Archive for the ‘Uncategorized’ Category

“FLU SHOTS – 2010″

Friday, August 27th, 2010

CDC Officials Urging Public To Get Flu Shot Sooner This Year.

The Wall Street Journal (8/25, Mckay) reports that this year, CDC and other health officials are urging Americans to get the flu shot, which contains protection against three strains, most notably, H1N1, early. CDC Director Thomas Frieden stated, “I think last year will be a plus rather than a minus in terms of vaccine coverage,” and added that the agency is working on new technology that will allow vaccines to be produced faster. Nevertheless, CDC officials are aware that some people are still hesitant to get the vaccine because of concerns that it was not adequately tested, or because they believe H1N1 is not a major health threat.

(adapted from E.M.Today)

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Promoting Prevention through the Affordable Care Act


NEJM | August 25, 2010 | Topics: Implementation, Public Health
Howard K. Koh, M.D., M.P.H., and Kathleen G. Sebelius, M.P.A.

Too many people in our country are not reaching their full potential for health because of preventable conditions. Moreover, Americans receive only about half of the preventive services that are recommended1 — a finding that highlights the national need for improved health promotion. The 2010 Affordable Care Act2 responds to this need with a vibrant emphasis on disease prevention. Many of the 10 major titles in the law, especially Title IV, Prevention of Chronic Diseases and Improving Public Health, advance a prevention theme through a wide array of new initiatives and funding. As a result, we believe that the Act will reinvigorate public health on behalf of individuals, worksites, communities, and the nation at large (see table) — and will usher in a revitalized era for prevention at every level of society.

Major Sections Related to Prevention in the 2010 Affordable Care Act.
First, the Act provides individuals with improved access to clinical preventive services. A major strategy is to remove cost as a barrier to these services, potentially opening new avenues toward health. For example, new private health plans and insurance policies (for plans or policy years beginning on or after September 23, 2010) are required to cover a range of recommended preventive services with no cost sharing by the beneficiary. These services include those rated as “A” (strongly recommended) or “B” (recommended) by the U.S. Preventive Services Task Force (USPSTF), vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP), and preventive care and screening included both in existing health guidelines for children and adolescents and in future guidelines to be developed for women through the U.S. Health Resources and Services Administration (HRSA). Examples of covered services include screening for breast cancer, cervical cancer, and colorectal cancer; screening for human immunodeficiency virus (HIV) for persons at high risk; alcohol-misuse counseling; depression screening (when systems are in place to ensure accurate diagnosis, effective treatment, and follow-up); and immunizations.
The prevention theme also affects individuals covered by public insurance programs. A number of policy changes will be phased in over time. For example, starting January 1, 2011, Medicare will cover, without cost sharing, an annual wellness visit that includes a health risk assessment and a customized prevention plan. Full coverage of many USPSTF-recommended services will also be available under Medicare with no cost sharing. Similarly, in 2013 and beyond, state Medicaid programs that eliminate cost sharing for preventive services recommended by the USPSTF or ACIP may be eligible for enhanced federal matching funds for providing those services.
Second, the law promotes wellness in the workplace, providing new health promotion opportunities for employers and employees. For example, the Act authorizes funds for grants for small businesses to provide comprehensive workplace wellness programs. The law also requires the secretary of health and human services to assess existing federal health and wellness initiatives and directs the Centers for Disease Control and Prevention (CDC) to survey worksite health policies and programs nationally.
Third, the Act strengthens the vital role of communities in promoting prevention. New initiative opportunities are designed to strengthen partnerships between local or state governments and community groups. For example, new Community Transformation Grants promise to improve nutrition, increase physical activity, promote smoking cessation and social and emotional wellness, and prioritize strategies to reduce health care disparities. Also, in further recognition that immunization is a foundation for public health, the Act authorizes states to use their funds to purchase vaccines for adults at federally negotiated prices. Grants for states will also support demonstration projects to improve vaccination rates.
Fourth, the Act elevates prevention as a national priority, providing unprecedented opportunities for promoting health through all policies. For example, a newly established National Prevention, Health Promotion, and Public Health Council, involving more than a dozen federal agencies, will develop a prevention and health promotion strategy for the country. The council will build on the foundation of preceding prevention initiatives, such as Healthy People (which has set the country’s health promotion and disease prevention agenda for the past 30 years),3 as well as efforts of expert groups such as the USPSTF, the Community Preventive Services Task Force, and the ACIP. A new Prevention and Public Health Fund, with an annual appropriation that begins at $500 million in fiscal year 2010 and increases to $2 billion in fiscal year 2015 and beyond, will invest in a range of prevention and wellness programs administered by the Department of Health and Human Services. Initial funds have already been invested in strengthening public health infrastructure, prevention research, surveillance, integration of primary care into community-based behavioral health programs, HIV prevention, obesity prevention, and tobacco control. Reinvigorated planning will also involve a national strategy to improve the quality of health care, improved data collection on health disparities,4 and authorization of a host of other new programs. Most newly authorized programs await appropriations and future funding as available through the annual budget process (exceptions are noted in the table).
The Act authorizes heavy investment in bolstering a primary care workforce that can promote prevention. For example, the law appropriates up to $1.5 billion for the National Health Service Corps between fiscal years 2011 and 2015 to place health care professionals in underserved areas, complementing other new investments for community health centers administered through HRSA. To guide future placements of health care professionals, a new National Health Care Workforce Commission will analyze needs.
Since tobacco dependence and obesity represent substantial health threats, the Act addresses these specific challenges in a number of ways. For example, the directives for the new health plans established after September 23, 2010, also include coverage, with no cost sharing, of tobacco-use counseling and evidence-based tobacco-cessation interventions, as well as obesity screening and counseling for adults and children. Starting this year, pregnant women on Medicaid will receive coverage, without cost sharing, for evidence-based tobacco-dependence treatments; in 2014, states will be forbidden from excluding from Medicaid drug coverage any pharmaceutical agents for smoking cessation, including over-the-counter medications, that have been approved by the Food and Drug Administration. To promote healthy weight for populations, the Act appropriates funds for fiscal years 2010 through 2014 for demonstration projects to develop model programs for reducing childhood obesity. And on the policy front, menu-labeling provisions require the disclosure of specified nutrient information for food sold in certain chain restaurants and vending machines. Collectively, these complementary actions in the clinic and the community will benefit individuals as well as populations.
In short, to prevent disease and promote health and wellness, the Act breaks new ground. We believe the law reaffirms the principle that “the health of the individual is almost inseparable from the health of the larger community. And the health of each community and territory determines the overall health status of the Nation.”3 Moving prevention toward the mainstream of health may well be one of the most lasting legacies of this landmark legislation.
This article (10.1056/NEJMp1008560) was published on August 25, 2010, at NEJM.org.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
Source Information
Dr. Koh is Assistant Secretary for Health, and Ms. Sebelius is the Secretary for Health and Human Services, Department of Health and Human Services, Washington, DC.
References
1. McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348:2635-2645
2. The Patient Protection and Affordable Care Act, P.L. 111-148, 23 March 2010.
3. Koh HK. A 2020 vision for healthy people. N Engl J Med 2010;362:1653-1656
4. Siegel B, Nolan L. Leveling the field — ensuring equity through national health care reform. N Engl J Med 2009;361:2401-2403

“JOINT VENTURE”©

Tuesday, August 10th, 2010

Remember moments, not days,

When health-care became your undying goal –

Remember moments, not days,

As service to injured or ill became your soul.


Emergency Poetry

Sunday, March 28th, 2010

POETRY BY DRJPWINTER

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TO SEASONS OF COEUR

drjpwinter

As young love brilliance faded,
Storms of passion now jaded -
As friendship salvage tenets stated,
Love and the spirit must be traded.

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“TO FAMILIES OF EMERGENCIES”

drjpwwinter

Harmony or storms

Riding life’s ocean waves –

With dangerous sneaker forms

Which always, love saves.

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“TO EMERGENCIES BONDING”

jpwinter

Nature’s bucky balls fly

In cosmos carbon flight -

Not to any naked eye

Bonds of absolute might.

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“TO THE CALL – STAT, STAT, STAT”

drjpwinter

ER team looks for life’s sign

DOA, Trauma Red and Code Blue -

Emergency calls define

As malpractice and lawyers ensue.

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TO FAVORITE DAUGHTERS

drjpwinter

One never knows of  love

As depth of breaths recede -

And graceful prayer rains from above,

A newborn rainbow when dark clouds preceed.

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“TO THE SEASONALLY EMERGENT”

drjpwinter

Winter wonderland

Spring wildflower in hand -

Summer parade band

Fall colors in ocean sand.

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“TO MY MENTOR MRYUK”

drjpwinter

Wizard to honor

Comrade to hail –

Physician of poisons

Career sunset sail.

music is not soul…it is the soul

Friday, February 13th, 2009

Music is the soul.  Music is the release of life.  Music is the now.  Do not wonder how the musician can create but wonder why.  Music is not the future, nor the past.  Music is the now.  Be bold musicians.  Be brave musicians.  Wonder only beyond the noise, create only beyond the universe.    drjpw

HAPPY NEW YEAR 2009 – BE HEALTHY & HAPPY !

Wednesday, January 28th, 2009

Please vote in latest OBAMA poll at the bottom right of this website…   Thanks.

OSTEOPOROSIS AND TREATMENT SIDE-EFFECTS * Jaw Osteonecrosis

Tuesday, December 12th, 2006

THE GOOGLE SEARCH FOR FOSAMAX AND OTHERS BRINGS FORWARD MANY PAID ADVERTISING LAW FIRMS REGARDING LAWSUIT INVITATION AND CONSULTATION REGARDING THIS CONCERN.

WWW.CASTMD.COM LOOKED TO SEE IF THIS IS A PROBABILITY OR POSSIBILITY FOR LITIGATION AND JURY AWARD.  WHAT DOES SOME OF THE LITERATURE SAY? 

MANY COMMENTS ARE BEING MADE OF THE RISK OF TAKING OSTEOPOROSIS MEDICATION FOR PREVENTING BONE LOSS, AND REBUILDING BONE.  MOST, IF NOT ALL OF THE CONTROVERSY IS RELATED TO JAW BONE LOSS, OSTEONECROSIS OF THE JAW.  THE CONTROVERSY ALSO RELATES TO THE POSSIBILITY OF THE MEDICINES CALLED "BIPHOSPHONATES" SUCH AS FOSAMAX, AREDIA, AND ZOMETA, AND POSSIBLY OTHERS.

OSTEONECROSIS OF THE JAW IS A DEVASTATING CONDITION.  THE BONE LOOKS AND ACTS INFECTED.  MOST CASES COME FROM THE ILL EFFECTS OF INFECTION DUE TO DENTAL PROBLEMS OR DENTAL SURGERIES.  MANY CASES, IF NOT ALMOST ALL, COME FROM THE USE OF INTRAVENOUS USE OF THE MEDICINES, WITH CASES OF METASTATIC BONE CANCER.

MERCK PUBLISHED THEIR CONTROLLED TRIALS OF OVER 17,000 PATIENTS, WITH 10 YEARS' DATA USING FOSAMAX, SHOWING NO REPORTS OF ONJ.  IN POST-MARKETING USE, MERCK ESTIMATES BY MARCH 31, 2006 THE CUMMULATIVE RISK FROM ALL SOURCES OF CAUSE WAS ESTIMATED AT LESS THAN 1/100,000 PATIENT-TREATMENT YEARS.

CURRENTLY, THE NATIONAL OSTEOPOROSIS FOUNDATION SEES THE RISK AS RARE IN PERSONS TAKING ANY ORAL FORM OF THE MEDICINE FOR OSTEOPOROSIS.  THE FOUNDATION ALSO STATES THAT IT BELIEVES THAT THE RISK OF FRACTURES AND BONE LOSS IS MUCH GREATER TO MOST PATIENTS THAN ANY RISK OF DEVELOPING THE ONJ PROBLEM DUE TO THE MEDICINES FOR OSTEOPOROSIS. 

PLEASE, IF YOU ARE ON A MEDICINE FOR REDUCTION OF OSTEOPOROSIS RISK, A BIPHOSPHONATE, TALK WITH YOUR DOCTOR AND STAY INFORMED.  HOPEFULLY THIS HAS ASSISTED YOU IN YOUR DECISION TO BE AND STAY HEALTHY.Cool

THE PRESTIGIOUS NEW ENGLAND JNL OF MED WILL SPEAK TO THE ISSUE THIS NEXT WEEK, I AM ANTICIPATING.

 

BABY BOOMER BREAKDOWN MEDICAL CLINIC & OXYGEN BAR *** A Health Screening Survey A MEDICAL PARODY

Saturday, December 9th, 2006

HEALTH SCREENING SURVEY

 

ARE YOUR HEMORRHOIDS HURTIN’ FROM TOO MUCH HARLEY RIDIN’

ARE YOU DRINKIN' MORE PRUNE JUICE THAN BEER

ARE YOU ASKIN' FOR DIRECTIONS CUZ YOU CAN’T SEE

ARE YOU PALPITATIN’ WHEN MAMA ISN’T EVEN THERE

ARE YOU CREAKIN’ MORE THAN THE FLOOR

ARE YOU BEDDIN’ DOWN BEFORE THE ‘LATE SHOW’

ARE YOU WONDERIN' ABOUT BUYIN’ THE RV

ARE YOU BUYIN' CROAKIES FOR YOUR READIN’ GLASSES

ARE YOU INVESTIN' IN FLAX AND FIBER COMPANIES

ARE YOU DRIBBLIN’ UNTIMELY INSTEAD OF BASKETBALLS

ARE YOU SHOPPIN’ WALMART AND GETTIN’ LOST

ARE YOU BORN BETWEEN '46 AND '64 

IF YES

COME TO THE NEW AND UNIQUE

 

“BABY BOOMER BREAKDOWN

MEDICAL CLINIC & OXYGEN BAR”©

(a select pathway)

(Based on the Vegas Oxygen Bars only with Medicare coverage)

YOU’LL LOVE THE TALKIN’

WITH LITTLE WALKIN’

 

SIP YOUR JUICE

AND PLAY SOME FOOS

 

NOT ONLY MEDICARE D CLASSES

BUT KENO AND LOTTO FOR THE MASSES

 

COME ONE COME ALL

BEFORE YOU TAKE THAT NEXT FALL

 

CALL FOR APPOINTMENTS NOW…BEFORE YOU FORGET

MATURE MATTERS(C) AND SHINGLES – VACCINE APPROVED !

Friday, November 3rd, 2006

Shingles Vaccine: What you need to know.

(from the CDC public website)

1. What is shingles?

Shingles is a painful skin rash, often with blisters.  It is also called Herpes Zoster.

A shingles rash usually appears on one side of the face or body and lasts a week to 10 days.  Its main symptom is pain, which can be quite severe.  Other symptoms of shingles can include fever, headache, chills and upset stomach.  Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death.

For about 1 person in 5, severe pain can continue even after the rash clears up. This is called post-herpetic neuralgia.

Shingles is caused by the Varicella Zoster virus, the same virus that causes  chickenpox.  Only someone who has had a case of chickenpox – or gotten chickenpox vaccine – can get shingles.  The virus stays in your body.  It can reappear many years later to cause a case of shingles.

You can’t catch shingles from another person with shingles. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles.  This is not very common.

Shingles is far more common in people 60 and older than in younger people.  It is also more common in people whose immune systems are weakened because of a disease such as cancer, or drugs such as steroids or chemotherapy.  At least 500,000 people a year in the United States get shingles.

2. Shingles vaccine

A vaccine for shingles was licensed in 2006.  In clinical trials, the vaccine prevented shingles in about half of people 60 years of age and older.  It can also reduce the pain associated with shingles.

A single dose of shingles vaccine is indicated for adults 60 years of age and older.

3. Some people should not get shingles vaccine or should wait.

A person should not get shingles vaccine who:

has ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine.  Tell your doctor if you have any severe allergies.

has a weakened immune system because of

- H.I.V. AIDS or another disease that affects the immune system,

- treatment with drugs that affect the immune system, such as steroids,

- cancer treatment such as radiation or chemotherapy,

- a history of cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.

has active, untreated tuberculosis.

is pregnant, or might be pregnant.  Women  should not become pregnant until at least three months after getting shingles vaccine.

Someone with a minor illness, such as a cold, may be vaccinated.  But anyone who is

moderately or severely ill should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101 point 3 degrees Fahrenheit or higher.

4. What are the risks from shingles vaccine?

A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. However, the risk of a vaccine causing serious harm, or death, is extremely small.

No serious problems have been identified with shingles vaccine.

Mild Problems

Redness, soreness, swelling, or itching at the site of the injection (about 1 person in 3).

Headache (about 1 person in 70).

Like all vaccines, shingles vaccine is being closely monitored for unusual or severe

problems.

5. What if there is a moderate or severe reaction?

What should I look for?

Any unusual condition, such as a high fever or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.  These usually occur within the             first few hours after vaccination.

What should I do?

Call a doctor, or get the person to a doctor right away.

Tell your doctor what happened, the date and time it happened, and when the

vaccination was given.

Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form.

Or you can file this report through the VAERS web site at w.w.w. dot v.a.e.r.s. dot o.r.g., or by calling 1-800-822-7967.

VAERS does not provide medical advice.

6. How can I learn more?

Your provider can give you the vaccine package insert or suggest other sources of information.

Call your local or state health department.

Contact the Centers for Disease Control and     Prevention (C.D.C.):

- Call 1-800-232-4636 (1-800-C.D.C. I.N.F.O.)

- Visit CDC’s website at w.w.w. dot c.d.c. dot g.o.v. slash n.i.p.

Department of Health and Human Services

Centers for Disease Control and Prevention

National Center for Immunization and Respiratory Diseases

Shingles Vaccine

9/11/06

Vaccine Information Statement (Interim)