Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

U.S. economy to row against austerity tide in 2013






WASHINGTON (Reuters) – Washington has steered clear of severe austerity measures for now, reducing the risk of recession, but a clutch of U.S. tax hikes will nevertheless be a drag on economic growth this year.


The U.S. Congress approved a deal late on Tuesday to scale back some $ 600 billion in scheduled tax hikes and government spending cuts known as the “fiscal cliff.”






Analysts said the package at least marked a temporary reprieve for the economy, and investors charged into U.S. stocks, pushing the Standard & Poor’s 500 up 2.5 percent on Wednesday.


However, the legislation, which is expected to be signed into law soon by President Barack Obama, will raise taxes on most Americans through a hike in the payroll tax used to fund Social Security pensions for the elderly.


Economists say the U.S. economy would likely grow much more quickly if the government was not raising taxes.


The payroll tax hike alone – which comes from the expiration of stimulus measures enacted to fight the 2007-09 recession – could push the average household tax bill up by about $ 700 this year, according to estimates from the Tax Policy Center, a Washington think tank.


That will likely reduce consumer spending and subtract about three quarters of a percentage point from economic growth, said Joseph LaVorgna, an economist at Deutsche Bank in New York.


The package will also raise income tax rates for households making over $ 450,000 a year, although rates will remain at 2012 levels for everyone else.


The other modest tax hikes, including a tax on wealthy households to help pay for Obama’s 2010 healthcare reform law, could shave another quarter of a point from growth.


“We are still getting some fiscal drag this year,” LaVorgna said.


Even so, the tenor of the deal was widely anticipated by economists in financial centers like Wall Street, and appears to support forecasts for economic growth of around 2 percent this year.


Barclays Capital said it was holding its growth forecast for this year at 2.1 percent.


A Reuters poll of analysts in December produced a median forecast for 1.9 percent U.S. economic growth in 2013.


“There seems to be a collective sigh of relief,” strategists at Brown Brothers Harriman wrote in a note to clients. “The full force of the U.S. fiscal cliff – (which) could have dragged the world’s largest economy into a recession – has been averted.”


The Congressional Budget Office had estimated that completely running over the fiscal cliff would have caused the economy to contract 0.5 percent this year. The full brunt of the cliff would have hit the average U.S. household with about an additional $ 3,500 in taxes this year, according to the Tax Policy Center.


Still, U.S. lawmakers only agreed to delay scheduled cuts on government spending on the military, education and other areas for another two months.


Many economists think ongoing talks in Congress will eventually lead these spending cuts to be put off until next year, presumably once lawmakers reach a deal to reduce spending over the longer term while granting the government authority to increase the national debt.


Then again, they might not reach a deal, and the planned spending cuts would then cut deeply into economic growth in the second half of the year.


“While we retain our 2013 GDP forecast, we also retain the view that fiscal policy presents downside risks to growth,” analysts at Barclays said in a research note.


Some economists noted that tax policy now looks more stable for the majority of Americans, removing some of the uncertainty that may have held back spending by consumers and business in recent months.


At the same time, with an axe still hanging above billions of dollars in government spending, many businesses are likely to remain cautious.


Analysts say financial markets are likely to remain on tenterhooks until Congress raises the nation’s $ 16.4 trillion debt ceiling, which the U.S. Treasury confirmed had been reached on Monday.


The government likely will need to raise the debt ceiling by February or March to remove the risk albeit remote, of the country defaulting on its debt. Such an extreme scenario would likely make it more expensive for governments and companies alike to borrow money, hurting the economy.


“We have some more certainty, but there are still quite a few questions left to be resolved,” said Dana Saporta, an economist at Credit Suisse.


(Additional reporting by Jonathan Spicer in New York; Editing by Leslie Adler)


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Senate’s “fiscal cliff” bill adds $4 trillion to deficits: CBO






WASHINGTON (Reuters) – The Congressional Budget Office on Tuesday said Senate-passed legislation to avert the “fiscal cliff” would add nearly $ 4 trillion to federal deficits over a decade, largely because it would extend low tax rates for almost all Americans.


The congressional scorekeeper’s analysis was released as a number of Republicans in the House of Representatives voiced opposition to the bill, and considered amending it with deeper spending cuts.






House Majority Leader Eric Cantor and others complained the bill’s spending cuts would do little to curb trillion-dollar deficits.


Senate-passed plan extends decade-old Bush-era tax rates for individuals earning up to $ 400,000 and couples earning up to $ 450,000 – nearly 99 percent of U.S. taxpayers.


But the non-partisan CBO compared the Senate plan’s revenue and expenditure changes to laws that are currently in force, which call for $ 600 billion in tax hikes and automatic spending cuts in 2013 alone – effectively a dive off the fiscal cliff.


With Congress feverishly working to avoid the fiscal cliff in recent weeks, many Washington policymakers had viewed the current-law budget “baseline” as unlikely to be maintained.


Compared to an alternative CBO scenario in which Congress extends all expiring tax provisions and turns off automatic spending cuts slated to start taking effect this week, the Senate plan achieves minimal deficit reduction in the early years.


Over 10 years, deficits under the Senate plan would be $ 3.75 trillion less than permanently extending all of the tax and spending policies in the alternative scenario. That is largely because the CBO expects that remaining on an unsustainable fiscal path would severely constrict economic growth later in the decade, holding back revenue growth and keeping outlays higher.


FISCAL 2013 EFFECTS


By going over the fiscal cliff, the CBO had previously forecast that the higher taxes and lower spending would slash the fiscal 2013 U.S. budget deficit by more than half, to $ 641 billion from $ 1.1 trillion the prior year.


But in its analysis of the Senate-passed plan, the CBO said fiscal 2013 revenues would be $ 280 billion lower and spending $ 50 billion higher, resulting in a $ 330 billion deficit increase, for a total deficit of around $ 971 billion.


Under the CBO’s keep-taxes-unchanged scenario, the deficit would be $ 1.04 trillion for fiscal 2013.


None of the CBO’s analyses takes into consideration possible future spending cuts and reforms to federal health care and retirement programs that Congress might make in a new budget battle emerging around mid-February over the next increase in the U.S. debt limit.


(Reporting By Kim Dixon and David Lawder; Editing by David Gregorio and Vicki Allen)


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Are recession babies prone to be delinquent teens?






NEW YORK (Reuters Health) – A new analysis of data on U.S. teens born during the early 1980s ties slightly higher rates of adolescent smoking, drinking, arrests and thefts to macroeconomic conditions during the first year of life.


What was “striking for us was it basically went across all socioeconomic strata,” said Dr. Seethalakshmi Ramanathan, the lead author of the study. “From a national level, it seems like everyone is affected.”






Ramanathan‘s study focused on babies born around the time of the recessions of 1980-1981 and 1982, when unemployment rates around the nation ranged from 6.6 percent to 11.25 percent, but she said she wouldn’t be surprised if the most recent recession also has a lasting impact.


“The mechanisms involved maybe different in intensity and severity, (but) based on the study it seems like there would be some effects,” said Ramanathan, a researcher at State University of New York Upstate Medical University.


Earlier research has suggested that widespread economic strain might negatively impact kids in the short term.


One group of researchers found that the rate of serious physical abuse towards children spiked as the U.S. economy crashed in 2007 (see Reuters Health report of September 19, 2011 here: http://reut.rs/q97xYA).


To get some sense of how recessions might affect children long term, Ramanathan and her colleagues used a 1997 survey of nearly 9,000 children who were born in the U.S. between 1980 and 1984.


The questions asked about drug, alcohol and gun use, arrests, theft and other behaviors.


The researchers were able to determine the economic circumstances for the region in which each kid spent his or her first two years of life.


They found that some of the delinquent behaviors were more common among children who were surrounded by higher unemployment during infancy.


For instance, the teens were nine percent more likely to use marijuana if the region where they celebrated their first birthday experienced a one percent drop in employment during the early 1980s.


This means that instead of 20 out of every 1,000 kids smoking pot, the increased risk in higher unemployment regions would result in 23 pot smokers out of every 1,000 teens.


Such an increase nationwide would result in 115,000 additional pot smokers, the group estimates in its report, published in the Archives of General Psychiatry.


“That’s a big number when you look at it,” Ramanathan told Reuters Health.


The risks for being arrested, joining a gang, stealing, and using alcohol and tobacco also increased between 6 percent and 17 percent among kids who were babies in areas experiencing a spike in unemployment.


The findings held up regardless of whether the kids grew up in wealthy homes or poor ones.


“These results suggest that, irrespective of socioeconomic status, unfavorable economic conditions during infancy may create circumstances that can have an adverse effect on the psychological development of the infant and lead to the development of behavioral problems,” the authors wrote in their study.


Assault, and the use of hard drugs or guns, however, were not affected by employment rates.


Ramanathan said it’s not clear why certain behaviors were more likely in regions impacted by the recessions.


“People have talked about how economic stability can help parents invest in the child’s development and how economic instability can affect family dynamics and the ability to be an effective parent,” she said.


But she added that this is speculation, and more studies need to unravel the factors that are taking root in infancy and spilling out in teenage delinquency.


“We can’t say high unemployment caused the effects. We don’t know what the mediating factors are,” Ramanathan said.


SOURCE: http://bit.ly/P0ZWgD Archives of General Psychiatry, online December 31, 2012.


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It’s a fight over fitness in Santa Monica’s parks






SANTA MONICA, Calif. (AP) — Physical fitness is a way of life on the beautiful beachfront oasis of Santa Monica. From sunrise to sunset, there’s huffing and puffing in the city’s parks as trainers put their students through the paces of every form of exercise imaginable.


All along the 420 acres of greenery paralleling the Pacific Ocean are groups of a dozen or more people furiously pumping iron, doing sit-ups, stepping on and off little benches and stretching on mats. Some flex their muscles with weight machines tied by big rubber bands to pretty much anything that’s anchored to the ground.






“It’s starting to look like a 24-Hour Fitness gym out there,” complained Johnny Gray, an assistant track coach at UCLA and former Olympic runner who says he’s often forced to navigate around weight machines, barbells and other exercise impediments as he runs.


In recent years, fitness classes have become as ubiquitous in Santa Monica’s signature Palisades Park as dog walkers and senior citizens playing shuffleboard.


Karen Ginsberg, the city’s director of community and cultural services, said other park users are complaining about fitness enthusiasts not only blocking pedestrian walkways but also making too much noise, killing the park’s grass with their weights and damaging its trees and benches with all the exercise gadgets they connect to them.


“Some people have also expressed concerns about people operating a business on city land and putting the city at risk of liability because they aren’t carrying insurance,” she said.


So now the City Council is considering requiring that fitness trainers who conduct workouts in Santa Monica’s parks and on its beaches pay an annual $ 100 fee and turn over 15 percent of their gross revenues to the city.


The council was to take up the issue of regulating fitness trainers this month, but that’s now been pushed back to at least March. Meantime, Ginsberg said city officials are looking at what restrictions they might put on the use of weights, bands and other equipment.


Although classes offering everything from fitness training to yoga to meditation can be found at several city parks and all over Santa Monica’s beaches, Palisades Park, with its stunning ocean views, is by far the most popular place.


As a result, city officials are considering limiting exercise class sizes there to no more than two students per trainer. Under the proposal being considered, other venues could still accommodate the larger groups as long as trainers pay the fees and provide proof of insurance.


The trainers respond that, like any responsible business operators, many already are insured and also know CPR. They also point out that they currently pay the city for business licenses and police-issued permits to hold their classes in the park. Although they don’t have to pay rent to anyone, they believe that’s enough overhead.


“I could easily go back indoors but that’s what I wanted to get away from,” said Ruben Lawrence, who has been offering boxing and fitness training classes at Palisades and other parks for six years. “I wanted to provide these programs to the masses at affordable rates to the community in a place people enjoy.”


Since the city began discussing the additional regulations, Lawrence said, he’s moved most of his classes to other parks in Santa Monica. If he has to pay the additional fees, however, he said he’ll likely just relocate to a gym.


Raisa Lilling, who offers vigorous exercise classes to the mothers of newborns, said she and other trainers have been working to keep their students quiet and out of the way of dog walkers, camera-toting tourists and others.


“I can absolutely see where they’re coming from, but a complete ban, I think, is a little extreme,” said Lilling, adding that the sides can always find a middle ground.


Lilling offers Stroller Strides classes in which mothers push kids in strollers across the park. As part of their workout, they’ll stop from time to time for vigorous bursts of cardio activity, including running up and down the park’s steep stairways to the beach while Lilling watch the kids.


“It’s not just a stroll in the park,” laughed the trainer, who is certified in CPR, carries insurance and also teaches yoga classes.


Ginsberg, emphasizing that planners are still fine-tuning the proposed regulations, agreed there should be a middle ground.


“I think we have to strike a balance between wanting an active community, which I think we do want, with the need to have some sort of ability for all users to enjoy our parks, particularly Palisades Park,” she said.


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Obama: “modestly optimistic” fiscal cliff deal can be reached









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State’s first flu death is Tulsa County resident






A Tulsa County resident between the ages of 19 and 64 is the first person in Oklahoma to die from the flu this season.

Since Sept. 30 there have been 24 hospitalizations due to flu reported in Tulsa County, the most for any county in the state.


Oklahoma County has reported 10, according to the Oklahoma State Department of Health.






There have been 75 flu hospitalizations throughout the state. Twenty-one of those were reported last week. The age range with the most hospitalizations was 65 and older with 28. Children under 4 accounted for 20 cases, according to the department.


Nationally 1,013 people have been hospitalized and eight children have died, according to the Centers for Disease Control and Prevention.


Flu activity has been increasing, particularly in the south central and southeastern regions of the county. Oklahoma reported regional flu activity last week while 29 states had widespread activity, according to the CDC.


6419e  basic States first flu death is Tulsa County resident


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Some cancer docs say their income tied to treatments






NEW YORK (Reuters Health) – A survey of cancer doctors finds that some believe they get paid more when they administer their patients’ chemotherapy and other drugs, raising concerns about conflict of interest and the potential for overtreatment.


Researchers found that oncologists, surgeons and other cancer specialists who get paid based on the number of services they provide were seven times more likely to say their pay increases when they oversee their patients’ chemotherapy treatments, compared to doctors who are paid a flat rate or salary.






“I think there is evidence out there that doctors are very responsive to financial incentives… So I think some patients should realize that doctors who are prescribing chemotherapy may be benefiting financially,” said Dr. Nancy Keating from Boston’s Harvard Medical School and Brigham and Women’s Hospital, the study’s senior author.


According to Keating and her colleagues, who published their study in the Journal of Clinical Oncology on Wednesday, some cancer doctors offer chemotherapy and other therapies in their offices.


Indeed, the researchers note, previous studies have found that as much as 65 percent of an oncologist office’s income typically comes from administering treatments. The rest comes from evaluating and managing patients’ cancers.


There are some advantages to patients in getting treatments at their doctors’ offices, such as not having to travel to a hospital, but some observers worry the practice gives doctors incentive to prescribe more chemotherapy or more expensive drugs because they’ll make more money.


In the last decade, the U.S. government tried to reduce the profit margin doctors were able to make by administering chemotherapy to their patients, but Keating told Reuters Health that didn’t solve the problem.


“I think there is some evidence out there that doctors just started prescribing more profitable drugs. So this is still an issue,” she said.


While the study could not determine whether patients received any unnecessary treatments, the researchers wanted to see whether doctors believe their pay is tied to their ability to give patients chemotherapy.


The researchers used a survey from 2005 through mid-2007 of 480 oncologists, who treated patients from across the country.


Overall, most participants said their income would be unaffected by prescribing chemotherapy or other drugs, or by referring patients to other specialists or hospices.


But 27 percent of the doctors said their pay would increase based on how much chemotherapy they administered and 25 percent said they’d get paid more if they administered more growth factors, such as so-called hormonal drugs, that regulate cell growth.


Doctors who were in some way paid based on how many services they provide – known as fee for service – were about seven times more likely to say their incomes would increase if they administered more chemotherapy or growth factors, compared to doctors who got a flat salary.


Doctors who had their own practices or were part of a smaller oncology group were about nine times more likely to say their income would increase if they administered their patients’ chemotherapy, compared to those who worked in a hospital.


“It really is pretty substantial differences. And often, I don’t think people pay that much attention to where their doctor works, but I think it does make a difference,” Keating said.


But Dr. Yu-Ning Wong of the Fox Chase Cancer Center in Philadelphia cautions that the new study only looks at whether the doctors believed their pay would increase if they could administer chemotherapy or other treatments.


“It didn’t say it actually did,” said Wong, who wrote a commentary accompanying the study.


She also told Reuters Health that she would not want cancer patients thinking they are receiving unnecessary care or treatments based on this study.


Still, Keating and her fellow researchers say, there needs to be a new way to pay doctors “to counter or eliminate these incentives to decrease unnecessary care and ensure that health care resources are used most effectively.”


Until then, Keating said patients should feel free to ask doctors whether they’ll benefit financially from their treatments.


“It’s certainly something I would want to know,” she said. “But I agree it’s not an easy thing to ask, but I do think it’s something to be aware of and I think it’s a fair question to ask.”


SOURCE: http://bit.ly/gPtMdm Journal of Clinical Oncology, online December 26, 2012.


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Obesity declining in young, poorer kids: study






NEW YORK (Reuters Health) – The number of low-income preschoolers who qualify as obese or “extremely obese” has dropped over the last decade, new data from the Centers for Disease Control and Prevention show.


Although the decline was only “modest” and may not apply to all children, researchers said it was still encouraging.






“It’s extremely important to make sure we’re monitoring obesity in this low-income group,” said the CDC‘s Heidi Blanck, who worked on the study.


Those kids are known to be at higher risk of obesity than their well-off peers, in part because access to healthy food is often limited in poorer neighborhoods.


The new results can’t prove what’s behind the progress, Blanck told Reuters Health – but two possible contributors are higher rates of breastfeeding and rising awareness of the importance of physical activity even for very young kids.


Blanck and her colleagues used data on routine clinic visits for about half of all U.S. kids eligible for federal nutrition programs – including 27.5 million children between age two and four.


They found 13 percent of those preschoolers were obese in 1998. That grew to just above 15 percent in 2003, but dropped slightly below 15 percent in 2010, the most recent study year included.


Similarly, the prevalence of extreme obesity increased from nearly 1.8 percent in 1998 to 2.2 percent in 2003, then dropped back to just below 2.1 percent in 2010, the research team reported Tuesday in the Journal of the American Medical Association.


Whether kids are obese is determined by their body mass index (BMI) – a measure of weight in relation to height – and by their age and sex.


For example, a four-year-old girl who is 40 inches tall would be obese if she was 42 pounds or heavier. A two-year-old boy who is 35 inches tall qualifies as obese at 34 pounds or above, according to the CDC’s child BMI calculator. (The CDC’s BMI calculator for children and teens is available here:.)


The new findings are the first national data to show obesity and extreme obesity may be declining in young children, Blanck said.


“This is very encouraging considering the recent effort made in the field including by several U.S. federal agencies to combat the childhood obesity epidemic,” said Dr. Youfa Wang, head of the Johns Hopkins Global Center on Childhood Obesity in Baltimore.


Blanck said between 2003 and 2010 researchers also saw an increase in breastfeeding of low-income infants. Breastfeeding has been tied to a healthier weight in early childhood.


Additionally, states and communities have started working with child care centers to make sure kids have time to run around and that healthy foods are on the lunch menu, she added.


Parents can encourage better eating by having fruits and vegetables available at snack time and allowing their young kids to help with meal preparation, Blanck said.


Her other recommendations include making sure preschoolers get at least one hour of activity every day and keeping television sets out of the bedroom.


“The prevalence of overweight and obesity in many countries including in the U.S. is still very high,” Wang, who wasn’t involved in the new study, told Reuters Health in an email.


“The recent level off should not be taken as a reason to reduce the effort to fight the obesity epidemic.”


SOURCE: http://bit.ly/JjFzqx Journal of the American Medical Association, online December, 25, 2012.


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Venezuela’s Chavez “improves slightly” after surgery: official






CARACAS (Reuters) – Venezuelan President Hugo Chavez‘s condition has “improved slightly” after a cancer operation in Cuba, the information minister said on Monday, amid doubts over whether the former soldier is in good enough health to continue governing.


“The patient has shown a slight improvement in his condition,” Venezuelan Information Minister Ernesto Villegas said during a terse televised statement, adding the president has maintained contact with family members.






Chavez has not been heard from in two weeks following a fourth operation for an unspecified type of cancer in the pelvic region. The government has said he suffered post-operatory complications including unexpected bleeding and a lung infection, but offered few details about his actual condition.


His death, or even his resignation for health reasons, would upend the politics of the South American OPEC nation where his personalized brand of oil-financed socialism has made him a hero to the poor but a pariah to critics who call him a dictator.


His allies are now openly discussing the possibility that he may not be back in time to be sworn in for his third six-year term on the constitutionally mandated date of January 10.


Opposition leaders say a delay to his taking power would be another signal that Chavez is not in condition to govern and that fresh elections should be called to choose his replacement.


They believe they have a better shot against Chavez’s anointed successor, Vice President Nicolas Maduro, than against the charismatic president who for 14 years has been nearly invincible at the ballot box.


But a constitutional dispute over succession could lead to a messy transition toward a post-Chavez era.


Maduro has become the government’s main figurehead in the president’s absence. His speeches have mimicked Chavez’s bombastic style that mixes historical references with acid insults of adversaries.


Opposition leader Henrique Capriles, who lost to Chavez in the October presidential vote, slammed Maduro in an interview published on Sunday for failing to seek dialogue with the opposition at a time of political uncertainty.


“Maduro is not the one that won the elections, nor is he the leader,” Capriles told the local El Universal newspaper. “Because Chavez is absent, this is precisely the time that (Maduro) needs help from people (in the opposition camp).”


Chavez has vastly expanded presidential powers and built a near-cult following among millions of poor Venezuelans, who love his feisty language and social welfare projects.


The opposition is smarting from this month’s governors elections in which Chavez allies won 20 of 23 states. They are trying to keep attention focused on day-to-day problems from rampant crime to power outages.


(Reporting by Brian Ellsworth; Editing by Sandra Maler)


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Few tests done at toxic sites after superstorm






OLD BRIDGE, N.J. (AP) — For more than a month, the U.S. Environmental Protection Agency has said that the recent superstorm didn’t cause significant problems at any of the 247 Superfund toxic waste sites it’s monitoring in New York and New Jersey.


But in many cases, no actual tests of soil or water are being conducted, just visual inspections.






The EPA conducted a handful of tests right after the storm, but couldn’t provide details or locations of any recent testing when asked last week. New Jersey officials point out that federally designated Superfund sites are EPA’s responsibility.


The 1980 Superfund law gave EPA the power to order cleanups of abandoned, spilled and illegally dumped hazardous wastes that threaten human health or the environment. The sites can involve long-term or short-term cleanups.


Jeff Tittel, executive director of the Sierra Club in New Jersey, says officials haven’t done enough to ensure there is no contamination from Superfund sites. He’s worried toxins could leach into groundwater and the ocean.


“It’s really serious and I think the EPA and the state of New Jersey have not done due diligence to make sure these sites have not created problems,” Tittel said.


The EPA said last month that none of the Superfund sites it monitors in New York or New Jersey sustained significant damage, but that it has done follow-up sampling at the Gowanus Canal site in Brooklyn, the Newtown Creek site on the border of Queens and Brooklyn, and the Raritan Bay Slag site, all of which flooded during the storm.


But last week, EPA spokeswoman Stacy Kika didn’t respond to questions about whether any soil or water tests have been done at the other 243 Superfund sites. The agency hasn’t said exactly how many of the sites flooded.


“Currently, we do not believe that any sites were impacted in ways that would pose a threat to nearby communities,” EPA said in a statement.


Politicians have been asking similar questions, too. On Nov. 29, U.S. Sen. Frank Lautenberg, D-N.J., wrote to the EPA to ask for “an additional assessment” of Sandy’s impact on Superfund sites in the state.


Elevated levels of lead, antimony, arsenic and copper have been found at the Raritan Bay Slag site, a Superfund site since 2009. Blast furnaces dumped lead at the site in the late 1960s and early 1970s, and lead slag was also used there to construct a seawall and jetty.


The EPA found lead levels as high as 142,000 parts per million were found at Raritan Bay in 2007. Natural soil levels for lead range from 50 to 400 parts per million.


The EPA took four samples from the site after Superstorm Sandy: two from a fenced-off beach area and two from a nearby public playground. One of the beach samples tested above the recreational limit for lead. In early November, the EPA said it was taking additional samples “to get a more detailed picture of how the material might have shifted” and will “take appropriate steps to prevent public exposure” at the site, according to a bulletin posted on its website. But six weeks later, the agency couldn’t provide more details of what has been found.


The Newtown Creek site, with pesticides, metals, PCBs and volatile organic compounds, and the Gowanus Canal site, heavily contaminated with PCBs, heavy metals, volatile organics and coal tar wastes, were added to the Superfund list in 2010.


Some say the lead at the Raritan Bay site can disperse easily.


Gabriel Fillippeli, director of the Center for Urban Health at Indiana University-Purdue University Indianapolis, said lead tends to stay in the soil once it is deposited but can be moved around by stormwaters or winds. Arsenic, which has been found in the surface water at the site, can leach into the water table, Fillippeli said.


“My concern is twofold. One is, a storm like that surely moved some of that material physically to other places, I would think,” Fillippeli said. “If they don’t cap that or seal it or clean it up, arsenic will continue to make its way slowly into groundwater and lead will be distributed around the neighborhood.”


The lack of testing has left some residents with lingering worries.


The Raritan Bay Slag site sits on the beach overlooking a placid harbor with a view of Staten Island. On a recent foggy morning, workers were hauling out debris, and some nearby residents wondered whether the superstorm increased or spread the amount of pollution at the site.


“I think it brought a lot of crud in from what’s out there,” said Elise Pelletier, whose small bungalow sits on a hill overlooking the Raritan Bay Slag site. “You don’t know what came in from the water.” Her street did not flood because it is up high, but she worries about a park below where people go fishing and walk their dogs. She would like to see more testing done.


Thomas Burke, an associate dean at the Johns Hopkins School of Public Health, says both federal and state officials generally have a good handle on the major Superfund sites, which often use caps and walls to contain pollution.


“They are designed to hold up,” Burke said of such structures, but added that “you always have to be concerned that an unusual event can spread things around in the environment.” Burke noted that the storm brought in a “tremendous amount” of water, raising the possibility that groundwater plumes could have changed.


“There really have to be evaluations” of communities near the Superfund sites, he said. “It’s important to take a look.”


Officials in both New York and New Jersey note they’ve also been monitoring less toxic sites known as brownfields and haven’t found major problems. The New York DEC said in a statement that brownfields in that state “were not significantly impacted” and that they don’t plan further tests for storm impacts.


Larry Ragonese, a spokesman for the New Jersey Department of Environmental Protection, said the agency has done visual inspections of major brownfield sites and also alerted towns and cities to be on the lookout for problems. Ragonese said they just aren’t getting calls voicing such concerns.


Back at the Raritan Bay slag site, some residents want more information. And they want the toxic soil, which has sat here for years, out.


Pat Churchill, who was walking her dog in the park along the water, said she’s still worried.


“There are unanswered questions. You can’t tell me this is all contained. It has to move around,” Churchill said.


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Federal appeals court rules against Hobby Lobby on contraception






OKLAHOMA CITY (Reuters) – A federal appeals court on Thursday rejected a claim by an arts and crafts chain that wants to be exempted from a requirement to provide emergency contraceptives to employees because it violates the religious principles of its owners.


The Court of Appeals in Denver ruled against family-owned Hobby Lobby‘s assertion that the religious beliefs of its owners should relieve them from providing the “morning after” and “week after” pills to their employees, as required under President Barack Obama‘s signature health care reforms.






Hobby Lobby vowed to appeal to the U.S. Supreme Court.


“The Green family is disappointed with this ruling,” said Kyle Duncan, general counsel for the Becket Fund for Religious Liberty, which is assisting Hobby Lobby in the legal case. “The Greens will continue to make their case on appeal that this unconstitutional mandate infringes their right to earn a living while remaining true to their faith.”


The medications at issue are classified as emergency contraceptives by the Food and Drug Administration, but the owners of Hobby Lobby call them “abortion-inducing drugs” because they are often taken after conception.


The lawsuit is among 42 legal actions that have been filed over the issue, according to the Becket Fund for Religious Liberty, a non-profit law firm in Washington, D.C.


The company faces fines of up to $ 1.3 million daily if it disobeys the mandate, which takes effect on January 1 for Hobby Lobby, a $ 3 billion chain, and its smaller sister operation, Mardel, a Christian-oriented bookstore and educational supply company.


Both companies are owned by the Green family of Oklahoma City, whose patriarch, David Green, is ranked 79th on Forbes Magazine’s list of the 400 richest Americans, with a net worth of $ 4.5 billion.


The family operates 514 Hobby Lobby stores in 41 states and employ 13,240 people. Inspirational Christian music is played in the stores, which are closed on Sundays.


U.S. District Judge Joe Heaton of the Western District of Oklahoma ruled on November 19 that the privately-owned companies are secular, for-profit enterprises that do not possess the same religious rights as the individual members of the family.


(Editing by Corrie MacLaggan and Lisa Shumaker)


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Alexza’s agitation drug gets FDA approval






(Reuters) – Alexza Pharmaceuticals Inc said the U.S. health regulators approved Adasuve, making it the first treatment for schizophrenia and bipolar disorder that can be inhaled.


Adasuve, which delivers an older antipsychotic drug called loxapine, passes through the lungs and into the bloodstream faster than a typical pill. Loxapine is available as an oral drug for schizophrenia.






The company said the product will include a boxed safety warning about potentially dangerous side effects including the potential for fatal bronchial spasms in people with asthma or chronic obstructive pulmonary disorder and a higher risk of death in elderly people with dementia-related psychosis.


Adasuve use will be restricted to mitigate the potential harm of bronchial spasms, Alexza said.


The FDA also required Alexza to conduct a large post- marketing clinical trial of patients to assess the real-world use of the drug.


“We believe that the ability to deliver medications rapidly and non-invasively will be important for patients and the professionals who care for them,” Chief Executive Thomas King said in the statement.


Three injectable drugs, Bristol-Myers Squibb’s Abilify, Eli Lilly’s Zyprexa and Pfizer Inc’s Geodon, are currently approved to calm patients with schizophrenia or bipolar disorder.


Adasuve, Alexza’s most advanced drug, will be available for commercial launch early in the third quarter of 2013, the company said.


Earlier this month, European health regulators recommended approval of Adasuve.


The FDA denied approval to Adasuve in May, after it found deficiencies at the company’s Mountain View, California manufacturing facility during an inspection.


The company’s shares fell 12 percent in the after market trading after the trade was halted at $ 5.79 before the drug- approval announcement.


(Reporting by Prateek Kumar; Editing by Sreejiraj Eluvangal)


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Early Language Skills Help Kids Manage Anger






The ability to use words as a toddler may affect the way a child manages anger later in life, a new study suggests.


Children with good language skills at age 2 expressed less anger during frustrating situations at age 4 than did those 4-year-olds with less advanced language skills, according to the study’s findings.






Children whose language skills developed quickly also expressed less anger at age 4.


While previous research suggested a link between language skills and the expression of anger in young children, few studies had followed children over time. [See Kids' Tantrums As Disorder Concern Doctors.]


The new study followed 120 children from 18 months old until they were 4. Children periodically underwent tests that assessed their language skills and their ability to cope with frustrating tasks. One task asked children to wait for eight minutes before opening a present while their mother finished work.


Two aspects of language appeared to help children rein in their anger. First, more-developed language skills allowed kids to ask for support from their parents during a frustrating situation  (for instance, asking the mother whether she was finished with her work). Children also used language to occupy or distract themselves from becoming angry. (One child dealt with the waiting task by counting for a full minute.)


“Better language skills may help children verbalize rather than use emotions to convey needs and use their imaginations to occupy themselves while enduring a frustrating wait,” said study researcher Pamela Cole, a professor of psychology at Pennsylvania State University..


The study appears today (Dec. 20) in the journal Child Development.


Pass it on:Toddlers with good language skills are better able to manage anger when they enter preschool.


Follow Rachael Rettner on Twitter @RachaelRettner, or MyHealthNewsDaily @MyHealth_MHND. We’re also on Facebook & Google+.


Copyright 2012 MyHealthNewsDaily, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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Sanofi to pay $109 million to settle U.S. kickback charges






(Reuters) – French drugmaker Sanofi has agreed to pay $ 109 million to settle charges that it violated the False Claims Act by providing free drugs as a form of kickbacks to physicians, the U.S. Justice Department announced on Wednesday.


The settlement resolves allegations that Sanofi submitted false average sales price reports for the drug Hyalgan, a knee injection to treat arthritis, that did not account for free units distributed contingent on future purchases.






Average sales prices are used to determine reimbursement rates by government health programs, such as Medicare. The Justice Dept said the practice caused government programs to pay inflated amounts for Hyalgan and a competing product.


Sanofi sales representatives were given thousands of free “sample” Hyalgan syringes and used the free drug as kickbacks with a promise to provide negotiated numbers of the syringes in order to lower Hyalgan’s effective price, the government claimed.


The drugmaker said it had taken “strong, proactive and effective steps” to address the issue and voluntarily halted the Hyalgan sampling program in 2009.


The settlement with the U.S. Attorney’s Office, District of Massachusetts, the U.S. Department of Justice and several states resolves all claims arising out of the investigation into sampling of Hyalgan, Sanofi said.


In addition to the $ 109 million payment, Sanofi said it expects to enter into a Corporate Integrity Agreement with the Office of the Inspector General of the United States Department of Health and Human Services that will place its operations under enhanced scrutiny.


There are no criminal charges against the company related to the Hyalgan allegations.


(Reporting by Bill Berkrot; Editing by M.D. Golan)


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Experts: Kids are resilient in coping with trauma






WASHINGTON (AP) — They might not want to talk about the gunshots or the screams. But their toys might start getting into imaginary shootouts.


Last week’s school shooting in Connecticut raises the question: What will be the psychological fallout for the children who survived?






For people of any age, regaining a sense of security after surviving violence can take a long time. They’re at risk for lingering anxiety, depression, post-traumatic stress disorder.


But after the grief and fear fades, psychiatrists say most of Newtown‘s young survivors probably will cope without long-term emotional problems.


“Kids do tend to be highly resilient,” said Dr. Matthew Biel, chief of child and adolescent psychiatry at MedStar Georgetown University Hospital.


And one way that younger children try to make sense of trauma is through play. Youngsters may pull out action figures or stuffed animals and re-enact what they witnessed, perhaps multiple times.


“That’s the way they gain mastery over a situation that’s overwhelming,” Biel explained, saying it becomes a concern only if the child is clearly distressed while playing.


Nor is it unusual for children to chase each other playing cops-and-robbers, but now parents might see some also pretending they’re dead, added Dr. Melissa Brymer of the UCLA-Duke National Center for Child Traumatic Stress.


Among the challenges will be spotting which children are struggling enough that they may need professional help.


Newtown’s tragedy is particularly heart-wrenching because of what such young children grappled with — like the six first-graders who apparently had to run past their teacher’s body to escape to safety.


There’s little scientific research specifically on PTSD, post-traumatic stress disorder, in children exposed to a burst of violence, and even less to tell if a younger child will have a harder time healing than an older one.


Overall, scientists say studies of natural disasters and wars suggest most children eventually recover from traumatic experiences while a smaller proportion develop long-term disorders such as PTSD. Brymer says in her studies of school shootings, that fraction can range from 10 percent to a quarter of survivors, depending on what they actually experienced. A broader 2007 study found 13 percent of U.S. children exposed to different types of trauma reported some symptoms of PTSD, although less than 1 percent had enough for an official diagnosis.


Violence isn’t all that rare in childhood. In many parts of the world — and in inner-city neighborhoods in the U.S., too — children witness it repeatedly. They don’t become inured to it, Biel said, and more exposure means a greater chance of lasting psychological harm.


In Newtown, most at risk for longer-term problems are those who saw someone killed, said Dr. Carol North of the University of Texas Southwestern Medical Center, who has researched survivors of mass shootings.


Friday’s shootings were mostly in two classrooms of Sandy Hook Elementary School, which has about 450 students through fourth-grade.


But those who weren’t as close to the danger may be at extra risk, too, if this wasn’t their first trauma or they already had problems such as anxiety disorders that increase their vulnerability, she said.


Right after a traumatic event, it’s normal to have nightmares or trouble sleeping, to stick close to loved ones, and to be nervous or moody, Biel said.


To help, parents will have to follow their child’s lead. Grilling a child about a traumatic experience isn’t good, he stressed. Some children will ask a lot of questions, seeking reassurance, he said. Others will be quiet, thinking about the experience and maybe drawing or writing about it, or acting it out at playtime. Younger children may regress, becoming clingy or having tantrums.


Before second grade, their brains also are at a developmental stage some refer to as magical thinking, when it’s difficult to distinguish reality and fantasy. Parents may have to help them understand that a friend who died isn’t in pain or lonely but also isn’t coming back, Brymer said.


When problem behaviors or signs of distress continue for several weeks, Brymer says it’s time for an evaluation by a counselor or pediatrician.


Besides a supportive family, what helps? North advises getting children back into routines, together with their friends, and easing them back into a school setting. Studies of survivors of the Sept. 11 terrorist attacks found “the power of the support of the people who went through it with you is huge,” she said.


Children as young as first-graders can benefit from cognitive-behavioral therapy, Georgetown’s Biel said. They can calm themselves with breathing techniques. They also can learn to identify and label their feelings — anger, frustration, worry — and how to balance, say, a worried thought with a brave one.


Finally, avoid watching TV coverage of the shooting, as children may think it’s happening all over again, Biel added. He found that children who watched the 9/11 clips of planes hitting the World Trade Center thought they were seeing dozens of separate attacks.


___


EDITOR’S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.


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Many have ovary surgery even with negative gene test






NEW YORK (Reuters Health) – Many women who test negative for gene mutations that heighten the risk of ovarian cancer still get their ovaries removed despite a lack of evidence that it reduces the risk of dying, says a new study.


“A higher number than expected went through with the surgery, and it probably has to do with doctors in the community not having enough information on their patients’ risk levels,” said Dr. Gabriel Mannis, the study’s lead author.






According to Mannis and his colleagues, who published their study in the Archives of Internal Medicine on Monday, the average woman’s risk of developing ovarian cancer is about 2 percent, but women with BRCA1 and BRCA2 gene mutations have a 40 percent and 20 percent risk, respectively.


For women that test positive for the gene mutations, the American Congress of Obstetricians and Gynecologists (ACOG) says, if they choose to have their ovaries removed, it should be when they are done having children and near 40 years old.


There are no guidelines, however, on ovary removal and screening for women whose blood tests don’t show the gene mutations but who may still be at an increased risk of cancer based on their family’s medical history.


“We don’t have a clear sense of what their risk level is, or what the role of screening should be,” said Mannis, of the division of oncology at the University of California, San Francisco.


For the new study, the researchers surveyed women at two hospitals about 4 years after they were tested for the gene mutations to see if they decided to be screened or have their ovaries removed.


Of 1,077 women surveyed, about 19 percent tested positive for a BRCA mutation, about 10 percent had no mutation, and the rest had unclear results.


The researchers found that about 70 percent of the women who tested positive for a mutation had their ovaries removed by the time they took the survey.


But, despite a lack of evidence that they should have their ovaries removed, about 12 percent of the women with unclear results still had the surgery.


OVARIAN CANCER SCREENING


The researchers also found that despite the U.S. Preventive Services Task Force recommending against screening for ovarian cancer in women without the gene mutations, about 20 percent of women whose test results didn’t clearly show the mutations still ended up getting screened in the year before taking the survey.


In a previously published study, women screened annually for ovarian cancer were no less likely to die from the disease than those who didn’t get regular screening (see Reuters Health article of Sep. 10, 2012. http://reut.rs/QAmMdk).


Aside from not being shown to help, the tests are also imperfect, said Dr. Jed Delmore, chair the Gynecologic Oncology Sub-committee for ACOG.


“I can simply say that as of today we don’t have a good screening,” said Delmore, of the University of Kansas School of Medicine in Wichita.


“At this point if doctors are going to proceed with screening in this group of women, there needs to be a conversation that we don’t really know if this will prevent you from dying sooner of ovarian cancer or that it may come back as a false positive,” said Mannis.


In that previous study, about one in ten screened women had a false positive result, and of those a third had one or both ovaries removed.


That means some women had both ovaries removed even though they were not at an increased risk for cancer, which needlessly put them in danger of a complication and forced them into menopause.


Plus, the removing an ovary can cost over $ 3,000.


Delmore told Reuters Health that it seems like an intermediate ground has been reached with a majority of BRCA-positive women having surgery to reduce their risk, and fewer BRCA-negative women having it.


He agreed with Mannis that doctors need to be honest with their patients about the limitations of today’s screenings and treatments.


“We have pretty solid information for women who are BRCA positive and clearly BRCA negative,” he said. “It’s just that group in the middle.”


Mannis told Reuters Health that the next step would be to identify that group’s risk levels, but both he and Delmore said that won’t be easy.


SOURCE: http://bit.ly/WiwDtv Archives of Internal Medicine, online December 17, 2012.


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Workplace Bullying Common, Could Lead to Medication Use






Dec 16, 2012 7:00am



If you’ve ever felt bullied at work, you’re not alone. A new study suggests workplace bullying is common, and so is the need for medical intervention.






The survey-based study of more than 6,000 Finns found that one in eight men and one in five women reported being bullied at work. And self-reported bullying victims were more likely to use of antidepressants, sleeping pills and sedatives.


“A potentially unexpected finding is that the results were somewhat stronger for men than women,” study author Dr. Tea Lalluka of the University of Hilsinki said, explaining that bullied men were slightly more likely to use medications than bullied women.


The study was published Thursday in the journal BMJ.


Even witnessing bullying can have health effects, according to the study. Men and women who observed workplace bullying were one and a half to two times as likely to need similar medications, reflecting true, medically confirmed mental problems.


“We’ve all seen it go on,” said Dr. Nadine Kaslow, vice chair of psychiatry at Emory University in Atlanta, who was not involved with the study. “It’s that bystander effect; nobody wants to do anything about it.”


The study was unable to examine the length or intensity of bullying among surveyed employees. But experts say preventing workplace bullying might help prevent serious mental health problems.


“There are employee assistance programs and wellness programs available to people,” Kaslow said. “I would encourage people to take advantage of those. Get support — social support, self care, exercise, eat well — whatever it is, make connections with people at work.”



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California home for developmentally disabled faces abuse inquiry






SAN FRANCISCO (Reuters) – California health officials have threatened to shut down part of the state’s oldest home for developmentally disabled adults due to evidence of physical abuse and neglect, in a move that could displace nearly 300 of its residents.


The state-run Sonoma Developmental Center could lose its license to run one unit if it does not fix the problems, according to a letter the state health department sent this week to the director of the sprawling facility in Eldridge.






Monitors this month and last “documented incidents of abuse constituting immediate jeopardy, as well as actual serious threats to the physical safety of female clients in certain units,” the California Department of Public Health letter said.


Among the incidents were physical abuse, a staff member exposing himself to a female client and inadequate monitoring of a patient who had propensity to swallow inedible items, leading to surgery, said Pam Dickfoss, assistant deputy director of the California Center for Health Care Quality.


The threat of sanctions against the board-and-care center in the heart of wine country represents a significant blow to a historic facility that opened at its current site in 1891 next to the bucolic town of Sonoma.


The center is northern California‘s only state-run residential facility for developmentally disabled adults and sits on 1,000 acres of land, including a petting zoo and sports fields.


Closure of the unit under scrutiny, the Intermediate Care Facility, could require moving 290 of the center’s more than 500 residents, officials said. It is unclear where they would be sent and officials say they hope that will not be necessary.


Administrators have vowed to correct deficiencies and said they plan to appeal the move to potentially strip them of federal funding and a state license for the unit under scrutiny.


“We are moving quickly to fix this center and protect our residents,” said Terri Delgadillo, director of the state Department of Developmental Services, which oversees the center.


She said the problems forced the removal of the center’s executive and clinical directors as well as other staff changes.


State monitors identified 57 deficiencies during a July visit, including four that posed an immediate danger to residents, and dozens of other threats to residents in more recent visits, the letter said.


The facility gets $ 117,000 a day in federal funding, said Nancy Lungren, a spokeswoman for the California Department of Developmental Services.


Most of the center’s residents suffer from cerebral palsy, epilepsy, autism, or a combination of those conditions. Many have lived their entire adult lives at the center.


Leslie Morrison, director of the investigations unit of Disability Rights California, a watchdog group, said she was troubled by reports from the facility over the past year.


“This has been developing for a long period,” Morrison said. “They have been trying to correct things, but it’s going to take a long time.”


(Editing by Alex Dobuzinskis and Eric Walsh)


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Alexza agitation drug gets EU recommendation, shares jump






(Reuters) – European health regulators recommended approval of Alexza Pharmaceuticals Inc‘s experimental drug Adasuve for controlling agitation in adults with schizophrenia and bipolar disorder, sending its shares up 19 percent.


Adasuve, Alexza’s most advanced drug in development, will be the first treatment for schizophrenia and bipolar disorder that can be inhaled.






“… The beautiful part of (the drug) is that the clinician can give (patients) almost instantaneous response, whereas possibly hours of waiting for any other kind of oral medication, and that is the critical key,” WBB Securities LLC analyst Steve Brozak told Reuters.


Three injectable drugs, Bristol-Myers Squibb’s Abilify, Eli Lilly’s Zyprexa and Pfizer Inc‘s Geodon, are currently approved to calm patients with schizophrenia or bipolar disorder.


The recommendation from the European Medicines Agency (EMA) will be forwarded to the European Commission, which normally endorses recommendations within two or three months.


Alexza estimates that as many as 8 million adults in the EU suffer from schizophrenia or bipolar disorder.


Adasuve is also under review by the U.S. Food and Drug Administration, with a decision expected by December 21.


“It’s simply a question of when it will get approved,” Brozak said.


The FDA denied approval to Adasuve in May, after it found deficiencies at the company’s Mountain View, California manufacturing facility during an inspection.


Adasuve, which delivers an older antipsychotic drug called loxapine, passes through the lungs and into the bloodstream faster than a typical pill. Loxapine is available as an oral drug for schizophrenia.


Adasuve, which the EMA said should be administered only in a hospital, is delivered using Alexza’s Staccato delivery device.


Two late-stage studies were conducted, and both demonstrated statistically significant reductions in agitation compared to a placebo, the company said. The study enrolled 344 adult patients with schizophrenia and 314 adult patients with bipolar disorder.


Alexza’s shares jumped 19 percent to $ 6.25 before easing back to $ 5.75 by mid-morning on the Nasdaq on Friday.


(Additional reporting by Ben Hirschler in London; Editing by Sriraj Kalluvila)


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Researchers Find More Than 200 Genes Linked to Crohn’s Disease






British scientists have identified more than 200 gene locations associated with Crohn’s disease, an incurable digestive disorder. Their research utilized the entire human genome, the complete set of human genetic information stored in DNA.


The total is larger than the number of genes located for any other disease, according to ScienceDaily. For example, there are 66 known locations for type 2 diabetes.






The researchers, from University College London (UCL), believe that their findings will eventually lead to more personalized Crohn‘s treatment. The disorder is one of the two principal types of inflammatory bowel disease (IBD). The other is ulcerative colitis. The Crohn’s & Colitis Foundation of America states that Crohn’s affects up to 700,000 Americans. It typically strikes between 15 and 35, but can occur at any age.


The exact cause of the disorder has eluded researchers for decades. Most experts believe that several factors play important roles in the development of the disease. Those cited most often are genetics, environmental factors, and an abnormal immune reaction to benign substances like bacteria in the intestines. Crohn’s is a chronic illness that can involve any part of the digestive tract from mouth to anus, according to PubMed Health.


Scientists have believed for years that understanding the genetic component of such a complex disease is critical to explaining symptoms and developing better methods of treatment. However, they have remained stymied over detailed genetic mapping for the disorder because of the large number of genes involved, complex interactions with the environment, and a wide range of symptoms.


The British team utilized data from a consortium with information on nearly 1,700 Crohn’s patients. Data provided by the U.S. National Institute of Diabetes and Digestive and Kidney Diseases on 813 patients led to replication of results of the British study.


Results from the UCL study appeared in the American Journal of Human Genetics. One of the factors the team believes was responsible for their success was use of highly detailed maps of the human genome. Another was their ability to subdivide Crohn’s patients by the way they presented with the disorder. The results also represent the first definite signs that certain patient sub-groups are predisposed to carry different risk genes.


Like most patients who have had this illness for decades, I often become impatient when I read about a discovery linked to the genetics of Crohn’s disease. Since about 20 percent of patients have a close family member with IBD, years ago, I asked whether I should have my daughter tested.


The doctor and I agreed that it was pointless. Her symptoms were either due to Crohn’s or not. Time would tell. From a patient’s perspective, what is strikingly different about the identification of more than 200 genes is the hope that it will lead to more personalized treatment, not just more data on a library shelf.


Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.


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