Obama Executive Orders Review Health And Other Strategies
Obama plans to review orders by the previous executive involving a broad range of subjects including health research. “Theres a lot that the president can do using his executive authority without waiting for congressional action, and I think well see the president do that,” Podesta said. “I think that he feels like he has a real mandate for change. We need to get off the course that the Bush administration has set.”
Podesta also said Obama is working to build a diverse Cabinet. That includes reaching out to Republicans and independents – part of the broad coalition that supported Obama during the race against Republican John McCain. Defense Secretary Robert Gates has been mentioned as a possible holdover.
“Hes not even a Republican,” Senate Majority Leader Harry Reid of Nevada said. “Why wouldnt we want to keep him? Hes never been a registered Republican.”
Obama was elected on a promise of change, but the nature of the job makes it difficult for presidents to do much that has an immediate impact on the lives of average people. Congress plans to take up a second economic aid plan before years end – an effort Obama supports. But it could be months or longer before taxpayers see the effect.
Obama could use his executive powers to at least signal that Washington is changing.
“Obamas advantage of course is hell have the House and the Senate working with him, and that makes it easier,” said Carl Tobias, a law professor at the University of Richmond. “But even then, having an immediate impact is very difficult to do because the machinery of government doesnt move that quickly.”
Presidents long have used executive orders to impose policy and set priorities. One of Bushs first acts was to reinstate full abortion restrictions on U.S. overseas aid. The restrictions were first ordered by President Reagan and the first President Bush followed suit. President Clinton lifted them soon after he occupied the Oval Office and it wouldnt be surprising if Obama did the same.
Executive orders “have the power of law and they can cover just about anything,” Tobias said in a telephone interview.
Bush used his executive power to limit federal spending on embryonic stem cell research, a position championed by opponents of abortion rights who argue that destroying embryos is akin to killing a fetus. Obama has supported the research in an effort to find cures for diseases such as Alzheimers. Many moderate Republicans also support the research, giving it the stamp of bipartisanship.
On drilling, the federal Bureau of Land Management is opening about 360,000 acres of public land in Utah to oil and gas drilling. Bush administration officials argue that the drilling will not harm sensitive areas; environmentalists oppose it.
“They want to have oil and gas drilling in some of the most sensitive, fragile lands in Utah,” Podesta said. “I think thats a mistake.”
“Its going to be a cheerful opposition,” said Rep. Mike Pence, R-Ind. “Were going to carry those timeless principles of limited government, a strong defense, traditional values, to the American people.”
Pence, of Indiana, is expected to take over the No. 3 leadership post among House Republicans.
In other transition matters, Obamas new chief of staff, Rahm Emanuel, would not say whether Obama would return to the Senate for votes during the postelection session this month. Obamas presence would be extraordinary, given his position as president-elect, especially if Congress takes up a much-anticipated economic stimulus plan.
“I think that the basic approach has been hes going to be here in Chicago, setting up his economic, not only his economic team, but the policies he wants to outline for the country as soon as he gets sworn in, so we hit the ground running,” Emanuel said.
Also, Emanuel would not commit to a Democratic proposal to help the auto industry with some of the $700 billion approved by Congress to for the financial bailout.
Source: txbea
Napping, Good Sleep Thought To Boost Memory
Good sleep is a casualty of our 24/7 world. Surveys suggest few adults attain the recommended seven to eight hours a night.
Way too little clearly is dangerous: Sleep deprivation causes not just car crashes but all sorts of other accidents. Over time, a chronic lack of sleep can erode the body in ways that leave us more vulnerable to heart disease, diabetes and other illnesses.
But perhaps more common than insomnia is fragmented sleep – the easy awakening that comes with aging, or, worse, the sleep apnea that afflicts millions, who quit breathing for 30 seconds or so over and over throughout the night.
Indeed, scientists increasingly are focusing less on sleep duration and more on the quality of sleep, whats called sleep intensity, in studying how sleep helps the brain process memories so they stick. Particularly important is “slow-wave sleep,” a period of very deep sleep that comes earlier than better-known REM sleep, or dreaming time.
Fishbein suspected a more active role for the slow-wave sleep that can emerge even in a power nap. Maybe our brains keep working during that time to solve problems and come up with new ideas. So he and graduate student Hiuyan Lau devised a simple test: documenting relational memory, where the brain puts together separately learned facts in new ways.
First, they taught 20 English-speaking college students lists of Chinese words spelled with two characters – such as sister, mother, maid. Then half the students took a nap, being monitored to be sure they didnt move from slow-wave sleep into the REM stage.
Upon awakening, they took a multiple-choice test of Chinese words theyd never seen before. The nappers did much better at automatically learning that the first of the two-pair characters in the words theyd memorized earlier always meant the same thing – female, for example. So they also were more likely than non-nappers to choose that a new word containing that character meant “princess” and not “ape.”
“The nap group has essentially teased out whats going on,” Fishbein concludes.
These students took a 90-minute nap, quite a luxury for most adults. But even a 12-minute nap can boost some forms of memory, adds Dr. Robert Stickgold of Harvard Medical School.
Conversely, Wisconsin researchers briefly interrupted nighttime slow-wave sleep by playing a beep – just loudly enough to disturb sleep but not awaken – and found those people couldnt remember a task theyd learned the day before as well as people whose slow-wave sleep wasnt disrupted.
That brings us back to fragmented sleep, whether from aging or apnea. It can suppress the birth of new brain cells in the hippocampus, where memory-making begins – enough to hinder learning weeks after sleep returns to normal, warns Dr. Dennis McGinty of the University of California, Los Angeles.
The catch-up sleep didnt help: Rested rats used room cues to quickly learn the escape hole in a maze. Those with fragmented sleep two weeks earlier couldnt, only randomly stumbling upon the escape.
None of the new work is enough, yet, to pinpoint the minimum sleep needed for optimal memory. Whats needed may vary considerably from person to person.
“A short sleeper may have a very efficient deep sleep even if they sleep only four hours,” notes Dr. Chiara Cirellia of the University of Wisconsin, Madison.
But altogether, the findings do suggest some practical advice: Get apnea treated. Avoid what Harvards Stickgold calls “sleep bulimia,” super-late nights followed by sleep-in weekends. And dont feel guilty for napping.
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Source: ctnhr
Tobacco Product “Snus” Targets Youth, Easy To Hide And Use At School
Snus – Swedish for tobacco, rhymes with “noose” – is a tiny, tea bag-like pouch of steam-pasteurized, smokeless tobacco to tuck between the cheek and gum. Aromatic to the user and undetectable to anyone else, it promises a hit of nicotine without the messy spitting associated with chewing tobacco. Just swallow the juice.
“I think Id rather throw up in my mouth,” says Flint, an 18-year-old West Virginia University student, emerging from a convenience store with a pack of Winstons and a coupon for free Camel Snus. “Id rather not swallow anything like that.”
Reynolds America Inc., the nations No. 2 tobacco company, can also expect resistance from the public health community. Experts wonder whether snus will help wean people off cigarettes and snuff, or just foster a second addiction. While snus has been around, it hasnt been prominent in this country.
“I think were all holding our breath in terms of whats going to be coming down the pike,” says Dorothy Hatsukami, director of the Tobacco Use Research Center at the University of Minnesota. “Theres not much known about these products – whats in these products, how theyre going to be used, whos going to be using them and what the effects of that use will be. … Will it create more harm or less harm?”
Reynolds is confident its new product will find a following. It launched Camel Snus in Austin, Texas, and Portland, Ore., in 2006, and has since expanded to test markets nationwide, with customers in nearly every state. Early next year, its taking snus national with a marketing blitz that spokesman David Howard says will include direct mail, print and Web advertising, and point-of-sale promotions.
Popular for decades in Sweden, where it was invented, snus has been banned in every other European Union nation since 2004 over concerns about carcinogens.
But smokeless tobacco is legal in the U.S., where there are two schools of thought: Some researchers suggest the lower risk of lung cancer makes snus an attractive alternative to smoking, while others fear an increase in problems including mouth lesions or pancreatic cancer.
The American Cancer Society supports any tool that helps smokers quit. “But we dont have any good scientific evidence that snus is one of those tools,” said Tom Glynn, director of cancer science and trends.
“If all smokers switched to snus tomorrow, in a few years wed certainly see less heart disease, less lung disease and fewer cancers,” he said. “But theres no evidence that smokers can switch and stay switched.”
Prevention officials already have their work cut out for them in West Virginia, which has the third-highest adult smoking rate in the U.S. at nearly 27 percent and the highest rate of “spit” or chewing tobacco use at 16 percent.
“The industry is brilliant, and whatever they want to outspend us by – $1 million, $10 million, $100 million – they can do it,” said Bruce Adkins of the state Division of Tobacco Prevention.
U.S. tobacco companies developed snus in response to both declining cigarette sales and consumer demand. With more public bans on puffing, they say smokers need socially acceptable alternatives.
Danny Wolfe, a 38-year-old computer draftsman, gave up regular spit tobacco and has been using Copenhagen tobacco pouches for several years. He spits out the juice; it gives him heartburn.
“Its the same product, just packaged differently. It doesnt get in your teeth. It doesnt have the mess,” says Wolfe, who was sick of smoking outside his Morgantown office. “Youre not quitting anything. Youre replacing.”
Snus is also popular with hunters, who try to avoid scent detection by their prey, and with coal miners, who work in underground mines where the smallest spark can trigger an explosion.
“I find that more rednecks use it,” Wolfe says. “I wont lie to you about that.”
Source: ctnhr
Anti-Smoking Laws Drop Cancer Rates By Half In Some US States
Also, the cancer death rate among men and women continued to drop, by an average of 1.8 percent a year through 2005, said the report published in the Journal of the National Cancer Institute.
The improvements are due to gains against some leading cancers – prostate, colorectal, breast and, for men, lung cancer. But numerous other types still are on the rise, including melanoma and kidney cancer.
Also, Tuesdays report highlights a disappointing missed opportunity: Huge state-by-state variations in anti-smoking policies that translate into big differences in lung cancer. Men in Kentucky die from lung cancer at twice the rate of men in California, for example. California, through higher cigarette taxes and other steps, has logged a 2.8 percent a year decline in that death rate, compared with less than a percent a year for Kentucky.
Nor is it clear that the drop in new cases represents a true decrease in cancer, or if some may be due to people skipping screenings that would have caught brewing disease, cautioned American Cancer Society epidemiologist Ahmedin Jemal, who led the report along with government scientists.
But NCI Director Dr. John Niederhuber said the decline seems steady enough to be real, a feat considering that cancer risk jumps with age and the U.S. is rapidly graying.
“This really is quite significant,” Niederhuber said. “Some of the things were doing, were doing right.”
Still, experts questioned if the good trends can survive the bad economy. Consider: The report credits a drop in colorectal cancer to a big increase in colonoscopies between 2000 and 2005. That screening can detect precancerous growths in time to remove them and avoid cancer – if people have insurance that pays.
Already the NCI has had a below-inflation budget for several years, cutting investment in research to prevent and treat cancer.
“Ive had to find about $175 million to take out of our budget, just take it out,” said Niederhuber. “Its hard to keep momentum. … Were chipping away at the bone.”
More recent rises in unemployment and poverty add to the concern, warned Dr. Louis Weiner, director of Georgetown Universitys Lombardi Comprehensive Cancer Center.
“Weve had some hard-won gains,” Weiner said. “To slow down progress when were so close to a fundamental understanding of cancer biology that we need to really made advances is really tragic.”
-New cases of lung cancer dropped about 1.8 percent a year among men but kept rising among women, about half a percent a year. Thats because smoking rates fell for men before they did for women, so men reaped the benefits sooner. It remains the top cancer killer, but the death rate dropped 1.9 percent a year for men and 0.9 percent among women.
-The rate of new breast cancer dropped about 2.2 percent a year, due largely to millions of women abandoning hormone replacement therapy starting around 2002. The death rate dropped 1.8 percent a year.
-For colorectal cancer, the incidence rate dropped 2.8 percent a year among men and 2.2 percent among women, largely due to screening. Early detection and improved care also fueled a 4.3 percent a year drop in the death rate for both sexes.
-Prostate cancer turned a corner, with the incidence rate dropping 4.4 percent a year between 2001 and 2005 after rising in previous years. The change probably reflects a leveling of prostate screening that had surged in the late 1990s.
-Melanoma, the deadliest skin cancer, jumped 7.7 percent a year among men and by nearly 3 percent a year among women.
Source: midtn
AIDS Drugs, Sex Education Effective In South Africa And Malawi
“Its quite a startling result,” said Charlie Gilks, an AIDS treatment expert at the World Health Organization and one of the papers authors. “In a relatively short amount of time, we could potentially knock the epidemic on its head.”
Gilks and colleagues used data from South Africa and Malawi. In their model, people were voluntarily tested each year and immediately given drugs if they tested positive for HIV, regardless of whether they were sick.
Within 10 years, HIV infections dropped by 95 percent. Other initiatives like safe sex education and male circumcision were also used.
The strategy would cut the estimated number of AIDS deaths between 2008 and 2050 by about half, from about 8.7 million to 3.9 million, leaving only sporadic HIV cases.
Experts think the strategys cost would peak at about $3.4 billion a year, though expenses would fall after an initial investment.
“This is certainly beyond the bounds of the current infrastructure for many countries, but that is not a reason not to think big,” said Myron Cohen, of the University of North Carolina, who has done similar research. He was not involved in the WHO study.
Only 3 million people are currently on AIDS drugs. Nearly 7 million people are still awaiting treatment, and about 3 million more people were infected last year. Worldwide, WHO guesses that about 33 million people have HIV.
Increasing access to testing and drugs would stretch already weak health systems in Africa, which has most of the worlds HIV cases.
“This is not like giving someone a Tylenol,” said Jennifer Kates, director of HIV policy for the Kaiser Family Foundation in Washington, DC. Once people start AIDS drugs, they must continue indefinitely. “The idea should be explored, but its a huge leap,” Kates said.
Handing out AIDS drugs to everyone who tests positive could also worsen drug resistance.
In addition, doctors dont know if its safe to take AIDS drugs for decades; the oldest drug combinations have only been around for about a dozen years.
That would benefit the community, but not necessarily the patients themselves. AIDS drugs come with side effects including vomiting, liver failure, and heart attacks.
WHO emphasized that the study findings do not signal a policy change. “This is only a theoretical exercise,” said Dr. Kevin De Cock, director of WHOs HIV/AIDS department. He said WHO would hold a meeting next year to study the idea more closely.
On the Net:
http://www.lancet.com
http://www.who.int
Source: midtn
Medicaid Paid For Unapproved Drugs To Fight Common Colds And Pain, US
United States medicaid paid nearly $198 million from 2004 to 2007 for more than 100 unapproved drugs, mostly for common conditions such as colds and pain. Data for 2008 were not available but unapproved drugs still are being sold. The AP checked the medications against FDA databases, using agency guidelines to determine if they were unapproved. The FDA says there may be thousands of such drugs on the market.
The medications date back decades, before the Food and Drug Administration tightened its review of drugs in the early 1960s. The FDA says it is trying to squeeze them from the market, but conflicting federal laws allow the Medicaid health program for low-income people to pay for them.
Medicaid officials acknowledge the problem, but say they need help from Congress to fix it. The FDA and Medicaid are part of the Health and Human Services Department, but the FDA has yet to compile a master list of unapproved drugs, and Medicaid – which may be the biggest purchaser – keeps paying.
“I think this is something we ought to look at very hard, and we ought to fix it,” said Medicaid chief Herb Kuhn. “It raises a whole set of questions, not only in terms of safety, but in the efficiency of the program – to make sure we are getting the right set of services for beneficiaries.”
At a time when families, businesses and government are struggling with health care costs and 46 million people are uninsured, payments for questionable medications amount to an unplugged leak in the system.
Sen. Charles Grassley, R-Iowa, has asked the HHS inspector general to investigate.
That unapproved prescription drugs can be sold in the United States surprises even doctors and pharmacists. But the FDA estimates they account for 2 percent of all prescriptions filled by U.S. pharmacies, about 72 million scripts a year. Private insurance plans also cover them.
The roots of the problem go back in time, tangled in layers of legalese.
It wasnt until 1962 that Congress ordered the FDA to review all new medications for effectiveness. Thousands of drugs already on the market were also supposed to be evaluated. But some manufacturers claimed their medications were grandfathered under earlier laws, and even under the 1962 bill.
Then, in the early 1980s, a safety scandal erupted over one of those medications. E-Ferol, a high potency vitamin E injection, was linked to serious reactions in some 100 premature babies, 40 of whom died.
In response, the FDA started a program to weed out drugs it had never reviewed scientifically. Yet some medications continued to escape scrutiny.
Critics say the FDAs case-by-case enforcement approach is not working.
“The FDA does not appear to have a systematic mechanism to report these drugs out,” said Jon Glaudemans, senior vice president of Avalere Health, a health care industry information company, “and there doesnt seem to be a systematic process by which health insurance programs can validate their status. And everyone is pointing the finger at someone else as to why we cant get there.”
In most cases, doctors, pharmacists and patients are not aware the drugs are unapproved.
“Over the years, they have become fully entrenched in the system,” said Patti Manolakis, a Charlotte, N.C., pharmacist who has studied the issue. Only a few unapproved drugs are truly essential and should remain on the market, she added.
Tackling the problem is made harder by confusing – and sometimes conflicting – laws, regulations and responsibilities that pertain to different government agencies.
Source: msjad
Bacteria Found To Congregate On Chicken Trucks
Even so, its not clear that germy debris will make you sick. None of the scientists who studied this problem got sick. And the disease-causing bacteria in question are normally spread by food or water, not air.
Rule and her colleagues at the Bloomberg School of Public Health focused on the so-called Delmarva Peninsula, a coastal area that includes parts of Delaware, Maryland and Virginia. The region is a chicken mecca, with one of the highest concentrations of broiler chickens per acre in the nation.
The researchers chose a 17-mile stretch of highway connecting chicken farms in Maryland to a processing plant to the south in Accomac, Va. They rode in four-door cars with all the windows down and the air conditioning off.
They checked the cars for bacteria after driving when there were no chicken trucks around. And they checked for bacteria after 10 trips behind flatbed trucks carrying crates of broiler chickens.
They collected bacteria from air samples, door handles and soda cans inside the car.
In all the truck chases, they found high levels of certain bacteria, including some that are resistant to antibiotics.
The study, released this week, is being published in the first issue of the Journal of Infection and Public Health, and its billed as the first to look at whether poultry trucking exposes people to antibiotic-resistant bacteria.
It was a casual conversation that inspired the effort.
“Somebody said, I went to the beach the other day and I got stuck behind a chicken truck, and boy, is that nasty,” Rule said.
She said studies to determine if chicken trucks can make you sick are somewhere down the road.
Dr. Keith Klugman, an Emory University epidemiologist who was not involved in the research, said getting sick that way is unlikely. Most healthy people dont suffer serious illness from these bacteria even when exposed in more conventional ways.
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On the Net:
Journal of Infection and Public Health: http://www.elsevier.com/locate/jiph
Source: midtn
Hippocampus Memory Effects Of Aging Studied
The memory exercise reported in the latest issue of the Journal of Neuroscience dealt with recognizing faces, but the findings apply to the more general task of trying to remember something a person sees or hears, said lead author Dale Stevens.
Stevens, a postdoctoral researcher at Harvard University, did the work while at the Rotman Research Institute at Baycrest, which is affiliated with the University of Toronto.
Older people who have to learn something should do all they can to focus on that task and eliminate potential distractions, he advised.
The study compared 10 healthy people in their 60s and 70s to a dozen younger volunteers, ages 22 to 36. Their brains were scanned while they looked at photographs of people they did not know. As each photograph was displayed for one second, the volunteers were asked if theyd seen it before in the study.
In all they saw 180 different faces, of which 120 showed up a second time. The older participants failed to recognize a face theyd already seen 43 percent of the time, compared to 26 percent for the younger volunteers.
Researchers went back to see what was going on in the brains of the volunteers when they first saw a face that they later failed to recognize. Why didnt those faces get planted in memory?
In both groups, a brain area called the hippocampus, which is involved in memory, was less active when a face failed to stick in the memory than when it did. That was no surprise. More interestingly, the older group also showed heightened activity in certain other brain areas while the younger volunteers did not.
Those areas included the auditory cortex, which plays a role in analyzing sound, and several areas involved in directing attention, Stevens said.
So what was going on? The brain-scanning machine was noisy, with lots of knocking, buzzing and banging like a jackhammer, Stevens said. Even with the earplugs the volunteers wore, “its a little distracting,” he said.
The brain activity in the older volunteers shows that the noise was more distracting to them than to the younger participants, and reveals the brain circuits involved, researchers concluded.
The study could not address when a persons brain starts to act up this way. But Cheryl Grady of the Rotman institute, another author, said she suspects it may begin between ages 40 and 60.
In any case, he said, “if you want to remember something, its more important if youre older than younger not to be listening to your iPod.”
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On the Net:
The Journal of Neuroscience: http://www.jneurosci.org/
Source: wijan
“Strength Through Laughter” Therapy, Patch Adams Inspires
They were taking part in the hospitals monthly “Strength Through Laughter” therapy. It is one of several types of laughter or humor therapy being offered by medical facilities around the country for patients diagnosed with cancer or other chronic diseases.
The programs feature joke sessions, clown appearances and funny movies.
While the verdict is out on whether laughter plays a role in healing, the American Cancer Society and other medical experts say it reduces stress and promotes relaxation by lowering blood pressure, improves breathing and increases muscle function.
On a recent day before Halloween, many of the two dozen patients at Montefiore arrived in costume to “spook cancer.”
“The session makes you feel better,” said Luz Rodriguez, 57, a breast cancer patient now in remission, who came disguised as a security officer. “I feel healthy when I laugh.”
The laughs generated a warmth among the group that was palpable, particularly when Rodriguez changed into an angel costume and went around offering a red rose and a hug or kiss to each of the participants.
Their facilitator, senior oncology social worker Gloria Nelson, started the session five years ago to help cancer patients focus on living, instead of dying.
“They have such amazing strength, but its a constant challenge, the fear of it coming back, how to go on living knowing you have cancer,” said Nelson, who came dressed as the mother of the bride. “Every time they laugh, its like kicking cancer out the door. Youre taking control, youre saying its not controlling me.”
The most famous case of laughters therapeutic effects on the body was described by Norman Cousins, editor of the Saturday Review, in his 1979 book, “Anatomy of an Illness.” He claimed that a combination of laughter and vitamins cured him of a potentially fatal illness.
“I made the joyous discovery that 10 minutes of genuine belly laughter had an anesthetic effect,” he wrote.
Still, laughter therapy is not for everyone. Some cancer patients are so overwhelmed with their diagnosis that they are unable to participate. Medical experts stress that laughter and other complementary therapies like acupuncture, massage and meditation are not substitutes for traditional medical treatment but can be used to help relieve the anxiety brought on by the disease.
The staff at the center first tried it in 2004. They felt “weird and silly” but when they tried it out with patients the next day, the laughter soon because contagious, said Katherine Puckett, a licensed clinical social worker and a mind-body medicine expert.
The therapy has since been integrated into the culture of the hospital, and is also offered at the centers facilities in Philadelphia, Tulsa and Seattle.
Steve Wilson, a psychologist who runs the World Laughter Tour, which also trains and certifies laughter club leaders, said about two dozen hospitals around the country have asked to be trained in the method in the past two to three years. One hospital wants to try the therapy with lung transplant patients because laughter allows more oxygen to move through the body.
An international program with a similar goal but totally different approach is “Caring Clowns.” The Thomas Jefferson University Hospital in Philadelphia uses the program of costumed volunteers to get patients to giggle – or at least smile – and open up.
“One of the challenges of being diagnosed with cancer is preserving your dignity … when we tell you to put on a gown where the back half is missing and everyones examining you and asking about bodily functions,” said Dr. Richard Wender, former president of the American Cancer Society and the hospitals chief of family medicine.
Source: txpla
Dilantin Epilepsy Medication Risk For Asians (Gene HLA-B1502)
Patients who test positive for a gene known as HLA-B1502 appear to be at increased risk of developing the skin problems, preliminary data indicate. About 10 percent to 15 percent of patients from parts of China, Thailand, Malaysia, Indonesia and the Philippines may carry the gene, as do 2 percent to 4 percent of South Asians, including Indians.
The FDA urged doctors to monitor patients closely, but said there is not enough information yet to recommend genetic testing. In most cases, patients who develop the skin problems do so in the first few months after starting to take the medications.
Because of the problem with skin reactions, the FDA last year recommended genetic testing for Asian patients taking another epilepsy drug, carbamazepine, sold under several brand names including Tegretol and Carbatrol. Doctors should also avoid Dilantin and the other medications for patients who have already tested positive for the gene, the FDA said.
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On the Net:
FDA safety alert: http://tinyurl.com/5fcnlf
Source: ctnhr