Health Habits of Adults Aged 18-29 Highlighted in Report on Nation′s Health

Young adults in the United States aged 18-29 face a number of health challenges, including increases in obesity, high injury rates, and lack of insurance coverage compared to older adults, according to the latest report on the nation′s health.

Health, United States: 2008 is the 32nd annual edition of the report prepared by CDC′s National Center for Health Statistics, and includes a compilation of health data from a number of sources within the federal government and in the private sector. The report uses the most current data available at the time of publication.

This year′s edition features a special section on adults aged 18 to 29, a group making many life choices including decisions about education, marriage, childbearing, and health behaviors such as tobacco and alcohol use, which will affect both their future economic and health status.
Highlights of the report:

* Obesity rates have tripled among young adults in the past three decades, from 8 percent in 1971-1974 to 24 percent in 2005-2006.
* In 2006, 29 percent of young men were current cigarette smokers, compared to 21 percent of young adult women. Between 1997 and 2006, the percentage of women 18–29 years of age who currently smoked cigarettes declined nearly 20 percent. Current smoking did not decline significantly among young men.
* In 2005, unintentional injuries or accidents, homicide, and suicide accounted for 70 percent of deaths among young adults 18–29 years of age. Three-quarters of the 47,000 deaths in this age group occurred among young men. Young adults also have the highest rate of injury-related emergency department visits of all age groups.
* In 1999–2004, almost 9 percent of adults aged 20–29 reported having major depression, generalized anxiety disorder, or panic disorder in the past 12 months.
* In 2006, adults aged 20–24 were more likely to be uninsured (34 percent) than those aged 18–19 (21 percent) and 25–29 (29 percent).
* In 2004–2006, 17 percent of adults aged 18–29 reported needing but not receiving one or more of the following services in the past year because they could not afford them: medical care, prescription medicines, mental health care, or eyeglasses.

The full report contains 151 data tables in addition to the special feature on young adults. The tables cover the spectrum of health topics, serving as a comprehensive snapshot of the nation′s health. Other highlights:

* In 2006, American men could expect to live 3.6 years longer, and women 1.9 years longer, than they did in 1990. Death rates from heart disease, stroke and cancer have continued to decline in recent years.
* Sixty-five percent of men and 80 percent of women aged 75 and older reported having high blood pressure or were taking high blood pressure medication in 2003–2006, compared to about 36 percent of adults aged 45–54.
* The proportion of the population with high cholesterol levels has been dropping, in large part due to increased use of cholesterol-lowering drugs. In 2003–2006, 16 percent of adults had high cholesterol. Women aged 55 and over were much more likely to have high cholesterol than their male counterparts.
* Approximately 25 percent of adults aged 60 and over had diabetes in 2003-2006.
* Obesity rates do not appear to be increasing as rapidly as they did in past decades, but remain high, with over a third of adults age 20 and over considered to be obese in 2005–2006.

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Clayton State Presents Free Seminar on Nutrition Supplements

Clayton State University’s Department of Recreation & Wellness will present a free seminar on a topic that’s been making headlines recently – nutrition supplements – on Friday, Feb. 20 in the University’s Student Activities Center.

“Not sure whether that pill you are popping is doing any good? How about those metabolism boosters and protein shakes?” asks Cindy Lauer, Clayton State’s director of Recreation & Wellness.

The seminar, which is open to the public, will be presented by Darin Spurlock, dietetic intern on “Supplement 101.” Spurlock’s presentation will begin at 11:45 a.m. and is expected to run for 30 minutes. Feel free to bring a lunch.

For more information, contact Lauer at (678) 466-4974.

A unit of the University System of Georgia, Clayton State University is an outstanding comprehensive metropolitan university located 15 miles southeast of downtown Atlanta.
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Patients Gain Protections in Health Information Technology Law

/PRNewswire-USNewswire/ -- Patients across the United States will benefit from a new health information technology (HIT) law providing comprehensive privacy and security standards for patient records including strong, protective provisions for psychotherapy records. The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the economic stimulus package, was passed by the House and Senate on February 13 and signed into law by President Obama on February 17.

The HITECH Act builds on the federal government's current efforts to encourage the development of a national interoperable, electronic health records network with the goal of providing improved patient care at lower cost. The core of the HITECH Act contains provisions to ensure records privacy and security as HIT develops. The Act will:

-- Provide for an ongoing process for setting standards to better ensure
that privacy and security are protected in the health care system

-- Incorporate Health Insurance Privacy and Accountability Act (HIPAA)
Privacy and Security Rule standards, where possible, including with
regard to psychotherapy notes and other sensitive patient information

-- Improve upon the HIPAA "minimum necessary" standard, which requires
that only the minimum amount of patient information can be disclosed
depending on the request for the information

-- Implement further restrictions on health care plan use of patient
records for administrative "health care operations" purposes

-- Allow a patient to pay privately for health care and not have his or
her records included in an electronic network

-- Implement a process to explore segmenting particularly sensitive
patient records (such as mental health records)

-- Provide a notice to the patient when privacy is breached

-- Examine technologies to help patients track how their records have
been disclosed

-- Contain new strong patient enforcement measures and strengthen
existing HIPAA enforcement measures

-- Require Health and Human Services to study expanding the HIPAA
psychotherapy notes authorization requirement to include mental health
testing data

-- Make psychologists eligible for funding provisions in the law to
implement health information technology into their practices and to
join into electronic networks in their communities

-- Preserve stronger state privacy laws and allow the continued
application of state consent provisions

-- Require a study for providing for patient consent in electronic
records systems

-- Protect the well-established psychotherapist-patient privilege
currently recognized under federal and state law, and

-- Provide for continued Congressional oversight to ensure the bill's
privacy and security standards are effective.

The HITECH Act is the most comprehensive HIT legislation introduced by Congress and represents a giant leap forward for psychologists and their patients, achieving strong patient records privacy and security protections.

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Johns Hopkins Leads First 12-Patient, Multicenter "Domino Donor" Kidney Transplant

Surgical teams at The Johns Hopkins Hospital, Barnes-Jewish Hospital in St. Louis and Integris Baptist Medical Center in Oklahoma City successfully completed Saturday the first six-way, multihospital, domino kidney transplant. All six donors — one man and five women, and six organ recipients – four men and two woman — are in good condition, according to Robert Montgomery, M.D., Ph.D., chief transplant surgeon at Johns Hopkins.

The procedure, kidney paired donation (KPD), takes a group of incompatible donor-recipient pairs (recipients coming to one of the three hospitals with a willing donor who is not compatible by blood or tissue) and matches them with other pairs in a similar predicament. By exchanging kidneys between the pairs, it is possible to give each recipient a compatible kidney. In this way each recipient receives a kidney from a stranger and transplants are enabled that otherwise would not have taken place. Involving multiple hospitals created even more possibilities for matches.

In Saturday’s so-called domino swap, a surgical team made up of nine surgeons, six anesthesiologists and 12 nurses began a cross-country set of operations with five incompatible pairs. An altruistic donor and a recipient who was next on the United Network for Organ Sharing (UNOS) organ recipient list started and ended the domino. Altruistic donors are those willing to donate a kidney to any needy recipient.

Just like falling dominoes, the altruistic donor kidney went to a recipient from one of the incompatible pairs, that recipient’s donor’s kidney went to a recipient from a second pair and so on. The last remaining kidney from the final incompatible pair went to the UNOS recipient.

As part of this complex procedure, Johns Hopkins flew one kidney to Integris Baptist; Integris Baptist flew one kidney to Barnes-Jewish and Barnes-Jewish flew one kidney to Johns Hopkins.

“We have performed a six-way domino procedure at our hospital before,” says Montgomery. “But this is the first time we have done something this ambitious on such a grand scale involving two other hospitals. This will serve as a blueprint for national match in which kidneys will be transported around the country resulting in an estimated 1,500 additional transplants each year.”

The 12 surgeries — all of which must start at the same time — began at 7 a.m. Eastern time. The nine surgeons in charge included four at Johns Hopkins, three at Integris Baptist and two at Barnes-Jewish. All finished by 7 p.m. Eastern time.

Johns Hopkins surgeons performed one of the first KPD transplants in the United States in 2001, the first triple-swap in 2003, the first double and triple domino transplant in 2005, the first five-way domino transplant in 2006 and the first six-way domino transplant in 2007. Johns Hopkins also performed the first multihospital, transcontinental three-way swap transplant in 2007.

Nearly 100 medical professionals took part in the transplants, including immunogeneticists, anesthesiologists, operating room nurses, nephrologists, transfusion medicine physicians, critical care doctors, nurse coordinators, technicians, social workers, psychologists, pharmacists, financial coordinators and administrative support people.

The other surgeons who participated in the surgery were Mohamad Allaf, M.D., Andrew Singer, M.D., and Dorry Segev, M.D., from Johns Hopkins Department of Surgery; Scott Samara, M.D., Shea Samara, M.D., and William Miller, M.D., from Integris Baptist Medical Center; and Surendra Shenoy, M.D., Ph.D.. and Martin Jendrisak, M.D., from Barnes-Jewish Hospital.

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FDA Clears New Immune Response Claim for the CryoValve(R) SG Pulmonary Human Heart Valve

/PRNewswire-FirstCall/ -- CryoLife, Inc. (NYSE:CRY) , a biomaterials, medical device and tissue processing company, announced today that the U.S. Food and Drug Administration (FDA) has cleared a new claim for the CryoValve(R) SG pulmonary human heart valve. The new labeling claim relates to reducing a component of the immune response in recipients of the CryoValve SG.

CryoValve SG pulmonary human heart valve is processed with the Company's proprietary SynerGraft(R) technology, which is designed to remove allogeneic donor cells and cellular remnants from the valve without compromising the integrity of the underlying collagen matrix.

The new claim relates to the fact that data from three company-sponsored clinical studies and a comprehensive review of the scientific literature on allograft heart valves shows that implantation of the CryoValve SG reduces the risk of inducing HLA class I and class II alloantibodies, based on Panel Reactive Antibody (PRA) measured at up to one year, compared to the standard- processed pulmonary human heart valve. The effect of reduced alloantibodies, however, on the long-term durability, or long-term resistance to rejection by the patient, of the CryoValve SG has not yet been clinically proven. The company has documented the implantation of more than 1,800 CryoValve SG pulmonary human heart valves.

The CryoValve SG pulmonary human heart valve is indicated for the replacement of diseased, damaged, malformed or malfunctioning native or prosthetic pulmonary valves. The valve can be used in conjunction with right ventricular outflow tract reconstruction procedures (RVOT), commonly performed in children with congenital heart defects. In addition, the valve can be used for pulmonary valve replacement during the Ross Procedure, an operation in which a patient's defective aortic valve is removed and replaced with his or her own pulmonary valve. The CryoValve SG is then surgically implanted in place of the removed native pulmonary valve.

A PRA screen is used to identify allosensitized patients prior to organ transplantation. An elevated PRA level, indicating pretransplant alloantibodies, increases the risk of organ transplant rejection and patient mortality. In addition, high and prolonged PRA levels may prevent or delay transplantation until a suitable crossmatch-compatible donor is identified.

"A major objective of our research and development is to reduce and ultimately eliminate the risk of an immune response for patients, and we are making great strides toward achieving that goal," said Steven G. Anderson, president and chief executive officer of CryoLife. "This new claim is important because a subset of patients receiving an allograft heart valve is likely to eventually require an organ transplant. Demonstration of reduced alloantibody levels with the CryoValve SG can be a key consideration for cardiac surgeons when replacing the pulmonary valve. Working with the FDA, we will monitor the long-term clinical outcomes over the coming years to assess what impact the SynerGraft process has on valve durability."

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Georgia State Scientists Investigate Role of Stem Cells in Adult Brain Cell Production

Georgia State researchers in the university’s Neuroscience Institute and the department of biology are investigating how stem cells create new brain cells in adulthood.

The scientists are looking at how new neurons — the basic cellular elements of the nervous system — are made during a process called neurogenesis in a species of crayfish called Procambarus clarkii.

“To drive the permanent production of cells in any given tissue, you need stem cells to support it,” said Manfred Schmidt, a Georgia State research scientist who led the project that was performed in the labs of professors Don Edwards and Charles Derby, mainly by Cha-Kyong Song, a graduate student and Laurel M. Johnstone, a research technician.

Decades ago, scientists believed that addition of new neurons stopped at adulthood, but they now recognize that neurogenesis continues, for both crustaceans and mammals alike. It continues because neuronal stem cells, which create different types of brain cells, continue to exist into adulthood, though not in as great of numbers as in embryos.

Neuronal stem cells take different forms depending on the type of animal. In crustaceans, relatively large cells called neuroblasts are responsible for neurogenesis, located in a part of the brain responsible for processing odor information, called the olfactory midbrain.

In other crustaceans, the neuroblasts are located near to where the new neurons are generally located. But Schmidt and his colleagues found that the neuroblasts in crayfish brains are located farther from where the new neurons are needed — forcing them to travel down pathways to get to their destinations.

“In essence, these are similar organisms, except the stem cells are further away from the action,” Schmidt said. “Now you have to ship out the cells that the stem cells are producing, through a long path to finally reach their target.”

Schmidt said this might be due to the way crayfish have evolved to live in freshwater environments, rather than in saltwater.

“That is a big evolutionary step, and in making this step, they might have lost some of their olfactory capacity,” he explained.

In order for stem cells — legacies of embryonic development — to live in adult body tissues, the cells need particular areas that are suitable environments for them to live, or niches. In crayfish, the niches surrounding neuroblasts are unique structures that can be distinctly identified as being clumps of cells associated with the stem cells.

“It seems that the mechanism of making a neuron in an adult animal is an extension of how this is done in the embryo,” Schmidt said, adding that he and other researchers hope to better understand these niches and how they support stem cells throughout adult life.

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Groundbreaking Paper Publishes Long Term Results of Successful Phase I Clinical Trial Using Autologous Neural Stem Cells to Treat Parkinson's Disease

/PRNewswire/ -- Scientists announced today the publication of a landmark peer-reviewed paper in the February issue of the Bentham Open Stem Cell Journal which outlines the long term results of the world's first clinical trial using autologous neural stem cells for the treatment of Parkinson's disease. According to lead author, Michel F. Levesque, MD, FRCS(C), FACS, "We have documented the first successful adult neural stem cell transplantation to reverse the effects of Parkinson's disease and demonstrated the long term safety and therapeutic effects of this approach." Dr Levesque is a principal investigator for NeuroGeneration, a biotechnology company, and is affiliated with the UCLA School of Medicine and the Brain Research Institute.

The researcher reports that the publication of the article, "Therapeutic Microinjection of Autologous Adult Human Neural Stem Cells and Differentiated Neurons for Parkinson's Disease: Five-Year Post-Operative Outcome" in the Bentham Open Stem Cell Journal heralds an important moment in regenerative and personalized medicine. "Our paper describes how we were able to isolate patient-derived neural stem cells, multiply them in vitro and ultimately differentiate them to produce mature neurons before they are reintroduced into the brain's basal ganglia. This is performed without the patient requiring immunosuppressants. Of particular note are the striking results this study yielded -- for the five years following the procedure the patient's motor scales improved by over 80% for at least 36 months. A word of caution must be added however, since this is a single case study, a larger clinical trial is needed to replicate these findings," says Levesque.

"We have been pioneering the use of neural stem cells for neurodegenerative disorders since 1998 and were the first research team to successfully use differentiated adult neural stem cells for the cellular restoration and treatment of Parkinson's disease. Our original methodology is based on the replication of several steps in human neurogenesis to regenerate millions of mature neurons characterized before transplantation. These steps are essential to establish safety, efficacy and to understand mechanisms of brain repair. The autologous approach mitigates the long term risks associated with allogenic transplants, including infection, inflammatory response, immune rejection, and poor biologic efficacy. In addition, we believe it was the combination of dopaminergic and GABA-ergic neurons that produced the long- lasting motor improvement. This suggests that in humans, Parkinson's disease is more than a chronic dopaminergic dysfunction and involves the GABA-ergic system with its glial environment. The relevance of this discovery cannot be understated because it questions the classical dopaminergic model of Parkinson's disease," says Levesque.

Scientists at NeuroGeneration are planning a larger prospective clinical trial for Parkinson's disease. "It's our hope that this trial will result in the launch of a cost-effective and lasting therapies for the millions of patients suffering from debilitating neurodegenerative disorders," concludes Levesque.

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Emory Crawford Long Hospital Renamed Emory University Hospital Midtown

Emory University has renamed Emory Crawford Long Hospital to Emory University Hospital Midtown (EUHM), effective today following the Emory University Board of Trustees’ decision.

For over 70 years, Emory’s midtown hospital has been wholly owned and operated by Emory University. The hospital will continue its growth in research and clinical trials, educating the next generation of health professionals, and providing the latest and most advanced medical technology and patient care.

"Today’s decision emphasizes the importance of Emory University Hospital Midtown within our health system,” says James W. Wagner, PhD, president of Emory University. “Being more clearly affiliated with Emory in the public eye will help expand upon the hospital’s 100-year tradition of providing outstanding care to people in metro Atlanta and throughout the region.”

Fred Sanfilippo, MD, PhD, Emory’s executive vice president for health affairs and chair of Emory Healthcare, says, “Changing Emory Crawford Long to Emory University Hospital Midtown will fuel progress toward the Woodruff Health Sciences Center’s goal of being the 21st century model for an academic health sciences and services center. By clarifying the hospital’s relationship with Emory’s entire health system, the new name will enhance its already impressive reputation in the community – enabling even greater opportunities for cutting-edge research, world-class education and high-quality patient- and family-centered care.”

Emory’s Midtown hospital celebrated its 100-year anniversary in 2008, and is an important part of Atlanta’s health care history and heritage.

Today, EUHM is a 511-bed community-based, acute care teaching facility. Chief Operating Officer Dane Peterson leads the hospital with its nearly 2,900 employees, 947 Emory medical faculty and nearly 537 private practice community physicians. The hospital is well known for services in cardiology, cardiac surgery, neurosurgery, cancer, gastroenterology, emergency medicine and weight management. Women’s services include prenatal and postnatal education, bone density testing, mammography and obstetrics, with a specialization in high-risk pregnancy.
“Emory University, being more visible on the hospital’s campus between the Peachtrees, will strengthen the hospital’s position as a symbolic gateway between Midtown and Downtown,” says John T. Fox, CEO of Emory Healthcare. “This visibility along the connector and public transportation lines will highlight Emory University Hospital Midtown as the clinical powerhouse it is amidst the heart of Atlanta’s business district and exploding live-work-play growth.”

The institution’s history dates back to 1908, when two physicians, Dr. Edward Campbell Davis and a former student of his, Dr. Luther C. Fischer, opened the 26-bed Davis-Fischer Sanatorium on Crew Street, near present-day Turner Field. With just 26 beds, the hospital quickly outgrew its capacity and by 1911, Davis and Fischer moved the hospital to its present site, opening an 85-bed Davis-Fischer Sanatorium on Linden Avenue.

In 1931, the hospital was renamed Crawford W. Long Memorial Hospital in honor of Dr. Crawford W. Long, the Georgia physician who discovered sulphuric ether for use as an anesthetic and was the first doctor to use anesthesia during surgery.
“We hope our patients and their families, as well as our staff and physicians, will see that while we have grown into a premier academic medical center, the Crawford Long name and its place in history will continue to be a source of pride,” says Fox.

While focused on Emory’s three-tiered mission of excellent patient care, cutting-edge research and a dynamic destination for education, the Midtown Atlanta landmark will also remain true to its heritage and history. The hospital will maintain some of its historical signage, while adding the initials CL for Crawford Long onto much of its new signage. A museum-quality historical display, erected in April 2008, will remain in a prominent location. EUHM’s museum, which further details its long-standing history, will be highlighted more prominently to both patients and visitors.

In addition to EUHM, Emory University’s hospitals include Emory University Hospital, Emory University Orthopaedics & Spine Hospital and Wesley Woods Center. Emory joint venture hospitals include Emory-Adventist Hospital, Emory Johns Creek Hospital and Emory Eastside Medical Center.
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U.S. Outpatient Surgeries on the Rise

The number of outpatient surgery visits in the United States increased from 20.8 million visits in 1996 to 34.7 million visits in 2006, according to a report from the Centers for Disease Control and Prevention. Outpatient surgery visits accounted for about half of all surgery visits in 1996 but nearly two thirds of all surgery visits in 2006, the report said.

The report, Ambulatory Surgery in the United States, 2006, contains the first data on outpatient surgery visits since 1996. The data were collected from 142 hospitals and 295 freestanding centers as part of the National Survey of Ambulatory Surgery (NSAS).

The outpatient surgery visits to freestanding centers increased three-fold from 1996 to 2006, whereas the rate for outpatient surgery visits to hospital centers was relatively unchanged. Visits to hospital centers, at 19.9 million, continued to outnumber those to freestanding centers, at 14.9 million (57 percent compared to nearly 43 percent).

The report also found that in 2006:

* An estimated 57.1 million surgical and nonsurgical procedures were performed during 34.7 million outpatient surgery visits in 2006.
* Females had significantly more ambulatory surgery visits (20 million) than males (14.7 million).
* The procedures performed most often during outpatient surgery visits included endoscopies of the large intestine (5.8 million) and small intestine (3.5 million) and extraction of lens for cataract surgery (3.1 million).
* The leading diagnosis for outpatient surgery visits was cataract, with three million visits, followed by benign tumor (neoplasm) with two million visits, and malignant tumor with 1.2 million visits.
* The average time spent in the operating room during an outpatient surgery visit varied from 61.7 minutes for hospital centers to 43.2 minutes for freestanding centers. Time spent in surgery and recovery and overall visit time were also higher for hospital centers.
* More than half of outpatient surgery visits (53 percent) were paid by private insurance.

The National Survey of Ambulatory Surgery is a nationally representative survey that covers surgery visits by children and adults and procedures performed in both hospital-based and freestanding surgery centers. It excludes federal, military and VA hospitals. Data were collected from medical records at the facilities.

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Mayo Clinic Identifies Best Treatments for Long-Term Survival in Brain Tumor Patients

(This is from late last year, but we felt it was still newsworthy)

A new Mayo Clinic study found that patients with low-grade gliomas survived longest when they underwent aggressive surgeries to successfully remove the entire tumor. If safely removing the entire tumor was not possible, patients survived significantly longer when surgery was followed by radiation therapy. This study is available online as an advance publication in Neuro-Oncology.

Gliomas are a type of brain tumor that form in the brain or spinal cord tissue and can spread within the nervous system. Low-grade gliomas are malignant and slow growing; overall, patients' average survival is five to seven years after diagnosis, even with treatment. Annually, about 17,000 Americans are diagnosed with a glioma. Of that total, 3,000 to 4,000 are categorized as low-grade. Mayo Clinic physicians treat more than 4,000 adults and children who have gliomas and other brain and nervous system tumors each year.

"Mayo Clinic has a long history of expertise in treating patients with brain tumors," says
Nadia Laack, M.D., a Mayo Clinic radiation oncologist and lead author of this study. "This makes our study unique in terms of the large volumes of patients seen here and the extensive length of follow-up."

Dr. Laack and a team of Mayo Clinic researchers studied the records of 314 adult patients with low-grade gliomas who were diagnosed between 1960 and 1992 and had an average of 13 years of follow-up. Nearly half of the patients who underwent aggressive surgeries (gross total resection or radical subtotal resection) were free of tumor recurrence 15 years after diagnosis.

When performing aggressive surgery was not a safe option, postoperative radiation therapy nearly doubled average survival. The average survival time was three years in patients who did not receive radiation therapy, while those who had radiation therapy survived an average of six years.

"This study is exciting because it shows how well glioma patients can do after surgery," says Dr. Laack. "An average of 15 years tumor-free is better than any previously published results. It is also exciting to discover that patients can benefit from radiation therapy. It not only lengthens the time before the tumor comes back, it actually improves the length of time people live. This builds on previous Mayo Clinic data that suggested similar results from a small study published nearly 20 years ago."

According to Dr. Laack, these findings may be controversial due to common concerns about possible long-term side effects of radiation therapy. At Mayo Clinic, these potential side effects are minimized by tightly focusing radiation therapy on the tumor, she says.

Other members of the Mayo Clinic research team included David Schomas, M.D.; Ravi Rao, M.D.; Fredric Meyer, M.D.; Brian O'Neill, M.D.; Caterina Giannini, M.D., Ph.D.; and Paul Brown, M.D. Edward Shaw, M.D. of Wake Forest University Baptist Medical Center also was a collaborator in this study.
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Workplace Environmental Changes May Help Prevent Obesity

Making simple changes to the workplace environment—such as signs reminding workers to choose healthier foods and be more physically active—may help to reduce obesity and other health risks, according to a study in the February 2009 Journal of Occupational and Environmental Medicine.

Positive health effects are noted within a year after the environmental modifications, according to lead study author Ron Z. Goetzel, PhD, of the Institute for Health and Productivity Studies at the Rollins School of Public Health, Emory University.

In the study, some facilities of a large chemical company underwent a series of environmental interventions designed to promote healthier lifestyles. For example, vending machines and cafeterias were stocked with healthy food choices, marked walking paths were established, and signs were strategically placed encouraging increased physical activity. Other sites did not receive the environmental modifications.

One-year follow-up data on more than 3,000 employees found small but significant health improvements for workers at sites with environmental modifications. The changes included a decreased risk of obesity—mainly because the percentage of overweight workers was unchanged at sites with environmental modifications, compared to an increase of nearly two percent at comparison sites.

The environmental modifications led to improvements in some other health risks as well, including a reduced rate of high blood pressure. The researchers also tested a more intensive program, emphasizing a more active role for company leadership. However, the intensive program was no more effective than the environmental modifications alone.

American companies are looking for new ways of reducing overweight and obesity among employees. A previous study by Goetzel's group found that medical costs are about 20 percent higher for obese workers than for normal-weight workers.

Simple, low-cost environmental modifications have been shown to have positive effects on health. The new research is part of a large-scale study sponsored by the National Heart, Lung and Blood Institute to determine whether such environmental changes can help in creating healthier work environments.

"Overall, our analysis revealed a modest effect on population health risks when environmental interventions are introduced at the worksite," Goetzel and colleagues conclude.

Although small, the changes are significant, and may increase with continued follow-up. The researchers also plan further studies to see if environmental modifications have positive effects on employees' productivity and use of health care services.
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Federal Court Declares Vaccines Do Not Cause Autism

/PRNewswire-USNewswire/ -- The following was released today by Every Child By Two:

The U.S. Court of Federal Claims today exonerated vaccines in the debate over the causes of autism. The three judges ruled that the measles-mumps-rubella vaccine (MMR), given in combination with thimerosal-containing vaccines, does not cause autism. The ruling is consistent with 18 major scientific studies which have failed to show a link between vaccines and the widely-diagnosed neurodevelopmental disorder.

The decision is the result of an extensive deliberation by three Special Masters, judges responsible for claims filed in the National Vaccine Injury Compensation Program. In his opinion on general causation, and the specific case of Michelle Cedillo, Special Master George Hastings wrote, "The petitioners have failed to persuade me that there is validity to any of their general causation arguments, and have also failed to persuade me that there is any substantial likelihood that Michelle's MMR vaccination contributed in any way to the causation of any of Michelle's own disorders."

"This is a real victory for children and a great day for science," said pediatrician Dr. Paul Offit, chief of Infectious Diseases and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia. "I hope that this decision will finally put parents' fears to rest and that we can once again concentrate on protecting children from the resurgence of deadly vaccine-preventable diseases such as measles and whooping cough."

"What is most important about these decisions is that the three cases were decided based on the overwhelming body of science," said Randolph Moss, partner and co-chair of the Government and Regulatory Litigation Practice Group at WilmerHale. "The Special Masters looked at the scientific evidence and credited the opinions of the scientific experts."

"It is a great relief to public health advocates to see that the Special Masters have based their judgment on the expert opinions of the scientific community," said Amy Pisani, MS, executive director of Every Child By Two. "We are hopeful that parents will have confidence in their decision to protect children against deadly diseases by vaccinating them on time."

This is the first of two decisions to be issued in what the U.S. Court of Federal Claims has dubbed the Omnibus Autism Proceeding. The second ruling will decide whether thimerosal-containing vaccines alone can cause autism. These judgments will decide over 5,000 claims that autism is caused by vaccines pending in this court.

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New CDC Study Shows Tobacco Marketing Influences Kids to Smoke, Underscores Need for FDA Regulation of Tobacco Products

/PRNewswire-USNewswire/ -- The following is a statement by Matthew L. Myers, President, Campaign for Tobacco-Free Kids:

Several scientific studies released today provide powerful new evidence that tobacco marketing causes kids to smoke, while anti-tobacco advertising campaigns prevent smoking. These studies send a loud and clear message to the nation's policy makers: We need less tobacco marketing and more tobacco prevention.

It is critical that Congress this year pass legislation granting the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products and marketing, which among other things would crack down on tobacco marketing that appeals to kids. It is also imperative that Congress and the states increase funding for programs proven to prevent kids from smoking and help smokers quit.

CDC Study: Youth Smokers Overwhelmingly Prefer Three Most Heavily Advertised Brands

A study published by the Centers for Disease Control and Prevention (CDC) finds that the three most heavily advertised cigarette brands - Philip Morris' Marlboro, Lorillard's Newport and R.J. Reynolds' Camel - continue to be the preferred brands of youth smokers. These brands were preferred by 78.2 percent of middle school smokers and 86.5 percent of high school smokers. Marlboro is preferred by more high school smokers, 52.3 percent, than all other brands combined.

This study indicates that, despite limited restrictions placed on tobacco marketing by the 1998 state tobacco settlement, tobacco marketing continues to have a large and disproportionate impact on the nation's youth. While tobacco companies claim they do not market to kids, they're sure doing a good job of getting kids to use their products. This study was published in the February 13, 2009, issue of the CDC journal Morbidity and Mortality Weekly Report (www.cdc.gov/mmwr).

Congress can protect our nation's children by granting the FDA authority to regulate the manufacturing, marketing and sale of tobacco products. This bill would impose specific restrictions on tobacco marketing that appeals to children. It would limit tobacco advertising in stores and in magazines with significant teen readership to black-and-white text only, eliminating the colorful images that depict smoking as cool and glamorous. It would ban outdoor tobacco advertising near schools and playgrounds, end tobacco sponsorships of sports and entertainment events, and require stores to place tobacco products behind the counter. The bill would also grant the FDA and the states authority to further limit tobacco marketing.

In addition to these marketing restrictions, the legislation would require larger and more effective health warnings, ban misleading terms such as "light" and "low-tar," strictly regulate all health claims about tobacco products, require disclosure of the contents of and changes to tobacco products, and empower the FDA to mandate changes in tobacco products, such as the reduction or removal of harmful ingredients.

Three Studies Finds truth(R) Prevention Campaign Reduces Smoking and Saves Money

In addition to the new CDC studies, three new research papers find that truth(R), the national youth smoking prevention campaign conducted by the American Legacy Foundation, has been both highly effective and cost-effective in preventing America's youth from starting to smoke. One study found that truth(R) was directly responsible for keeping 450,000 teens from starting to smoke during its first four years, while a second study found that the campaign not only paid for itself in its first two years, but also saved between $1.9 billion and $5.4 billion in health care costs. These two studies were published online today by the American Journal of Prevention Medicine (www.ajpm-online.net). A third study in the February issue of Ethnicity and Health found that youth exposed to the truth(R) campaign were more likely to have anti-tobacco beliefs and attitudes.

These studies show that tobacco prevention campaigns are a vital element of the overall effort to reduce tobacco use and its devastating consequences. Unfortunately, both nationally and in the states, these programs are badly underfunded and fall woefully short of the $13.4 billion a year the tobacco companies spend to market their deadly and addictive products. This year, the states will collect $24.6 billion in revenue from the tobacco settlement and tobacco taxes, but will spend less than three percent of it on tobacco prevention and cessation programs. No state currently meets the CDC's recommendation for funding such programs and many states are considering cuts to their programs.

It is critical that both the federal government and the states increase funding for programs to prevent kids from smoking and help smokers quit. As underscored by the new studies, the evidence is abundantly clear that these programs not only reduce smoking and save lives, they save money by reducing tobacco-related health care costs. It is penny-wise and pound-foolish to skimp on funding for these programs.

Today's new studies follow a landmark August 2008 report by the National Cancer Institute that reached the federal government's strongest conclusions to date that 1) tobacco advertising and promotion cause kids to smoke and 2) mass media campaigns are effective at reducing smoking, especially when combined with other tobacco control strategies.

Tobacco use is the number one cause of preventable death in the United States, killing more than 400,000 people and costing the nation nearly $100 billion in health care bills year. The Institute of Medicine, the President's Cancer Plan and other public health authorities have recommended a clear plan for winning the fight against tobacco use. It includes FDA regulation of tobacco products, well-funded tobacco prevention and cessation programs, and other proven measures such as higher tobacco taxes and smoke-free workplace laws. It is critical that Congress and other elected leaders take urgent action to protect our children and the nation's health.

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Vascular Experts Call for Increased Awareness of Growing Problem of Lymphedema

/PRNewswire/ -- Although major advances have been made in the prevention and treatment of cancer, more attention needs to be given to one of the more serious side effects of surgery, radiation and chemotherapy -- the painful and often progressive condition called lymphedema, a panel of vascular experts reported today.

"While we hear so much about cardiovascular disease, few physicians are familiar with lymphedema -- the other vascular disease," said Stanley G. Rockson, M.D., Chief of Consultative Cardiology and Director of the Stanford Center for Lymphatic and Venous Disorders, Stanford University School of Medicine.

"Because cancer survivors are living longer, and because lymphedema occurs more frequently in older cancer survivors, more people are at risk for developing the disease. The incidence of lymphedema is especially higher among Latinos and African-American women who have undergone breast cancer treatment," added Dr. Rockson, who was the moderator of a symposium on lymphedema awareness held last night at the 21st Annual Meeting of the American Venous Forum, presented at the Arizona Grand Resort. The AVF meeting runs through Saturday, February 14th.

The Other Vascular Disease

Lymphedema is an incurable, often painful debilitating condition that affects an estimated 3-5 million people in the United States and 170 million people worldwide (The World Health Organization). It most commonly occurs as a result of cancer treatment from surgery and radiation therapy. More than 3.3 million breast cancer survivors in the United States are at a lifetime risk for the disease. Although major advances have been made in the prevention and treatment of cancer, minimal attention has been given to lymphedema diagnosis and management. But this is slowly changing due to education and awareness.

Characterized by progressive swelling of one or more limbs due to the accumulation of excessive lymph fluid, lymphedema affects both men and women. Once established, the disease has an inexorable tendency to progress. In the United States, it most commonly occurs in the upper limb after breast cancer surgery and lymph node removal on the body side in which the surgery was performed. Some 15-30 percent of breast cancer survivors will experience the condition, and for many it remains a lingering threat because it can strike many years after their cancer was treated. Lymphedema may also occur in the lower limbs or groin (genital edema) after surgery for colon, ovarian or uterine cancer in which removal of lymph nodes is required.

Physicians and medical staff who practice in fields where lymphedema is infrequently seen may fail to correctly diagnose the condition. Moreover, many insurance companies make the expensive mistake of not recognizing lymphedema as a serious condition that becomes progressively worse without proper treatment. And lymphedema treatment providers and insurers may not be aware of the most advanced therapeutic technologies, leaving the patient with the risk of suboptimal care.

Lymphedema Diagnosis and Treatment

Most people do not know what lymphedema is until they have it. Physical examination may reveal a region of persistent edema, and painful thickened skin with a dimpled "orange-skin" texture, among other signs. Treatment for lymphedema varies depending on the severity of the edema and the degree of chronic scarring of the affected limb. Most people with chronic lymphedema follow a daily regimen of life-long self-care as prescribed by their physician or overseen by a certified lymphedema therapist.

Decongestive Therapy

The gold standard of care for lymphedema relies upon a set of techniques called Complex Decongestive Therapy (CDT) designed to reduce swelling and maintain skin health. CDT includes exercise, skin care, compression, and a clinically proven massage technique called Manual Lymphatic Drainage (MLD). Initially, CDT involves frequent (sometimes daily) visits to a certified therapist for as long as six weeks. Once the swelling is reduced, self-management is required for ongoing care at home, along with the use of elastic compression garments, non-elastic directional flow garments, and often, an automated pneumatic compression pump.

The use of older-generation compression pumps has been associated with discomfort and pain, skin irritation, and a higher risk of skin thickening and inflammation. Additionally, these simpler pumps do not offer the programmability of more advanced pumps to treat the trunk or chest lymphatics, and have been associated with creating new areas of swelling in the chest, back and genitals. As a result, the use of these non-programmable pumps has fallen from favor in medical practice.

Watch for Danger Signs

Experts advise certain steps can be taken to reduce the chances of developing lymphedema, especially if you've had cancer treatment that may have damaged your lymphatic system. These include maintaining a healthy diet, exercising regularly and avoiding infections from cuts and insect bites.

If you do get an infection, however slight, consult your doctor immediately for a possible course of antibiotics to reduce the risk of lymphedema developing. If you've had a double mastectomy, any needle procedures should be preferentially performed in the leg rather than the arm. Be alert for any subtle or unusual swelling.

Obesity is a risk factor because it puts excess stress on the lymphatic system. Additionally, burns and scarring can damage or destroy lymphatic capillaries.

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National Health Care Experts Say, "Time is now" for Health Care Reform

Reforming America¿s health care system requires innovative strategies for disease prevention, primary care and finance and payment, leaders from the health and policymaking communities declared during three days of panel discussions recently held at Emory University.

Participants in the Center for Entitlement Reform's expert panel meetings also agreed that comprehensive health reform encompassing those three key areas is essential to controlling the rise in chronic diseases and stemming the growth in health care spending that threatens to overtop federal budgets.

The meetings convened a bipartisan group of national health leaders and were sponsored by the Emory University Center for Entitlement Reform and the Peter G. Peterson Foundation.

"There is an urgent need to develop effective models of primary care that link up clinicians and community-based prevention," says Kenneth E. Thorpe, PhD, professor and chair of health policy and management at Emory's Rollins School of Public Health, and executive director of the Center for Entitlement Reform.

"America consistently spends more for care than any other industrialized nation, but it's not necessarily the right care," says Thorpe. "Our intent with these meetings is to develop true consensus in health care reform. Across the board, thought leaders agreed that better public and private policies to promote prevention and management of chronic illness, strengthen primary care and modernize finance and payment are needed."

Leaders from some of the most influential organizations in the health care debate assembled at Emory to discuss priorities for health reform in 2009, and how they will lend their efforts to finding consensus recommendations. Janet Collins, PhD, participated in the prevention-focused meeting. She directs the National Center for Chronic Disease Prevention and Promotion at the federal Centers for Disease Control and Prevention (CDC).

"Population-based preventive care is the missing book-end to clinical care, and an important factor in moving the focus of the system to disease prevention and health promotion," says Collins. "In short, real health reform starts with prevention."

Robert Berenson, MD, a senior fellow at the Urban Institute, participated in the panel tackling reforms in care delivery. He outlined recommendations on patient-centered medical homes that he said could facilitate partnerships between individual patients, their personal physicians, and patients¿ families and communities to improve individual health and health system functioning.

According Berenson, 20 percent of the Medicare population suffers from five or more chronic conditions, and at least two thirds of Medicare spending goes toward chronic care.

Chronic diseases increasingly affect younger Americans as well. According to the CDC, chronic disease accounts for about 75 percent of the nation's aggregate health care spending - or about $5,300 per person in the U.S. each year.

"Cost control currently is impossible, but it is absolutely vital," says Henry Aaron, PhD, a senior fellow at the Brookings Institution. Speaking on health care finance and payment, Aaron warns, "Large and growing federal health care spending threatens unsustainable budget deficits, while large and growing private health care spending threatens to crowd out growth of consumption other than on health care." Aaron argues that current payment arrangements should be modified so patients and providers have incentives to economize, and that research should be undertaken so that they have information to do so sensibly.

Peter G. Peterson Foundation Vice President Gene Steuerle notes the importance the Obama Administration and leaders in the 111th Congress have placed on moving forward a comprehensive health reform bill to address prevention, delivery, cost, quality and coverage early in 2009.

"The new Administration has already begun to lay the framework for health care reform legislation," says Steuerle. "I congratulate the Center for Entitlement Reform on assembling this respected group of bipartisan health care leaders and outlining their consensus recommendations. We have a unique opportunity to reform our health care and entitlement programs to reflect current economic realities and longer life spans, while also making the programs solvent, sustainable and more savings-oriented."

Consensus priorities from each of the three expert panel meetings will be compiled by the Center for Entitlement Reform to make policy recommendations that inform and educate business and labor leaders, health services and health care professionals, the media and the public.

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