U.S. Health Care Spending Now at $2.7 Trillion: Report

monday, jan. 7 (healthday news) -- health care spending grew nearly 4 percent in 2011, reaching $2.7 trillion -- a new high, according to a federal government report issued monday.

although this seems like a huge amount of money, the rise actually represents the third consecutive year of "relatively slow growth," the researchers said. whether spending will pick up again as the economy improves, as it has in the past, isn't known, they added.

"the stable growth in national health spending in 2011 is the result of mixed trends," micah hartman, a statistician in the office of the actuary at the centers for medicare and medicaid services, said during a monday afternoon press conference.

these trends include slowed growth (compared to years past) in expenditures for health insurance, government-funded research and funding for public health, hartman said.

those slowdowns, however, were "offset by faster growth in personal health care goods and services," hartman noted. "the main drivers of the spending trends were medicare, private health insurance and consumer out-of-pocket payments," he said.

health care reform has had little effect on spending numbers so far, the researchers said. although some provisions of the obama administration's affordable care act were in place in 2011, their effect on spending was minimal, hartman said. it won't be until 2014 and beyond that the full benefits of the law will be seen, he said.

the report, which is issued annually, was published in the january issue of the journal health affairs.

among other findings in the report:

• health care spending as a part of the country's gross domestic product (gdp) has remained steady at 17.9 percent from 2009 to 2011.
• americans' personal health care spending increased briskly -- from 3.7 percent in 2010 to 4.1 percent in 2011 -- in part due to higher prescription-drug prices and higher costs for doctor and clinical services, the researchers found. personal health care includes all goods and services used to treat diseases in individual people, and excludes expenditures such as government administration and the net cost of health insurance.
• cost of doctor and clinical services jumped 4.3 percent in 2011, compared to about 3 percent in 2010, hartman said.
• spending on prescription drugs increased 2.9 percent in 2011, a big rise compared to the historically low annual increase of 0.4 percent in 2010. this growth is due primarily to the rise in brand-name prescribing and the introduction of new drugs.

the steep growth in drug costs, however, "was partly offset by slower growth for hospital services," hartman said. spending for these services was slowed by 4.2 percent, due to cuts in medicaid and hospital use, he said.

and although the growth in spending for medicaid slowed in 2011, spending for medicare, private insurance and out-of-pocket costs sped up, the researchers noted.

"medicare spending grew 6.2 percent in 2011, accelerating the growth from 4.3 percent in 2010," hartman said. the growth was largely due to one-time spending for skilled nursing facilities, he said.

medicaid spending increased 2.5 percent in 2011, down from 5.9 percent in 2010. the slower growth was due to states spending less on the program as matching federal grants ran out, hartman noted.

private insurance costs also grew as some 1 million more people enrolled. most of these new members were children of current policy-holders recently covered by the affordable care act, he said.

out-of-pocket spending for health care among consumers grew 2.8 percent in 2011, accelerating from 2.1 percent growth in 2010, hartman said.

as for the future, the researchers said they are concerned that spending on health care will only gain speed as the u.s. economy rebounds, something that has happened after past recessions.

Source:www.womenshealth.gov

Many States Say 'No' to Health Insurance Exchanges

tuesday, dec. 18 (healthday news) -- half of the states in the nation have rebuffed a key provision of the obama administration's health reform law: the creation of state-based health insurance exchanges, according to data compiled by the henry j. kaiser family foundation.

states had until friday, dec. 14, to submit blueprints for creating their state-based insurance exchanges.

by default, the federal government will implement health insurance exchanges in the 25 states that are not moving forward, helping the uninsured gain coverage. another seven states, according to the kaiser foundation's count, will operate exchanges in federal-state partnerships. these arrangements will allow states to share the administrative burden of exchange implementation with the federal government.

"i'm sure it's a disappointment because the overall hope and plan from the beginning was to have as many states as possible to go ahead and implement their own exchanges," said frank mcardle, an independent health policy and benefits consultant in bethesda, md.

on monday, u.s. health and human services secretary kathleen sebelius said in a blog posting that the federal government had received 10 state applications to run an exchange. last week, the federal government granted conditional approval of insurance exchanges in another eight states and the district of columbia, where significant progress has been made in setting up those health insurance marketplaces. in all, 18 states and the district of columbia intend to run their own exchanges.

"we're looking forward to jan. 1, 2014, when consumers and small businesses will be enrolled through the exchanges in private health insurance plans and millions more americans will have the coverage they need and deserve," sebelius wrote.

state-based health insurance exchanges are a key element of the patient protection and affordable care act, the controversial health reform legislation championed by president barack obama. each exchange will operate a website where uninsured residents of the state and small employers can compare various health-plan options offered by insurance companies, much in the same way that consumers shop online for hotel rooms and airplane tickets that suit them best.

the health reform law is designed to help some 30 million uninsured americans by expanding medicaid, the publicly run program that helps the poor obtain medical care; creating subsidies for lower-income people to buy private coverage; and establishing the state exchanges.

with enrollment for the exchanges set to begin oct. 1, 2013, the obama administration and its contractors face the mammoth task of building a federal exchange that can be rolled out in states that have no insurance exchange and creating a central data hub where states can verify a person's eligibility for tax credits, premium subsidies and other health programs, such as medicaid and the children's health insurance program.

dr. daniel derksen, chair of public health policy and management at the university of arizona in tucson and former director of the new mexico office of health care reform, expects the federal government to "work hard" to get those systems in place but anticipates "hitches" along the way.

"i think it would be irresponsible to say a switch is going to be flipped and come january 1st [2014] this thing will work perfectly. there's just a lot of moving pieces with this thing," noted derksen, who led efforts to build new mexico's health insurance exchange.

many gop governors not setting up state-run exchanges

although the affordable care act, derided as obamacare by its critics, became law in march 2010, many opponents at the state level dragged their heels on exchange activities pending the u.s. supreme court's decision last june on the law's constitutionality and the outcome of the november presidential election. some states nixed the exchanges, citing anticipated costs, lack of federal guidance and outright opposition to the law.

responding to a request from republican governors, sebelius last month extended the deadline for submitting a letter of intent and application to operate an exchange to dec. 14. states falling behind on exchange-building activities can still request help. the deadline to apply to operate an exchange in partnership with the federal government is feb. 15, 2013.

for the most part, states with republican governors opted to default to a federal exchange. just five republican-led states will run their own exchanges, and two will partner with the federal government.

"the great irony of this whole thing is you have the majority of the republican governors really allowing the federal takeover of health care when they could choose to have a state exchange," derksen said.

but will people care whether their state is the face behind the exchange?

"from a consumer perspective, whether you have a state-run exchange or a federal exchange doesn't make a huge difference," said caroline pearson, a director at avalere health llc, a washington, d.c.-based consulting firm. in either case, she noted, people will get coverage.

where it begins to matter is in the details, pearson explained. states can customize health plan options to accommodate the particular needs of their residents, she said. and because medicaid eligibility rules are state-specific, states may be able to do a better job of helping lower income people who apply through the exchange to coordinate coverage with the state medicaid program, she added.

avalere health predicts that roughly two-thirds of the 8.2 million people expected to buy coverage through the exchanges in 2014 will do so through a federally administered or partnership exchange.

"consumers also need to watch the debate over the fiscal cliff," mcardle cautioned. to offset scheduled tax increases and spending cuts slated to take effect in the new year, congress could reduce health insurance subsidies under the affordable care act, making health coverage less affordable.

"if the fiscal cliff and deficit reduction negotiations were to result in a reduction in federal subsidies available under the aca [affordable care act] starting in 2014, that could make coverage in the health insurance exchanges less affordable for some people," he said.

Source:www.womenshealth.gov

Children With Asthma at Higher Risk for Shingles: Study (3/5/2012)

Children With Asthma at Higher Risk for Shingles: Study

Painful skin condition typically strikes older adults, researchers note.
MONDAY, March 5 (HealthDay News) -- Children with asthma have a higher risk for developing shingles -- a painful skin rash -- following infection with the herpes zoster virus, new research reveals.

The authors noted that 1 million Americans are estimated to be infected with the herpes zoster virus every year. However, typically it's a problem that strikes men and women over the age of 60 or people with weakened immune systems.

Researchers analyzed 277 medical records involving patients under the age of 18 who had experienced an episode of shingles between 1996 and 2001.

Stacking up the shingles cases against 277 children who had no history of shingles, the team found that asthmatic patients were 2.2 times more likely to have a case of shingles compared to those who did not have asthma.

While 23 percent of the shingles patients had a history of asthma before the onset of shingles, only 35 patients without shingles (about 12.5 percent) had asthma in their past.

The findings are slated to be presented Monday at the American Academy of Allergy Asthma & Immunology annual meeting in Orlando, Fla.

"It had previously been unknown whether asthma status poses an increased risk of shingles among children," study author Dr. Young Juhn, a pediatrician at Mayo Clinic Children's Center in Rochester, Minn., said in an academy news release. "These results suggest that asthma significantly increases the risk for shingles in children."

The researchers' previous work found that microbial infections in people with asthma came from airway-related conditions such as strep infections and whopping cough and serious pneumococcal disease.

"However, shingles is not an airway-related illness, and cell-mediated immune function is an important host-defense mechanism from developing shingles," Juhn said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Source: http://www.womenshealt.gov/new/news/headlines/662398.cfm/

IT DOESN'T HAVE TO BE LIKE THIS

IT DOESN'T HAVE TO BE LIKE THISBy Tracey Spicer

March 1, 2012

I don't know what's more heartbreaking.

Watching the ABC footage of cattle being tortured and mutilated by abattoir workers in Indonesia; or knowing the federal government is too shortsighted to see there's a simple solution.

For years, the World Society for the Protection of Animals and the Meat Workers Union have lobbied for live exports to be phased out, replaced by a chilled and frozen meat trade.

Animal activists and abattoir workers are unusual bedfellows.

But their Humane Chain campaign provides compelling evidence this can protect animals AND jobs.

Each year Australia exports more than four million sheep to the Middle East and almost a million cattle, predominantly to Indonesia.

Tens of thousands of animals die on board the ships. Those that survive the journey often have their throats slit while fully conscious. Four Corners opened our eyes to this horrific practice in May last year.

This prompted the Federal Government to ban live cattle exports for two months. It was the right outcome at the wrong time. Farmers simply weren't ready.

Many had to shoot starving cattle as the ban dragged on.

Facing a backlash, the government resumed the trade under 'strict guidelines' stating exporters must guarantee the welfare of all livestock leaving Australia.

This is impossible to police, unless you put a hidden camera in every abattoir.

Source: http://thehoopla.com.au/it-doesnt-have-to-be-like-this//

WHO'S AFRAID OF THE ONLINE TROLL? By Wendy Harmer

February 29, 2012

Trolls…

I've had a few.

But, then again…

Too few to mention.

We're having this encounter online.

Not down the shops, not in a car park, in a footy grandstand or in a slow-moving queue.

I can't see you. You can't see me.

In cyberspace, no-one can see your face when you’re shouting mindless, ugly abuse.

I was reminded of this yesterday when, stuck in a traffic jam my fellow drivers wound down their car windows to watch a disturbing road rage incident unfold.

Shouts. Swearing. Fists shaking. Cars refusing to move after the lights turned green as the argument raged. Ugly stuff. Frightening.

Those of us nearby were noting number plates and had 000 on speed dial. A few got out of their cars to see what was up. We acknowledged each other with a nod, knowing we were there as witnesses in the event things became physically violent.

That sort of support is not there when you are at home, alone and the abuse comes through on your computer screen.

It can make you feel very vulnerable indeed.

There's hardly a human posting their opinion online who hasn't complained of being bombarded with ugly, cruel and explicitly violent comments from anonymous 'trolls'.

NB: In internet slang, a 'troll' is someone who makes comments with one aim in mind – to provoke and upset.

Doesn't matter if you are male or female; whether you're in the depths of despair or celebrating your triumphs, seems there's always some 'anonymous' who is there to rain on your parade. To make you feel small and unworthy.

Now we have the chance to peek behind the mask thanks to a brilliant report from News Ltd. journalist Claire Connelly who interviewed three such 'trolls'.

Source: http://thehoopla.com.au/afraid-big-bad-troll//

Older Adults Do Get a Good Night's Rest, Survey Finds (3/1/2012)

Older Adults Do Get a Good Night's Rest, Survey Finds

Sleep disturbances, daytime fatigue not a given in later years.

By Lisa EspositoHealthDay Reporter
THURSDAY, March 1 (HealthDay News) -- The older you get, the better you sleep, according to new research that challenges conventional wisdom that a good night's rest is harder to come by with age.

In a survey of 150,000 adults, people in their 70s and 80s had the fewest complaints of sleep disturbance, while those between the ages of 18 and 24 had the most. Except for a bump in complaints in middle age, sleep appears to improve steadily over the course of a lifetime.

One big implication of the study is that health-care providers should not just dismiss poor sleep as a normal part of aging, said study author Michael Grandner, a research associate at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania.

The study, which appears in the March issue of the journal Sleep, looked at responses to a phone survey conducted in 36 U.S. states and territories. People described how often they had experienced sleep disturbance or daytime drowsiness in the previous two weeks.

"In women, you saw very clear increases in both sleep disturbance and daytime tiredness [in middle age]; in men you also saw an increase in later middle age," Grandner said. "I think in women, you're seeing an effect of pre-menopause and menopause. With men, it's a little later. That's where career peaks -- and peak stress -- occurs, in the later 50s."

Men in that age group are also at higher risk of sleep apnea and other health problems, he noted.

Health problems -- especially depression -- had a significant effect on sleep, the survey found.

"One of the most important findings was that depression was a significant predictor for sleep problems," said Michael Vitiello, a professor of psychiatry and behavioral sciences at the University of Washington in Seattle, and an expert on sleep and aging.

"I applaud the investigators for this labor-intensive and comprehensive examination of the question," he said. "I've been on the 'It isn't aging, it's illness' bandwagon for many years. It's a treatable disorder. Much of the sleep disturbance seen in older adults is not driven by aging, but by illness."

Healthy older people sleep better, both experts said. They don't necessarily nap more, and dozing off at the opera or movies is by no means a given.

In his own research, Vitiello said, "we looked at napping in older adults -- but not as large a sample, and found that, like sleep complaints, napping is driven by illness burden. If an older person complains [of sleep problems], something's going on and it needs to be dealt with. A physician shouldn't say, 'OK, you're old.' "

Treatment could include referring a patient to a sleep clinic or to a psychiatrist, Vitiello said. And Grandner said patients have been helped by combinations of psychotherapy and relaxation therapy.

Because of the nature of the study -- a "cross-sectional" survey -- the authors said they can't conclude that a cause-and-effect relationship exists between aging and sleep.

Vitiello did point out some methodology issues with the survey, such as an overall response rate of only 40 percent. And, because the study was landline based -- no cellphones -- he added that could affect participation rates among different age groups.

"The common knowledge is that sleep deteriorates with age," Grandner said. And, he added, many sleep-lab studies have shown "certain aspects of sleep get worse as you get older. Older people tend to take longer to fall asleep, they have more awakenings. A lot of the restorative and healing functions of sleep tend to happen less in older people.

"However, what we found [in the study] was that even if their sleep objectively might be worse, their experience of their sleep is better," he said. Part of the explanation may be that older people have other health problems that leave sleep issues lower on their radar. "Somebody who's much younger [might have] a much higher expectation of how they're going to sleep," he said.

It could also be that people in poor health -- who are more likely to have sleep problems -- are less likely to survive to older ages, he said.

For his part, Vitiello said, "If you're healthy, you're probably sleeping quite well, even into your 80s. So, if you see an older person who is having a lot of problems staying awake during the day, you shouldn't just excuse that as, 'Oh, that's just an old-people thing.' "

Source: http://www.womenshealt.gov/new/news/headlines/662278.cfm/

A Rose By Any Other Name

The
human nose is a marvelous thing.
It can detect over 10,000 different smells and our sense of smell can call up powerful memories in an instant.

Room
scenting is a very personal choice. A particular scent will connect to an event, person or thing. When you smell it again, it often triggers
memory in the form of a conditioned response, for example the smell of the
ocean call up a particular seaside holiday.

Smell
can also activate the subconscious and influence your mood. Instead of reminding you of specific holiday
details, the ocean scent might make you feel content or happy. Fragrance is so
powerful it can take you from a
feeling of calmness and relaxation to a feeling of joy and stimulation.

Fragrance
categories include:

Floral
– this can be a single flower
or classic floral blends, which may have fresh, fruity, or even powdery
elements.

Citrus
Fruity –includes such
fragrances as lemon, orange, bergamot, apple and berries.

Aquatic - scents
from nature, which bring the outdoors inside all year round. Fresh clean
scents are usually inspired by fragrances taken from nature's elements, like
the rainforest and the ocean.

Nature
Greens - lively fragrances such as green tea, spring
leaves and fresh mown grass are great for living areas and hallways
because they are both revitalising and welcoming. The beauty of
nature and green culture has grown demand for green vegetable and aromatic
herb-based fragrances like thyme and new
mown hay.

Oriental - rich
scents that evoke the feeling of warmth and comfort are becoming increasingly
popular, especially in the autumn. People want to bring the scent of warm
woods and rare spices into the home with fragrances such as sandalwood, vanilla
and cloves.

Food
- foodie aromas can lend an atmosphere of nostalgia – a
fragrance such as cinnamon or ginger may rekindle happy memories of family
times spent in the kitchen and create feelings of wellbeing and reassurance.

You can also consider the season when choosing
a scent. Winter is a popular time for
the likes of apple, cinnamon and pine, while scents like pumpkin, spice and
maple leaves are popular for autumn.

We are bombarded with
artificially scented products. The chemicals often used to formulate these
fragrances can be toxic to the human body over time. It is estimated that 95% of the synthetic fragrances on the market
today are derived from petroleum by-products. These chemicals can cause irritation to the nose, eyes and throat and
are often found in artificially scented air fresheners, soaps, detergents and
cleaners, deodorants, lotions, perfumes and other more common products, so
do check labels before you buy.

There are many different types of home
fragrance units on the market. The
scented candle and pot – pourri are are among the oldest forms of scenting
homes. Candles can offer design variety but over the years accidental house
fires and soot marks have become an issue.

To
use a safer product many people have moved on to reed diffusers, which are
particularly pleasing to the eye.
Wall plugs, light bulb heated warmers and scented oils are all alternative
options.

Layering
your home fragrance will add greater depth, which can be achieved through the
use of candles, flowers and perhaps diffusers. Candles and flowers will give you a
short-burst of fragrance lasting a few days and an aroma diffuser will provide
you with a constant delicate underlying scent that can last for months, just be
sure your fragrances enhance one another and don't clash.

Lilly
Light

To add fragrance and beauty to your home Ashleigh & Burwood would like to
offer one lucky Women
Talking subscriber the chance to win a Premium Fragrance Lamp Gift Set.

Each Fragrance Lamp is
individually handcrafted, and each piece is therefore completely unique

To enter answer the following question:

Name one of the oil
fragrances

For help visit www.ashleigh-burwood.co.uk

Send your answer to competitions@womentalking.co.uk
ensuring you put the words fragrance in the subject header and also include
your Women Talking username with the
submission.

Please note this competition is only open to Women Talking subscribers and any entry
without a valid username will not be accepted.

The competition closes on March 31st and the winner will be contacted soon after.

Source: http://womentalking.co.uk/new//topics/lifestyle/rose-any-other-name/

Big Drop in Americans' Blood Level of Trans Fats, CDC Says (2/8/2012)

Big Drop in Americans' Blood Level of Trans Fats, CDC Says

New findings focus on whites but studies on other groups underway.
WEDNESDAY, Feb. 8 (HealthDay News) -- Trans fat levels in the blood of white adults in the United States fell by 58 percent between 2000 and 2009, which should help lower the risk of cardiovascular disease in the nation, a U.S. Centers for Disease Control and Prevention study says.

The findings suggest that public health initiatives to increase consumer awareness about the danger that trans fats pose to heart health and to help people reduce their consumption of trans fats have been effective, according to the researchers.

They analyzed data from white adults who took part in the U.S. National Health and Nutrition Examination Survey from 2000 to 2009. Their goal was to examine trans fat blood levels before and after the 2006 implementation of a U.S. Food and Drug Administration law requiring food and some dietary supplement makers to list the amount of trans fats on the Nutrition Facts panels of the product label.

During the study period, some local and state health departments worked to force restaurants to limit their use of trans fats in food and to boost campaigns about the health risks of trans fats.


"The 58 percent decline shows substantial progress that should help lower the risk of cardiovascular disease in adults," Christopher Portier, director of the CDC's National Center for Environmental Health, said in an agency news release.

"Findings from the CDC study demonstrate the effectiveness of these efforts in reducing blood [trans fats] and highlight that further reductions in the levels of trans fats must remain an important public health goal," he added.

Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Medical Center, is encouraged by the new findings.

"Trans-fats have been shown to be highly linked to atherosclerosis, the hardening and narrowing of arteries," Weintraub said. "Cities have banned trans-fats from restaurant cooking and this report shows there can be a true measurable difference from these proactive actions."

The study, published Feb. 8 in the Journal of the American Medical Association, provides information for white adults only. However, additional CDC studies are underway to examine blood trans fat levels among adults in other racial/ethnic groups, children and teens.

Foods high in trans fats include store-bought baked goods such as crackers, cookies and cakes, many fried foods and some shortenings and margarines.

Unlike other dietary fats, trans fats are not necessary for people and do not promote good health, according to the CDC. High consumption of trans fats increases levels of LDL "bad" cholesterol, which boosts the risk of cardiovascular disease.

Another expert also weighed in on the findings.

"With the direct effect of trans-fatty acids on the increase in LDL, which is the cholesterol leading to heart disease, this FDA initiative clearly had significant benefits on public health outcomes," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City.

But problems with the American diet are still far from solved, Weintraub warned.

"The new CDC report shows that people are concerned about trans-fats, since a nearly 60 percent decrease is really impressive," Weintraub said. "But Americans are still getting fatter and diabetes is getting higher. We shouldn't feel we have these epidemics beat because trans-fats are down."

Source: http://www.womenshealth.gov/new//news/headlines/661596.cfm/

Avoid Window Seats to Cut Risk for In-Flight Blood Clots: Study (2/7/2012)

Avoid Window Seats to Cut Risk for In-Flight Blood Clots: Study

Experts say DVTs can strike any immobilized passenger, not just those in economy class.

By Alan MozesHealthDay Reporter
TUESDAY, Feb. 7 (HealthDay News) -- Potentially dangerous blood clots in the legs known as deep venous thromboses (DVTs) got the nickname "economy class syndrome" from widely publicized incidents involving passengers on long-haul flights.

However, new guidelines from a leading physicians' group suggest the class you sit in on a plane may not raise your DVT risk, but your proximity to the aisle might.

Sitting in a window seat is a risk factor for DVT, the American College of Chest Physicians (ACCP) warn in their new advisory, regardless of whether it's in economy or first class.

"DVT risk has nothing to do with economy class," said Dr. Gordon H. Guyatt, chair of the ACCP panel that drafted the new guidelines. "Really, the evidence is that actually where you sit isn't really an issue. It's how much you move around. And if you're in a window seat you are probably more willing to sit for long periods of time being uncomfortable because you are reluctant to make anybody else move to let you out."

The new recommendations are published in the February issue of CHEST.

DVTs are blood clots that typically occur in the legs. They can become especially dangerous if they travel through the bloodstream to the lungs, where they can form potentially lethal pulmonary embolisms.

The current guidelines, which are endorsed by a wide range of American medical associations, are the ninth in a series of ACCP updates on the issue. They were drafted after the panel extensively reviewed findings from relevant studies published since the last update in 2008.

Long-haul immobility does boost DVT risk, the experts noted. But as the ACCP panel sifted through the evidence, they found no basis for the notion of "economy class syndrome." Rather, folks in a window seat might be more hesitant to get up and move around -- and that might raise their odds for a DVT.

Still, "the first thing to say is that if you are a healthy person you should not really worry about DVT because your risk -- even on a long-term flight -- is considerably less than one in a thousand," said Guyatt, who is also professor in the department of clinical epidemiology and biostatistics at McMaster University in Hamilton, Ontario, Canada. "So these guidelines are for those who have more than a normal risk. For those who have had a clot before, or an abnormality of their coagulation system, or disability that affects mobility. Or if you are obese or have active cancer."

In addition to those risk factors, the ACCP says that air passengers who are elderly, pregnant, take supplementary estrogen (including oral contraceptives) or recently underwent surgery and/or trauma also face a higher-than-normal risk for DVT.

Apart from seating considerations, the guidelines also suggest that people on flights lasting six or more hours move about frequently and stretch their calf muscles.

Higher-risk individuals should also wear graduated compression stockings that stretch below the knee. Guyatt said it "would be crazy" for passengers at normal risk to wear such stockings, and the ACCP guidelines specifically argue against their use by healthy passengers.

The guidelines also generally discourage the taking of aspirin and/or anticoagulant medications for the specific intent of lowering DVT risk. That said, those at very high risk are encouraged to consult their doctors in order to weigh the pros and cons of such drugs.

For his part, Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston, said the new DVT guidelines "make obvious good sense."

"Getting up once every hour or two during a long flight and walking up and down the aisle is what you want to do," he noted. "It's not about class and the slight extra room you'll get in business. It's about sitting by the window and looking over at the guy sleeping next to you and thinking you'll wait rather than get up. That's the issue."

"I would also add that all of this would also apply to people taking long car trips," Cannon said. "I've had tons of people driving home on long car rides who have had problems with DVT. Hence the emphasis on mobility. It's all about making sure you get up or get out and move."

Source: http://www.womenshealth.gov/new//news/headlines/661525.cfm/

TONY'S WOMAN PROBLEMBy Tracey Spicer

Booze and Family History of Colon Cancer a Bad Mix: Study (2/3/2012)

Booze and Family History of Colon Cancer a Bad Mix: Study

Red meat, smoking and skipping veggies also associated with a raised cancer risk, research finds.
FRIDAY, Feb. 3 (HealthDay News) -- People who consume a few alcoholic drinks a day and have a family history of colorectal cancer are at increased risk for developing colon cancer, new research suggests.

For the study, researchers in Boston examined data from more than 87,000 women in the Nurses' Health Study and 47,000 men in the Health Professionals Follow-up Study, and found that 1,801 cases of colon cancer were diagnosed among the participants from 1980 onward.

People with a family history of colorectal cancer who drank an average of 30 or more grams of alcohol per day (about 2.5 typical drinks in the United States) were at increased risk for colon cancer, according to lead author Eunyoung Cho, of the Channing Laboratory, department of medicine at Brigham and Women's Hospital and Harvard Medical School, and colleagues.

Those at greatest risk also ate the most red meat, smoked more and consumed the least folate, which suggests they ate fewer green vegetables and cereal. The findings indicate that other lifestyle factors, such as diet, play an important role in colon cancer risk, the researchers said.

Although the study uncovered an association between these factors and colon cancer risk, it did not prove a cause-and-effect relationship.

Among people who did not have a family history of colorectal cancer, no significant association was found between alcohol consumption and colon cancer. Greater alcohol intake was not associated with a consistent increase in cancer risk, the authors noted in a news release from Boston University Medical Center.

The study was published in the February issue of the American Journal of Clinical Nutrition.

Source: http://www.womenshealth.gov/new//news/headlines/661274.cfm/

'Co-Occurring' Disorders May Explain Change in Autism Diagnosis (1/23/2012)

'Co-Occurring' Disorders May Explain Change in Autism Diagnosis

As symptoms of other conditions become more apparent, labels may vary, study suggests.

By Jenifer GoodwinHealthDay Reporter
MONDAY, Jan. 23 (HealthDay News) -- Many children with autism also have other developmental or psychiatric conditions, including learning disabilities, speech delays, attention or seizure disorders and anxiety.

According to new research, some of those co-occurring conditions may explain why autism diagnoses often change as children get older.

In a survey by researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore, more than one-third of parents with children between 6 and 17 years old reported that their child's diagnosis of autism had changed over time.

"We don't know what changed the diagnosis. However, we want to deliver the message that it's important to look at the other coexisting conditions, evaluate them before you make a diagnosis, and also recognize these conditions vary by development age," said study author Li-Ching Lee, an associate scientist in the epidemiology and mental health departments at the School of Public Health.

Autism is a neurodevelopment disorder characterized by problems with social interaction, communication and restricted interests and behaviors.

In the study, researchers used 2007-2008 survey data from the parents of nearly 1,400 children aged 3 to 17 who had received a diagnosis of an autism spectrum disorder (ASD), including autism, Asperger disorder -- a mild form of autism, and pervasive developmental disorder-not otherwise specified.

Parents were asked if their child currently had a diagnosis of autism or an ASD, or had had one in the past.

Nearly 26 percent of parents of children aged 3 to 5 reported a change in diagnosis, the researchers said. Nearly 34 percent of parents of children aged 6 to 11 and 35 percent of the parents of 12- to 17-year-olds reported their child was diagnosed with autism at some point but no longer was considered to have autism, the researchers found.

Overall, children with two or more co-occurring developmental or psychiatric conditions were five times more likely than kids with fewer coexisting conditions to continue to have an autism diagnosis, the researchers said.

Kids who had a moderate-to-severe learning disability were 11 times more likely to continue to have an autism diagnosis over time, while kids with a developmental delay were nine times more likely to retain an autism diagnosis, the study authors said.

Researchers didn't look at why certain conditions are associated with a change in autism diagnosis. But some of the symptoms of various development and psychiatric conditions can overlap, so it's possible that having certain ones can lead to a misdiagnosis until the child gets older and their issues become more clear, according to the study.

For example, kids diagnosed with a hearing problem showed a tendency to "lose" their autism diagnosis over time. Researchers speculated that behaviors that initially resembled autism symptoms -- not responding or not engaging -- were later discovered to stem from impaired hearing.

The study is published in the February issue of Pediatrics.

Dr. Joseph Horrigan, assistant vice president and head of medical research for the advocacy group Autism Speaks, cautioned not to make too much of the findings. The children weren't actually followed over time, nor were they actually examined, a methodology that would be the "gold standard" of research.

Because the results were based on a telephone survey, Horrigan said, "I'd be a little cautious about over-interpreting whether this means there's likely to be change in an autism diagnosis or a loss of an autism diagnosis for a given individual."

Nor did researchers look at kids whose diagnosis went the other way -- that is, they were initially not diagnosed with autism but were later diagnosed with it.

However, the findings highlight how often kids with ASD experience other conditions, some of which may be treatable with medications or with educational interventions. These include anxiety, attention-deficit hyperactivity disorder (ADHD), depression, epilepsy and learning disabilities.

"Up until the recent past, there's been a tendency to spend most of the time and energy on the autism and the autism diagnosis, and thinking about a treatment package that's keyed directly to the autism," Horrigan said. "What's important here is they are highlighting some of the most common co-occurring disorders, a number of which are readily amenable to treatments."

An estimated one in 110 U.S. children -- many more boys than girls -- has autism, according to the U.S. Centers for Disease Control and Prevention.

Source: http://www.womenshealth.gov/new//news/headlines/660958.cfm/

Bipolar Drug May Spur Weight Gain, Thyroid Problems: Review (1/20/2012)

Bipolar Drug May Spur Weight Gain, Thyroid Problems: Review

Overall, lithium still 'treatment of choice' but docs urged to watch for and manage side effects.
THURSDAY, Jan. 19 (HealthDay News) -- A new medical review finds that lithium, a common treatment for bipolar disorder, can lead to weight gain and causes high rates of abnormalities in the thyroid and parathyroid glands.

But the researchers found few signs of a link to skin problems or hair loss, and a suspected connection to birth defects hasn't been proven, according to the report published in the Jan. 20 online edition of The Lancet.

Overall, the findings reaffirm lithium's role as "a treatment of choice for bipolar disorder," two doctors wrote in an accompanying editorial.

While lithium is less popular than it was in the 1970s and '80s as a treatment for bipolar disorder, it's probably the most effective available mood stabilizer, said Dr. Bryan Bruno, acting chairman of the department of psychiatry at Lenox Hill Hospital in New York City, who was not involved with the review but is familiar with the findings.

"It remains very beneficial, and it's still a first-line agent for bipolar disorder," Bruno said.

But lithium has a variety of possible side effects, noted the authors of the review, led by Dr. John Geddes of the University of Oxford, Warneford Hospital in Oxford, England. Their analysis included 385 studies.

The review found that lithium can cause weight gain, slightly hinder the kidneys' ability to concentrate urine, and cause increased activity of the thyroid and parathyroid glands.

Geddes and his colleagues suggest that doctors talk about the possible side effects with patients and add a blood calcium test to the testing regimen to check for possible hyperparathyroidism.

Bruno said the information about hyperparathyroidism is new, and added that he's likely to order the relevant test more often.

Dr. Michael Berk, a professor of psychiatry at Deakin University in Australia and a co-author of an accompanying commentary in the journal, said that lithium "is still widely used, but perhaps not as widely used as it should be."

Commenting on the review, he stated: "While lithium has potential side effects, these can be managed by understanding and anticipating them, in order to maximize the benefits and minimize the risks."

Source: http://www.womenshealth.gov/new//news/headlines/660880.cfm/

'The Pill' Can Help Ease Period Pain, Study Finds (1/18/2012)

'The Pill' Can Help Ease Period Pain, Study Finds

Many doctors already prescribe oral contraceptives 'off-label' for this purpose, experts note.
TUESDAY, Jan. 17 (HealthDay News) -- There's more evidence that use of the oral contraceptive pill can help ease the cramps, bloating and other pain some women experience during their period.

Some previous research, as well as anecdotal evidence, have suggested that the Pill could help women with painful periods, but a 2009 review of all available research concluded there was limited evidence for such a conclusion.

The new findings, from a Swedish study that has been running for 30 years, show that women who used the combined birth control pill (estrogen plus progestin) suffered less severe pain than women who did not use the Pill, the researchers said.

Their study findings appear online Jan. 18 in the journal Human Reproduction.

Experts estimate that pain associated with menstrual periods accounts for 600 million lost working hours and $2 billion in lost productivity in the United States each year.

One expert in the United States noted that doctors have long used the Pill to help ease such symptoms.

"Many obstetrician/gynecologists have used oral contraceptive pills to help alleviate menstrual pain, otherwise known as dysmenorrhea," said Dr. Jenifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "This is technically an off-label use of these commonly prescribed medications," she added.

The Swedish researchers noted that younger women typically suffer more from painful periods than older women. And while they did find that symptoms eased somewhat with increasing age, the effects of age and Pill use were independent of each other and use of the Pill had a greater effect overall.

The study included three groups of women who turned 19 in 1981, 1991 and 2001. Each group included 400 to 520 women, who were asked about their pattern of menstruation and menstrual pain, reproductive history, contraceptive use, height and weight.

The women provided this information at ages 19 and 24.

"By comparing women at different ages, it was possible to demonstrate the influence of [the Pill] on the occurrence and severity of dysmenorrhea, at the same time taking into account possible changes due to increasing age," Dr. Ingela Lindh, of the Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, said in a journal news release. "We found there was a significant difference in the severity of dysmenorrhea depending on whether or not the women used combined oral contraceptives."

Dr. Steven Goldstein, an obstetrician/gynecologist at NYU Langone Medical Center in New York City, said: "The study results are not surprising. It's gratifying to see researchers documenting scientifically what practitioners have been seeing for a very long time. The amount of discomfort from a woman's period with a combination birth control pill is a fraction of what it is without the Pill. There is a diminution of pain from the Pill."

For her part, Wu believes that "doctors should include a discussion of all the benefits and risks when presenting birth control options, and the improvement of dysmenorrhea is a significant benefit to oral contraceptive pills."

Source: http://www.womenshealth.gov/new//news/headlines/660778.cfm/

Americans Aren't Getting Any Skinnier (1/17/2012)

Americans Aren't Getting Any Skinnier

But, the good news is the overall rate of obesity is stabilizing, researchers report.

By Serena GordonHealthDay Reporter
TUESDAY, Jan. 17 (HealthDay News) -- One in three American adults and one in six American children are obese, new government reports show.

That's the bad news. The good news is that over the past 12 years, those rates have remained roughly the same.

"The stabilization of obesity rates has been going on for some time. And, this is not just the U.S. It's happening all over the world," said Katherine Flegal, author of the reports and a senior research scientist with the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention.

"Even if we can just keep the prevalence rates the same, we're doing well," said registered dietitian Nancy Copperman, director of public health initiatives in the Office of Community Health at the North Shore-LIJ Health System in Great Neck, N.Y.

"It's as if you're on an expressway going 65 miles per hour. You can't suddenly throw the car in reverse. You have to slow down before you can reverse course. Hopefully, what we're doing now is slowing down so we can reverse course," Copperman said.

The reports on the obesity trends -- one on adults and one on children and teens -- are published in the Jan. 17 issue of the Journal of the American Medical Association. Flegal is the lead author of the study on obesity in adults, and the senior author on the study on obesity in children and adolescents.

The consequences of obesity are far-reaching. People who are obese are more likely to develop type 2 diabetes, heart disease, stroke, high blood pressure, certain cancers, high cholesterol, liver and gallbladder disease, sleep apnea, osteoarthritis and gynecological problems, according to the CDC.

The estimated medical costs of caring for the obese average about $147 billion a year, the CDC estimates.

In the current study of obesity trends in adults, Flegal and her colleagues reviewed data from the most recent U.S. National Health and Nutrition Examination Survey (NHANES), from 2009 to 2010. They compared this data to older adult obesity data from 1999 through 2008. The newer set of data included nearly 6,000 adult men and women. The older set of data included almost 23,000 American men and women.

According to the latest data, the average body mass index (BMI) was 28.7 for men and women. BMI is a rough estimate of a person's body fat. The higher the number, the more overweight or obese a person is. A BMI of 25 to 29.9 is overweight in an adult, and 30 or above is considered obese for an adult, according to the CDC. This means the average American is overweight, but not obese.

However, the rate of obesity was nearly 36 percent for both adult men and adult women in 2009 to 2010. In general, this rate has remained stable since 1999, according to the study.

Several groups did see small, but statistically significant increases in the rate of obesity over the 12-year study period. They included non-Hispanic black women, and Mexican-American women and men, according to the study.

The second study compared the most recent obesity figures (2009-2010) in children and teens from NHANES to obesity trends from six other surveys dating back to 1999 to 2000. The most recent data included 4,111 American children.

In 2009 to 2010, nearly 17 percent of children and adolescents were obese and almost 32 percent were overweight or obese, according to the study. Obesity rates from 2007 to 2008 and 2009 to 2010 stayed the same. The researchers did find an increase in the prevalence of obesity in male children and teens when they compared the most recent figures to 1999 to 2000.

In infants, overweight is measured through weight-for-recumbent length. Almost 10 percent of infants had a high weight-for-recumbent length measurement. But, this rate was the same in 2009 to 2010 as it was in 1999 to 2000, except for one group. Mexican-Americans infants were more likely to have a high weight-for-recumbent length than infants born to other groups.

"We need to think about the populations that are shown in these studies to have a higher prevalence of obesity, and what interventions we can do," Copperman said. "We need to figure out what is different about them, and we may need to tailor prevention specifically to those populations."

Copperman also said it's important to focus on prevention to avoid obesity in the first place. "When you look at this from a public health perspective, it's easier to prevent something than to let it run its course and then try to treat it. Being overweight and obese isn't just a cosmetic thing, it's a disease," she added.

Source: http://www.womenshealth.gov/new//news/headlines/660798.cfm/

A GIRL'S GUIDE TO HOMELESSNESSBy Meredith Jaffe