Tuesday, April 7, 2009

News Clipping Archives

 

Maryland / Regional

Public health touches each part of our lives (Carroll County Times)

Removing the Doubt (Washington Post)

A Smoking Experience That's Unmatched (Washington Post)

Family Asks Fairfax Prosecutor To Investigate Funeral Home (Washington Post)

In Good Health — Autism awareness (Frederick News-Post)

 

National / International

Study: 1 in 5 American 4-year-olds is obese (Baltimore Sun)

As Food Recalls Continue to Sprout, What Can a Consumer Do? (Washington Post)

DNA Test Outperforms Pap Smear (New York Times)

House Dust Yields Clue to Asthma: Roaches (New York Times)

City Gears Up for 2010 Head Count (New York Times)

U.S. Launches HIV-Prevention Campaign (Salisbury Daily Times)

 

Opinion

Another day care being lost (Cumberland Times-News)

Domestic Violence Bills Forwarded to O'Malley (Annapolis Capital)

 

 

Maryland / Regional

 

Public health touches each part of our lives

 

By Barb Rodgers, Carroll County Health Department

Carroll County Times

Tuesday, April 7, 2009

 

Our communities, workplaces, schools and homes are filled with examples of public health.

 

Our communities can have a large influence on our health. Where we live affects the air we breathe, the number of places we have to be physically active, the quality of our education and the availability of healthy foods and preventive services.

 

Public health at the community level provides an opportunity to address many of the broader issues that impact health across our nation. Public health looks at community design and encourages people to take health into consideration and encourage us to be more active. Public buildings are designed so the disabled can easily access them. Local health organizations, pharmacies and others offer flu vaccine clinics to help keep us healthy. State and local politicians work to enact tobacco-free laws and other policies affecting our health.

 

We spend just as much time, if not more, in our workplace than at home. Health and safety in the workplace are just as important as health and safety in our homes. From work-site wellness programs aimed at helping workers live healthy lives to safety regulations aimed at keeping them safe on the job, public health works to address concerns facing us in all aspects of our lives. Public health has worked to create tobacco-free workplaces, healthy lunches in the company cafeteria, employee preventive screening programs and employee incentive programs for healthy behaviors. Public health encourages work sites to provide programs for employees to help them deal with stress. With economic concerns affecting the living wage, public health ensures that these concerns do not harm workers’ health.

 

We will do anything to protect our children, especially their health. Since they spend most of their days at school and around other children, it is important to understand how public health affects them. School environments are inspected and school immunizations are required. Public health provides vision and hearing screenings.

 

Good health starts in the home. From the time we’re born, and even before, public health is working to protect our families across generations. Whether it’s receiving immunizations or other preventive services, living in a lead-free home, eating safe foods or seeking services as we age, public health is a part of every aspect of our lives. In our homes, public health plays a role by ensuring the water we drink, the car seats we use and the medical services we trust to help build a foundation for a healthy life.

 

Barb Rodgers is the director of health planning and community improvement for the Carroll County Health Department. If there is a public health topic you would like to see addressed in a future article please write to the Health Department at P. O. Box 845, Westminster, MD 21158-0845.

 

More information

April 6 to 12 is National Public Health Week. Think about how public health is the foundation for our nation’s health and well-being. What can you do to help make Carroll County a healthier community? For more information about public health or a directory of Carroll County Health Department Services, e-mail brodgers@dhmh.state.md.us.

 

Copyright 2009 Carroll County Times.

 

Removing the Doubt

Women with cancer in one breast or not at all tell why they chose to have preventive double mastectomies.

 

By Rachel Saslow

Washington Post

Tuesday, April 7, 2009; HE01

 

Karen Aulner, 36, has never been given a diagnosis of cancer. She has, however, been watching her older sister fight the disease since 2000. So when Aulner tested positive in 2004 for a gene mutation that put her at high risk of breast cancer, she asked her doctor to remove both of her healthy breasts.

 

"My sister was the healthiest person I ever knew," Aulner says. "She's slender, she worked out all the time, she loved fruits and vegetables -- and she's dying. If I could not have that happen to me? Heck, yeah."

 

Aulner is one of a growing number of women threatened by cancer who have opted for a preventive bilateral mastectomy: surgery to remove both breasts. The procedure has become more common not only among women with cancer in only one breast but also for women with no cancer at all.

 

The choice has been driven in part by the availability of tests that can identify mutations of the BRCA1 and BRCA2 genes, which increase a woman's risk of breast cancer. It also is related to more-sophisticated surgical options, including breast reconstruction from a woman's own tissue. But to remove both breasts remains a difficult and emotional decision, one that can reassure or haunt the patient for years.

 

A 2007 University of Minnesota study found that the percentage of U.S. women with cancer in one breast who chose a double mastectomy more than doubled over five years, from 4.2 percent in 1998 to 11 percent in 2003. Although the less invasive procedure called a lumpectomy is still far more common, the increase means there are more women who have gone through bilateral surgery and can provide advice or an example to others.

 

In March, Rep. Debbie Wasserman Schultz (D-Fla.), 42, revealed she had had a double mastectomy last year at the National Naval Medical Center in Bethesda. She had received a diagnosis of early-stage cancer in her right breast in December 2007 and had a lumpectomy. Then, she tested positive for the BRCA2 mutation and, after consulting with doctors and her husband, decided to have both breasts removed. She has had seven surgeries in all, including the insertion of silicone implants and having her ovaries taken out.

 

This all happened quietly, while she continued representing her district and campaigning, first for Hillary Rodham Clinton and then for Barack Obama. Even her children didn't know until two days before her news conference, which she held to promote earlier testing for breast cancer.

 

"The doctors said I had a 65 percent chance of a recurrence of cancer in the other breast," Wasserman Schultz said in a telephone interview. "Those odds were too high for me."

 

Her decision paid off immediately, she said: In some of the tissue removed from her right breast, doctors found a second cancer, a type called ductal carcinoma in situ.

 

Actress Christina Applegate had a double mastectomy last summer, inspiring a wave of articles and talk-show discussions. The 37-year-old star of TV's "Samantha Who?" had early-stage cancer in one of her breasts and tested BRCA1-positive. "I'm definitely not going to die of breast cancer," she said defiantly in a television interview. And of the benefits of reconstructive surgery: "I'm going to have cute boobs till I'm 90."

 

Like Applegate, many women who have chosen bilateral mastectomy describe it as the lifting of a great burden, because they no longer have to face the stress of mammograms or feel panicky if they find a small lump during a self-exam.

 

Others have some regrets about the surgery, saying the psychological effects have been worse than they expected. Susan Dunn, a Baltimore-based writer, had a two-centimeter tumor in her right breast when she was 32. She chose a double mastectomy because she had two little kids and wanted to be as aggressive as possible.

 

Now, 14 years later, she has mixed feelings about her decision. She looks back on the experience as a six-month cancer whirlwind: Only three weeks after her diagnosis, she was in the operating room. Everything non-cancer in her life was put on hold. She lost all her hair during chemotherapy.

 

Eventually her life returned to normal. Her hair grew back. But her breasts? They were gone forever.

 

"If I had to do it again, I would do just one," she says. "I don't think I understood the permanence of it. . . . On the other side, I'm alive and I don't worry about dying."

 

Dunn says she has tried to dissuade other women from choosing the bilateral surgery. But for Karen Aulner, having a double mastectomy never felt like a choice.

 

* * *

 

Aulner learned that her older sister, Kristine Hansen, had found a lump in her right breast in the fall of 2000. Hansen, now 38, had recently given birth to her third child. Her doctor wasn't concerned, Hansen recalled in a telephone interview from her home in McPherson, Kan., but 3 1/2 months later, she got a second opinion. Her new doctor told her she had inflammatory breast cancer -- the aggressive, fast-growing kind. She was given a 40 percent chance of surviving for five years.

 

After six rounds of chemotherapy to shrink the cancer, Hansen asked for a double mastectomy rather than a single. "I just thought, 'This is stupid; so many times I've heard that it comes back in the other breast,' " Hansen said. "I was very small-chested, so it was pointless to keep one tiny little boobie." (Breast cancer cannot leap from one breast to the other.)

 

Statistics to help women like Hansen make the decision can be complicated for an anxious patient to understand.

 

A woman who has no cancer but has a BRCA mutation has a 65 to 80 percent risk of developing breast cancer in her lifetime, according to Lillie Shockney, administrative director of the Johns Hopkins Breast Center, who has counseled hundreds of women with the disease. That risk falls to 5 percent after a preventive double mastectomy.

 

A woman who has early-stage breast cancer but no BRCA mutation has a 5 to 20 percent risk of a local recurrence after a lumpectomy and radiation. That goes down to 1 percent with a double mastectomy.

 

Why does any chance remain at all? Shockney explains it is virtually impossible to remove every breast cell, and "just a few remaining cells is enough to give breast cancer a place to grow." The risk remains even after a rare "radical" mastectomy, which involves removing pectoral muscles and lymph nodes.

 

Women who have had cancer in one breast and have a BRCA mutation, such as Hansen, have a risk of 3 percent per year of developing cancer in the opposite breast, says Todd Tuttle, the lead researcher on the 2007 University of Minnesota study, and the risk is cumulative. That may help explain why younger women are more likely to choose the bilateral procedure than older women. They're looking ahead to 30 or 40 more years of life, and the calculations begin to stack up against them.

 

However, the risk of developing cancer is a separate question from whether the surgery can extend a patient's life.

 

Tuttle says that in most cases, a woman receiving a diagnosis of breast cancer has the same chance of "survival" -- defined as living another five years -- whether she has a lumpectomy with radiation or a double mastectomy.

 

After Tuttle's 2007 study was published, he heard from lots of women about the reasons they had had the surgery and the psychological aftermath. The e-mails ranged from "I did this five years ago and I regret it" to "I knew it wasn't going to affect my breast cancer survival rate, but I wanted my breasts to look symmetrical." Others expressed relief at not expecting to face mammograms or biopsies again.

 

Cynthia Gilman, a lawyer who lives in Alexandria, initially considered having a lumpectomy after her 2003 breast cancer diagnosis at age 43, but a conversation with her surgeon changed her mind. Gilman had calcifications in both breasts (mineral deposits that may or may not indicate cancer) and dense breast tissue, making detection of new tumors more difficult. Her surgeon told her, "I don't know how I'm going to monitor you."

 

"I didn't want to live my life not knowing if every little lump or bump was cancer," Gilman says. "I chose not to do that.

 

Six years down the road, she says she is 100 percent happy with her decision and hasn't regretted it for one second.

 

At the Johns Hopkins Breast Center, Lillie Shockney has counseled many women with dense breast tissue who opt for a double mastectomy. Despite having regular mammograms, some of them had found on their own a lump that turned out to be cancerous.

 

"The breast tissue is white, the tumors are white, and we can't find a polar bear in a snowstorm," Shockney says.

 

* * *

 

During Hansen's double mastectomy, doctors removed seven lymph nodes under her right arm; one tested positive for cancer. Though the cancer appeared to be gone for 2 1/2 years, she says she never deluded herself into thinking she was safe, partly because of that one lymph node. In 2003, her doctors saw a shadow on a CT scan of one of her lungs. Maybe it's pneumonia, Aulner remembers hoping. But it was the beginning of another tumor.

 

Aulner, a nursing student who lives in Las Vegas, watched her sister battle cancer a second time. And in 2004 she made an appointment for a BRCA test. She paid about $500 out of her own pocket: If it came back positive, she didn't want her health insurance company to know.

 

It was a tense wait. Aulner remembers going on walks with her husband, Dwane, to talk about what they would do with a positive or a negative result. After about a week, she picked up the results at her OB-GYN's office. She took the sealed envelope into the parking lot and into her car, and opened it alone. Positive. She was facing up to an 80 percent chance of developing breast cancer during her lifetime.

 

"I'm a person of action," she says. "For me, it was very easy. Let's move forward."

 

She went back to her OB-GYN and asked what to do. "He basically said, 'I've never had anyone like you before,' and that was it," she recalls. "I had no guidance." She called several surgeons in Las Vegas, and none of them would consider performing a preventive mastectomy. She ended up having the surgery in New Orleans, at a practice that she found online.

 

Aulner's sister had tried implants, but they became infected and she opted for prosthetic breasts. Aulner chose a DIEP (deep inferior epigastric perforator) flap reconstruction. In this surgery, breasts are reconstructed from the patient's own abdominal skin and fat. It took three operations, including one that took 12 hours and a five-day hospital recovery, but Aulner says it was worth it for what she hopes is "a permanent solution."

 

Aulner's husband, parents and close friends were "totally on board" with her choice, she says. So was her sister, even though her own double mastectomy had not prevented her disease from recurring. Some acquaintances, however, were perplexed. A friend of a friend asked her, "Women don't die of breast cancer anymore, do they?"

 

* * *

 

They do. Kristine Hansen is almost certainly going to die of breast cancer.

 

In the past eight years, besides the double mastectomy, she has had her ovaries and her uterus taken out. When breast cancer spreads, it usually goes to the lungs, bones and liver: Hansen has three tumors in her liver and seven in her brain. She undergoes "maintenance chemotherapy" every other Monday, which will extend her life but not cure her disease. (She calls it "chemo lite.") She has half of her eyelashes and eyebrows and no hair on her head.

 

During a phone interview one Wednesday afternoon, Hansen was low-key, recuperating from the chemo two days earlier. She was home folding laundry, not wearing her prosthetic breasts or a wig.

 

"I look like an 'it,' " she said. "I don't look like a girl."

 

But usually she stays upbeat and describes a rich life. Since her diagnosis, she and her husband have visited France and Italy; she hopes to go to Spain and Portugal next. For her birthday two years ago, her family gave her a Volkswagen Beetle. "I don't want to die driving a minivan," she says.

 

Aulner flies out to see her sister as often as she can. They always schedule visits for "the good weeks," weeks that Hansen hasn't had chemotherapy. Hansen, who says she likes "girly" clothes and has a wardrobe of 15 wigs, likes to shop at BCBG. Aulner and Hansen's kids trail along, stopping for ice cream.

 

Three years after her genetic testing, Aulner decided there was one more cancer risk she could eliminate. She had learned that, according to the National Cancer Institute, a women with an altered BRCA1 or BRCA2 gene has a 16 to 60 percent lifetime risk of getting ovarian cancer, compared with 1.7 percent for the general population.

 

Aulner went to her doctor and asked him to remove her ovaries. She had the operation in December 2007.

 

Copyright 2009 Washington Post.

 

A Smoking Experience That's Unmatched

Battery-Powered Cigarettes Deliver a Low-Cost Nicotine Fix. Is That Good or Bad?

 

By Richard Leiby

Washington Post

Tuesday, April 7, 2009; HE01

 

I had lunch, a cup of coffee and a smoke the other day at the offices of the American Legacy Foundation in downtown Washington. I puffed away for a good 15 minutes, savoring the irony.

 

Here I was, surrounded by zealous anti-smokers -- Legacy is among the nation's most influential and well-funded tobacco-fighting organizations -- yet I had been invited over to partake in all the nicotine I could handle.

 

Of course there was a catch: What I puffed on wasn't a Marlboro or any other combustible cancer stick. I didn't need an ashtray. The "smoke" was more accurately fog -- small, vaporous clouds. I was trying out a controversial new nicotine-delivery device that somewhat resembles a cigarette but is actually a plastic tube with a glowing LED at its tip.

 

"If you just suck on it, it should work," scientist David B. Abrams said, handing me an Njoy brand e-cigarette. (That's "e" for electronic; nothing to do with the Internet, except that the devices are sold there in abundance.) Inside the tube is a lithium battery that warms and aerosolizes a nicotine solution; Njoy says it works like a vaporizer.

 

After a few puffs, I found myself wreathed in a fine mist of nostalgia. An e-cig supplies none of the flavor or warmth of a real smoke ("Joy of the palate, delight of the nose!" as one forgotten poet put it), yet I was transported back to the days when smoking didn't equal social opprobrium, when hacks like me hammered on typewriters with nicotine-stained fingers, inhaling madly as deadline loomed.

 

In a word, I got a buzz.

 

True, you might be sucking on plastic, but the experience is, as Abrams said, "close to the real deal."

 

As the Legacy foundation's resident expert on addiction and smoker behavior, Abrams and other researchers are intrigued by the devices but also deeply concerned. Could they become another weapon in the smoking-cessation arsenal? Or could they hook more young people on nicotine and serve as a gateway to tobacco use? The products are unregulated, untested in this country and not approved by the Food and Drug Administration, which has sanctioned other nicotine-supplying substitutes such as patches and gum.

 

Late last month, Sen. Frank Lautenberg (D-N.J.), author of the law that banned smoking on airplanes years ago, sent a letter urging the FDA to take "immediate enforcement action against manufacturers of 'electronic cigarettes' and take these products off the market until they are proven safe." FDA is beginning to get on the case: Although the devices are available online and in scattered retail outlets, the agency says it has halted some imports and is evaluating whether sales require FDA approval.

 

E-cigs supply nicotine via the lungs -- albeit without the tar, carbon monoxide and other nasties in tobacco smoke -- and thus provide the almost instantaneous "hit" that smokers crave. They offer that "exquisite regulation of brain chemistry that makes smoking so powerful and rewarding," said Abrams, a PhD health psychologist who has studied addiction for 30 years.

 

"People don't realize that we know of no other way to finely tune the brain than puffing on a cigarette," he told me.

 

Later, as I sat dragging on the vapor tube, I thought about that. Nicotine truly is a remarkable drug, because it seems to span the spectrum of psychological effects: Some people relax with tobacco products (a fine cigar after dinner); others get an instant boost that helps them focus. One of my editors swears she never wrote better headlines, faster, than when you could smoke in The Post's newsroom.

 

Abrams, who smoked as a teenager and has tried e-cigs in the name of science, is no knee-jerk foe of nicotine. "I see no problem with giving people lifetime medicinal nicotine," he said. But he certainly doesn't endorse e-cigs, especially since studies have only begun on their safety and efficacy.

 

Scientists also worry that e-cigarettes may de-motivate hard-core smokers from quitting, by allowing them to stave off nic fits by "smoking" in offices, restaurants and other places where they can't normally light up. Thus the e-cigs become what Abrams calls a "bridge product."

 

In a joint statement, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association and the Campaign for Tobacco-Free Kids blasted e-cigarettes for being "marketed towards young people, who can purchase them in fruit flavors and online, without having to verify their ages."

 

Njoy literature claims that one of its cartridges (which contain water, flavoring, propylene glycol and nicotine) will last the equivalent of a half-pack of real butts. Unlike those 10 cigarettes, though, which burn down and get stubbed out one at a time, the e-cig doesn't go "out." There's a danger of sucking down too much at one sitting: Nicotine affects heart rate and blood pressure. At least one controlled study is underway, at Virginia Commonwealth University in Richmond, to find out the impact of e-cigs on nicotine levels in the blood.

 

"I'm not necessarily saying these products are dangerous," said psychology professor Thomas Eissenberg of VCU's Institute for Drug and Alcohol Studies. "I just think we ought to know what people get when they use them before we sell them."

 

His study of 40 smokers, supported by the National Cancer Institute, endeavors to determine how e-cigarettes deliver nicotine and whether they actually suppress withdrawal symptoms.

 

"For example, if you wake up in the morning craving nicotine, will this take care of that craving?" Eissenberg asked "If it doesn't, then it's a failure. If it makes you go back to your own brand, it's a failure."

 

Well, at least a failure as a smoking-cessation product. But evidently trying to avoid government regulation, Njoy and other distributors don't make any claim to helping people quit.

 

"Our target market is the legal-age smoker looking for a product to partake of their dependency in places they cannot smoke -- and to save a few dollars," James Leadbeater, chief executive of Njoy, said from company headquarters in Scottsdale, Ariz. "We are not breaking the nicotine habit, just giving people a better way to get the nicotine."

 

Given that federal taxes on cigarettes rose significantly on April 1, cost may push some smokers toward alternatives. On the Internet, the Njoy "starter kit," including batteries, a charger and four cartridges, goes for $75. Leadbetter estimates that after the initial investment in hardware, use of his product costs the equivalent of $2.50 per pack. (A pack of smokes runs something like $5 to $9, depending on brand and sales location.)

 

But "one of the issues that the smoker has to get over is to get used to the taste," said Leadbeater, adding that he has never smoked. (As an ex-smoker, I'd have to agree: The Njoy doesn't taste anything like the real deal. Its vapor delivered a moist, fruity flavor, reminiscent of a hookah session more than anything else.) "They have to make a trade-off so they can use it as an alternative in places that they can't smoke now."

 

I haven't heard of any celebrity e-cig endorsers, but at least one politician is an aficionado. Rep. Cliff Stearns (R-Fla.) said he uses the device -- but chooses a nicotine-free cartridge. "Frankly, I enjoy 'vaping' as a relaxing way to enjoy 'smoking' without nicotine and the harmful effects of smoke and combustible tobacco," he told us in a statement.

 

The congressman says he's such a fan, "I hope to send a package to President Obama to help him quit or to meet with him and enjoy a harmless, carcinogen-free smoke." Such bipartisanship is touching, and I can't help but steal a friend's joke about why cigarettes are such a great social cohesive, transcending race, religion and class: We smokers are all black on the inside.

 

As for me, I found "vaping" too, well, plastic to be enjoyable. After I left the Legacy Foundation -- established through proceeds of the great tobacco settlement of 1998 and dedicated ever since to saving lives -- I walked past smokers clustered under the eaves of nearby buildings. A tantalizing wisp of tobacco smoke wended its way through the gentle rain, reaching my nostrils. I inhaled. It smelled delectable.

 

The old genie beckoned.

 

Just then there developed a burning in my mouth and an accumulation of phlegm in my throat -- the aftereffects, I realized, of liquid nicotine and just a whiff of secondhand smoke. I walked on, resisting the addictive draw of nostalgia.

 

Electronic cigarettes claim advantages over tobacco products. (Juana Arias - Juana Arias for The Washington Post)

 

Comments: leibyr@washpost.com

 

Copyright 2009 Washington Post.

 

Family Asks Fairfax Prosecutor To Investigate Funeral Home

 

By Josh White

Washington Post

Tuesday, April 7, 2009; B01

 

The family of a deceased U.S. Army veteran whose body was stored for months in a Falls Church funeral home's unrefrigerated garage is asking Fairfax County prosecutors to investigate the case as a crime.

 

Richard Morgan Jr., a Harrisonburg, Va., criminal defense attorney, hand-delivered a letter to Commonwealth's Attorney Raymond F. Morrogh's office yesterday arguing that the actions of National Funeral Home and its parent company, Houston-based Service Corporation International, amount to felonies. Morgan said his father's body was "defiled" because it was left to rot on a garage rack, a possible felony under a Virginia law regulating the treatment of corpses.

 

The body of Maj. Richard Morgan was left from November to February in a light oak coffin in the garage at SCI's central care facility, located in the same building as National Funeral Home, according to current and former employees who saw the coffin and the body inside. Morgan's family identified photographs of his remains -- dressed in a dark green suit, white shirt and red tie -- that were taken by former funeral home employee Steven Napper on Dec. 12 as he catalogued problems he felt the company was ignoring.

 

Napper, an embalmer and former Maryland state trooper, reported unsanitary and unethical conditions to the Virginia Board of Funeral Directors and Embalmers before resigning in February. His accounts were bolstered by other employees -- including one who came forward publicly yesterday -- and a client who stumbled upon the conditions in the garage and a walk-in cooler at the funeral home. The building serves as a central clearinghouse for bodies coming from five area SCI funeral homes.

 

Napper said as many as half a dozen bodies destined for burial at Arlington National Cemetery, including Morgan's, were left on the unrefrigerated racks because coolers were full and his supervisors said the company did not want to spend more money.

 

"This is going to keep happening unless and until people feel the oppressive weight of government and the possibility that they could be thrown in jail," Morgan said yesterday in an interview after he left the letter for Morrogh. "This should not be considered a cost of business. We need to make an example of this."

 

Morrogh, who was out of town yesterday and had not yet received the letter, said he could not comment on what he might do. State officials declined to comment. SCI officials have said they take the allegations seriously and are investigating, but they said they have yet to substantiate them.

 

The Washington Post reported Sunday that current and former SCI employees and a customer alleged unsanitary and unethical conditions at SCI's regional central care facility.

 

They said the facility stored as many as 200 bodies in unrefrigerated areas, including the garage, and that the bodies, sometimes fully exposed, leaked fluids on the floor.

 

Morgan, 41, said he felt betrayed by what happened to his father's body. He said he was told it would be refrigerated from the time of the death in November until his burial with full military honors Feb. 6 at Arlington. Morgan said he and his family members -- including a sister in Montgomery County and another sister who is deployed to Afghanistan with the Virginia National Guard -- were distraught after learning that their father's body was instead left on a storage rack to decompose.

 

"Somebody willfully and intentionally put my father's corpse on that rack," said Morgan, whose father served 20 years in the Army before working for it as a civilian for 26 more years. He left in 1994. "Those are the people I'd like to see punished."

 

Morgan, who was quoted anonymously in Sunday's Post report, said an SCI official contacted him over the weekend and denied the allegations, although he said he received no explanation for Napper's photographs, which showed bodies stored in the unrefrigerated garage. Morgan said the SCI official agreed to refund the $14,111.65 the family paid for funeral services.

 

"Our investigation is ongoing, and it would be inappropriate for us to comment upon it at this time or to discuss the substance of any conversations with client families," J. Scott Young, president of SCI Virginia Funeral Services, said in a statement. "In the event that any regulators or law enforcement authorities decide to investigate or make any sort of inquiry, they would have our full cooperation."

 

The family of retired Army Col. Andrew DeGraff, whose body was also left in a coffin on the garage rack next to Morgan's, said they would support a criminal investigation.

 

"My ultimate goal when I heard about this whole incident is that they lose their license and they are no longer allowed to do this business," said Grace Wozniak, DeGraff's granddaughter.

 

Another current SCI employee blew the whistle yesterday to decry what he has seen at their central facility in Falls Church. Robert Ranghelli, 19, of Manassas Park said the operation there is "a disgrace."

 

In addition to dressing bodies and making them up for viewings, Ranghelli handles "removals," or picking up the dead to take them to National Funeral Home. He said he has worked there since January and has seen numerous bodies stored in the garage, including as many as a dozen veterans on the racks waiting for burial at Arlington. He took photographs of coffins, some of which he said contained bodies, on the racks and of blood stains on the floor.

 

He said supervisors have asked him to store bodies on the racks and have skipped parts of the cleaning process in order to save money, even if families are charged for it.

 

"It's a death factory," said Ranghelli, who is also a volunteer firefighter and emergency medical technician. "I've had a lot of sleepless nights. I just don't feel right having to do things like place people's loved ones on racks in the garage."

 

Ranghelli said that he saw a state board investigator taking photographs and going through files at the funeral home last month and that she visited again yesterday. He said yesterday that supervisors there were scrambling to clean the facility over the weekend, when The Post first exposed the allegations. He said that employees bleached the cooler to remove stains and that some of the SCI funeral homes came to retrieve bodies stored there.

 

Numerous clients said yesterday that they called area SCI funeral homes and were told that the company is looking into the situation.

 

John Mastal, 37, said his father, retired Air Force Col. Jerome Mastal, died June 29 and was buried Sept. 28 at Arlington. He said employees of Demaine Funeral Home in Alexandria -- an SCI property -- told his family that the body would be refrigerated at their central facility.

 

"It was comforting at the time, but now I have lots of questions," Mastal said.

 

"Today, they say the bad conditions did not exist. Hopefully, this didn't happen to my father, but how am I ever going to know?"

 

Staff writer Tom Jackman contributed to this report.

 

© 2009 The Washington Post Company.

 

In Good Health — Autism awareness

 

By Ashley Andyshak

Frederick News-Post

Tuesday, April 7, 2009

 

Though one of 150 children in the U.S. has an autism spectrum disorder, researchers have yet to determine why some develop these disorders while others don't.

 

Autism symptoms typically appear within the first three years of life and affect a child's ability to communicate with others, according to the Autism Society of America. There's no cure, but early diagnosis and intensive therapies can help.

 

A recent study found that autism may be triggered by environmental factors.

 

In a study published in the February issue of Neurotoxicology, researchers evaluated 4,779 Swedish children to determine if indoor environmental factors, asthma or allergy affect the development of autism spectrum disorders.

 

During the five-year study, 72 of the children developed autism, Asperger's syndrome, or Tourette's syndrome.

 

Data show several factors may have contributed to the diagnoses, including maternal smoking, family economic problems, condensation on windows in the home (signifying poor ventilation), and polyvinyl chloride, or PVC, flooring. Male children made up the majority of the diagnosed children (60 boys compared to 12 girls).

 

Children who reported having asthma or other airway problems at the start of the study were also more likely to develop an autism spectrum disorder during the five years.

 

Researchers wrote in the study's abstract that these variables are among the few environmental factors linked to autism and therefore warrant further study.

 

More information about the study is available at sciencedirect.com

 

While it may be years or decades before a definitive cause for autism is discovered, there are resources available now for families of children with autism. Local resources include:

 

* Frederick County chapter of the Autism Society of America, 301-746-8080.

 

* Frederick County Health Department Infants & Toddlers program, 301-600-1612.

 

* Autistic or Asperger-challenged kids whose Members are In this Together for their Youth (AMITY), 301-663-0909.

 

Copyright 1997-09 Randall Family, LLC. All rights reserved.

 

National / International

 

Study: 1 in 5 American 4-year-olds is obese

Rate is even higher among American Indian children

 

Associated Press

By Lindsey Tanner

Baltimore Sun

Tuesday, April 7, 2009

 

CHICAGO - A striking new study says almost 1 in 5 American 4-year-olds is obese, and the rate is alarmingly higher among American Indian children, with nearly a third of them obese.

 

Researchers were surprised to see differences by race at so early an age.

 

Overall, more than half a million 4-year-olds are obese, the study suggests. Obesity is more common in Hispanic and black youngsters, too, but the disparity is most startling in American Indians, whose rate is almost double that of whites.

 

The lead author said that rate is worrisome among children so young, even in a population at higher risk for obesity because of other health problems and economic disadvantages.

 

"The magnitude of these differences was larger than we expected, and it is surprising to see differences by racial groups present so early in childhood," said Sarah Anderson, an Ohio State University public health researcher. She conducted the research with Temple University's Dr. Robert Whitaker.

 

Dr. Glenn Flores, a pediatrics and public health professor at University of Texas Southwestern Medical School in Dallas, said the research is an important contribution to studies documenting racial and ethnic disparities in children's weight.

 

"The cumulative evidence is alarming because within just a few decades, America will become a 'minority majority' nation," he said. Without interventions, the next generation "will be at very high risk" for heart disease, high blood pressure, cancers, joint diseases and other problems connected with obesity, said Flores, who was not involved in the new research.

 

The study is an analysis of nationally representative height and weight data on 8,550 preschoolers born in 2001. Children were measured in their homes and were part of a study conducted by the government's National Center for Education Statistics. The results appear in Monday's Archives of Pediatrics & Adolescent Medicine.

 

Almost 13 percent of Asian children were obese, along with 16 percent of whites, almost 21 percent of blacks, 22 percent of Hispanics, and 31 percent of American Indians.

 

Children were considered obese if their body-mass index, a height-weight ratio, was in the 95th percentile or higher based on government BMI growth charts. For 4-year-olds, that would be a BMI of about 18.

 

For example, a girl who is 4 1/2 years old, 40 inches tall and 42 pounds would have a BMI of about 18, weighing 4 pounds more than the government's upper limit for that age, height and gender.

 

Some previous studies of young children did not distinguish between kids who were merely overweight versus obese, or they examined fewer racial groups.

 

The current study looked only at obesity and a specific age group. Anderson called it the first analysis of national obesity rates in preschool kids in the five ethnic or racial groups.

 

The researchers did not examine reasons for the disparities, but others offered several theories.

 

Flores cited higher rates of diabetes in American Indians, and also Hispanics, which scientists believe may be due to genetic differences.

 

Also, other factors that can increase obesity risks tend to be more common among minorities, including poverty, less educated parents, and diets high in fat and calories, Flores said.

 

Jessica Burger, a member of the Little River Ottawa tribe and health director of a tribal clinic in Manistee, Mich., said many children at her clinic are overweight or obese, including preschoolers.

 

Burger, a nurse, said one culprit is gestational diabetes, which occurs during a mother's pregnancy. That increases children's chances of becoming overweight and is almost twice as common in American Indian women, compared with whites.

 

She also blamed the federal commodity program for low-income people that many American Indian families receive. The offerings include lots of pastas, rice and other high-carbohydrate foods that contribute to what Burger said is often called a "commod bod."

 

"When that's the predominant dietary base in a household without access to fresh fruits and vegetables, that really creates a better chance of a person becoming obese," she said.

 

Also, Burger noted that exercise is not a priority in many American Indian families struggling to make ends meet, with parents feeling stressed just to provide basic necessities.

 

To address the problem, her clinic has created activities for young Indian children, including summer camps and a winter break "outdoor day" that had kids braving 8-degree temperatures to play games including "snowsnake." That's a traditional American Indian contest in which players throw long, carved wooden "snakes" along a snow or ice trail to see whose lands the farthest.

 

The hope is that giving kids used to modern sedentary ways a taste of a more active traditional American Indian lifestyle will help them adopt healthier habits, she said.

 

Copyright 2009 Baltimore Sun.

 

As Food Recalls Continue to Sprout, What Can a Consumer Do?

 

By Jennifer Huget

Washington Post

Tuesday, April 7, 2009; HE03

 

Peanuts and pistachios have much in common. Neither is a true nut: the peanut is a legume, same as a bean or a pea, while the pistachio is a seed. Long dismissed as high-calorie snacks, both are enjoying newfound recognition as healthful foods, full of fiber, beneficial fats, vitamins and minerals that make them worth including in your daily diet.

 

Both were also the subject of recent food-safety alarms. The large-scale recall of products containing peanut-based ingredients processed by the Georgia-based Peanut Corporation of America, which started in January, and last week's recall of pistachios processed by Setton Pistachio in California have highlighted the flaws (and, yes, some strengths) of the nation's food-safety system. The circumstances surrounding those recalls, however, have little in common.

 

The peanut recall stemmed from the Centers for Disease Control and Prevention's detection last fall of clusters of salmonella infection. It took months of sleuthing to tie them to a tub of contaminated peanut butter in a Minnesota nursing home and from there to PCA; months later, products containing PCA peanuts and peanut paste are still being identified and recalled by manufacturers who bought those ingredients. We learned in March that Nestlé USA had conducted its own inspections and found conditions so filthy it declined to do business with PCA. Hundreds have been sickened, and at least nine deaths are attributed to the outbreak.

 

By contrast, in late March Kraft Foods reported to the Food and Drug Administration that one of its affiliates had inspected the Setton plant and found contaminated pistachios. Kraft's decision to share that information with the FDA enabled the agency to get ahead of any potential outbreak (which may still occur), issuing a blanket warning to consumers to avoid any foods containing pistachios until more is known. No illnesses or deaths have been definitively tied to the pistachio contamination.

 

David Acheson, the FDA's associate commissioner for food safety, notes that although the agency has worked to get the word out about recalled products, it's in a reactive mode; he'd like to see the agency more frequently on the proactive side of events. "We're getting better on the reactive, rapid-response side of things," Acheson says, "but we need to modernize our techniques and approaches" to better prevent outbreaks in the future.

 

As the situations have unfolded, one thing has grown increasingly clear: Somebody has to be in charge of keeping our food safe. As it stands, that responsibility is parceled out among more than a dozen government agencies, most prominent among them the FDA and the Department of Agriculture, whose jurisdictions are defined in mysterious ways. (For instance, if a frozen pizza has just a cheese topping, it's regulated by the FDA, but if it has meat, it's the USDA's to monitor.) Once people are sickened by food-borne pathogens such as salmonella and E. coli, the CDC joins in, investigating and tracking outbreaks and providing information about preventing and treating illness caused by those pathogens.

 

Private industry has adopted some food-safety measures on its own. Many companies routinely sponsor independent inspections of their factories, for instance. And many follow HACCP (Hazard Analysis and Critical Control Points) practices, a set of protocols developed for NASA in the 1960s to ensure that astronauts aren't sickened by food-borne pathogens while in space. But politicians, pundits and the public are turning up the heat, noting that self-policing hasn't worked and calling for increased government regulation.

 

Lawmakers, recognizing a hot-button issue when they see one, have offered proposals to fix the food-safety system. Among the key recommendations: giving the FDA the power to institute mandatory recalls (which many of us likely assumed the agency already had), establishing a single new agency to oversee all aspects of food safety and improving the government's ability to track food "from farm to fork." Reforms are likely to be costly.

 

President Obama, who has expressed concern over the safety of his daughter's peanut-butter sandwiches (which are likely safe, if they're made with jarred grocery-store peanut butter, which hasn't been implicated in the ongoing recalls), has called for creation of a working group to advise him on beefing up food-safety laws and coordinating government efforts to keep the food supply secure. He has also earned praise for appointing Margaret Hamburg, an expert in both bioweapons and infectious diseases, to head the FDA. That move signals the president's understanding of the grave implications posed by threats to our food supply.

 

Salmonella and E. coli, currently the two major food-contamination culprits, typically infect animals and are spread via their feces and can thus easily contaminate meat and poultry. But if contaminated water runoff from livestock or poultry farms reaches a produce farm, it can infect the food growing there; rodents can also spread these bacteria.

 

Poor hygiene among workers picking and handling produce can also spread infection, as can cross-contamination, when pathogen-ridden food comes into contact with as-yet-uncontaminated food. Restaurant staff and other food handlers can also contaminate food if they don't follow proper sanitation procedures such as washing their hands after using the bathroom.

 

The majority of food-borne infections aren't related to broad outbreaks but to more-isolated exposure in homes, restaurants and other venues. That's why it's important to continue washing and drying fresh produce, keeping that egg salad out of the sun and in the fridge, using a separate knife and cutting board to handle raw meat, and cooking meat and eggs thoroughly. But to assume such food hygiene will protect us from all the bad bugs out there is naive.

 

The moment when I almost threw up my hands came in 2001, when I reported on salmonella- and E. coli-tainted bean sprouts. Everyone had been thinking of bean sprouts as health food until they started sickening people. It turns out that even thorough washing of bean sprouts doesn't help, as the salmonella bacteria are often embedded in the seeds themselves. There's no way to know your bean-sprout seeds or the sprouts that sprout from them are infected. And while cooking vegetables can kill most pathogens, when's the last time you've cooked a peanut or pistachio?

 

So what's a concerned consumer to do?

 

Unfortunately, Acheson says, not much. "Obviously, when you buy a product that's in a bag, like peanuts or pistachios, you take it on good faith that the company has done due diligence," Acheson says. "With something like raw chicken, you know you have to cook it thoroughly. But there is nothing a consumer can do about a product that's in a package."

 

Check out today's Checkup blog post, in which Jennifer shares her adventures in crockpot yogurt-making. Subscribe to the Lean & Fit newsletter by going to http://www.washingtonpost.com and searching for "newsletters." Go to Wednesday's Food section to find Nourish, a weekly feature with a recipe for healthful eating. And e-mail your thoughts to Jennifer at checkup@washpost.com.

 

Copyright 2009 Washington Post.

 

DNA Test Outperforms Pap Smear

 

By Donald G. Mcneil Jr.

New York Times

Tuesday, April 7, 2009

 

A new DNA test for the virus that causes cervical cancer does so much better than current methods that some gynecologists hope it will eventually replace the Pap smear in wealthy countries and cruder tests in poor ones.

 

Not only could the new test for human papillomavirus, or HPV, save lives; scientists say that women over 30 could drop annual Pap smears and instead have the DNA test just once every 3, 5 or even 10 years, depending on which expert is asked.

 

Their optimism is based on an eight-year study of 130,000 women in India financed by the Bill and Melinda Gates Foundation and published last week in The New England Journal of Medicine. It is the first to show that a single screening with the DNA test beats all other methods at preventing advanced cancer and death.

 

The study is “another nail in the coffin” for Pap smears, which will “soon be of mainly historical interest,” said Dr. Paul D. Blumenthal, a professor of gynecology at Stanford medical school who has tested screening techniques in Africa and Asia and was not involved in the study.

 

But whether the new test is adopted will depend on many factors, including hesitation by gynecologists to abandon Pap smears, which have been remarkably effective. Cervical cancer was a leading cause of death for American women in the 1950s; it now kills fewer than 4,000 a year.

 

In poor and middle-income countries, where the cancer kills more than 250,000 women a year, cost is a factor, but the test’s maker, Qiagen, with financing from the Gates Foundation, has developed a $5 version and the price could go lower with enough orders, the company said.

 

“The implications of the findings of this trial are immediate and global,” Dr. Mark Schiffman of the National Cancer Institute wrote in an editorial accompanying the study. “International experts in cervical cancer prevention should now adopt HPV testing.”

 

At the moment, there are huge gaps in how rich and poor countries screen.

 

In the West, women get smears named for their inventor, Dr. Georgios Papanikolaou. Cells are scraped from the cervix and sent to a laboratory, where they are stained and inspected under a microscope by a pathologist looking for abnormalities. Results may take several days.

 

The DNA screen also needs a cervical scraping, but it is mixed with re-agents and read by a machine.

 

In poor countries, most women get no routine screening. Pain sends them to a hospital, by which time it is often too late.

 

But in some countries, women get “visualization,” pioneered in the last decade, also with Gates Foundation support: a health worker looks at the cervix with a flashlight and swabs it with vinegar. Spots that turn white may be precancerous lesions, and are immediately frozen off. Diagnosis and treatment take only one visit.

 

Pap smears fail in the third world because there are too few trained pathologists and because women told to return often cannot.

 

The Indian study, begun in 1999, divided 131,746 healthy women ages 30 to 59 from 497 villages into four groups. One group, the control, got typical rural clinic care: advice to go to a hospital if they wanted screening. The second got Pap smears, the third got flashlight-vinegar visualization, and the fourth got a DNA test, then made by Digene, which is now owned by Qiagen. The company did not pay for or donate to the study, its authors said.

 

After eight years, the visualization group had about the same rates of advanced cancer and death as the control group. The Pap-smear group had about three-fourths the rates, and the DNA test had about half.

 

Significantly, none of the women who were negative on their DNA test died of cervical cancer. “So if you have a negative test, you’re good to go for several years,” Dr. Blumenthal said.

 

The study’s chief author, Dr. Rengaswamy Sankaranarayanan of the International Agency for Research on Cancer in Lyon, France, said, “With this test, you could start screening women at 30 and do it once every 10 years.”

 

Asked whether that advice would apply in the United States, Debbie Salsow, director of gynecologic cancer for the American Cancer Society, replied, “Absolutely no.”

 

“A negative test would mean a woman’s chances of developing cancer are small, but not zero,” she added. “But if he’d said five years, I wouldn’t have a strong reaction.”

 

Since 1987, she said, the cancer society and the American College of Obstetricians and Gynecologists have recommended Pap smears only every three years after initial negative ones. In 2002, they recommended the HPV test too, and evidence is mounting that the Pap smear can be dropped.

 

“But we haven’t been able to get doctors to go along,” Dr. Salsow said. “The average gynecologist, especially the older ones, says, ‘Women come in for their Pap smear, and that’s how we get them in here to get other care.’ We’re totally overscreening, but when you’ve been telling everyone for 40 years to get an annual Pap smear, it’s hard to change.”

 

Dr. Sankaranarayanan said most European countries screen every three to five years, and many do not start before age 30.

 

Cervical cancer is caused by a few of the 150 strains of the human papillomavirus. Women pick strains up as soon as they start having intercourse, but more than 90 percent of cases clear up spontaneously within two years. Early DNA tests would find these, but lead to useless overtreatment. So in women ages 20 to 30, doctors often order repeat Pap tests, which is expensive but may catch the tiny minority of cancers that develop in less than 15 years.

 

“The U.S. has high resources and low risk-tolerance,” Dr. Schiffman explained, while countries like India have little money and are forced to tolerate risk.

 

Dr. Jan Agosti, the Gates Foundation officer overseeing its third world screening, said Qiagen’s new $5 test — which proved itself in a two-year study in China — runs on batteries without water or refrigeration, and takes less than three hours. In countries where women are “shyer about pelvic exams,” she added, it even works “acceptably well” on vaginal swabs they can take themselves.

 

Copyright 2009 The New York Times Company.

 

House Dust Yields Clue to Asthma: Roaches

 

By Elissa Ely, M.D

New York Times

Tuesday, April 7, 2009

 

Asthma is the most common chronic disease of childhood, one that strikes the poor disproportionately. Up to one-third of children living in inner-city public housing have allergic asthma, in which a specific allergen sets off a cascade of events that cause characteristic inflammation, airway constriction and wheezing.

 

Now, using an experimental model that required leaving the pristine conditions of the lab for the messier ones of life, a team of scientists from the Boston University School of Medicine have discovered what that allergen is.

 

“For inner-city children,” said the lead researcher, Dr. Daniel G. Remick, a professor of pathology, “the major cause of asthma is not dust mites, not dog dander, not outdoor air pollen. It’s allergies to cockroaches.”

 

Dr. Remick and his colleagues (then at the University of Michigan) published their first paper in 2002, after developing their model over several years. Their laboratory was in Detroit, where, as in many other cities, public housing suffered from pest infestation.

 

The team made home visits with an old-time data-collection instrument: the vacuum cleaner.

 

“We collected house dust — big dust bunnies — added water, let them mix overnight, and spun the junk out of them, until we had extract,” said Dr. Remick, now 56.

 

The extract was filled with proteins from Blattella germanica — the common cockroach — whose exoskeletons and droppings become airborne after death. Back in the laboratory, mice were exposed to the dust bunny particles. After being injected, they were immunologically primed: their cellular response systems went on alert.

 

When exposed to the same particles a second time by inhaling them, the systems on alert went to attack. Mice that had been breathing easily had difficulty exhaling, and their respiration slowed — a rodent corollary to wheezing. They were having asthma attacks.

 

Analysis of their lungs showed that their airways were clogged with white blood cells, mostly of a type called eosinophils, that caused mucus secretion, tissue damage and changes in muscle contractibility. Mice in a control group, exposed to dust mites instead of cockroach protein, had none of the same respiratory or pathologic changes.

 

The team reproduced their results in several sites; different dust bunnies, same allergic reaction.

 

“We’re pretty excited,” Dr. Remick said in an interview, “because this is the first time someone has actually taken stuff from houses where kids have asthma.”

 

Researchers not directly involved with the studies said they were excited, too. “It’s a clever thing,” said Dr. Lester Kobzik, a pathology professor at Harvard Medical School. “He’s collected the nasty material people actually get allergic to.

 

“You can’t call up your chemical supplier of scientific reagents and say, ‘I would like five pounds of exactly the same house dust,’ ” Dr. Kobzik continued. “Remick had a bucketload, so he could do several years’ worth of experimentation and study it carefully.”

 

Dr. Peter A. Ward, a professor of pathology at the University of Michigan Health Services, who recruited Dr. Remick into residency almost 25 years ago, called the work “probably the closest thing in animal models to simulating what one sees in human asthma.”

 

Most laboratory asthma research still uses genetically created proteins to induce symptoms in mice; often, the proteins are taken from egg whites. This is scientifically pleasing, but less relevant to real life. Egg whites (which humans rarely grow allergic to) have little in common with the city dust children are more likely to cavort through and inhale.

 

Using the same mouse model, Dr. Remick is now studying the effects of various asthma treatments, including the anti-inflammatory drugs called tumor necrosis factor inhibitors, like Remicade and Enbrel. The drugs, already used for treating rheumatoid arthritis and inflammatory bowel disease, appear to derail a crucial immunologic compound that attracts eosinophils.

 

“Blocking tumor necrosis factor in a mouse model improves asthma,” Dr. Remick said. “It’s pretty slick.”

 

And a more exotic strategy is also under investigation. A few years ago, when Dr. Remick’s colleague Jiyoun Kim presented results of the mouse model at a professional conference in Korea, an audience member asked whether he had heard about standard Chinese herbal treatment.

 

He took herb samples back to the United States, and in mice they proved to block eotaxin, the compound that sets off asthmatic reactions.

 

Chinese herbs carry the whiff and romance of an easy solution without the rigors of federal drug trials. But Dr. Remick warns that caution is in order.

 

“The power and trouble with Chinese herbal medicines,” he said, “is that they have more than one active ingredient — they have dozens. We know they block eotaxin, but we don’t know everything they block, or what actually makes things better.”

 

Complicating the treatment is the disease; asthma has many mechanisms. “There may be 50 different inflammatory processes going on,” Dr. Remick went on. “We’re still in the process of precisely defining which part of the herbs block which part of the inflammatory response.”

 

Still, hopeful parents, attracted by herbal treatments, have caused the researchers some anxious moments. “Yesterday,” Dr. Remick said, “I was contacted by someone whose co-worker wanted to know whether she should use Chinese herbs to treat her daughter’s asthma. I immediately replied that she shouldn’t. It’s not a question of Eastern versus Western medicine. Other drugs that treat asthma are better defined at this point. Herbs shouldn’t be front-line.”

 

“If my child had asthma,” he added, “I’d take her to the pediatrician.”

 

Copyright 2009 The New York Times Company.

 

City Gears Up for 2010 Head Count

 

By Fernanda Santos

New York Times

Tuesday, April 7, 2009

 

Based on the most recent estimates, released last July, there are 8,363,710 people living in New York City, which is 4 percent more than there were in 2000, when the last census was conducted.

 

The number confirms that the city is still the nation’s most populous and diverse: It has the largest Chinese contingent outside Asia, twice as many residents of African descent as any other American city, and more Latinos than in any other place in the country.

 

New York City’s diversity, which Mayor Michael R. Bloomberg has repeatedly extolled as one its greatest assets, also presents challenges to the Census Bureau as it gears up for another count next year. Chief among them is the fact that there are about 500,000 illegal immigrants living in the city and asking them to fill out a governmental form can be a daunting proposition, as many of them fear their status will be discovered and they will be deported.

 

“There’s nothing to fear from filling out a census survey,” Mayor Bloomberg said on Tuesday at the Queens Central Library in Jamaica, where books, magazines and other periodicals can be found in more than 44 languages. “If you’re an undocumented immigrant and you fill out a survey, your life will not be affected.”

 

Flanked by census and city officials, as well as hundreds of colorful books, Mr. Bloomberg stood at the library’s children’s room to announce the creation of the NYC 2010 Census Office, whose main goal is to ensure that more New Yorkers than ever before will fill out the census questionnaires they will receive in March.

 

Also on Tuesday, in a separate effort to bolster the number of census respondents, the mayor and the City Council speaker, Christine C. Quinn, wrote to Commerce Secretary Gary Locke, asking that the Census Bureau, which Mr. Locke oversees, count legally married same-sex couples as “married” in the 2010 census. As it stands, the bureau plans to count these couples as “unmarried partners,” since federal law does not recognize same-sex marriages.

 

“Recognizing these unions for statistical purposes may encourage greater participation in the census” among lesbians, gays and bisexuals, Mayor Bloomberg said. “And greater participation and accuracy are the end goals of the census outreach effort.”

 

Census results are used to determine which states gain — or lose — seats in Congress, as well how much money cities and states receive from the federal government. Getting as accurate a count as possible is important, then, especially at a time when the economy is struggling and municipalities are battling for every dollar they can receive in federal aide.

 

Census information is essentially collected in two phases, through questionnaires mailed to every household in the country and by workers who come knocking on the doors of those who do not respond — a costly and time-consuming enterprise. In 2000, New York City logged a 55 percent response rate, well below the average of 67 percent nationwide, Mr. Bloomberg said.

 

With the nation’s highest percentage of hard-to-count residents — renters, low-income families, blacks and Hispanics, and single men and women — the city will be orchestrating several programs through its census office. They include a public information campaign to residents in general and one specific to public housing developments, which are home to one in 13 New Yorkers; and partnerships with groups like religious institutions, nonprofit organizations and labor unions, which can help spread the message.

 

“It’s not about me asking someone if they’re undocumented or documented,” said the office’s coordinator, Stacey Cumberbatch, a former chief of staff for the Housing Authority. “It’s reaching out to all communities in New York City and encouraging people to participate.”

 

Copyright 2009 The New York Times Company.

 

U.S. Launches HIV-Prevention Campaign

 

By Betsy McKay

Salisbury Daily Times

Tuesday, April 7, 2009

 

The federal government is launching a national campaign to prevent HIV infection, moving to improve prevention efforts against an epidemic that continues to spread at home as well as overseas, officials announced.

 

In a news conference Tuesday, officials from the Obama administration and the Department of Health and Human Services said the five-year campaign, called Act Against AIDS, would largely target African-Americans, Latino populations and other groups most at risk. The campaign will be led by the Centers for Disease Control and Prevention.

 

The move comes several months after the CDC revised statistics showing the annual rate of HIV infection in the U.S. to be far higher than previously thought. Roughly 56,000 people become infected with HIV every year domestically, according to the new CDC statistics, compared with a previous annual estimate of 40,000 new cases a year. About 14,000 people die of AIDS annually in the U.S.

 

While African-Americans make up only 12% of the U.S. population, they represent nearly half of new HIV infections and AIDS deaths every year, the CDC said. Many of those at the highest risk of HIV infection don't realize the level of risk they face or believe that HIV is no longer a serious health threat, according to officials.

 

The first phase of the new campaign will be an awareness message aimed at the general public emphasizing that one American becomes infected with HIV every 9 ½ minutes, officials said. Messages will be delivered through online banner, transit and radio ads, as well as online videos.

 

While the U.S. government spends billions of dollars on HIV/AIDS domestically each year, only 4% of its budget is currently devoted to prevention efforts, according to a Kaiser Family Foundation analysis.

 

The CDC said it is enlisting the help of the Kaiser foundation to disseminate its message through major media and entertainment outlets. The agency has also formed a partnership with several African-American organizations to help it get its message out. They include 100 Black Men of America, the National Urban League and the Southern Christian Leadership Conference.

 

Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved.

 

Opinion

 

Another day care being lost

 

Cumberland Times-News Letter to the Editor

Tuesday, April 07, 2009

 

To the Editor:

 

— Dear members of the Western Maryland Community. We are losing yet another adult day care center, in our area, the Western Maryland Health System Adult Day Care Center at a building at St. Mary’s Catholic Church on Oldtown Road in Cumberland.

 

This day care has served our community for the last 26 years and is currently taking care of 73 patrons. We do not have enough facilities to absorb all these patrons, and they cannot be placed in another day care because there is no room available.

 

I would like to share with you a letter I have sent to Barry Ronan, president and CEO of the Western Maryland Health System, and as of today, he has not responded.

 

Dear Sir: I want to thank you and the Western Maryland Health System for three years of care for my mother at your medical day care on Oldtown Road.

 

She was shown so much love and attention by Jane Jenkins and her staff. My mother was well taken care of and stimulated to actually thrive with her condition.

 

This day care has done an exceptional job at caring for all the patrons. This community has been truly blessed to have such a group of people working for you.

 

My mother is 84 and has Alzheimer’s Disease. She is a retiree of the Western Maryland Health System, having worked in surgery at Memorial Hospital for 30 years. Medicine, activities, and structure provided by the day care have stabilized the progression of the disease and enabled my mother to remain in her home.

 

I have just visited four day care centers in the area: Evergreen, Willow Creek, Covenant House, and Georges Creek. There are no openings for my mother, for she is not yet Medicaid. Right now, so to speak, she is “on the streets.” Many others from the 73 who need placement fall into this category.

 

My mother’s neurologist, Dr. Janjua, feels the psychosocial stimulation at day care will help my mother significantly and delay placement in a nursing home.

 

Statistics indicate Alzheimer’s patients cognitively decline rapidly with a change from their home place to a nursing home.

 

It is cost effective for the state to pay to keep people in day care instead of the nursing home.

 

One month of nursing home care is approximately $6,000, Day care is (six days at $73/day = $438/week = $1,752/month) Quite a difference. Some people may only require the stimulation two times a week (two days at $73/day $146/week =$584/month) or (three days at $73/day = $217/week = $876/month)

 

Would state or federal aid coming to that Western Maryland Medical Day Care keep it open?

 

I would like to talk to you in person about the fate of these day care participants. These people and their families and friends are the constituents that live in the community that your hospital serves.

 

Remember that it is biblical: In order for one to receive — one has to give. I am willing to talk to the legislators, federal, and state about these issues.

 

Do you have any ideas about how I should approach the legislators representing the people of Maryland? Please write back about an appointment time with me.

 

Carolyn L. Davis

Cumberland

 

I am asking for community support in finding ways to keep this day care open. It is centrally located and has a wonderful staff. You may show your support by contacting all who you know who would have an interest in this, as well as, writing me:

Carolyn Davis

PO Box 188

Cumberland, MD 21502

 

Copyright 2009 Cumberland Times-News.

 

Domestic Violence Bills Forwarded to O'Malley

 

Annapolis Capital Letter to the Editor

Tuesday, April 7, 2009; B02

 

The Maryland General Assembly has given final approval to legislation that will make it easier for judges to confiscate firearms from domestic violence suspects, a top priority of the legislative session for Gov. Martin O'Malley.

 

Last night, the Senate passed two bills dealing with protective orders and sent them to O'Malley (D) for his signature. One of the bills, passed on a 31 to 15 vote, gives judges the option of removing firearms from people issued seven-day temporary protective orders after being accused of threatening violence.

 

The other, approved 32 to 15, requires that judges order the confiscation of guns from those who are issued final protective orders.

 

O'Malley has argued that the bills will make victims of domestic violence safer by making it harder for their abusers to respond to legal action with a firearm. The legislation has found a champion in Lt. Gov. Anthony G. Brown (D), whose cousin was shot and killed by an estranged boyfriend last year.

 

Opponents said the measures would give victims a false sense of security because abusers determined to do harm would find a way, even if legal access to guns was restricted.

 

Also last night, the House gave final approval to another O'Malley priority: extending the availability of unemployment benefits to part-time workers. That measure passed 92 to 41.

 

-- Rosalind S. Helderman and John Wagner

 

Copyright 2009 Annapolis Capital.

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