and lab manuals, as well as laboratories around the world. The protocols will cover a wide range of experimental biology, from genetics and immunology to bioinformatics and imaging. Ronemus emphasizes that CSH Protocols is a research journal that accepts submissions of protocols from the scientific community for peer-reviewed publication. Ronemus also notes that many features of the journal take advantage of Web technology, in particular the opportunity for scientists to join a conversation about protocols by adding their own comments, questions, and ideas. "Each published protocol is a citable contribution to the scientific literature, but, once put online, protocols will continue to evolve as users add their own observations. In this way, researchers will have access to the most up-to-date information available."
The community aspect of the journal is a natural extension of Cold Spring Harbor Laboratory's long-established tradition of excellence in technical education. Dr. John Inglis, the journal's publisher, points out that the scientific community has gathered for decades at Cold Spring Harbor Laboratory to discuss concepts and technologies. "Emerging methods have been explored in hands-on courses and the resulting knowledge has been conveyed to labs worldwide through carefully constructed manuals." Inglis added, "As a not-for-profit science publisher committed to research and education, our aim is to make CSH Protocols a virtual gathering place where scientists search for and store information they can rely on, annotate it, share it with colleagues, and contribute improvements and updates for the benefit of all." By registering for the site's alerting services, users will keep abreast of the latest developments in their particular fields of interest.
CSH Protocols is now available via institutional site license. Free trials are currently underway enabling librarians and scientists to explore the site and experience its outstanding utility and functions. Further details can be found at cshprotocols/
In encouraging trials of the site, Dr. Inglis said, "We realize the community has a choice in online protocol resources. We believe that a comparison of our features, subject coverage, and pricing will make CSH Protocols the first choice in online methods for molecular and cell biologists."
CSH Protocols Subject Coverage
Antibodies
Bioinformatics/Genomics
Cell Biology
Chromatography
Computational Biology
DNA Delivery/Gene Transfer
Electrophoresis
Genetics
High-Throughput Analysis
Imaging/Microscopy
Immunology
Laboratory Organisms
Molecular Biology
Neuroscience
Plant Biology
Polymerase Chain Reaction (PCR)
Proteins and Proteomics
RNA Interference (RNAi)
Small Interfering RNA (siRNA)
Stem Cells
Transgenic Technology
About Cold Spring Harbor Laboratory
Established more than a century ago, Cold Spring Harbor Laboratory, New York, is a private, non profit basic research and educational institution. Its 330 scientists conduct groundbreaking research in cancer, neurobiology, plant genetics, and bioinformatics. Their studies have won numerous awards and honors, including three Nobel Prizes. The Laboratory is recognized internationally for professional training programs that bring more than 8000 scientists to its campus each year, innovative graduate education, and outreach that enhances K-12 education and the public understanding of science.
About Cold Spring Harbor Laboratory Press
From its beginnings in 1933 as an initiative to publish an Annual Symposium in Quantitative Biology, Cold Spring Harbor Laboratory Press is now an internationally recognized science publisher. The largest of the five educational divisions of the Laboratory, with more than 200 books in print, 6 research journals, and a variety of multimedia and online resources, its publications inspire and train scientists, educate students, and explain science to the public.
COLD SPRING HARBOR LABORATORY PRESS
500 Sunnyside Boulevard
Woodbury, New York 11797
Web: cshprotocols/
Contact: Wayne Manos
Cold Spring Harbor Laboratory
Buy Differin Online no Prescription
DOJ Subpoenas UnitedHealth For Documents Related To Omnicare
The Department of Justice is investigating potential health care offenses committed by nursing-home pharmacy company Omnicare that involve alleged attempts to steer patients to certain Medicare prescription drug plans, according to a court document, Bloomberg/Hartford Courant reports (Bloomberg/Hartford Courant, 11/7). UnitedHealth Group said last week that on Sept. 24 it received a subpoena from DOJ requesting information about Omnicare "under its authority to investigate health care fraud offenses."
The Office of the Attorney General in Boston requested that UnitedHealth relinquish all documents used in a separate U.S. District Court case under which Omnicare has filed suit against UnitedHealth for alleged illegal negotiations that left Omnicare with a lower reimbursement rate. The UnitedHealth subpoena requested that the insurer provide all documents in that suit concerning "attempts by Omnicare to steer patients to (Medicare prescription drug) plans."
UnitedHealth said that it turned in all documents requested to DOJ and that the department said it will work directly with Omnicare to obtain any additional documents. The Sept. 24 subpoena is separate from an August request for documents related to Omnicare's alleged steering of Medicare beneficiaries and its rebate arrangements, UnitedHealth said.
Omnicare spokesperson Andy Brimmer on Tuesday said that the company does not comment on continuing litigation, adding, "Omnicare and our peers deal with government inquiries and reviews on a regular basis. We believe we've complied with all applicable laws related to Medicare Part D" (Wisenberg Brin, Wall Street Journal, 11/7).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Dexamethasone Without Prescription
The Office of the Attorney General in Boston requested that UnitedHealth relinquish all documents used in a separate U.S. District Court case under which Omnicare has filed suit against UnitedHealth for alleged illegal negotiations that left Omnicare with a lower reimbursement rate. The UnitedHealth subpoena requested that the insurer provide all documents in that suit concerning "attempts by Omnicare to steer patients to (Medicare prescription drug) plans."
UnitedHealth said that it turned in all documents requested to DOJ and that the department said it will work directly with Omnicare to obtain any additional documents. The Sept. 24 subpoena is separate from an August request for documents related to Omnicare's alleged steering of Medicare beneficiaries and its rebate arrangements, UnitedHealth said.
Omnicare spokesperson Andy Brimmer on Tuesday said that the company does not comment on continuing litigation, adding, "Omnicare and our peers deal with government inquiries and reviews on a regular basis. We believe we've complied with all applicable laws related to Medicare Part D" (Wisenberg Brin, Wall Street Journal, 11/7).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Dexamethasone Without Prescription
Proposed Targets For Voluntary Salt Reduction In Packaged And Restaurant Foods Announced By Health Department
The National Salt Reduction Initiative, a New York City-led partnership of cities, states and national health organizations, has unveiled its proposed targets to guide a voluntary reduction of salt levels in packaged and restaurant foods. Americans consume roughly twice the recommended limit of salt each day - causing widespread high blood pressure and placing millions at risk of heart attack and stroke - in ways that they cannot control on their own. Only 11% of the sodium in Americans' diets comes from their own saltshakers; nearly 80% is added to foods before they are sold. Through a year of technical consultation with food industry leaders, the National Salt Reduction Initiative has developed specific targets to help companies reduce the salt levels in 61 categories of packaged food and 25 classes of restaurant food. Some popular products already meet these targets - a clear indication that food companies can substantially lower sodium levels while still offering foods that consumers enjoy.
The Health Department will solicit additional comments on the targets this month, and the initiative will adopt final targets this spring.
The goal of the initiative is to cut the salt in packaged and restaurant foods by 25% over five years - an achievement that would reduce the nation's salt intake by 20% and prevent many thousands of premature deaths. The sodium in salt is a major contributor to high blood pressure, which in turn causes heart attack and stroke, the nation's leading causes of preventable death. These conditions cause 23,000 deaths in New York City alone each year - more than 800,000 nationwide - and cost Americans billions in healthcare expenses.
"Consumers can always add salt to food, but they can't take it out," said Dr. Thomas Farley, New York City Health Commissioner. "At current levels, the salt in our diets poses health risks for people with normal blood pressure, and it's even riskier for the 1.5 million New Yorkers with high blood pressure. If we can reduce the sodium levels in packaged and restaurant foods, we will give consumers more choice about the amount of salt they eat, and reduce their risk of heart disease and stroke in the process."
Once finalized, the targets will provide a comprehensive framework for reducing sodium in the nation's food supply - and a way to monitor progress. The initiative includes two-year and four-year targets for each category of food, and it leaves ample room for variety within each category. If a company commits to the sodium target in a particular food category, the target will apply to its overall portfolio in that category - not to each individual product. A company selling three equally popular lines of crackers could keep one type extra salty as long as its overall cracker portfolio met the target for crackers, measured in milligrams of sodium per 100 grams of cracker. The proposed targets are posted at nyc/health/salt.
Until February 1, the Health Department will solicit additional comments from the food industry, especially from those companies that have not yet participated in the target-setting process, as well as consumer organizations and other interested parties.
The recommended daily limit for sodium intake is 1,500 mg for most adults (including anyone who is black or over 40) and 2,300 mg for others. Some food products, such as deli-meat sandwiches, pack that much sodium in one serving. But much of the salt in Americans' diets comes from breads, muffins and other foods that don't taste salty. Salt levels can vary dramatically among popular products in the same category, such as breakfast cereals, indicating that lower levels are both technically feasible and commercially viable.
Other countries are already reducing salt in packaged and restaurant foods. In the United Kingdom, a similar collaboration between the food industry and government has already resulted in salt reductions of 40% or more in some food products, with the overall goal of reducing the salt in processed and restaurant foods by one third by 2010. Canada, too, is actively addressing the issue, and Australia, Finland, Ireland, and New Zealand have all launched large scale, countrywide initiatives to help reduce the salt in their foods.
National and international health organizations have reviewed the proposed targets and are now voicing support for the initiative. "The American Heart Association applauds the efforts of the National Salt Reduction Initiative to proceed with this very carefully focused effort to reduce sodium in prepared foods," said Dr. Clyde Yancy, the association's president. "The American Heart Association recognizes the potential benefit to many Americans of reducing sodium intake. Consuming too much sodium is associated with high blood pressure, a risk factor for heart attack and stroke. Reducing sodium in processed foods, which account for the majority of sodium consumption in the United States, could significantly decrease risks for cardiovascular disease, which remains the nation's leading cause of death."
"Excess sodium greatly increases the chance of developing hypertension, heart disease and stroke," said Dr. J. James Rohack, president of the American Medical Association. "The AMA has long supported a reduction of sodium in processed foods, fast food products and restaurant meals as a means to lower sodium intake and reduce the risk for cardiovascular disease among Americans."
The National Salt Reduction Initiative has received a great deal of support from philanthropists and donors, including the W.K. Kellogg Foundation. Funding for the evaluation of population salt intake was provided by the Robert Wood Johnson Foundation, the New York State Health Foundation, the National Association of County & City Health Officials and the federal Centers for Disease Control and Prevention.
Source:
Jessica Scaperotti
New York City Health Department
Buy Allopurinol Without Prescription
The Health Department will solicit additional comments on the targets this month, and the initiative will adopt final targets this spring.
The goal of the initiative is to cut the salt in packaged and restaurant foods by 25% over five years - an achievement that would reduce the nation's salt intake by 20% and prevent many thousands of premature deaths. The sodium in salt is a major contributor to high blood pressure, which in turn causes heart attack and stroke, the nation's leading causes of preventable death. These conditions cause 23,000 deaths in New York City alone each year - more than 800,000 nationwide - and cost Americans billions in healthcare expenses.
"Consumers can always add salt to food, but they can't take it out," said Dr. Thomas Farley, New York City Health Commissioner. "At current levels, the salt in our diets poses health risks for people with normal blood pressure, and it's even riskier for the 1.5 million New Yorkers with high blood pressure. If we can reduce the sodium levels in packaged and restaurant foods, we will give consumers more choice about the amount of salt they eat, and reduce their risk of heart disease and stroke in the process."
Once finalized, the targets will provide a comprehensive framework for reducing sodium in the nation's food supply - and a way to monitor progress. The initiative includes two-year and four-year targets for each category of food, and it leaves ample room for variety within each category. If a company commits to the sodium target in a particular food category, the target will apply to its overall portfolio in that category - not to each individual product. A company selling three equally popular lines of crackers could keep one type extra salty as long as its overall cracker portfolio met the target for crackers, measured in milligrams of sodium per 100 grams of cracker. The proposed targets are posted at nyc/health/salt.
Until February 1, the Health Department will solicit additional comments from the food industry, especially from those companies that have not yet participated in the target-setting process, as well as consumer organizations and other interested parties.
The recommended daily limit for sodium intake is 1,500 mg for most adults (including anyone who is black or over 40) and 2,300 mg for others. Some food products, such as deli-meat sandwiches, pack that much sodium in one serving. But much of the salt in Americans' diets comes from breads, muffins and other foods that don't taste salty. Salt levels can vary dramatically among popular products in the same category, such as breakfast cereals, indicating that lower levels are both technically feasible and commercially viable.
Other countries are already reducing salt in packaged and restaurant foods. In the United Kingdom, a similar collaboration between the food industry and government has already resulted in salt reductions of 40% or more in some food products, with the overall goal of reducing the salt in processed and restaurant foods by one third by 2010. Canada, too, is actively addressing the issue, and Australia, Finland, Ireland, and New Zealand have all launched large scale, countrywide initiatives to help reduce the salt in their foods.
National and international health organizations have reviewed the proposed targets and are now voicing support for the initiative. "The American Heart Association applauds the efforts of the National Salt Reduction Initiative to proceed with this very carefully focused effort to reduce sodium in prepared foods," said Dr. Clyde Yancy, the association's president. "The American Heart Association recognizes the potential benefit to many Americans of reducing sodium intake. Consuming too much sodium is associated with high blood pressure, a risk factor for heart attack and stroke. Reducing sodium in processed foods, which account for the majority of sodium consumption in the United States, could significantly decrease risks for cardiovascular disease, which remains the nation's leading cause of death."
"Excess sodium greatly increases the chance of developing hypertension, heart disease and stroke," said Dr. J. James Rohack, president of the American Medical Association. "The AMA has long supported a reduction of sodium in processed foods, fast food products and restaurant meals as a means to lower sodium intake and reduce the risk for cardiovascular disease among Americans."
The National Salt Reduction Initiative has received a great deal of support from philanthropists and donors, including the W.K. Kellogg Foundation. Funding for the evaluation of population salt intake was provided by the Robert Wood Johnson Foundation, the New York State Health Foundation, the National Association of County & City Health Officials and the federal Centers for Disease Control and Prevention.
Source:
Jessica Scaperotti
New York City Health Department
Buy Allopurinol Without Prescription
An Important New Health Tool For Policymakers: Canada's Cancer Risk Management Model
If Canada's smoking rates were cut by half to an average national rate of 11% within five years, it would result in 35,900 fewer cases of lung cancer by 2030 and save $656 million in treatment costs, according to analysis using a new web-enabled platform developed for the Canadian Partnership Against Cancer and presented at the 14th World Conference on Lung Cancer in Amsterdam, hosted by the International Association for the Study of Lung Cancer (IASLC).
"The Cancer Risk Management simulation model developed for the Canadian Partnership Against Cancer simulates the demographic characteristics of the Canadian population and projects cancer occurrences," said the abstract's author, Dr. Bill Evans, M.D., president of the Juravinski Cancer Centre at Hamilton Health Sciences in Hamilton, Ontario, Canada. "For lung cancer, it can be used to explore the impact of smoking cessation on such things as downstream treatment costs, life-years gained and the impacts on tax revenue. It can also project the impact of introducing a population-based screening program or increasing the uptake of adjuvant chemotherapy for surgically resected lung cancer. The cost impacts of new systemic treatments, such as molecular targeted therapies, can be estimated for specific populations, such as stage IV non-small cell lung cancer, with the budget impact for individual provinces. These simulations can help to inform decision-makers as to the relative costs and benefits of proposed new cancer control strategies."
The Cancer Risk Management (CRM) model uses dynamic, longitudinal microsimulation techniques to simulate and project realistic, representative Canadian populations, offering the potential to study changes in screening, prevention, and treatment.
The impact of decreasing smoking rates is provided as an example. For this simulation, smoking rates were decreased over a 5-year time frame from a 22% national average in 2010 to 11%. Over 20 years, this would save 587,000 person-years of life, or an average of 0.09 years per smoker. By 2030, the lung cancer incidence rate would drop from 87 to 72 per 100,000 people, resulting in cumulative savings in direct lung cancer treatment costs of $656 million and a decrease in tax revenue from cigarettes of $81.1 billion. Compared with the 5-year smoking cessation timeframe, achieving a 50% reduction in smoking rates in 3 or 10 years would add 59,800 life-years or reduce them by 117,900, respectively.
Lung, colorectal and cervical cancer modules have been built that incorporate Canadian demographic characteristics (births, mortality, immigration, emigration), educational status, risk factors (e.g. smoking, radon exposure for lung cancer) and economic factors (earnings, taxes, government transfers). CRM uses the latest data on the incidence, disease management and cancer case fatality in Canada, the impact of cancer treatments on population health and the cost to the health care system. Data sources include large national surveys, cancer registries and census data, as well as medical literature and expert opinion.
Source:
RenГ©e McGaw
International Association for the Study of Lung Cancer
Buy Didanosine Without Prescription
"The Cancer Risk Management simulation model developed for the Canadian Partnership Against Cancer simulates the demographic characteristics of the Canadian population and projects cancer occurrences," said the abstract's author, Dr. Bill Evans, M.D., president of the Juravinski Cancer Centre at Hamilton Health Sciences in Hamilton, Ontario, Canada. "For lung cancer, it can be used to explore the impact of smoking cessation on such things as downstream treatment costs, life-years gained and the impacts on tax revenue. It can also project the impact of introducing a population-based screening program or increasing the uptake of adjuvant chemotherapy for surgically resected lung cancer. The cost impacts of new systemic treatments, such as molecular targeted therapies, can be estimated for specific populations, such as stage IV non-small cell lung cancer, with the budget impact for individual provinces. These simulations can help to inform decision-makers as to the relative costs and benefits of proposed new cancer control strategies."
The Cancer Risk Management (CRM) model uses dynamic, longitudinal microsimulation techniques to simulate and project realistic, representative Canadian populations, offering the potential to study changes in screening, prevention, and treatment.
The impact of decreasing smoking rates is provided as an example. For this simulation, smoking rates were decreased over a 5-year time frame from a 22% national average in 2010 to 11%. Over 20 years, this would save 587,000 person-years of life, or an average of 0.09 years per smoker. By 2030, the lung cancer incidence rate would drop from 87 to 72 per 100,000 people, resulting in cumulative savings in direct lung cancer treatment costs of $656 million and a decrease in tax revenue from cigarettes of $81.1 billion. Compared with the 5-year smoking cessation timeframe, achieving a 50% reduction in smoking rates in 3 or 10 years would add 59,800 life-years or reduce them by 117,900, respectively.
Lung, colorectal and cervical cancer modules have been built that incorporate Canadian demographic characteristics (births, mortality, immigration, emigration), educational status, risk factors (e.g. smoking, radon exposure for lung cancer) and economic factors (earnings, taxes, government transfers). CRM uses the latest data on the incidence, disease management and cancer case fatality in Canada, the impact of cancer treatments on population health and the cost to the health care system. Data sources include large national surveys, cancer registries and census data, as well as medical literature and expert opinion.
Source:
RenГ©e McGaw
International Association for the Study of Lung Cancer
Buy Didanosine Without Prescription
Vaccination Of Children And 70 Percent Of U.S. Population Could Control Swine Flu Pandemic
An aggressive vaccination program that first targets children and ultimately reaches 70 percent of the U.S. population would mitigate pandemic influenza H1N1 that is expected this fall, according to computer modeling and analysis of observational studies conducted by researchers at the Vaccine and Infectious Disease Institute (VIDI) at Fred Hutchinson Cancer Research Center.
Published in the Sept. 11 issue of Science Express, the early online edition of the journal Science, the study which includes the first estimate of the transmissibility of pandemic H1N1 influenza in schools recommends that 70 percent of children ages 6 months to 18 years be vaccinated first, as well as members of high-risk groups as identified by the U.S. Centers for Disease Control and Prevention. These groups include health care and emergency services personnel and those at risk for medical complications from pandemic H1N1 illness such as persons with chronic health disorders and compromised immune systems. Two doses of vaccine, delivered three weeks apart, may be needed to confer adequate protection to the virus.
Corresponding author Ira Longini, Ph.D., and colleagues emphasized that a combination of factors the availability of an effective vaccine to protect people against pandemic H1N1, coupled with the timing of the outbreak will determine how quickly the epidemic can be slowed. The researchers estimate that to bring the epidemic under control aggressive vaccination of the population must begin at least a month before the epidemic peak, concentrating on children as much as possible.
"Our estimates of pandemic H1N1 in households, schools and in the community places this virus in the higher range of transmissibility," said Yang Yang, Ph.D., first author of the paper and a staff scientist at VIDI.
Although social distancing and the use of antiviral medicines can be partially effective at slowing pandemic flu spread, vaccination remains the most effective means of pandemic influenza control, the authors conclude. From a cost effectiveness measure, vaccination remains the most effective, while closing schools and other social gathering places is the least cost effective.
Vaccination increases population-level immunity and lowers the effective reproductive number of the virus, which results in two main effects: slowing the spread of infection and reducing the height of the epidemic peak; and reducing the overall illness attack rate, hospitalizations and mortality.
Other key findings in the study:
-- The current pattern of pandemic spread is most likely to be similar to the Asian influenza A (H2N2) pandemic of 1957-58. Substantial spread was expected to begin in early September with the epidemic peaking in mid to late October.
"In this case, child-first, phased vaccination would need to start as soon as possible, and no later than mid September to be effective for mitigation," said Longini, a biostatistician in the Center for Statistical and Quantitative Infectious Diseases at the Hutchinson Center. He is also a professor of biostatistics at the University of Washington School of Public Health. Longini said that the current U.S. plan called for the vaccination to probably start in mid October, which could still be effective if the epidemic peaked in November or December as it did during the Hong Kong influenza A(H3N2) of 1968-69.
-- Children will experience the highest illness attack rates based upon epidemiological observations from the U.S. and around the world. In addition, from an outbreak of pandemic H1N1 at a private school in New York last April, the authors estimate that the typical student will infect an average of 2.4 other children in his or her school.
Many findings in this study are based on epidemiological studies and vaccine trails in the past for seasonal influenza vaccines.
"We would hope to be able to estimate the effectiveness of pandemic vaccines and other mitigation measures so that we can understand the control of pandemic H1N1 influenza," said M. Elizabeth Halloran, D.Sc., M.D., a co-author of the study and member of VIDI and professor of biostatistics at the University of Washington School of Public Health.
-- The predicted rate of pandemic H1N1 transmissibility how many people an infected person will infect during influenza's infectious period in the beginning of an outbreak is estimated to be 1.3 to 1.7. A value of 1.6 means that the epidemic could generate a total of 2.2 billion cases worldwide over a year. That translates to an overall illness attack rate of 32 percent of entire populations of a city or country. A person infected by someone else can expect to fall ill about two days after infection.
Longini and colleagues are considered among the world's leading disease modeling experts. They are part of the federal government's Models of Infectious Disease Agent Study (MIDAS) Network, an effort funded by the National Institute of General Medical Sciences at the National Institutes of Health.
Funding for the study came from the National Institute of General Medical Sciences and the National Institute of Allergy and Infectious Diseases.
Source: Fred Hutchinson Cancer Research Center
Buy Gentamicin Eye Drops Without Prescription
Published in the Sept. 11 issue of Science Express, the early online edition of the journal Science, the study which includes the first estimate of the transmissibility of pandemic H1N1 influenza in schools recommends that 70 percent of children ages 6 months to 18 years be vaccinated first, as well as members of high-risk groups as identified by the U.S. Centers for Disease Control and Prevention. These groups include health care and emergency services personnel and those at risk for medical complications from pandemic H1N1 illness such as persons with chronic health disorders and compromised immune systems. Two doses of vaccine, delivered three weeks apart, may be needed to confer adequate protection to the virus.
Corresponding author Ira Longini, Ph.D., and colleagues emphasized that a combination of factors the availability of an effective vaccine to protect people against pandemic H1N1, coupled with the timing of the outbreak will determine how quickly the epidemic can be slowed. The researchers estimate that to bring the epidemic under control aggressive vaccination of the population must begin at least a month before the epidemic peak, concentrating on children as much as possible.
"Our estimates of pandemic H1N1 in households, schools and in the community places this virus in the higher range of transmissibility," said Yang Yang, Ph.D., first author of the paper and a staff scientist at VIDI.
Although social distancing and the use of antiviral medicines can be partially effective at slowing pandemic flu spread, vaccination remains the most effective means of pandemic influenza control, the authors conclude. From a cost effectiveness measure, vaccination remains the most effective, while closing schools and other social gathering places is the least cost effective.
Vaccination increases population-level immunity and lowers the effective reproductive number of the virus, which results in two main effects: slowing the spread of infection and reducing the height of the epidemic peak; and reducing the overall illness attack rate, hospitalizations and mortality.
Other key findings in the study:
-- The current pattern of pandemic spread is most likely to be similar to the Asian influenza A (H2N2) pandemic of 1957-58. Substantial spread was expected to begin in early September with the epidemic peaking in mid to late October.
"In this case, child-first, phased vaccination would need to start as soon as possible, and no later than mid September to be effective for mitigation," said Longini, a biostatistician in the Center for Statistical and Quantitative Infectious Diseases at the Hutchinson Center. He is also a professor of biostatistics at the University of Washington School of Public Health. Longini said that the current U.S. plan called for the vaccination to probably start in mid October, which could still be effective if the epidemic peaked in November or December as it did during the Hong Kong influenza A(H3N2) of 1968-69.
-- Children will experience the highest illness attack rates based upon epidemiological observations from the U.S. and around the world. In addition, from an outbreak of pandemic H1N1 at a private school in New York last April, the authors estimate that the typical student will infect an average of 2.4 other children in his or her school.
Many findings in this study are based on epidemiological studies and vaccine trails in the past for seasonal influenza vaccines.
"We would hope to be able to estimate the effectiveness of pandemic vaccines and other mitigation measures so that we can understand the control of pandemic H1N1 influenza," said M. Elizabeth Halloran, D.Sc., M.D., a co-author of the study and member of VIDI and professor of biostatistics at the University of Washington School of Public Health.
-- The predicted rate of pandemic H1N1 transmissibility how many people an infected person will infect during influenza's infectious period in the beginning of an outbreak is estimated to be 1.3 to 1.7. A value of 1.6 means that the epidemic could generate a total of 2.2 billion cases worldwide over a year. That translates to an overall illness attack rate of 32 percent of entire populations of a city or country. A person infected by someone else can expect to fall ill about two days after infection.
Longini and colleagues are considered among the world's leading disease modeling experts. They are part of the federal government's Models of Infectious Disease Agent Study (MIDAS) Network, an effort funded by the National Institute of General Medical Sciences at the National Institutes of Health.
Funding for the study came from the National Institute of General Medical Sciences and the National Institute of Allergy and Infectious Diseases.
Source: Fred Hutchinson Cancer Research Center
Buy Gentamicin Eye Drops Without Prescription
Report: House Health Reform Bill Will Greatly Improve Health Care In North Carolina For Families, Seniors, Businesses, And Children
An historic piece of legislation, awaiting a vote in the U.S. House of Representatives, would dramatically improve health care for the people of North Carolina. A report from Families USA, the national organization for health care consumers, details how the bill will make health insurance more affordable and will eliminate insurance industry abuses that affect both the quality and availability of health insurance.
The Families USA report, "Health Coverage in North Carolina: How Will Health Reform Help?" details the changes that North Carolina businesses and families can expect to see.
"The pending health insurance reform bill in the U.S. House of Representatives is designed to provide peace of mind to North Carolina's families by making health care and coverage more affordable and reliable. It will eliminate insurance company abuses, protect people from loss of coverage when they switch or lose jobs, and prevent people from having to run up huge debts or file for bankruptcy," Ron Pollack, Executive Director of Families USA, said today.
"With this bill, we will finally-after decades of debate and delay-be able to implement true health insurance reform in this nation."
The report explains how major changes in health coverage will particularly help residents of North Carolina:
- Gender and Health Status: Insurance companies will no longer be permitted to charge North Carolinians higher premiums based on their health status or gender.
- Affordable Premiums: Premiums will be affordable for families, and there will be more and better insurance options. The House bill also contains a public plan option for North Carolinians. Affordability has been a particular concern in North Carolina, where health premiums have risen 5.3 times more quickly than median earnings in the past decade.
- Aid for Small Business: Small businesses in North Carolina will receive tax credits to help with the cost of providing health care coverage for their employees.
- Caps on Cost-Sharing: Families and individuals in North Carolina will receive protection from high out-of-pocket costs.
- Low-Income Coverage: There will be an expanded Medicaid safety net for low-income people.
- Maintaining and Renewing Coverage: Individuals will be able to maintain affordable coverage and renew such coverage when they get sick.
- COBRA: Unemployed workers will have new options for quality coverage as alternatives to COBRA.
- The Uninsured: The House bill will provide health insurance coverage for an additional 1.2 million North Carolinians who are currently uninsured.
- Medicare Improvements: The "doughnut hole" will disappear, and other personal expenses in Medicare will be covered.
- Pre-Existing Conditions: Insurance companies will no longer be able to discriminate against North Carolinians based on a pre-existing condition.
- Spending Caps: Insurance companies will be forbidden to place annual or lifetime spending caps on North Carolinians' insurance policies.
- Premium Value: More dollars spent on health care insurance premiums will go toward health care.
"These are hugely significant changes for North Carolina that will greatly improve the quality of life of its residents," Pollack said. "These reforms will ease the burden of parents trying to provide health coverage for themselves and their children, and they will aid business owners in their efforts to provide their employees with essential benefits like health coverage."
"As people around the country learn more about what is truly in the health reform legislation, they will strengthen their conviction that the status quo cannot be an option for our nation. It is time to act."
Source
Families USA
Buy Lotrisone Without Prescription
The Families USA report, "Health Coverage in North Carolina: How Will Health Reform Help?" details the changes that North Carolina businesses and families can expect to see.
"The pending health insurance reform bill in the U.S. House of Representatives is designed to provide peace of mind to North Carolina's families by making health care and coverage more affordable and reliable. It will eliminate insurance company abuses, protect people from loss of coverage when they switch or lose jobs, and prevent people from having to run up huge debts or file for bankruptcy," Ron Pollack, Executive Director of Families USA, said today.
"With this bill, we will finally-after decades of debate and delay-be able to implement true health insurance reform in this nation."
The report explains how major changes in health coverage will particularly help residents of North Carolina:
- Gender and Health Status: Insurance companies will no longer be permitted to charge North Carolinians higher premiums based on their health status or gender.
- Affordable Premiums: Premiums will be affordable for families, and there will be more and better insurance options. The House bill also contains a public plan option for North Carolinians. Affordability has been a particular concern in North Carolina, where health premiums have risen 5.3 times more quickly than median earnings in the past decade.
- Aid for Small Business: Small businesses in North Carolina will receive tax credits to help with the cost of providing health care coverage for their employees.
- Caps on Cost-Sharing: Families and individuals in North Carolina will receive protection from high out-of-pocket costs.
- Low-Income Coverage: There will be an expanded Medicaid safety net for low-income people.
- Maintaining and Renewing Coverage: Individuals will be able to maintain affordable coverage and renew such coverage when they get sick.
- COBRA: Unemployed workers will have new options for quality coverage as alternatives to COBRA.
- The Uninsured: The House bill will provide health insurance coverage for an additional 1.2 million North Carolinians who are currently uninsured.
- Medicare Improvements: The "doughnut hole" will disappear, and other personal expenses in Medicare will be covered.
- Pre-Existing Conditions: Insurance companies will no longer be able to discriminate against North Carolinians based on a pre-existing condition.
- Spending Caps: Insurance companies will be forbidden to place annual or lifetime spending caps on North Carolinians' insurance policies.
- Premium Value: More dollars spent on health care insurance premiums will go toward health care.
"These are hugely significant changes for North Carolina that will greatly improve the quality of life of its residents," Pollack said. "These reforms will ease the burden of parents trying to provide health coverage for themselves and their children, and they will aid business owners in their efforts to provide their employees with essential benefits like health coverage."
"As people around the country learn more about what is truly in the health reform legislation, they will strengthen their conviction that the status quo cannot be an option for our nation. It is time to act."
Source
Families USA
Buy Lotrisone Without Prescription
Epidemiological Modeling Study Shows Vaccination, Antivirals And Social Distancing May Blunt Impact Of H1N1 Influenza
The relatively low number of new cases created by a single case of H1N1 influenza indicates that mitigation strategies such as vaccination, social distancing and the use of antiviral drugs may help to lessen the final impact of the virus, suggests an epidemiological modelling study cmaj/cgi/doi/10.1503/cmaj.091807 reported in CMAJ (Canadian Medical Association Journal).
The study looked at data from laboratory-confirmed cases of H1N1 between April 13 and June 20, 2009 in Ontario, Canada and performed 1000 simulations to estimate epidemiological parameters for the virus. These findings may be useful to policy-makers in managing the pandemic.
"Because the 2009 influenza pandemic continues to evolve, these values are critical for planning and can be used to reduce some of the uncertainty around the health burden likely to be associated with this disease in the coming months," writes Dr. David Fisman of the Dalla Lana School of Public Health, University of Toronto, and coauthors.
The study found that the median incubation period for H1N1 influenza was 4 days and the duration of symptoms 7 days. Patients aged 18 years and under recovered more quickly than older patients and the risk of hospital admission among laboratory-confirmed cases (who likely represented 1-10% of total cases) was 4.5%.
People under 1 year of age and over 65 years were at higher risk of hospital admission. Adults older than 50 years made up 7% of cases but accounted for 7 of 10 initial deaths.
According to the study's estimates, the characteristics of the H1N1 virus are similar to those of seasonal influenza. "However, when combined with high attack rates in younger groups, there may be greater absolute numbers of hospital admissions and deaths than are observed in a typical influenza season," write the authors, although this may be attributed to enhanced surveillance during a pandemic.
Source: Kim Barnhardt
Canadian Medical Association Journal
Buy Elavil Online no Prescription
The study looked at data from laboratory-confirmed cases of H1N1 between April 13 and June 20, 2009 in Ontario, Canada and performed 1000 simulations to estimate epidemiological parameters for the virus. These findings may be useful to policy-makers in managing the pandemic.
"Because the 2009 influenza pandemic continues to evolve, these values are critical for planning and can be used to reduce some of the uncertainty around the health burden likely to be associated with this disease in the coming months," writes Dr. David Fisman of the Dalla Lana School of Public Health, University of Toronto, and coauthors.
The study found that the median incubation period for H1N1 influenza was 4 days and the duration of symptoms 7 days. Patients aged 18 years and under recovered more quickly than older patients and the risk of hospital admission among laboratory-confirmed cases (who likely represented 1-10% of total cases) was 4.5%.
People under 1 year of age and over 65 years were at higher risk of hospital admission. Adults older than 50 years made up 7% of cases but accounted for 7 of 10 initial deaths.
According to the study's estimates, the characteristics of the H1N1 virus are similar to those of seasonal influenza. "However, when combined with high attack rates in younger groups, there may be greater absolute numbers of hospital admissions and deaths than are observed in a typical influenza season," write the authors, although this may be attributed to enhanced surveillance during a pandemic.
Source: Kim Barnhardt
Canadian Medical Association Journal
Buy Elavil Online no Prescription
Some Physicians Ask Patients To Sign Agreements To Promise Not To Post Negative Comments On Web Sites
Some physicians have begun to ask patients "to agree to what amounts to a gag order that bars them from posting negative comments" on Web sites where patients can rate their doctors anonymously because of concerns about the fairness of such reviews, the AP/Contra Costa Times reports.
In response to such concerns, Jeffrey Segal, a neurosurgeon, in 2007 founded Medical Justice, a company that charges physicians a fee for use of a standardized waiver agreement under which patients promise not to post on Web sites comments about the doctor, "his expertise and/or treatment." Medical Justice advises physicians to have all patients sign the agreement and refuse care for those who do not sign. Medical Justice also informs physicians when negative comments appear on Web sites, and physicians can use agreements to prompt the sites to remove those comments and possibly take legal action against patients. Medical Justice currently serves about 2,000 physicians.
Segal said, "Consumers and patients are hungry for good information" about physicians, but many comments posted by patients on Web sites provide the opposite, as some sites "are little more than tabloid journalism without much interest in constructively improving practices." He added that many such comments do not address the most important issues, such as the medical abilities of physicians. In addition, he said that physicians cannot address such comments directly because of the Health Insurance Portability and Accountability Act and medical ethics.
The American Medical Association has not taken a position on agreements under which patients promise not to post comments about their physicians on Web sites. However, AMA President Nancy Nielsen has said that Web sites where patients can rate their physicians "have many shortcomings." Comments posted by patients on Web sites "should be taken with a grain of salt and should certainly not be a patient's sole source of information when looking for a new physician," she said.
John Swapceinski, co-founder of RateMds, said of such agreements, "They're basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive" (Tanner, AP/Contra Costa Times, 3/3).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Diamox Without Prescription
In response to such concerns, Jeffrey Segal, a neurosurgeon, in 2007 founded Medical Justice, a company that charges physicians a fee for use of a standardized waiver agreement under which patients promise not to post on Web sites comments about the doctor, "his expertise and/or treatment." Medical Justice advises physicians to have all patients sign the agreement and refuse care for those who do not sign. Medical Justice also informs physicians when negative comments appear on Web sites, and physicians can use agreements to prompt the sites to remove those comments and possibly take legal action against patients. Medical Justice currently serves about 2,000 physicians.
Segal said, "Consumers and patients are hungry for good information" about physicians, but many comments posted by patients on Web sites provide the opposite, as some sites "are little more than tabloid journalism without much interest in constructively improving practices." He added that many such comments do not address the most important issues, such as the medical abilities of physicians. In addition, he said that physicians cannot address such comments directly because of the Health Insurance Portability and Accountability Act and medical ethics.
The American Medical Association has not taken a position on agreements under which patients promise not to post comments about their physicians on Web sites. However, AMA President Nancy Nielsen has said that Web sites where patients can rate their physicians "have many shortcomings." Comments posted by patients on Web sites "should be taken with a grain of salt and should certainly not be a patient's sole source of information when looking for a new physician," she said.
John Swapceinski, co-founder of RateMds, said of such agreements, "They're basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive" (Tanner, AP/Contra Costa Times, 3/3).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Diamox Without Prescription
NFID Releases Call For Action To Address Meningitis Inoculation Disparities Among Minorities
"Improving Meningococcal Vaccination Rates in Adolescents and Reducing Racial, Ethnic and Socioeconomic Disparities" (.pdf), National Foundation for Infectious Diseases: The report discusses disparities in meningitis awareness among certain racial and ethnic groups, identifies barriers to immunization and outlines strategies to increase vaccination rates among adolescents of all races. The report makes several recommendations for health care providers to improve outreach efforts to at-risk populations, including the implementation on educational programs, offering educational material in different languages, providing alternative clinic sites and informing eligible families of no-cost vaccine programs (PR Newswire release, 12/2).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Zithromax Without Prescription
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Zithromax Without Prescription
Physician Communication Measured By Glanceable Dashboard
Much like a dashboard gives a good read on how your car is doing, researchers hope they'll soon give physicians a better idea of how they are doing with patients.
Glanceable data is available for stock market reports, the weather and a growing array of data consumers want in rapid, succinct fashion. "We are moving fast and we want data fed to us in a way we can process without thinking about it," says Dr. Peggy Wagner, research director for the Department of Family Medicine in the Medical College of Georgia School of Medicine. But it made her think: Why not have a globe on every doctor's desk that says how they are doing from the patient's perspective?
It's not quite a globe, but MCG researchers have developed a touch screen kiosk that lets patients quickly answer questions about their physician encounter. Their input instantly becomes a colorful measure displayed on a 24-inch monitor at the back of the clinic: red abstract orbs for below average, yellow for average and green for above-average. "This changes real time as patients put in more data," says Dr. Wagner. To help protect patient anonymity, the glanceable dashboard only updates with every fifth patient. Patient feedback about an individual physician is included in private e-mails to that physician at the end of each week.
The kiosks are collecting data for eight weeks in primary care practice sites in Tifton, Jesup, Blackshear and Moultrie, Georgia. Only two sites have the glanceable dashboard. "Our assumption is physicians will change their behavior to get more green lights," says Dr. Wagner, and having the dashboards in only two locations will help her determine if that is true.
Patients are asked six communication-related questions such as "Did the doctor you saw today explain things in a way that was easy to understand? Did the doctor listen carefully to you? Did the doctor you saw today show respect for what you had to say?" Questions were drawn from the 2007 Consumer Assessment of Healthcare Provider and Services' Clinician and Group Survey developed by the Agency for Healthcare Research and Quality, which is funding the study.
"We want to help health care providers maximize the relatively short time they have with patients but there has to be a way to measure that first," says Dr. Wagner. This feasibility study will look at whether patients will take a survey while the visit is fresh on their minds - many mailed surveys end up in a recycling bin - and how physicians respond.
Study sites, which include practices with two to seven physicians, will be able to keep the systems after the study is complete to gather pretty much any type of useful data such as whether patients were offered flu shots or whether a subpopulation, such as diabetics, are getting the extra care needed. "You could use the dashboard idea to ask questions about anything. It has a lot of application for the future," Dr. Wagner says. Hardware and software, developed for the project at MCG, is exceedingly adaptable, usable on a laptop or even a palmtop computer, says Stan Sulkowski, educational program specialist in the Department of Family Medicine.
The initial focus on physician-patient communication cuts to the heart of an increasing number of anecdotal and documented reports of patient dissatisfaction. There is no good result from bad communication, she says. "Patients vote with their feet." If they stay but don't really understand or believe what their doctor is telling them to do, they don't do well.
The number one predictor of malpractice is poor communication, not that something bad has happened," says Dr. Wagner who teaches good patient communication to first-year medical students. "These are the kind of things that would enable a lot of green lights: talking to patients in ways they can understand, never talking down to them, making sure their questions are answered. Everybody is trying to teach this it's just hard to teach."
The innate desire to do well may help physicians modify their habits when they see vivid evidence that they are not, says Dr. Wagner. "I think physicians are caring - and competitive - people." Still, little is known about how to effectively change physician behavior. She hopes the pilot study will lead to a larger study of the issue. "To me, it's the most exciting thing I have ever done," says Dr. Wagner. "Maybe it comes from being a patient myself. I want good care and I want some input."
For physicians who are not doing well, the study offers faculty development. "If they get a lot of red lights in communication, they can request that we come in and do communication training," says Dr. Wagner, the study's principal investigator. Patients also will be periodically quizzed on whether the kiosk was patient friendly and researchers will conduct focus groups with doctors and staff to get their reactions.
Source: Toni Baker
Medical College of Georgia
Buy Lumigan Online no Prescription
Glanceable data is available for stock market reports, the weather and a growing array of data consumers want in rapid, succinct fashion. "We are moving fast and we want data fed to us in a way we can process without thinking about it," says Dr. Peggy Wagner, research director for the Department of Family Medicine in the Medical College of Georgia School of Medicine. But it made her think: Why not have a globe on every doctor's desk that says how they are doing from the patient's perspective?
It's not quite a globe, but MCG researchers have developed a touch screen kiosk that lets patients quickly answer questions about their physician encounter. Their input instantly becomes a colorful measure displayed on a 24-inch monitor at the back of the clinic: red abstract orbs for below average, yellow for average and green for above-average. "This changes real time as patients put in more data," says Dr. Wagner. To help protect patient anonymity, the glanceable dashboard only updates with every fifth patient. Patient feedback about an individual physician is included in private e-mails to that physician at the end of each week.
The kiosks are collecting data for eight weeks in primary care practice sites in Tifton, Jesup, Blackshear and Moultrie, Georgia. Only two sites have the glanceable dashboard. "Our assumption is physicians will change their behavior to get more green lights," says Dr. Wagner, and having the dashboards in only two locations will help her determine if that is true.
Patients are asked six communication-related questions such as "Did the doctor you saw today explain things in a way that was easy to understand? Did the doctor listen carefully to you? Did the doctor you saw today show respect for what you had to say?" Questions were drawn from the 2007 Consumer Assessment of Healthcare Provider and Services' Clinician and Group Survey developed by the Agency for Healthcare Research and Quality, which is funding the study.
"We want to help health care providers maximize the relatively short time they have with patients but there has to be a way to measure that first," says Dr. Wagner. This feasibility study will look at whether patients will take a survey while the visit is fresh on their minds - many mailed surveys end up in a recycling bin - and how physicians respond.
Study sites, which include practices with two to seven physicians, will be able to keep the systems after the study is complete to gather pretty much any type of useful data such as whether patients were offered flu shots or whether a subpopulation, such as diabetics, are getting the extra care needed. "You could use the dashboard idea to ask questions about anything. It has a lot of application for the future," Dr. Wagner says. Hardware and software, developed for the project at MCG, is exceedingly adaptable, usable on a laptop or even a palmtop computer, says Stan Sulkowski, educational program specialist in the Department of Family Medicine.
The initial focus on physician-patient communication cuts to the heart of an increasing number of anecdotal and documented reports of patient dissatisfaction. There is no good result from bad communication, she says. "Patients vote with their feet." If they stay but don't really understand or believe what their doctor is telling them to do, they don't do well.
The number one predictor of malpractice is poor communication, not that something bad has happened," says Dr. Wagner who teaches good patient communication to first-year medical students. "These are the kind of things that would enable a lot of green lights: talking to patients in ways they can understand, never talking down to them, making sure their questions are answered. Everybody is trying to teach this it's just hard to teach."
The innate desire to do well may help physicians modify their habits when they see vivid evidence that they are not, says Dr. Wagner. "I think physicians are caring - and competitive - people." Still, little is known about how to effectively change physician behavior. She hopes the pilot study will lead to a larger study of the issue. "To me, it's the most exciting thing I have ever done," says Dr. Wagner. "Maybe it comes from being a patient myself. I want good care and I want some input."
For physicians who are not doing well, the study offers faculty development. "If they get a lot of red lights in communication, they can request that we come in and do communication training," says Dr. Wagner, the study's principal investigator. Patients also will be periodically quizzed on whether the kiosk was patient friendly and researchers will conduct focus groups with doctors and staff to get their reactions.
Source: Toni Baker
Medical College of Georgia
Buy Lumigan Online no Prescription
Blogs Comment On Health Reform, Abortion Coverage, New Cancer Screening Recommendations
The following summarizes selected women's health-related blog entries.
Buy Ceftin Without Prescription
~ "BlogTalk: Grading Obama, Abortion Flares," Maria Newman, New York Times' "The Caucus": Although several aspects of the health care reform debate "will be contentious," the Senate's bill has notably "reignited the debate in the country over abortion rights," Newman writes. Recently, "many voters sat through thinly veiled sermons during Sunday Mass about putting pressure on their congressional representatives to keep abortion from being funded through the health care plan," she continues. According to Newman, Eliza Newlin Carney on Monday wrote in National Journal that the "furor" of the debate "has brought fresh scrutiny to the nation's Catholic bishops, who've emerged as formidable lobbyists but who face virtually none of the lobbying or disclosure rules that apply to the rest of Washington." This has "angered some on Capitol Hill, who argue the Catholic bishops have stepped over the line, and prompted calls for more transparency and better oversight of lobbying religious organizations," according to Newman (Newman, "The Caucus," New York Times, 11/23).
~ "Senate Bill More Closely Preserves Abortion Status Quo," Jessica Arons, RH Reality Check: The Senate's health reform bill "maintains most of the Capps compromise," Arons writes, referring to an amendment introduced during House committee markups that "attempted to strike a balance and preserve the status quo on abortion funding." However, the Senate's language "inserts additional provisions to ensure that no federal money will be used to pay for abortion services beyond those currently allowed by federal law," she writes. While these provisions "may go further toward addressing abortion-rights opponents' concerns," they also may "require new concessions for abortion-rights advocates," Arons continues. She adds that more analysis "is necessary to determine the full ramifications of this new language on abortion coverage" (Arons, RH Reality Check, 11/24).
~ "Un-Pelosi: The Senator Who'll Kill the Stupak Amendment," Max Blumenthal, The Daily Beast's "Blogs & Stories": In an interview with The Daily Beast, Sen. Kirsten Gillibrand (D-N.Y.) "expressed confidence that the Stupak amendment would not appear in a final congressional health care reform bill," Blumenthal writes. Gillibrand said, "It shows great leadership on [Senate Majority Leader] Harry Reid's (D-Nev.) part that he put in a provision that maintains the status quo and ensures that Stupak won't be in there," adding, "And I am confident we have 60 votes to get the bill through." She expressed that she is "confident that any Republican attempt to re-insert Stupak ... will be soundly defeated," Blumenthal writes, adding that getting the votes needed to pass such an amendment "is considered a near impossibility" in the Democratically controlled Senate (Blumenthal, "Blogs & Stories," The Daily Beast, 11/20).
~ "Here's Who Should Really Worry About Cervical Cancer, Doctors Say," Shari Roan, Los Angeles Times' "Booster Shots": Recently revised cervical cancer screening recommendations "might worry some women accustomed to getting screened every year," but most doctors say they should not be alarmed, Roan writes. The women "who should be worried, physicians point out, are those who remain under-screened," she writes, adding that half of the women who die from cervical cancer never had a Pap test and that 10% had not been screened in the five years before detection (Roan, "Booster Shots," Los Angeles Times, 11/19).
~ "GOPers Tie Breast Cancer Change to Health Care Reform," Eric Zimmermann, The Hill 's "Blog Briefing Room": Republican senators on Friday "tried to make the case ... that new recommendations on breast cancer screening foreshadow the rationing that would take place under Democratic health care reform," Zimmermann writes. The guidelines say that most women do not need to get mammograms before age 50, with biennial screening after that. According to Zimmermann, Sen. Lisa Murkowski (R-Alaska) said during a leadership press conference that there is a "concern about rationing" under the Democrats' health reform plans, which she said "we're seeing ... play out a little bit" through the new breast cancer screening guidelines. HHS Secretary Kathleen Sebelius "has said that her department does not agree with the panel's recommendation and urged women to continue regular screenings at age 40," Zimmermann writes (Zimmermann, "Blog Briefing Room," The Hill, 11/20).
~ "Senate's Women Could Sway Health Bill," David Herszenhorn, New York Times' "Prescriptions": "Controversial issues in the Senate often do not get resolved until a bipartisan 'gang' is formed to strike a deal," Herszenhorn says. He adds that "there is the possibility" that a "Gang of Four" -- Sens. Susan Collins (R-Maine), Mary Landrieu (D-La.), Blanche Lincoln (D-Ark.) and Olympia Snowe (R-Maine) -- will be "calling the shots" in the chamber's health reform debate. "If it happened, it would reflect women's rising power in the Senate more generally," he writes, adding that the "role of women senators could also highlight a battle taking place behind the scenes to restore a package of preventive health services for women that got dropped from the bill because of cost concerns." The package included screening for ovarian cancer and postpartum depression (Herszenhorn, "Prescriptions," New York Times, 11/23).
~ "Another Look at Stupak-Pitts," Lanny Davis, Huffington Post blogs: In a previous column, Davis stated that his opposition to the Stupak amendment in the House bill (HR 3962) was not enough to jeopardize his support for health care reform. He now writes that the angry response to that column has shown him that "[t]here is an opportunity for compromise." According to Davis, "the one thing everyone agrees on" is that the "Hyde Amendment status quo should not be disturbed." To achieve compromise, "pro-choice supporters will probably have to give up a public option that includes abortion coverage," though Stupak supporters in turn should "support a proposal that requires at least one insurance policy on a state exchange include abortion coverage so long as another, identical policy does not include abortion coverage," Davis argues. He continues, "If this doesn't fly with Stupak supporters, then they will prove that their agenda is not about preserving the Hyde status quo, but rather, to make it more difficult for women to obtain an abortion under the new health care system" (Davis, Huffington Post blogs, 11/20).
~ "The Mammogram Mess," Paul Waldman, The American Prospect: The uproar over the U.S. Preventive Services Task Force's new mammogram guidelines "shows how opportunistic politicians can be ... and how as a country we have an inherent bias toward more health care, whether or not it's better health care," Waldman writes. The controversy over the guidelines -- which say that "regular mammograms before age 50, for women who have no risk factors like family history or a smoking habit, do more harm than good in aggregate" -- also reveals how difficult it can be to debate health claims based on aggregate data when abundant personal anecdotes support a different conclusion, according to Waldman. "[N]ews reports about this issue have been filled with women testifying about the success of their own pre-50 mammograms," including women "who can say, 'If I hadn't had a mammogram when I was 41, I'd be dead,'" Waldman writes. "The other side will be represented by a scientist wielding a stack of studies and figures," he adds. In rendering judgments, people "put more weight on what we can see and what happens to the people we know than on abstract calculations of risk and reward," Waldman notes. Ultimately, "[t]his episode, in which a nonbinding recommendation by a panel of experts with no power to impose anything on anyone was whipped into a firestorm of fear-mongering, suggests we won't be having a reasoned discussion about the efficacy of mammograms anytime soon," Waldman concludes (Waldman, The American Prospect, 11/24).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Buy Ceftin Without Prescription
AP Looks At How McCain's Health Plan Would Affect Employer Coverage
The number of employers that would drop health insurance for employees under the health care proposal of presumptive Republican presidential nominee Sen. John McCain (Ariz.) remains a "great unknown," the AP/Houston Chronicle reports. The proposal would replace an income tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families for the purchase of private coverage.
According to presumptive Democratic presidential nominee Sen. Barack Obama (Ill.), the proposal would "shred" the employer-sponsored health insurance system, which currently provides coverage for about 158 million workers. Most health care analysts say it "won't go that far," but "both liberals and conservatives say McCain's approach would strengthen the individual and small-group insurance market" and "pull in workers now covered through their jobs," the AP/Chronicle reports.
Paul Fronstin, a senior research associate at the Employee Benefit Research Institute, said that, under the McCain proposal, younger, healthier workers whose health insurance premiums would cost less than their tax credit are the most likely to shift from employer-sponsored to individual coverage. "To the degree that happens, the employer-based market will become less healthy as sicker, older workers stay with their employer-based coverage while more of the healthier workers move to the individual market," according to the AP/Chronicle.
According to presumptive Democratic presidential nominee Sen. Barack Obama (Ill.), the proposal would "shred" the employer-sponsored health insurance system, which currently provides coverage for about 158 million workers. Most health care analysts say it "won't go that far," but "both liberals and conservatives say McCain's approach would strengthen the individual and small-group insurance market" and "pull in workers now covered through their jobs," the AP/Chronicle reports.
Paul Fronstin, a senior research associate at the Employee Benefit Research Institute, said that, under the McCain proposal, younger, healthier workers whose health insurance premiums would cost less than their tax credit are the most likely to shift from employer-sponsored to individual coverage. "To the degree that happens, the employer-based market will become less healthy as sicker, older workers stay with their employer-based coverage while more of the healthier workers move to the individual market," according to the AP/Chronicle.
Comments
Fronstin said, "What you'll see happening is average cost in the employer market will go up and average cost in the individual market will go down," adding, "You'll start to get into a cycle where people at the margin start to leave employer coverage for individual coverage. At some point, employers will start to ask: Why am I doing this if my workers don't value it anymore? If I don't need to do this to be competitive in the labor market, why should I do it?"
Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, said, "This stuff about shredding the employer market, that's just campaign rhetoric in the sense that nothing changes real quickly in this country," adding, "We're not going to see employers drop coverage en masse, and the reason is health insurance benefits remain an important tool for attracting good employees and retaining good employees."
Len Burman, co-director of the Tax Policy Center, said, "It would be a mixed bag for the employer system. On the one hand, it's a much more generous tax subsidy than what currently exists for low- and middle-income workers," adding, "On the other hand, since you can get the credit outside work, some employers would probably drop coverage."
Dan Crippen, a McCain adviser who helped develop the proposal, rejected predictions that the plan would prompt a large number of employers to drop health insurance for employees. He said, "We've talked to a lot of employers who have no interest in giving up their insurance now no matter what the system would be" (Freking/Pickler, AP/Houston Chronicle, 7/6).
Balanced Budget Proposal
The McCain campaign on Monday plans to issue a policy paper on a proposal to balance the federal budget by the end of his first term through a reduction in spending for entitlement programs and other plans, The Politico reports. In the 15-page paper, titled "Jobs for America: The McCain Economic Plan," the campaign highlights his health care and other economic proposals. The paper states, "In the long term, the only way to keep the budget balanced is successful reform of the large spending pressures in Social Security, Medicare and Medicaid."
McCain "has a comprehensive health care reform plan that will reduce the spiraling cost of health care -- a major burden for those small businesses that offer health insurance and a major impediment for those who cannot," the paper states. According to the paper, "McCain opposes costly mandates or 'pay or play' requirements that would raise the financial burden on small business, cut the ability to hire, expand or raise payrolls."
In addition, McCain will "look to bring greater affordability and competition to our drug markets through safe reimportation of drugs and faster introduction of generic drugs" and will "promote the availability of smoking cessation programs," according to the paper (Allen, The Politico, 7/7).
Obama on Health Care for Veterans
During a speech on Thursday in Fargo, N.D., Obama discussed the need to improve health care and other services for veterans, the Boston Globe reports. He said that as president he would improve health care services provided by the Department of Veterans Affairs, with a specific focus on treatment for post-traumatic stress disorder.
According to Obama, the U.S. must provide veterans with the "care and benefits they have earned." He added that the "deplorable conditions" at military health care facilities such as Fort Bragg and Walter Reed Army Medical Center highlight the "broken bureaucracy of the VA." Obama said, "It doesn't have to be this way. Not in this country," adding, "There are many aspects of the war in Iraq that have gone inalterably wrong, but caring for our veterans is one thing we can still get right" (Helman, "Political Intelligence," Boston Globe, 7/3).
Group To Launch Health Care Reform Ad Campaign
Health Care for America Now on Tuesday will launch a $40 million national advertising campaign that calls for access to comprehensive, affordable health care in the U.S., group spokesperson Jacki Schechner said last week, the New York Times reports. According to Schechner, the campaign will promote the theme, "You can't trust the insurance industry to fix the health care mess." She said, "We're educating the public about our principles and what we'd like to see from the president and the new Congress."
The campaign includes an initial purchase of $1.5 million for national television, print and online ads, with the group expected to spend an additional $25 million. The first ad will appear in national newspapers, on CNN and MSNBC, and online.
Elizabeth Edwards, a breast cancer patient and the wife of former Democratic presidential candidate and former Sen. John Edwards (N.C.), will speak at the inaugural event for the group on Tuesday at the National Press Club in Washington, D.C. According to the Times, the "presence of Mrs. Edwards, an outspoken liberal activist and health care advocate, could give fundraising efforts a boost," as she "has made health care her signature issue since Mr. Edwards dropped out of the Democratic presidential race in January" (Bosman, "The Caucus," New York Times, 7/3).
Additional Coverage
Bloomberg/Miami Herald on Saturday examined the differences in the health care and other economic proposals from McCain and Obama (Benjamin, Bloomberg/Miami Herald, 7/5). On Monday, the Times examined how health care and other economic issues are "increasingly setting the contours of the race" between McCain and Obama (Nagourney, New York Times, 7/7). The Financial Times on Sunday examined a proposal by Obama to prohibit prices based on health status in the non-group health insurance market (Guha, Financial Times, 7/6).
Editorials, Opinion Pieces
Several newspapers recently published an editorial and several opinion pieces about health care issues in the presidential election. Summaries appear below.Paul Krugman, New York Times: "By huge margins, Americans think the economy is in lousy shape," in large part because of the "housing bubble and its aftermath, rising health care costs and soaring raw materials prices," columnist Krugman writes in the Times. He adds that, although most of the health care debate has focused on the uninsured and the underinsured, the discussion also must address the cost of health insurance premiums, which are a "major business expense." Health insurance premiums have "surged" since 2000, "imposing huge new burdens on business," Krugman writes. "If Bill Clinton's attempt to reform health care had succeeded, the U.S. economy would be in much better shape today," he adds (Krugman, New York Times, 7/7).
Bruce Josten, The Politico: The current health care debate involves the "wrong or, at best, an incomplete conversation" and is "setting the wrong expectations for the American people," Josten, executive vice president for government affairs at the U.S. Chamber of Commerce, writes in an opinion piece in The Politico. According to Josten, although many "candidates and pundits suggest that small changes won't work -- that what we really need is a sweeping, top-down upheaval that can only happen through a federal solution" -- a "single solution doesn't exist." He writes that the U.S. needs a "multifaceted program of wellness and prevention, transparency, technology and consumer responsibility to cover more people and provide better care at lower cost." Josten adds, "We can dramatically reduce costs by implementing health IT, focusing on wellness and prevention, reducing medical errors and ending frivolous medical malpractice suits." In addition, he writes, "We need quality care, not just universal care. We need affordable care, not the false promise of 'free' care" (Josten, The Politico, 7/3).
Jeanne Lambrew, The Politico: "The health care crisis -- and the opportunity to address it -- will be waiting for the next president on day one," Lambrew, a senior fellow at the Center for American Progress and an associate professor of public affairs at the Lyndon B. Johnson School of Public Affairs at the University of Texas, writes in an opinion piece in The Politico. She adds, "Fortunately, some solutions are ready to go." Such proposals include a shift in the "health care system toward proven prevention and the management of chronic disease," improved information on "what works and what we pay for" and the implementation of health care IT, Lambrew writes. "These health system tools are apolitical," but "some (but not all) politicians disagree on how best to harness them," Lambrew writes. She concludes that "reforming the health system requires leadership and commitment that can come only from the White House" and that the "full cost savings and health improvements of these nonpartisan ideas for improving the system can be realized only when all Americans are insured" (Lambrew, The Politico, 7/3).
Wall Street Journal: The recent "theatrics" by congressional Democrats over the failure of the Senate to invoke cloture on a bill that would delay a scheduled 10.6% reduction in Medicare physician reimbursements and reduce funds for Medicare Advantage offer a "preview of the health care market if Democrats control both Congress and the White House" and should serve as "another health care red alert" for McCain, a Journal editorial states. According to the editorial, traditional Medicare should "convert ... into a premium-support program like" MA to address increased costs. However, in an "Obama administration, Advantage is dead," as he "wants to go in the other direction and create a Medicare-like 'public option' for everyone of any age" (Wall Street Journal, 7/7).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Buy Trecator SC Without Prescription
Подписаться на:
Комментарии (Atom)