Help protect our planet, support the landmark climate legislation

Moments ago, Congressman Henry Waxman (D-CA) fired the starting gun on the most important legislative fight of our lives, introducing draft legislation that could unleash America's green energy future and address global warming.

This is the first step toward passing landmark climate legislation this year. It will be a long hard fight.

If we succeed, we will make a critical investment in our children's ecological and economic futures.

Naturally there are numerous opponents to any bills that limit industry (emissions laws, clean water laws etc). My friends at the environmental defense fund estimate that we will be out spent 20 to 1 on this bill.

If the vote comes to your district, you know what to do. The future of our planet depends on it.

I encourage you support the environmental defense fund, who is helping to spearhead this process. Donations can be made in any amount $5 or above at http://www.edf.org/home.cfm and clicking donate


If we fail? Well, we cannot fail.

Pistachios may have salmonella

While investigating two people who called the FDA complaining of gastrointestinal illness that could be associated with the nuts, the link hasn't been confirmed. FDA said central California-based Setton Pistachio of Terra Bella Inc., the nation's second-largest pistachio processor, was voluntarily recalling its pistachio products. Potentially contaminated products may have been sold in 31 states so far. It will "take weeks to figure out how many products" could be affected, said Jeff Farrar, chief of the Food and Drug Branch of the California Department of Public Health.

Salmonella bacteria is the most common cause of food borne illness and typiically causes diarrhea, fever and cramping. The infection can be life-threatening for children, the elderly and people with weakened immune systems. I want to stress that the recall is voluntary, and that both roasted products and frozen products containing pistachio (ice cream) are likely safe to eat because the processing/storage of these foods kills salmonella. Infection is unlikely.

Coming Soon....Visitor Polls

epidemiologyandpublichealth.blogspot.com administration is designing quick polls to gauge our audience's preferences. Depending on response, we may use this method to conduct a convenience sample for a low 'hanging fruit' publication.

Polls should be active within a week.

Who Says Soccer Isnt Violent?

In the Ivory Coast, Soccer Fans Mean Business. A stampede at a World Cup qualifying soccer match in the Ivory Coast killed at least 22 people and wounded 132 today? No, this wasn't a case of a herd of elephants infiltrating the stadium. Instead, it was unruly fans trying to fill the stadium before kickoff. Hundreds of fans at the Felix Houphouet-Boigny arena pushed against each other shortly before the game trying to get into the stadium to see a match between Ivory Coast and Malawi, setting off a panic that led to the stampede. With a lack of modern security forces, the stampede got out of control. Riot Police had to come and fire tear gas into the crowd to calm the situation. Im not sure if or how many were arrested, but with at least 22 deaths, someone will be held accountable. Those in the stadium report that a wall gave out, which crushed at least 10 people. I always thought soccer houligans were dangerous, but this is ridiculous!

Slips and Falls Among The Elderly, Accidents Waiting to Happen

At the Request of a Colleauge, I wanted to give you some information about slips and falls among the elderly. I gave a talk on this very topic, and its a much more serious problem than people realize. Unintentional falls are a threat to the lives, independence and health of adults ages 65 and older. Every 18 seconds, an older adult is treated in an emergency department for a fall, and every 35 minutes someone in this population dies as a result of their injuries. Although one in three older adults falls each year in the United States, falls are not an inevitable part of aging. There are proven strategies that can reduce falls and help older adults live better and longer. The CDC has provided a lot of information about this issue, and so I would like to share some of it with you.


The following materials courtesy CDC give an overview of the problem of older adult falls and how they can be prevented.

Fact Sheets

Falls Among Older Adults: An Overview
This fact sheet gives an overview of the problem of falls among older adults in the United States. You will also find prevention tips and links to resources developed by CDC.

Costs of Falls Among Older Adults
This fact sheet describes the costs of falls among older adults - more than $19 billion annually – and includes information on how these costs are calculated and distributed.

Hip Fractures Among Older Adults
More than 90% of hip fractures among adults 65 and older are the result of a fall. This sheet provides information on the number of hip fractures, groups at risk, and prevention tips.

Falls in Nursing Homes
Falls are more common in nursing homes than in the overall community. You can learn about the extent of falls in nursing homes, their causes, and some prevention strategies.

CDC Fall Prevention Activities
This page highlights CDC-sponsored projects aimed at preventing falls among older adults.

Will Something Finally be Done About the Out of Network/In Network Insurance Scheme?

Its only taken decades but finally the government is trying to rein in costs associated with health insurance. Ever been scared to go to another doctors office other than your own? Well part of that is probably a financial issue. You can pay up to 75% more out of pocket when you go to an out of network provider. What do I mean by out of network?...Insurers have certain doctors in their umbrella of physicians, those who usually receive more payment for controlling their costs. If you go to another doctor not on their list, you have to pay a lot more. J Rockefeller has had enough.

Courtesy yahoo health: Sen. Jay Rockefeller, chairman of the Senate Commerce, Science and Transportation Committee, wants answers from companies known to deliberately charge more for out of network services, at a hearing Tuesday from the chief executives of UnitedHealth Group Inc. and its subsidiary Ingenix Inc., a claims database used by insurers nationwide to calculate out-of-network rates.

The inquiry follows lawsuits and an investigation by New York Attorney General Andrew Cuomo alleging that UnitedHealth and Ingenix manipulated rate data so insurers had to pay less and patients more for out-of-network services.

"They're lowballing deliberately. They deliberately cut the numbers so the consumer has to pay more of the cost," Rockefeller, D-W.Va., said in an interview with The Associated Press on Friday.

"It's scamming. It's fraud," he said.

Whike some have taken steps to reduce the huge disparity in charges, Rockefeller and other lawmakers, along with doctors and consumer groups, view the matter as far from over. They say more accountability and transparency is needed in how insurance companies determine out-of-network rates, and that patients need to understand how it's done to avoid sticker shock when they get their medical bills.

ER Physician Has Her License Revoked!

According to the New York State Department of Health site:

The New York State Board for Professional Medical Conduct has revoked the license of a Rhinebeck emergency department physician, permanently prohibiting her from practicing medicine in New York State.
In a decision handed up March 2, the Board charged Kimberly Godfrey, D.O., with gross negligence, negligence on more than one occasion, gross incompetence, incompetence on more than one occasion, and failure to maintain accurate patient records.
The Department has determined that Dr. Godfrey failed to perform adequate physical exams or take adequate histories, document medical records, and appropriately follow up when patients experienced complications.
She had agreed to an interim non-disciplinary order on August 2, 2008, precluding the practice of medicine until the investigation was complete.
The license revocation decision followed a hearing before a hearing committee of the Board for Professional Medical Conduct comprised of two physicians and a lay person. During the course of the hearing, both the physician and the state had the opportunity to offer evidence and present witnesses.
The Office of Professional Medical Conduct in the New York State Department of Health is responsible for investigating complaints about physicians, physician assistants, and special assistants. The Board for Professional Medical Conduct, comprised of some 200 physicians and lay members, is responsible for adjudicating charges of misconduct.

What clinical trials are set to begin?

I was asked by a family member today about new clinical trials going on, and how one would go about getting into them. Well there are hundreds going on right now, but some of the newer ones with paricipants currently being enrolled (courtesy centerwatch) are:


Ocular Hypertension
If you have been diagnosed with ocular hypertension or open angle glaucoma and are currently using Xalatan eye drops, you may qualify for this study.
The research site is in Clarksville, Tenn.
More information
Please see http://www.centerwatch.com/clinical-trials/listings/studylist.aspx?CatID=202.
-----
Diabetes Mellitus, Type 2
If you have been diagnosed with type 2 diabetes, you may be eligible for this study of a new insulin treatment.
The research site is in Idaho Falls, Idaho.
More information
Please see http://www.centerwatch.com/clinical-trials/listings/studylist.aspx?CatID=603.
-----
Prostate Disorders
If you are a man 45 or older with enlarged prostate, BPH symptoms and erectile dysfunction, you may qualify for this study.
The research site is in Tarzana, Calif.
More information
Please see CenterWatch. All rights reserved.

Too much salt bad for you...duh!

Accroding to a recent CDC study, 7 out of 10 Americans should restrict their salt consumption, but very few of them do. About 145 million U.S. adults are thought to be more sensitive to salt — a group that includes anyone with high blood pressure, African-Americans and everyone older than 40.

That group should eat no more than about two-thirds of a teaspoon of salt each day. But only 1 in 10 people in that targeted group are meeting that guideline, according to estimates released Yesterday by the Centers for Disease Control and Prevention.
"I don't think 'alarming' is too strong" a term for describing the results, said Dr. Darwin Labarthe, director of the CDC's Division for Heart Disease and Stroke Prevention.
Sodium increases the risk of high blood pressure, which is major cause of heart disease and stroke.

Salt is the main source of sodium for most people.
Health officials estimate that about 80 percent of the average American's salt intake occurs without them salting their food.

It comes from the salt in many packaged and processed foods and meals served in restaurants.

Processed foods are completely loaded with it, as it is the main preservative!

Salt reduction has become a recent focus of public health campaigns. New York City's health department, the American Heart Association and nearly three dozen other organizations are trying to persuade food manufacturers and chain restaurants to reduce salt content by more than 50 percent over the next 10 years. The CDC and federal health agencies also having sodium-reduction talks with food companies.

If you are hypertensive like myself, and cannot limit your salt intake, the best way to reduce risk of high blood pressure is to drink TONS of water, and get plenty of exercise.

The debate over salt and high blood pressure has been debated for decades, but its hard to ignore that hypertension prevalence has tripled in 25 years, matching the increase in salt found in many processed foods

New Study Shows Circumcision Prevents HPV and herpes

Circumcision not only protects against HIV in heterosexual men, but also HPV and herpes. Circumcised males reduced their risk of infection with HPV by 35 percent and herpes by 28 percent.

Earlier studies in Africa had previously shown that circumcision had a protective effect from HIV, sometimes by up to 60 percent. These most recent findings are reported in Thursday's New England Journal of Medicine

Matthew Golden, a researcher I am very familiar with said "Evidence now strongly suggests that circumcision offers an important prevention opportunity and should be widely available,"

About 30 percent of men are circumcised. In the United States, where about 80 percent of men are circumcised, but is often done for aesthetic or religous reasons, not for sexual health.

For more on the study, see todays New England Journal of Medicine (3/27) or http://news.yahoo.com/s/ap/20090325/ap_on_he_me/med_circumcision_stds;_ylt=AjhgALX.rUkwpBovkhZpyWDVJRIF

HPV can cause cervical cancer and genital warts. Herpes greatly increases the chances of infection with HIV. Preventing these diseases will have a trickle down effect of preventing other STD, most importantly HIV. It is well known that having one STD of any kind greatly increases your risk of contracting another. HOWEVER, I dont believe circumcision should be seen as an effective protection method. Condoms are the only way to fully protect, limiting number of sexual partners etc. However, in places like Sub-Saharan Africa where HIV is more common than the common cold, I think any bit of protection will go a long way, even circumcision.

Health Insurers Fighting For Their Existence, Are You Kidding..

The health insurance industry has opted to potentially eliminate its controversial practice of charging higher premiums to people to those with pre-existing medical conditions. The offer from America's Health Insurance Plans and the Blue Cross and Blue Shield Association is a potentially significant shift in the debate over reforming the nation's health care system to rein in costs and cover an estimated 48 million uninsured people. In a letter to certain US Senators, the companies say they will "phase out the practice of varying premiums based on health status in the individual market" if all Americans are required to get coverage.

The major reason they are doing this? Yup, they are trying to prevent the creation of a Universal insurance plan that would compete with them, something that many democrats are working toward. To help stave off universal coverage talks, the industry has already made a number offered to end the practice of denying coverage to sick people.

More on this can be found at: http://news.yahoo.com/s/ap/20090324/ap_on_he_me/insurers_sick_people


I for one wouldn't mind seeing these major corporations roll over in this recession. They helped bring us to this point...many small businesses have had to close their doors because they cannot afford to pay salaries and health coverage.

Its so slimy how these companies will start to give 'concessions' to avoid going out of business.

Since when is caring for the sick a 'concession'? Health Insurance Companies are here to help us when we are sick. right? Thats what their commercials say....

Bravo Mr. Governor

Governor David A. Paterson of New York State, signed a bill last week to ensure that New Yorkers who lost their jobs at small businesses will qualify for federal benefits that pay up to 65 percent of Consolidated Omnibus Budget Reconciliation Act (COBRA) health insurance premiums. The Governor submitted his Program Bill last week because a change in State law was needed to allow eligible workers from small businesses to access the subsidized coverage. The subsidy, part of the American Recovery and Reinvestment Act (ARRA), is available to individuals who were involuntarily terminated on or after September 1, 2008.

Taking steps in the right direction to guarantee health coverage for all, although COBRA is very expensive, so 65% may not be enough.

For more information:

http://www.ny.gov/governor/press/press_0320095.html

Congratulations to Charlotte Druschel MD, MPH

Charlotte Druschel, M.D., M.P.H., Director of the Congenital Malformations Registry and Research Section in the New York State Department of Health (DOH), has been named the 2008 recipient of the Godfrey P. Oakley Jr. Award, presented by the National Birth Defects Prevention Network to honor her lifetime contributions to the field of birth defects research.

Dr. Druschel is an amazing researcher, and a former colleague of this site's administrator. She is very deserving of this award

For more information : http://www.health.state.ny.us/press/releases/2009/2009-03-19_dr_druschel_receives_award.htm

Injured by a vaccine, or think you were?

I was asked this question, that is how do I report a vaccine reaction:

The National Vaccine Information Center (NVIC) is a non-profit, educational organization founded in 1982 by parents of vaccine-injured children and located in Vienna, Virginia.

As a consumer vaccine safety advocacy organization, they worked on the National Childhood Vaccine Injury Act of 1986 and were responsible for urging the creation of safety provisions in that historic law.

This included a centralized vaccine reaction reporting system, called the Vaccine Adverse Events Reporting System (VAERS) that is jointly operated by the federal Food and Drug Administration and Centers for Disease Control.


Visit VAERS to report an adverse event, and contact your primary care physician. If it is an emergency (anaphylatic shock) dial 911!

Yellow Peas are that good?

Certain proteins found in the yellow garden pea appear to help lower blood pressure as well as delay, control or even, yes even, prevent the onset of chronic kidney disease, at least in rats, a Canadian study is suggesting; a news report on yahoo health recently covered.

This animal model lools promising. Yellow peas dont hurt, at least we know that!

The lead investigator in the study, Rotimi E. Aluko, an associate professor in the department of human nutritional sciences at the University of Manitoba in Winnipeg "What we seem to have here is sort of a natural approach to treating this disease, as opposed to the normal pharmacological approach...We're talking about an edible product, not a drug, which can help to reduce blood pressure and, at the same time, reduce the severely negative impact of kidney disease"

Kidney disease affects 13 percent of American adults and is very difficult to treat adequately, with most people developing cardiovascular complications from high blood pressure linked to kidney malfunction.

So, in essence, eat your peas, uh, that is the yellow ones (I prefer green).

Using Google Earth in Public Health Activities

So I'm taking a Geographic Information Systems Class, and we were taught to use Google Earth. This is a program that I had for about a year prior to this class, mainly for finding places of interest before travelling there. They offer a street view level which is cool, and you may remember seeing a google vehicle driving through your neigboorhood with a big 3D camera..this is how they generated such a street view. So, its cool in that sense.

However, it also has public health uses, as you can tag locations from a satellite view. For example, if you have access to such data, you can highight all hospitals in an area, find shortest routes, plug in disease rate information to target future interventions etc. While there are a lot of mapping programs used by health officials, namely map info and arcgis, which are more professional, Google Earth may be used in resource poor settings, or in situations where more specialized training in other software packages is unavailable. Developing nations could be key here, as the software is free, and requires limited training to utilize.

So, if your in public health, consider using it for basic mapping applications. If your not, consider using the program for fun, or to see your house from a street view.


FYI. I will be writing a publication with a professor in the use of such a program for public health applications--will update you on that when time comes

Splitting the FDA?

I saw this on Yahoo News this morning and must say it is no suprise drug makers would like to see FDA split, because they can push through new drugs faster. However, FDA exists to ensure products are safe, and this is why it may take 7-10 years to get a drug to market. Drug makers must conduct phase 1, 2 ,3 trials successfully before a drug can be licensed for sale in the U.S. However, a patent on a particular formula may only be for 10 years, so their is pressure on company's bottom lines to get the product out quickly. It will be interesting to see if the current administration rearranges FDA under pressure from drug makers, health care CEOs, and associated lobbying groups.

Violence in Tibet

In Tibet, violence continues. As it spreads, public health activities in the region will be placed on the backburner.

A Synopsis of the latest events:

Yesterday hundreds of Tibetans attacked a police station and government officials in northwestern China despite heightened security, prompting the arrests Sunday of nearly 100 monks, state media reported.
Six of those arrested for alleged involvement in the attack were caught by police while 89 others turned themselves in, according to the official Xinhua News Agency. All but two were monks, it said.
The protest appeared to be in response to the disappearance of a Tibetan who escaped from police custody in Qinghai province, Xinhua said.
According to a Tibetan exile, the protest involved as many as 2,000 people and was sparked by the apparent suicide of a monk being investigated for unfurling a Tibetan flag.
Xinhua said several hundred people — including nearly 100 monks from the Ragya Monastery — attacked the police station in Ragya, a township in the Tibetan prefecture of Golog, on Saturday, assaulting policemen and government staff.
Some officials were injured slightly in the assault, Xinhua said, without elaborating.
A man who answered the phone at Qinghai's public security department said he had not heard about the attack or the arrests. Phone calls to other police departments and government offices in the area rang unanswered.
The violence is the latest known incidence of unrest following a bomb explosion Monday in an unoccupied police station in predominantly Tibetan Ganzi prefecture in Sichuan province. The explosion shattered the building's windows but no injuries were reported.

Considering Universal Health Care in California

First, A few facts about California and Healthcare. One in five Californians has no health insurance at all and most of these people are average working people.
Usually, their employer is one of the many who does not provide healthcare coverage and they don’t make enough to pay for an individual policy for them and their family.

Of those Californians who do have insurance, many are underinsured and are very surprised to discover that their insurance doesn’t cover a large chunk of their costs if they get sick or injured. In fact half of all the personal bankruptcies in America are caused by medical costs and three-quarters of those bankrupted had insurance at the time they became ill or injured.
People are also very worried about losing the insurance they might get at work because employers are, more and more, cutting back on health insurance and other benefits and, of course, losing or changing your job means losing your insurance.

Plenty of money is being spent on healthcare-one out of every six dollars spent in America, it’s just not spent to cover everyone. And, while spending generally has risen by 7.5%, insurance premiums have gone up by double-digits every year for the last five. Wages have increased only 1.7%. Costs are getting shifted to patients, physicians who are not getting reimbursed for their work, workers.

Insurance companies deny claims and treatments in order to save money, narrow provider networks, exclude more and more people for “pre-existing conditions” or because they take certain kinds of prescription drugs (most of the most popular ones) or work in a particular field.

A Field Poll commissioned by the California Wellness Foundation revealed that 80% of
Californians want the government to guarantee access to affordable healthcare coverage. When asked why healthcare costs are increasing, the majority pointed to excessive insurance company profits, followed by waste, fraud and inefficiency