Hispanic

Hispanics living longer than whites, blacks. But why?

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This story comes from KaiserHealthNews partner, NPR’s health blog Shots.

For the first time, the statisticians over at the Centers for Disease Control and Prevention figured out how to estimate the life expectancy of Hispanics in this country.

And, it turns out, Hispanics born recently can expect to live longer than either whites or blacks.

How much longer?

Well, a Hispanic person born in 2006 can expect to live to the ripe old age of about 80 years.

More than 2 years longer than non-Hispanic whites who’re looking at about 78 years.

And for non-Hispanic blacks, the expected lifespan is nearly 8 years shorter at 73 years.

Chart showing the differences in life expectancy between U.S. racial and ethnic groups

Source: CDC

The Associated Press reports it’s the latest evidence for an apparent Hispanic paradox: the group is living longer than others in this country despite less fortunate socioeconomic circumstances. Nineteen percent live below the poverty line.

One reason may be that such a large proportion — about 39 percent of the 45 million Hispanics — are immigrants.

Moving from one country to another takes some effort and fitness. So the United States may be attracting relatively healthier people from Mexico, the largest source of Hispanic immigrants, and other countries, according to the AP.

A more detailed look at specific health risks, including measures of blood pressure, metabolism and inflammation, found that Hispanics born in this country were at higher risk for cardiovascular disease than those who were immigrants.

The longevity advantage appears strongest among older Mexican men, previous research indicates. An analysis from a few years back raises the idea that the difference might also be due in part to sicker immigrants returning to their home countries later in life.

You might wonder why it took CDC until now to tease these data out. For starters, death certificates across the country didn’t uniformly note whether or not someone was Hispanic until 1997.

Also, the CDC had to account for a tendency in the way death certificates were filled out that underestimated the deaths for Hispanics.

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.

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A judge's wooden gavel

Suit against health law will move to trial after Florida judge’s ruling

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A judge's wooden gavel“In a foreboding ruling for the Obama administration, a federal judge in Florida decreed Thursday that a legal challenge to the new health care law by officials from 20 states could move forward …,” The New York Times reports: “‘

At this stage in the litigation, this is not even a close call,’ wrote Judge Roger Vinson of Federal District Court in Pensacola, Fla., before asserting that the insurance mandate was an unprecedented exercise of Congressional authority.

‘Of course, to say that something is ‘novel’ and ‘unprecedented’ does not necessarily mean that it is ‘unconstitutional’ and ‘improper,’ Judge Vinson continued.”

“The Florida case is one of more than 15 legal challenges to the health care law that are aiming for an ultimate hearing before the United States Supreme Court” The full hearing is scheduled for Dec. 16 (Sack, 10/14).

The Wall Street Journal: The states say “that requiring people to carry insurance or pay a fine exceeds Congress’s powers under the Constitution to regulate economic activity, because they say the decision to go without insurance isn’t an activity. … The Obama administration says that nearly all Americans get medical care through a doctor or hospital, and that requiring them to carry insurance simply regulates how they pay for services they will inevitably demand when they get sick.”

“The plaintiffs argue that the entire law should be invalidated. The administration counters that many other pieces of the legislation could stand without the individual mandate, including the expansion of Medicaid. … Many legal scholars believe the administration is likely to win the core case, but they don’t rule out a plaintiffs’ victory” (Adamy, 10/15).

The Hill: “Other federal judges have already issued divergent rulings. … In August, a judge in California threw out a suit against the individual mandate saying the plaintiffs had no standing to sue since the requirement doesn’t start until 2014. That case has been appealed. … Another lawsuit was dismissed in Maryland, and its appeal rejected. … And this past Thursday, a federal district judge in Michigan upheld the mandate’s constitutionality in a separate lawsuit” (Pecquet, 10/14).

The Los Angeles Times: The Florida lawsuit, led by that state’s attorney general, Republican Bill McCollum, is the most broad-based challenge to the new law.Nineteen states have joined the suit: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington. …Vinson dismissed four less fundamental complaints made by the states, including all but one in which the states argued that the healthcare law infringes on their sovereignty. [He] concluded that more litigation may be needed to settle the states’ claim that the healthcare overhaul unlawfully forces them to expand their Medicaid insurance programs for the poor” (Levey, 10/14).

The Washington Post: While states can theoretically choose not to spend extra money on Medicaid to expand coverage, “the states contend that because doing that would force them to give up a huge cash infusion from the federal government and leave millions of their poorest citizens without insurance, they effectively have no choice” (Aizenman, 10/15).

Politico: “The White House downplayed the ruling Thursday.” Stephanie Cutter, an assistant to the president for special projects, wrote on the White House blog: “This is nothing new. We saw this with the Social Security Act, the Civil Rights Act, and the Voting Rights Act – constitutional challenges were brought to all three of these monumental pieces of legislation, and all of those challenges failed. So too will the challenge to health reform” (Haberkorn, 10/15).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

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.

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chelator

FDA targets marketers of unapproved “chelation” products

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FDA Warns Marketers of Unapproved ‘Chelation’ Drugs

Federal regulators are warning eight companies to stop selling so called ‘chelation’ products that claim to treat a range of disorders from autism to Alzheimer’s disease by removing toxic metals from the body.

The Food and Drug Administration (FDA) says the companies have not proven their products are safe and effective in treating autism spectrum disorder, cardiovascular disease, macular degeneration, Parkinson’s disease or any other serious illness.

Some of the companies also claim their products can detect the presence of heavy metals in the body in an attempt to justify the need for chelation therapy.

FDA compliance expert Deborah Autor says the companies are preying on people made vulnerable because of serious illness.

“These products are dangerously misleading because they are targeted to patients with serious conditions and limited treatment options,” says Autor.

In letters dated Oct. 14, FDA warns the companies that they are facing possible legal action if they continue to make unsubstantiated claims. The firms that received the letters (along with the chelation products they market) are:

  • World Health Products, LLC: Detoxamin Oral, Detoxamin Suppositories, and the Metal Detector test kit
  • Hormonal Health, LLC and World Health Products, LLC: Kelatox Suppositories, and the METALDETECTOR Instant Toxic Metals Test
  • Evenbetternow, LLC: Kids Chelat Heavy Metal Chelator, Bio-Chelat Heavy Metal Chelator, Behavior Balance DMG Liquid, AlkaLife Alkaline Drops, NutriBiotic Grapefruit Seed Extract, Natur-Leaf, Kids Clear Detoxifying Clay Baths, EBN Detoxifying Bentonite Clay, and the Heavy Metal Screen Test
  • Maxam Nutraceutics/Maxam Laboratories: PCA-Rx, PC3x, AFX, AD-Rx, AN-Rx, Anavone, AV-Rx, BioGuard, BSAID, CF-Rx, CreOcell, Dermatotropin, Endotropin, GTF-Rx, IM-Rx, Keto-Plex, Natural Passion, NG-Rx, NX-Rx, OR-Rx, Oxy-Charge, PN-Rx, Ultra-AV, Ultra Pure Yohimbe, and the Heavy Metal Screening Test
  • Cardio Renew, Inc: CardioRenew and CardioRestore
  • Artery Health Institute, LLC: Advanced Formula EDTA Oral Chelation
  • Longevity Plus: Beyond Chelation Improved, EndoKinase, Viral Defense, Wobenzym-N
  • Dr. Rhonda Henry: Cardio Chelate (H-870)

FDA says consumers should avoid non-prescription products offered for chelation or detoxification. FDA-approved chelating agents are available by prescription only and are approved for use in specific indications such as the treatment of lead poisoning and iron overload. The agency says even the prescription medications carry significant risks, and they should only be used with medical supervision.

The products come in a number of forms, including sprays, suppositories, capsules, liquid drops, and clay baths.

Overall, FDA says there’s been an increase in the number of nonprescription, chelation products that claim to cleanse the body of toxic chemicals and heavy metals.

Although some of the products are marketed on the Internet as dietary supplements, by law they’re unapproved drugs and devices because they claim to treat, mitigate, prevent, or diagnose disease.

This article appears on FDA’s Consumer Update page, which features the latest on all FDA-regulated products.

Posted: October 14, 2010

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Doctor simple

How to talk about your symptoms

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Talking about symptoms with your health care team

By Becky Ham
HBNS Science Writer

What brings you in here today?

It’s a simple question that’s at the heart of many patient-doctor conversations, but it’s not a question to take lightly.

Discussing your symptoms with a doctor, nurse, nurse practitioner or physician’s assistant can be one of the most important tasks you perform as a patient, putting you on the right road to treatment and recovery or sending you down a blind alley of confusion and misdiagnosis.

What to Say-and How to Say It

As a family doctor, Carol “Vicki” Koenig knows what she wants to hear from her patients. “It is their symptoms -what the patient feels, what makes it better or worse, what’s worked before and what hasn’t,” said the retired physician from Exmore, Va.

During Patrina Reddick’s chemotherapy for breast cancer, her son kept an ongoing, written record of all the side effects she experienced. “I had to find a way to tell them how I was feeling each day,” says Reddick, a counselor and mentor from Charlotte, N.C.

Your symptoms are what you know. When you describe them to your clinician, that’s the time when she or he is learning from you. Here are a few tips on what to say when describing your symptoms and sharing your personal health knowledge:

  • Give your health care providers a basic description of your problem-one to two sentences should do it
  • Tell them when you experience the symptoms and how often they occur
  • Let them know if anything makes the symptoms better or worse
  • Tell them if you have ever experienced the symptoms before, and under what circumstances
  • Tell them if anyone else in your family or workplace is experiencing the same symptoms.

These questions can help the doctor sort out with you whether your symptoms relate to a new condition, an old medical problem, or a side effect of your medications. Although we think of symptoms as “problems,” some symptoms can be good news, signaling an improvement in the way you feel or a sign that your current treatment is working.

How you describe your symptoms can be just as important as what you describe. Most physicians-and experienced patients-urge you to be as detailed and descriptive as possible, to help zero in on a diagnosis and track the progress of your care.

____________________

From the moment you pick up the phone to schedule an appointment, you’re sharing vital information with your doctors and other providers that can help you get the best possible health care.

Registered nurse Mary Jo Kreitzer, Ph.D., director of the Center for Spirituality and Healing at the University of Minnesota, has developed a 20-minute interactive guide to help you better communicate with your health care team.

Kreitzer’s online module, can help you learn what to say, what (and who) to bring, how to ask for what you need, and what information you should have after you leave the doctor’s office.

_____________________

Adjectives are important. Don’t just call it pain, said Shelley Ellis, a Dallas, Texas consultant with endometriosis. “I would use descriptive words like dull, throbbing, intense, or piercing.”

Sometimes ranking pain on a scale from one to 10 (with 10 the highest for example) can be a good way to track changes and severity of your discomfort.

Be sure to give a location for your symptoms, and don’t be afraid to point if necessary and possible to do so. In some cases, a picture can help you tell the story, as Linda Jitmoud found out.

“Science has provided many wonderful medications and tests, but the doctor’s decision to order a test or prescribe a medication most often depends on the information provided by the patient.”–Ohio State University PACE System

When she wanted to show her swollen glands to her oncologist, the Lexington, Ky., writer snapped a photo to bring in to her next appointment.

Writing down your symptoms can help you remember everything you’re experiencing and make your time with the doctor more efficient. Carol Jay Levy, a North Wales, Pa., resident who suffers from chronic pain, recommends keeping a symptoms diary if you have a chronic illness.

“Having a diary so you can be very specific when you visit the doctor always helps,” she said. “Then you can tell them, ‘I feel worse at night, when I’m tired, when I stand for 15 minutes.’”

“I used a combination of verbally telling my story along with a sheet of paper that summarized what I was experiencing,” Ellis said. “In every case that piece of paper made the most difference in my next course of treatment.”

Your Symptoms, Your Say

But remember: not everyone describes symptoms the same way, and you may have to try several times to get your story across.

Some people describe asthma symptoms as more of an upper-respiratory phenomenon, like a tight or itchy throat, while others described a more lower respiratory response like “hurts to breathe” or “out of air.” Doctors expect to hear: “shortness of breath” or “wheezing.”

Doctors want to hear how you feel, not what you think your diagnosis is, said Davis Liu, a family physician in Sacramento, Calif.

Although you might come in saying you think you have the flu, “doctors are very specific with terminology and what you mean could be completely different than what a doctor understands the term to mean,” he noted.

Instead of saying that you have a certain condition, talk about how you’ve had a fever for three days, or that you have a sharp pain in your stomach.

Be insistent about your symptoms if it feels like your provider isn’t clear on what you’re experiencing. Your doctor may have the technical knowledge, but only you can accurately describe the impact your symptoms have on your life.

A recent report in the New England Journal of Medicine found numerous studies showing that doctors often downgrade the severity of patients’ self-reported symptoms, particularly when it comes to medication side effects.

It may help to keep a record of the frequency and severity of your symptoms, so you can talk about them with certainty.

Finally, you might have difficulty describing your symptoms if they sound embarrassing, if they are about sexual activities or concerns , if they may be as a result of actions that are illegal (like drug use), if you fear you may be judged or criticized (like using alcohol or smoking), or if they relate to emotional or personal problems.

You could start the conversation by saying something like, “This is difficult for me to share with you but I need your help…”

But if you can’t trust your doctor with this kind of information, says Koenig, it’s time to find another doctor.

“If you took the time to make the appointment, at some point you have to screw up your courage and say what’s on your mind,” she says. “The doctor is not a mind reader. And there is nothing a doctor hasn’t heard or dealt with before.”

An Urgent Conversation

If all of this hasn’t convinced you that the symptoms conversation is an important one, consider this: the average doctor’s visit lasts 13 minutes. It pays to be ready to tell your story.

“Knowing the amount of time my doctor can spend with me is important,” Levy said. “If it’s only a few minutes, I need to be prepared with the most important thing to say. Coming with a list helps so the time is not wasted with thinking of what I may have forgotten.”

The symptoms conversation can set the tone for your future care, helping your doctor correctly diagnose your condition and work with you to start the right treatment plan.

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.

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Stamp reading "Rejected"

Insurers denied coverage to 1 in 7, citing pre-existing conditions

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Stamp reading "Rejected"

Graphic: sundesigns

The nation’s four largest for-profit health insurers denied coverage to more than 651,000 people over a three-year period, citing pre-existing conditions, according to an analysis of insurer data detailed in a Congressional investigation.

Between Aetna, Humana, UnitedHealth Group, and WellPoint, that averages out to a denial of coverage for one out of every seven applicants, according to an Energy and Commerce Committee memo about the investigation.

The memo, released by Energy and Commerce Chairman Henry Waxman and Bart Stupak, both Democrats, touts provisions in the health care reform bill that address pre-existing condition denials.

But all politics aside, the investigation contains some interesting figures and information culled from thousands of pages of documents provided by the insurers.

The memo points out, for instance, that since 2007, the number of denials on the basis of pre-existing conditions has risen each year, outpacing the increase in applications for insurance coverage:

A year-by-year analysis shows a significant increase in the number of coverage denials each year. The insurance companies denied coverage to 172,400 people in 2007 and 221,400 people in 2008. By 2009, the number of individuals denied coverage rose to 257,100.Between 2007 and 2009, the number of people denied coverage for pre-existing conditions increased 49%. During the same period, applications for insurance coverage at the four companies increased by only 16%.

Individuals were denied coverage based on “an extensive list of medical conditions,” the memo noted.

One company had a list of more than 400 medical diagnoses used to decline coverage to those seeking it, and common conditions such as pregnancy, diabetes, and heart disease were included on the list.

As we’ve noted, under the health care reform bill, insurers are no longer able to deny coverage to children on the basis of pre-existing conditions, but this does not get extended to all age groups until 2014.

A spokesman for Aetna did not dispute the memo’s findings, but told The Wall Stret Journal that they “document what many health insurers, including Aetna, have been saying for years – that the individual market needs to be reformed so we can improve access for all consumers.”

To learn more:

“Rejected” Graphic courtesy of sundesigns

Local Resources:

Want to know more? Follow ProPublica on Facebook and Twitter, and get ProPublica headlines delivered by e-mail every day.

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Dr. Wendy Sue Swanson

Drs & pts blog & tweet abt health, sickness & life

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Dr. Wendy Sue Swanson

@SeattleMamaDoc

By Sally James (@jamesian)

Every morning, the first thing that Seattle pediatrician Wendy Sue Swanson does is check her twitter account, Swanson confessed to a crowd of doctors and other health professionals on Monday in a Seattle conference room.

But Swanson was not apologizing, she was proudly saying: “I think doctors have to be out there,” and by out there, she means speaking to the thousands of patients who are already on Facebook, Twitter and other social media platforms.

She sees being online communicating as an ethical imperative, because if one’s patients are absorbing health information from the Internet, she feels she should be out there speaking to them, too.

Swanson is the blogger SeattleMamaDoc on Seattle Children’s website. She tries to post twice a week about health issues that she deems worthy of comment.

Recently she has blogged about health scares, such as tainted infant formula, and emotional issues, such as her own feeling overwhelmed by her responsibilities as a doctor and a mother.

Traditionally, doctors have kept their thoughts and feelings to themselves, and they are taught in their training that it is important to maintain a professional distance from their patients.

In fact, some medical schools tell their incoming students that one of the first things they need to do is scrub their Facebook and other online sites of material that might undermine their professional standing.

But this week Seattle’s Swedish Medical Center, which has just launched a social media collaboration with the Mayo Clinic, brought together a panel of rebels–doctors, patients and others working in the health field–who have shed that cultural corset and, like Swanson, have begun to blog, twitter and share some of their innermost thoughts with the world.

The panel spoke at a pre-conference meeting of a Swedish Medical Center symposium called Innovation in the Age of Reform.

Besides Swanson, who goes by the twitter tag @SeattleMamaDoc, the speakers included: @epatientdave (patient Dave deBronkart) , @endogodess (pediatric endocrinologist Jen Dyer), @nickdawson (hospital financial expert Nick Dawson), @KentBottles (quality strategist Kent Bottles), @Doctor_V (pediatrician Bryan Vartabedian) and @doctoranonymous (family practitioner Mike Sevilla).

While they brought mostly heartwarming stories of insights and effectiveness from their social web experiences, they faced tough questions from the audience: When is talking about an unnamed patient revealing too much for the national privacy law, HIPPA? How do you deal with the time demands of an on-line interface with your patients? What if you post on Facebook that you drank a great bottle of wine, and the next day, something goes wrong at the hospital? Will a lawyer try to blame the wine in a malpractice suit?

Veteran of hospital administration, Kent Bottles, answered the wine question briefly. Doctors have been living in public, and drinking wine, since long before the Internet, he pointed out. “Get over it,” he advised to those afraid of risk in the brave new social media world. “Do your best for your patients,” he added.

“ePatient” Dave deBronkart captivated the audience with the story of his own diagnosis with what was called “incurable” kidney cancer a few years ago, and how he believes his online links to other patients and their families helped him find successful treatment.

deBronkart, who was a marketing and data person before becoming a full-time advocate of epatients, believes the social media universe holds a key to potentially empowering patients in new ways.

Such patient involvement shouldn’t threaten doctors, deBronkart argued, leveraging the energy of patients who use online media can multiply a doctor’s effectiveness.

When the panel was over, the over-filled room exploded with loud discussion of the old-fashioned kind, face-to-face.

Sally James is a freelance medical writer in Seattle, who has recently written about global health research and immunotherapy for cancer. Read more here.

To learn more:

  • For profiles of the Social Media panelists go here.
  • Swedish is recording the symposium , organized as part of its celebration of its 100 year anniversary, which will soon be online.
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A selection of pills and capsules spilled out on a white surface

500,000 in Washington could lose prescription-drug coverage–Seattle Times

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A selection of pills and capsules spilled out on a white surfaceSome 500,000 Washington adults whose prescriptions are now covered by Medicaid could soon lose that benefit unless lawmakers provide special funding when they reconvene in January, Sean Collins Walsh reports in the Seattle Times.

Medicaid’s adult drug program, which provides medication to the state’s poorest individuals through a combination of state and federal funding, will be eliminated in March if the Legislature can’t come up with $40 million before Feb. 1, according to the Department of Social and Health Services (DSHS).

“For Doug Porter, the state’s Medicaid director, losing the program would be “beyond painful,’” Walsh writes.

To learn more:

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Photomicrograph Mycobacterium tuberculosis.

Seattle team ready to test TB vaccine booster in humans–Seattle Times

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Scientists at Seattle’s Infectious Disease Research Institute have developed a promising vaccine to help fight tuberculosis (TB), writes Seattle Times science reporter Sandi Doughton in todays issue of the paper.

Photomicrograph Mycobacterium tuberculosis.

Mycobacterium tuberculosis--CDC

If successful, the vaccine would likely serve as a booster for a vaccine called BCG (Bacille Calmette-Guérin) that is widely used in developing world, where TB is more common, writes Doughton.

Their new booster vaccine has been tested only in animals so far. But if the results are similar in humans, it could prove a valuable tool in reducing the toll of a disease that kills nearly 2 million people a year.

Researchers hope to begin testing the vaccine in humans next year, but even if successful it is likely it will take a decade for the vaccine to reach the market.

To learn more:

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X-ray of a broken hip

Possible fracture risk with osteoporosis drugs–FDA

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X-ray of a broken hip

Femoral (thigh bone) Fracture

The Food and Drug Administration (FDA) is warning there is a possible risk of a rare type of thigh bone (femoral) fracture in people who take drugs known as bisphosphonates to treat osteoporosis.

The agency warned patients and health care professionals of this risk on Oct. 13, 2010, because the rare type of femoral fracture has been predominantly reported in patients taking these prescription medications.

FDA says the possible risk of thigh fracture will be reflected in a labeling change for bisphosphonate medications that treat osteoporosis and in a medication guide that will be required to be given to patients when they pick up their prescription.

Bisphosphonates are a class of drugs that slow or inhibit the loss of bone mass. They have been used successfully since 1995 to prevent and treat osteoporosis and similar diseases. Osteoporosis is a disease in which the bones become weak and are more likely to break.

FDA says it is not clear whether bisphosphonates are the cause of the unusual bone breaks known as subtrochanteric femur fractures, which occur just below the hip joint, and diaphyseal femur fractures, which occur in the long part of the thigh.

Medication Guide, Labeling Change

The changes to labeling and the medication guide will affect only bisphosphonates approved for osteoporosis. These include

  • oral bisphosphonates such as Actonel, Actonel with Calcium, Atelvia, Boniva, Fosamax, Fosamax Plus D, and their generic products
  • injectable bisphosphonates such as Boniva and Reclast and their generic products

Labeling and the medication guides for bisphosphonates that are used for other conditions will not change.

FDA says the optimal duration of bisphosphonates treatment for osteoporosis is unknown—an uncertainty the agency is highlighting because these fractures may be related to use of bisphosphonates for longer than five years.

FDA medical officer Theresa Kehoe, M.D., says the agency continues to evaluate data about the safety and effectiveness of bisphosphonates when used long-term for osteoporosis treatment.

“In the interim, it’s important for patients and health care professionals to have all the safety information available when determining the best course of treatment for osteoporosis,” she says.

Advice for Consumers

If you are currently taking bisphosphonates for osteoporosis, FDA advises that you

  • keep taking your medication unless you are told to stop by your health care professional
  • read the medication guide. It will describe the symptoms of an atypical femur fracture. The guide also advises you to notify your health care professional if you develop symptoms
  • tell your health care professional if you develop new hip or thigh pain (commonly described as dull or aching pain), or have any concerns with your medications
  • report any side effects with your bisphosphonate medication to FDA’s MedWatch program

online: www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm

by regular mail: Use postage-paid, pre-addressed FDA form 35004, available online atwww.accessdata.fda.gov/scripts/medwatch/

by Fax: (800) FDA-0178

by phone: (800) FDA-1088

FDA also recommends that health care professionals be aware of the possible risk in patients taking bisphosphonates and consider periodic reevaluation of the need for continued bisphosphonate therapy, particularly for patients who have been on bisphosphonates for longer than five years.

This article appears on FDA’s Consumer Update page, which features the latest on all FDA-regulated products.

Posted: October 13, 2010

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Alert Icon with Exclamation Point!

“Death cap” mushroom poisoning reported in King County

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King County health officials are warning county residents not to eat wild mushrooms unless they are absolutely sure the fungi are safe after learning that a Bellevue woman fell ill from eating deadly Amanita phalloides mushrooms, also know as “death cap” mushrooms.

“Amanita phalloides look very much like some edible types of mushrooms and increasingly can be found in the wild, in local parks, and even in our own backyards,” said Dr. David Fleming, Director and Health Officer for Public Health – Seattle & King County. ” Only people who really know what they’re doing should eat mushrooms they’ve picked themselves.”

The Bellevue woman was hospitalized last month after eating the poisonous mushroom, officials said, but she has since recovered.

“Mushroom poisonings are almost always caused by people eating wild mushrooms collected by nonspecialists,” said Dr. William Hurley, Medical Director for Washington Poison Center.

Recent immigrants to the U.S. can mistake poisonous mushrooms found here in the Northwest for edible mushrooms found in their native lands, Dr. Hurley said.

“In fact,” he added, “the reported cases of poisoning by Amanita phalloides in the Northwest have been immigrants from Thailand, Cambodia and Laos.”

Facts about Amanita phalloides from Public Health:

  • The Amanita phalloides, sometimes called “death cap” mushrooms, are highly toxic.
  • They cannot be distinguished from safe mushrooms using taste or smell.
  • Symptoms of poisoning by these mushrooms include abdominal pain, vomiting and diarrhea.
  • The first symptoms usually start within six to 24 hours of ingestion.
  • Poisoning may result in damage to the liver and other vital organs, or even death.
  • If you suspect you may have eaten a poisonous mushroom, do not wait for symptoms to appear. Call Washington Poison Center at 1-800-222-1222 right away.

To learn more:

  • The Puget Sound Mycological Society offers mushroom identification clinics for the public on Mondays from 4-7 p.m. at the University of Washington’s Center for Urban Horticulture through the end of October. Visit www.psms.org or call 206-522-6031 for more information.
  • For more information on poisonous mushrooms visit the federal Food and Drug Administration’s mushroom website.

The Washington Poison Center, a 501(c)(3) nonprofit charitable organization, prevents harm from poisoning through expertise, collaboration, and professional and public education. Reachable 24/7, the national poison hotline, 1-800-222-1222, will connect you to specially-trained pharmacists, nurses, and poison specialists. Calls about humans are free and confidential, however calls concerning animals cost $30. Services are available for non-English speakers, and for the deaf and hearing impaired. For more information, visit www.wapc.org.

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Photo: Matthew Bowden

Women’s health groups call for free Rx birth control

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By Julie Rovner

This story comes from our partner, NPR’s health blog Shots .

Photo: Matthew Bowden

There’s something many women of child-bearing age can rally behind in the new health overhaul law: free contraceptives.

At least that’s the idea behind a campaign launched yesterday by the Planned Parenthood Federation of America and the American Congress of Obstetricians and Gynecologists.

Called Birth Control Matters, the initiative aims to make sure all prescription methods of contraception are covered without copays as part of the preventive services package that will be determined sometime in the next year by the Institute of Medicine and the Department of Health and Human Services.

“This is a fundamental economic issue,” Planned Parenthood President Cecile Richards told reporters at a briefing Tuesday. “Women say ‘I could possibly not have to pay $50 a month for birth control pills anymore?’ ”

But it’s not something for nothing, said ACOG Vice President for Practice Activities Hal Lawrence: “Providing contraceptive care keeps women healthy, and when you keep women healthy they have healthier pregnancies.”

He says over the years ACOG and other medical experts have assembled a wide body of evidence that planning and spacing pregnancies reduces infant mortality, pregnancy complications, and birth defects; all of which saves the health system far more than the cost of contraception.

The public apparently agrees, according to a new polling done for Planned Parenthood by Hart Research Associates.

More than 70 percent of those polled earlier this summer said prescription birth control should be covered under preventive health care, including 77 percent of Catholic women, 72 percent of GOP women votes and 60 percent of male voters.

“This is different from other aspects of the abortion debate,” Hart Research President Geoff Garin. “Contraception is the middle ground in the abortion wars where those on both sides meet happily.”

Well, not quite everyone. The nation’s Catholic bishops have already objected to including birth control on the list of free preventive services.

Richards of Planned Parenthood says she’s confident that’s an obstacle that can be overcome. “I don’t think the women of America are looking to the bishops to determine what their health care access should be,” she said.

But if she wasn’t at least a little bit worried, the new campaign might not be trying to collect a million signatures to make sure contraception gets on that list of approved services.

PHOTO: Matthew Bowden – to view more go to www.matthewbowden.com

This is one of KHN’s “Short Takes” – brief items in the news. For the latest from KHN, check out our News Section .

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.

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A surgeon listens to a patient's lungs with a stethoscope

Hospitals lure doctors away from private practice

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Jenny Gold
KHN Staff Writer

This story was produced in collaboration with NPR

Raleigh, N.C. — Dr. Alden Parsons, a thoracic surgeon, had just finished fifteen years of medical training.

But instead of entering the potentially lucrative world of private practice, she went to work for the Rex Healthcare hospital system in February.

A surgeon listens to a patient's lungs with a stethoscope

Dr. Alden Parsons, a thoracic surgeon, listens to Julia Neal's breathing at her office in Raleigh, N.C. After she completed her 15 years of medical training, Parsons decided to skip private practice and instead accepted a position at Rex Healthcare, a local hospital system. (Jenny Gold)

“I don’t know anyone who went out into their own practice,” Parsons, 38, says of her classmates.

While some continued their training or joined university faculties, the rest went to work for groups affiliated with hospitals. “Trying to be a mother and a wife and a thoracic surgeon, I needed a job that would help me streamline things.”

Last year, half of new doctors were hired by hospitals, according to the Medical Group Management Association, a professional organization for physician practices.

According to a 2009 report by the American Medical Associationone in six doctors works for a hospital, and the number is quickly growing.

Several factors are driving the trend. For some doctors, the recession is making it more difficult to run a small business, with fewer patients coming in for care and others unable to pay their bills.

And many physicians like Parsons who are just starting out don’t want the long hours and administrative headaches that come with private practice.

For Rex Healthcare and many other hospitals, hiring doctors is crucial to their strategies.

Having more doctors in the fold guarantees a steady stream of patient referrals and, say hospital executives, bolsters care through better coordination of services.

They also emphasize the impact of the new health overhaul law: it rewards creation of more efficient, integrated models of care.

Some experts worry, however, that hiring doctors and forming the “accountable care organizations” envisioned under the law could give hospitals much more negotiating clout with health insurers – and drive up insurance prices paid by employers and consumers.

Steve Burriss, senior vice president in charge of physician employment at Rex, part of the University of North Carolina’s health care system, has hired about 30 physicians over the past few years and is in talks with another 55.

He has to act quickly because Raleigh is a highly competitive market and each of the major systems— among them Duke Medicine, WakeMed Health & Hospitals and Novant Healthwants to grow and attract patients with private insurance, which typically pay more than the Medicare and Medicaid programs for the elderly, poor and disabled.

For a hospital, says Burriss, anything that disrupts the stream of patient referrals, including losing the loyalty of local physicians, “can have a really big impact on your ability to make money. Just a 3 percent change in any of that can really wipe out your whole bottom line.”

Burriss estimates there are only about 67 doctor practices left in the Raleigh area that are not yet affiliated with a hospital. In the next five years, he says, the vast majority will be scooped up by local hospital systems. The doctors have some leverage: “If we don’t accommodate the needs they have,” he says, “they’re going to look to someone else.”

Dr. Casey looks in her patient's ear with an otoscope

Dr. Michele Roberts Casey examines patient Janice Seitzinger at her office on the campus of WakeMed Health & Hospitals in Raleigh, N.C. Casey, a primary care physician, made the leap from private practice to hospital employment in April. (Jenny Gold)

Dr. Michele Roberts Casey, a primary care physician, made the leap from private practice to WakeMed in April.

The hospital system offered her a competitive salary, a bonus based on how many patients she saw, and a promise to handle all of the administrative services for the practice—billing, claims processing, help negotiating payments from insurers, retirement benefits and even a new electronic health records system.

“We spend so many hours doing administrative work in the (private practice) world, it’s very frustrating,” says Dr. Casey, 41. “We don’t have that here. We can focus on patients, we can take good care of our patients and they can remain our priority.”

Joining WakeMed looked like a good deal to Casey. She and three colleagues had decided to leave the practice they were in and strike out on their own, but the reality of opening a new business changed their minds.

“We were looking at property in the city and electronic health records systems, and it was a little bit overwhelming to look at the number of different things that you have to tackle to start a practice,” she says.

This isn’t the first time hospitals have gone doctor shopping. In the 1990s, they went on a buying frenzy. Dr. Bill Jessee, president and chief executive officer of the Medical Group Management Association, remembers the experiment as something of a disaster.

Because hospitals often put the doctors on flat salaries without the financial incentive to see more patients, doctors “weren’t working as hard as they were before their practice was acquired.” In fact, Jessee adds, “the first thing a lot of physicians did is take a vacation.”

Hospitals lost a lot of money and ended up divesting most of the practices.  This time, hospitals are providing incentives like some of those Casey receives, such as bonuses based on how many patients they see.

But the local hospitals won’t get all the doctors – certainly not Casey’s sister, Dr. Lisa Roberts, who owns a gynecology practice around the corner from WakeMed and prizes her independence.

Dr. Lisa Roberts stands in a meticulously decorated exam room at her private gynecology practice in Raleigh, N.C. She says she enjoys being a small-business owner “as much as I love going to the O.R. to operate or just to see my patients for routine visits.” (Jenny Gold)

Dr. Lisa Roberts stands in a meticulously decorated exam room at her private gynecology practice in Raleigh, N.C. She says she enjoys being a small-business owner "as much as I love going to the O.R. to operate or just to see my patients for routine visits." (Jenny Gold)

Roberts, 40, looks just like her sister, but with darker hair. The office she opened about nine years ago in the middle of a strip mall is meticulously decorated with vases of dried flowers, curtained-off dressing areas and a beverage bar in the waiting room. Patients, she says, should think “that they’re in a spa rather than in a physician’s office.”

Designing and managing the practice takes a great deal of her time. But Roberts, a business major in college, says she enjoys being a small business owner “as much as I love going to the O.R. to operate or just to see my patients for routine visits.”

Meanwhile, she’s watching to see how her sister’s hospital practice works out. Hospitals have indeed changed their approach since the doctor-buying days of the 1990s, she says, “but we haven’t seen that they can run a successful practice yet. And I know I can run a practice.”

Choosing between private practice and working at a hospital may be a weighty decision for doctors, but patients may not notice much of a difference.

Janice Seitzinger has been a loyal patient of Casey’s for five years and stayed with her when she took a job at WakeMed. The office has changed, but not her care.

“I mean, she’s the same,” Seitzinger says of Casey. And now there’s the added convenience of having lab tests done in the office, rather than driving to another location.

WakeMed hopes that sooner or later, patients will notice an improvement in their care.  The hospital currently employs about 138 doctors and plans to hire another 60 over the next six months. In 2000, WakeMed employed just 47.

Dr. Susan Weaver, who hired Casey and oversees all of the physician practices at WakeMed, says employing doctors is “about how you can really work together to elevate the quality of care while keeping costs down. Medicine’s going to change, and we’re going be prepared to change with it.”

The idea is that by teaming up, doctors and hospitals can avoid repeat tests and offer the best possible care at the lowest price.

It’s a notion that has long been percolating in the health care field, but Weaver says the new health law is accelerating the process, in part by “making physicians nervous. They’re sensing that change is necessary and they want and desire and need perhaps a partnership with a health system. So our timetable to get there into an accountable care and truly clinically integrated system has sped up.”

Sounding a cautionary note, Paul Ginsburg, president of the nonprofit Center for Studying Health System Change in Washington, D.C., says insurers and their customers can get stuck with higher prices for doctors’ care.

That’s because hospitals that employ doctors generally have more negotiating clout with insurers than doctors working in private practice.

The price difference can be so big, Ginsburg says, that hospitals can pay the doctors more and “still have something left over” for themselves.

But, Ginsburg says, if doctors and hospitals can work together to avoid repeat tests and unnecessary procedures, it could both improve the quality of care and even save money. And  “that will be a good thing for patients long term.”

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.

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Twenty-dollar bill in a pill bottle

Open insurance season may bring sticker shock

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When you examine your health plan options during open enrollment season this fall, you may get sticker shock from the increases in both the premiums and the cost-sharing for services.

Even benefits that are increasing under the health-care overhaul may come with financial strings attached.

If you’re one of the roughly half of workers with a choice of more than one health plan, or if you’re just trying to gauge what you may have to pay to keep your family healthy next year, here’s what to look out for:

Higher Premiums

The employee’s share of the average $13,770 total premium for family coverage went up 14 percent this year, to $3,997, according to the annual employer health benefits survey conducted by the Kaiser Family Foundation and the Health Research & Educational Trust and released last month. (Kaiser Health News is a program of the foundation.)

In the past five years, employees’ premium contributions have grown 47 percent, while overall premiums increased 27 percent.

Workers’ relative share of the premium this year grew to 30 percent of the total for family coverage, up from 27 percent last year.

Higher Deductibles

More than a quarter of employees now face annual deductibles of at least $1,000, according to the Kaiser/HRET study. Some plans offer a health savings account, or HSA, an option that lets you sock away money tax-free to cover health-care expenses.

More From This Series: Insuring Your Health

Katie and Ricky Harbaugh have a high-deductible plan. When their daughter Kylie was born last year, they got hit with roughly $7,000 in out-of-pocket costs, including a $5,000 deductible and 20 percent coinsurance for hospitalization.

In previous years, Katie Harbaugh’s company made a $4,500 contribution to her HSA to help cover the deductible. But last year, her employer eliminated the HSA along with its contribution. The Hagerstown, Md., couple is still paying off the medical bill.

“For a person like me who has a family, a high-deductible plan just doesn’t work,” says Katie Harbaugh. “I have two kids.

Last year alone I was in the emergency room three times.”

More Coinsurance

When you visit the doctor or a specialist, it’s likely you’ll still pay a flat co-payment of $20 or some other amount. But increasingly, health plans are adding coinsurance, meaning you will also pay a percentage of the charges.

For example, 53 percent of plans now require coinsurance charges for hospital admissions, up from 42 percent two years ago, according to the PricewaterhouseCoopers Health and Well-Being Touchstone survey of 700 companies.

Coinsurance is also on the rise for prescription drugs and emergency room visits, according to the survey.

Typically, coinsurance isn’t charged after you’ve reached your plan’s out-of-pocket maximum, says Mike Thompson, a principal in PricewaterhouseCoopers’s human resources practice.

But that out-of-pocket limit may still be more than you can afford, he adds. “As employees make their choices, it’s important to say, ‘If the worst happens, how much would I have to pay out-of-pocket?’”

Extra For Dependents

The health-care overhaul gave parents the option of keeping their adult children under the age of 26 on their policies, but there’s likely to be a price associated with that, say benefits consultants. Increasingly, plans are charging for every dependent on a plan rather than including an unlimited number in a single family premium.

To help sidestep the rising costs, you may be able to make some plan changes work to your financial advantage next year and get better care at the same time.

Workers may also increasingly see another strategy to limit costs: surcharges, typically ranging from $200 to $500, for spouses who could get insurance through their own jobs.

“If you have coverage available somewhere else, they want you off their books,” says Sara Taylor, health and welfare solutions leader at Aon Hewitt.

Emphasis On Wellness

To help sidestep the rising costs, you may be able to make some plan changes work to your financial advantage next year and get better care at the same time.

S

ome may dislike the Big Brother approach, but companies aren’t apologizing.

Most employers already have wellness programs of some sort. They may offer smoking cessation or weight management classes, for example, or discounts on gym memberships.

Next year, employers expect to beef up wellness programs, hoping to save money by keeping employees healthier, according to a survey released in September by human resources consultants Mercer.

Increasingly, employers are linking participation in wellness programs with employee health insurance costs. Employers may give workers a break on premiums or deductibles, for example, if they meet certain biometric targets for healthy blood sugar, blood pressure and cholesterol levels, says Tracy Watts, a partner at Mercer.

As companies try to get a handle on chronic disease costs, they’re also dangling the possibility of access to better, cheaper insurance for employees who take certain steps.

For example, workers who fill out a health-risk assessment might get slightly lower premiums in the company’s core plan.

If the questionnaire identifies them as having a chronic condition that needs treatment, and if they participate in a disease management program and work with a health coach to keep their diabetes in check, for example, they might “graduate” into a plan with better benefits and lower cost-sharing.

Some may dislike the Big Brother approach, but companies aren’t apologizing.”The problem [with voluntary programs] is that people don’t participate,” says Watts. “So they’re trying different strategies.”

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.

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Project to adapt global strategies to improve local health.

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In rural India, health workers send automatic messages to the mobile phones of their HIV patients to remind them to take their medications.

In the Kenya, community health workers go to remote villages where there are no doctors to teach mothers about the importance of breast feeding, immunizations and protecting their children from malaria.

And in Nicaragua, a microfinance organization that provides microloans and business training to women also connects women to a low-cost medical and dental program

These are just a few of the strategies that are being adopted in the developing world to improve health, often with the help of Seattle-based global health organizations like PATH, the University of Washington and the Gates Foundation.

Now a new project, announced today, will test whether these and similar global health approaches can be used to tackle the health problems of communities just miles from headquarters of these global health organizations where health statistics often rival those of impoverished developing world nations.

The project, the Global to Local Health Initiative, a partnership of the Washington Global Health Alliance; Public Health – Seattle & King County; HealthPoint , a network of 12 community clinics; and Swedish Medical Center will work in collaboration with local governmental, business and community groups in South King County.

While King County has some of the best health statistics in the nation, there are communities here where health statistics such as life expectancy and infant mortality rates are comparable to those found in some impoverished developing world nations, said Dr. David Fleming, director and health officer of Public Health – Seattle & King County, in an interview last week.

Global to Local Logo

In fact, in terms of health, the gaps between King County’s most well-off communities and its most deprived are often one of the largest seen any county in the nation, Dr. Fleming said.

“A person living in our most affluent communities, for example, can expect to live eight years longer than a person living in our poorest communities,” he noted.

The life expectancy of a child born in Auburn today, for example, is just 75 years, six years less than the county average and on par with countries like Ecuador, Morocco and Tunisia.

King County communities with the greatest health problems are largely communities made up of U.S.-born minorities, immigrants and refugees. Poverty and lack of services as well as language and cultural barriers are common.

Dr. David Fleming

The new initiative was announced today at the Bell Harbor International Conference Center during the Swedish Medical Center’s 2010 Healthcare Symposium.

Swedish has committed $1 million to the five-year project, and Sen. Patty Murray has included $400,000 in funding for supplies and equipment in a bill slated to go before the full Senate Appropriations Committee.

The initial focus of the efforts will be communities in SeaTac and Tukwila, which have some of the most diverse communities in the nation.

Lisa Cohen, director of the Washington Global Health Alliance, a Seattle-based nonprofit that works to promote the state’s global health activities, called the health disparities in the county “shocking.”

“Here we have one of the greatest concentrations of global health expertise in the world and to have these sorts of disparities in our own backyard is untenable,” Cohen said.

The initiative sprung, Cohen said, from a dinner meeting two years ago in which Dr. Rod Hochman, Swedish’s CEO, invited a group of global health experts to dinner to discuss strategies to improve health care delivery in King County.

Among the attendees were Chris Elias, president of PATH; Nobel Prize-winner Dr. Lee Hartwell of the Fred Hutchinson Cancer Research Center; Dr. King Holmes, chairman of the Global Health Program at the University of Washington; Dr. Fleming, who has worked in global health at both the U.S. Centers for Disease Control and Prevention and the Bill & Melinda Gates Foundation; and Dan Dixon, vice president for External Affairs for Swedish.

Out of that meeting a plan emerged to create a pilot program to see whether global health strategies could be applied here. If successful, the same strategies could be applied elsewhere in the state and across the country, said Cohen.

At this stage, five strategies commonly used in the developing world are being considered:

  • The deployment of community health workers, who know local communities, their languages, cultures and needs.
  • The mobilization of existing community-based organizations to address health-related issues
  • The creation of focused campaigns to promote particular initiatives, such as vaccinations
  • The adoption new technology, such as mobile phones, to communicate health messages and coordinate care
  • The close coordination of public health services with primary care
  • Promotion of economic development, which has a strong impact on health

Other strategies may be adopted as the initiative team gathers advice from the communities, says Adam Taylor, the project coordinator.

Over the past several months, Taylor has been meeting with community groups, local government officials and attending focus groups to find out first what are the priorities of the communities.

“We’re trying to get the lay of the land, to find out what services people say they need and … to find out what people are already doing,” he said. “We want to make sure we work in harmony with those groups that are already working in these areas.”

Meanwhile, two global health experts at PATH, Jessica Cohen and Sarah McGray are reviewing the scientific literature to identify the strength and weaknesses of various global health strategies that might be adopted by the initiative.

Laying this groundwork is essential, says Public Health’s Dr. Fleming. “We need to identify the range of global health strategies that are promising—the toolbox—and we need to work with the communities to find out what people in those communities are most concerned about,” he said.

“The intersection of those two things—the utility of the tools and the problems of the community—will create the ‘sweet spot’ where the program will be doing its work,” Dr. Fleming said.

Dr. Fleming said he expect that some of the initiative’s program will begin this fall and winter.

Disclosure: Michael McCarthy has provided editorial services to Swedish Medical Center.

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Allen event draws top brain scientists to Seattle

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Human cerebellum -- Allen Institute

More than 150 neuroscientists came to Seattle to attend the first Annual Allen Institute for Brain Science Conference held earlier this month at the Experience Music Project at Seattle Center.

The speakers and attendees at the two-day conference included some of the world’s top neuroscientists, and, as a result, the presentations were highly technical.

Still the talks gave even the non-expert a glimpse into the rapidly evolving field of brain research in which new technologies are making it possible to dissect the incredibly complex molecular machinery that underlies thought, feeling and consciousness.

The Allen Institute for Brain Science was founded by Paul Allen, the billionaire Microsoft co-founder, investor and philanthropist, who said in an interview with the press during the conference that he has long had in interest in the workings of the human mind.

Nerve fiber tracts in the human brain -- Allen Institute

“As a software engineer,” Allen said, he had always had “percolating” in the back of his mind the question: “’How in the heck does the human brain do so many things, so much better than a computer?”

The primary goal of the institute is to accelerate brain research by providing researchers with the most detailed information possible about the brain’s anatomy, genetics and biochemistry–the substrate of the mind.

The institute gathers this information by adapting highly automated “high-throughput” industrial production techniques to perform laboratory work that would take years, if not decades, for university researchers to complete using standard techniques.

This “unique high-through-put, industrial-scale approach” is “our hallmark,” Allen said.

The institute’s first project was to create a three-dimensional gene-expression map of the mouse brain that shows with pinpoint accuracy where the 20,000 genes of the mouse genome are activated and in which cells.

Allen Developing Mouse Brain Atlas

The institute followed up that project with such projects as a 3-D atlas of the mouse spinal cord, an atlas of the developing mouse brain that tracks the changes in gene activity in the brain from embryo to adulthood, and, this fall, began posting online the first data from a 3-D gene-expression atlas of the human brain, a project that is still underway.

Allan Jones, the institute’s CEO, said that to date the institute’s team has processed more than 2.8 million tissue sections, created more than 625,000 microscope slides (enough to stretch from Fremont, where the institute is based, to Tacoma), and generated a petabyte–1 million gigabytes–of data.

There were 16 presentations at the conference. Most were highly technical descriptions of basic brain research, but here is a brief description of three of the presentations to give a taste of the type of research that is going on.

Then a light when on in my head . . .

Edward Boyden, professor at the Massachusetts Institute of Technology’s Media Lab, assistant professor of Biological Engineering and Brain and Cognitive Sciences and head of the MIT Synthetic Neurobiology Group, discussed his work using light to instantaneously switch brain circuits on and off.

Boyden uses a technique called optogenetics in which brain cells are genetically engineered to produce a light-sensitive protein that stops the cell from sending signals when they are exposed to a specific wavelength of light.

By inserting light-emitting probes into the brains of these genetically engineered mice, scientists can see how turning on and shutting off individual brain circuits affects brain function and behavior.

While this approach is an extremely interesting research tool, someday a similar light-switch “neuron silencing” strategy could be used to treat such conditions as epilepsy and chronic pain.

In related research, Boyden and his coworkers are developing the use of these light-sensitive cells as a possible treatment for blindness replacing damaged cells of the retina with new light-sensitive, genetically-engineered cells.

The Allen Institute plans to webcast the conference but in the meantime here’s a video of a lecture Boyden gave on brain-computer interfacing techniques last year that covers much of what he talked about at the Seattle conference.

Mind Games: The battle of the sexes

Harvard researcher Catherine Dulac, professor of Molecular and Cellular Biology at Harvard, described how brain development appears to be shaped by a process in which genes from the mother and genes from the father are preferentially switched on and off as the brain grows.

We inherit two copies of most genes, one from our father and one from our mother. However, these genes are not always equally influential.

In some cases, genes from one parent or the other can be chemically modified so that their activity is reduced or even completely shut down, a process called imprinting.

In many cases, imprinting specifically targets a gene from one parent or the other, that is, affecting either the maternal gene inherited from the mother or the paternal gene from the father.

In a study that appeared in the August 6th issue of the journal Science, Dulac and colleagues report the results of two studies looking at imprinting in the developing mouse brain.

They found that a surprisingly large number of genes and other segments of the genome appeared to be affected by imprinting more than 1300 in all.

In addition, they found that patterns of imprinting varied depending on where in the brain you looked and at what point in development.

In general, imprinting favored the expression of maternal genes during embryonic development while paternal genes appeared to be favored in the adult brain.

The researchers also found that imprinting patterns in the brains of males and females differed.

The findings, Dulac said, should help scientists better understand how the brain develops, explain how male and female brains differ, and how environmental stresses–such as poor nutrition or infection–during pregnancy and early life might affect the developing brain.

Here is a video of a talk Dulac gave earlier this year. (The audio is bad for the first few minutes but improves after her microphone is adjusted.):

Dissecting the brain’s wiring diagram

Stephen Smith, professor of Professor, Molecular & Cellular Physiology Stanford University, presented stunning images of the brain created using a new technique called 3-D array tomography.

Courtesy Stephen Smith

The human brain is arguably the most complex thing we know of in the universe; there are an estimated 100 billion neurons, each reaching out to communicate with 1,000 to 10,000 other neuron– creating an estimated 100 trillion or more interconnections.

In order to understand how the brain works, we will have to work out the “wiring diagram” of these interconnections, Smith said.

To do this, Smith and his coworkers have been developing 3-D array tomography to image the brain.

In this process, samples of brain tissue are preserved in a resin block and then shaved off in extremely thin layers.

These thin sections can then be stained to make a variety of structures visible and imaged.

The images can then be fed into a computer that can reconstruct the brain in 3-D representations providing exquisitely detailed pictures of the brain architecture (an example on the right: cortex of the mouse brain).

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Disclosure: Michael McCarthy has provided editorial services to the Allen Institute for Brain Science.

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