Friday, January 31, 2020
U.S. declares public health emergency from coronavirus; misinformation about it is spreading faster than the disease itself
Trying to prevent spread of coronavirus, federal officials said Friday that the government would keep foreign nationals who recently visited China from entering the United States, and would quarantine some Americans returning from that country.
"Declaring a public health emergency over the coronavirus outbreak, Health and Human Services Secretary Alex Azar said the president has imposed a temporary ban on entry for foreign nationals who have been to China in the last 14 days," The Washington Post reports. "American citizens returning from mainland China would be subject to health screening and up to 14 days of quarantine.
Misinformation about the coronavirus is spreading more quickly than the disease itself, "testing Big Tech platforms' ability to police rule-breaking content and China's ability to control domestic criticism," Sara Fischer and Ina Fried report for Axios.
Platforms such as Facebook, Twitter and Google are trying to stop the spread of misinformation, including fake government warnings and false reports about how many Americans are infected. Some misinformation comes from private Facebook groups, The Washington Post reports.
China is also battling misinformation circulating on its social-media platform Weibo, but to complicate matters, the government is spreading misinformation of its own in an effort to allay people's worries. "Chinese state media has tweeted photos purporting to show a new hospital, but which were actually stock images from a company that sells modular containers," Axios reports.
Beshear wants cigarette-tax hike, new tax on electronic cigarettes
By Melissa Patrick
Kentucky Health News
To pay for such things as a teacher-pay increase and 350 news social workers to fight child abuse and neglect, Gov. Andy Beshear wants to raise the tax on all tobacco products and add a new tax to electronic cigarettes, the only tobacco product in Kentucky that does not have an excise tax.
The Democratic governor's taxes would have to be approved by the Republican-controlled General Assembly. Republicans often balk at new taxes, but comments from several in the GOP leadership suggest that some version of the e-cigarette tax will pass, and that is much less likely for the other tobacco-related ones.
Beshear's proposal calls for a 10-cent tax increase on cigarettes, to $1.20 per pack from $1.10, and a tax on e-cigarettes at 10 cents per fluid milliliter. His office said eight of the 19 states that tax so-called "vaping" products do so with a per-milliliter tax instead of a percentage of of the sales price.
It would also raise the tax on snuff and chewing tobacco from .19 cents per unit to .38 cents per unit and would raise the tax on other tobacco products, like cigars, from 15 percent on the average wholesale price to 30%, which would make the tax rates on other tobacco products the same as the proposed $1.20 cigarette rate
These additional taxes would raise $50.3 million in the upcoming fiscal year, which begins on July 1, and $43.9 million the following fiscal year -- for a total of $94.2 million in the next biennium, according to Beshear's 2020-2022 Executive Budget Revenue Proposal.
If the proposed hike on cigarettes were to pass, it would place Kentucky at the same rate as West Virginia, but would be noticeably higher than Indiana, Missouri, Tennessee and Virginia. It would also bring Kentucky closer to the two bordering states with the highest rates, Ohio at $1.60 per pack and Illinois at $2.98 per pack. The national average is $1.81 per pack.
In 2018, lawmakers increased the cigarette tax by 50 cents, to $1.10 per pack.
Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, praised the governor's proposals to raise tobacco product taxes, while also noting the health savings that would result from them.
"In addition to raising revenue on one side of the budget, they reduce health care and business costs and increase employee productivity on the other," Chandler said in a news release. "We know they're effective: the recent cigarette tax hike raised $140 million in new revenue its first year; at the same time, Kentuckians bought 36 million fewer packs of cigarettes."
Rep. Steve Rudy, chair of the House budget committee, said the most likely taxes to pass are those on electronic cigarettes, because “We’re trying to curtail this. . . . I’ve had a lot of school superintendents and teachers tell me it’s becoming an epidemic in the schools.”
Between 2017 and 2019, e-cigarette use more than quadrupled among the state's middle-school students and nearly doubled among its high-school students, with one in four high schoolers and one in five middle schoolers reporting monthly use; and one in 10 high school students reporting daily use.
Sen. Chris McDaniel, chair of the Senate Appropriations and Revenue Committee, more cautiously said he needed to examine all of the components of Beshear's proposal before deciding how to proceed, but said he was open to looking at it.
"Any tax needs to be evaluated in the confines of its total impact," he said. "Since the last [cigarette] tax, we've seen a decline in smoking in the commonwealth. We know we've had a bit of an impact there. And we're going to take a look at it as part of the whole."
Senate Majority Floor Leader Damon Thayer said, "I think a tax on vaping is something that needs to be considered. I don't think it should be as high as the tax on cigarettes, but I think it probably should be higher than the current 6% sales tax. So I think there is probably some momentum towards getting something done on that."
Thayer explained that he didn't think they should be taxed the same amount because they are "not the same product" and added that while it's important to work toward decreasing the youth vaping epidemic, it's also important to recognize "there is evidence that vaping helps addicted adult smokers wean themselves off traditional cigarettes."
A 700 page U.S. Department of Health and Human Services report released Jan. 23 titled, "Smoking Cessation, A Report of the Surgeon General" says more research is needed before we can conclusively make the claim that e-cigs help people stop smoking.
"In summary, the evidence is inadequate to infer that e-cigarettes, in general, increase smoking cessation; factors contributing to the uncertainty include the changing characteristics of e-cigarettes, the many different contexts in which they are used, and the limited number of studies conducted to date," says the report.
As for the 10 cent hike in the cigarette tax, Thayer said, "It's too soon to talk about that."
A bill to tax e-cigarettes in Kentucky has already been posted in the House Appropriations & Revenue committee, which is chaired by Rudy.
House Bill 32, sponsored by Rep. Jerry Miller, R-Louisville, would impose a 27.5% excise tax on e-cigarettes and other tobacco products that are currently taxed at 15%, making them the same percentage increase that was applied to the cigarette tax.
The bill's fiscal note shows that increases in the excise tax and the sales tax, which will result from the increased prduct price, and the initial floor stocks tax would result in $44.7 million in the first fiscal year and $49.4 million in the second, for a total of $94.1 million.
"I believe the tax bill will move out of the House, I feel pretty confident about that," Miller said. "We are working on modifying it to make sure it passes the Senate."
He said it was helpful that the governor had included an e-cig tax in his revenue proposal, noting that Beshear told him after his Jan. 14 budget address that he was supportive of his bill and that he even liked his bill better.
Miller said that was likely because his proposed e-cig tax would generate more money than the governor's proposal. "Whereas his is 20 million-ish, mine is in the 30 million range," he said.
Asked if he was willing to compromise the 27.5%, he said, "As I tell people, I don't pass perfect bills, I pass the best bills that can pass and I'm going to get the best bill I can pass through the Senate and onto the governor's desk."
Miller has also filed HB 69, which would further regulate e-cigarettes.
Miller unsuccessfully sponsored an e-cigarette tax bill in the 2019. In 2018, an e-cig tax was included in legislation that raised the tax on traditional cigarettes, but was removed in the Senate just before final passage and after lobbying by Altria Group, the largest tobacco company and 35% owner of Juul Labs, the largest e-cig company.
A recent Kentucky Health Issues Poll found that 75% of Kentucky adults would support such a tax.
Kentucky Health News
To pay for such things as a teacher-pay increase and 350 news social workers to fight child abuse and neglect, Gov. Andy Beshear wants to raise the tax on all tobacco products and add a new tax to electronic cigarettes, the only tobacco product in Kentucky that does not have an excise tax.
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| Gov. Andy Beshear makes his budget speech. (Image from KET) |
Beshear's proposal calls for a 10-cent tax increase on cigarettes, to $1.20 per pack from $1.10, and a tax on e-cigarettes at 10 cents per fluid milliliter. His office said eight of the 19 states that tax so-called "vaping" products do so with a per-milliliter tax instead of a percentage of of the sales price.
It would also raise the tax on snuff and chewing tobacco from .19 cents per unit to .38 cents per unit and would raise the tax on other tobacco products, like cigars, from 15 percent on the average wholesale price to 30%, which would make the tax rates on other tobacco products the same as the proposed $1.20 cigarette rate
These additional taxes would raise $50.3 million in the upcoming fiscal year, which begins on July 1, and $43.9 million the following fiscal year -- for a total of $94.2 million in the next biennium, according to Beshear's 2020-2022 Executive Budget Revenue Proposal.
If the proposed hike on cigarettes were to pass, it would place Kentucky at the same rate as West Virginia, but would be noticeably higher than Indiana, Missouri, Tennessee and Virginia. It would also bring Kentucky closer to the two bordering states with the highest rates, Ohio at $1.60 per pack and Illinois at $2.98 per pack. The national average is $1.81 per pack.
In 2018, lawmakers increased the cigarette tax by 50 cents, to $1.10 per pack.Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, praised the governor's proposals to raise tobacco product taxes, while also noting the health savings that would result from them.
"In addition to raising revenue on one side of the budget, they reduce health care and business costs and increase employee productivity on the other," Chandler said in a news release. "We know they're effective: the recent cigarette tax hike raised $140 million in new revenue its first year; at the same time, Kentuckians bought 36 million fewer packs of cigarettes."
Rep. Steve Rudy, chair of the House budget committee, said the most likely taxes to pass are those on electronic cigarettes, because “We’re trying to curtail this. . . . I’ve had a lot of school superintendents and teachers tell me it’s becoming an epidemic in the schools.”
Between 2017 and 2019, e-cigarette use more than quadrupled among the state's middle-school students and nearly doubled among its high-school students, with one in four high schoolers and one in five middle schoolers reporting monthly use; and one in 10 high school students reporting daily use.
Sen. Chris McDaniel, chair of the Senate Appropriations and Revenue Committee, more cautiously said he needed to examine all of the components of Beshear's proposal before deciding how to proceed, but said he was open to looking at it.
"Any tax needs to be evaluated in the confines of its total impact," he said. "Since the last [cigarette] tax, we've seen a decline in smoking in the commonwealth. We know we've had a bit of an impact there. And we're going to take a look at it as part of the whole."
Senate Majority Floor Leader Damon Thayer said, "I think a tax on vaping is something that needs to be considered. I don't think it should be as high as the tax on cigarettes, but I think it probably should be higher than the current 6% sales tax. So I think there is probably some momentum towards getting something done on that."
Thayer explained that he didn't think they should be taxed the same amount because they are "not the same product" and added that while it's important to work toward decreasing the youth vaping epidemic, it's also important to recognize "there is evidence that vaping helps addicted adult smokers wean themselves off traditional cigarettes."
A 700 page U.S. Department of Health and Human Services report released Jan. 23 titled, "Smoking Cessation, A Report of the Surgeon General" says more research is needed before we can conclusively make the claim that e-cigs help people stop smoking.
"In summary, the evidence is inadequate to infer that e-cigarettes, in general, increase smoking cessation; factors contributing to the uncertainty include the changing characteristics of e-cigarettes, the many different contexts in which they are used, and the limited number of studies conducted to date," says the report.
As for the 10 cent hike in the cigarette tax, Thayer said, "It's too soon to talk about that."
 |
| Rep. Jerry Miller |
House Bill 32, sponsored by Rep. Jerry Miller, R-Louisville, would impose a 27.5% excise tax on e-cigarettes and other tobacco products that are currently taxed at 15%, making them the same percentage increase that was applied to the cigarette tax.
The bill's fiscal note shows that increases in the excise tax and the sales tax, which will result from the increased prduct price, and the initial floor stocks tax would result in $44.7 million in the first fiscal year and $49.4 million in the second, for a total of $94.1 million.
"I believe the tax bill will move out of the House, I feel pretty confident about that," Miller said. "We are working on modifying it to make sure it passes the Senate."
He said it was helpful that the governor had included an e-cig tax in his revenue proposal, noting that Beshear told him after his Jan. 14 budget address that he was supportive of his bill and that he even liked his bill better.
Miller said that was likely because his proposed e-cig tax would generate more money than the governor's proposal. "Whereas his is 20 million-ish, mine is in the 30 million range," he said.
Asked if he was willing to compromise the 27.5%, he said, "As I tell people, I don't pass perfect bills, I pass the best bills that can pass and I'm going to get the best bill I can pass through the Senate and onto the governor's desk."
Miller has also filed HB 69, which would further regulate e-cigarettes.
Miller unsuccessfully sponsored an e-cigarette tax bill in the 2019. In 2018, an e-cig tax was included in legislation that raised the tax on traditional cigarettes, but was removed in the Senate just before final passage and after lobbying by Altria Group, the largest tobacco company and 35% owner of Juul Labs, the largest e-cig company.
A recent Kentucky Health Issues Poll found that 75% of Kentucky adults would support such a tax.
Hearing loss may affect brain health
Hearing is a complex sense that provides us with awareness of environmental sounds and, more importantly, the ability to communicate. The ear is the organ responsible for perceiving sound, but it may not be so obvious that the brain is responsible for processing the sound. It is necessary that both organs work properly for hearing to occur.
The link between hearing loss and cognition is not fully understood
In recent years, there has been extensive research examining how age-related hearing loss and brain function (cognition) are associated. There are some general concepts that might contribute to the association between hearing loss and cognition. One theory is that hearing loss leads to a decreased input to the brain, so there is less processing that occurs, which contributes to cognitive decline (a “bottom-up” approach). Another theory is that early cognitive deficits may impact a person’s ability to process sound, and thus contribute to hearing loss (a “top-down” approach). Irrespective of which theory is correct, it is clear that the association between hearing and cognition is very real. This association emphasizes the need to improve our approach to testing and treating hearing loss.
How is hearing loss measured, and what’s considered a deficit?
Most audiologists and otolaryngologists define normal hearing as someone being able to hear any level above 25 decibels. This value is somewhat liberally designated, and largely based on the average range below which most people in a population experience hearing trouble. Most clinicians who manage patients with hearing loss will admit that conventional hearing tests are imperfect, despite the important information they provide. The imperfections in conventional hearing tests are due to the fact that it is a simple measure that is trying to quantify a complex process. For example, hearing tests present simple tones and words, but hearing in real-life situations involves sentences, speech, and language, which is much more complicated to hear and would require more complicated testing to evaluate.
Researchers and clinicians who specialize in hearing loss have considered that the current standard for normal hearing may be too liberal. Additionally, research suggests there may be a role for new definitions of normal hearing that account for people who are experiencing symptoms of hearing loss, but are considered to have normal hearing by current standards. These people might be considered as having “borderline hearing loss” or “subclinical hearing loss.”
New research highlights the need to improve our approach to subclinical hearing loss
A recent article in JAMA Otolaryngology highlights this need. In this article, researchers reviewed two large population databases of 6,451 people who had had hearing and cognitive testing. The research showed that those who were 50 or older had cognitive scores that seemingly declined even before they reached clinically defined hearing loss (subclinical hearing loss). The research also noted that the association between hearing and cognition is stronger among subjects with normal hearing compared to those with hearing loss. For example, in the population they analyzed, cognition scores dropped in the normal hearing population faster than in the population with hearing loss. This result is somewhat counterintuitive, and suggests that maybe what we currently define as normal hearing may in fact include some people with hearing deficits. It also challenges what clinicians have accepted as standard classifications for hearing loss on hearing tests.
What does this mean if you are concerned about hearing loss?
First, it is worth clarifying that the new research does not in any way suggest that hearing loss is going to lead to cognitive decline. Just because these things are associated, does not mean they are causally related. Next, what these findings make clear is that it is important to have hearing tested if you notice problems with your hearing, such as challenges hearing when in social settings, requiring the radio or television at higher volumes, or constantly requiring people to repeat themselves.
The coordinated functions of the ear and the brain place a new priority on addressing hearing loss
Do not ignore symptoms of hearing loss, because you do not want to miss an opportunity to address hearing deficits. In addition, do not hesitate to ask your provider specific details about your hearing results. Often patients can be afraid to ask for details about their results because they do not want to admit that they do not understand the result, and it is important to raise concerns about your hearing even if your hearing test is normal. By taking care of your hearing, you are addressing an obvious issue (hearing loss) with not-so-obvious consequences (cognition).
Unfortunately, hearing aid use is very low despite the high incidence of hearing loss. Ask your provider about options to rehabilitate your hearing with hearing aids. Depending on the type of hearing loss you have, other options may be available to you as well, such as procedures to improve the hearing.
The post Hearing loss may affect brain health appeared first on Harvard Health Blog.
Thursday, January 30, 2020
Regular marijuana use may enlarge the heart's main blood-pumping chamber, limited study in United Kingdom suggests
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| Image from Marijuana Direct |
"People who regularly use marijuana tend to have a larger left ventricle, which is the main pumping chamber of the heart, according to the findings," reports Dennis Thompson of HealthDay. "Routine stoners also appeared to have early signs of impaired heart function, measured by how the fibers of the heart muscle deform during contraction."
However, when marijuana use stops, "The heart appears to recover in both size and function," Thompson reports. "The researchers warn that the study 'should be interpreted with caution, and more research is required' to understand the potential mechanisms and dose-related effects of cannabis use."
That being said, "The results jibe with concerns people have had about the effects of pot on the heart, said Dr. Martha Gulati, editor-in-chief of the cardiology college's patient-education website.
"There's so much we don't know about cannabis use and its effect on the heart, but one of the things we do know is that when people use marijuana, particularly if they smoke it, the heart rate and the blood pressure go up, and the heart has to work harder," she said.
The study was published in one of the college's peer-reviewed journals, JACC Cardiovascular Imaging. (A review in the same journal said marijuana can interact with common heart medications, including statins and blood thinners, potentially putting patients at risk, NBC News reports.)
The study was observational, not controlled, so other factors may have caused the heart-structure changes, said Dr. Mary Ann McLaughlin, a cardiologist at Mount Sinai Hospital in New York City, who reviewed the findings for HealthDay.
"Alcohol can also cause similar types of changes in the left ventricle with chronic drinking, which can get better when people stop drinking," McLaughlin said. "They said they adjusted for alcohol use in this study, but the question is whether the use was adequately assessed."
Thompson notes, "Europeans also are known to mix their marijuana with tobacco, which has notoriously harmful effects on the heart," citing Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws. "Experts also noted that the number of pot users in this study was very small." It observed 47 current, regular users and 105 previously regular users. The rest of the 3,400 sample from the United Kingdom "rarely used pot, if at all."
While more research is needed, Thompson writes, "Until there are more answers, people with heart problems might want to avoid pot, the experts said."
Gulati said, "If you have heart disease, you should really use marijuana with caution. In fact, I, as a cardiologist, would recommend you not to use it because of the physiologic effects of increasing your heart rate and putting more demand and stress on the heart."
Dr. Steven Stack, Lexington emergency physician and 2016 AMA president, named to lead state Department for Public Health
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| Dr. Steven Stack |
Acting Health Secretary Eric Friedlander said Stack is a seasoned health-care policy advocate and educator.
"Steven has almost 20 years of years of clinical, operational and management experience to help guide our state Department for Public Health staff and galvanize both its assistance programs and educational efforts. He is an excellent choice to modernize our state’s public health services," Friedlander said in a press release.
Stack takes over the department at a time when it is asking lawmakers to approve a major system overhaul, which also includes changes in how local health departments would be funded. In addition, dozens of local departments are facing pension challenges that could force big cuts in services.
“I am proud to be a part of health programming that is innovative, accountable and focused on making Kentuckians’ lives better,” Stack said in the release. “Our state health officials are here to support and enhance local health department. We can’t forget that health care is local, and we have to balance a practice of targeting the right care with the approach of maximizing our state and federal resources."
Stack is an emergency physician at Saint Joseph Hospital East in Lexington. He is also an adjunct professor at the University of Tennessee's business college. He has served as a councilor (trustee) and advocacy workgroup chair of the World Medical Association. He served 13 years as a member of the Lexington-Fayette Urban County Government’s Emergency Medical Advisory Board.
Stack will replace Dr. Angela Dearinger, who was appointed in August. She was the third physician to hold the position in the previous administration of Republican governor Matt Bevin, whom Democrat Andy Beshear narrowly ousted in the November election. She will return to the University of Kentucky as assistant dean of its College of Medicine, says the release.
Food allergy, intolerance, or sensitivity: What’s the difference, and why does it matter?
Chances are that you or someone you know has experienced unpleasant symptoms after a meal or snack. Maybe you experienced some degree of sneezing, wheezing, rashes, brain fog, joint pain, nausea, bloating, diarrhea, or another symptom. This may have led you to believe you have a food allergy — and maybe you do. But it’s also possible that you have a food intolerance, celiac disease, or a food sensitivity. This is important, because some of the reactions can range from just annoying to life-threatening.
Food intolerances
Food intolerance refers mostly to the inability to process or digest certain foods. The most common food reaction appears to be lactose intolerance. As we get older, our ability to digest dairy decreases. That’s because, with age, our intestines make less of the enzyme (lactase) that processes lactose, a type of sugar present in milk and dairy products. As a result, we have more lactose sitting in the digestive tract, which can cause stomach bloating, inflammation, and diarrhea. Research has found that only about 35% of people worldwide can digest lactose beyond the age of about seven or eight.
Lactose intolerance is not a serious disease, but it can be quite uncomfortable. Avoiding dairy products is a surefire way to avoid symptoms; some, like milk, tend to produce more severe symptoms than others, like yogurt and cheese. Over-the-counter lactase enzyme supplements can also help.
Food allergies
A more severe problem happens when someone develops a true allergic reaction, an overblown response by the body’s immune system against a seemingly harmless substance — in this case, a food. The classic example is the potentially life-threatening difficulty breathing and low blood pressure following exposure to peanuts or seafood. Food allergies can show up at any time in our lives, even during older adulthood.
If you think you may have a food allergy, consider allergy testing and treatment, especially if your symptoms are severe (significant rashes, feeling of passing out, facial swelling, and problems breathing). Scrupulously reading ingredient labels is wise. And carrying epinephrine shots in case of accidental ingestion or contact with the food in question is essential and can be lifesaving.
Celiac disease
Celiac disease affects about 1% of the Western population. In this autoimmune condition, the ingestion of gluten initiates a complex inflammatory reaction that can make people with celiac disease very sick. Celiac disease is not a true allergy; eating gluten once does not cause an immediate life-threatening problem. However, prolonged and continuous ingestion can cause diarrhea, weight loss, and malnutrition.
Avoiding gluten is the only solution to this problem. Gluten is found in a variety of grains, including wheat, rye, barley, semolina, bulgur, and farina. Many processed foods also contain gluten. People with celiac disease must also be careful about cross-contamination, when a gluten-free food comes into contact with a gluten-containing food.
Food sensitivities
After eating certain foods, a large part of the population experiences symptoms that are not related to food intolerances, food allergies, or celiac disease. These are referred to as food sensitivities. Though there is controversy around what exactly happens in the body of someone with a food sensitivity, it appears that exposure to specific foods may create an immune reaction that generates a multitude of symptoms. The symptoms are not life-threatening, but they can be quite disruptive and include joint pain, stomach pain, fatigue, rashes, and brain fog. Gluten is probably the best-known trigger of food sensitivities.
The best tool we have to identify food sensitivities is a process of careful observation and experimentation. Removing certain foods believed to cause reactions from the diet for two to four weeks, reintroducing them one by one, and watching for symptoms is the current gold standard to pin down what may be causing symptoms. This so-called “elimination diet” is not high-tech, and it is far from perfect. A physician or nutritionist can provide guidance for undertaking an elimination diet, and can help you understand limitations and avoid possible pitfalls. Removing certain foods can help stave off undesirable symptoms and improve your quality of life.
Food reactions, especially sensitivities, can also fade away with time. Our bodies, immune systems, and the gut microbiome are continually changing, and what may not sit well today may be fine to have later on in life. At some point, you may consider reintroducing small amounts of a food that you have been sensitive to, to see what you may be able to tolerate.
The bottom line
Though food reactions are common, they can be challenging to understand. Identifying the cause can be difficult and time-consuming, but it is worth the time and effort. Once you’ve identified the problem, and the food or foods that trigger it, a nutritionist or a physician can help you develop the most comprehensive diet that is safe for you.
The post Food allergy, intolerance, or sensitivity: What’s the difference, and why does it matter? appeared first on Harvard Health Blog.
Wednesday, January 29, 2020
U.S. House passes Senate bill to mainatin anti-fentanyl laws
The U.S. House passed a Senate bill Wednesday to keep deadly fentanyl and similar opioids listed as some of the most dangerous drugs, and President Trump is expected to sign it Friday, the day before the listings would expire.
The legislation would keep fentanyl compounds as Schedule I substances under the law governing the Drug Enforcement Administration, "giving law enforcement the tools they need to bring drug dealers to justice," said a press release from Rep. Hal Rogers, R-Somerset.
"Fentanyl, a synthetic opioid that is 50 to 100 times stronger than heroin, continues to be the most lethal drug for Kentucky causing nearly 800 overdose deaths in 2018 alone," said a press release from U.S. Sen. Mitch McConnell, the Senate majority leader. The Senate passed the bill Jan. 16.
The federal Centers for Disease Control and Prevention says the U.S. had more than 28,000 deaths involving synthetic opioids (other than methadone, which is used to treat addiction) in 2017, more deaths than from any other type of opioid.
The legislation would keep fentanyl compounds as Schedule I substances under the law governing the Drug Enforcement Administration, "giving law enforcement the tools they need to bring drug dealers to justice," said a press release from Rep. Hal Rogers, R-Somerset.
"Fentanyl, a synthetic opioid that is 50 to 100 times stronger than heroin, continues to be the most lethal drug for Kentucky causing nearly 800 overdose deaths in 2018 alone," said a press release from U.S. Sen. Mitch McConnell, the Senate majority leader. The Senate passed the bill Jan. 16.
The federal Centers for Disease Control and Prevention says the U.S. had more than 28,000 deaths involving synthetic opioids (other than methadone, which is used to treat addiction) in 2017, more deaths than from any other type of opioid.
Are you getting enough sleep… or too much? Sleep and stroke risk
The importance of getting enough sleep has been emphasized by hundreds of studies in recent years, and we’ve covered the topic many times on this blog.
Inadequate sleep has been linked to obesity, heart disease, diabetes, high blood pressure, and other health problems. And, according to the National Highway Traffic Safety Administration, up to 72,000 car accidents and 6,000 deaths occur each year due to sleep-deprived drivers.
But what about too much sleep? Could that be bad for you, too? According to a new study, the answer may be yes.
More sleep, more strokes?
Researchers publishing in the December 11, 2019, online issue of Neurology describe an analysis of stroke risk among nearly 32,000 adults with an average age of 62. The study’s authors compared rates of stroke with study subjects’ self-reported sleep habits.
Their findings were surprising (at least to me) and included:
- Those who reported sleeping nine or more hours each night had a 23% higher risk of stroke than those sleeping less than eight hours each night.
- Stroke risk was 25% higher among those who took midday naps for at least 90 minutes compared with those napping for less than 30 minutes.
Poor sleep quality was also linked to higher stroke risk
Combinations of these factors had an even more dramatic effect on stroke risk, including an 85% higher risk among those who slept at least nine hours each night and also took midday naps for at least 90 minutes. Similarly, an 82% higher stroke risk was observed among those who slept longer at night and also reported poor sleep quality.
Does this mean too much sleep causes strokes?
If you are a person who sleeps more than nine hours each night, takes long midday naps, and feels your sleep quality is poor, these results may be troubling. But before trying to change your sleep habits, keep in mind this study did not conclude that more sleep actually causes strokes.
This study found an association between stroke risk and longer sleep, longer midday napping, or poor sleep quality. But an association is not the same as causation. Rather than longer sleep duration causing strokes, there are other possible explanations for the findings. For example, people who sleep more at night or nap more during the day may have other risk factors for stroke, such as:
- A higher incidence of depression. Excessive sleeping or poor sleep quality may be symptoms of depression, and prior studies have noted higher stroke rates among depressed individuals.
- A more sedentary lifestyle. Those who are not active may sleep or nap more and also have more cardiovascular risk factors (such as smoking or hypertension) than those who exercise regularly. Past research has noted less favorable cholesterol levels and larger waist circumference among long sleepers and nappers.
- Sleep apnea. Longer sleep duration, more napping, and poor-quality sleep may be more common among people with sleep apnea, a condition linked to an increased risk of stroke. This new study did not ask subjects about sleep disorders such as sleep apnea.
In addition, this study had weaknesses that could call its findings into question or limit its applicability. These include reliance on self-reported sleep habits and quality, and inclusion only of middle-aged and older Chinese adults without prior cancer or cardiovascular disease; the results might have been quite different if others were included in the study.
The bottom line
Sleep is a mysterious thing. It’s often unclear why some people sleep more or less than others, or why certain sleep disorders (such as insomnia or sleep apnea) affect so many people while sparing others. At a time when there’s so much media emphasis on the importance of getting enough sleep, this new study raises the possibility that more sleep may not always be a good thing. Still, we’ll need additional research on the question of whether more sleep is hazardous before making any firm recommendations to limit sleep duration.
The post Are you getting enough sleep… or too much? Sleep and stroke risk appeared first on Harvard Health Blog.
Tuesday, January 28, 2020
How safe is exercise during pregnancy?
Two lines on a home pregnancy test, a flickering heartbeat on ultrasound, and suddenly your world has changed: you’re pregnant! Regardless of where this new path takes you, you may start to examine your daily decisions in a new way as you discover an intense drive to protect the growing baby inside you. Even your exercise routines may come under scrutiny, particularly if late-night Googling has you second-guessing everything that you believed you knew.
Just how safe is exercise during pregnancy?
The short answer? Exercise during pregnancy is not only safe, it’s encouraged. An overriding principle for pregnancy is: what is good for mom is good for baby. The American College of Obstetricians and Gynecologists (ACOG) and the US Office of Disease Prevention and Health Promotion note that exercising during pregnancy may reduce
- weight gain
- risk for gestational diabetes, particularly in overweight or obese women
- risk for cesarean delivery.
Plus, it helps pregnant women prevent or manage inevitable aches and pains. Regular physical activity during pregnancy may help psychological well-being and possibly even reduce depression and anxiety during the postpartum period. Additionally, women who exercise during pregnancy may recover more quickly after the birth.
How active should you be?
Best-laid plans aside, the ACOG recommends engaging in moderate activity for 20 to 30 minutes on three to seven days per week throughout your pregnancy. It is safest to avoid exercising for longer than 45 minutes in one session to prevent hypoglycemia (low blood sugar).
The best time to boost your activity level is before you conceive. Generally, you can safely continue to exercise at the level of strenuous activity you practiced before your pregnancy. So, if you enjoyed moderate activity, stick with that rather than ramping up during your pregnancy. If you enjoyed vigorous activity, you may be able to continue this, though it’s safest to check with your obstetric team to be sure.
Of course, many women become pregnant without an established exercise routine in place. If this is true for you, start slowly and ramp up gradually. For example, try walking a few more times per week, then add to the amount of time you walk. Finally, you might step up intensity by walking more quickly.
What types of exercise can you do?
The best exercises to engage in are activities you actually enjoy doing. Pregnant women can generally do brisk walking, swimming, stationary cycling, low-impact aerobics, yoga or Pilates, and running. Most of these activities can be modified for your growing belly.
There are some activities you should avoid, including:
- contact sports that could cause injury, such as basketball, hockey, or soccer
- sports that are risky or likely to cause falls, such as skiing, surfing, or gymnastics
- scuba diving
- hot yoga or hot Pilates, because increases in body temperature might harm a fetus.
What if you have a high-risk pregnancy?
What if your pregnancy is not straightforward? High-risk pregnancies come in a variety of forms. Often, they occur when women have complex medical conditions (such as epilepsy or lupus), develop a condition that could affect the pregnancy (such as a short cervix or placenta previa), or if the fetus has a complex condition (such as a heart defect).
Usually, doctors recommend mild activity like walking or stretching, because it isn’t linked to poor outcomes, such as inadequate growth or preterm delivery. Even if you have a high-risk condition where vigorous activity is discouraged, you and your doctor can come up with an individualized plan for light, safe activities.
Although bed rest was advised in the past for certain high-risk conditions, it hasn’t been shown to improve outcomes. And unfortunately, bed rest can put you at a higher risk for blood clots, loss of bone density, and deconditioned muscles, which could further complicate your pregnancy. The mood-boosting benefits of exercise may be even more critical in high-risk pregnancies.
The bottom line
Whether you are new to exercise or a lifelong athlete, physical activity is generally safe and well tolerated in pregnancy. With rare exceptions, mild to moderate exercise offers physical and psychological benefits. If you have a high-risk pregnancy, your obstetrician can help you choose activities that will be safe for you and your baby. Pregnancy is the first step along the journey of parenthood. Let regular physical activity now become part of a lifetime of dedication to good health for your family.
The post How safe is exercise during pregnancy? appeared first on Harvard Health Blog.
Monday, January 27, 2020
Beyond heart health: Could your statin help prevent liver cancer?
Liver cancer is hard to treat. It’s a top-five cause of cancer-related death worldwide and a growing cause of cancer-related deaths in the United States. Since liver cancer is often found at a late stage, when treatment has limited benefit, there has been increasing interest in prevention. That’s where statin medications might come in.
Liver cancer is usually caused by chronic liver disease, so an important way to prevent liver cancer is to treat the underlying trigger. For example, curing hepatitis C infection — an important cause of chronic liver disease — reduces the risk of liver cancer. However, if the liver disease has progressed to an advanced stage, the risk of liver cancer remains high even after removing the underlying cause.
Statins and liver disease: what’s the connection?
Statin medications are widely known to lower cholesterol levels and decrease the risk of cardiovascular disease. When statins first came on the market, there was great concern that statins might injure the liver. It turns out that not only are significant side effects rare, but statin medications are likely beneficial for the liver. In fact, research has shown that for people with liver disease, statins are associated with a reduced risk of liver failure, liver cancer, and death (see this study, this study, and this study).
It turns out that some statins may be better at preventing liver cancer than others. Specifically, lipophilic statins (those that dissolve more readily in lipids such as oils and fats) may be more effective for preventing liver cancer than hydrophilic statins (those that dissolve more readily in water). This suspected difference is supported by observations that lipophilic statins can more easily get into diseased liver cells, passing readily through cell walls, which are made mostly from lipids. Once inside cells, lipophilic statins may do a better job interfering with cancer formation.
Lipophilic statins include atorvastatin (Lipitor), simvastatin (Zocor), Fluvastatin (Lescol), and lovastatin (Altoprev). Hydrophilic statins include pravastatin (Pravachol) and rosuvastatin (Crestor).
Study links lipophilic statins to reduced risk of liver cancer
A recent study published in Annals of Internal Medicine took a closer look at the effect of different statin types on liver cancer risk. In the largest and most comprehensive study on the topic to date, the study researchers examined liver cancer risk over 10 years in a group of more than 16,000 adults with viral hepatitis (a possible cause of chronic liver disease). Based on records from the Swedish national registry, their results demonstrate that individuals who took a lipophilic statin (in this case atorvastatin or simvastatin) were at a significantly lower risk of developing liver cancer than those who were not taking a statin (3.3% versus 8.1%). In contrast, the study did not find a statistically significant benefit in liver cancer risk for individuals taking hydrophilic statins (rosuvastatin or pravastatin) compared to those not taking a statin. Taking either type of statin was associated with a lower risk of death compared to not taking a statin at all.
As with all studies, this one had some limitations. They include only looking at individuals from Sweden, only those with liver disease from viral hepatitis (as opposed to other causes of liver disease), and having relatively fewer data points for people taking hydrophilic statins, which might have made it harder to find a benefit.
A cause-and-effect relationship?
While a strong connection has been drawn between lipophilic statins and decreased liver cancer risk, research has not yet proven that these medications prevent liver cancer. Demonstrating a cause-and-effect relationship would require a study where people with chronic liver disease are randomized to receive either a lipophilic statin or a control medication.
It is possible that other unmeasured factors could actually account for the observed difference in cancer risk. These factors might include differences in liver disease severity, or other differences in treatment that correlate with statin prescribing patterns. However, the Annals study did demonstrate that higher doses of lipophilic statins were associated with a lower risk of liver cancer, implying a cause-and-effect relationship may indeed be present.
Weigh risks and benefits with your doctor
Further evidence is needed before recommending that individuals take statins specifically for liver disease. While there may be a benefit, there is also a small but real risk of side effects and the consideration of cost.
If you have liver disease and are planning to start a statin for cardiovascular disease, it would be worth discussing with your doctor the risks and benefits of selecting a lipophilic statin such as atorvastatin or simvastatin. In the meantime, ongoing and future studies will help to define the precise role of these medications for preventing liver cancer and the progression of liver disease.
The post Beyond heart health: Could your statin help prevent liver cancer? appeared first on Harvard Health Blog.
Sunday, January 26, 2020
Anti-diabetes activists hope resolution for Ketoacidosis Awareness Day will be only first of many diabetes bills to pass House, Senate
By Melissa Patrick
Kentucky Health News
A resolution to increase awareness of a health condition that can kill diabetics, called diabetes ketoacidosis, has passed the state House. It is one of several diabetes-related bills filed this session, including measures to address the rising cost of insulin.
The sponsor, Rep. Danny Bentley, R-Russell, told the House, "We always talk about diabetes, but we don't talk about how people die from it."
More than one in eight Kentucky adults have been diagnosed with diabetes, and 1.1 million Kentucky adults, or nearly one in three, have pre-diabetes that has been diagnosed or undiagnosed, according to the 2017 Kentucky Behavioral Risk Factor Survey. In that year, diabetes was the seventh leading cause of death in Kentucky, according to the federal Centers for Disease Control and Prevention.
House Resolution 14, which passed Jan. 23 on a voice vote, proclaims April 26, 2020 as Diabetes Ketoacidosis Awareness Day in Kentucky. DKA happens when a person lacks sufficient insulin to help move glucose, a type of sugar, between the bloodstream and the body's cells, where it is used for energy. When this happens, the body breaks down fat for fuel, which results in a buildup in ketones, which are acid.
If this persists for an extended period, the ketones build up in the blood, causing excessive thirst, frequent urination, nausea and vomiting, abdominal pain, fatigue, confusion and fruit-scented breath.
DKA can result in dangerous levels of dehydration, low levels of potassium, swelling of the brain, fluid in the lungs, and damage to the kidneys and other organs due to fluid loss, diabetic coma and death.
Bentley, a pharmacist who has Type I diabetes, a condition where the body produces no insulin, said people with Type I have the highest risk of DKA, but it can also happen in those with Type II diabetes, where the body produces some, but not enough, insulin.
The resolution says DKA may account for up to 75 percent of all Type I diabetes-related deaths in patients under 30 years of age.
Other diabetes-related bills to watch
DKA can be prevented with the effective treatment of diabetes, but with the skyrocketing cost of insulin and other supplies needed to manage the disease, many diabetics go untreated or are under-treated because they ration their insulin to make it last. Several bills have been introduced this legislative session to address this.
Bentley held a press conference Jan. 16 to talk about diabetes bills he is sponsoring. He was joined by lawmakers from both sides of the aisle, as well as representatives from Kentucky Insulin4All, the American Diabetes Association and the Kentucky Medical Association.
"For those who require insulin to live, the cost has spiraled out of control as Representative Bentley has mentioned. And for many it's beyond their reach," said Gary Dougherty, ADA's chief state-government lobbyist. "This has forced one in four insulin users to use less than their doctor has prescribed for them, putting their lives and health at risk."
Bentley thanked Gov. Andy Beshear for drawing attention to the issue of diabetes and the high cost of insulin at his Jan. 14 State of the Commonwealth address.
Beshear said, "There are a number of bills in the legislature right now to curb the costs of insulin. Representative Danny Bentley, a Republican, and Representative Patti Minter, a Democrat, are sponsoring one such bill. Let’s pass it. The approximately 530,000 diabetics, according to the American Diabetes Association, in this state are counting on it."
Bentley said Beshear "realizes that we have people in this state who are allotting their doses and dying from ketoacidosis."
Minter, a Bowling Green Denocrat whose son has Type 1 diabetes, is a co-sponsor of Bentley's resolution and House Bill 12, which would cap the cost-sharing requirements for prescription insulin at $100 per 30-day supply, no matter the type or amount of insulin a person is prescribed. This bill would only apply to private insurers, not Medicaid or Medicare. Including Bentley, it has 71 sponsors. It has been posted for consideration in the House Health and Family Services Committee.
Similar legislation has passed in Colorado and in Illinois, where it awaits the governors' signature.
Minter has also introduced HB 21 that would require insurance companies in Kentucky to keep covering pre-existing conditions in the event the federal Patient Protection and Affordable Care Act is overturned. Diabetes is considered a pre-existing condition, and prior to the ACA, an insurance company could deny coverage to those who have it.
Bentley said in the last 14 years, the price of insulin has gone up over 550%. He said retail cost for his own insulin requirements would be about $6,000 a year.
.
"When we adhere to good management, we save dollars on diabetes," he said. "If we can help a person manage their disease, we save money for the state, taxpayer and everyone."
Rep. Charles Booker, D-Louisville, who has Type I diabetes, offered his support of Bentley's bill and told about his experience with ketoacidosis.
"I've had to make decisions on whether to put food on the table for my girls or pay for my insulin," said Booker, a U.S. Senate candidate. "And I'm going to choose my girls every time, and I fell into diabetic ketoacidosis. . . . I couldn't move. I couldn't hug my girls. I thought I was done. A lot of Kentuckians are not as fortunate as I am to be here."
Bentley has also introduced HB 72, which he called the "Rx Accumulator Bill." It would require insurers to apply any financial assistance used by a patient, like a rebate or coupon, to their deductible. This bill would not only help people with diabetes, but also those with other health conditions. It has been posted in the House Banking and Insurance Committee.
He has also filed HB 248 and HB 249, which deal with the cost of insulin, including issues related to cost transparency.
"As a Type 1 Diabetic, I know firsthand the struggle diabetics face when they do not have access to insulin," he said in the press release. "These pieces of legislation will help take the burden away for Kentuckians who are diabetic."
Two diabetes-related bills have also been filed in the Senate, both by Sen. Phillip Wheeler, R-Pikeville. Senate Bill 23 would create an insulin assistance program. It has been assigned to the Senate Health and Welfare Committee. SB 69 would also cap the co-payment for prescription insulin at $100 per 30-day supply. It has been assigned to the Senate Banking and Insurance Committee.
Last year, the state passed a Bentley bill to allow pharmacists to dispense insulin and respiratory inhalers in the smallest supply available in an emergency. Kentucky already had a law to allow pharmacists to dispense a 72-hour emergency supply of a prescription medicine, but because insulin and most inhalers are not available in doses that small, they couldn't dispense them.
The law is called "Kevin's Law" for Kevin Houdeshell, an Ohio man with diabetes who died after running out of insulin on New Year's Eve in 2013, despite multiple efforts to reach his doctor to get the refill.
Kentucky Health News
A resolution to increase awareness of a health condition that can kill diabetics, called diabetes ketoacidosis, has passed the state House. It is one of several diabetes-related bills filed this session, including measures to address the rising cost of insulin.
 |
| Rep. Danny Bentley holds an insulin pen at a Jan. 16 press conference. Rep. Deanna Frazier, R-Richmond, looks on. (Legislative Research Commission photo) |
More than one in eight Kentucky adults have been diagnosed with diabetes, and 1.1 million Kentucky adults, or nearly one in three, have pre-diabetes that has been diagnosed or undiagnosed, according to the 2017 Kentucky Behavioral Risk Factor Survey. In that year, diabetes was the seventh leading cause of death in Kentucky, according to the federal Centers for Disease Control and Prevention.
House Resolution 14, which passed Jan. 23 on a voice vote, proclaims April 26, 2020 as Diabetes Ketoacidosis Awareness Day in Kentucky. DKA happens when a person lacks sufficient insulin to help move glucose, a type of sugar, between the bloodstream and the body's cells, where it is used for energy. When this happens, the body breaks down fat for fuel, which results in a buildup in ketones, which are acid.
If this persists for an extended period, the ketones build up in the blood, causing excessive thirst, frequent urination, nausea and vomiting, abdominal pain, fatigue, confusion and fruit-scented breath.
DKA can result in dangerous levels of dehydration, low levels of potassium, swelling of the brain, fluid in the lungs, and damage to the kidneys and other organs due to fluid loss, diabetic coma and death.
Bentley, a pharmacist who has Type I diabetes, a condition where the body produces no insulin, said people with Type I have the highest risk of DKA, but it can also happen in those with Type II diabetes, where the body produces some, but not enough, insulin.
The resolution says DKA may account for up to 75 percent of all Type I diabetes-related deaths in patients under 30 years of age.
Other diabetes-related bills to watch
DKA can be prevented with the effective treatment of diabetes, but with the skyrocketing cost of insulin and other supplies needed to manage the disease, many diabetics go untreated or are under-treated because they ration their insulin to make it last. Several bills have been introduced this legislative session to address this.
 |
| Bentley and advocates held a press conference to discuss several diabetes-related bills. (KHN photo by Melissa Patrick) |
"For those who require insulin to live, the cost has spiraled out of control as Representative Bentley has mentioned. And for many it's beyond their reach," said Gary Dougherty, ADA's chief state-government lobbyist. "This has forced one in four insulin users to use less than their doctor has prescribed for them, putting their lives and health at risk."
Bentley thanked Gov. Andy Beshear for drawing attention to the issue of diabetes and the high cost of insulin at his Jan. 14 State of the Commonwealth address.
Beshear said, "There are a number of bills in the legislature right now to curb the costs of insulin. Representative Danny Bentley, a Republican, and Representative Patti Minter, a Democrat, are sponsoring one such bill. Let’s pass it. The approximately 530,000 diabetics, according to the American Diabetes Association, in this state are counting on it."
Bentley said Beshear "realizes that we have people in this state who are allotting their doses and dying from ketoacidosis."
Minter, a Bowling Green Denocrat whose son has Type 1 diabetes, is a co-sponsor of Bentley's resolution and House Bill 12, which would cap the cost-sharing requirements for prescription insulin at $100 per 30-day supply, no matter the type or amount of insulin a person is prescribed. This bill would only apply to private insurers, not Medicaid or Medicare. Including Bentley, it has 71 sponsors. It has been posted for consideration in the House Health and Family Services Committee.
Similar legislation has passed in Colorado and in Illinois, where it awaits the governors' signature.
Minter has also introduced HB 21 that would require insurance companies in Kentucky to keep covering pre-existing conditions in the event the federal Patient Protection and Affordable Care Act is overturned. Diabetes is considered a pre-existing condition, and prior to the ACA, an insurance company could deny coverage to those who have it.
Bentley said in the last 14 years, the price of insulin has gone up over 550%. He said retail cost for his own insulin requirements would be about $6,000 a year.
.
"When we adhere to good management, we save dollars on diabetes," he said. "If we can help a person manage their disease, we save money for the state, taxpayer and everyone."
Rep. Charles Booker, D-Louisville, who has Type I diabetes, offered his support of Bentley's bill and told about his experience with ketoacidosis.
"I've had to make decisions on whether to put food on the table for my girls or pay for my insulin," said Booker, a U.S. Senate candidate. "And I'm going to choose my girls every time, and I fell into diabetic ketoacidosis. . . . I couldn't move. I couldn't hug my girls. I thought I was done. A lot of Kentuckians are not as fortunate as I am to be here."
Bentley has also introduced HB 72, which he called the "Rx Accumulator Bill." It would require insurers to apply any financial assistance used by a patient, like a rebate or coupon, to their deductible. This bill would not only help people with diabetes, but also those with other health conditions. It has been posted in the House Banking and Insurance Committee.
He has also filed HB 248 and HB 249, which deal with the cost of insulin, including issues related to cost transparency.
"As a Type 1 Diabetic, I know firsthand the struggle diabetics face when they do not have access to insulin," he said in the press release. "These pieces of legislation will help take the burden away for Kentuckians who are diabetic."
Two diabetes-related bills have also been filed in the Senate, both by Sen. Phillip Wheeler, R-Pikeville. Senate Bill 23 would create an insulin assistance program. It has been assigned to the Senate Health and Welfare Committee. SB 69 would also cap the co-payment for prescription insulin at $100 per 30-day supply. It has been assigned to the Senate Banking and Insurance Committee.
Last year, the state passed a Bentley bill to allow pharmacists to dispense insulin and respiratory inhalers in the smallest supply available in an emergency. Kentucky already had a law to allow pharmacists to dispense a 72-hour emergency supply of a prescription medicine, but because insulin and most inhalers are not available in doses that small, they couldn't dispense them.
The law is called "Kevin's Law" for Kevin Houdeshell, an Ohio man with diabetes who died after running out of insulin on New Year's Eve in 2013, despite multiple efforts to reach his doctor to get the refill.
Medical News Today: Cancer: Using copper to boost immunotherapy
Scientists have successfully destroyed cancer cells in mice by using copper-based nanoparticles and immunotherapy. Importantly, the cancer did not return.
Saturday, January 25, 2020
Flu activity in Kentucky again drops a bit, but remains high, and nine more adults die from it in state; not too late to get a flu shot
Nine more Kentucky adults have died from influenza, bringing the flu season's total to 30, two under the age of 18, according to the state Department for Public Health.
While flu activity remains high in the state, the latest weekly report shows the number of new cases dropped for the third week in a row. In the week ending Jan. 18, Kentucky counted 1,544 new cases. Not all cases are counted, because flu does not have to be reported.
At the same time last year, Kentucky's numbers were less concerning. The state had a total of 4,166 lab-confirmed cases and 13 deaths, one a minor. There have been 11,548 confirmed cases this season.
Health officials urge everyone six months and older to get a flu shot each year, and note that much of flu season remains.
Hotspots continued around the state. Perry and Pike counties continued to be hit hard by the flu in the week ending Jan. 18, with 76 new cases in Perry and 71 new cases in Pike, for respective totals of 715 and 523. Barren added 75 new cases, for a total of 475; Warren 65, for a total of 416; Bullitt 61, for a total of 527; and Allen 57, for a total of 179.
Senate President Stivers, long the key obstacle to medical marijuana in Kentucky, now says he sees 'a narrow path' for it
 |
| Senate President Robert Stivers |
Kentucky Health News
The most important legislative opponent of legalizing medical marijuana in Kentucky said Friday that there is a "narrow path forward" for it. Senate President Robert Stivers said that the day after a medical-cannabis bill was filed in his chamber.
Senate Bill 107 has bipartisan sponsorship from 11 of the Senate's 38 members. It is a companion bill to House Bill 136, with 44 co-sponsors, including House Speaker David Osborne.
The House bill's prime sponsor, Rep. Jason Nemes, R-Louisville, told Tom Latek of Kentucky Today that most House Republicans support it and he is optimistic it will pass this year.
Stivers has said he wouldn't support a medical-marijuana bill without medical studies to back it up, but Friday he said it would be a balancing act to weigh the good and the bad of passing such a law.
"I know that Representative Nemes is trying hard and that he is modifying and amending, and I think there is a path, but it is a narrow path," he said.
Stivers said that in the 20-plus studies that have been delivered to him, he has found there are "statistically significant indicators" to use medical marijuana, such as nausea from chemotherapy, or spasticity in people with multiple sclerosis. But he cautioned that the studies were small and of short duration, and he said there are better medicines for glaucoma, an eye condition that many medical-cannabis supporters mention.
He also said that like all medicine, the good must outweigh the bad, noting "statistically significant indicators" in studies showing marijuana exposure to those under 25 hurts brain development; that prolonged exposure increases the likelihood of psychotic experiences; that it has 50 percent more carcinogens in it than tobacco; and can cause heart disease.
"So, it becomes a balancing test," he said. "And nobody has really come, in my opinion, to give us that good path forward."
He added, "Does anybody here in this chamber or the other chamber want to see individuals suffer? No, we don't. But we also don't want to exacerbate a drug problem or a problem with cancers, heart disease, anything like that."
The 160-page medical-marijuana bills offer a list of conditions for which cannabis can be prescribed, such as terminal illness and epilepsy, but don't limit prescribing to those conditions, and would allow physicians to prescribe marijuana to their patients as long as they have a "bona fide" relationship.
The 11 sponsors of SB 107 are Sens. C.B. Embry Jr., R-Morgantown; Perry Clark, D-Louisville; Denise Harper Angel, D-Louisville; Jimmy Higdon, R-Lebanon; Morgan McGarvey, D-Louisville; Gerald Neal, D-Louisville; Michael Nemes, R-Shepherdsville; Dennis Parrett; D-Elizabethtown; Reginald Thomas, D-Lexington; and Robin Webb, D-Grayson.
A medical-marijuana bill passed the House Judiciary Committee 16-1 last year, but with only five days left in the legislative session and opposition in the Senate, it did not get a vote in the full House.
This year's House bill awaits a hearing in the House Judiciary Committee. The Senate bill has not yet been placed in a committee.
Marijuana is legal medicine in 33 states and the District of Columbia. Recreational marijuana is legal in 10 states, most recently Illinois, the first bordering Kentucky.
If approved, the medical marijuana program would start Jan. 1, 2021.
Unanimous Senate sends female genital mutilation ban to House
By Melissa Patrick
Kentucky Health News
A bill to ban female genital mutilation in Kentucky unanimously passed the Senate Jan. 22 and went to the House Judiciary Committee for consideration.
The sponsor of Senate Bill 72, Majority Caucus Chair Julie Raque Adams of Louisville, told senators that FGM has no health benefits and creates life-long physical and physiological harm. It is usually performed on girls between 4 and 14.
“Female genital mutilation is one of the most egregious forms of child abuse," Adams said. "It is internationally recognized as a violation of human rights and a form of discrimination against women."
Kentucky is one of 15 states where FGM is still legal. A federal ban that had been in place for more than two decades was found unconstitutional in 2018, putting the responsibility on states.
The United Nations Population Fund estimates that 200 million women and girls have suffered FGM. The federal Centers for Disease Control and Prevention estimates that 513,000 American females are at risk of FGM or have undergone it. In Kentucky, that number is estimated at 1,845, according to the Population Reference Bureau.
An FGM survivor named Jenny, who asked that her last name remain private, gave several reasons for the bill at the Jan. 15 Senate Health & Welfare Committee meeting.
She said a law banning the practice would offer support to women who are surrounded by people who still believe in it, but want to give their daughters "an out;" prompt women who have had FGM to ask questions, since many think it is done to all females; let people in other states know that Kentucky is not a "safe haven" for it; and promote badly needed education about it.
The bill would make FGM a felony if performed on a female under 18. It would ban trafficking girls across state lines for FGM, and revoke the licenses of medical providers convicted of the practice. It classifies FGM as a form of child abuse and would require mandatory reporting of it.
It would also mandate training for law enforcement and require the state Department for Public Health to produce and disseminate educational materials about it, and allow victims of the practice to file civil lawsuits up to 10 years after turning 18.
The bill had 12 sponsors, representing both parties. Click here for a fact sheet about FGM.
Kentucky Health News
A bill to ban female genital mutilation in Kentucky unanimously passed the Senate Jan. 22 and went to the House Judiciary Committee for consideration.
 |
| Sen. Julie Raque Adams |
“Female genital mutilation is one of the most egregious forms of child abuse," Adams said. "It is internationally recognized as a violation of human rights and a form of discrimination against women."
Kentucky is one of 15 states where FGM is still legal. A federal ban that had been in place for more than two decades was found unconstitutional in 2018, putting the responsibility on states.
The United Nations Population Fund estimates that 200 million women and girls have suffered FGM. The federal Centers for Disease Control and Prevention estimates that 513,000 American females are at risk of FGM or have undergone it. In Kentucky, that number is estimated at 1,845, according to the Population Reference Bureau.
An FGM survivor named Jenny, who asked that her last name remain private, gave several reasons for the bill at the Jan. 15 Senate Health & Welfare Committee meeting.
She said a law banning the practice would offer support to women who are surrounded by people who still believe in it, but want to give their daughters "an out;" prompt women who have had FGM to ask questions, since many think it is done to all females; let people in other states know that Kentucky is not a "safe haven" for it; and promote badly needed education about it.
The bill would make FGM a felony if performed on a female under 18. It would ban trafficking girls across state lines for FGM, and revoke the licenses of medical providers convicted of the practice. It classifies FGM as a form of child abuse and would require mandatory reporting of it.
It would also mandate training for law enforcement and require the state Department for Public Health to produce and disseminate educational materials about it, and allow victims of the practice to file civil lawsuits up to 10 years after turning 18.
The bill had 12 sponsors, representing both parties. Click here for a fact sheet about FGM.
The new coronavirus: What we do — and don’t — know
A rapidly evolving health story broke in late December when a novel illness originating in Wuhan, China made the news. Reports of the number of infected people swiftly rose, and isolated cases of this new coronavirus — dubbed 2019-nCoV by scientists — have appeared in several countries due to international travel. At this writing, almost 1,300 confirmed cases and over 40 deaths have occurred in China, according to an article in the New York Times.
Fortunately, public health officials in many countries, including the US, have put measures in place to help prevent further spread of the virus. These measures include health screenings at major airports in the US for people traveling from Wuhan. In China, travel restrictions are in effect.
With information changing so quickly and every news report about the virus seeming to raise the stakes, you may be wondering how worried you should be. Here’s a primer on what we do — and don’t — know about this virus and what it may mean for you. While there is much we don’t yet understand about the virus, public health officials, medical experts, and scientists are working in collaboration to learn more.
What is a coronavirus?
Coronaviruses are an extremely common cause of colds and other upper respiratory infections. These viruses are zoonoses, which means they can infect certain animals and spread from one animal to another. A coronavirus can potentially spread to humans, particularly if certain mutations in the virus occur.
Chinese health authorities reported a group of cases of viral pneumonia to the World Health Organization (WHO) in late December 2019. Many of the ill people had contact with a seafood and animal market in Wuhan, a large city in eastern China, though it has since become clear that the virus can spread from person to person.
What are the symptoms of this coronavirus?
The symptoms can include a cough, possibly with a fever and shortness of breath. There are some early reports of non-respiratory symptoms, such as nausea, vomiting, or diarrhea. Many people recover within a few days. However, some people — especially the very young, elderly, or people who have a weakened immune system — may develop a more serious infection, such as bronchitis or pneumonia.
How is it treated?
Scientists are working hard to understand the virus, and Chinese health authorities have posted its full genome in international databases. Currently, there are no approved antivirals for this particular coronavirus, so treatment is supportive. For the sickest patients with this illness, specialized, aggressive care in an intensive care unit (ICU) can be lifesaving.
Should you worry about catching this virus?
Unless you’ve been in close contact with someone who has the coronavirus — which right now, typically means a traveler from Wuhan, China who actually has the virus — you’re likely to be safe. In the US, for example, only two cases of the virus have been confirmed so far, although this is likely to change.
While we don’t yet understand the particulars of how this virus spreads, coronaviruses usually spread through droplets containing large particles that typically can only be suspended in the air for three to six feet before dissipating. By contrast, measles or varicella (chickenpox) spread through smaller droplets over much greater distances. Some coronaviruses also have been found in the stool of certain individuals.
So it’s likely that coughs or sneezes from an infected person may spread the virus. It’s too early to say whether another route of transmission, fecal-oral contact, might also spread this particular virus.
Basic infectious disease principles are key to curbing the spread of this virus. Wash your hands regularly. Cover coughs and sneezes with your inner elbow. Avoid touching your eyes, nose, or mouth with your hands. Stay home from work or school if you have a fever. Stay away from people who have signs of a respiratory tract infection, such as runny nose, coughing, and sneezing.
In the US, the average person is at extremely low risk of catching this novel coronavirus. This winter, in fact, we are much more likely to get influenza B — the flu — than any other virus: one in 10 people have influenza each flu season. It’s still not too late to get a flu shot, an easy step toward avoiding the flu. If you do get the flu despite having gotten the vaccine, studies show that severe illness, hospitalization, ICU admission, and death are less likely to occur.
The bottom line
Given the current spread of this virus and the pace and complexity of international travel, the number of cases and deaths will likely to continue to climb. We should not panic, even though we are dealing with a serious and novel pathogen. Public health teams are assembling. Lessons learned from other serious viruses, such as SARS and MERS, will help. As more information becomes available, public health organizations like the Centers for Disease Control (CDC) in the US and the World Health Organization (WHO) will be sharing key information and strategies worldwide.
The post The new coronavirus: What we do — and don’t — know appeared first on Harvard Health Blog.
Friday, January 24, 2020
Think hard before shaming children
As a parent, it’s easy to slip into shaming your child. It can happen so easily, as you blurt out what you are thinking:
“Do you really want to go out looking like that?”
“You let your teammates down during that game.”
“Why can’t you get good grades like your sister?”
“Why do you hang out at home all the time instead of going out like other kids?”
“Why are you crying? It’s not that bad.”
As we blurt out such things, we usually don’t think of them as shaming. We think of them as something that might help our child recognize a problem — and perhaps motivate them to change. We think of them as constructive criticism.
The line between criticism and shaming
The problem is that there is a fine line between criticism and shaming — and shaming is a bad idea. Here’s why:
- Sometimes children truly cannot change what is being shamed. Not everyone is a star student or athlete, we all make mistakes despite our best efforts, and some children are more sensitive or introverted than others, for example. We also can’t always change how we look, which is why fat-shaming is a terrible idea.
- Sometimes what is being shamed is part of a child’s identity. Clothing choices are a good example, especially for teens. So is how and with whom a child chooses to spend their time.
- Shaming may make children feel like they cannot change. Rather than motivating them, it may make them feel like they aren’t capable. And as a corollary and consequence…
- Shaming may make children feel bad about themselves. When the people you love the most, and whose opinion matters most, say bad things about you, it can be more than hurtful — it can affect your self-esteem in ways that can become ingrained and permanent.
How to put a stop to shaming
To prevent shaming, we need to stop and think before we speak. There are two things you should always ask yourself if you are about to criticize your child:
- Is this something they can change?
- Is it important that they change it?
Be really honest with yourself about the answers, especially to the second question. If the answer to either one is no, then it’s not something to criticize, end of story. Don’t take the risk of shaming or hurting your relationship with your child — and don’t waste your time or energy.
If the answer to both is yes, then ask yourself these questions:
- Is this a good place and time to say anything?
- Do they want to change this behavior?
Criticizing a child in public may be important, especially if they have been rude or hurtful to someone, or done something that could be unsafe. But outside of those circumstances, public criticism is shaming. It also may not be a great idea to criticize when a child is already upset, or when they are in a situation where they need to keep their composure or not be distracted; that’s less about shaming and more about being kind and effective.
If a child really doesn’t want to change a behavior, then you are going to have to think of a different way of managing it than just pointing it out. Which leads to the last and most important question:
- Is there a better way of changing this behavior?
The answer to that is most likely going to be yes.
We do best as parents when we take the time to understand why our children do what they do — and find collaborative, supportive ways to help them make safe, kind, and healthy choices. As parents, our words have power; as much as we can, we need to use that power for good.
Follow me on Twitter @drClaire
The post Think hard before shaming children appeared first on Harvard Health Blog.
Thursday, January 23, 2020
Medical News Today: Could a probiotic prevent or reverse Parkinson's?
Scientists recently tested probiotics in a roundworm model of Parkinson’s. A particular bacterium had a protective effect and improved symptoms.
Bill to raise legal age to purchase tobacco products from 18 to 21 passes state Senate 28-10, goes to House
By Melissa Patrick
The bill passed with a committee substitute adding language to make it better fit the federal law and remove penalties for 18- to 20-year-olds.
SB 56 allows the products to be confiscated and shifts the penalty to retailers who fail to adequately check buyers' identifications.
Senate Republican Caucus Chair Julie Raque Adams of Louisville praised the bipartisan bill, which is largely aimed at decreasing the epidemic of electronic-cigarette use among youth.
“We were so close to having nicotine be eliminated from one of the problems we had to add for our youth across the state," she said. "Unfortunately, with the introduction of vaping ... we now have an entire population that is addicted to nicotine once again.”
Between 2017 and 2019, e-cigarette use more than quadrupled among Kentucky's middle-school students and nearly doubled among its high-school students, with one in four high schoolers and one in five middle schoolers reporting monthly use; and one in 10 high school students reporting daily use.
A similar bill was introduced in the last legislative session, but tobacco-friendly senators blocked it. Some tobacco companies lobbied for it, and the federal change, to reduce pressure for regulation of electronic cigarettes.
Noting against Alvarado's bill were Sens. Matt Castlen, R-Owensboro; Perry Clark, D-Louisville; Stan Humphries, R-Cadiz; Robby Mills, R- Henderson; John Schickel, R-Union; Wil Schroder, R-Wilder; Damon Thayer, R-Georgetown; Robin Webb, D-Grayson; Stephen West, R-Paris; and Mike Wilson, R-Bowling Green.
Kentucky Health News
A bill to raise the legal age to purchase tobacco products, including electronic cigarettes, from 18 to 21 passed the state Senate 28-10 and went to the House.
Senate Bill 56, sponsored by Sen. Ralph Alvarado, R-Winchester, would bring Kentucky's statute in line with the new federal law raising the age to 21, which has already gone into effect.
It also removes status offenses for youth who purchase, use or possess tobacco products, which are often called PUP laws.
“The bottom line is this bill will reduce youth access to tobacco products, slash the number of kids who start using tobacco before age 18, decrease youth tobacco addiction and lead to lower tobacco-use rates overall as these teens grow and mature into adulthood,” said Alvarado, chair of the Senate Health and Welfare Committee.A bill to raise the legal age to purchase tobacco products, including electronic cigarettes, from 18 to 21 passed the state Senate 28-10 and went to the House.
 |
| Sen. Ralph Alvarado |
It also removes status offenses for youth who purchase, use or possess tobacco products, which are often called PUP laws.
The bill passed with a committee substitute adding language to make it better fit the federal law and remove penalties for 18- to 20-year-olds.
SB 56 allows the products to be confiscated and shifts the penalty to retailers who fail to adequately check buyers' identifications.
Senate Republican Caucus Chair Julie Raque Adams of Louisville praised the bipartisan bill, which is largely aimed at decreasing the epidemic of electronic-cigarette use among youth.
“We were so close to having nicotine be eliminated from one of the problems we had to add for our youth across the state," she said. "Unfortunately, with the introduction of vaping ... we now have an entire population that is addicted to nicotine once again.”
Between 2017 and 2019, e-cigarette use more than quadrupled among Kentucky's middle-school students and nearly doubled among its high-school students, with one in four high schoolers and one in five middle schoolers reporting monthly use; and one in 10 high school students reporting daily use.
A similar bill was introduced in the last legislative session, but tobacco-friendly senators blocked it. Some tobacco companies lobbied for it, and the federal change, to reduce pressure for regulation of electronic cigarettes.
Noting against Alvarado's bill were Sens. Matt Castlen, R-Owensboro; Perry Clark, D-Louisville; Stan Humphries, R-Cadiz; Robby Mills, R- Henderson; John Schickel, R-Union; Wil Schroder, R-Wilder; Damon Thayer, R-Georgetown; Robin Webb, D-Grayson; Stephen West, R-Paris; and Mike Wilson, R-Bowling Green.
First abortion bill of session clears committee; 2 more in hopper; Beshear administration lets Planned Parenthood apply for clinic
By Melissa Patrick
Kentucky Health News
A bill to require health care providers to do everything possible to save the life of a baby who is born alive has passed out of committee and now heads to the full Senate, where it is expected to pass.
The sponsor, Sen. Whitney Westerfield, R-Hopkinsville, paraphrased several Bible passages in his opening remarks, including one in which the prophet Jeremiah quotes God as telling him that He knew him before He formed him in the womb and meant him to be a prophet.
"Before we had a window into the womb through ultrasound, the Lord told us what was happening to that growing life -- for those who believe and follow God's word," Westerfield said.
His Senate Bill 9 would require health care providers give "medically appropriate and reasonable life-saving and life-sustaining medical care and treatment" to any infant born alive, including after a failed abortion, and would make it a felony for not doing so.
The bill, called the "Born Alive Infant Protection Act," passed Jan. 23 out of the Senate Veterans, Military Affairs and Public Protection Committee on a 9-0 vote, all of them Republicans. No one spoke in opposition to it. Westerfield filed a similar bill last year that passed the Senate, but ran out of time in the House. Eighteen of the 38 senators are sponsors.
Westerfield told reporters after the committee meeting that he was not aware of any instances in which an infant was born alive in Kentucky from a failed abortion and that the measure is needed to "prevent it from ever happening," Bruce Schreiner reports for The Associated Press.
Westerfield added that he's concerned about situations such as late-term abortions that are allowed in some states where an infant might survive, Deoborah Yetter reports for the Louisville Courier Journal. Kentucky law prohibits abortions after 20 weeks, before a fetus is considered viable.
In a letter to members of the committee, Kate Miller, advocacy director of the American Civil Liberties Union Foundation of Kentucky, called the bill an "unnecessary and dangerous piece of legislation" that "has nothing to do with how abortion care actually works and is based on false claims. Bills like these perpetuate myths and lies about abortion care, patients who receive this care, and the doctors who care for them."
Westerfield told the committee that he hopes Democratic Gov. Andy Beshear would sign the bill or let it become law without his signature, but if he vetoes it, "I look forward to overriding that veto." Gubernatorial vetoes can be overridden by majorities in each chamber, and Republicans have supermajorities in both.
Two other anti-abortion bills have been filed in the legislative session that began Jan. 7.
House Bill 67, sponsored by Rep. Joseph Fischer, R-Ft. Thomas, would amend the state constitution to specify that it includes no protection for abortion rights. It has been assigned to the House Elections, Constitutional Amendments & Intergovernmental Affairs Committee.
House Bill 142, sponsored by Rep. Lynn Bechler, R-Marion, would prohibit public money from going to any entity that performs, induces, refers for or counsels in favor of abortions. It has been assigned to the House Appropriations & Revenue Committee.
Last year, the Republican-led General Assembly passed four anti-abortion bills. Two have been delayed by legal challenges, including one that bans abortion once a heartbeat is detected (usually around six weeks of pregnancy) and one banning abortion due to gender, race or disability of a fetus.
A law that bans the most common second-trimester abortion procedure is also being challenged in the courts. This law was struck down by a federal judge, a decision that was appealed by the administration of then-Gov. Matt Bevin, a Republican.
In a Jan. 3 letter, the Beshear administration informed Planned Parenthood of Indiana and Kentucky that it could apply for a license to provide abortions at its clinic in downtown Louisville, Deborah Yetter reports for the Louisville Courier Journal.
That would be the second abortion provider in the state, in addition to EMW Women's Surgical Center in Louisville. An abortion clinic in Lexington closed after enforcement action by the Bevin administration, which denied Planned Parenthood's application and accused it in a lawsuit of providing 23 illegal abortions.
“Gov. Beshear’s administration recognized that our license had been wrongfully denied and that the previous administration didn’t follow the proper process," said Hannah Brass Greer, chief legal counsel for Planned Parenthood.
Planned Parenthood has denied that it provided illegal abortions, saying it was acting on instructions of the former administration led by then-Gov. Steve Beshear, Andy Beshear's father, who advised it to offer the procedure in order to be inspected for final action on the license.
The current Beshear administration has dropped the lawsuit, stating there was no failure to comply with the law, Yetter reports.
Kentucky Health News
A bill to require health care providers to do everything possible to save the life of a baby who is born alive has passed out of committee and now heads to the full Senate, where it is expected to pass.
 |
| Sen. Whitney Westerfield |
"Before we had a window into the womb through ultrasound, the Lord told us what was happening to that growing life -- for those who believe and follow God's word," Westerfield said.
His Senate Bill 9 would require health care providers give "medically appropriate and reasonable life-saving and life-sustaining medical care and treatment" to any infant born alive, including after a failed abortion, and would make it a felony for not doing so.
The bill, called the "Born Alive Infant Protection Act," passed Jan. 23 out of the Senate Veterans, Military Affairs and Public Protection Committee on a 9-0 vote, all of them Republicans. No one spoke in opposition to it. Westerfield filed a similar bill last year that passed the Senate, but ran out of time in the House. Eighteen of the 38 senators are sponsors.
Westerfield told reporters after the committee meeting that he was not aware of any instances in which an infant was born alive in Kentucky from a failed abortion and that the measure is needed to "prevent it from ever happening," Bruce Schreiner reports for The Associated Press.
Westerfield added that he's concerned about situations such as late-term abortions that are allowed in some states where an infant might survive, Deoborah Yetter reports for the Louisville Courier Journal. Kentucky law prohibits abortions after 20 weeks, before a fetus is considered viable.
In a letter to members of the committee, Kate Miller, advocacy director of the American Civil Liberties Union Foundation of Kentucky, called the bill an "unnecessary and dangerous piece of legislation" that "has nothing to do with how abortion care actually works and is based on false claims. Bills like these perpetuate myths and lies about abortion care, patients who receive this care, and the doctors who care for them."
Westerfield told the committee that he hopes Democratic Gov. Andy Beshear would sign the bill or let it become law without his signature, but if he vetoes it, "I look forward to overriding that veto." Gubernatorial vetoes can be overridden by majorities in each chamber, and Republicans have supermajorities in both.
Two other anti-abortion bills have been filed in the legislative session that began Jan. 7.
House Bill 67, sponsored by Rep. Joseph Fischer, R-Ft. Thomas, would amend the state constitution to specify that it includes no protection for abortion rights. It has been assigned to the House Elections, Constitutional Amendments & Intergovernmental Affairs Committee.
House Bill 142, sponsored by Rep. Lynn Bechler, R-Marion, would prohibit public money from going to any entity that performs, induces, refers for or counsels in favor of abortions. It has been assigned to the House Appropriations & Revenue Committee.
Last year, the Republican-led General Assembly passed four anti-abortion bills. Two have been delayed by legal challenges, including one that bans abortion once a heartbeat is detected (usually around six weeks of pregnancy) and one banning abortion due to gender, race or disability of a fetus.
A law that bans the most common second-trimester abortion procedure is also being challenged in the courts. This law was struck down by a federal judge, a decision that was appealed by the administration of then-Gov. Matt Bevin, a Republican.
In a Jan. 3 letter, the Beshear administration informed Planned Parenthood of Indiana and Kentucky that it could apply for a license to provide abortions at its clinic in downtown Louisville, Deborah Yetter reports for the Louisville Courier Journal.
That would be the second abortion provider in the state, in addition to EMW Women's Surgical Center in Louisville. An abortion clinic in Lexington closed after enforcement action by the Bevin administration, which denied Planned Parenthood's application and accused it in a lawsuit of providing 23 illegal abortions.
“Gov. Beshear’s administration recognized that our license had been wrongfully denied and that the previous administration didn’t follow the proper process," said Hannah Brass Greer, chief legal counsel for Planned Parenthood.
Planned Parenthood has denied that it provided illegal abortions, saying it was acting on instructions of the former administration led by then-Gov. Steve Beshear, Andy Beshear's father, who advised it to offer the procedure in order to be inspected for final action on the license.
The current Beshear administration has dropped the lawsuit, stating there was no failure to comply with the law, Yetter reports.
Mental health first-aid training bill passes state House
By Melissa Patrick
Kentucky Health News
A bill to create a training program for mental-health first aid has unanimously passed the stae House and is in the Senate.
House Bill 153, sponsored by Rep. Kim Moser, R-Taylor Mill, would train people in how to best address the needs of someone experiencing a mental-health or substance-use crisis.
“The Mental Health First Aid Act will put this evidence-based training program in the hands of educators, law enforcement, first responders, military personnel, our faith leaders—really anyone who interacts with the general public and anyone at risk,” said Moser, who chairs the House Health and Family Services Committee.
Moser noted that mental health is the underlying cause of many issues in society, such as substance-use disorder, suicide and violence.
To that point, she said Kentucky has a high rate of substance misuse and addiction problems, with 1,333 people dying from a drug overdose in 2019. She added that in 2017, 766 Kentuckians died by suicide and noted that suicide is the second leading cause of death for people ages 15 to 34 and the U.S. suicide rate for veterans is 17 per day.
She said the objectives of the program are to build mental health and substance use literacy and to help the public identify, understand and respond to the early signs of mental health issues.
The curriculum is already being used in pockets of the state and this program will take it statewide, she said. She added that the certification does not replace a licensed counselor and is not mandated.
The training would be administered by the Cabinet for Health and Family Services and would be paid for through a trust, funded with state and federal appropriations, grants and private donations.
“Any money in this trust fund would be used specifically for this training program or suicide prevention programs,” she said.
Rep. Mary Lou Marzian, D-Louisville, a nurse, praised the legislation, but voiced concern that there was no funding allocated for it. She called on the lawmakers to find a way to fund it other than "begging for donations and handouts."
"I think that is a very poor way to try to fund one of the most important pieces of legislation [for] the neediest of our citizens with substance abuse issues and mental illness," Marzian said.
Kentucky Health News
A bill to create a training program for mental-health first aid has unanimously passed the stae House and is in the Senate.
 |
| Rep. Kim Moser |
“The Mental Health First Aid Act will put this evidence-based training program in the hands of educators, law enforcement, first responders, military personnel, our faith leaders—really anyone who interacts with the general public and anyone at risk,” said Moser, who chairs the House Health and Family Services Committee.
Moser noted that mental health is the underlying cause of many issues in society, such as substance-use disorder, suicide and violence.
To that point, she said Kentucky has a high rate of substance misuse and addiction problems, with 1,333 people dying from a drug overdose in 2019. She added that in 2017, 766 Kentuckians died by suicide and noted that suicide is the second leading cause of death for people ages 15 to 34 and the U.S. suicide rate for veterans is 17 per day.
She said the objectives of the program are to build mental health and substance use literacy and to help the public identify, understand and respond to the early signs of mental health issues.
The curriculum is already being used in pockets of the state and this program will take it statewide, she said. She added that the certification does not replace a licensed counselor and is not mandated.
The training would be administered by the Cabinet for Health and Family Services and would be paid for through a trust, funded with state and federal appropriations, grants and private donations.
“Any money in this trust fund would be used specifically for this training program or suicide prevention programs,” she said.
Rep. Mary Lou Marzian, D-Louisville, a nurse, praised the legislation, but voiced concern that there was no funding allocated for it. She called on the lawmakers to find a way to fund it other than "begging for donations and handouts."
"I think that is a very poor way to try to fund one of the most important pieces of legislation [for] the neediest of our citizens with substance abuse issues and mental illness," Marzian said.
Ads touting McConnell's record on surprise billing, Medicare for All could be a surprise of their own, since they confuse the issues
 |
| This ad promoting Sen. Mitch McConnell conflates the issues of surprise billing and Medicare for All. |
Kentucky Health News
A conservative group has started television and radio commercials in Kentucky and other states thanking Senate Majority Leader Mitch McConnell and others in Congress for blocking legislation that would offer consumers some protection from surprise medical bills.
While that may not sound politically advantageous to the senator's re-election campaign, the ads conflate and confuse the surprise-billing issue with the much more prominent "Medicare for All" proposal, which is favored by the most liberal Democratic presidential candidates.
The TV ad says, "Some politicians are too scared to stand up to the special interests. But not Mitch McConnell. He fights for us, like on health care and surprise medical billing. Special-interest groups have tried to use the issue to implement a government-run Medicare for All scheme, putting our hospitals and care at risk. But Mitch said NO, because he knows how devastating that would be, for us and our children. So, thank you, Mitch McConnell, for putting patients first."
The Taxpayers Protection Alliance said that in December, McConnell "and legislative allies halted attempts by members of Congress such as Sen. Lamar Alexander (R-Tenn.) and Rep. Frank Pallone (D-N.J.) to have the government impose rate-setting in cases of surprise medical billing. Surprise bills occur when patients receive unwanted and unexpected healthcare bills in the mail days or even weeks after a hospital room visit."
Yes, but the surprise-billing issue has little if anything to do with "Medicare for All," one possible exception being that proponents of the latter cite the former as one problem it would solve. TPA says the two are related this way: "Surprise medical billing is only an issue because of rampant government intervention in the medical sector due to Obamacare and Medicare’s disastrous rural price controls. This is a problem that was specifically caused by misguided government intervention. In fact, three-quarters of Obamacare networks are now considered ‘narrow’ with few choices for patients, leading to many patients receiving ‘surprise bills.’"
TPA says its campaign in Kentucky, Kansas, Texas, and New York is intended to thank McConnell "and like-minded lawmakers for standing up for patients and opposing the federal government dictating health-care prices across the country."
This isn't the first time that a group with undisclosed sources of money has tried to mischaracterize the issue of surprise billing. Last summer, a "dark money" group called Doctor Patient Unity ran an ad campaign in Kentucky and other states saying that Alexander's bill would hurt patients and help insurance companies. The campaign targeted McConnell, Sen. Rand Paul and six other senators.
The TV ad says, "Some politicians are too scared to stand up to the special interests. But not Mitch McConnell. He fights for us, like on health care and surprise medical billing. Special-interest groups have tried to use the issue to implement a government-run Medicare for All scheme, putting our hospitals and care at risk. But Mitch said NO, because he knows how devastating that would be, for us and our children. So, thank you, Mitch McConnell, for putting patients first."
The Taxpayers Protection Alliance said that in December, McConnell "and legislative allies halted attempts by members of Congress such as Sen. Lamar Alexander (R-Tenn.) and Rep. Frank Pallone (D-N.J.) to have the government impose rate-setting in cases of surprise medical billing. Surprise bills occur when patients receive unwanted and unexpected healthcare bills in the mail days or even weeks after a hospital room visit."
Yes, but the surprise-billing issue has little if anything to do with "Medicare for All," one possible exception being that proponents of the latter cite the former as one problem it would solve. TPA says the two are related this way: "Surprise medical billing is only an issue because of rampant government intervention in the medical sector due to Obamacare and Medicare’s disastrous rural price controls. This is a problem that was specifically caused by misguided government intervention. In fact, three-quarters of Obamacare networks are now considered ‘narrow’ with few choices for patients, leading to many patients receiving ‘surprise bills.’"
TPA says its campaign in Kentucky, Kansas, Texas, and New York is intended to thank McConnell "and like-minded lawmakers for standing up for patients and opposing the federal government dictating health-care prices across the country."
The proposed legislation "doesn’t set actually set rates for out-of-network procedures, but instead sets benchmarks for how much out-of-network providers can collect if a surprise bill shows up," health journalist Trudy Lieberman notes. "But in a TV ad that lasts a few seconds, how would the viewer be able to make that distinction?"
This isn't the first time that a group with undisclosed sources of money has tried to mischaracterize the issue of surprise billing. Last summer, a "dark money" group called Doctor Patient Unity ran an ad campaign in Kentucky and other states saying that Alexander's bill would hurt patients and help insurance companies. The campaign targeted McConnell, Sen. Rand Paul and six other senators.
