Health Insurance is needed for your family

images-14More than half of poor families and a third of middle income families had no health insuranceduring the preceding year, and a substantial number had been without insurance for longer than that, according to a new survey by the Commonwealth Fund.

The survey found that 57 percent of adults in families who earn less than $29,726 (which is 133 percent of the poverty level) were uninsured at some point in the preceding year, and more than a third of those individuals lacked insurance for two years or more.

Moving up the income bracket, the survey found that more than one-third of adults in moderate-income families — those earning between $29,726 and $55,875 for a family of four (133 to 249 percent of the poverty level) — were uninsured during the preceding year, and 18 percent had been uninsured for two years or more.

In contrast, about one in 10 adults in families with incomes at four times the poverty level — at or above $89,400 for a family of four — were uninsured at some point during the preceding year, and just 3 percent were uninsured for two years or more.

“People with low and moderate incomes run the highest risk of lacking job-based health insurance, are least able to afford health insurance on their own, and are the most at risk of not being able to afford care in the absence of coverage,” Commonwealth Fund vice president and lead author Sara Collins said in a press release. “Consequently, problems getting needed care in the United States are disproportionately concentrated among low- and moderate-income families.”

The survey is based on responses from a randomly-selected sample of 977 low-income adults ages 19 to 64 who completed an online survey. It was conducted in the summer of 2011. The survey focused on adults, not children, because most low-income children are covered by Medicaid, which varies by state.

The survey also found that adults in low-earning families without insurance often lack recommended preventive health screenings.

Just 10 percent of low-income uninsured adults over the age of 50 had received the recommended screening for colon cancer, just one-third of low-income uninsured women ages 40 to 64 had received a mammogram, and just one-third of adults with low and moderate incomes had had their cholesterol checked in the past five years.

By comparison, those in the same income range with insurance were much more likely to have the screening tests, and those with higher incomes also were more likely to be screened, regardless of insurance status.

The most common reason given for skipping a recommended cancer screening test was that the individual didn’t think the test was necessary. But cost was a factor, too, especially among those who were uninsured at some point in the past year. For instance, 10 percent of women with insurance didn’t get a Pap test in the previous year because of cost, while 40 percent of women without insurance said cost was the reason they didn’t get the test.

Low- and moderate-income adults without health insurance also were less likely to report having a regular doctor and reported going to the emergency room for nonemergency reasons — such as needing a prescription or feeling that other sources of medical care cost too much — more often than those with insurance in the same income bracket.

The Affordable Care Act (ACA) will “narrow, if not entirely eliminate, the profound income inequities that currently exist in the U.S. health care system,” the study authors said. The law bans insurers from denying coverage based on a person’s existing illness and requires insurers to cover proven preventive services free of charge to the patient.

In 2014 — the year that everyone will be required to have health insurance — insurers will no longer be able to charge more based on gender or age, Medicaid requirements will be lowered so more people will be eligible for the program, and insurance exchanges will start functioning and people who qualify will be given subsidies to help them purchase a plan from their state’s exchange.

How to Adopting Healthy Habits

unduhan-26Interested in adopting healthier habits? You have a better chance of success if you find a friend with similar traits to share the experience, a new study suggests.

Participants paired with others of similar body mass, age, fitness level and diet preferences were three times as likely to adopt healthy behaviors as those matched randomly in an Internet-based study conducted by a researcher from the Massachusetts Institute of Technology (MIT).

“I think the reality is, we as individuals may have less motivation to change on our own than if we’re surrounded by our peer group, even if we met on a social network site,” said Dr. Victor Fornari, director of child and adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y., who is familiar with the study. “We’re very influenced by the group phenomenon.”

The study is published in the Dec. 2 issue of the journal Science.

For the study, an online social network was created to promote health and fitness. Broken into small groups of “health buddies,” 710 participants were introduced to the idea of an online diet diary through a “dummy” participant who invited others to take part. Each participant was provided with a personalized, online “health dashboard” that displayed real-time information, such as daily exercise minutes, healthy behaviors and personal characteristics of the health buddies.

At the end of seven weeks, those who were matched with health buddies using the principle of “homophily” — the tendency of people to have similar friends — were far more likely to use the diet diary and take part in other healthy behaviors than participants whose buddies were assigned randomly. Not one obese individual signed up for the diet diary in the random networks, compared to more than 12 percent of obese participants in the similarly matched networks.

The results also suggest that the most effective social environment for increasing the willingness of obese people to adopt a behavior is one where they interact with others with similar health characteristics, the study said.

“I think it was a pretty brilliant study,” said Tricia M. Leahey, an assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University and Miriam Hospital’s Weight Control and Diabetes Research Center in Providence. “It’s neat that they’re actually starting to manipulate a social network in a way specific to homophily.”

Group therapy is also partially based on the premise that people can empathize better with others they relate to, said Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City.

“The question of whether people can benefit from role models that show how to move out of similar thinking is also part and parcel of the development of social networks,” Manevitz said. “We all need to be able to interact with people who can promote other senses of self, that you can take in and create within yourself.”

However, the current findings refute prior research. Leahey wrote a study published in January 2011 that indicated that overweight people tend to have more social contacts who are also overweight or obese.

“We can say, ‘Gee, if I’m in a network of relatively healthy individuals and become friends with someone who’s overweight or obese, we might be influenced by this one individual,'” she said. “So I guess it cuts both ways.”

Adult Stem Cells Advantages

unduhan-25Stem cell research is one of the most talked-about fields in modern medicine. It’s also one of the most misunderstood. Many people associate it with only embryonic stem cells, which are a source of much ethical debate, but there’s actually an entire world of data and inquiry that involves adult stem cells, which are found in our own bodies and may hold the key to treating some important health conditions.

Recent headlines, for example, have touted “major breakthroughs” in adult stem cell science and cardiovascular disease, and a number of high-profile celebrities, politicians, and athletes have undergone experimental stem cell treatments for pain and nerve damage. As more and more people seek out information about these procedures, here’s what you need to know.

Adult Stem Cells vs. Embryonic Stem Cells

Compared with the field of embryonic stem cell research, adult stem cell research is relatively new territory. For a long time, the medical community was interested primarily in embryonic stem cells, which are pluripotent, meaning they have the potential to generate any one of the 200 other cell types in the human body. Adult stem cells, conversely, are thought to be limited to forming types of cells based on their tissue of origin. For example, hematopoietic stem cells, found in bone marrow, give rise to blood cells, while adipose-derived stem cells, found in fat, give rise to adipocyte (fat) cells. Recent research has suggested that some types of stem cells may be able to transform into other cells via a process called transdifferentiation, but data – and scientific opinion – is mixed on this point.

Moreover, says Donald Kohn, MD, a scientist with the Broad Stem Cell Research Center at UCLA, “adult stem cells in general don’t have the ability to make more of themselves. When we take them from, say, the bone marrow, we can’t make more of them. The number we get out of the body is the most we have, and by the time we give them back [as in a transplant], we have less.” This, along with the fact that adult cells can be difficult to isolate from tissue, made pluripotent embryonic stem cells initially more compelling to researchers.

In recent years, however, scientists have shifted some of the focus to adult stem cells, partly out of necessity – federal and state legislation restricts funding for projects involving the creation, treatment, or destruction of embryos for research purposes – and partly because of new discoveries about the benefits of adult cells.

For one thing, Kohn says, there may be less risk of rejection with adult stem cells, since they’re often autologous, meaning they come from a person’s own body. “Embryonic stem cells don’t match your patient,” he explains. There’s a risk, as with any transplant, that the body won’t accept them.

Second, adult stem cells are readily available to everyone. We all have them inside of us – in our organs, bone marrow, blood, fat, etc. – so there’s a built-in (though limited) supply of donor material that matches our genetic makeup.

Finally, and perhaps most notably, adult stem cells don’t present the same ethical issues associated with embryonic stem cells, which, when harvested, result in the destruction of the embryo – a point of much controversy and debate in the medical, political, and religious sectors. Adult stem cells sidestep this problem because there’s no loss of human or potential human life.

Stem Cell Procedures in the News

Which is not to say, however, that adult stem cell research is immune to controversy.

Earlier this year, in July, Texas governor and Republican presidential hopeful Rick Perry raised some eyebrows – and red flags – when he underwent an experimental stem cell procedure to fuse part of his spine. The treatment, which was done outside of an approved clinical trial, involved liposuctioning fat from Perry’s body, separating and re-growing the stem cells from that fat, and then reinjecting the cells into Perry’s back and bloodstream in the hopes that they would form bone or cartilage. At the time, experts in the field balked at Perry’s decision to have the procedure, saying there was no scientific evidence to support its effectiveness – or, more importantly, its safety – and that by choosing to pursue an untested treatment, the politician risked blood clots, infection, even cancer cell growth.

“[Perry] went far outside mainstream medicine to treat his bad back – an irresponsible choice that endangered himself and anyone who might follow his lead,” wrote Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania, in a commentary for MSNBC. “The promise of adult stem cells may be fulfilled one day, but that day is not yet here.”

Caplan’s worry that high-profile procedures like Perry’s send the wrong message to patients is a concern shared by many in the stem cell research community. “When a highly visible celebrity/athlete chooses to undergo an untested/unproven therapy, and if they happen to get better without knowing whether the therapy is what caused the improvement, they encourage many other people to ignore scientific evidence and to substitute hope and blind trust for proof,” said Lawrence Goldstein, PhD, director of the University of California-San Diego Stem Cell Program, in an e-mail to ABCNews.com. “The downside is that many people might be hurt by subjecting themselves to a risky procedure, or a procedure with unknown risks, when there is no evidence of benefit to be gained.”

Dr. Goldstein’s statement was in response to news that Indianapolis Colts quarterback Peyton Manning had reportedly flown to Europe in September to take advantage of an unapproved stem cell procedure that he hoped would fix a nerveinjury in his neck. (It didn’t.) Other athletes who have had similarly controversial procedures to heal sports injuries include Yankees pitcher Bartolo Colon and football player Terrell Owens.

Most recently, actress Suzanne Somers revealed that she had undergone a new stem cell treatment to regrow her right breast after losing most of it to cancer more than a decade ago. Somers’ procedure, unlike others mentioned here, was part of an approved clinical trial and involved injecting stem cell-enriched fat into her breast to replace the damaged tissue. You can learn more about her treatmenthere.

The Current and Future State of Adult Stem Cell Research

Of course, not all stem cell procedures are as polarizing as those performed on Perry and Manning. Bone marrow stem cell transplants, using hematopoietic (blood) cells, have actually been used for decades – since about 1970 – as a treatment for certain genetic diseases and cancers, namely those affecting the blood, bone marrow, and lymphatic system. In fact, Everyday Health television show host and former Survivor winner Ethan Zohn had one in 2009 after he was diagnosed with and treated for a rare form of Hodgkin lymphoma.

Standard first line of treatment for both leukemia and lymphoma depends on a variety of factors but generally includes some amount of chemotherapy with or without radiation and/or surgery. In many cases, however – such as those in which the cancer comes back after a period of remission or is initially unresponsive to treatment – patients may require high-dose chemo, which destroys not only the cancer cells but also some of the individual’s healthy cells.

“Normally, we temper how much chemo we give so that we don’t damage the bone marrow too much,” Kohn says. “But with hematopoietic stem cell transplants, you can push up to the next level and give a lot more. Hopefully you wipe out the cancer – but you also wipe out normal bone marrow. So the stem cells are used to rescue you.”

In most cases, Kohn notes, the stem cells used are autologous (your own). Doctors extract them from your blood or bone marrow prior to administering the chemo, freeze them, and then reinject them into your bloodstream after treatment. Over time, they return to the bone, replacing the marrow and generating new blood cells.

In situations where an autologous transplant is not possible or has already been done, doctors may use cells from a donor whose tissue type matches the patient’s. This is riskier, because of the chance of rejection, but it’s not uncommon.

“Thousands of hematopoietic transplants are performed every year,” Kohn says. And other life-saving procedures may be on the way.

Middle Finger

Whether you call it flipping the bird or just giving the finger, rap star M.I.A. created a frenzy with one simple gesture during Madonna’s Super Bowl halftime show pointing her middle finger up in the air. Now there’s some interesting scientific information about just how long it takes for that finger to react to a stimulus.

In a study published in the Proceedings of the National Academy of Sciences, study subjects were shown an image of a hand on a computer monitor. If one of the fingers was marked, the subjects were asked to press a key with that finger, as quickly as possible. The thumb and little finger were found to have the fastest reaction times, while the middle finger was the slowest.

Each part of the body including the finger has its own nerve cell area in the brain. After further tests, the researchers concluded that the speed of the middle finger is inhibited by the nerve cells of its “neighbor” on each side. “In principle, each finger is able to react equally quickly,” said Dr. Hubert Dinse, the lead author. “Only in the selection task, the middle finger is at a distinct disadvantage.”

But slowest finger or not, M.I.A. still managed to get that pesky middle digit up in the air. What makes it so offensive, anyway? According to BBC News, waving the middle finger has been considered an insult since at least ancient Greek times, when the philosopher Diogenes used it to express his opinion of the orator Demosthenes. The Latin poet Martial called the middle finger “the indecent one,” and German tribesmen used theirs to “greet” advancing Roman soldiers.

Anthropologist Desmond Morris gives some clues as to why: “The middle finger is the penis and the curled fingers on either side are the testicles. By [giving the finger], you are offering someone a phallic gesture.”

If anything, M.I.A.’s stunt proves that this ancient gesture hasn’t lost its power to shock. NBC, which broadcast the Super Bowl, has issued an apology for not blurring out the rapper’s finger, but the network may still be subject to a fine from the Federal Communications Commission.

Fewer Broken Bones

Researchers in Florida may have uncovered a rare positive outcome from the downturn in the local economy: fewer injuries to workers.

The new study finds that traumatic orthopedic injuries dropped by 16 percent in the city of Tampa as the economy soured — a possible sign that fewer construction workers were getting injured on the job as that industry bottomed out.

The findings can’t confirm a connection between the injury rate and the economy, nor do they prove that construction workers account for the difference over time. Still, the research is food for thought and may confirm the trend that surgeons noticed over the past few years, said study author Dr. Daniel S. Chan, staff orthopedic surgeon at Florida Orthopedic Institute in Tampa.

“We observed declines in our numbers, and we thought it was the economy,” he said.

The researchers examined the number of trauma cases treated at the Florida Orthopedic Institute from 2001-2009. They then checked to see if they corresponded with factors reflecting the rise and fall of the economy over that period.

The Tampa area was a hot spot during the last big U.S. housing boom, and the researchers especially wanted to find out if the decrease in cases they observed coincided with the subsequent meltdown of the home construction industry.

Falls are an especially common injury for construction workers, Chan noted. Among other things, falls on construction sites can fracture ankles, shinbones and heel bones, he said.

The researchers found that cases of “orthopedic trauma” from the county did undergo a decline: from 2,065 in 2007 to 1,743 in 2009, a drop of 16 percent. And at the same time, the unemployment rate in the county rose steeply, from 4 percent to 10.7 percent over that same period.

Construction worker employment, especially, fell steeply — by 36 percent from 2006-2009, the study found, while the number of county building permits issued dipped by 80 percent from 2005 to 2009.

Overall, the researchers found that the number of trauma cases were statistically connected to the unemployment rate of the previous year. That’s possibly because it took a while for construction projects already in progress to come to an end, Chan said.

The findings could reflect a seemingly paradoxical fact about hard economic times, Chan said: In some cases, the health of people actually improves because they take less risks (including on-the-job risks) and take better care of themselves.

Still, Dr. Wilford K. Gibson, an orthopedic surgeon with Atlantic Orthopaedic Specialists in Virginia Beach, Va., said he’s hesitant “to draw a correlation to decreased employment and cast stones at the construction industry.”

Surgery is not good at all

The timing of an operation doesn’t affect a patient’s subsequent risk of complications or death, a new study finds.

For example, there’s no difference in death rates between elective surgery performed in the afternoon versus the morning or on Monday instead of Friday, the researchers said. Their findings should help to ease concerns that fatigue may lead to a higher rate of safety problems when operations are performed later in the day or week, they said.

The study included an analysis of the outcomes of more than 32,000 elective surgeries performed. The overall complication rate before discharge was 13 percent, and the overall risk of death within 30 days of surgery was 0.43 percent.

After the researchers adjusted for other factors, the risk of complications or death was not significantly different for patients who had surgery at different times of the day between 6 a.m. and 7 p.m. or week.

The time of year also had no impact on the risk of complications or death. This included July and August, when most new residents start working in teaching hospitals.

The study appears in the December issue of the journal Anesthesia & Analgesia.

“Elective surgery thus appears to be comparably safe at any time of the workday, any day of the workweek, and in any month of the year in our teaching hospital,” Dr. Daniel Sessler, of the Cleveland Clinic, and colleagues concluded in a journal news release.

Some previous studies have suggested that patients are at greater risk if they undergo late-day surgery.

Women health is so important

When it comes to aggressive courtship strategies, sexist men and women seem to be perfect for each other, new research suggests.

U.S. researchers conducted two surveys: One included 363 college students at a large Midwestern university, and the other was a national Internet poll of 850 adults.

The male and female participants were asked about their sexist attitudes toward women and whether they were willing to engage in uncommitted or short-term sex. Men were also asked how often they used assertive strategies to initiaterelationships and women were asked if, and to what degree, they found these types of advances desirable.

The researchers found that men who favored casual sex were more likely to use aggressive courtship strategies, while women who were also open to casual sexwere more likely to respond to such approaches.

The surveys also revealed that men with negative, sexist attitudes toward women were more likely to use assertive strategies, and women with sexist attitudes toward other women were more likely to respond to these overtures.

The findings were published recently in the online edition of the journal Sex Roles.

“Our results suggest that assertive courtship strategies are a form of mutual identification of similarly sexist attitudes shared between courtship partners,” Jeffrey Hall and Melanie Canterberry, of the University of Kansas, reported in a journal news release.

“Women who adopt sexist attitudes are more likely to prefer men who adopt similar attitudes. Not only do sexist men and women prefer partners who are like them, they prefer courtship strategies where men are the aggressors and women are the gatekeepers,” the authors concluded.

The dangerous of tatto

An investigation into skin lesions that two people developed after getting tattoos has concluded that both were infected with a bacteria not previously linked to the practice.

The infections involved Mycobacterium haemophilum, which usually only strikes individuals whose immune system are compromised. In this instance, however, the patients, both from Seattle, developed rashing despite the fact that both had normal immune systems, a report on the investigation found.

“Two people developed chronic skin infections after receiving tattoos at the same parlor,” explained study lead author Dr. Meagan K. Kay from the U.S. Centers for Disease Control and Prevention. “The patrons were thought to have been exposed through use of tap water during rinsing and diluting of inks.”

Kay, an epidemic intelligence service officer with the CDC, and her team report their findings in the September issue of the CDC’s journal Emerging Infectious Diseases.

The authors pointed out that tattooing is not considered a sterile procedure, is not regulated at the federal level and can be risky. And while the specific inks and colorings (pigments) commonly used to apply tattoos are regulated by the U.S. Food and Drug Administration, the rules usually apply only when cosmetics or color additives are involved.

The latest concern about associated infection risk arose in 2009 when a 44-year-old man and a 35-year-old man sought care for skin infections that had developed at the site of tattoos acquired at a facility in the Seattle region.

Lesion cultures and lab testing revealed that M. haemophilum was the culprit in the case of the first patient. Skin evaluations and patient interviews led the researchers to conclude that the second man most probably also suffered from the same sort of bacterial infection, although they technically classified his situation as a “suspected case.”

A follow-up investigation of the tattoo parlor revealed that municipal water had been used to dilute the ink during the tattooing process.

Water is considered to be a source for M. haemophilum. And though the facility was cleared of any safety violations, and no M. haemophilum bacteria was found in analyzed water samples, the tattoo operators were told to use sterile water for all future tattoo applications.

“It is important to remember that tattooing is not a sterile procedure and infections can occur after tattoo receipt,” Kay said. “Measures should be taken by tattoo artists to prevent infections, including proper training, use of sterile equipment, and maintaining a clean facility. Use of tap water during any part of the tattoo procedure should be avoided,” she explained.

“Those who suspect an infection in their tattoo should consult with their doctors,” she added. “Common infections can present as increased redness, warmth, swelling, pain and discharge.”

Myrna L. Armstrong, professor emeritus at the school of nursing at Texas Tech University’s Health Sciences Center in Lubbock, said the investigation serves to highlight the general risks of getting a tattoo.

“This is an invasive procedure. And there’s basically no regulation in force. Or very sporadic regulation. So as someone who’s been looking into tattoos and body piercing for more than 20 years, I would say that it’s really not very surprising that this can happen,” Armstrong said.

The effect of TV

Spending your days in front of the television may contribute to a shortened lifespan, a new study suggests.

Researchers in Australia found that people who averaged six hours a day of TV lived, on average, nearly five years less than people who watched no TV.

For every hour of television watched after age 25, lifespan fell by 22 minutes, according to the research led by Dr. J. Lennert Veerman of the University of Queensland.

But other experts cautioned that the study did not show that TV watching caused people to die sooner, only that there was an association between watching lots of TV and a shorter lifespan.

Though a direct link between watching TV and a shortened lifespan is highly provocative, the harms of TV are almost certainly indirect, said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine.

“As a rule, the more time we spend watching TV, the more time we spend eatingmindlessly in front of the TV, and the less time we spend being physically active,” Katz said. “More eating and less physical activity, in turn, mean greater risk for obesity, and the chronic diseases it tends to anticipate, notably diabetes, heart disease and cancer.”

Another explanation for the possible link may be that people who watch excessive amounts of TV “are lonely, or isolated, or depressed, and these conditions, in turn, may be the real causes of premature mortality,” he added.

The report was published in the Aug 15 online edition of the British Journal of Sports Medicine.

In the study, researchers used data on 11,000 people aged 25 and older from the Australian Diabetes, Obesity and Lifestyle Study, which included survey information about how much TV people watched in a week. Researchers also used national population and mortality figures.

In 2008, Australian adults watched a total of 9.8 billion hours of TV. People who watched more than six hours of TV were in the top 1 percent for TV viewing.

The statistics suggest that too much TV may be as dangerous as smoking and lack of exercise in reducing life expectancy, the researchers said.

For example, smoking can shorten of life expectancy by more than four years after the age of 50. That represents 11 minutes of life lost for every cigarette and that’s the same as half an hour of TV watching, the researchers said.

Without TV, researchers estimated life expectancy for men would be 1.8 years longer and for women, 1.5 years longer.

“While we used Australian data, the effects in other industrialized and developing countries are likely to be comparable, given the typically large amounts of time spent watching TV and similarities in disease patterns,” the researchers noted.

Dr. Gregg Fonarow, associate chief of cardiology at the David Geffen School of Medicine at University of California, Los Angeles, said that “there is increasing evidence that the amount of time spent in sedentary activity such at TV watching, distinct from the amount of time spent in purposeful exercise, may adversely impact health.”

And although participating in a regular exercise program can help, it may not be enough to offset the risks of spending too much of the rest of the day — while at work or at home — getting no exercise whatsoever.

“Staying active and reducing time spent sedentary may be of benefit in reducing the risk of cardiovascular disease and may be considered as part of a comprehensive approach to improve cardiovascular health,” Fonarow added.

Dr. Robert J. Myerburg, a professor of medicine at the University of Miami Miller School of Medicine, added that “a sedentary lifestyle can reduce life expectancy.”

Resistant Salmonella

The identification of a new multidrug resistant strain of salmonella-shows–the importance of public health surveillance in a global food system, French scientists say.

Their analysis of national surveillance systems in the United States, Denmark, France, England and Wales revealed the emergence of the S. Kentucky strain of salmonella, which has a high level of resistance to ciprofloxacin, a common treatment for severe salmonella infections.

This strain infected 489 patients in France, England and Wales, and Denmark between 2000 and 2008. The first infections were acquired mainly in Egypt between 2002 and 2005. Since 2006, infections have also been acquired in various parts of Africa and the Middle East.

About 10 percent of the European patients said they hadn’t traveled to any of these areas, which suggests that their infections may have resulted from eating contaminated imported foods or through contact with infected people, said the Pasteur Institute researchers.

The investigators found that chickens and turkeys from Ethiopia, Morocco and Nigeria carried the S. Kentucky strain, an indication that poultry may be an important source of infection.

The study is published online in the Journal of Infectious Diseases.