John Wecker

Pacific Northwest Diabetes Research Institute (PNDRI) announced today that John Wecker, PhD has been appointed president and CEO.

Dr. Wecker was most recently Global Program Leader, Vaccine Access and Delivery at PATH.

PNDRI is an independent non-profit biomedical and clinical research center that focuses on eliminating diabetes and its complications.

The Institute, which has a team of 85 physicians, scientists and technical staff, was founded in Seattle in 1956 by Dr. William Hutchinson, Sr., who also founded the Fred Hutchinson Cancer Research Center.

Before he joined PATH, Dr. Wecker worked for Boehringer Ingelheim, a global pharmaceutical company, where he led pharmaceutical product development teams and championed the company’s efforts to expand access to treatments for HIV/AIDS in the developing world.

During this time he established a program to provide medication for the prevention of mother-child transmission of HIV/AIDS, free of charge to over 120 countries around the world.

Dr. Wecker received his doctorate in Biological Psychology from the University of Rochester, Rochester, NY.

Dr. Wecker succeeds Dr. Jack Faris, who has been serving as acting CEO during the past eighteen months. Dr. Faris will remain part of the PNDRI team as a strategic advisor.

Dr. Wecker will begin at PNDRI on April 23^rd.

To learn more:

• For more information about PNDRI, visit www.pndri.org or call (206) 726-1200.

Photo by Brainloc

By Randy Dotinga, Contributing Writer
Health Behavior News Service 

Single, middle-aged people who live alone spend more time sitting.  A new study, published in the American Journal of Preventive Medicine discovered that men tended to sit for longer periods watching TV on the weekends while women sat for longer periods doing activities such as reading or dining out.

Unemployed people tended to spend more time sitting than employed people.

Sitting habits, which lead to risks of poor health, were found to vary by gender, age, health status and during weekdays versus weekends.

“Sitting is not the same for everyone,” said study lead author Nicola Burton, Ph.D., a senior research fellow at The University of Queensland. “If we want to identify who does prolonged sitting, we need to think about the context of sitting and take into account group differences.”

Key Points:

• Single people who live alone or have health restrictions spend the most time sitting on a daily basis.

• Men spend more time sitting while watching TV or using the home computer, while women spend more seated time doing other leisure activities, like reading or eating out.

• People without jobs spend more time sitting than people who are employed full-time.

It’s important to study sitting habits because research has begun to link them to health problems, Burton said. “While people may associate prolonged sitting with muscular problems such as back and neck pain, research evidence is emerging to suggest that prolonged sitting a total of more than 6-8 hours a day or watching television more than 4 hours a day is in itself also potentially harmful for cardiovascular and metabolic health.”

Among other things, she said, researchers have linked lots of sitting to high blood pressure, heart problems, diabetes and higher death rates. Studies suggest that sitting causes problems even in people who exercise, she said.

The study authors analyzed survey responses from 7,719 people aged 40 to 65 in Australia who were asked about their daily activities. The researchers found that people sit longer on weekends than on weekdays, and sitting habits among groups differed depending on what they did while sitting. The findings would probably be similar in other Western countries like the United States, Burton said.

“The next step is to develop and evaluate strategies to reduce sitting time, and see what works for whom, and in what context,” she said. “This is different from strategies to increase exercise, as sitting time can be exchanged for things other than exercise.”

Is it really possible to neither sit nor exercise? Yes, Burton said. “Some research is suggesting that interrupting sitting time is important, so people could think about how to break up sitting for light activity that is not exercise, like doing things around the house during TV commercial breaks or taking standing or walking breaks during the working day.”

Susan B. Sisson, an assistant professor who studies diet and exercise at the University of Oklahoma said the findings are important because they can be used to figure out how best to coax people to not sit so much. “For example, this study found that individuals that are single and living alone sit more… A media campaign telling people to do on a walk with their spouse would likely not be as effective in this group.”

For more photos by Brainloc go here.

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

Photo Dan Shirley

By Julie Appleby
KHN Staff Writer

While controversy over one aspect of the Obama administration’s contraception rule – whether and when religiously affiliated employers must comply – has dominated recent headlines, that debate has obscured other questions about how the rules will actually be implemented.

Under the health law, insured women will qualify for contraceptives without a copaymentas part of a range of preventive medical services. But insurers and advocates are frustrated by the lack of details. They’re asking, for example, whether surgical procedures must also be covered at no additional cost to patients.

“The unknown answers to the myriad of questions remain very worrisome,” says Judith Lichtman, senior advisor to the National Partnership for Women and Families, an advocacy group in Washington D.C.

America’s Health Insurance Plans (AHIP), the industry lobbying group, sent a list of questions to the Department of Health and Human Services (HSS) in September, asking for clarification on what types of contraceptives must be covered and how insurers should structure their policies. A spokesman for AHIP says the group is still awaiting answers to some questions.

Contraceptives are part of a package of women’s preventive health care services under the Affordable Care Act — including screening for diabetes, counseling about sexually transmitted diseases and breast feeding support — that must be provided without deductibles or co-pays in all new policies beginning Aug. 1. The package was drawn up after recommendations from the Institutes of Medicine (IOM). Other parts of the health law also provide no-cost-sharing preventive services for children and all adults, such as certain cancer screenings and immunizations.

Here are some questions, and answers when we could determine them, about the rules:

1) Are male-based contraceptive methods, such as vasectomies or condoms, covered by the rule?

An HHS official said on Friday that women’s preventive services guidelines apply to women only.

Guidelines issued by the Health Resources and Services Administration, part of HHS, require coverage without cost sharing for “all Food and Drug Administration-approved contraceptive methods, sterilization procedures and patient education and counseling for all women with reproductive capacity” as prescribed by a provider, according to the Federal Register.

The insurers’ letter from September says they interpreted the rule to include only female-based contraception and that the requirement to waive co-payments “does not apply to methods and procedures intended for males.”

But Adam Sonfield, senior public policy associate at the Guttmacher Institute, a reproductive health research group, says the language is unclear, and it would be foolish to exclude vasectomies. For one thing, he says, they are less expensive and pose a lower risk of complications than female surgical sterilization methods. Plus, he says, waiving co-payments for services for one sex but not the other raises issues of discrimination.

“I can’t see how it would be in anyone’s interest to treat them differently,” says Sonfield.

2) Are over-the-counter products like female condoms, spermicides, sponges covered by the rules and, if so, will they require a prescription and how will insurers reimburse policyholders for purchases at retail stores?

Products that must be covered without cost-sharing include over-the- counter contraceptives when they are prescribed by doctors, the HHS official said Friday. But getting a prescription for such items raises other issues, say advocates and insurers.

Insurers wrote HHS in September that “it is unclear what specific over-the-counter products are to be included.”

In addition, the letter warned that requiring a prescription for such items “would increase the burden on an already over-burdened primary care system and drive up administrative costs.”

Insurers wrote the industry has no simple way to track and reimburse policyholders who purchase those items at retail stores. Setting up such systems, “could cost tens of millions” and exceed the cost of the products themselves.

Requiring a prescription should definitely not be required, says Lichtman, who said such a move would make using contraception more difficult and expensive for women.

3) If a hospital stay is required for surgical procedures, such as when a women gets her tubes tied, would the procedure be covered without cost sharing?

Insurers say it is not clear if hospitalization or complications that might occur from surgery would be covered without the patient paying a co-payment or a deductible because they are not considered preventive.

Sonfield at Guttmacher argues they would be covered.

“It’s like saying you have to cover blood transfusions, but not the hospital stay,” he says. “That doesn’t make sense. If you’re covering it, you’re covering it all.”

HHS has not weighed in on this question, but is expected to issue additional guidance in the coming months.

Julie Appleby reports on the implementation of the health care overhaul law, the interplay of health care treatments and costs, trends in health insurance, and policy issues affecting hospitals and other medical providers. Her KHN stories have appeared in USA Today, the Washington Post, the Philadelphia Inquirer and MSNBC, among others. Before joining KHN in March 2009, Appleby spent 10 years on the health care industry and policy beat for USA Today. She also worked at the San Francisco Chronicle, the Financial Times in London and the Contra Costa Times in Walnut Creek, Calif. She serves on the board of the Association of Health Care Journalists and her education includes a Master of Public Health degree. | Contact: JulieA@kff.org

4) Will insurers be required to cover all products in a class, such as all IUDs, or all birth control pills? Can insurers require a co-pay for a brand-name drug if a generic is available?

Many insurers have “tiered” pharmacy benefits under which patients pay differing amounts for brand-name, as opposed to generic, products. Some require patients who choose a brand-name drug, when an equivalent generic is available, to pay the price difference between the two. Insurers say HHS guidance allows them to use such “reasonable medical management” to help control costs. That would include allowing insurers to charge patients for brand name drugs, it says.

The HHS official confirmed that, but stressed the plan must “accommodate any individuals for whom it would be medically inappropriate by having a mechanism for waiving the otherwise applicable cost-sharing for the branded version.”

Advocacy groups and insurers are in discussions with HHS over those and other questions related to preventive care, says Lichtman. Her group hopes the agency will soon release additional guidelines that “are broad enough so that all methods prescribed by doctors necessary for women’s health will be covered.”

5) Who will be covered for contraceptives without co-payments?

The package of women’s preventive care benefits must be offered in all new insurance policies sold to individuals and employers starting Aug. 1, as well as in most policies that renew afterwards on the date that they renew. There is an exception for insurance provided by certain nonprofit religious employers who object to birth control.

Twenty-eight states already require insurers to cover contraceptives, although large, self-insured employers are generally exempted from state rules. But a 2010 Kaiser Family Foundation/HRET survey of employers found that 85 percent of large firms offered prescription contraceptives in their plans, although they often required a patient co-pay or deductible. (KHN is a program of the foundation)

As for the types of procedures covered, the IOM cites a 2011 Bureau of Labor Statistics analysis of 3,900 employer plans, which found that policy documents representing about 70 percent of participants did not mention sterilization. But when sterilization services were mentioned, nearly 90 percent of the policies covered both female and male surgical sterilization procedures.

PHOTO: Courtesy of Dan Shirley

KHN wants to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

By Carolyn M. Clancy, M.D.

February 7, 2012

With Valentine’s Day around the corner, hearts shapes are everywhere – on cards, candy, and clothing. But every day of the year, your heart plays a big role in your health and well-being. And conditions or habits that harm our hearts, like high blood pressure or smoking, put our hearts at risk.

The risk is serious. Heart disease and strokes kill more than 800,000 Americans each year and cost $445 billion each year, according to the Department of Health and Human Services (HHS) (PDF File, PDF Help). People with heart disease are often unable to work or enjoy normal activities. They are also at higher risk of early death.

To help combat heart disease, especially heart attack and stroke, HHS recently joined several groups that include doctors, nurses, pharmacists, insurance companies, and drug stores in a campaign called Million Hearts.

Over the next 5 years, the partners aim to help millions of Americans improve their heart health by preventing and treating high blood pressure, high cholesterol, and tobacco use.

The goals are ambitious. But the good news is that heart disease can be prevented or reduced with two approaches.

The first is making healthy choices, like quitting smoking (or never starting), and lowering the amount of salt and trans fats we consume. Today, 19 percent of the U.S. population smokes; in 5 years, the partnership aims to cut that to 17 percent.

The second approach is making treatment for heart disease available for people who need it. Simple but effective techniques, known as the “ABCS,” help focus these efforts. The ABCS stand for: Aspirin for people at risk, Blood pressure control, Cholesterol management, and Smoking cessation.

We have good tools to treat heart disease, but they’re not used enough. Today, less than half (47 percent) of people at risk for heart disease take a daily aspirin. The Million Hearts campaign hopes to increase that to 65 percent by 2017. Reducing salt intake, a factor in high blood pressure, by 20 percent, is another goal.

HHS is working with partners to help attain the Million Hearts goals. The partners include:

• The American Heart Association  is offering access to online tools , including one that helps you understand your heart health.

• America’s Health Insurance Plans  and its members are hosting programs to reduce heart disease with programs that promote fitness, lower obesity and manage chronic disease.

• The Y is expanding coverage of its diabetes prevention program  and other national disease prevention programs to better address risks for diabetes, heart attack, and stroke.

My Agency, the Agency for Healthcare Research and Quality (AHRQ), supports the Million Hearts campaign and has tools and knowledge that can support its goals.

For example, one AHRQ-funded resource that highlights innovative practices describes how pharmacists can help people lower their risk for heart disease.

In the HealthyHeartClub.com program, pharmacists educate patients to lower their heart risk by changing their diet, exercising more, and taking the right medicines. Working with primary care doctors, pharmacists meet with patients, email them weekly, and provide access to classes and tools that support their goals. It works! After 3 months, patients’ weight, blood pressure, and daily activity all improved.

AHRQ’s Effective Health Care Program produces free, plain-language booklets that can help you learn about treatment options for high blood pressure and high cholesterol. They describe treatment options, discuss risks and benefits, and identify areas where more research is needed.

All these resources for the Million Hearts initiative have one thing in common—they are an excellent source of information to share with your health care provider. Together, you can discuss steps you need to take to be sure you’re healthy for many more Valentine’s Days in the future.

I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.

Resources

U.S. Department of Health and Human Services: Million Hearts

New public-private initiative aims to prevent 1 million heart attacks and strokes in five years
http://millionhearts.hhs.gov/docs/Million_Hearts_Press_Release.pdf [PDF Help]

Million Hearts
http://millionhearts.hhs.gov/

Heart Disease Prevention: Million Hearts
http://millionhearts.hhs.gov/about-hd-prevention.shtml

Agency for Healthcare Research and Quality

AHRQ Innovations Exchange: Innovation Profile
http://innovations.ahrq.gov/content.aspx?id=3182

Effective Health Care Program

Choosing Medications for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=75

Treating High Cholesterol: A Guide for Adults
http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=351

American Heart Association

AHA
http://www.heart.org/HEARTORG/

American Heart Association/American Stroke Association 

My Life Check
http://50.56.33.51/mlc01/main_en_US.html

America’s Health Insurance Plans (AHIP)

AHIP Statement on Million Hearts Initiative
http://www.ahip.org/News/Press-Room/2011/AHIP-Statement-on-Million-Hearts-Initiative.aspx

The Y

The Y Joins CDC, HHS, CMS in Million Hearts Initiative
http://www.ymca.net/news-releases/20110913-cdc.html

Current as of February 2012

Internet Citation:

Million Hearts Campaign Aims to Lower Risk, Improve Care. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, February 7, 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc020712.htm

From NIH News in Health 

February is American Heart Month—a time to reflect on the sobering fact that heart disease remains the number one killer of both women and men in the United States.

The good news is you have the power to protect and improve your heart health.

NIH and other government agencies have been working to advance our understanding of heart disease so that people can live longer, healthier lives. Research has found that you can lower your risk for heart disease simply by adopting sensible health habits.

To protect your heart, the first step is to learn your own personal risk factors for heart disease. Risk factors are conditions or habits that make you more likely to develop a disease. Risk factors can also increase the chances that an existing disease will get worse.

Certain risk factors—like getting older or having a family history of heart disease—can’t be changed. But you do have control over some important risk factors such as high blood cholesterol, high blood pressure, smoking, excess weight, diabetes and physical inactivity. Many people have more than one risk factor.

To safeguard your heart, it’s best to lower or eliminate as many as you can because they tend to “gang up” and worsen each other’s effects.

A large NIH-supported study published last month underscores the importance of managing your risk factors. Scientists found that middle-aged adults with one or more elevated risk factors, such as high blood pressure, were much more likely to have a heart attack or other major heart-related event during their remaining lifetime than people with optimal levels of risk factors.

“For example, women with at least 2 major risk factors were 3 times as likely to die from cardiovascular disease as women with none or 1 risk factor,” says Dr. Susan B. Shurin, acting director of NIH’s National Heart, Lung and Blood Institute. “You can and should make a difference in your heart health by understanding and addressing your personal risk.”

Protect Your Heart

• Don’t smoke.

• Maintain healthy cholesterol levels and blood pressure.

• Maintain a healthy weight.

• Choose more heart-healthy foods.

• Get and stay active.

• Know your family history.

• Learn the signs that something’s wrong.

• Set a good example.

To tackle your heart risk factors, it helps to know your numbers. Ask your health care provider to measure your blood cholesterol and blood pressure. Then determine if your weight is in the healthy range.

The higher your cholesterol level, the greater your risk for heart disease or heart attack. High blood cholesterol itself doesn’t cause symptoms, so you can’t know if your cholesterol is too high unless you have it tested. Routine blood tests can show your overall cholesterol level and separate levels of LDL (“bad”) cholesterol, HDL (“good”) cholesterol and triglycerides. All of these blood measurements are linked to your heart health.

High blood pressure (hypertension) is another major risk factor for heart disease, as well as for stroke. High blood pressure is often called the “silent killer” because, like high cholesterol, it usually has no symptoms. Blood pressure is always reported as 2 numbers, and any numbers above 120/80 mmHg raise your risk of heart disease and stroke.

“Scientific evidence is strong that controlling high blood cholesterol and high blood pressure prevents cardiac events such as heart attacks,” says Dr. Michael Lauer, a heart disease specialist at NIH.

Your weight is another important number to know. To find out if you need to lose weight to reduce your risk of heart disease, you’ll need to calculate your body mass index (BMI, a ratio of weight to height). This NIH web page can help: www.nhlbisupport.com/bmi/bmicalc.htm. A BMI between 25 and 29.9 means that you’re overweight, while a BMI of 30 or higher means obesity.

Next, take out a tape measure. A waist measurement of more than 35 inches for women and 40 inches for men raises the risk of heart disease and other serious health conditions. Fortunately, even a small weight loss (between 5% and 10% of your current weight) can help lower your risk.

NIH has many tools available to help you aim for a healthy weight, including physical activity tips and a menu planner. To learn more, visit http://healthyweight.nhlbi.nih.gov/.

A heart-healthy diet includes a variety of fruits, vegetables and whole grains, as well as lean meats, poultry, fish, beans and fat-free or low-fat dairy products. Try to avoid saturated fat, trans fat, cholesterol, sodium (salt) and added sugar.

NIH’s Therapeutic Lifestyle Changes (TLC) and Dietary Approaches to Stop Hypertension (DASH) diets both promote healthy eating. U.S. News & World Report named TLC and DASH the top 2 overall diets for 2012.

Regular physical activity is another powerful way to reduce your risk of heart-related problems and enjoy a host of other health benefits. To make physical activity a pleasure rather than a chore, choose activities you enjoy. Take a brisk walk, play ball, lift light weights, dance or garden. Even taking the stairs instead of an elevator can make a difference.

Resources for further information and tips

“At least 2 and a half hours a week of moderate-intensity physical activity can lower your risk of heart disease, stroke, hypertension and diabetes—a winner on multiple counts,” says Dr. Diane Bild, a cardiovascular epidemiologist at NIH.

If you have diabetes, it’s important to keep your blood sugar, or glucose, under control. About two-thirds of people with diabetes die of heart or blood vessel disease. If you’re at risk for diabetes, modest changes in diet and level of physical activity can often prevent or delay its development.

If you happen to be a smoker, the best thing you can do for your heart is stop. People who smoke are up to 6 times more likely to suffer a heart attack than nonsmokers. The risk of heart attack increases with the number of cigarettes smoked each day.

The good news is that quitting smoking will immediately begin to reduce your risk, and the benefit in reduced risk will continue to increase over time. Just one year after you stop smoking, your risk will have dropped by more than half.

Beyond controlling your risk factors, you should be alert to certain symptoms and get checked by a doctor. Common signals that something‘s wrong with your heart include angina—pain in the chest, shoulders, arms, neck, jaw or back—as well as shortness of breath, irregular heartbeat or palpitations (arrhythmia)
and fatigue.

Be aware that the symptoms of a heart attack can vary from person to person. If you’ve already had a heart attack, your symptoms may not be the same if you have another one.

Finally, don’t forget that you can influence your loved ones’ heart health by setting an example. Do you have children, grandchildren or other young people who look up to you? If you follow a heart-healthy lifestyle, it’s more likely that they will, too.  Because heart disease begins in childhood, one of the best things you can do for those you love is to help children build strong bodies and healthy habits.

The bottom line is, it’s never too late to take steps to protect your heart. It’s also never too early. Start today to keep your heart strong. Talk to your doctor about your risk and to create an action plan. Love your heart.