Monday, July 6, 2009

News Clipping Archives

Maryland / Regional

No summer relief from swine flu in Md. (Baltimore Sun)

The strange summer of flu (Baltimore Sun)

Health, music get top billing at black festival (Baltimore Sun)

Carroll officials favor health-care reform (Carroll County Times)

Teens: Smoking bill an unlikely deterrent (Carroll County Times)

New juvenile center surrounded by arguments (Baltimore Sun)

6 escape briefly from New Beginnings Youth Center (Annapolis Capital)

Court rejects medical examiner request for records (USA Today)

Worcester notes surge in rabies cases (Salisbury Daily Times)

Delaware mosquito complaints near record (USA Today)

2 more parvovirus cases found at Virginia shelter (USA Today)

 

National / International

Tuberculosis: TB Vaccine Too Dangerous for Babies With AIDS Virus, Study Says (New York Times)

Think safety before diving in (Baltimore Sun)

Cancer update 2009 (Baltimore Sun)

Blood feud (Washington Post)

Therapeutic cancer vaccines show promise (Baltimore Sun)

Whose side are health advocacy groups on? (Baltimore Sun)

Tobacco Stocks May Thrive Despite FDA Regulation (Wall Street Journal)

Familiar Players in Health Bill Lobbying (Washington Post)

Dogs Sniffing Out Health Problems (New York Times)

UN chief says $1 billion may be needed for antivirals, vaccines against swine flu this year (Baltimore Sun)

 

Opinion

Take the heat off of summer (Carroll County Times Editorial)

You Can't Always Pay for Care Yourself (Wall Street Journal Letter to the Editor)

 

 

Maryland / Regional

No summer relief from swine flu in Md.

Health experts warn against complacency as H1N1 spreads

 

By Stephanie Desmon

Baltimore Sun

Monday, July 6, 2009

 

The flu is usually gone by now. Dr. Ann Morrill isn't generally prescribing Tamiflu and bed rest in July to her Perry Hall patients. The emergency department at St. Joseph Medical Center in Towson doesn't typically do a dozen flu tests a day this deep into summer.

 

But the H1N1 influenza virus - commonly called swine flu - continues to spread in Maryland and many other states, even though some experts thought it would have faded away by now across the country.

 

During the last week of June, the state confirmed 166 new cases - the highest weekly total since the first cases were confirmed here May 4. And officials believe that for every confirmed case, there are many more that go unconfirmed as the sick either don't seek medical treatment or are refused testing. Based on its mathematical models, the Centers for Disease Control and Prevention estimates that as many as 1 million Americans have been sickened by this pandemic flu since the outbreak began.

 

"It died down in the press quite a bit, so many people think it's gone away," said Dr. Gail Cunningham, who heads the emergency department at St. Joseph. The hospital had a record number of visits in June because of people with flu-like illnesses. "The reality is, it's very much still present."

 

Dr. Anthony S. Fauci, director of the Bethesda-based National Institute of Allergy and Infectious Diseases, said summer's warm weather and high humidity make it hard for a flu virus to survive. In fact, the seasonal flu strain has disappeared.

 

But this new strain isn't behaving like the seasonal flu that hits each winter. It keeps infecting more people, despite what the calendar says.

 

"This is persisting in society," Fauci said. "It's unusual for the flu to do that."

 

Summer camps are feeling the impact. Sandy Hill Camp in Cecil County sent campers home midway through a two-week session last week after 19 children came down with flu-like symptoms in 48 hours. The Muscular Dystrophy Association canceled more than half of its weeklong camp sessions - including two scheduled for Camp Maria in Leonardtown - on fears that children with already-compromised immune systems could become critically ill if they came down with flu, something that is more likely in a setting of shared cabins and meals in close quarters.

 

"We decided it was a little too risky," said Bob Mackle, an MDA spokesman.

 

For the most part, health officials say, the symptoms of this flu strain have been mild to moderate, with 170 deaths nationwide, including one in Maryland. Nearly all who have gotten ill have recovered.

 

But some have been hospitalized, particularly people with underlying medical conditions and already-suppressed immune systems. There have also been cases of otherwise healthy people who have been hospitalized with flu.

 

"If you get it, you feel like you've been hit by a train," said Dr. Harold Standiford, an epidemiologist at the University of Maryland Medical Center. "But in terms of causing serious illness, we're very fortunate that it has not done that very often.

 

At the Maryland Department of Health and Mental Hygiene's laboratory, where swabs are being sent to test for the H1N1 virus, technicians are on the lookout for whether the virus is mutating. They are concerned that swine flu could become resistant to Tamiflu (so far there are no reports that it has done so in the United States) or could become more severe. At this point, tests are only being done on swabs from people who are seriously ill.

 

Seasonal flu in a typical year kills 36,000 people in the United States, primarily the elderly. Children and young adults have been more susceptible to the new H1N1 strain. Some doctors believe that older people might have been exposed to similar strains of flu decades ago and that could be providing some protection.

 

Seasonal flu tends to peak between December and February, and the state usually stops monitoring for it in mid-May. But this year, Maryland health officials have continued the monitoring program, getting regular reports from private doctors, public clinics and hospitals.

 

The trend is definitely upward: During the last week in May there were 23 confirmed cases of H1N1; during the last week of June there were 166. There are 578 confirmed cases in Maryland, but some officials say those numbers might be meaningless because there are believed to be thousands of people who have gotten ill but have not been tested for the virus.

 

At St. Joseph, 174 rapid flu tests were given in the past two weeks and most came back negative. Cunningham said she believes the test "may be inaccurate."

 

"It's not picking up the cases," she said.

 

Morrill, the Perry Hall doctor, has had such a hard time getting her patients tested that when she sees someone sick with flu-like symptoms she assumes it is the H1N1 virus and prescribes Tamiflu.

 

Many influenza researchers had expected swine flu to disappear this summer because that is how previous pandemics have behaved. In the 1918 pandemic, flu appeared in the spring and slowed down in the summer, only to rev up again in fall and winter.

 

Rene F. Najera, an epidemiologist with the state health department, said Maryland is now in an "acceleration phase" of the flu and he expects the peak to hit soon. He said "herd immunity" will force the flu to slow its pace.

 

"We'll hit a critical point where so many people are infected or recovering that it will be hard for it to jump from one person to the next," he said.

 

Cunningham said she expects cases to stay steady before increasing this fall.

 

It is unclear what this summer of flu could mean when it's actually flu season again. In the Southern Hemisphere, where flu season is just beginning, Argentina, Australia and other nations are reporting H1N1 outbreaks.

 

While there has long been a vaccine for seasonal flu, there isn't one for swine flu. Development is under way but the U.S. Department of Health and Human Services has not decided whether a vaccine will be mass produced. If that decision is yes, the agency's secretary has suggested that 600 million doses of vaccine would have to be manufactured.

 

Dr. William Schaffner, an infectious diseases expert at Vanderbilt University, said he worries that H1N1 is off the radar screens of most people - and of doctors.

 

"What I have seen among patients and some physicians is, they're kind of blowing it off," he said. "They're kind of nonchalant about it.

 

"If people don't take it seriously, if vaccine is going to be administered, they won't take advantage of it."

 

Tips for avoiding H1N1 flu

•Wash your hands often with soap and water.

 

•Cover your nose and mouth when you cough or sneeze.

 

•Avoid close contact with sick people.

 

•If you have flu-like symptoms, stay home to keep from infecting others and spreading the virus.

 

Source: Centers for Disease Control and Prevention

 

Copyright © 2009, The Baltimore Sun.

 

The strange summer of flu

 

By Stephanie Desmon

Baltimore Sun

Monday, July 6, 2009

 

"If you've seen one influenza season, you've seen one influenza season," Dr. William Schaffner, an infectious diseases expert at Vanderbilt University in Nashville, has told me more than once. It's an attempt at some medical humor, I guess, but there may be plenty of truth in his quip.

 

Researchers and public health officials have been trying to pin down this H1N1 virus since it hit the U.S. in April. They don't know if it will stay mild (it has sickened an estimated 1 million in the U.S. but killed 170 at last count). They thought it would go away over the summer since flu usually does, but in many places, more people keep coming down with it. The official number of new confirmed cases in Maryland, for example, has risen every week since the first case was confirmed here in May (and, officials say, those numbers are likely much higher since most people who get sick don't visit the doctor and most people who go to the doctor aren't getting tested for flu). Experts predict the virus could come back worse for flu season this fall and winter, like the Spanish Influenza of 1918 did. That remains to be seen, of course. ...

 

The truth is, since this is a new strain of the flu, health officials haven't a clue how it will behave. They want us to be wary of the swine flu, but not afraid. They want us to be comforted by the fact that the symptoms are mild, but concerned enough to avoid catching it if at all possible. They want us not to cry out that a vaccine is needed unless they are able to mass-produce one in time for the coming flu season. Then they will want us to line up and get immunized.

 

Said Dr. David Blythe, the state's epidemiologist: "It's hard to know what to expect when you have a new flu virus."

 

Copyright 2009 Baltimore Sun.

 

Health, music get top billing at black festival

African American Heritage offers 3 days of song, educational exhibits

 

By Arin Gencer

Baltimore Sun

Monday, July 6, 2009

 

Standing in a lot next to M&T Bank Stadium, Aaliyah McCray, 12, slipped the blue hula hoop over her head and faced Chris Pierce, 9.

 

"Ready, set, go!" shouted Ashley Bertrand, who was refereeing the contest. Cheers erupted as the two swung their hoops and began moving their hips, working to keep the rings up.

 

A few seconds later, the hoops clattered to the ground about the same time.

 

"A tie," Bertrand said. The two competed again, with Aaliyah eventually winning.

 

The contest, put on by Maryland Physicians Care's Healthy Groove program, was part of this year's African American Heritage Festival, which celebrates black culture and history. Besides the usual booths of food, carnival rides and abundant musical entertainment - which was to include Anita Baker, R&B group Tony! Toni! Tone! and En Vogue - the three-day festival focused on three issues affecting the black community, organizers said: health and wellness, financial literacy and education.

 

"Our focus is to really help eradicate these disparities in the African-American community," said LaRian Finney, chair and producer of the event.

 

To that end, Maryland Physicians Care, a managed-care organization, set up health-centered stations that featured the hula hoop competition, as well as Wii video-game bowling and samples of healthily prepared food, including corn on the cob, grilled pineapple, chicken stir-fry and apples with sugar-free caramel syrup - along with recipes. The stations were intended to show people things they can do in everyday life to be healthy, said Carrie Dudley, program coordinator for Healthy Groove.

 

Jamie Baldwin, 11, said she particularly enjoyed the apple dish. The girl managed to cream her Wii opponent with a strike, after taking her turn with the hula hoop.

 

"I like coming," Jamie said of the festival, which she attended with her grandparents. "I think it's great."

 

Roxie McCray, of Bel Air, said she's come regularly for years, and brought her 3-year-old grandson, Christian Vias, along for the first time. "I just like it - all the stands, all the stuff they sell," said McCray, who also competed against her hula-hooping daughter, Aaliyah. McCray collected health information at last year's festival as well.

 

McCray later ventured inside a tent where an 8-foot-tall, reddish-pink tunnel lured the curious. The Prevent Cancer Foundation's 20-foot-long Super Colon walked people through the stages of colon cancer, from a normal colon to the malignant growths that signal the disease's advanced stage. The disease is the third leading cause of cancer deaths among African-Americans, according to the exhibit.

 

The huge display helps break the ice on a subject some are reluctant to consider, said Janet Hudson with Prevent Cancer, who added that the disease can be 90 percent preventable, with the help of screenings. "That's what it's all about, getting people talking to one another," she said.

 

Also amid the displays, musical performances and food, several vendors and participants paid tribute to Michael Jackson: Songs such as "Don't Stop 'Til You Get Enough" and other hits occasionally boomed from loudspeakers, and an enterprising few arrived with items commemorating the late singer.

 

On Saturday, vendor Abdul Hakeen brought 400 shirts of various colors bearing pictures of the "King of Pop." Hakeen left with just two, he said. He arrived with several dozen more yesterday.

 

"Since Mike passed, we've been selling them everyday," Hakeen said.

 

Nearby, posters that said "R.I.P. Michael" and "We'll always love you" - with images of Jackson from his earliest and later days - were for sale.

 

Organizers estimated a crowd of more than 225,000 attended the festival over the weekend - a figure with which they were very pleased, Finney said. "We think it's a home run."

 

Copyright © 2009, The Baltimore Sun.

 

Carroll officials favor health-care reform

 

By Erica Kritt

Carroll County Times

Monday, July 6, 2009

 

Three of Carroll County’s top health officials say they are in favor of health-care reform, but say there are still many questions that have to be answered before a universal health-care plan can be rolled out.

 

More than 45 million people in the United States — and more than 700,000 in Maryland — are uninsured.

 

President Barack Obama and many in Congress are attempting to reform health care in America and insure all Americans. In early June, Sen. Edward Kennedy, D-Mass., and chairman of the Senate Committee on Health, Education, Labor and Pensions, unveiled the Affordable Health Choices Act. Broadly speaking, the 651-page bill released by Kennedy would revamp the way health insurance works. Insurance companies would face a slew of new government rules, dealing with everything from guaranteed coverage for people with health problems to possible limitations on profits. Taxpayers, employers and individuals would share in the cost of expanding coverage to nearly 50 million uninsured Americans, according to an Associated Press report.

 

Under the bill, Americans would also be able to buy long-term-care insurance from the government for $65 a month.

 

While there has been a lot of concern over having a government-funded insurance program, County Health Officer Larry Leitch said he doesn’t think it’s that radical an idea.

 

“We have a public option, a huge public option, in place. It’s called Medicare,” Leitch said. John Sernulka, executive director and CEO of Carroll Hospital Center, said he is in favor of reform but wary of debating how to tackle all the necessary changes without sacrificing care.

 

“I am very concerned about how we as a nation will pay for this reform,” he said. “There are major budget cuts in Medicare. They are scary. It’s going to impact the way patients get care in this country.”

 

In an ABC news special “Prescription for America,” Obama addressed some of the issues of a plan for a public option.

 

“What I’ve said is, let’s change the system so that our overall cost curve starts going down by investing in a range of things — prevention, health, IT, etc. We will have some upfront costs,” Obama said on the television special that aired June 24. “But what we’ve said is … that whatever it is that we do, we pay for. So it doesn’t add to our deficit.”

 

One of the major aspects of Obama’s plan is to make sure everyone can be covered by some form of insurance. According to statistics from healthreform.gov that are compiled by the U.S. Department of Health and Human Services, 23 percent of middle-income families in Maryland today spend more than 10 percent of their income on health care.

 

And since 2000, average family premiums have increased 79 percent in Maryland, according to healthreform.gov.

 

Sernulka said that if the country is going to insure millions more people, the health industry needs to be ready.

 

“Are we going to have enough doctors to handle [the increase]?” he said.

 

Maryland is already facing a physician shortage.

 

According to a study done by the Maryland Hospital Association and the Maryland State Medical Society in 2008, the number of physicians in clinical practice in the state is 16 percent lower than the national average.

 

The report also noted the ratio of physicians to patients is going to decline in the coming years. By 2015, 32 percent of the current surgeons in the state are expected to retire.

 

“It’s very important we maintain an adequate number of physicians,” said Tricia Supik, executive director and CEO of the Partnership for a Healthier Carroll County.

 

The Partnership is a joint venture between Carroll Hospital Center and the Carroll County Health Department that seeks to improve health and the quality of life in the county.

 

With health care, Supik, Sernulka and Leitch all agreed that the practice of care needs to change. “MRIs, CAT scans can be very valuable in certain circumstances, but doctors are overusing them,” Leitch said.

 

Sernulka reiterated that, saying doctors should be trained to be good diagnosticians who can understand what to test for instead of ordering a bunch of tests to get a grasp on the symptoms. At a forum on health care in Virginia on Wednesday, Obama talked about the need to emphasize the quality of care over the quantity of care.

 

“The biggest thing we can do to hold down costs is to change the incentives of a health-care system that automatically equates expensive care with better care,” the president said. He said the formula system drives up costs “but doesn’t make you better.”

 

Leitch said people are going to have to learn to live with less health care, for example not running to the hospital for cuts and scrapes.

 

“We use the health-care system like a buffet table,” Leitch said.

 

Sernulka said the reformers and politicians should heed the example of the Mayo Health System, which makes doctors, hospitals and nursing homes work together to care for 70 communities in Iowa, Minnesota and Wisconsin.

 

“The system is designed to get the patient into the right format,” Sernulka said.

 

Supik said emphasizing wellness, prevention and chronic care management will be key to a reforming the health-care system.

 

In the American Recovery and Reinvestment Act, $1 billion was directed to improve prevention and wellness care. The Office of Management and Budget states that one-third of all illnesses result directly from poor diet, lack of exercise and smoking.

 

All three Carroll health officials are in favor of reforming the current health-care system. “Any systemic change that lowers cost and improves care for patients, we would be in favor of it,” Supik said.

 

The Associated Press contributed to this article.

 

Copyright 2009 Carroll County Times.

 

Teens: Smoking bill an unlikely deterrent

 

By Alicia McCarty

Carroll County Times

Monday, July 6, 2009

 

ELDERSBURG — Although President Barack Obama is optimistic about the effects of recent landmark anti-smoking legislation, Carroll County teens are not.

 

The Family Smoking Prevention and Tobacco Control Act, signed by Obama June 22, is the strongest anti-smoking legislation ever passed in the U.S. The act grants the FDA unprecedented power to regulate tobacco products. Among the changes are restrictions on advertising, such as the use of words like “light” or “mild,” and mandated larger warning labels.

 

In addition, fruit- and candy-flavored cigarettes, long viewed as a ploy to entice youths to start smoking, are now banned.

 

Despite the array of changes, Carroll teens do not think the legislation will have a large impact on youths because advertising and flavored products are not the problem.

 

“I don’t think I’ve ever really known anyone to start smoking because the cigarette is flavored,” said Calvin Strumsky, of Westminster, a 19-year-old nonsmoker.

 

Strumsky, along with Chelsie Grooms, another 19-year-old nonsmoker from Westminster, both agreed that the new regulations probably won’t have as large an impact as Congress thinks, citing peer pressure and rebellion as the true reasons for teen smoking.

 

John Smith, an 18-year-old smoker from Westminster, thought the legislation would have a bigger effect on younger teens, but as for 17-, 18- and 19-year-olds, he said, nothing would change. “Teenagers are hardheaded,” he said.

 

Smith said he began smoking because his friends smoked and now he regrets the decision. Theron Johnson, a 20-year-old nonsmoker from Eldersburg, agrees with the legislation but doesn’t think it’s going to make a difference in the number of teens who smoke. He also cited price as the major deterrent for youth.

 

“If raising prices [of tobacco products] hasn’t stopped [teen smokers], nothing will,” he said. Smoker Charles Rutter, 18, misses his favorite brand of cigarettes, Camel Frost, which he’s had trouble finding in recent days.

 

Although switching cigarette brands has been a nuisance for Rutter, he has continued to smoke. He also doesn’t believe the legislation will have a significant effect on youths.

 

Christina Kramer, manager of the Tobacco Stop in Westminster, doesn’t see the legislation making much of a difference either.

 

“Kids are going to do what they’re going to do,” she said.

 

Kramer also said her younger customers purchase roll-your-own cigarette products. Most of the flavored tobacco products she sells go to senior citizens or to those who have been smoking for a number of years.

 

Kramer thinks the biggest problem is cashiers not checking IDs, not flavored cigarettes or light and mild labels.

 

Barbra White, with the cigarette restitution fund program at the Carroll County Health Department, is much more optimistic about the changes. According to White, the act is expected to reduce youth smoking by 11 percent in the next decade.

 

White thinks the most positive aspect of the new legislation is that it will stop new products targeting young people from entering the market.

 

The Health Department is a longtime partner of county schools, providing them with funding for prevention programs. The Health Department also holds a class for teens caught with tobacco. “Tobacco prevention has been well-established in the curriculum,” said White, a fact that, in addition to the new legislation, will in White’s opinion reduce the number of young smokers.

 

Copyright 2009 Carroll County Times.

 

New juvenile center surrounded by arguments

Child advocates doubt that academy will stay small, or temporary

 

By Julie Bykowicz

Baltimore Sun

Monday, July 6, 2009

 

Silver Oak Academy, a reform school for juvenile delinquents, will open this month in rural Carroll County with nine boys, slowly expanding to four dozen - just a fraction of the size it could be.

 

The sprawling facility, with a 20,000-square-foot vocational training center and six dormitories, can accommodate at least triple that number, a legacy of the ambitious expansion plans of its previous owner, Bowling Brook Preparatory School, which was forced to close after a student died. And the company currently operating it, Rite of Passage, is known for super-sized juvenile justice programs in Western states that it clearly wants to replicate here.

 

Even before its opening, as soon as this week, the fight has begun over just what shape Silver Oak Academy will take, part of a broader discussion about Maryland's approach to rehabilitating juvenile offenders.

 

Lawmakers agreed last year that state-run juvenile facilities must be no larger than 48 beds and should be near the hometowns of the children they serve, with particular emphasis on Baltimore. Such a model, national experts have found, gives kids a better chance of avoiding new arrests and succeeding in school once they return home.

 

The state has designated $188 million to build new juvenile facilities in line with that approach, but construction is years away. Meanwhile, more than 200 juvenile offenders are awaiting treatment in lock-ups or have been sent to other states.

 

State juvenile justice leaders see programs like Silver Oak as a way to temporarily fill a void, and Gov. Martin O'Malley calls the facility simply a "bridge" to the ultimate goal of small, state-run juvenile facilities across the state.

 

"There really is a desire on the part of everybody for our regionalized system," said Department of Juvenile Services Secretary Donald DeVore. "It is going to take time to get there."

 

Child advocates don't buy it.

 

A step backward?

Rite of Passage has invested far too much money to be temporary, they say, and the opening of Silver Oak is a step backward for juvenile justice. It is about 10 miles from the 48-bed, state-run Victor Cullen Center, a higher-security youth facility, and both are more than an hour's drive from Baltimore.

 

"This doesn't contribute a damned thing to developing regionalization," said Jim McComb, a longtime child advocate and former director of the Maryland Association of Families and Youth.

 

The advocates also worry that, over time, the private provider will grow to resemble its troubled predecessor, Bowling Brook, where 17-year-old Isaiah Simmons died after being restrained by employees. The 50-year-old reformatory in rural Keymar had grown over the years to house about 175 boys. Advocates argued that rapid expansion doomed that school.

 

Bowling Brook's closing gave Rite of Passage its long-awaited entree to Maryland.

 

Founded 25 years ago by a former UCLA tennis player, Rite of Passage is best known for its largest reform schools, which include one with 500 beds in Colorado and another with a capacity of 250 in Arizona.

 

The company houses a handful of Maryland kids at its Arizona facility and had been tracking the state's juvenile justice issues for years. It concluded that the state needs many more beds than it has, said James Bednark, director of Rite of Passage's Maryland operation.

 

In January, the Nevada-based Rite of Passage purchased Bowling Brook's 78-acre property for $8 million, according to state property records. It also took on $2 million of the former owner's debts to the state and spent another $250,000 on renovations.

 

"You don't often find a facility like the one we're in," Bednark said.

 

The first new residents at Silver Oak will be Maryland boys now at the company's Arizona program, which Bednark said will smooth out the opening because they will already be familiar with Rite of Passage's policies.

 

All residents will be teen-agers found "responsible" - the juvenile equivalent of guilty - of offenses such as assault and drug crimes. The program won't accept the highest-level offenders, murderers and rapists, for example, but will take kids with low-level emotional and substance abuse problems.

 

They will take classes to work toward a high school diploma or GED and receive vocational training. There are no razor-wire fences, armed guards or alarms, meaning staff members provide the only security.

 

"Kids respond the way you and I would expect them to," said Kevin McLeod, Silver Oak's director of group living. "In detention, kids have to take care of themselves. Here, the adults serve as surrogate parents. Here, we can let young men be young men."

 

McLeod, a Park Heights native who has been involved with youth services for 25 years, most recently in Miami, is among the 27 employees Rite of Passage has hired so far. More will be added, Bednark said, as the population expands.

 

Even after all 48 youths have arrived, the 78-acre campus no doubt will feel empty.

 

"Our predecessor obviously had big plans," Bednark said as he flicked on the lights in a 151-seat auditorium. When it was shuttered, Bowling Brook had been constructing a vast work force training center, which included fully equipped metal and woodworking shops.

 

Bednark said he has been talking to Carroll Community College about having night programs there, separate from the juvenile offenders.

 

"There's Maryland taxpayer money in this," he said. "It would be a shame to have it go unused."

 

The Department of Juvenile Services limited Rite of Passage's capacity to 48 youths - parallel to the cap on state-run facilities. To expand, the company would need the approval of Juvenile Services and the Board of Public Works, made up of the governor, treasurer and comptroller.

 

Some lawmakers, including Sen. Bobby A. Zirkin of Baltimore County, tried to outlaw the growth of any private provider beyond 48 beds. One after another, child advocates testified in favor of the legislation. The only group to oppose it was Rite of Passage, which in the past year and a half has spent about $50,000 on lobbyists, including Josh White, a former O'Malley government aide and campaign manager, according to ethics filings.

 

The legislation failed.

 

Zirkin compared the lobbying to that of the cigarette companies or public utilities. "It was yet another sad episode in the history of juvenile justice in this state. Money is being made on the backs of kids by those who were able to influence the legislative process."

 

DeVore, who strongly advocated for the 48-bed limit on state-run facilities, does not want a similar cap for providers, his spokeswoman said, to allow him discretion in determining the best size for each place.

 

The secretary said Rite of Passage is a good program. But he has also assured state officials that it is not in the state's long-term juvenile justice plan.

 

Before approving the company's license at last month's Board of Public Works meeting, State Treasurer Nancy Kopp asked for an assurance that DeVore views Silver Oak as "an interim facility."

 

"That's correct," DeVore told her.

 

Child advocates see it differently.

 

"What we seem to now be doing is rebuilding a system that never works and can't work," said Matthew Joseph, director of Advocates for Children and Youth, a Baltimore-based nonprofit.

 

The Board of Public Works approved a three-year, $9.8 million contract with Rite of Passage, though Comptroller Peter Franchot voted against it.

 

McComb said the company has been honest about its desire to be larger. "The mathematics just don't work for 48 kids," he said.

 

For now, though, Bednark said the company knows it is "locked into serving 48 kids." Asked about whether Silver Oak will seek to expand, he replied, "Our track record will speak for itself, and it will speak positively."

 

Copyright © 2009, The Baltimore Sun.

 

6 escape briefly from New Beginnings Youth Center

 

Associated Press

Annapolis Capital

Monday, July 6, 2009

 

LAUREL, Md. (AP) — Six teens escaped briefly from the District's New Beginnings Youth Center in Laurel, just weeks after the $46 million center opened.

 

The teens were spotted and caught near the junction of the Baltimore Washington Parkway and Maryland Route 198 about an hour after the search for the teens was launched Sunday afternoon.

 

This is the second escape from New Beginnings, which replaced the Oak Hill Youth Center, was designed to be more like a college than a jail. A day after it opened, a juvenile inmate scaled a fence. He was captured two days later.

 

The Department of Youth Rehabilitation Services says it will investigate Sunday's incident.

 

Copyright 2009 Annapolis Capital.

 

Court rejects medical examiner request for records

 

Associated Press

USA Today

Monday, July 6, 2009

 

DOVER, Del. (AP) — The Delaware Supreme Court has refused the state medical examiner's request to overturn a ruling barring access to records about a psychiatric patient's death.

 

The justices ruled last week that Dover Behavioral Health System did not have to produce the records in response to a subpoena.

 

The case involved Joseph Heverin, a 22-year-old Huntington's disease victim denied a bed in a state medical facility because he was a registered sex offender. He choked to death at the Dover clinic last year while eating lunch.

 

The clinic argued that the records sought by the state were privileged because they were part of the medical peer review process. The state argued that the peer review privilege did not apply to the records in question.

 

Copyright 2009 The Associated Press. All rights reserved.

 

Worcester notes surge in rabies cases

 

By Jenny Hopkinson

Salisbury Daily Times

Monday, July 6, 2009

 

SNOW HILL -- It was obvious something about the fox wasn't right.

 

The creature was lurking near his daughter's home in the daylight and attacked a neighbor, so Roland Culp was concerned.

 

"It was trying to get into the house and bumping on doors and such," Culp said. "We knew it was rabid."

 

He put the sick creature out of its misery and turned the body over to the Health Department, whose test results confirmed his suspicions.

 

That fox, lurking near Nassawango Road, is one of 20 rabid creatures -- mostly raccoons and foxes -- found in Worcester County in the past two months, a surge in local confirmed cases of the disease. The Worcester County Health Department has been alerted of at least 11 other possibly infected creatures that were unable to be tested. Last year, there were only four laboratory confirmed cases.

 

The increase is becoming a problem, said Janet Tull, rabies coordinator for the health department. The animals have been found in both rural and densely populated areas of the county, including one confirmed case in Ocean City and three in Ocean Pines. In that pine-forested subdivision, where street lights are rare, all of the encounters have been with rabid raccoons.

 

"There is no way for us to know where the next case will be," she said. "Be proactive because you aren't going to know when there will be a rabid animal on your property -- it often occurs with no warning."

 

Rabies is a virus that attacks the nervous system and is spread through contact with the saliva of an infected animal, normally through bites, according to the Maryland Department of Health and Mental Hygiene. The disease in Worcester County is found most often in raccoons and foxes, although skunks, cats, bats and groundhogs -- among others -- are also known to carry rabies in Maryland.

 

Both humans and pets have been attacked by infected animals during the surge in the past few months, said Tull. Four unvaccinated dogs have been euthanized.

 

"It's a very different situation if your pet is currently vaccinated and comes in contact with a rabid animal," Tull said, stressing the importance of protecting domesticated dogs and cats.

 

Pet owners should make sure their animals' vaccinations are up to date and check with a vet to make sure the protection has not expired. The health department also recommends that pets be fed inside so the food won't attract stray cats and wild animals. People should alert the local police or animal control if they see a raccoon, fox or other rabies species acting strangely. Furthermore, be careful not to touch pets who have been in a fight, Tull said, since infected saliva may still be in the fur.

 

There is no obvious indication as to why there has been such an increase in cases this spring. However, Tull added, regardless of the amount, pet owners and residents should always be careful when it comes to wild animals.

 

"It could stop tomorrow, and we may not get another case for a while," she said. "But it's always present, there's always rabies in Worcester County and in Maryland, and there are necessary precautions that people should take."

 

Copyright 2009 Salisbury Daily Times.

 

Delaware mosquito complaints near record

 

Associated Press

USA Today

Monday, July 6, 2009

 

MILFORD, Del. (AP) — Delaware's Department of Natural Resources and Environmental Control officials say a dry winter, wet spring and late hatching are driving a near record number of complaints about mosquitoes.

 

Mosquito Control Coordinator Bill Meredith says the Milford office has received nearly 1,900 telephone complaints in the past month from Kent and Sussex counties. That number almost matches the statewide total for all of last year, which hit about 2,100.

 

About 10 percent of the state's woodlands were sprayed earlier this year. DNREC typically dispatches fog trucks to spray areas at night after receiving complaints.

 

Meredith says the current complaints revolve around woodland pond mosquitoes, which typically live for six-to-eight weeks. This wave of mosquitoes is expected to subside around the middle of July.

 

Copyright 2009 The Associated Press. All rights reserved.

 

2 more parvovirus cases found at Virginia shelter

 

Associated Press

USA Today

Monday, July 6, 2009

 

SUFFOLK, Va. (AP) — Two new cases of parvovirus will keep Suffolk's animal shelter closed for another week.

 

The city closed the shelter June 27 and euthanized at least 12 dogs after officials learned that a dog adopted from there died from the highly contagious virus.

 

City officials had planned to reopen the shelter Monday. But the city said two animals tested positive for parvovirus over the weekend.

 

City spokeswoman Debbie George says one animal was found dead and the other was non-symptomatic.

 

George says shelter workers will continue to monitor the dogs there and clean the facility.

 

Copyright 2009 The Associated Press. All rights reserved.

 

National / International

Tuberculosis: TB Vaccine Too Dangerous for Babies With AIDS Virus, Study Says

 

By Donald G. McNeil Jr.

New York Times

Monday, July 6, 2009

 

The vaccine against tuberculosis that is routinely given to 75 percent of the world’s infants is too risky to give to those born infected with the AIDS virus, says a new study published by the World Health Organization. It recommended that vaccination be delayed until babies can be tested.

 

The Bacille Calmette-Guérin vaccine, known as BCG, protects children well against deadly tuberculous meningitis, though it does less well against the lung form. It has been in use since 1921, and children in many countries — though not the United States, which never adopted it — bear its characteristic round scar.

 

But because it is a live vaccine, a weakened strain of bovine tuberculosis, it can cause its own problem — “disseminated BCG disease,” a type of bacterial infection that can rage through the body. It is fatal in more than 70 percent of cases.

 

In countries like South Africa, where both tuberculosis and mother-to-child transmission of the AIDS virus is common, the vaccine gives infected children almost no protection against tuberculosis and instead may kill them with BCG disease, the authors found. The study, done in three South African pediatric hospitals, was complex because BCG disease and tuberculosis can look identical, so each infection had to be cultured.

 

Although they recommend delaying vaccination, the authors acknowledge that will not be easy. In poor countries, babies are often not brought back at 6 weeks for a test and 10 weeks for a shot. So the dangerous practice of vaccinating every baby may continue, because it protects the uninfected ones.

 

Copyright 2009 The New York Times Company.

 

Think safety before diving in

 

Ask the Expert: Dr. Cristina Sadowsky, Kennedy Krieger Institute

 

Baltimore Sun - Expert advice

Monday, July 6, 2009

 

With summer in full swing and many families headed to the pool and beach, we're reminded that diving accidents are a common cause of spinal cord injuries. Males between the ages of 15 and 25 are the most common victims of diving injuries, 90 percent of which result in paralysis. Dr. Cristina Sadowsky of the International Center for Spinal Cord Injury at Kennedy Krieger Institute offers ways to prevent diving injuries with five things to keep in mind before you dive in and cool off this summer.

 

•Before you dive, check the depth of the water by entering feet first. Always remember "feet first, first time."

 

•Never dive in shallow water. Water should be at least twice your height in depth before you consider a dive.

 

•Be especially cautious of open water, such as lakes, rivers and oceans, where water depths are affected daily by tides, droughts and floods. In natural bodies of water, you also don't know what dangerous debris might be just under the surface.

 

•Never drink and dive. To dive, you need to be able to think clearly to judge distance and depth, monitor speed and direction, and coordinate the movements of your body.

 

•When you do dive, dive safely. Hold your head up and keep your hands linked and your arms extended over your head. Although you may not prevent a minor injury, your arms will protect your head and neck from direct impact.

 

Call 911 if you believe a swimming partner has sustained a spinal cord injury. Stabilize the victim's head in alignment with his or her neck and back, and gently rotate the person onto his back to ensure he can breathe. Then, wait for the emergency medical team to arrive. It is very important that a diving victim is not moved from the water without proper equipment, as that movement can cause further damage to the spinal cord.

 

Copyright © 2009, The Baltimore Sun.

 

Cancer update 2009

The American Cancer Society projects cancer statistics and trends for the year.

 

By Tammy Worth

Baltimore Sun

Monday, July 6, 2009

 

Cancer death rates have declined steadily in the United States over the last 15 years and are expected to do so again this year. Estimated new cases, however, are expected to tick up slightly from 2008 -- because of the increased use of screening, experts say, not necessarily a surge in risk.

 

Beyond those broad outlines, cancer's portrait is considerably more nuanced, depending on age, race, gender, lifestyle and a host of other factors that vary from person to person.

 

In its new Cancer Facts & Figures 2009, the American Cancer Society says that an estimated 650,000 deaths have been avoided over the last 15 years because of a decline in overall cancer rates. The 2009 report says that cancer death rates in 2005 compared with those in 1990 in men and in 1991 in women decreased by 19.2% and 11.4%, respectively.

 

Though men are more likely to be diagnosed with prostate cancer than any other type of cancer and women more likely to be diagnosed with breast cancer, neither is the leading cause of cancer death. For both men and women, the leading cancer killer is lung and bronchial cancer. There is no routine screening considered effective for detecting lung cancer.

 

The predominant reasons for the decline in deaths to date are increased screening (leading to earlier diagnoses of some cancers and thus a higher cure rate), improved treatments and a reduced incidence of smoking-related cancers in men, says Elizabeth Ward, vice president of surveillance and health policy for the American Cancer Society.

 

The survival rates have also increased. There are approximately 11 million cancer survivors in the country -- more than three times greater than in 1970, according to the National Cancer Institute. This is mainly due to improved treatments that have increased the overall five-year survival rate from 50% in the mid-1970s to 66% today, the report notes. The survival rate for children's cancers has jumped from less than 50% to 80% over the same time period.

 

"We can continue to reduce deaths," Ward says. "We can continue to make great progress by encouraging public policy and screening. It is also important to do research because there are still some areas where we have limited tools."

 

Ward says the growing number of survivors merits more focus on helping them live healthy lifestyles, manage long-term side effects of medications and avoid cancer recurrence.

 

Cancer Statistics 2009, released in May, is the most recent update on the state of cancer in the United States.

 

The report estimated that this year:

 

* 1,479,350 people will be diagnosed with cancer -- 766,130 men and 713,220 women, up from 745,180 and 692,000, respectively, in 2008.

 

* 562,340 will die of the disease -- 292,540 men, and 269,800 women, down from 294,120 and 271,530 in 2008.

 

* The disease, almost half of which will be lung, colon, prostate and breast cancers, will kill almost 1,500 a day.

 

* The most common cancer diagnoses in men will be prostate, lung and colon, with prostate accounting for one-fourth of new cases.

 

* The most common cancer diagnoses in women will be breast, lung and colon, with breast accounting for about 27% of new cases.

 

* About one-third of the expected cancer deaths will be linked to behavior-related factors such as obesity, physical inactivity and poor nutrition. There will also be more than 1 million skin cancers diagnosed, many of which are caused by indoor tanning and overexposure to the sun.

 

But overall, Americans are increasingly aware of the influence of lifestyle modifications such as reduced alcohol intake, healthful eating and increased exercise, says Sandhya Pruthi, the director of the Mayo Clinic's Breast Diagnostic Clinic in Rochester, Minn.

 

So while cancer is still the nation's second-leading killer, behind heart disease, it's not the uniform threat many Americans once thought.

 

Copyright © 2009, The Los Angeles Times.

 

Copyright 2009 Baltimore Sun.

 

Blood feud

Parents concerned that states are banking blood samples from newborns without parents' consent

 

By Rob Stein

Washington Post

Monday, July 6, 2009

 

Matthew Brzica and his wife hardly noticed when the hospital took a few drops of blood from each of their four newborn children for routine genetic testing. But then they discovered that the state had kept the dried blood samples ever since - and was making them available to scientists for medical research. n "They're just taking DNA from young kids right out of the womb and putting it into a warehouse," said Brzica, of Victoria, Minn. "DNA is what makes us who we are. It's just not right."

 

The couple is among a group of parents challenging Minnesota's practice of storing babies' blood samples and allowing researchers to study them without their permission. The confrontation, and a similar one in Texas, has focused attention on the practice at a time when there is increasing interest in using millions of these collected "blood spots" to study diseases.

 

Michigan, for example, is moving millions of samples from a state warehouse in Lansing to freezers in a new "neonatal biobank" in Detroit in the hopes of helping make the economically downtrodden city a center for biomedical research. The National Institutes of Health is funding a $13.5 million, five-year project aimed at creating a "virtual repository" of blood samples from around the country.

 

The storage and use of the blood is raising many questions, including whether states should be required to get parents' consent before keeping the samples long-term or making them available to scientists, and whether parents should be consulted about the types of studies for which they are used. The concern has prompted a federal advisory panel to begin reviewing such issues.

 

"There has not been a good national discussion about the use of these samples," said Jeffrey Botkin, a pediatrician and bioethicist at the University of Utah who is studying policies and attitudes about the newborn blood samples as part of a federally funded project. " Genetics is an area that touches a nerve. The public is concerned about massive databases."

 

Hospitals prick the heels of more than 4 million babies born each year in the United States to collect a few drops of blood under state programs requiring that all newborns be screened for dozens of genetic disorders. The programs enable doctors to save lives and prevent permanent neurological damage by diagnosing and treating the conditions early.

 

Although parents are usually informed about the tests and often can opt out if they object for religious and other reasons, many give it little thought in the rush and exhaustion of a birth. And parents are generally not asked for permission to store the samples or use them for research. Each state determines what is done with the blood spots afterward.

 

The stored samples are mostly used to validate the accuracy of newborn screening and evaluate new tests. But scientists are also using them for other types of research, including to study specific genetic disorders, explore the frequency and causes of birth defects, decipher how genes and environmental factors interact, and probe whether exposure to chemical pollutants early in development plays a role in cancer and other diseases.

 

Research projects are approved, officials in Maryland and other states said, only after undergoing careful scientific and ethical review. In most cases, all identifying information is stripped from the samples.

 

But the states can still link each sample to an individual child - and that worries some parents, patient groups, bioethicists and privacy advocates, especially with advances in genetics and electronic data banks linking medical information from different sources.

 

"It's fine and good to say these can't be identified, but how real is that?" said Hank Greely, a Stanford University bioethicist. "Just because you don't have a name or Social Security number doesn't mean you can't identify it."

 

"I'm not a big scaremonger about the dangers of DNA medicine," Greely said. "But you could use someone's DNA to make some inferences about their future health, about their future behavior, and if you got samples from their parents or a DNA databank, you can make inferences about family relationships."

 

Because of those and other concerns, parents and privacy activists in Minnesota are asking that more than 800,000 blood spots that have been stored without parents' approval since 1997 be destroyed.

 

The Minnesota case prompted a similar parents' lawsuit in March against Texas, which since 2002 has stored an estimated 4 million samples. The litigation spurred the Texas legislature to require the state health department to start getting parents' permission to store the samples and honor requests that samples be destroyed. But the lawsuit is pending over what should be done with the samples on file.

 

Law enforcement agencies have been cataloguing millions of DNA fingerprints in recent years, raising similar concerns.

 

State officials argue that strict safeguards protect the privacy of information associated with the blood samples and say details about a child's medical history are provided to researchers only if parents are contacted individually for approval.

 

Concerned that the debate might undermine the newborn screening programs, the federal Advisory Committee on Heritable Disorders in Newborns and Children will discuss the issue in September.

 

"There are obviously legal and ethical issues that need further discussion," said Rodney Howell, who chairs the committee. "Unfortunately we live in a world of conspiracy theories. We want to inform people that these spots are retained in some states and that they are carefully guarded. We want to be totally transparent."

 

Copyright © 2009, The Baltimore Sun.

 

Therapeutic cancer vaccines show promise

They wouldn't prevent the disease, but might help people who are already fighting it.

 

By Jill U. Adams

Baltimore Sun

Monday, July 6, 2009

 

It's a deceptively simple idea: What if doctors could recruit the body's own immune system to fight cancer? The complexities of the immune system have kept this from becoming reality, until now. Three cancer vaccines -- for prostate cancer, melanoma and lymphoma -- have achieved positive results in so-called Phase 3 clinical trials -- the kind of studies that the Food and Drug Administration requires for a medicine to gain approval.

 

At the annual meeting of the American Society of Clinical Oncology held May 29 to June 2, researchers reported that a vaccine against follicular lymphoma, called BiovaxID, delayed remission after chemotherapy by more than one year, on average.

 

At the same meeting, other researchers said that a melanoma vaccine caused tumors to shrink in twice as many patients as those receiving a standard FDA-approved therapy.

 

And at the annual meeting of the American Urological Assn. in April, researchers reported that the vaccine Provenge extended the lives of men with metastatic prostate cancer by four months, on average.

 

Doctors are cautiously optimistic about the news. "Researchers have been working very hard to get some positive results," says Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society in Atlanta. "These three trials do suggest that vaccines will be used in the actual treatment of patients in the not too distant future."

 

But even with these tentative successes, a big question remains open: Will vaccines ever become more than small players in the medical treatment of cancer -- a group of diseases that presently kills some 560,000 Americans each year?

 

Only two cancer vaccines currently have FDA approval and both are strictly preventive, targeting viruses that can lead to cancer. Most U.S. children are vaccinated against hepatitis B, a virus that can cause liver disease and cancer. A vaccine for genital human papillomavirus (HPV), which can cause genital warts and cervical cancer, is now recommended for adolescent girls.

 

The new medicines -- called therapeutic cancer vaccines -- act differently. They are not preventive in the traditional concept of vaccines. Rather, patients already afflicted with cancer are vaccinated in the hope that the shots will tell their immune systems how better to fight growing tumors. And because the immune system has a long memory, it's hoped that this immune boost might also ward off cancer recurrences.

 

Researchers have been working on the strategy for at least four decades and have suffered many failures, even in vaccines that showed promise in Phase 1 and Phase 2 clinical trials, which test safety and effectiveness of experimental treatments in a small number of patients. "It's been a really frustrating journey for a lot of researchers," Lichtenfeld says. "A lot of hope and a lot of dashed hopes, unfortunately."

 

Basic research on the immune system in the last 10 to 15 years has led to an explosion of new knowledge about the intricacies of the immune system -- and some clues as to why these early strategies failed. For instance, it's now known that tumors can shut down immune activity in their vicinity. The three new vaccines, as well as many more under development, have incorporated past lessons and new knowledge to improve their odds.

 

Generally, vaccines are made from a substance that only cancer cells make (or that they make far more of than normal cells do) -- say, a protein that sits on the surface of a tumor cell. Then the vaccine is injected into the body. If the immune system senses that the substance is a foreign invader, then it starts to ramp up a response. The mechanisms vary, but essentially the body makes new immune cells and sends them out on search-and-destroy missions, seeking out anything that contains that same substance, or marker.

 

In the past, small protein fragments -- called antigens -- that are present in high amounts on cancer cells were used in cancer vaccines. But the ones that were chosen did not stimulate enough of an immune response to attack tumors effectively.

 

"We know a lot about tumor antigens," says Dr. Leisha Emens, an oncologist at Johns Hopkins University who is researching breast cancer vaccines. "I don't think we've done that great of a job identifying which ones are the most important."

 

You don't want just any immune response, you want one that will effectively attack the cancer cells, she says.

 

Dr. Donald Morton, chief of the melanoma program at the John Wayne Cancer Institute in Santa Monica, tells a cautionary tale. He led a different melanoma vaccineall the way through to a Phase 3 clinical trial. With 1,600 patients worldwide, it was much larger than the recent crop of studies. Morton says the rate of survival in the study was the highest he'd ever seen. However, that rate did not differ from the control group, who received only an immune stimulant, and the trial was halted in 2006. "There's no question that some patients responded to the vaccine," he says, based on a review of the data. However, many more patients did not.

 

The three vaccines with recent success don't work in all patients either, even though researchers tried to define patient populations that would be most amenable to vaccine therapy. In the melanoma vaccine trial, only patients with certain tissue types -- akin to tissue-typing for organ transplantation -- were included.

 

In the lymphoma vaccine trial, only patients who responded to chemotherapy and remained in remission for six months were eligible to receive the vaccine.

 

The vaccines don't measure up to other cancer therapies that have passed muster with the FDA in recent years, such as Herceptin, Gleevec and Rituxan, says Dr. John Glaspy, director of the Women's Cancers Program at UCLA's Jonsson Comprehensive Cancer Center. Gleevec, in particular, has revolutionized the care of the most common adult leukemia, known as chronic myeloid leukemia, raising five-year survival rates to 89% of patients taking the drug. Before Gleevec, patients' chances of surviving for five years with existing treatments were closer to 50%. "Those are huge breakthroughs in oncology that have made big impacts," Glaspy says.

 

Cancer vaccines have made comparable advances on the basic science front, but they have not yet translated into successful medicines. Yet researchers are reinvigorated by the recent successes because they suggest that, with combination therapies and careful patient selection, the vaccine strategy could work to fight cancer. "It's feasible," Glaspy says. "We're starting to see a few patients do well."

 

The ideal of therapeutic cancer vaccines still shimmers with promise: Imagine a medicine that's specific to a tumor and free of side effects. "If we can get the immune system to engage in this process, it works completely differently than any other cancer treatment out there. And the neat thing about the immune system is that it remembers," Emens says. "If we can get it to work, it has the potential to add a lot."

 

Even those stung with failure hold onto hope. "I remained convinced that the immune system is very important in the control of cancer," Morton says. "We just need to know what the right buttons are to push so that everybody responds."

 

Copyright © 2009, The Los Angeles Times

 

Copyright 2009 Baltimore Sun.

 

Whose side are health advocacy groups on?

The names might sound impressive -- but when parsing their message, you'll want to know who they serve.

 

THE HEALTHY SKEPTIC

 

By Chris Woolston

Baltimore Sun

Monday, July 6, 2009

 

Obesity is a national health crisis -- or it isn't. Vaccines cause autism -- or they don't. Think of any current health controversy, and you can be sure that plenty of experts have already taken opposite sides.

 

Some of the most influential and vocal health experts belong to advocacy organizations such as the Center for Science in the Public Interest and the American Council on Science and Health. These groups have well-oiled publicity machines, connections in Washington and a proven ability to show up in news stories. But who are they, and what do they stand for?

 

In large part, they stand for controversy. "Consumer groups will run with an issue if they think it will get them publicity and funding," says Robert Mayer, a professor of family and consumer studies at the University of Utah in Salt Lake City. That doesn't automatically mean that the issues championed by the groups aren't valid -- but it helps, when assessing their words, to know more about them. Here, the Healthy Skeptic takes a look at a few of the groups behind the press releases.

 

American Council on Science and Health

 

The ACSH calls itself an "independent, nonprofit, tax-exempt organization" with an advisory board of 350 physicians, scientists and policy experts. The organization says 40% of its funding comes from corporations, although it doesn't specify which ones. Previous donors to ACSH have included Anheuser-Busch, Coca-Cola and Bristol-Myers, according to the Center for Media and Democracy, a Madison, Wis.-based nonprofit organization that publishes PR Watch, a quarterly newsletter that tracks advocacy organizations and PR groups.

 

That money doesn't buy loyalty, says ACSH associate director Jeff Stier: "I have no problem accepting funds from corporations as long as there are no strings attached."

 

With one notable exception -- tobacco -- the ACSH generally sides with industry on every health controversy, says Sheldon Rampton, research director for the Center for Media and Democracy. Some of these stances are well-supported by science. For instance, the group has debunked claims that childhood vaccines cause autism, a position that puts them in the same camp as most scientists and public health experts. On the other hand, the group also dismisses any suggestion that phthalate compounds in plastics pose health risks, a threat that most experts say is still an open question.

 

"They have quite a few legitimate scientists on their board," Mayer says. (The panel that investigated phthalates in the late 1990s was headed by former Surgeon General Dr. C. Everett Koop.) Although they don't always reach the same conclusions as other consumer watchdog groups, they genuinely do seem interested in consumer safety and real science, he adds.

 

"We're controversial," Stier says. "We're always looking for areas where there's a gap between conventional wisdom and science."

 

The Center for Consumer Freedom

 

The CCF calls itself a "nonprofit organization devoted to promoting personal responsibility and protecting consumer choices." Founder Rick Berman, a Washington lobbyist, says his organization collects money from more than 100 companies, but he keeps the identity of donors secret, even from his own staff. According to the Center for Media and Democracy, past supporters of CCF include the American Beverage Institute, Monsanto, Tyson Foods and Wendy's.

 

The CCF has staked out some unusual territory in the health wars. The group has criticized Mothers Against Drunk Driving and fought against lowering the blood alcohol content thresholds for DUI laws. It strongly opposed a law requiring nutrition labeling in New York City restaurants. And it has frequently claimed that junk food doesn't cause obesity. For that matter, it believes that the entire obesity "crisis" is little more than media hype.

 

"We're libertarians," says Justin Wilson, a senior researcher at CCF. "Our convictions are founded on science." He claims that obesity is good for the economy -- all of those diet plans and doctor visits keep money flowing. He also says consumers deserve "full information" on health topics, as long as it doesn't interfere with their choices. "We should all be able to enjoy a meal guilt-free."

 

The CCF is often criticized as an unflinching mouthpiece for industry, especially food and beverage companies. "They are a completely self-serving operation," Mayer says. Rampton is more blunt: "[Berman] would promote arsenic if the arsenic industry paid him," he says.

 

Center for Science in the Public Interest

 

This organization, publisher of the Nutrition Action Healthletter, is best known for its reports detailing the nutritional excesses of Italian restaurants, Chinese restaurants and movie theater concession stands. It once memorably dubbed the dish fettuccine Alfredo (typically more than 1,000 calories and 50 grams of saturated fat per restaurant portion) "a heart attack on a plate."

 

Often derided as the "food police" by the Center for Consumer Freedom, CSPI provides reliable information to reporters, politicians and the general public, Rampton says. "A lot of their funding comes from subscriptions to the newsletter," he says. "Readers expect them to be thorough and practical. That keeps them honest."

 

The group may go overboard occasionally -- did anyone really need a breathless press release to know that buttered popcorn is fattening? -- but it generally takes a "level-headed" approach to nutrition, Mayer says. He singles out CSPI's open-minded stance on genetically modified food: "They could probably sell more [newsletters] if they claimed that you'd turn into Frankenstein by eating GMO corn."

 

Michael Jacobson, executive director of CSPI, says the organization does not accept money from corporations or government agencies. "We believe in personal responsibility, but we believe in industry responsibility too."

 

Public Citizen

 

This group, founded by Ralph Nader in 1971, takes public stands on health and safety issues involving pollution, medicine and consumer products. Like CSPI, it's funded mainly by individuals and subscriptions to newsletters, including the monthly Worst Pills, Best Pills, a continuation of the book by the same name. It doesn't take money from corporations or the government.

 

Some of Public Citizen's most high-profile work has been in the field of drug safety. The group may have a tendency to overstate the dangers of prescription drugs, but for good reason, Mayer says. "They have to push against drug companies who claim that everything can be cured with a pill." In general, its positions on medications and other products tends to be well-supported by science, he adds. "They've done a good job of identifying risky drugs that were later pulled off the market."

 

Public Citizen sounded the alarm on the painkiller Vioxx in 2001, three years before Merck withdrew the drug over concerns about heart risks.

 

"We do our own research, and we publish in medical journals," says Peter Lurie, deputy director of Public Citizen's Health Research Group. "We feel that a large fraction of new drugs offer few benefits over existing drugs." Patients should avoid such new drugs for at least seven years until their safety can be established, he says. "We're not against all medications. When we warn against a particular drug, we almost always recommend a different drug instead."

 

Physicians Committee for Responsible Medicine

 

You can't tell from the name, but PCRM is dedicated to animal rights. Among other activities, the group lobbies against animal research, touts the health benefits of meat-free diets and rails against dairy as a cancer-causer. It runs "The Cancer Project," which promotes a vegan diet through activities such as free cooking classes.

 

PCRM claims to have more than 100,000 members, including about 5,000 physicians. The group says it is funded by individual contributions and subscriptions to its quarterly magazine, Good Medicine, along with occasional grants from the federal government and private foundations.

 

The general public should understand that every position from PCRM stems from its commitment to animal rights, Rampton says. The group trumpets research showing that too much red meat can increase the risk of heart disease. But instead of encouraging moderation, the group recommends vegetarian diets. "It's healthy advice, but health doesn't seem to be their primary intention," Rampton says.

 

Dan Kinburn, general counsel for PCRM, says that the group always cites scientific data when it files a lawsuit or issues a press release. "Nobody has ever disputed the science," he says. "Instead, they attack our motives. We believe that a vegan diet is a superior diet. We don't think there's any good data that even small amounts of milk or meat are good for you."

 

Curious about a consumer health product? Send an e-mail to health@latimes.com. Read more at latimes.com/skeptic.

 

Copyright © 2009, The Los Angeles Times

 

Copyright 2009 Baltimore Sun.

 

Tobacco Stocks May Thrive Despite FDA Regulation

 

By Brett Arends

Wall Street Journal

Monday, July 6, 2009

 

Cars, alcohol and fatty foods also kill a lot of people every year, but Washington reserves its real wrath for cigarette makers.

 

President Barack Obama, who smokes the occasional cigarette himself, last week took the fresh air of the Rose Garden to sign the second anti-smoking law of his young administration. It gives the Food and Drug Administration power to regulate cigarettes for the first time, and imposes some new restrictions on marketing. An earlier law raised the federal tax to $1.01 per pack from 39 cents.

 

These laws may actually prove a net positive for tobacco stocks.

 

Why?

 

First, uncertainty surrounding the effects is keeping many shares cheap. Institutional investors in particular tend to shy away from stocks in these kinds of uncertain situations. As a result, tobacco stocks are languishing and dividend yields are hefty. Marlboro parent Altria yields 7.9%. Reynolds American stock yields about 9% - more, remarkably, than the bonds: Its 2016 bonds are yielding about 7.5% to maturity, the 2018 bonds, 8.3%.

 

Second, the new laws may help the big players by reducing independent competition. Adam Spielman, industry analyst at Citigroup, says industry profits have been held back in recent years in part by small, independent makers of cut-price cigarettes. He expects a lot of those companies to respond to the new regulatory burdens by closing up or selling out. A major beneficiary may be Britain’s Imperial Tobacco, which has been building market share at the discount end with brands like USA Gold and Sonoma.

 

Third, while the new laws may spur some people to quit smoking, many people have been trying to quit anyway -- they have been for years. That trend hasn’t hurt the industry because the companies’ profits have rises faster than their volumes have fallen. Cigarettes have still been a solid investment, because the companies generate so much cash and the shares have been cheap. Some numbers: If you had invested $100 in a broad stock market index fund at the start of 1985, you’d have about $1,100 today. If you’d invested that money in tobacco stocks, according to FactSet, you’d have more than $16,000.

 

Fourth, FDA regulation may actually help legitimize the industry - and further reduce the rapidly diminishing litigation risk.

 

Rising cigarette taxes will spur some people to trade down to cheaper cigarettes. But quitting - as the President’s own story shows - is a lot harder than it sounds . (From my own experience, I suggest reading Alan Carr’s “The Easy Way to Stop Smoking”. It worked for me).

 

The riskiest stock in the pack is probably Lorillard, because nearly all its profits come from menthol brand Newport. It is possible, in theory at least, that the FDA might ban menthol cigarettes. Analysts think it highly unlikely. But any investor who is nervous could buy some insurance against a total collapse in the stock. How? By purchasing “put options,” a type of contract that only pays out if a stock falls a long way. Lorillard stock is about $69. The January 2011 $40 put options, which will pay out if the stock falls below that level, cost about $2.10 per share.

 

Many people feel uncomfortable about the idea of investing in tobacco stocks and “profiting from smoking.” But if you benefit from any government services you already are. Average state, local and federal taxes come to about $2.14 per pack. Big government and big tobacco are increasingly hard to distinguish. That, too, may reassure investors.

 

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved.

 

Familiar Players in Health Bill Lobbying

Firms Are Enlisting Ex-Lawmakers, Aides

 

By Dan Eggen and Kimberly Kindy

Washington Post

Monday, July 6, 2009

 

The nation's largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues, according to an analysis of lobbying disclosures and other records.

 

The tactic is so widespread that three of every four major health-care firms have at least one former insider on their lobbying payrolls, according to The Washington Post's analysis.

 

Nearly half of the insiders previously worked for the key committees and lawmakers, including Sens. Max Baucus (D-Mont.) and Charles E. Grassley (R-Iowa), debating whether to adopt a public insurance option opposed by major industry groups. At least 10 others have been members of Congress, such as former House majority leaders Richard K. Armey (R-Tex.) and Richard A. Gephardt (D-Mo.), both of whom represent a New Jersey pharmaceutical firm.

 

The hirings are part of a record-breaking influence campaign by the health-care industry, which is spending more than $1.4 million a day on lobbying in the current fight, according to disclosure records. And even in a city where lobbying is a part of life, the scale of the effort has drawn attention. For example, the Pharmaceutical Research and Manufacturers of America (PhRMA) doubled its spending to nearly $7 million in the first quarter of 2009, followed by Pfizer, with more than $6 million.

 

The push has reunited many who worked together in government on health-care reform, but are now employed as advocates for pharmaceutical and insurance companies.

 

A June 10 meeting between aides to Baucus, chairman of the Senate Finance Committee, and health-care lobbyists included two former Baucus chiefs of staff: David Castagnetti, whose clients include PhRMA and America's Health Insurance Plans, and Jeffrey A. Forbes, who represents PhRMA, Amgen, Genentech, Merck and others. Castagnetti did not return a telephone call; Forbes declined to comment.

 

Also inside the closed committee hearing room that day was Richard Tarplin, a veteran of both the Department of Health and Human Services and the Senate, where he worked for Christopher J. Dodd (D-Conn.), one of the leaders in fashioning reform legislation this year. Tarplin now represents the American Medical Association as head of his own lobbying firm, Tarplin Strategies.

 

"For people like me who are on the outside and used to be on the inside, this is great, because there is a level of trust in these relationships, and I know the policy rationale that is required," Tarplin said in explaining the benefits of having government experience.

 

But public interest groups and reform advocates complain that the concentration of former government aides on K Street has distorted the health-care debate, and that it further illustrates the problem posed by the "revolving door" between government and private firms.

 

"The revolving door offers a short cut to a member of Congress to the highest bidder," said Sheila Krumholz, executive director of the Center for Responsive Politics, which compiled some of the data used in The Post's analysis. "It's a small cost of doing business relative to the profits they can garner."

 

Aides to Baucus and other lawmakers bristle at any suggestion of special treatment for former staff members. Baucus spokesman Scott Mulhauser said the senator "remains committed to working with a variety of stakeholders" as the Finance Committee attempts to come up with a bill this summer.

 

"The senator and his staff meet daily with individuals, nonprofits and interests from across the health-care spectrum, and are proud that all interests are treated equally and that no one receives special treatment of any kind," Mulhauser said. "As a result, the Finance Committee has been praised by members of Congress and the media for its uniquely inclusive and transparent health-care reform process."

 

The Post examined federally required disclosure reports submitted by health-care firms that spent more than $100,000 lobbying in the first quarter of this year. It used current and past filings to identify former lawmakers, congressional staff members and executive branch officials.

 

The analysis identified more than 350 former government aides, each representing an average of four firms or trade groups. That tally does not include lobbyists who did not report their earlier government experience, such as PhRMA President W.J. "Billy" Tauzin, a former Republican congressman from Louisiana. Federal law does not require providing such detail.

 

Overall, health-care companies and their representatives spent more than $126 million on lobbying in the first quarter, leading all other industries, according to CRP and Senate data. PhRMA led the pack in spending and employs 49 former government staff members among its 136 lobbyists, according to The Post's analysis. Dozens of other former insiders are employed as lobbyists by Pfizer, Eli Lilly, the AMA and the American Hospital Association, each of which spent at least $3.5 million on lobbying from January through March.

 

The aim of the lobbying blitz is simple: to minimize the damage to insurers, hospitals and other major sectors while maximizing the potential of up to 46 million uninsured Americans as new customers. Although many firms have vowed to help cut costs, major players such as PhRMA, America's Health Insurance Plans and others remain opposed to the public-insurance option, a key proposal that President Obama has endorsed.

 

Several major Democratic bills include such a plan, but Baucus's committee -- which is acting as the central broker in the debate -- has not committed to the idea. Instead, the Finance Committee has focused recently on private-insurance cooperatives and other proposals seen as more palatable to the insurance industry and centrist Democrats. More than 50 former employees of the committee or its members lobby on behalf of the health-care industry, records show.

 

Deploying former government officials is a key strategy for pressing such positions on Capitol Hill, according to industry lobbyists, many of whom discussed the issue on the condition of anonymity. They say that legislative or administration experience helps ensure that policies considered by Congress do not imperil health-care interests, which account for about one-sixth of the U.S. economy.

 

At the same time, these lobbyists say, a personal connection to lawmakers and their staffs does not guarantee success.

 

"If anyone thinks hiring a former staffer for Baucus or [Charles] Schumer or Blanche Lincoln is going to get them what they want, they are crazy," said one health-care lobbyist who used to work on the Finance Committee, referring to several key Democratic senators. "If we were being judged on that, a lot of us should be fired."

 

William K. "Billy" Wynne, a former Baucus health counsel who now works for the Health Policy Source lobbying firm, said that "there's nothing insidious" about medical companies and groups hiring former legislative staff members. He also notes that he is subject to a two-year limit on contacts with Baucus's office.

 

"The technical processes of the House and Senate are not intuitive or widely known," Wynne said. "Like with any service, people who have experience are going to be valuable to people who don't."

 

Some trade groups and companies appear to emphasize hiring lobbyists with legislative or executive experience. Wellpoint, one of the world's largest insurance conglomerates, employs 11 lobbyists with government experience and three with none. One of its veterans is Stephen Northrup, who worked for several years for Sen. Mike Enzi (R-Wyo.), including a year as his health policy director on the Senate Health, Education, Labor and Pensions Committee.

 

"I think the experience on Capitol Hill gives you a better appreciation of the challenges that members and staff face," said Northrup, who began his Washington career as a lobbyist before entering government. "Every institution has its own rhythm. You need to understand when people need information."

 

The personal and professional ties between lawmakers, their staffs and lobbyists are often complex. Consider the case of Tarplin and his wife, Republican lobbyist Linda Tarplin. The two worked on opposite sides of the Family Medical Leave Act debate in the 1990s, and each has held high-ranking HHS positions -- he for Bill Clinton and she for George H.W. Bush.

 

Now they run their own health-care lobbying firms, drawing on their connections. Last year, Richard Tarplin's firm reported $650,000 in lobbying income and his wife's firm -- Tarplin, Downs and Young -- reported $3.5 million.

 

"We have been in situations that are much more combative than this," Linda Tarplin said of the health-care fight. "Both Democrats and Republicans want health-care reform. The rub has always been they tend to get there in different ways."

 

At least eight former HHS appointees have also crossed over into health-care lobbying, representing more than 25 companies with a stake in the reform legislation. Most were presidential appointees with high-ranking positions, such as the Tarplins.

 

A few have also cycled back into government. Jack Charles Ebeler, a former Clinton HHS official, left his job as president and chief executive of the Alliance of Community Health Plans a few months ago to become senior adviser for health policy on the House Energy and Commerce Committee.

 

Financial disclosure statements show that Ebeler received consulting fees over the past two years from UnitedHealth Group, Academy Health, the Medicare Rights Center, the Center for Health Care Strategies and the International Foundation of Employee Benefit Plans. Ebeler declined interview requests by The Post.

 

One of the most prominent examples of Washington's revolving door is Tauzin, who took the $2.5 million-a-year job as head of PhRMA in 2005 after shepherding a Medicare prescription drug plan through Congress.

 

Uproar over the appointment led Congress in 2007 to pass a bill barring former members from bringing clients onto the House and Senate floors and from lobbying their friends in members-only gyms. The legislation also forbade direct lobbying contacts with former colleagues for a year in the House and two years in the Senate; efforts to enact a wider ban went nowhere.

 

Tauzin and other lobbyists rebuff critics, arguing that it is unsurprising that those with experience on Capitol Hill should then draw on that background.

 

"Is it a distortion of baseball to hire coaches who have played baseball? Is it a distortion of universities to hire from academia?" Tauzin asked rhetorically. "The bottom line is that people work in the fields in which they have experience. Somehow there are people who think that's unusual for politics, but I think it's pretty normal."

 

Graphics editor Karen Yourish, database editor Sarah Cohen and research editor Alice Crites contributed to this report.

 

Copyright 2009 Washington Post.

 

Dogs Sniffing Out Health Problems

 

By Tara Parker-Pope

New York Times

Monday, July 6, 2009

 

Peter DaSilva for The New York Times Dogs like Kobi, a yellow Labrador, have participated in cancer detection studies.

 

Catching up on my weekend Web reading, I came across an interesting video from National Geographic, about dogs who sniff out cancer and health problems associated with diabetes.

 

One of the dogs featured, a collie named Tinker, began whining and barking when his owner, who has diabetes, experienced dangerous drops in blood sugar. Although Tinker wasn’t trained at first, his reactions to the hypoglycemic attacks led to further training as a qualified “hypo alert” dog. The video also features the work of the British research center, Cancer and Bio-Detection Dogs.

 

The center has 17 rescue dogs at various stages of training that will be paired up with diabetic owners, including many children, reports Reuters.

 

Last year, researchers from Queen’s University in Belfast decided to investigate anecdotal reports from dog owners who said their pets warned them of hypoglycemic attacks. They surveyed 212 dog owners, all of whom had Type 1 diabetes, an autoimmune disorder that prevents the body from producing insulin. A regular concern with Type 1 is that blood sugar will drop precipitously low, causing a person to fall unconscious.

 

Among the dog owners, 138, or 65 percent, said their dog had shown a behavioral reaction to at least one of their hypoglycemic episodes. About a third of the animals had reacted to 11 or more events, with 31.9 percent of animals reacting to 11 or more events. The dogs got their owners’ attention by barking and whining, (61.5 percent), licking (49.2 percent), nuzzling (40.6 percent), jumping on top of them (30.4 percent), and/or staring intently at their faces (41.3 percent). A small percentage of the dogs reportedly tremble in fear at the time of a hypoglycemic attack.

 

To learn more, watch the three-minute video or read the transcript on the National Geographic Web site.

 

And for more on dogs detecting cancer read “Moist Nose Shows Promise in Tracking Down Cancer,” by my colleague Donald G. McNeil, Jr.

 

Copyright 2009 The New York Times Company.

 

UN chief says $1 billion may be needed for antivirals, vaccines against swine flu this year

 

Associated Press

By Eliane Engeler

Baltimore Sun

Monday, July 6, 2009

 

GENEVA (AP) — The United Nations may need more than $1 billion this year to help poor countries fight the swine flu pandemic, the world body's Secretary-General Ban Ki-moon said Monday.

 

"The funding has not been flowing as we have been expecting," Ban said. "We are now mobilizing all resources possible."

 

The money is needed to ensure the poorest countries get vaccine supplies and antivirals if the global epidemic continues to spread, he told a news conference.

 

World Health Organization chief Margaret Chan told the donors that she wants to mobilize a minimum stockpile of vaccines to 49 of the world's least developed countries as a first step. She did not name the countries.

 

"Many of the developing countries have weak health systems," said Chan. "They actually go into this pandemic what I call empty-handed. They don't have antivirals. They don't have vaccines. They don't have antibiotics."

 

The swine flu outbreak has been relatively mild so far and most people recover without taking antivirals, but Ban said it should not be taken for granted that the outbreak will continue to be mild.

 

Health officials are concerned that people in poorer countries and those fighting other health problems like malaria, tuberculosis, malnutrition and pneumonia might be more susceptible to swine flu.

 

"For the remainder of this year, it is our estimate that we may need ... over $1 billion," Ban said, without elaborating.

 

But speaking to donor countries later Monday, Ban said he counted on their support for funding.

 

"Public funding should come first before we ask for any private fundings," he told government officials.

 

The United Nations in May asked vaccine producers to reserve a portion of their pandemic vaccine production for poor countries, but has yet to make a specific appeal for general donations.

 

Some companies have agreed to help. GlaxoSmithKline PLC offered to donate 50 million doses of pandemic vaccine to WHO for distribution to developing countries.

 

Chan said she estimated that covering about 5 percent of a country's population would be reasonable for vaccine stockpiles to make sure that doctors, nurses and other health care workers are protected. Like Ban, she gave no detailed cost estimates.

 

"We hope to mobilize some funds to procure commodities, including antibiotics, antivirals and vaccines to countries," Chan said.

 

Some 429 people have died of swine flu and over 94,000 have been infected, according to the latest totals by the WHO. But experts fear the number of infected people may be much higher than those confirmed.

 

Last week, Britain's health minister said the country faces a projected 100,000 new swine flu cases a day by the end of August. Britain is the hardest-hit nation in Europe amid the global swine flu epidemic.

 

Chan warned governments that the pandemic "could have a devastating impact in the developing world" and urged countries to improve their health systems.

 

At an EU health conference, Sweden's health minister said Monday that countries must prepare for a second wave of infections that could be deadlier than the current outbreak.

 

There is a risk the virus could change its character and spread rapidly as European children return to school after summer holidays, Maria Larsson said at the meeting in Jonkoping, Sweden.

 

British health authorities said Monday that a 9-year-old who had "serious underlying health problems" died after contracting swine flu.

 

Elsewhere Monday, three athletes tested positive for the virus at the World University Games in Serbia and a Berlin high school was shut down after eight pupils were diagnosed with swine flu.

 

In Rio de Janeiro, the Brazilian soccer club Cruzeiro requested that the first leg of the Copa Libertadores final against an Argentine team be postponed because of a swine flu outbreak in Argentina.

 

The swine flu epidemic has killed at least 44 people in Argentina and led to a public health emergency being declared in the capital of Buenos Aires last week.

 

Associated Press writer Malin Rising in Jonkoping, Sweden, contributed to this report.

 

Copyright 2009 Associated Press. All rights reserved.

 

Opinion

Take the heat off of summer

 

Carroll County Times Editorial

Monday, July 6, 2009

 

Summer is typically a time for increased outdoor activities, but as the daytime temperatures increase it is important to take care of yourself and be aware of the symptoms of heat exhaustion.

 

Last year, 17 people in Maryland died from hyperthermia. This year has already claimed two lives, a 23-month-old who was left unattended in a car and a 74-year-old who died in his home where the temperature was more than 99 degrees.

 

Children and the elderly are especially susceptible to heat-related illnesses. According to the state Department of Health and mental Hygiene, children have higher metabolisms so they require more fluids per pound then adults. They also lose water quickly and can’t tell you when they are hot.

 

The elderly, the department notes, may have more difficulty regulating their body temperature. This is especially true if they are suffering from other illnesses.

 

But it isn’t just the elderly and children who are at risk. People who work outdoors, or even those who are engaging in activities outside on hot days should be aware of the risks and take extra precautions.

 

Symptoms of heat exhaustion include light-headedness, nausea, cramps and rapid pulse.

 

Tips to help avoid heat exhaustion include wearing light colored clothes, drinking lots of water, taking breaks and seeking shaded areas to rest in.

 

If you have elderly neighbors or relatives, take the time to check up on them regularly to ensure that they are doing OK, and never leave children or pets unattended in vehicles, where the inside temperature can rise quickly.

 

By being aware of the symptoms of heat exhaustion, and by taking a few simple precautions, we can make sure that we get the full enjoyment from the warm summer months and reduce our risks of becoming victims to heat exhaustion.

 

Copyright 2009 Carroll County Times.

 

You Can't Always Pay for Care Yourself

 

Wall Street Journal Letter to the Editor

Monday, July 6, 2009

 

In his July 1 letter, Michael Swick says that a patient can always pay for care himself, so insurance companies cannot deny him care. That is true of most private insurance but it is not true of Medicare. Medicare does not allow the doctor to accept payment beyond what Medicare allows, and it does not allow private payment for care not allowed by Medicare rules. Doctors are being prosecuted right now for violating these rules. The only fellowship-trained geriatrics specialist in central Iowa has dropped out of Medicare completely because she was being harassed about seeing her elderly patients more frequently than Medicare allowed.

 

One reason doctors fear President Obama's plan for health "reform" is that private care may be banned, as it was in Canada.

 

Michael Kennedy, M.D.

Mission Viejo, Calif.

 

Printed in The Wall Street Journal, page A12

 

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved.

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