Psoriatic arthritis affects the nails in many ways, causing pitting, discoloration, and brittleness. Learn more about the signs and symptoms in this article.
Thursday, January 31, 2019
Medical News Today: Removing plaque and tartar from teeth
The buildup of plaque and tartar on the teeth can cause bad breath, tooth decay, and gum disease. However, several simple home remedies can help treat and prevent plaque and tartar. Learn more here.
Medical News Today: Foot bones: Everything you need to know
The feet support the human body when standing, walking, running, and more. They are complex structures with 26 bones. Learn more about foot bones and foot anatomy here.
Medical News Today: What is the secondary stage of syphilis?
The secondary stage of syphilis has symptoms including sores on the genitals, mouth, and anus. Diagnosis involves a physical exam. Learn more about secondary syphilis here.
Medical News Today: Can you lose weight with the 7-day GM diet?
The GM, or General Motors, weight-loss diet plan involves eating only specific food groups each day for a total of 7 days. In this article, we look at how the diet works, its benefits and risks, and possible meal plans.
Medical News Today: Could blocking these immune cells aid weight loss?
The small intestine harbors metabolism-regulating immune cells that can consign nutrients of digestion to fat storage rather than energy use.
1 in 5 Kentucky households delay or forgo medical care due to cost; higher co-payments and deductibles may be a factor
The overall share of 21 percent was about the same as in 2014, the last year the poll asked the question. That was also the first year that Kentucky expanded Medicaid to households with incomes up to 138 percent of the federal poverty level.
Interestingly, the poll found more difference between people with incomes above and below 200 percent of the poverty line. Among those with higher incomes, the share delaying or forgoing care rose to 20 percent, from 14 percent in 2014. Among those with lower incomes, the delay-or-forgo share declined to 25 percent, from 29 percent in 2014.
Why would people with higher incomes report more trouble paying for medical care, while those with lower incomes were reporting less trouble? Perhaps because co-payments and deductibles in private insurance plans have increased, while those in Medicaid and other government insurance plans have remained stable or nonexistent, said Ben Chandler, CEO of the Foundation for a Healthy Kentucky, co-sponsor of the poll.
"The Affordable Care Act and Medicaid expansion in Kentucky significantly reduced the percentage of uninsured Kentuckians, but many still struggle with other cost barriers," Chandler said in a foundation news release. "We need to find a way to bridge those gaps to improve health and to reduce the higher health-care costs that result when we delay or forgo essential and preventive care."
The poll also found that more Kentucky adults do not use a regular doctor, health clinic or other appropriate source of health care than they reported in 2009, the first time the poll asked such questions, "but that hasn't necessarily translated into more visits to inappropriate sources such as emergency room or urgent-care-clinic visits," the foundation said.
In the poll, 24 percent of Kentucky adults said they do not have a usual place to go for health care, compared to 18 percent in 2009. "About 8 percent of Kentucky adults said they go to the emergency room or an urgent-care center when they need care, a figure that has remained steady since 2009," the foundation said.
Kentucky adults without health insurance were nearly twice as likely to lack a usual source of health care as those with coverage, the poll found.
"Going to the same place for medical care, a place that knows you and your medical history, is key to maintaining good health and preventing chronic disease," Chandler said. "You're more likely to have regular wellness visits, immunizations and health screenings and to avoid dangerous medication interactions and preventable hospital admissions when you have both health insurance and a regular care provider. The fact that those living on low incomes are less likely to have either of these is another example of how poverty often leads to poorer health."
The telephone poll of Kentucky adults is also funded by Interact for Health, a Cincinnati-area foundation. Its margin of error is plus or minus 2.5 percentage points.
Medical News Today: How can a vegan diet improve your health?
A new study adds to the evidence suggesting that plant-based foods can boost your health. Vegan meals, the researchers say, help promote good gut hormones.
Medical News Today: How does alcohol affect allergies?
Alcohol has many effects, sometimes leading to symptoms that resemble allergies. This may be a sign of an alcohol allergy or intolerance. Alcohol may also worsen existing allergies. Learn more alcohol allergies, and alcohol's effects on existing allergies, here.
Why keep a food diary?
Many people begin the new year with a resolve to improve their health. This improvement often starts with changing what they eat.
A food diary can be a useful tool in this process. It can help you understand your eating habits and patterns, and help you identify the foods — good and not-so-good — you eat on a regular basis. Research shows that for people interested in losing weight, keeping a journal can be a very effective tool to help change behavior. In one weight loss study of nearly 1,700 participants, those who kept daily food records lost twice as much weight as those who kept no records.
What should you include in a food diary?
Most experts agree that the secret to successful food journaling is accuracy and consistency. So, what should you record? A basic food diary should include the following:
- What are you eating? Write down the specific food and beverage consumed and how it is prepared (baked, broiled, fried, etc.). Include any sauces, condiments, dressings, or toppings.
- How much are you eating? List the amount in household measures (cups, teaspoons, tablespoons) or in ounces. If possible, it is best to weigh and measure your food. If you are away from home, do your best to estimate the portion.
- When are you eating? Noting the time that you’re eating can be very helpful in identifying potentially problematic times, such as late-night snacking.
Jotting down where you’re eating, what else you’re doing while you’re eating, and how you’re feeling while eating can help you understand some of your habits and offer additional insight.
- Where are you eating? Record the specific place you are consuming food, whether it’s at the kitchen table, in your bedroom, in the car, walking down the street, at a restaurant, or at a friend’s home.
- What else are you doing while eating? Are you on the computer, watching TV, or talking with a family member or a friend?
- Who are you eating with? Are you eating with your spouse, children, friend, or a colleague, or are you alone?
- How are you feeling as you’re eating? Are you happy, sad, stressed, anxious, lonely, bored, tired?
Tips for successful food journaling
Here are more tips for keeping a successful food diary:
- Write down the food or beverage as soon as you consume it. Don’t wait until the end of the day because your recollection is likely to be less accurate.
- Be as specific as you can with the food or beverage. For example, if you are drinking a latte, note the type and size.
- Be sure to include any alcoholic beverages you consume.
- A smartphone app like Lose It! or MyFitnessPal can support your efforts. These apps also offer information on calories and other nutrients.
You’ve kept a food diary. Now what?
After completing a week’s worth of food journaling, step back and look at what you’ve recorded. Search for any trends, patterns, or habits. For example, you might consider:
- How healthy is my diet?
- Am I eating vegetables and fruit every day? If so, how many servings?
- Am I eating whole grains each day?
- Am I eating foods or beverages with added sugar? If so, how frequently?
- Do my moods affect my eating habits? Do I reach for unhealthy snacks when I’m tired or stressed?
- How often do I eat on the run?
Set SMART healthy eating goals
Once you’ve identified areas for improvement, set one or two healthy eating goals for yourself. In doing so, use the SMART goal format. That means your goals should be Specific, Measurable, Achievable, Relevant and Time-based. Here are a few examples of SMART goals.
Food diary observation: You average two servings of vegetables per day.
Goal: Eat more vegetables.
SMART goal: Eat three servings of vegetables per day.
Food diary observation: You order takeout three or four nights per week.
Goal: Cook more at home.
SMART goal: Order take out no more than one or two nights per week.
Food diary observation: You eat healthy meals and snacks until about 3 pm, when you hit the office vending machine.
Goal: Eat healthier snacks.
SMART goal: Bring a healthy snack (a piece of fruit and a small handful of nuts) to work every day.
Keeping a food journal can be very informative and move you toward improving your health. Using the data from your food diary to make SMART changes, and continuing to track your progress, is a great place to start your journey for a healthier 2019.
The post Why keep a food diary? appeared first on Harvard Health Blog.
Medical News Today: What causes gas pain during pregnancy?
Gas pain is common during the early and late stages of pregnancy. In this article, we discuss the causes of gas pain, how to relieve symptoms and other conditions that cause similar symptoms.
Medical News Today: Is fenugreek good for you?
Fenugreek is an herb with many potential health benefits, including improving cholesterol and blood pressure. It may also cause some unwanted effects. Learn more about fenugreek here.
Medical News Today: Dementia: The worrying 'rise of pseudomedicine'
In a recent article, a team of neurologists attacks an ongoing increase in pseudomedicine that claims to protect brain health and treat dementia.
Medical News Today: Schizophrenia: Restoring brain circuitry to improve symptoms
Researchers finally zero in on the brain network that drives the severity of negative symptoms in schizophrenia and suggest a noninvasive treatment.
Wednesday, January 30, 2019
Medical News Today: Everything you need to know about convulsions
Convulsions are common in some types of seizures and rare in a few other conditions. Learn more about the causes of convulsions and what to do if someone experiences them here.
Medical News Today: What are the stages of multiple sclerosis?
Multiple sclerosis is a long-term progressive disease that affects the nerves. Learn about the types, treatment options, and what to expect at each stage of its progression here.
Medical News Today: Home remedies for calluses
Calluses are hard, thickened areas of skin that result from excessive rubbing or pressure. Although they can be uncomfortable, calluses are rarely serious, and a person can usually treat them at home. Here, we discuss seven home remedies for getting rid of calluses.
Medical News Today: How to soothe a baby crying in their sleep
Most babies cry in their sleep at some point. In this article, we look at the reasons why they cry in their sleep, how to soothe the baby, and what the normal sleep patterns are for babies.
Medical News Today: How to tell if contractions are real
Braxton-Hicks contractions prepare the body for labor, but they are not real contractions. Real contractions are consistent and increasingly frequent. Learn more here.
Medical News Today: 11 causes of swollen ankles
Swollen ankles, or edema, are a common symptom of a variety of conditions. Learn more about the causes of swollen ankles, including lymphedema, pregnancy, cellulitis, and blood clots, here. We also cover how best to treat them.
Medical News Today: How do you read a TB skin test?
A purified protein derivative (PPD) test is a test that helps diagnose tuberculosis. It is a straightforward and painless test, and the results can lead to faster treatment. Learn more here.
Medical News Today: What to know about psoriatic arthritis of the knee
Psoriatic arthritis can affect many joints, including the knees. Symptoms in the knee can cause significant problems with walking and standing. In this article, learn about how doctors diagnose and treat psoriatic arthritis of the knee.
Medical News Today: How long can a person live with HIV?
There is no set length of time that a person can live with HIV. Life expectancy increases as new treatments become available. People can now manage HIV as a chronic condition. Learn more here.
Medical News Today: Breast changes during pregnancy
During pregnancy, a woman may notice breast changes from as early as 1 week after conception. These changes can continue right up until the birth of the baby and beyond. However, breast changes vary from woman to woman, and not everyone will experience them. Learn more here.
Medical News Today: Hearing loss and cognitive decline: Study probes link
Data from an 8-year study of 10,000 men aged 62 or older reveals a link between hearing loss and a markedly greater risk of subjective cognitive decline.
Celery Juice: Miracle Drink or Overhyped Fad?
With hashtags like #healing, #miracle, and #foodasmedicine, you might think the latest trend taking over Instagram involves the fountain of youth or the cure for cancer. But these glowing descriptors refer to none other than the juice of your ordinary lunchbox veggie: celery.
Wait, celery? Like, ants-on-a-log, bits-in-your-tuna-salad celery? Even as a licensed nutritionist, I’ve never been too impressed with the nutrient profile of this humble vegetable. To me, celery has always seemed like a low-calorie choice for a light afternoon snack or for adding extra crunch to soups, not much more. But could I be wrong? And could juicing be the key to unlocking celery’s untold health benefits?
The Health Claims
The health claims surrounding celery juice are, admittedly, pretty bold. According to Medical Medium Anthony William, Instagram’s most famous celery juice evangelist, drinking the stuff can heal eczema, psoriasis, and acne. It also theoretically reduces bloating, fights autoimmune disease, tackles acid reflux, and eradicates bacteria and viruses. Other proponents have declared it contains “detoxifying properties that cleanse the body of all germs and toxins.” (Mmkay, we may have to draw the line there.)
Still, dramatic personal testimonies are hard to argue with. Side-by-side before-and-after photos show a woman with severe acne, now radiant with post-celery juice clear skin. Various bloggers attest that celery juice on an empty stomach first thing in the morning has led to weight loss, improved digestion, and even “a feeling of zen bliss.” How do you account for that?
The Experts Weigh In
While Medical Medium Anthony William may have 1.4 million Instagram followers, he does not actually possess any medical or nutrition degrees. So, to get the bottom of what’s legit and what’s not, I dug into the science and spoke to some credentialed nutrition professionals to see what they have to say about celery juice. (And oh, boy, do they have a lot to say about it.)
First of all, what’s so great about celery? Is there anything inherent in this unassuming veggie that makes it more nutritious than, say, cucumbers or carrots? Probably not. Celery does contain large amounts of vitamin K, which keeps blood clotting normally and may reduce bone loss. And it boasts smaller amounts of important nutrients like vitamin C, vitamin A, and folate—all in an extremely low-calorie package of 16 calories per cup. But all vegetables contain vitamins and minerals, and compared with many others, celery is low in fiber and other nutrients you might hope to get in a vegetable, like magnesium or calcium.
Even so, any veggie is a good veggie. “Celery, like many vegetables, is a rich source of flavonoids,” says registered dietitian Erin Palinski-Wade, CDE, author of 2-Day Diabetes Diet. “These flavonoids have been found to help fight against chronic disease and may ward off inflammation.” A 2017 review of nine studies concluded that celery also had high antioxidant activity. “These antioxidants can prevent cell damage and protect against chronic disease,” says clinical nutritionist Josh Axe, DC, DNM.
Do we really need to juice it, though?
If celery is a healthy choice, why go to the trouble of juicing it? Wouldn’t we do just as well crunching some with a side of ranch? “Eating celery will provide you with the same phytochemicals and flavonoids that are found in celery juice,” confirms Palinski-Wade. “The benefit [of juicing] is that you can consume these nutrients in larger quantities by juicing as compared to eating large quantities of celery each day, which may not always be practical.”
But some see major drawbacks to the juicing phenomenon. “Juicing anything generally removes or significantly breaks down fibers in the food product, which is not ideal,” says Monica Auslander Moreno, MS, RDN. “Those fibers help us feel full, and the act of chewing is satiating in itself.” Plus, if it’s vitamins A or K you’re after from celery, these nutrients are both fat-soluble, meaning that eating them with fat helps your body absorb them. So that side of ranch may be the better way to go, after all.
Other Drawbacks
On the whole, many credentialed health pros view celery juice with far more skepticism than enthusiasm. According to Moreno, jumping on the juice bandwagon “is just profoundly misguided and will not confer any more ‘benefits’ than eating celery would confer. There is no clinical or anecdotal evidence that is convincing enough for me to recommend or personally drink celery juice.” Some have gone a step further in their criticism of the trend. Registered dietitian and frequent media commentator Abby Langer, RD, called out the Medical Medium on Twitter for promoting “classic charlatan BS” and has dismissed celery juicing as “pure idiocy.”
Even Dr. Axe, known for his more alternative approach to healing through diet, doesn’t think the craze lives up to its hype. “Many people mistakenly believe that consuming a few servings of celery juice—or any other ‘superfood’—can be a quick fix for better health. However, celery juice alone is unlikely to have much of an impact on health, especially if it’s paired with a poor diet and lack of physical activity,” he says.
But what if you really love the stuff?
For those who feel their lives have been transformed by celery juice, the opinions of experts may not hold a candle to personal experience. It’s true that everybody is different, and science can’t account for every individual response to food. So, if you feel celery juice gives you more energy, reduces bloating, or clears up your acne, rock on with your green self. Just note that there’s power in the placebo effect, which may account for your results more than any miraculous properties of celery. “The placebo effect is strong enough to cure or kill,” Moreno says—and when it comes to the “cure,” that’s not a bad thing.
Plus, though celery juice may not be the miracle elixir its proponents believe, is there really anything wrong with drinking it? Couldn’t you make a lot worse choices in your diet? “There are no harmful side effects to drinking celery juice, and it may provide some health benefits,” Palinski-Wade says. “If you are drinking celery juice and enjoying it, there’s no reason to stop.” Moreno agrees. “If someone adores their celery juice like I adore my daily yogurt, I would say go for it! We should all eat foods we love and look forward to.”
Then again, if you’re thinking of planting a celery garden and dropping a wad of cash on a juicer that's going to take up all of your kitchen storage, you may want to think again. For good health, most dietitians emphasize eating a diet full of fruits and vegetables—not just celery and definitely not just juiced. It may sound boring, but the road to better health is often rooted more in these common-sense principles and less in social media trends.
6 "Healthy" Instagram Food Trends That Don't Always Live Up to the Hype
Instagram is home to some serious clean-eating food porn. Scrolling through your feed can make you want to run out and drop some cash on a matcha latte or an acai bowl, but is it really worth getting sucked into the pretty colors and the gorgeous photography?
Time to drop some knowledge—not everything you see on Instagram is as it seems (shocking!), and following so-called “clean eating” feeds is not always the way to get killer abs and endless energy. This time of year, when diets run rampant and everyone is ready to jump on the “healthy eating” bandwagon, arm yourself with the knowledge of which social media trends are worth skipping.
Green Juice
We’ve all seen the girl holding a green juice and showing off her killer abs. You immediately start to wonder if you should be setting aside $10-plus per day for a fancy juice. Don’t waste your money. “You don’t have to buy your juice at an expensive juice bar for it to be good for you,” says Amy Gorin, MS, RDN.
If you’re looking for a beverage with benefits, opt for something that has protein and fiber that won’t spike your blood sugar, like a good old-fashioned smoothie. You may be thinking, But a smoothie doesn’t have 10 different kinds of fruit and veggies in it. We hear that, but why not add those veggies to your plate rather than try to sip them through a straw? You’ll get the beneficial fiber that's otherwise broken down during the juicing process.
Here's a simple formula I recommend for smoothies to get plenty of protein and healthy fats in your filling drink—1 1/2 cups frozen fruit + 1 tablespoon healthy fats (like hemp or flax seeds) + 1 cup protein (can be from milk, yogurt, or protein powder). Gorin also suggests using 100-percent fruit juice in the smoothie, instead of a sweetener like honey or maple syrup. We also like adding one date for a hint of sweetness. Need some more smoothie inspo? We got you with these five-ingredient beauts.
Fat Bombs
With more than 9 million posts on Instagram, #keto doesn’t seem to be going away anytime soon. But are “fat bombs” and a healthy keto diet synonymous? “I cringe every time I see a recipe touted as a fat bomb because it’s generally super high in calories and devoid of the beneficial antioxidants and phytochemicals needed from fruits, veggies, and high-quality carbs,” says Lauren Harris-Pincus, MS, RD, author of The Protein-Packed Breakfast Club.
In other words, there’s a healthy way to “fat bomb” and a not-so-healthy way. Even though butter, cream, bacon, and loads of cheese are technically “allowed” on the keto diet, that doesn’t mean you should load up your cart with all the bacon cheeseburger essentials every time (sans the bun, of course). Instead, try a “fat bomb” that embraces healthy fat ingredients, like nut butter, almond flour, olive oil, and avocado. Here are some fat bombs we can get down with.
Fancy Infused Water
Remember the days when you just had to choose between still and sparkling? Now the water options include cactus, aloe, maple, and who knows what will pop up next. Toby Amidor, MS, RD, and Wall Street Journal best-selling cookbook author, says to ignore the hype over these amped-up waters. “Aloe water claims to energize, while maple water says it helps with thyroid and bone health, but there is very little research to back up any of the claims,” she says.
In other words, don't waste your money. If you like the taste, go for it, but it's not a magical elixir to undo a bad night’s rest or a crappy diet. The best thing to chug is still good old plain water. “It’s the best calorie-free option to help you stay hydrated,” Amidor says. If your taste buds need a little pick-me-up, opt for a sugar-free flavored seltzer. After all, #lacroixwater is definitely trending.
Tea-Toxes
You’ve likely seen the girl with the flat stomach boasting about how “skinny teas” offer amazing weight-loss results! Don’t fall for the hype. These diet teas usually include an herb called senna, which is also used as an over-the-counter laxative. The National Institute of Health says senna is likely safe when taken in the short term but unsafe when used for long periods of time. Using a laxative-type supplement to lose weight can not only cause diarrhea and dehydration, but it may also promote disordered eating.
Instead, cozy up with a mug of green tea, herbal tea, or black tea. Heck, even kombucha is worth throwing in there. As a matter of fact, research suggests that drinking green tea in combination with eating a healthy diet can aid in weight loss without any nasty side effects. Plus, a meta-analysis found that drinking black tea may lower bad cholesterol levels in healthy adults. Doesn’t that sound better than drinking a laxative?
Matcha Lattes
Latte art makes us stop and double tap every.damn.time. There’s nothing prettier than a gorgeous handmade heart in a cup of green matcha tea, but buyer, beware. Matcha lattes taste amazing, but some coffee shops create that memorable taste using hidden sugary ingredients, like flavored milk or syrups. On its own, matcha is an antioxidant-rich green tea with an earthy taste. It picked up steam as a health beverage because it contains a compound called ECGC, which may help break down fat.
Let’s just say that pure matcha tea is an acquired taste, and it’s not naturally sweet. Next time you order a matcha latte for the 'gram, chat with your barista about what’s in it. Opt for just milk or unsweetened almond milk and see if you still enjoy the drink.
Acai Bowls
The base of these good-looking bowls is that royal purple superfood, the acai berry. Packed with antioxidants that have been linked to reducing the risk of several diseases, the acai berry on its own is definitely as good for you as you think, but it’s also quite sour and tangy. In other words, the thing that makes acai bowls taste so great is not the acai, it’s the add-ins and toppings. First, the acai is usually blended with some sort of sweetener to make it taste good. Then it’s covered in sugary additives, like honey, granola, or sweetened coconut flakes. In other words, acai bowls can be a real calorie and added-sugar bomb.
You don’t need to avoid them entirely, but just make sure you check the ingredients before going all-in. Start by making your own lighter version at home. Trader Joe’s actually sells pure blended frozen acai, which you can mix with unsweetened almond milk, some leafy greens, and a drop of honey. Top it off with your favorite fruits, a dab of nut butter, and seeds like hemp and chia for that much-needed crunch.
Appetite-Suppressant Lollipops
We think you’re smart enough to know these are total BS, but with celebs like the Kardashians promoting them, it’s worth saying again. Hey, guys, don't expect a lolli to make you skinny! And on top of that, do not fall for crazy products that are meant to suppress your appetite. Having a hunger for food is natural. Go ahead and eat a regular lollipop when you want something sweet, and oh, I don’t know, exercise and eat well too.
The Takeaway
If Instagram can help motivate you to make healthier choices, that's a win. But just do some digging to make sure what you're ordering at the juice bar or coffee shop is actually doing you some good and not wrecking your eat-less-sugar goals. We leave you with this: A matcha latte at Starbucks can pack more than 30 grams of sugar. No wonder it tastes so damn good.
Medical News Today: Short, regular movement breaks lower risk of early death
For people who are sedentary, swapping just 30 minutes of sitting for exercise can significantly reduce the risk of early death, a new study finds.
What to do if you think your child has the flu
We are in the thick of influenza season now, and so it’s natural that if you hear your child start coughing, you wonder: could this be the flu?
The flu is different from the common cold, but it’s not always easy to tell them apart, especially at the beginning. The flu usually comes on suddenly, and its symptoms can include fever, runny nose, cough, sore throat, headache, muscle aches, feeling tired, and generally just feeling rotten. Some people have vomiting and/or diarrhea, too. Not everyone has all these symptoms, and the illness can range from mild to severe. So what do you do if you think your child might have the flu?
Call your doctor
You don’t necessarily need an appointment, but you should call for advice. Describe your child’s symptoms. Based on the symptoms, and your child’s particular situation (such as any medical problems they might have, or vulnerable people like infants or elderly living with you), your doctor may want you to bring your child in, and may want to prescribe antiviral medication. Because every child and every situation is different, you should call and get advice that is tailored to your child and family. Once you’ve done that, or once you’re back home with a diagnosis of flu…
Stock up on supplies
There are a few things that make getting through the flu easier, including:
- acetaminophen and ibuprofen for fever and aches
- a reliable thermometer, if you don’t have one
- hand sanitizer (buy a few to keep all over the house)
- tissues
- fluids to keep your child hydrated, such as clear juices, broth, oral rehydration solution (for infants), and popsicles (which are great for sore throats, and eating them is the same as drinking). If you don’t have a refillable water bottle (one with a straw is great if kids are lying down), get one of those too.
- honey (if your child is older than a year) and cough drops (if your child is at least preschool age)
- saline nose drops
- a humidifier, if you don’t have one
- simple foods like noodle soups, rice, crackers, bread for toast.
Make sure your child rests
Turn off or at least limit the screens, as they can keep children awake when their body needs them to sleep. Keep rooms darkened, and limit activity. If they aren’t sleeping, quiet things like reading (or reading to them), drawing, card games, etc. are best.
Push fluids, don’t worry about food
When children are fighting the flu, the most important thing is that they stay hydrated. They need a bit of sugar and salt too, which is why juices and broths are good choices. If they only want water, give them some crackers to get the sugar and salt — but don’t worry too much if they don’t want to eat more than that. They will eat more when they feel better.
Watch for warning signs
Most children weather the flu fine, but some children get very sick, and there can be complications. Call your doctor or go to an emergency room if your child has:
- a high fever (102° F or higher) that won’t come down with acetaminophen or ibuprofen, or a new fever after your child seemed to be getting better
- any trouble breathing
- severe pain of any kind
- severe sleepiness, so that it’s hard to wake them or keep them awake
- trouble drinking or keeping fluids down
- anything that seems strange or worries you (I always respect a parent’s “Spidey sense”).
Keep your child home until they are well
That doesn’t necessarily mean they can’t go to school or daycare until they are cough- or runny nose-free, but it does mean that they have to be fever-free for at least 24 hours, not coughing constantly, able to eat and drink, and have enough energy to do whatever school or daycare entails. Not only is this important for your child’s recovery, but it’s important for preventing the spread of influenza. Which leads me to the last point…
Do your best to keep others from getting sick
Besides keeping your child home (and staying home yourself if you catch it), there are other things you can do, such as:
- make sure everyone in the house washes their hands frequently (that’s where the hand sanitizer all over the house comes in handy)
- teach everyone to cover coughs and sneezes (they should do it into their elbow, not their hands)
- don’t share cups, utensils, towels, or throw blankets
- wipe down surfaces and toys regularly
- discourage visitors (use technology for virtual visits instead)
- be thoughtful about physical contact. Some degree of contact and snuggling is part of parenthood, but siblings may want to keep a bit of distance, and you can always blow kisses and do pretend hugs instead of the real thing.
Remember, too, that it’s never too late to get a flu shot if you haven’t already.
To learn more about the flu and what to do, visit flu.gov.
The post What to do if you think your child has the flu appeared first on Harvard Health Blog.
Medical News Today: Are tattoos linked to poor health and risky behavior?
As tattoos become increasingly popular, a new study examines the relationship between body art, physical and mental health, and risky behavior.
Medical News Today: Could stem cells reverse diabetes?
Previous attempts to develop insulin-producing cells from stem cells have not been completely successful. A recent study, however, offers fresh hope.
Tuesday, January 29, 2019
Medical News Today: What to know about multifocal breast cancer
Multifocal breast cancer is where a person has more than one tumor in one area of their breast. In this article, we look at the causes, diagnosis, staging, treatment, and prognosis for multifocal breast cancer.
Medical News Today: Breast cancer: How fast does it spread?
In the early stages of breast cancer, it may not spread at all. It is difficult to know how fast invasive breast cancer can spread in 1 year, as it depends on the cancer’s stage, grade, and other factors. In this article, we discuss the growth and progression of breast cancer.
Medical News Today: Could targeting this enzyme slow aging and related diseases?
In showing how an enzyme halts cell division by producing reactive oxygen species, scientists shed new light on the biology of aging and related diseases.
Medical News Today: Menopause: Mindfulness may reduce symptoms
A new study concludes that mindfulness might help menopausal women who struggle with symptoms that can include irritability, depression, and anxiety.
Medical News Today: High blood pressure linked to zinc deficiency
A new study finds that zinc deficiency can play a role in high blood pressure. The researchers examine how zinc's impact on the kidney might be to blame.
How to stay safe in bitterly cold weather
Kentucky Cabinet for Health and Family Services news release
With zero to sub-zero temperatures predicted later this week around the state, many Kentuckians could be exposed to harsh winter elements. To prepare for these conditions, Department for Public Health officials are emphasizing the importance of limiting exposure to the cold and taking necessary steps to prevent hypothermia.
“When the thermometer drops, people are at increased risk for hypothermia,” said DPH Commissioner Jeff Howard, M.D. “Hypothermia occurs when an individual’s body temperature drops below what is necessary to achieve normal metabolism and other bodily functions. In severe cases or when the body is not properly warmed, death can result.”
The condition occurs most often when an individual is submerged in icy waters. However, people exposed to cold weather who aren’t sufficiently prepared also are at an increased risk for the condition.
To prevent hypothermia, DPH advises Kentuckians to:
If you notice any of these signs, take the person’s temperature. If it is below 95° F, the situation is an emergency – get medical attention immediately.
If medical care is not available, begin warming the person as follows:
“Be sure to check on your neighbors, especially if you have older adults living near you, to make sure they are okay during these frigid temperatures,” concluded Dr. Howard. “And take steps to protect your pets, livestock and farm animals from the cold too.”
To learn more, go to our website: www.chfs.ky.gov and type in “hypothermia” in the “What can we help you find?” search tool. More information on hypothermia is at https://www.cdc.gov/disasters/winter/staysafe/hypothermia.html.
With zero to sub-zero temperatures predicted later this week around the state, many Kentuckians could be exposed to harsh winter elements. To prepare for these conditions, Department for Public Health officials are emphasizing the importance of limiting exposure to the cold and taking necessary steps to prevent hypothermia.
“When the thermometer drops, people are at increased risk for hypothermia,” said DPH Commissioner Jeff Howard, M.D. “Hypothermia occurs when an individual’s body temperature drops below what is necessary to achieve normal metabolism and other bodily functions. In severe cases or when the body is not properly warmed, death can result.”
The condition occurs most often when an individual is submerged in icy waters. However, people exposed to cold weather who aren’t sufficiently prepared also are at an increased risk for the condition.
To prevent hypothermia, DPH advises Kentuckians to:
- Wear appropriate clothing. Layer clothes made of synthetic and wool fabrics, which are best for keeping warm. Always remember to wear hats, coats, scarves and gloves.
- Avoid consuming alcohol if outdoors. Alcohol can actually speed the loss of heat from the body.
- Avoid overexertion from activities that cause excessive sweat. This can lead to damp clothing, which causes chills.
- Stay as dry as possible.
If you notice any of these signs, take the person’s temperature. If it is below 95° F, the situation is an emergency – get medical attention immediately.
If medical care is not available, begin warming the person as follows:
- Get the victim into a warm room or shelter.
- If the victim is wearing any wet clothing, remove it.
- Warm the center of the body first – chest, neck, head and groin using an electric blanket if available. You can also use skin-to-skin contact under loose, dry layers of blankets, clothing, towels or sheets.
- Warm beverages can help increase body temperature, but do not give alcoholic beverages. Do not try to give beverages to an unconscious person.
- After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
- Get medical attention as soon as possible.
“Be sure to check on your neighbors, especially if you have older adults living near you, to make sure they are okay during these frigid temperatures,” concluded Dr. Howard. “And take steps to protect your pets, livestock and farm animals from the cold too.”
To learn more, go to our website: www.chfs.ky.gov and type in “hypothermia” in the “What can we help you find?” search tool. More information on hypothermia is at https://www.cdc.gov/disasters/winter/staysafe/hypothermia.html.
Medical News Today: How long can you detect marijuana in the body?
The body processes marijuana at varying rates, which may change depending on dose, hydration, body fat percentage, and, sometimes, the sensitivity of the test. Learn more here.
When a pelvic exam is traumatic
If you’re a survivor of sexual assault or trauma, medical visits may heighten anxiety, particularly if you’re concerned that a pelvic exam will be performed. As an obstetrician-gynecologist, I have had patients who experienced sexual assault confess that they have avoided or delayed seeking medical care due to their anxiety surrounding pelvic exams. Even for women without a history of sexual trauma, pelvic exams and a visit to the gynecologist may be embarrassing or painful; for women with a history of sexual trauma, it can be unbearable.
Statistics tell us that one of out of every three women has experienced sexual violence. The #MeToo movement empowered women to speak out about their experiences. Discussions engendered by the movement connected us to people rather than just to a number, subtly shifting how we as a society think about and process sexual violence. On social media, the hashtag #triggerwarning alerts viewers to potentially disturbing information. However, little discussion has focused on the intersection of trauma and health care.
What does research tell us?
Studies have found that survivors of sexual assault have higher rates of anxiety compared to the general population. They may also be affected by post-traumatic stress disorder (PTSD), which can make them feel as though they are being re-traumatized by a pelvic exam. While taking the initial step to proceed with a gynecologic visit or pelvic exam may feel insurmountable, there are ways that health care providers and patients can approach this visit to make it feel safe for survivors.
A study published in Obstetrics & Gynecology focused on survivors of sexual assault who were pregnant and analyzed what helped them throughout the pregnancy and during the time of delivery. These women wanted their health care providers to know about their history of sexual trauma. At the time of delivery, they wanted to know who would be present in the labor and delivery room. And they wanted to be able to control how much or how little of their bodies they exposed.
How can you talk to your doctor about trauma?
Communication is key to the physician-patient relationship, especially when a patient has a history of trauma. In my practice, I want my patients to feel empowered to inform me of their history, without ever feeling the need to delve into specifics or details. They can choose to establish rapport prior to undergoing a pelvic exam, even if that necessitates multiple visits. They can dictate the pace of the pelvic exam and tell me if they need a break or feel overwhelmed.
As the patient, it can feel difficult to ask this much, but as a women’s health physician, one way in which I can address a woman’s anxiety about a pelvic exam is by giving her control over the exam and over her body. I appreciate it when patients voice their concerns. I always tell my patients, particularly those with a history of sexual trauma, that they have control over their bodies and the exam, and that my office is a safe space for them.
Wondering what to say?
Maybe you’re wondering what to say. People may start the conversation in different ways. Here are some ideas that may help:
- You might start by saying, “I feel anxious when I come to the doctor.”
- You could say a few words about what worries you: being touched, needing to undress, having a pelvic exam.
- You can choose how much to explain. “I’ve experienced sexual assault. I’d rather not talk about the details, though.”
- You can even keep it vague: “Pelvic exams are difficult for me because of my history.”
- You can share any ideas you have about how to make you comfortable during a pelvic exam or any medical exam. Please also share anything that you’ve found helpful. “It might help if you explain steps before doing them. I hope you’re willing to go slowly, stop for a break, or even stop the exam if I start feeling overwhelmed.”
If you’re a survivor of sexual violence, I encourage you to openly communicate with your health care providers. If you’re a provider, listen carefully and do all you can to create a safe space that allows women to obtain the care that they need without compromise.
Resources
Boston Area Rape Crisis Center has a phone (800-841-8371) or web chat hotline and offers a range of resources to people in the greater Boston area.
The National Sexual Violence Resource Center has a list of groups that offer online support for sexual violence survivors.
RAINN offers information on recovering from sexual violence, a national hotline (800-656-4673), and access to local resources.
The Voices and Faces Project hosts writing workshops for people who have experienced gender-based violence called The Stories We Tell.
The post When a pelvic exam is traumatic appeared first on Harvard Health Blog.
Medical News Today: Removing stitches at home
To prevent infection and ensure proper wound healing, it is usually best for a healthcare professional to remove a person's stitches. However, with sufficient care and sterile equipment, it is possible for an individual to remove their stitches safely at home. Learn more here.
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Monday, January 28, 2019
Medical News Today: What are the signs of depression in men?
The signs of depression can vary between men and women. Men are generally more likely to feel anger and to engage in substance abuse and risky behavior. In this article, we discuss the behavioral, physical, and emotional signs of depression in men and explain how to get help.
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Medical News Today: What happens when breast cancer metastasizes in the lungs?
Metastatic, or stage 4, breast cancer in the lungs is when breast cancer cells are growing in the lungs. In this article, we look at what happens when breast cancer metastasizes in the lungs, including the symptoms, causes, treatments, and prognosis.
Hormonal therapy for aggressive prostate cancer: How long is enough?
Men weighing treatment options for intermediate- or high-risk cancer that is still localized to the prostate can face a tricky question. A standard approach in these cases is to give radiation to the prostate along with drugs that block testosterone, a hormone that makes the cancer cells grow faster. For how long should this hormone therapy last? That’s not entirely clear. The drugs have side effects, such as fatigue, impotence, and a loss of muscle mass. But radiation doesn’t control prostate cancer effectively without them. Doctors therefore aim to give hormone therapy only for as long as it takes to help their patients, without causing any undue harm.
Now, newly published results from a phase 3 clinical trial are providing some needed guidance.
How the study was performed
During the study, scientists randomized 1,071 men with intermediate- or high-risk localized prostate cancer into four groups. One group received radiation and six months of an anti-testosterone drug called leuporelin, and the second group received radiation plus 18 months of leuporelin therapy. Two other groups were treated with the same regimens of either radiation plus six or 18 months of leuporelin therapy, along with another drug called zoledronic acid, which helps to limit skeletal pain and related complications should cancer spread to the bones. Study enrollment occurred between 2003 and 2007 at 23 treatment centers across New Zealand and Australia.
Here’s what the results showed
After a median follow-up of just over 10 years, 9.7% of men who were treated with radiation and leuporelin for 18 months had died from prostate cancer, compared to 13.3% of the men treated with radiation and leuporelin for six months. Adding zoledronic acid made no difference in either case.
The authors concluded that hormonal therapy is more effective at preventing prostate cancer death when it’s given for 18 months rather than six. And similar benefits were noted for other endpoints as well. For instance, prostate tumors were less likely to metastasize, or spread, among men in the longer duration treatment group, and it took longer for their cancers to become resistant to hormone therapy if it was reinitiated later.
In earlier clinical research, scientists discovered that hormonal therapy given for three years protects against prostate cancer death more effectively than a six-month treatment regimen. But three years of hormone therapy isn’t easily tolerated, and evidence so far shows that 10-year survival rates after either 18 months or three years of hormonal therapy are similar, the authors of the new study claim.
“This study reaffirms what many clinicians have put into practice: longer duration hormonal therapy in appropriately selected patient populations provides a greater benefit,” said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org. “Prior studies using three years of hormonal therapy have also shown this, but it is important to recognize that some men may have significantly delayed return of the body’s testosterone upon completion of the therapy — a fact that needs to be discussed when contemplating longer-term treatment programs.”
The post Hormonal therapy for aggressive prostate cancer: How long is enough? appeared first on Harvard Health Blog.
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Controlling systolic blood pressure to below 120 mm Hg significantly lowered the risk of mild cognitive impairment in older adults.
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Ask Yourself These 2 Questions Every Morning to Have Game-Changing Days
Some people journal every morning, while others meditate or work out. Personally, I begin every day by asking myself these two questions—a practice that has made me feel way more positive, focused, and supported.
As soon as I wake up, I ask, "What do I value the most today?"
Thinking this way helps direct me toward my biggest priority for the day ahead. Maybe it's a work project, time with loved ones, or just rest, but every day, I choose what I want to put first.
I didn't always do this—so often, it's tempting to focus on what we don't desire throughout our day. We might think, I really don't want to have a headache right now, or I don't want to be running late. But when we find ourselves getting stuck on what we don't want, that can become an opportunity for us to decide what's truly important. If you catch yourself thinking of all the things you don't want to happen, ask yourself what type of values are important instead. What do you want to focus on today? Maybe connection, love, kindness, or contribution?
EDITOR'S PICK
The second question: "How do I want to feel for the day?"
The feeling I choose is usually closely linked to what I want to value. If I decide to value work, I may choose to feel productive and creative. If I want to value my time with loved ones, I'll want to feel generous and present.
This process is all about shifting our focus to what we can really do to prioritize our values and generate the feeling we do want, as opposed to what we don't want. If you decide you want to feel healthy, vibrant, awake, free, effective, on time—and you keep your focus on those feelings—you'll begin to shift your perspective.
I have honestly set an intention and turned my day around: I had a bad virus, and it really took me out of my daily routine. In the morning, I felt really sick and had to stay in bed. I could feel the guilt of not being able to keep up with my work start to creep up. But I was able to remind myself what my intention and my values were—and what I wanted to feel. I decided to value my health, and I wanted to feel rejuvenation.
What I noticed was that the more I gave myself permission to rest and recover, the more the anxiety around not getting things done went away. I learned how to take naps during the day and how to put my phone in my nightstand drawer so I wouldn't be constantly checking it. It became easier for me to do those things—guilt-free—when I knew my focus for the day was my health. I was able to take care of myself and heal.
When I can set the tone of my day, it trickles into everything I do.
I've seen this with my clients too. I was working with a woman who was really struggling to feel supported in her day-to-day. It was so easy for her to think of all the ways she wasn't getting the support she craved in her business, her relationships, and her life. I wanted to shift her values to what she desired, so I asked her to make a list of all the ways she had felt supported in the last week, the last month, and the last year.
When she was able to remember what it felt like to receive support in the past, it was easier for her to focus on getting support in the present. And if something came up where she still didn't feel supported, then her action was to state what she needed to get her needs met, even if it was something as simple as telling a barista, "I actually ordered a hot drink, not an iced one—can you please fix it?" That simple shift in deciding she wanted to feel supported led to a helpful, proactive approach for living life (even in the smallest moments).
When we shift our perspective to what we desire and what we value, we begin to see those opportunities pop up in our day-to-day lives. By applying these simple strategies to my morning routine, I've even begun to see the world a little bit differently—and it's definitely decreased my overall stress too. What would happen if you did the same?
Andee Love is a spiritual success coach who helps individuals and entrepreneurs spark business growth and overcome blocks to success. Start now with her free Success Formula.
A List of the Gross Things Making Their Way Into Your Tea
I thought I was in the minority, but, turns out, my love for tea isn't so unique: Tea just so happens to be the most popular beverage in the world besides water. Yes, it even beats coffee. I love tea for the variety of flavors, but it doesn't hurt that it has some serious health benefits too. Some studies have shown that the antioxidants found in the tea leaf can help prevent cancer, improve metabolic and cardiovascular function, and could even slow the progression of degenerative diseases like Parkinson’s and Alzheimer’s). With that info in my back pocket, I was confident that my sipping would have me soaring.
So when I first heard that tea bags can sneak in some pretty gnarly ingredients, I was shocked. No way. Not possible. I decided to do some digging and look into just how problematic my go-to afternoon pick-me-up could be. Isn't it just tossing a tea bag into hot water? If you regularly enjoy a cozy afternoon cuppa tea, you'll want to be aware of these super-sh*tty ingredients that might be lurking in your mug.
Pesticides
OK, so we obviously aren’t sharing anything new by telling you that exposure to pesticides probably isn’t great for your health. But if tea isn’t something you would normally associate with the dangers of agricultural chemicals, think again.
Multiple studies have been conducted in the past few years, and each one concluded that, yes, pesticides exist in a ton of teas: A study in 2012 found pesticides in 100 percent of the teas tested; a follow-up study in 2014 discovered pesticides in 94 percent of samples. What’s worse, many of the brands contained quantities considered unsafe for regular consumption. The FDA’s 2014 Pesticide Report found unacceptable levels of pesticides in 57 percent of the retail teas tested.
Not what you expected in your cup, right? Here's the thing: Occasional pesticide exposure isn’t likely to cause any devastating health problems. The challenge here is that long-term consequences of pesticide consumption aren't definitive, but a study like this is proof that it can't be good. If you’re someone who drinks tea on a regular basis, this is definitely something to be wary of.
Heavy Metals
One nutritional tidbit you might not have known is that drinking tea can contribute to your daily dose of calcium, potassium, magnesium, and zinc. But these aren’t the only minerals in your brew.
A study published in the Journal of Toxicology tested for toxic elements in a variety of common tea brands, and the findings are pretty unsettling. Seventy-three percent of brewed teas contained lead when steeped for the standard time of 3-4 minutes, and the quantity was even higher when steeped for longer. Umm, lead in my tea? Thank you, next. They also found potentially unsafe levels of aluminum, cadmium, and, oh yeah, arsenic. Feeling queasy yet?
I bet you’re wondering, how the heck does lead get into a tea bag? Companies would never add these toxins to products on purpose (or at least, we’d like to think they wouldn’t); it really all depends on where the tea was grown. Heavy metals inevitably accumulate in the soil on tea plantations due to the close proximity to coal-fired power plants, industrial waste runoff, and pesticide use.
One upside is that young tea leaves contained lower levels of heavy metals compared to mature tea leaves because their roots had less time to absorb the toxic elements in the soil. The only problem is young leaves are typically more expensive, and most large tea companies rely on mature leaves for their product.
Plastic
If you think the leaves themselves are the only problem in your teacup, you’d be wrong. You know those fancy-looking tea bags shaped like little silk pyramids? You probably thought those were made out of some type of cloth… nope. They’re typically made of plastic: polyethylene terephthalate (PET) or polypropylene, to be exact. Again, not the first thing you’d instinctively steep in a cup of boiling water before drinking it.
While there aren't a ton of studies spelling this out for us, I'm going to make an educated guess here and bet that plastic tea bags are iffy because there's a good chance they’re leaching BPA and other endocrine-disrupting chemicals into your beverage, and why many reusable water bottles and plastic food storage containers are now BPA-free. Bisphenol A (BPA) has been linked to cardiovascular disease, diabetes, and serious problems with reproductive development. Then there’s the whole laundry list of estrogen-mimicking chemicals that can mess up your entire reproductive system and even increase your risk of getting cancer.
If you apply this information to tea, it’s likely that those chemicals are leaching out of your plastic tea bag and into your cup, just like they’d leach out into a single-use plastic water bottle. The history of tea drinking is estimated to be nearly 3,000 years old, but it wasn’t until after World War II that people began using tea bags in the infusion process. And it’s too bad they started because tea tastes way better when you use loose-leaf, plus you can get an adorable little infuser like this guy.
Artificial Flavoring
One of the sneakiest things tea companies can do is trick you into thinking you’re drinking something you’re not. Generally speaking, if you’re drinking something with a name like Raspberry Pizzaz or Tropical Sunset, odds are there are not actual raspberries or mangos in that tea bag.
This is because food scientists and flavor engineers are masters at manipulating synthetic chemicals to create flavors that mimic those of real foods. Oh, and don’t get me started on all the FDA loopholes companies can use to label something natural instead of artificial. It’s essentially code for all kinds of chemicals that don’t have to be explicitly listed—so read your labels and always buy organic when possible.
Tell me something positive, please.
We have some good news too. A lot of progress has been made regarding many of the issues we just discussed. In 2017, China promised to implement stricter regulations on pesticide usage, and many major tea companies have switched to plastic-free tea bags and more biodegradable options.
And you can now get your tea locally grown. Yes, that's correct: U.S.-grown tea is becoming a thing. What was once a crop almost exclusively grown in China and India is now being cultivated in our own backyards. Tea can only thrive in very specific climatic conditions, but there are some regions in the United States that allow relatively large farms to flourish, especially in tropical Hawaii, California, and some parts of the Southeast.
Where do we go from here?
OK, so we know that was a lot to take in. We can see you pushing that mug away—but you don't have to. We’re not trying to freak you out, just laying out all the facts so you can make more informed choices and look into your favorite brands to make sure they're making all the right calls. Because let's be serious, tea can be super good for you. It’s just a matter of figuring out what to watch out for and knowing where to buy the high-quality stuff.
The best way to avoid potentially harmful ingredients is by buying organic, ideally loose-leaf tea. Organic tea leaves aren’t sprayed with pesticides the way their non-organic counterparts are, making them a much healthier choice. Loose-leaf tea is frequently higher quality (which usually means younger leaves and less heavy metals), and you can buy compostable tea filters or stainless steel tea infusers that are just as convenient as the pre-bagged alternative.
Don’t worry, though, we’re not going to leave the task of finding healthy high-quality tea entirely up to you. We’ve done some digging to determine a few of the best tea brands that you can feel confident drinking. Numi Tea, Traditional Medicinals (specifically herbal but still a great choice), Mighty Leaf Tea, Mountain Rose Herbs, Vahdam Teas, and the Little Red Cup Tea Co. are all great options. And let's not forget about local tea shops, where you can talk to people who really know their stuff to get all the details.
Medical News Today: What to know about marijuana withdrawal
After frequently using marijuana, or cannabis, people may experience withdrawal symptoms when they stop. Such symptoms include cravings, irritability, and sleep problems. In this article, we discuss the symptoms and timeline of marijuana withdrawal, treatments, and tips for coping.
Your genes and addiction
Over the last decade, the prevalence of opioid addiction has increased to epidemic levels, but unfortunately therapeutic interventions for the treatment of addiction remain limited. We need to better understand the triggers for the development of addiction in order to develop more targeted prevention and treatments. One of the key questions that researchers in the field of neuropsychiatry are trying to answer is why some people are more vulnerable to addiction. As in most cases of psychiatric disorders, genetic and environmental factors interact to determine how vulnerable, or likely, you are to developing a substance use disorder.
Drugs of abuse, including opioids, act on the brain’s reward system, a system that transfers signals primarily via a molecule (neurotransmitter) called dopamine. The function of this system is affected by genetic and environmental factors. For example, a recent study published in the scientific journal PNAS revealed one of those genetic factors. Researchers demonstrated that a type of small infectious agent (a type of RNA virus called human endogenous retrovirus-K HML-2, or HK2) integrates within a gene that regulates activity of dopamine. This integration is more frequently found in people with substance use disorders, and is associated with drug addiction.
How does stress induce epigenetic changes?
Accumulating evidence suggests that environmental factors, such as stress, induce epigenetic changes that can trigger the development of psychiatric disorders and drug addiction. Epigenetic changes refer to regulations of gene expression that do not involve alterations in the sequence of the genetic material (DNA) itself. Practically, epigenetic changes are information that is added on to already existing genetic material, but can affect the expression of genes.
A stressful situation, such as the death of a significant other or the loss of a job, triggers the release of steroid hormones called glucocorticoids. Those stress hormones trigger alterations in many systems throughout the body, induce epigenetic changes, and regulate the expression of other genes in the brain. One of the systems that is affected by stress hormones is the brain’s reward circuitry. The interaction between stress hormones and the reward system can trigger the development of addiction, as well as a stress-induced relapse in drug or alcohol recovery.
Stress reduction can help reduce the risk of developing an addiction and prevent relapse
Fortunately, the negative effects of stress can be alleviated by other factors, such as physical activity or social support. These behaviors produce epigenetic changes that prevent the development of addiction and can have a beneficial role in treatment when used in combination with other interventions, such as cognitive behavioral therapy and, for some people, medications. One of the ways that physical activity could be effective is by reducing negative feelings, including stress and the accompanied stress-induced epigenetic changes. In the example of a stressful situation such as the death of a significant other or loss of a job, if a person engages in physical activity this can reduce their stress-induced epigenetic changes, which will decrease the risk of developing addiction or stress-induced relapse.
Hope for targeted addiction treatments
We now know that the function and dysfunction of the brain’s reward system is complicated, plastic (undergoes changes based on negative and positive factors), and involves complex interactions of genetic and environmental factors. Alterations in gene expression can lead to changes in the function of the brain’s reward system, so a person is more or less likely to self-administer drugs. Together this knowledge can ultimately lead to the development of multilevel and more efficient prevention and therapeutic approaches to address the ongoing opioid epidemic.
Resources
Human Endogenous Retrovirus-K HML-2 integration within RASGRF2 is associated with intravenous drug abuse and modulates transcription in a cell-line model. Proceedings of the National Academy of Sciences, September 24, 2018.
The post Your genes and addiction appeared first on Harvard Health Blog.
Medical News Today: Defeat cravings for unhealthful food in 2 minutes
According to a fascinating new study, exposing yourself to the smell of unhealthful food might, in fact, reduce your desire to consume it.
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Sunday, January 27, 2019
Ambulances report fewer overdose calls, say trend is partly due to availability of Narcan and increased use of meth
The Anderson News found that OD ambulance calls in the Central Kentucky county declined 20 percent from 2017 to 2018, from 95 to 77 -- but the county's emergency director, Bart Powell, "said he and others in emergency management attribute the decline in ambulance calls to the widespread availability of Narcan, the drug used to revive overdose victims," Editor-Publisher Ben Carlson reports. Also, "Addicts are turning to other sources to get high."
Powell said other ambulance services in Kentucky have seen similar declines in OD calls and attribute them to the availability of Narcan, the commonly used brand of the drug naloxone, which counteracts the effects of opiates and opioids.
"Narcan, which previously was administered only by medical care providers, has in recent years been made available to police officers and the general public," Carlson notes. "As a result, those who overdose on opioids can be revived by family members, friends or responding police officers if they arrive ahead of an ambulance."
Powell said, “The introduction and availability of Narcan to the general public has resulted in a slight reduction on our runs because they are self-treated at the scene,” Powell said. “That’s backed up by other EMS providers in the state.”
Barrick, "who for years has helped raise awareness of opioid addiction and education, said there are some encouraging signs. “Families are much more educated regarding treatment options,” he said. “The stigma regarding addiction has changed, and schools and churches are also more willing to help with support and education.”
Medical News Today: Diabetes: How optimism may influence your risk
New research suggests that optimism may lower the risk of type 2 diabetes among postmenopausal women. Conversely, negative emotions may heighten risk.
Medical News Today: Chinese fir tree compound may help to combat cancer
New research finds that a chemical analog of a compound found in the endangered Chinese fir tree 'Abies beshanzuensis' can help fight off cancer.
Saturday, January 26, 2019
Struggling with addiction, or know someone who is? Here is expert advice for finding quality treatment
By Anne M. Herron
Acting director, Center for Substance Abuse Treatment
U.S. Substance Abuse and Mental Health Services Administration
It can be overwhelming and confusing to know where to start if you need to find treatment for an alcohol or drug addiction. Addiction touches nearly everyone in some way, yet, like all health care, effective treatment must be tailored to the needs of the individual. With many addiction treatment options, finding a program that will provide the quality care you or your loved one needs to address the specific addiction issues can be challenging. These steps will help you know what to look for to find a treatment program that is high quality and tailored to your needs.
How do you find treatment? If you have insurance, a good first step is to contact your insurer. Ask about your coverage and whether they have a network of preferred providers. If you don’t have insurance, you still have access to quality care. Each state has funding to provide treatment for people without insurance coverage.
What should you look for in a program or provider? Quality treatment programs offer a full range of services which have been shown to be effective in treatment and recovery from addiction. Keep these points in mind when weighing your options.
Accreditation: Make sure the treatment program is licensed or certified by the state. This ensures the provider meets basic quality and safety requirements. You should also check that the program is accredited, which means it meets standards of care set by a national, compliance organization. Be sure to ask the program to show you how people using their services have rated them.
Evidence-based treatment: Check to determine if the program offers effective and proven substance use disorder treatments, such as medication management, cognitive behavioral therapy, drug and alcohol counseling, education about the risks of drug and alcohol use, and peer support. Quality treatment providers or programs offer more than one form of effective treatment. Effective programs will also be mindful of or address mental health and physical disorders that will affect substance use treatment.
Continuing care: For many people addiction requires ongoing medication and supports. Quality programs provide treatment for the long term, which may include ongoing counseling or recovery coaching and support, and helps in meeting other basic needs like sober housing, employment supports, and continued family involvement.
Once you’ve identified a treatment program that meets the criteria above, call for an appointment. Many programs provide walk-in services. If they can’t see you or a family member within 48 hours, find another provider. (It is important that the provider or program connect you to care quickly.) You can find more information about finding addiction treatment at https://findtreatment.samhsa.gov/ or calling the National Helpline at 1-800-662-HELP (4357).
Acting director, Center for Substance Abuse Treatment
U.S. Substance Abuse and Mental Health Services Administration
It can be overwhelming and confusing to know where to start if you need to find treatment for an alcohol or drug addiction. Addiction touches nearly everyone in some way, yet, like all health care, effective treatment must be tailored to the needs of the individual. With many addiction treatment options, finding a program that will provide the quality care you or your loved one needs to address the specific addiction issues can be challenging. These steps will help you know what to look for to find a treatment program that is high quality and tailored to your needs.
How do you find treatment? If you have insurance, a good first step is to contact your insurer. Ask about your coverage and whether they have a network of preferred providers. If you don’t have insurance, you still have access to quality care. Each state has funding to provide treatment for people without insurance coverage.
What should you look for in a program or provider? Quality treatment programs offer a full range of services which have been shown to be effective in treatment and recovery from addiction. Keep these points in mind when weighing your options.
Accreditation: Make sure the treatment program is licensed or certified by the state. This ensures the provider meets basic quality and safety requirements. You should also check that the program is accredited, which means it meets standards of care set by a national, compliance organization. Be sure to ask the program to show you how people using their services have rated them.
Evidence-based treatment: Check to determine if the program offers effective and proven substance use disorder treatments, such as medication management, cognitive behavioral therapy, drug and alcohol counseling, education about the risks of drug and alcohol use, and peer support. Quality treatment providers or programs offer more than one form of effective treatment. Effective programs will also be mindful of or address mental health and physical disorders that will affect substance use treatment.
Medication: Confirm whether the program offers FDA approved medication for recovery from alcohol and opioid use disorders. However, keep in mind that currently, there are no FDA approved medications to help prevent relapse from other problem substances.
Families: Family members have an important role in understanding the impact of addiction on families and providing support. Make sure the treatment program includes family members in the treatment process.
Continuing care: For many people addiction requires ongoing medication and supports. Quality programs provide treatment for the long term, which may include ongoing counseling or recovery coaching and support, and helps in meeting other basic needs like sober housing, employment supports, and continued family involvement.
Once you’ve identified a treatment program that meets the criteria above, call for an appointment. Many programs provide walk-in services. If they can’t see you or a family member within 48 hours, find another provider. (It is important that the provider or program connect you to care quickly.) You can find more information about finding addiction treatment at https://findtreatment.samhsa.gov/ or calling the National Helpline at 1-800-662-HELP (4357).
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Managed-care firms and legislators do another Groundhog Day, but changes might be coming; Passport voices concerns
By Melissa Patrick
Kentucky Health News
FRANKFORT, Ky. -- Medicaid managed care organizations and others in the health-insurance industry spent the first half of a three-hour meeting bragging about their work, and the second half being told by lawmakers that their version of events isn't reality.
"All these numbers and all these rosy pictures that you've been painting -- that's not the reality of where we are with the MCOs, and the most vulnerable people are the ones paying the price for this," Sen. Danny Carroll, R-Paducah, said at the Feb. 23 meeting of the legislature's interim joint health committee. "You can tout how great you are all you want, it's not reality and we have got to do better and you have got to do better in your organizations."
Kentucky has five MCOs that manage care for most of the 1.4 million Kentuckians on Medicaid, which has a $11.5 billion annual budget. They are: Aetna, Anthem Blue Cross Blue Shield Medicaid, Humana Caresource and WellCare, all part of the for-profit health-insurance industry; and the Louisville-based nonprofit Passport Health Plan, which voiced concern at the meeting about the state's recent cuts in its reimbursements.
Passport CEO Mark Carter said "the elephant in the room" was that his company could be facing bankruptcy by the middle of the year if Kentucky does not reverse the cuts. The state cut Passport's reimbursements by 4.1 percent, while increasing others' an average of 2.2 percent. The company has filed an appeal, but told the lawmakers they would prefer to work with the Cabinet for Health and Family Services to find a solution.
"It makes no sense for us to be in conflict with our primary customer," Carter said. Passport provides Medicaid to more than 300,000 low-income people in Jefferson and surrounding counties. It has 65 percent of the market share in its region.
Sen. Ralph Alvarado, R-Winchester, co-chair of the committee, said Health Secretary Adam Meier would join Passport at the next meeting to discuss this issue. (Friday afternoon, Gov. Matt Bevin announced that Alvarado would be his running mate for lieutenant governor.)
Since 2011, Kentucky has used managed care, which pays participating organizations a set rate per member as an incentive to limit claims from members. Before then, outside the Louisville area, providers who cared for Medicaid patients were paid on a fee-for-service basis, meaning they billed for each service they provided. Since managed care replaced that, providers have complained about delayed and denied payments from the MCOs.
During the first half of the meeting, Stephanie Stumbo, acting executive director of The Kentucky Associations of Health Plans, a health-insurance lobby, told lawmakers that managed-care organizations have saved taxpayers upwards of $1.2 billion, including about $350 to $400 million in state dollars.
She said MCOs also better manage Medicaid members' use of health services, and improve health-care quality and the coordination and integration of care.
Lawrence Ford, chairman of the association and senior director for government relations for Anthem, said 90 percent of the money insurers get for patient care is spend on medical claims and quality improvement. He said 9 percent goes toward non-medical expenses, like technology, wages and administrative costs, and when appropriate, only 1 percent goes toward their profit margin.
"Kentucky is getting a better return today on its investment and its Medicaid program with its MCO partners than it was previously," he said.
The second half of the meeting wasn't so upbeat, with one lawmaker after the other either ranting about their issues with the managed care organizations or asking pointed questions that few stepped up to answer.
Sen. Stephen Meredith, R-Leitchfield, a former hospital administrator who has been vocal about his dislike for the managed-care model, was the first to rant, as Alvarado called it.
Meredith lectured the MCOs on the administrative burdens they place on providers; the lack of "fair and equitable" pay to their providers, particularly to rural hospitals; the length of time it takes for providers to become credentialed to participate in their programs; and the challenges of getting providers to work in rural communities, which he largely blamed on poor pay.
"You're not doing things to reduce the regulatory burden for health-care providers at all, " he said.
Ford said he agreed with many of the points Meredith raised, but reminded Meredith that they have "constraints" and are required to work within the rules set forth by the state and federal governments. He began to say that they would need more money in the budget to pay providers more, but Meredith interrupted him saying, " I don't think we have to put more money in Medicaid. I think the Medicaid budget is as big as it ever needs to be if we are spending our monies appropriately, but we're not doing that."
The discussion continued in the same vein for about an hour and a half.
Sen. Morgan McGarvey, D-Louisville, who is new to the committee but has spent four years on the Medicaid Oversight and Advisory Committee, said, "It feels like Groundhog Day," the movie in which the same day was redone over and over, He said every year, MCOs make the same "infomercial" presentations and lawmakers say that's not the reality, but nothing gets done about it.
McGarvey said what he hears from his providers and constituents is that "they are not getting payments and they are not getting their services."
He said it's past time to find out what the real story is, meaning that they all need to have honest conversations with each other. But when he asked, "Is there something different we can do that will help this problem out?" no one stepped up to answer.
Sen. Max Wise, R-Campbellsville, brought up the low rates that pharmacy-benefit managers, which contract with MCOs, are paying independent pharmacists. A report is expected to be released soon to detail these practices.
Carroll, who deals daily with MCOs through his non-profit agency that provides therapy and medical-based child care, came with a list of questions. He said that he, as a provider, has had to deal with the same issues of delayed and denied payments "over and over" again and that this is standard.
"You know, all the MCOs paint a rosy picture, and the reality of how the system is actually working is that that is a false picture," he said.
Carroll asked the highest-ranking person from each MCO to stand up to answer the question, "Is there a systematic approach to delaying or denying claims on a regular basis to manage your cash flow, to manage your revenue?" All said no.
Committee Co-Chair Rep. Kim Moser, R-Taylor Mill, said that if these issues can't be worked out behind the scenes then, "My solution will be to file legislation to hold the providers accountable."
So far, two bills that deal with MCOs have been filed, both by Meredith.
Senate Bill 42 would cut the number of MCO contracts in the state to three. It would also require that rural health-care providers be reimbursed at least at the median amount paid to urban providers in the nearest metropolitan area, with penalties for noncompliance.
Senate Bill 39 would require all MCOs to provide quarterly all payment schedules for reimbursements to the Medicaid Oversight and Advisory Committee.
Alvarado, a family physician who has been vocal about his frustrations with MCOs was unusually quiet during the meeting. He said that in the interest of time, he would submit his concerns in writing.
But he did say there had been improved transparency and responsiveness from MCOs over the years and they and the state have made real changes. He asked the MCOs to be good partners to make the changes that still need to be made so that legislation doesn't have to be filed.
"Things have gotten better," he said. "But we're still a long way from where we need to be."
Kentucky Health News
FRANKFORT, Ky. -- Medicaid managed care organizations and others in the health-insurance industry spent the first half of a three-hour meeting bragging about their work, and the second half being told by lawmakers that their version of events isn't reality.
"All these numbers and all these rosy pictures that you've been painting -- that's not the reality of where we are with the MCOs, and the most vulnerable people are the ones paying the price for this," Sen. Danny Carroll, R-Paducah, said at the Feb. 23 meeting of the legislature's interim joint health committee. "You can tout how great you are all you want, it's not reality and we have got to do better and you have got to do better in your organizations."
Kentucky has five MCOs that manage care for most of the 1.4 million Kentuckians on Medicaid, which has a $11.5 billion annual budget. They are: Aetna, Anthem Blue Cross Blue Shield Medicaid, Humana Caresource and WellCare, all part of the for-profit health-insurance industry; and the Louisville-based nonprofit Passport Health Plan, which voiced concern at the meeting about the state's recent cuts in its reimbursements.
Passport CEO Mark Carter said "the elephant in the room" was that his company could be facing bankruptcy by the middle of the year if Kentucky does not reverse the cuts. The state cut Passport's reimbursements by 4.1 percent, while increasing others' an average of 2.2 percent. The company has filed an appeal, but told the lawmakers they would prefer to work with the Cabinet for Health and Family Services to find a solution.
"It makes no sense for us to be in conflict with our primary customer," Carter said. Passport provides Medicaid to more than 300,000 low-income people in Jefferson and surrounding counties. It has 65 percent of the market share in its region.
Sen. Ralph Alvarado, R-Winchester, co-chair of the committee, said Health Secretary Adam Meier would join Passport at the next meeting to discuss this issue. (Friday afternoon, Gov. Matt Bevin announced that Alvarado would be his running mate for lieutenant governor.)
Since 2011, Kentucky has used managed care, which pays participating organizations a set rate per member as an incentive to limit claims from members. Before then, outside the Louisville area, providers who cared for Medicaid patients were paid on a fee-for-service basis, meaning they billed for each service they provided. Since managed care replaced that, providers have complained about delayed and denied payments from the MCOs.
During the first half of the meeting, Stephanie Stumbo, acting executive director of The Kentucky Associations of Health Plans, a health-insurance lobby, told lawmakers that managed-care organizations have saved taxpayers upwards of $1.2 billion, including about $350 to $400 million in state dollars.
She said MCOs also better manage Medicaid members' use of health services, and improve health-care quality and the coordination and integration of care.
 |
| Lawrence Ford and Sen. Stephen Meredith, R-Leitchfield |
"Kentucky is getting a better return today on its investment and its Medicaid program with its MCO partners than it was previously," he said.
The second half of the meeting wasn't so upbeat, with one lawmaker after the other either ranting about their issues with the managed care organizations or asking pointed questions that few stepped up to answer.
Sen. Stephen Meredith, R-Leitchfield, a former hospital administrator who has been vocal about his dislike for the managed-care model, was the first to rant, as Alvarado called it.
Meredith lectured the MCOs on the administrative burdens they place on providers; the lack of "fair and equitable" pay to their providers, particularly to rural hospitals; the length of time it takes for providers to become credentialed to participate in their programs; and the challenges of getting providers to work in rural communities, which he largely blamed on poor pay.
"You're not doing things to reduce the regulatory burden for health-care providers at all, " he said.
Ford said he agreed with many of the points Meredith raised, but reminded Meredith that they have "constraints" and are required to work within the rules set forth by the state and federal governments. He began to say that they would need more money in the budget to pay providers more, but Meredith interrupted him saying, " I don't think we have to put more money in Medicaid. I think the Medicaid budget is as big as it ever needs to be if we are spending our monies appropriately, but we're not doing that."
The discussion continued in the same vein for about an hour and a half.
Sen. Morgan McGarvey, D-Louisville, who is new to the committee but has spent four years on the Medicaid Oversight and Advisory Committee, said, "It feels like Groundhog Day," the movie in which the same day was redone over and over, He said every year, MCOs make the same "infomercial" presentations and lawmakers say that's not the reality, but nothing gets done about it.
McGarvey said what he hears from his providers and constituents is that "they are not getting payments and they are not getting their services."
He said it's past time to find out what the real story is, meaning that they all need to have honest conversations with each other. But when he asked, "Is there something different we can do that will help this problem out?" no one stepped up to answer.
Sen. Max Wise, R-Campbellsville, brought up the low rates that pharmacy-benefit managers, which contract with MCOs, are paying independent pharmacists. A report is expected to be released soon to detail these practices.
Carroll, who deals daily with MCOs through his non-profit agency that provides therapy and medical-based child care, came with a list of questions. He said that he, as a provider, has had to deal with the same issues of delayed and denied payments "over and over" again and that this is standard.
"You know, all the MCOs paint a rosy picture, and the reality of how the system is actually working is that that is a false picture," he said.
Carroll asked the highest-ranking person from each MCO to stand up to answer the question, "Is there a systematic approach to delaying or denying claims on a regular basis to manage your cash flow, to manage your revenue?" All said no.
Committee Co-Chair Rep. Kim Moser, R-Taylor Mill, said that if these issues can't be worked out behind the scenes then, "My solution will be to file legislation to hold the providers accountable."
So far, two bills that deal with MCOs have been filed, both by Meredith.
Senate Bill 42 would cut the number of MCO contracts in the state to three. It would also require that rural health-care providers be reimbursed at least at the median amount paid to urban providers in the nearest metropolitan area, with penalties for noncompliance.
Senate Bill 39 would require all MCOs to provide quarterly all payment schedules for reimbursements to the Medicaid Oversight and Advisory Committee.
Alvarado, a family physician who has been vocal about his frustrations with MCOs was unusually quiet during the meeting. He said that in the interest of time, he would submit his concerns in writing.
But he did say there had been improved transparency and responsiveness from MCOs over the years and they and the state have made real changes. He asked the MCOs to be good partners to make the changes that still need to be made so that legislation doesn't have to be filed.
"Things have gotten better," he said. "But we're still a long way from where we need to be."
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Fewer Kentuckians worry about losing health insurance, and more of them are covered by employer-sponsored plans, poll finds
By Melissa Patrick
Kentucky Health News
About 90 percent of Kentucky adults have health insurance and fewer of them are worrying that they might lose it, according to the latest Kentucky Health Issues Poll. It also found that the number of Kentuckians getting insurance through their employer went up, while the number of them getting it through public insurance went down, perhaps a reflection of better economic conditions.
“Health insurance coverage opens a door to the health-care system,” Dr. O’dell Moreno Owens, president and CEO of Interact for Health, which co-sponsors the poll with the Foundation for a Healthy Kentucky, said in a news release.
“A lack of adequate insurance makes it difficult for people to get the health care they need and, when they do get care, burdens them with large medical bills,” Owens said. “People with coverage are better equipped to promote and maintain health, prevent and manage disease, and reduce unnecessary disability and premature death.”
The survey, taken by telephone Aug. 26 through Oct. 21, found that 16 percent of Kentucky adults with health insurance, or one in six, worry that they could lose their health coverage. That was down from one in four in last year's poll.
Kentucky adults with lower incomes were more likely to be concerned that they would lose coverage. The poll found that 32 percent of those earning less than 138 percent of the federal poverty level (those eligible for Medicaid) expressed concern, compared to 17 percent of those making between 138 percent and 200 percent of the poverty level and only 9 percent of those above 200 percent.
Some of the worries of those with lower incomes, especially if they gained their health insurance through the expansion of Medicaid to the 138 percent level, could be due to the changes to the program that are set to kick in on April 1. They will require many of them to work or do community engagement 80 hours a month, with strict reporting requirements if they want to keep their coverage. More than 18,000 people have lost coverage in Arkansas since September 2018 due to failing to meet such requirements, according to the Kaiser Family Foundation.
The poll found that the share of Kentuckians with public insurance (such as Medicaid, Medicare or veteran's benefits) in 2018 dropped to 27 percent, down from 35 percent in the prior year's poll. This number has bounced up and down generally between these two numbers since 2015. The poll's margin of error is plus or minus 2.5 percentage points.
The share of Kentuckians with employer-provided insurance jumped to 48 percent from 39 percent last year. This rate has also bounced around since 2014, when the rate was 50 percent. Another 14 percent of Kentuckians said they either purchased their own plan, were covered by a parent's plan or another source, or weren't sure how they were covered.
In 2014, when then-Gov. Steve Beshear expanded Medicaid, the share of Kentuckians without health insurance dropped from 25 percent to 12 percent. This rate was 11 percent in the latest poll, down from 15 percent last year
The poll surveyed a random sample of 1,569 adults via landlines and cell-phones. The poll was given only to adults ages 18-64, because nearly all adults 65 and older are insured.
Kentucky Health News
About 90 percent of Kentucky adults have health insurance and fewer of them are worrying that they might lose it, according to the latest Kentucky Health Issues Poll. It also found that the number of Kentuckians getting insurance through their employer went up, while the number of them getting it through public insurance went down, perhaps a reflection of better economic conditions.
“A lack of adequate insurance makes it difficult for people to get the health care they need and, when they do get care, burdens them with large medical bills,” Owens said. “People with coverage are better equipped to promote and maintain health, prevent and manage disease, and reduce unnecessary disability and premature death.”
The survey, taken by telephone Aug. 26 through Oct. 21, found that 16 percent of Kentucky adults with health insurance, or one in six, worry that they could lose their health coverage. That was down from one in four in last year's poll.
Kentucky adults with lower incomes were more likely to be concerned that they would lose coverage. The poll found that 32 percent of those earning less than 138 percent of the federal poverty level (those eligible for Medicaid) expressed concern, compared to 17 percent of those making between 138 percent and 200 percent of the poverty level and only 9 percent of those above 200 percent.
Some of the worries of those with lower incomes, especially if they gained their health insurance through the expansion of Medicaid to the 138 percent level, could be due to the changes to the program that are set to kick in on April 1. They will require many of them to work or do community engagement 80 hours a month, with strict reporting requirements if they want to keep their coverage. More than 18,000 people have lost coverage in Arkansas since September 2018 due to failing to meet such requirements, according to the Kaiser Family Foundation.
The poll found that the share of Kentuckians with public insurance (such as Medicaid, Medicare or veteran's benefits) in 2018 dropped to 27 percent, down from 35 percent in the prior year's poll. This number has bounced up and down generally between these two numbers since 2015. The poll's margin of error is plus or minus 2.5 percentage points.
The share of Kentuckians with employer-provided insurance jumped to 48 percent from 39 percent last year. This rate has also bounced around since 2014, when the rate was 50 percent. Another 14 percent of Kentuckians said they either purchased their own plan, were covered by a parent's plan or another source, or weren't sure how they were covered.
About two in 10, or 19 percent, of the poll respondents said they had unstable insurance; that number has been about the same since 2015. Eight percent said they were insured, but went uninsured at some point in the past year.
The poll surveyed a random sample of 1,569 adults via landlines and cell-phones. The poll was given only to adults ages 18-64, because nearly all adults 65 and older are insured.
