The great e-cig debate

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Fred Hutch and SCCA experts weigh in on the good, bad and ugly of the electronic cigarette quandary

By Diane Mapes / Fred Hutch News Service

Jenny McCarthy

TV personality Jenny McCarthy is a paid spokesperson for Blu eCigs. Photo by Blu eCigs

Since electronic cigarettes were introduced to the world a decade ago, they have grabbed headlines, frustrated physicians and thoroughly confused consumers.

“Our patients are highly motivated to quit, but they’re confused about the mixed messages of e-cigarettes,” said Donna Manders, a certified tobacco treatment specialist at Seattle Cancer Care Alliance. “A lot of them believe the hype that is out there, that these must be safe because they’re being sold everywhere.”

Unfortunately, there are far more advertisements, celebrity spokesmodels (like anti-vaccine advocate Jenny McCarthy) and new brands of e-cigs than strong, evidence-based studies.

“There’s a lot of excitement but very little data,” said Jonathan Bricker, psychologist and smoking cessation researcher in the Public Health Sciences division of Fred Hutchinson Cancer Research Center. “The FDA has to regulate the device before a researcher can conduct a trial on its efficacy for smoking cessation and the devices aren’t regulated yet. We’re in a Catch-22.” Continue reading

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Barriers hinder Asian-Americans and Pacific Islanders seeking insurance, report

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By Shefali Luthra
KHN / September 24

Language and cultural issues, along with immigration concerns, could still pose major barriers to enrolling Asian-Americans, Native Hawaiians and Pacific Islanders in health insurance plans this fall, according to a report released Wednesday by Action for Health Justice, an advocacy coalition that aims to educate these populations about the health law.

The report argues that efforts to enroll people from those ethnic groups were undermined last year by ineffective translations of health law guides; limited language options on the federal online marketplace, healthcare.gov; insufficient training for enrollment assisters and complications in processing applicants’ immigration information.

If those issues are not addressed by this year’s open enrollment – which begins Nov. 15 – they will likely continue to be a roadblock to expanding coverage, according to the report. Continue reading

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Rise in US diabetes rates slow – CDC

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From the US Centers for Disease Control and Prevention

Glucometer showing a blood sugar of 105New CDC data published in the Journal of the American Medical Association, JAMA, suggest that after decades of continued growth in cases of diagnosed diabetes, the rate of increase may be slowing from year to year.

The study, “Prevalence and Incidence in Trends for Diagnosed Diabetes Among Adults Aged 20 to 79 Years, United States, 1980–2012,” was published today.

“Our findings suggest that, after decades of continued growth in the prevalence and incidence of diagnosed diabetes, the diabetes epidemic may be beginning to slow for the first time,” said Linda Geiss, a chief epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study.

What This Means:

  • About 1.7 million new cases are diagnosed each year. For the first time, this study shows that number is not getting bigger every year, as in years past, but the numbers are still alarmingly high.
  • These data suggest a change in momentum, a turning of the tides. Now is not the time to let up. Although this news inspires hope, there is still much work to be done.
  • The rate of increase may be slowing from year to year, but diabetes is an urgent public health epidemic, affecting more than 29 million Americans.
  • Although overall growth rates of diagnosed diabetes seem to be slowing, the rate of increase of new cases continues to rise among some groups including:
    • Non-Hispanic blacks.
    • Hispanic men and women, and
    •  People with less than a high school education.

“While this news is encouraging, our work is more important now than ever,” says Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “These evolving trends show we’re moving in the right direction, but millions of people are still diagnosed with diabetes yearly. We need to fortify our efforts to see a real, sustained decrease in new cases of diagnosed diabetes.”

What You Can Do:

Reducing new cases of diabetes is unlikely without continuing to reduce obesity, improve diet, and reduce sedentary lifestyle in the U.S. population, and particularly in those at high risk of developing diabetes. Long-term lifestyle change programs—like the CDC-managed National Diabetes Prevention Program—can help those at high risk of developing the disease.

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Health news headlines – September 24th

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Credit: Dan Shirly

Credit: Dan Shirly

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Global health news – September 24th

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Globe floating in air

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King County budget breakdown: Broken tax system leads to public health cuts – Puget Sound Business Journal

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Map of SeattleSpecific cuts include health clinic closures, services reductions, and testing for HIV and sexually transmitted diseases. The county will also reduce outreach to patients with chronic problems such as obesity and smoking.

via King County budget breakdown: Broken tax system leads to deeper cuts – Puget Sound Business Journal.

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Number of insurers on exchanges to rise 25 percent, HHS Says

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ACA health reform logoBy Mary Agnes Carey
KHN

The number of health insurance companies offering plans in the insurance exchange marketplaces this fall will increase by 25 percent, giving consumers more choices for coverage, Health and Human Services Secretary Sylvia Burwell announced Tuesday.

When the marketplace enrollment reopens in November, 77 new insurers will be offering coverage in the 44 states for which HHS had data, which includes the 36 states that use the federal marketplace and eight states that run their own, the department reported.

The number of competitors on the marketplaces is considered important because it signifies the vitality of the exchange and can mean increased competition and lower prices for consumers.

It also means that insurers see the health law’s online marketplaces or exchanges, as a good business opportunity, senior HHS officials said. Continue reading

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A new look at why surgical rates vary

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surgeons performing surgery in operating roomBy Michael Ollove
Stateline

Several years ago, a California study showed that a half-dozen elective surgeries were being performed far more often in Humboldt County than they were in the rest of the state.

The procedures included hip and knee replacements, hysterectomies and carotid endarterectomies, a surgery to remove plaque buildup in the carotid arteries.

Geographical variation in the delivery of health care can harm patients and increase costs. That is especially true when it comes to surgery, which is usually more expensive and riskier than less invasive treatments.

Medicaid makes up a huge portion of state budgets, so the issue of health care variation is a pressing one for states looking to hold down costs.

In Humboldt County, doctors, hospitals, and others involved in health care wondered why surgeons in their area operated so often, and if they could do anything to get closer to the state norms.

To find out, they launched the Humboldt County Surgical Rate Project, which brought together doctors, health-care advocates, community organizations, unions, colleges and small employers.

As it turned out, a large part of “what was actually happening out there” was surprisingly simple . . .

“We weren’t trying to identify anyone as a ‘bad guy,’” said Betsy Stapleton, a retired nurse practitioner who is the co-director of the Humboldt County Surgical Rate Project. “The idea was to identify what was actually happening out there and to figure out ways to address it. It led to really fascinating conversations.”

As it turned out, a large part of “what was actually happening out there” was surprisingly simple: Patients in Humboldt County weren’t playing a big enough part in their own health care decisions. Continue reading

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Insurers hesitant to cover many proton beam treatments

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Comparison_of_dose_distributions_between_IMPT_(right)_and_IMRT_(left)By Michelle Andrews
KHN

Everyone seems to agree that proton beam therapy–a type of radiation that can attack cancerous tumors while generally sparing the surrounding tissue–is an exciting technology with a lot of potential.

But some insurers and disease experts say that, until there’s better evidence that proton therapy is more effective at treating various cancers than traditional types of less expensive radiation, coverage shouldn’t be routine.

That approach doesn’t sit well with proponents, some of whom say that insurance coverage is critical for necessary research of the controversial therapy’s uses.

Critics assert that the rush to build the centers is putting a very large cart before the horse.

Meanwhile, the number of proton therapy centers — huge structures that can cost more than $200 million — continues to increase.

Fourteen are in operation in the United States and a dozen more under development, according to Leonard Arzt, executive director of the National Association for Proton Therapy.

Critics assert that the rush to build the centers is putting a very large cart before the horse. Continue reading

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Quantifying the ‘Angelina Jolie effect’

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Actress’ impact on genetic testing for breast, ovarian cancer is ‘global and long lasting’

Angelina Jolie - Photo courtesy of the UK Foreign and Commonwealth Office

Angelina Jolie – Photo courtesy of the UK Foreign and Commonwealth Office

By Mary Engel / Fred Hutch News Service

Sept. 18, 2014

The so-called Angelina Jolie effect not only is real but has been “global and long lasting,” leading to a twofold increase in the number of women getting genetic testing to help determine their risk for hereditary breast cancer, according to new studies from the United Kingdom and Canada.

The number of women found to have a genetic mutation that increased their risk also has doubled.

And contrary to concerns that women at low risk for hereditary breast cancer would flood testing centers, researchers said that those being tested are women like Jolie who have a family history of breast cancer or who have personal risk factors such as ethnicity.

Certain ethnic groups, including Ashkenazi Jews, have a higher prevalence of BCRA mutations, which significantly increase breast cancer risk.

Women got the correct message

“What surprised us was that we didn’t get the worried well,” said Dr. Andrea Eisen, head of preventive oncology for breast cancer care at the Sunnybrook Odette Cancer Centre in Toronto and an author of the Canadian study, in a phone interview.  “We got women who got the correct message. That was gratifying.”

Jolie disclosed in a May 2013 op-ed in The New York Times that she had undergone a preventive double mastectomy after finding that she carries the rare BRCA1 gene mutation, which dramatically raises her risk of breast and ovarian cancers. Continue reading

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More Proof That Anti-Obamacare States Desperately Need Obamacare

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ACA health reform logoSeven of the 11 large metro areas where the uninsured rate was higher than the 14.5 percent national average last year are located in states that refused to expand to Medicaid under the Affordable Care Act.

Two are in Florida, three are in Texas, and the others are Atlanta and Charlotte, North Carolina.

The metro area with the highest uninsured rate was Miami, at a staggering 25 percent, compared to the national low of 4 percent in greater Boston.

via More Proof That Anti-Obamacare States Desperately Need Obamacare.

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Too many of us die in hospital instead of home. Here’s why.

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Paula Ron Faber 300

Paula and Ron Faber walk their dog Millie in 2009, between cancer diagnoses. (Photo by Shelley Seccombe)

This story is part of a partnership that includes WNYCNPR and Kaiser Health News. 

It was September 2012 and it was life-long smoker Paula Faber’s third cancer in a decade, but she did not hesitate.

“She was going to fight it every inch of the way,” says her husband Ron Faber.

“I would have rather have had a really okay four-and-a half months than this endless set of treatments.”

By August 2013 after much fighting, Paula Faber died at age 72. Ron Faber now regrets the intervening 11 months of chemotherapy, radiation, painkillers and side effects that reduced his wife to 67 pounds of frayed nerves.

Instead, the pain could have been managed so she could focus on the quality of life.

“I would have rather have had a really okay four-and-a half months than this endless set of treatments,” the stage actor said.

As they confronted Paula’s terminal diagnosis, the decision the Fabers made is among the most difficult anyone can make.

But it turns out that in the New York metropolitan region, patients opt for aggressive treatment much more often than other Americans. Continue reading

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Global health – September 22nd

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Globe floating in air

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Top five stories of the week

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Credit: Dan Shirly

Credit: Dan Shirly

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Health news headlines – September 21st

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surgeons performing surgery in operating room

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