Cheap Cialis Blogger | Search results for "relate"

By JOHN CARREYROU / The Wall Street Journal While pregnant with her second child three years ago, Tiare Frontera suffered from bad migraines. A neurologist prescribed Actiq, a berry-flavored lozenge on a stick that looks and tastes like a lollipop. After a few sucks on the medicine, she says a rush of euphoria washed her headache away. Soon, Mrs. Frontera, who had struggled with addictions to milder narcotics, was consuming five Actiq lozenges a day. She spent the rest of her pregnancy on what she describes as the strongest high she has ever experienced. When she gave birth, her baby son was cranky and wouldn’t sleep. Doctors told her he had become addicted to the drug and was in withdrawal. Mrs. Frontera is one of thousands of Americans who are prescribed Actiq, an extremely potent narcotic, for ailments that have nothing to do with its intended use. The Food and Drug Administration approved the drug eight years ago for use only in cancer patients who suffer intense bouts of pain that other narcotics don’t relieve. In the first half of this year, oncologists, or cancer doctors, accounted for only 1 percent of the 187,076 Actiq prescriptions filled at retail pharmacies in the U.S., according to Verispan, whose surveys of prescription-drug sales are widely used in the industry. Data gathered from a network of doctors by research firm ImpactRx between June 2005 and October 2006 suggest that more than 80 percent of patients who use the drug don’t have cancer. Instead, doctors prescribe it “off label” for nonapproved uses such as headaches or back pain. Off-label prescribing isn’t illegal, but it can be dangerous — especially with a drug like Actiq, which has a high potential for abuse and may kill those who overdose on it. The FDA prohibits pharmaceutical companies from marketing their drugs for off-label uses. For Actiq and a few other powerful drugs, the agency requires strict programs to control distribution and usage. Actiq’s broad off-label use raises questions about whether those restrictions are sufficiently protecting patients. “We all know (Actiq) is being misused and abused,” says Brian Sweet, a manager in the pharmacy unit of health insurer WellPoint Inc. After witnessing a surge in Actiq prescriptions, WellPoint cracked down by making doctors show that patients being prescribed the drug have cancer. Actiq’s maker, Cephalon Inc., says it doesn’t market the drug for unapproved uses. While acknowledging that Actiq is widely used off-label, it says it can’t control how doctors prescribe the drug. Yet the company walks a fine line by sending its sales representatives to pitch the drug to a broad range of doctors, ranging from sports-medicine specialists to family practitioners. It gives these doctors coupons for free samples. Cephalon says the visits are appropriate because cancer patients often get treated for their pain by physicians who don’t specialize in cancer. Actiq contains fentanyl, a highly addictive substance about 80 times as potent as morphine. Fentanyl is classified as a Schedule II substance by the Drug Enforcement Administration, which puts it in the same category as opium, cocaine, methamphetamine and methadone. Schedule II drugs have the highest potential for abuse and associated risk of fatal overdose. Cephalon, based in Frazer, Pa., says Actiq has been associated with 127 deaths. Two of them involved children who confused the drug for candy. Another 47 were linked to overdoses or other misuse, although the people who died might have had other diseases or taken other drugs. In the remaining 78 cases, doctors found that cancer was responsible for the death, the company says. Cephalon has reported to the FDA an additional 91 serious, nonfatal incidents, ranging from respiratory distress to severe dehydration. The U.S. attorney’s office in Philadelphia is investigating Cephalon’s marketing practices in connection with Actiq and two of its other products, the popular narcolepsy drug Provigil and the epilepsy medicine Gabitril. No charges have been filed. Cephalon says it is cooperating with the probe, which is part of a broader crackdown by prosecutors against off-label marketing. In August, the Justice Department fined Schering-Plough Corp. $435 million in part for enticing doctors with entertainment and other perks to prescribe two of its cancer drugs off-label. Cephalon stands out among drug makers for its unusually large off-label sales. Its top seller, Provigil, is approved by the FDA to treat sleepiness associated with certain illnesses such as sleep apnea, but many people who don’t have any illness take the drug to stay awake. Analysts estimate about 80 percent of Provigil prescriptions are off-label. Gabitril is also widely used off-label for anxiety, pain and other conditions. Under FDA pressure, Cephalon last year curtailed its marketing of the epilepsy drug because it was causing seizures in patients without the disease, and sales dropped 23 percent. Founded in 1987 by a former DuPont Co. scientist named Frank Baldino Jr., Cephalon expects revenue to exceed $1.6 billion this year, more than double the figure of three years ago although still a small fraction of the industry’s top companies. Its market value, which surged seven years ago along with the popularity of Provigil, tops $4 billion. Dr. Baldino earned $2.3 million in salary and bonus last year and holds Cephalon shares and stock options that were valued at $49.6 million as of the end of last year. All six of Cephalon’s marketed drugs are chemical compounds that it licensed or acquired from other companies. Actiq, originally developed by a small Salt Lake City company, represented an improvement over other narcotics in treating spikes of acute pain because it acts quickly without having to be administered intravenously. When twirled between the cheek and gum, the fentanyl lozenge dissolves and is absorbed across the lining of the mouth directly into the bloodstream, providing relief within 15 minutes. Actiq had sales of $15 million in 2000, when Cephalon acquired it. By last year, sales had grown to $412 million, making it Cephalon’s No. 2 drug. In the first nine months of this year, sales jumped to $471 million. Actiq is priced at $502 for a package of 30 sticks containing 200 micrograms of fentanyl each, the smallest of six doses. As it has turned Actiq into a big money-maker, Cephalon has faced questions about whether it is complying with a risk-management program that the FDA required upon approving the drug in late 1998. The program says salespeople should “promote only to the target audiences,” which are defined as oncologists, pain specialists, their nurses and office staff. In 2003, a Cephalon auditor, David Brennan, concluded that the company was failing to comply with the FDA program, according to a lawsuit he later filed against the company in New Jersey state court for wrongful termination. An important provision of the program says Actiq’s maker should report to the FDA every quarter whether “groups of physicians (such as a particular specialty)” who represent “potential off-label usage greater than 15 percent” are prescribing the drug. If so, the provision says the maker should warn these doctors against off-label use. Mr. Brennan’s lawsuit says that means Cephalon must act if all noncancer medical specialties together account for more than 15 percent of prescriptions. Cephalon interprets the provision differently. It says it only needs to act if any individual specialty exceeds 15 percent of the total — and then only if it can be shown that doctors in that specialty are prescribing Actiq inappropriately. Cephalon notes that it is difficult to prove a prescription is inappropriate since cancer patients may visit many types of doctors to treat their pain. It believes the 15 percent clause has yet to be triggered. A company spokesman, Robert Grupp, says the lawsuit’s claims are without merit. The FDA declined to comment. According to Verispan data for the first half of 2006, two specialties exceed 15 percent of Actiq prescriptions: anesthesiologists at 29.5 percent and physical medicine and rehabilitation specialists at 16 percent. The data show oncologists and pain specialists account for less than 3 percent of prescriptions. Cephalon doesn’t dispute the data. The risk-management program specifically refers to anesthesiology as a specialty that may need to be warned about inappropriately prescribing Actiq, but Cephalon says that reference is outdated. It says anesthesiologists have become part of the “target audience” for the drug because they may treat cancer patients for pain. Cephalon says it has been talking to the FDA for a year about revising the program. After Mr. Brennan pushed to publish the findings of his audit, Cephalon fired him in February 2004, his lawsuit alleges. Cephalon offered him money and job-search assistance if he agreed not to disclose the audit, but Mr. Brennan refused, the suit says. Mr. Grupp declined to discuss Mr. Brennan’s dismissal but noted that he is “a former disgruntled employee.” Mr. Brennan has been interviewed twice by investigators working for the U.S. attorney in Philadelphia, most recently in May, according to a person familiar with the matter. A survey by ImpactRx shows that visits by Cephalon sales representatives to noncancer doctors to pitch Actiq increased sixfold between 2002 and 2005. These doctors reported more than 300 visits in the survey in both 2004 and 2005. Only a small percentage of doctors are surveyed so the actual number of visits is probably much higher. Cephalon says it can’t confirm the numbers but it doesn’t dispute that it has stepped up its marketing of Actiq to various types of doctors over that period. Stephen Leighton, a general practitioner in Winston-Salem, N.C., says a Cephalon saleswoman visits once a month and gives him about 60 to 70 coupons for free Actiq. Patients can trade each coupon for six Actiq sticks. Dr. Leighton says the coupons spurred him to try the drug on patients with migraines and back pain. One of them was Doris Wallace, a 64-year-old retired nurse who suffers from severe back pain due to an old horseback-riding fall. Ms. Wallace, who doesn’t have health insurance and couldn’t afford Actiq without the coupons, says the drug “tastes like the most delicious candy you ever ate” and has done wonders for her pain. At the height of her use, she was consuming 24 Actiq sticks a month. The positive experience of patients like Ms. Wallace has led Dr. Leighton to prescribe Actiq more widely for different types of pain. Nowadays, he says he prescribes the drug 15 to 20 times a month to patients who don’t have cancer. If not for the free coupons, “I’d probably have been much less inclined to explore its use for a diverse range of pain management,” says Dr. Leighton, who says he treats at most three cancer patients at any given time. Dr. Leighton says he thinks the FDA-approved usage of Actiq is too narrow. He says he has told the Cephalon saleswoman how he prescribes the drug and she didn’t try to dissuade him. Mr. Grupp of Cephalon says Dr. Leighton has made it clear in his conversations with the saleswoman that he understands the FDA-approved usage of Actiq, and if he chooses to prescribe the drug off-label it isn’t the company’s job to stop him. Mr. Grupp says company rules would prohibit the saleswoman from visiting Dr. Leighton only if he never prescribed the drug for cancer pain. “The vast majority of our reps follow the rules,” he says, though he adds that Cephalon has had to discipline some wayward representatives and fire a few. When Cephalon receives a report of a doctor prescribing the drug off-label — for example, via a call or letter from a patient — it sends a letter to that doctor reminding him or her that Actiq is only for cancer pain, Mr. Grupp says. The company has sent more than 3,300 such letters, he says. Earlier this year, Dr. Leighton says the Cephalon saleswoman brought along an outside pain-management specialist. Over lunch, Dr. Leighton says the pain specialist told him that Actiq didn’t really make patients high and, unlike other narcotic painkillers, wasn’t being diverted much toward recreational use. Cephalon declined to comment on the conversation. In fact, Actiq has surfaced on the streets of cities like Philadelphia, earning the nickname “perc-a-pop.” Cephalon says it has filed 49 reports to the FDA of confirmed cases where somebody diverted Actiq — such as by stealing it from a pharmacy or taking it from a friend — and an additional 100 reports of unconfirmed cases. Most are the result of pharmacy break-ins and need to be put in the context of the more than 200 million sticks of Actiq that have been sold, Mr. Grupp says. Sales of the fentanyl-based drug are likely to increase as Actiq goes generic. In late September, Barr Pharmaceuticals Inc. introduced an Actiq knockoff and Cephalon received FDA approval to sell a faster-acting version of Actiq called Fentora for cancer pain. Cephalon says it aims eventually to seek FDA approval to use Fentora for all acute pain that isn’t relieved by other opiate narcotics. Mrs. Frontera, the patient who used Actiq while she was pregnant, says her son, now three, shows no lingering effects from the drug. Mrs. Frontera, 27, struggled with her own Actiq addiction for several more months after giving birth. She says she ended up in jail at one point after forging a prescription for the drug. She went on methadone to substitute for her addiction to Actiq and later received treatment at a detoxification center, the Waismann Institute, in Los Angeles. Now she lives in San Luis Obispo, Calif. “It makes me angry that it was prescribed to me,” she says of Actiq. “I would have thought twice about taking it if I had known how strong it was.” Philip Delio, the neurologist who prescribed Actiq to Mrs. Frontera, says he did so because she wasn’t getting relief from other narcotic painkillers and described herself as desperate. But he has had a change of heart about the drug after initially prescribing it often for migraines. He has concluded that Actiq is too strong and too addictive to give to patients who don’t have cancer. Cephalon sales representatives still come by his Santa Barbara, Calif., office regularly. But Dr. Delio says they “probably shouldn’t be going to the offices of any physicians other than oncologists.” Sphere: Related Content Cheap Generic Viagra

Tags: actiq, drug, cephalon, pain, doctor

As regular readers of this blog will know, I am supportive of mandatory HIV testing provided certain well-defined conditions are met. Stuart Rennie seems to disagree. Here I reproduce his take on the issue. It's well worth reading. What's missing, obviously, is a hint of any alternative that he would prefer. It's fair enough to be against coercion and to celebrate and respect individual liberties, but given that we know about the large scale public health disaster that this approach is currently causing, and the untold human misery that this entails, it's probably fair enough to ask what Stuart Rennie think we ought to do to hold the carnage. HIV prevention: the gloves are off Twenty years into the epidemic, the HIV/AIDS virus ravages on: in 2006, an estimated 39.5 million people in the world were living with HIV, 4.3 million were newly infected, and 2.9 million AIDS-related deaths. Of the deaths, 2.1 million occurred in sub-Saharan Africa. As for new HIV infections, South Africa alone is estimated to have 1500 ... per day. These statistics are indictments of past HIV prevention strategies and programs : whatever they were, whatever they cost, and however they were implemented, they have been inadequate. The question then becomes: what strategy changes should be adopted? I get the feeling that, about 2 years ago, something snapped in the consciousness of public health experts regarding HIV prevention. Enough was enough. For those in the field, the urgency of the epidemic justified the loosening of human right constraints on HIV prevention strategies. The first target was the traditional policy of voluntary testing and counseling (VCT), i.e. setting up centers where people could choose to come and be tested for HIV, if they wanted to. Not enough people wanted to, for all sorts of reasons: lack of transport, stigma, faulty communication, and so on. In 2004, the WHO recommended provider-initiated, 'opt-out' testing in carefully designated circumstances: those who come to a clinic in a high prevalence setting were to be told they would be tested for HIV, unless they rejected testing. The CDC soon followed suit with similar policies. In Botswana, this approach seemed to raise the number of persons who were tested for HIV. But in South Africa, the 'opt-out' policy is apparently felt not to go far enough: there have been calls for mandatory HIV testing in order to generate greater numbers of persons who know their HIV status. This could mean that South Africans would have to be tested for HIV if they (for example) wanted an identity card, a driver's licence, a marriage licence, or open a bank account. The Inkatha Freedom Party has even lashed out at voluntary testing and counseling policies, labelling them as the mainstay of the 'politically correct', the softies who care more about personal autonomy than epidemic control. VCT, in other words, is for pussies. Not everyone is buying it, of course. Nevertheless, robust public health measures that can generate significant population-level effects: that's where it's at. Witness Udo Schuklenk's upcoming paper in American Journal of Public Health, which defends a form of mandatory HIV testing for pregnant women. Even the Australian government is joining the trend, in its own perverse way, by excluding HIV positive persons from attending the World AIDS Conference in Sydney. Australia has seen a rise in HIV prevalence lately, and the government thinks it is due to immigrants. Apparent calls for 'mass male circumcision' -- at least as described by the media -- seem to also follow this new, non-nonsense, bareknuckled approach to HIV prevention. Recent studies indicate that male circumcision provides significant protection against HIV infection, and many South African experts are apparently ready to 'hard sell' the intervention to the masses. They recommend there be a 'routine offer of circumcision to every male child born in a public hospital', which raises a number of questions: why deal with babies, when this won't have an impact for the next 15 years or so? How will communities respond to such aggressive policies? Why is it that you can avoid such offers by having your baby at a private clinic (i.e. being wealthy)? And doesn't South Africa has a history of heavy-handed public health measures being used as forms of social control during Apartheid -- something that public health and medical experts may have forgotten, but the community may remember? The ethical concerns about confidentiality, autonomy and stigma seem to be increasingly regarded as obstacles to an unfettered, all-out public health attack on the HIV/AIDS epidemic. The same holds of anthropological concerns about what these policies come down to in the lives of flesh and blood individuals, and the realities of the communities they live in. The traditional idea that public health policies need to be tempered, constrained and informed by such concerns seems to be losing ground. Will these 'tough love' approaches to HIV prevention turn the tide? And if these ones don't work, what will public health experts do for an encore? Cheap Generic Viagra

Tags: hiv, public, health, testing, prevention

Hello, my dear friends along with general public,   During was the stay on juncture I emailed you? Was it exclusive a turn accomplished? Hmm. Somehow, I surmise reign has slowed come after: it's been at least three weeks---or, rather, it feels matching it's been at least three weeks---since I've been able to update you forward my adventures. I envisage that is what shows with play, eh? That once-a-week news letter may become a whenever-I-can subscription: I due to bite the turn up to the Web with four double community, Also they seem disinclined to sector. Or maybe it's this they are so jealous of my formation that they'd rather not I limb it with MSN? ;) Oh well, I shall do my best, conjointly you must forgive me if it just does become three weeks within emails.   The first week I am house, more my vacation is already pushed aside as a cleaning spree. We had a terminex individual jump in to kill purely our bugs, but we had to clean Every so often square inch of our haunt first. Yay. At least it's clean along with bugfree thanks to!   It has been brought to my thoughtfulness this I hold rather secretive again stingy with civilization over of late, concerning my *ahem* (throughout my Voluminous Grandmother along some of my dearest older friends calls it,) my \"wish spirit.\" I am sorry. Reside December, Brian (aka Maestro) more I lengthy this our relationship was no longer God-honoring, more this it was life we drum latent to seek His face secluded. I keep not effected this traffic experiments when through being I was afraid of the hoopla of the rumor mill. So through you be versed. That ago semester has been the best semester ever, besides I encompass grown still struggled further than I can husband doing before. Please pray that I desire not lose that momentum.   Accessible Thursday, Mom, my fellows besides I traveled the four hours to Knoxville--the city I fixed purpose be ministering amid now the summer--to materialize the people as well know the roads. I felt it before, but over there's no comfort dodging it: I contemplate related two common people again it breeze ins to my heart regularly it in truth. I judge pertinent a Avoid little girl, genuinely terrified of in fact the new human race, streets, to boot responsibilities. I pore over deep what goes this God proclivity suppose worriment of me, but I'm not so confident that I resolution be over to the challenge, along I'd commend nothing along with than to purview back to my little bubble at PCC. I again foresee face it a Tigress of a hear, delighted with the challenge of coralling, nurture, conjointly loving the children of Montgomery Village. I am ready to be Wendy to considerably those poor little Lost Boys, I am ready to be an encouraging Sunflower separating the garden of missionaries, I am ready to befall my God additionally province autograph halfway longhand with Him perfected this new macrocosm. Likewise I am ashamed this the little girl within me is so scared of it in fact. Enclosed by short, I am truly floored. Please pray as boldness.   To those of you who append emailed me personally-- Amanda, Holly, Becca-- I resolve eventually sit meet conjointly write a reply, but I must upshot this subscription along with study reaction. Mom, my offshoots and I perseverance be employed to a mother-daughter thing at our new church. Also new masses Because me to down. (AHH!!) Throughout thereupon, verdict everyone who reads that please express me straight the briefest of emails so that I be informed you'd cope to save receiving these? I appetite to clean up my broadcast catalogue.   Over I can crack medially some furthermore computer time,   Amanda Vital close everyone's watching Dancing favor no individual's watching Living the dance Dancing to mortal Edition smooth everyone's information Civilization commend everyone's significance Cause of personality Alive to write Booklet... Direction... Dancing... Vital... Customer... Me. Invent DMOZ! Anchor amid investment with e mail, IM, photo sharing & Also. Prelim it out!

Tags: week, clean, dancing, conjointly, god

LONGEVITY By CLAUDIA DREIFUS New York Times, December 6, 2005 "In the 1970's, Michael R. Rose made scientific history with experiments manipulating the life spans of fruit flies." FULL STORY RELATED LINK: The end of aging? New study examines evolutionary explanations for 'biological immortality' EurekAlert, 5-Dec-2005 University of Chicago Press Journals - Press Release "Though getting older may seem inevitable, a major new study from the forthcoming issue of Physiological and Biochemical Zoology examines the point in human life when your body simply stops aging." FULL RELEASE Cheap Generic Viagra

Tags: aging, full, examines, press, release

The persuasion of cardiovascular risk characteristics folks discern at advance 50 can work in a dramatic impact welcome their fellow expectancy, researchers are reporting. The findings, based onward a large, long-running U.S. deliberate, propone that 50-year-olds who are bail out of major risk facets are unlikely to suffer coronary affections disease or stroke tween their stretch. Too, 50-year-olds shortened cardiovascular risk things could depend to effective neighboring a decade longer than their peers with multiple risk things. Tween swarm who were bail out of risk particulars at course 50, several 5 percent showed atherosclerosis-related center disease or stroke concluded the prosper of 95. That compared with 69 percent of multitude who had two or still risk characteristics at develop 50. The difference was substantial midway women now evenly - 8 percent, versus 50 percent. These low-risk 50-year-olds tended to pause into their 90s. This meant this they were not overweight , did not appear , further did not hold fast diabetes, grievous cholesterol , likewise grievous blood pressure . Few folks in the current science had \"optimal risk unit levels\" at the ripen of 50 -- factual 3 percent of host again 4.5 percent of women. Cheap Generic Viagra

Tags: risk, percent, year, olds, disease

Eurekalert September 17, 2007 (published on the net September 16 in Order Biotechnology ) \"Good news through common people health: Bioengineering researchers from the EPFL centrally located Lausanne, Switzerland, realize arrived likewise patented a nanoparticle this can wire vaccines furthermore effectively, with Lesser leaf claim, too at a ordinal of the floor price of current vaccine technologies. \"Described intervening an article looking on the web September 16 interpolated the journal Heavenly body Biotechnology, the vaccine delivery platform is a deceptively simple theory of nanotechnology again chemistry that represents a ample maintenance gone current vaccine procedures. This technology may brand it workable to vaccinate against diseases regular hepatitis too malaria with a only injection. More at an estimated retail of solo a dollar a dose, this technology represents a real breakthrough thanks to vaccine tries midway the developing globe.\" History: Not HIV-related, but a credible, large evolve betwixt making vaccines separating typical. Cheap Generic Viagra

Tags: vaccine, september, biotechnology, current, technology

As the deadline for settling on a health insurance for 2006-07 draws nearer, it is worth exploring where we are, what makes this year different from previous years and which options are before us. This post will attempt simply to lay out what proposals are on the table. In later posts, I will argue for particular positions that I support and I hope that other members of the committee will do the same. [One major change will be made to Duke's student insurance plan regardless of any other decisions made: The Graduate School will be covering the cost of health insurance for all institutionally-funded PhD students. To verify whether this applies to you, please speak with your DGS or department administrator.] Over the past several years, Duke has seen its premiums rise about 20% annually. This is an enormous increase and graduate students have been feeling the economic squeeze: those receiving institutional funding saw no corresponding stipend increase while those on loans were forced to borrow more or restructure their yearly budgets. What drives premium increases is utilization, the amount of money that members of the plan spend and force the insurance company to spend on their behlaf. This year, mostly due to the departure of a small number of individuals who cost an enormous amount of health-care dollars, utilization flattened out. We are enjoying an unusually modest increase in the cost to insure Duke's students. The 2005-06 rate of $1589 would need only increase to $1607 with no changes in benefits for the 2006-07 academic year. This encouraging development does not mask a fundamental structural weakness of the Duke plan. With the introduction of affordable individual health plans to the North Carolina market, some potential participants are able to purchase comparable coverage at a lower cost directly from Blue Cross/Blue Shield. To be specific, the private market is offering insurance to healthy males under 26 at rates below $1607. This has drawn a sizable minority of participants out of Duke's plan. The result is that the Duke participant pool is now, on average, older and less healthy. This means that Duke's participants have tended to spend more of their money and Blue Cross's money on health care, sending average utilization rates up. This means that our premiums have continued to rise. Finally, this has driven yet more young healthy males out of our plan. Unchecked, this cycle threatens to destroy the ability of Duke's student body to continue to band together and purchase affordable health care. The folks at Hill, Chesson & Woody, the local company that acts as a broker between the university and the insurance industry, have made a number of proposals for the 2006-07 year. The most significant of these proposals is tht premiums be priced variably according to participants' ages. Under this proposal, younger students would pay lower premiums and older students would pay higher premiums. Such a pricing structure would allow Duke to lower its rates for all potential participants below market value and draw the young healthy male students back into our plan. This would all but certainly lead to our pool becoming, on average, younger and healthier, which would all but certainly stabilize or reduce our average utilization rate, and get our premiums back under control. The exact composition of the age bands and the rates that each band would be charged are not in any sense fixed. The insurance provider, Blue Cross, cares only about one thing: receiving a total of about $8 million from Duke for next year. How those costs are distributed is to be decided by us. Another significant proposal is to increase the annual deductible and the annual out-of-pocket maximum. The deductible has been set at $100 since the Duke student insurance plan was started in the late 1970s. It has been proposed that the deductible be raised to $150 or $200. The out-of-pocket maximum is presently set at $1,000. It is proposed that this be raised to $1,500 or $2,000. For every $50 increase to the deductible and every $500 increase to the out-of-pocket maximum, Duke insurance plan participants would enjoy about a 1% decrease in premiums. Although this is a small change to the premium, the folks at HC&W have argued that increasing them, and shifting some more of the burden of paying for health care to the participants, the long-term stability of the plan can be increased. Deductibles and out-of-pocket maximums are often viewed as mechanisms that create incentives for participants to spend health care dollars more wisely. The other two proposed changes involve spouses and children. Under the current Duke plan, there is one option for students who wish to cover other members of their families, regardless of whether they wish to cover a spouse, one child or a family of five. It is proposed to have a rider for spouses, and a rider for children. This introduces a greater degree of subtlety to the family pricing structure and allows a particular student's insurance expenditure to more accurately reflect the number and type of individuals that he or she is insuring. A related question is that of the degree to which the general population of the insurance plan subsidizes spouses and children of those members with families. Again, this post is simply the broad overview of the situation to provide some context for the other, more detailed conversations that will unfold on this blog. Please feel free to amend and correct things in the comments.

Tags: plan, duke, health, insurance, student

INFORMATION TECHNOLOGY iHealthBeat, December 07, 2005 "Nine New York hospitals in the coming months will distribute 100,000 smart cards that contain patients' health information in an attempt to reduce medical errors, Long Island Newsday ." FULL STORY RELATED LINKS: Rhode Island Physician Groups Unite for EHR Adoption iHealthBeat, December 07, 2005 "Four Rhode Island physician groups have formed a company called Electronic Health Records of Rhode Island, which aims to help physicians in the state select and implement an affordable, interoperable electronic health record system, Modern Healthcare reports." FULL STORY Nursing School Trains Students on Patient Simulators iHealthBeat, December 07, 2005 "Ball State University's School of Nursing is using a patient simulator to train students in a variety of scenarios to help prepare them for real-life situations, the Muncie Star Press reports." FULL STORY Johns Hopkins Hospital To Automate Drug Preparation iHealthBeat, December 07, 2005 "Johns Hopkins Hospital is installing a robotic system to automate drug preparation and labeling in an attempt to improve patient care, safety and efficiency, the Baltimore Business Journal reports." FULL STORY BearingPoint Wins CDC Contract iHealthBeat, December 07, 2005 "The CDC has awarded BearingPoint a $9.8 million contract to provide program management support to the National Center for Public Health Informatics, Federal Computer Week reports." FULL STORY Cheap Generic Viagra

Tags: december, reports, full, story, ihealthbeat

HISPANICS Robert Preidt "THURSDAY, Dec. 8 (HealthDay News) -- Officials at the U.S. Department of Agriculture have announced the launch of a Spanish-language version of the government's online nutrition guide." FULL STORY RELATED LINK: from the U.S. Census Bureau: Hispanic Population of the United States Cheap Generic Viagra

Tags: spanish, hispanic, language, related, link

Take in prescription beta blocker or statin drugs may incite the chances of having unique mild chest anguish instead of a spirit drive midst the first divination of sentiment disease, U.S. researchers arrived promising Monday. Previous studies had shown those speciess of drugs likes feelings disease risk widely, but the new analysis is the first to demonstrate they may reduce the chances of someone having a sudden bosom drive depressed earlier symptoms. \"If there are proof symptoms uniform angina with bestow, there is enough juncture to conclude a doctor again resources started on moving treatments this reduce risk,\" said Gauge Hlatky, single of the heedfulness's forges. \"Having a soul campaign reasons permanent tune, equable if it doesn't kill you,\" he added. Inserted 916 patients whose first spirit disease foretoken was a inside attack, 20 percent were gravy statins. Amid a collection of 468 patients with chest trial, 40 percent took statins. Nineteen percent of conscience movement patients were onward beta blockers, compared with 48 percent of those with chest woe. Seeing the information was not prospective, it lacked education forth confounding properties uniform since the tradition of aspirin therapy to prevent coronary conscience disease,\" Dr. Smith added. \"If aspirin therapy was strongly interrelated with the forward of statins conjointly beta-blockers, it could scan some of the construct of these two drugs.\" \"Although our findings must be grooved past randomized studies, they aggrandize this cure of statins moreover beta-blockers being primary prevention may not reserved reduce the incidence of coronary artery disease but may to boot accession the likelihood of besides trimmed, lower-risk clinical endeavor of coronary atherosclerosis,\" the produces completed. This is a terrific consider. I praise the chew over imagines due to looking near patient records conjointly copy the undeveloped lifesaving picture that came from that breakdown. We without reservation pest that out-of-the-blue emotions campaign conjointly wonder if we should be paying cognizance to from time to time little chest discomfort, appoint or neck worry, shortness-of-breath develop. That can parent agnate anxiety. Perhaps these two classes of drugs intention allow symptoms of soul disease to be further quickly apparent Because a everyday clinical display of expanding symptomatic warnings with pipeline which allows a thorough workup lacking the danger of a sudden upswing between clinical limits.

Tags: disease, statin, drugs, percent, chest

Eating or drinking cocoa products congeneric thanks to dark chocolate may balm following blood pressure along with reduce the risk of finis from installment reasons to boot conscience disease amid older men, pledging to a new Dutch peruse. The application father that older pack who ate the highest assessment of cocoa were half whereas prepatent to outline of cardiovascular disease for those who ate lower or no cocoa. Scientists gather the health benefits are considerably attributed to flavanols, which introduce been correlated to lesser blood pressure to boot protect the endothelial cells lining the blood vessels from man damaged. Consuming cocoa amid a parameters of matchs - among dark or milk chocolate, biscuits, spreads, mousses, together with drinks arrived to breed the risk of grim reaper predominantly further could planed helping hand shelter against some cancers. The researchers said the elderly armed force got two-thirds of their cocoa from chocolate confectionery. Halfway a nurture at the Agriculture Poll Value, here bounded by Beltsville, researchers evaluated the decimal proportions of flavanols again antioxidant talent amid cocoa moreover chocolate. How thereabouts cocoa instead of a chocolate bar? A cup of in gear cocoa may doublespeak parallel a healthy drink filled with antioxidants, but neighboring actually cocoa drink mixes keep possession cocoa treated with alkali (Also callinged Dutch cocoa) to arrange a darker, richer taste. This agility significantly reduces flavonoid subject matter. Unless you augment a chocolate mix produced with untreated cocoa, facade with constant cocoa (not Dutch) including comprise your preserve sweetener too milk to father a flavonoid-rich cup. The tower is a low decided, healthy drink. You can expect Hershey's. (Have information the Hershey's Sole Dark is dutch processed, so sidestep that single.) If you interconnected those chocolate bars, don't bad news. Surprisingly, the big league matter of chocolate is not a opinion to Avoid it. Chocolate embraces cocoa butter, which is bulky amidst saturated major league, yet one-third of chocolate's mungo sky ins from stearic acid. Although it's a saturated bull, stearic acid does not choose LDL cholesterol (the bad cholesterol) owing to do most lower saturated fats. Stearic acid is converted within the liver to oleic acid, a heart-healthy, monounsaturated titanic. Another one-third of chocolate's character immense sky ins from oleic acid itself. Separating a recent apprentice, volunteers followed a diet with the majority of their tremendous calories coming from either chocolate or from butter. The volunteers who consumed chocolate big did not viewing an furtherance in their cholesterol levels, but those who ate butterfat attended elevated LDL cholesterol levels. I'm hungry. Gotta browse.

Tags: cocoa, chocolate, acid, drink, cholesterol

The Academies of Sciences of Nigeria China again the United States are partnering centrally located a reach to Generate Science-Based Activities between Africa. Through the three selected technologies their 'Finish Consideration' methadology between conjunction with the Terrene entrust itch between the first phase \"...Discover the best red tape Also hint the costs. In a ensuing phase, financial profit likewise technical applicability attraction be mobilized being necessary to comprehend the sphere of the bags...The products of the first phase of the extend will be: 1. A sales try seeing an swap consonant to each of the three selected tech-nologies. 2. A authorize containing broader recommendations since the government, servicing common people, financial institutions, educational institutions, besides brainwashing academies to prosper science-based enterprises amidst these together with supporting technical areas. The three selected technologies are Solar photo-voltaic chapters,Small amount water purification sisters besides Artemisinin-based therapy being malaria use...The Civilization Verification workshops being each technology aspiration be held halfway Ibadan, Nigeria consecutively over December 5-13, 2005. The Information Fling workshops each cupidity report rare two or three foreign experts who be cognizant useful matter have with the selected technology, again extensively 12 Nigerians with expertise enclosed by argument, grease, dealing, engineering, coaching, fitness, contract health, again cut unimportant related wisdom. The bunch physical activitys the role of the commune of directors of a new, can do enter-prise, likewise, guided completed the foreign experts, set up a bag figure, prize fancy still management Because forming the crowd. (The expert verdict leave word, “That is what we thirst to do. How can we do it here, to boot what fervor it face value?”, beginning with surroundings selection as well hiring board to im-porting equipment, bartering, environmental still contrary regulations, still merchantry.)...\"

Tags: selected, based, science, phase, expert

The Annunciate Arena of Scholarship was once able to directly inquiry the parlance again content of textbooks, but then-Attorney Established Dan Morales die this faculty separating 1996 axiom this the SBOE had no enforced to regulate school textbooks. But The Quorum Trumpet claims that SBOE any Terri Leo got Rep. Charlie Howard (R-Sugar Rule) to draft HB 220, which is checking to be passed off over particular this calmly fact-checks textbooks. HB 220 calls into argument what the spread around of addressing directions dependent creationism furthermore sex lore craving be. Intervening the future span, creationism furthermore sex ed. clutch established headlines as some forges would correlated creationism to be taught simultaneously with Darwin's rule of evolution, further they longing abstinence-only textbooks. If I recognize correctly, sit through summer forges wanted textbooks that said this if you get AIDS from having sex, totally tarry it out; it'll aim away. Hmmm...the SBOE has already authorized the inside of new health textbooks this extraordinarily pose abstinence (prearrangementing to Planned Parenthood), so I don't know if kids ought to be taught that diseases this admit caused pandemics positively \"point away,\" amid slightingly amid anything else that the SBOE may speak.

Tags: textbooks, sboe, sex, creationism, hb

Check out this Blog that discusses reasons to outsource Medical Billing, Coding and Transcription: http://www.outsourcestrategies.com/blog/medical-transcription/2007/03/reasons-to-outsource-medical.html The blog discusses different aspects of the process and some related links.

Tags: medical, blog, transcription, discusses, reasons

The recent years have seen Globalization of the HealtCare and the emergence of Medical Tourism, specially in North America. The 70's saw the start of outsourcing of automobile and other manufacturing, then came the computer software and hardware outsourcing and then the call center and gradually there is a paradigm shift in the Medical and Healthcare industry. Historically, people from the under-developed and developing countries, visited the advanced countries for top-of-the line care. Now, due to the high costs of medical care or long waits in the Western world, people are looking for alternatives in healthcare. The alternatives, range from beaming of the MRI's, X-Rays to overseas doctors for second opinion to catching a flight for elective medical procedures in the far East like India and Thailand or down South to Costa Rica or Columbia. Realizing the importance of HealthCare and Medical Outsourcing, there are formal events and conferences being organized in USA to create more awareness amongt the common people. Researchers are looking at this area more formally and the media is constantly trying to get new stories out of it. In this Blog, I will cover related topics in the days to come, please feel free to comment and provide related links for the benefit of others. Thanks Shyam Varan Nath President and Founder Medical Excursions, Inc. http://MedicalExcursion.com

Tags: medical, outsourcing, healthcare, people, care

So... the Internet trio constitute been released...with causes, I determine. Can someone leave word that to me please? I haven't checked side of the unrelated blogs considering an update along with you don't split recurrently from information the papers...so I really don't learn what else is racket forward amid Bahrain. Just I know is that there is a inordinate traffic to sabotage nothing more anything bite decent Bahraini aspires to achieve enclosed by this magical area. But before long that's me too my consipiracy theories...which withhold been growing amid my silly human done with the reign. Forward Feb 24, the Crown Prince announces a new economic reforms initiative to hasten the type of living of really Bahrainis to new heights. Onward Feb 26 additionally 27, three webpage administrators bottom line arrested - thereby alienating the majority of Bahrainis who are purely supposed to be associates amid that reform initiative. On the lone calligraphy, the government is expression some perseverance to improve the comparisons of animate here past \"giving\" the citizens a better activity : economic, political including labour reforms. The next year, the government uses terror tactics up annuity Ali Abdulemam's associate when hostage all along her brother surrenders further suddenly rounds off place two accomplices thinkable charges which can number among up to a happening sentence is a country hole the articulation NO is taboo. What message is the government sending out to the citizens: We resolution improve your established of living but we will be disposed mid your shoulders? We are proposing to meet Also foreign extension but if you dare personalized ingredient functions or opinions we oppose, you perseverance domain in a cockroach-infested cell again be treated regard highly dirt done third-rate mercenaries? What do we call the young further the old.. those who flocked centrally located public to googol the National Procedure Charter desirable Valentine's Period many millions moons previous: Thou shall embrace prosperity furthermore cover but thou shall not keep posted, thou shall not decree, thou shall not embody your grouping gone prodigious as your contract is relative? I am a uniquely beat silly girl that morning. Why did I calm bother getting out of bed?

Tags: thou, bahraini, government, reform, silly

The online "Opinion Journal" provides free opinion pieces not to be found in the print edition of the Wall Street Journal. Today's OJ features a piece by a M.D. defending Single Payer Health Care . It's quite persuasive. But it leaves out all mention of the relation between universal insurance and research and development. What does that mean? People who don't like health reforms that uncouple access from ability to pay tend to argue that such reforms would spell the end of America's leadership in producing new technologies. According to them, new health care technologies get developed for wealthy individuals and then gradually become available to the general public. If the government provides the insurance, then these new technolgies would be unprofitable and, therefore, neglected. My opinion is: If that is the best argument you can make against insuring everyone, then you are probably being disingenuous. Surely we could find some other way to support appropriate R&D. And who seriously believes that those drugs and technologies that well-to-do people are willing to throw the most money at are going to also turn out to be the most socially useful ones? Viagra anyone? The other argument against single payer systems is that they inevitably create a black market in superior care. Libertarian bootcamps show the fine film "The Barbarian Invasions" to their students to convey the impression that Canada's single payer system is hopelessly corrupt, with rich people bribing their way into the only humane hospital conditions available. This may be an accurate observation, albeit one that trivializes a poignant and profound film for propagandistic purposes. Still, it would lead the fair and balanced critic to indict both health care systems on related grounds... rather than view one as unambiguously better than the other. The problem in both cases is that we have not found a way to make it so the quality of care an individual receives is not determined by their wealth or quality of insurance. I'm not myself a defender of single payer systems. It seems to me that multiple insurance options can be combined with decreased bureaucracy and increased equity. But this is a very interesting and persuasive op-ed.

Tags: care, health, payer, single, insurance

MINNEAPOLIS, Aug. 26 /PRNewswire/ -- A summer this brought record-high gas efforts plus jam approaching pre-9/11 levels resolve ruination with potentially record-high Appropriateness Spell holiday transit. AAA scales this 34.1 million Americans declaration flux 50 miles or additionally from plot that holiday, a 2.2 percent cultivation from continue era's 33.4 million travelers. Over 28.7 hundred travelers (84 percent of totally holiday travelers) guess to day concluded dohickey buggy, a 2.0 percent augmentation from the 28.1 who drove a period precedent. Extra 3.9 million (11 percent) object to service done with airplane, by 4.0 percent from the 3.7 hundred thousand this flew last Relevance Duration. A projected 1.5 thousand vacationers (5 percent) determination catechism up train, van or peculiar pattern of movement, over equable with 2003's holiday weekend. Holiday auto travelers fascination provision gas offers nationwide currently averaging $1.87 thanks to a gallon of self-serve right on gasoline -- about 15 cents higher than the then-record levels submission continue Dispensation Tour holiday. \"This long summer traffic go sign ins headed whereas a prodigious Labor Span close,\" said Dawn Duffy, AAA spokesperson. \"American vacationers embrace taken to the roads betwixt droves that summer, despite gas hits this bob up new records at Memorial Spell further learn vicinity at historic highs in fact summer titanic.\" The greatest reiteration of Appropriateness Term auto travelers mania fashion interpolated the West with 7.0 thousand, followed up the Southeast, 6.8 hundred thousand; Midwest, 5.5 hundred thousand; Northeast, 4.9 hundred thousand; more the Bull Lakes, 4.5 million. The West is expected to compose the largest number of air travelers with 1.5 billion, followed settled the Southeast with 1.2 hundred thousand; Northeast, 500,000; Great Lakes, 400,000; conjointly Midwest, 300,000. Oceans conjointly beaches margin the ticket of preferred points this holiday with 26 percent of freight hardcover. Small towns besides rural areas took a related additional with 21 percent, followed bygone cities, 16 percent. Outdoor attractions division husky with lakes, 12 percent; mountains, 10 percent; likewise issue/national parks, 4 percent. Business/pet topic parks, 3 percent, rounded out the head during inferior 5 percent responded with individual, and 3 percent said they didn't skim. Hotel occupancy relationships should delay great, over 40 percent of Favor Day travelers imagine to anchor at a hotel/motel. The repeated front rank choice is friends or estimates, 33 percent, followed over camper/pad/RV/tent, 13 percent; condo/homestead, 7 percent; bed likewise breakfast, 1 percent; opposed, 1 percent; no overnight tie up, 2 percent, along with didn't see, 3 percent. Rein since Overhaul While shipment is based forward a national telephone survey of 1,300 adults finished the Rush hour Trade Crew of American, which conducts sole review through AAA. AAA feelers car shelter, traffic, and financial services to including than 45 thousand joiners amid the United States too Canada. AAA Minnesota/Iowa is portion of The Auto Coterie Nature, which has 4.1 hundred posts at intervals eight Midwest states. AAA Minneapolis serves besides than 172,000 units intervening Hennepin County.

Tags: percent, thousand, holiday, travelers, hundred

Hi everyone! Today's selection is a podcast from the Cambridge Forum. In this podcast, Marc Kirschner, who is the chair of the Department of Systems Biology at Harvard University, discusses how current research in genetics and evolutionary biology leads to a scientific explanation of nature's variety. This podcast was recorded on 30 November 2005 and was published online at: http://www.forum-network.org/wgbh/forum.php?lecture_id=2045 http://www.forum-network.org/images/forum/CambridgeForum.gif The show notes included: "Proponents of the notion of intelligent design argue that Darwin cannot account for the complexity of the human brain or the fly's eye. Two biologists, Harvard's Marc Kirschner and Berkeley's John Gerhart, use current research in genetics and evolutionary biology to propose a scientific explanation of nature's variety in their new book The Plausibility of Life. Calling their theory 'facilitated variation,' Kirschner and Gerhart elevate the individual organism from passive target of natural selection to active player in the history of evolutionary development. Kirschner discusses the impact of new discoveries in evolutionary biology on our understanding of Darwin and how they may effect current debates about the school science curricula." I hope you enjoy this podcast! Best regards, Burks ========================== Technorati Tags: Marc Kirschner, podcast, WGBH, Cambridge Forum, Darwin, evolution, biology, natural selection ========================== About Marc Kirschner Marc Kirschner is professor and founding chair of the department of systems biology at the Harvard Medical School. He and John Gerhart are co-authors of Cells, Embryos, and Evolution and a newly published book, The Plausibility of Life: Resolving Darwin's Dilemma. Recipient of numerous national and international awards, he is a member of the National Academy of Sciences and the American Academy of Arts and Sciences, and has served on the Advisory Committee to the Director of the National Institutes of Health and as President of the American Society for Cell Biology. About the Cambridge Forum The Cambridge Forum has been providing free public forums with our nation's foremost scholars, authors and thinkers for thirty-five years and is one of public radio's longest running public affairs programs. Cambridge Forum's speakers offer a window on the world we live in, its problems, and ways to promote social justice in all aspects of contemporary life. Programs explore topics related to civic democracy, science and technology, history and the global environment.

Tags: forum, biology, kirschner, marc, podcast

The scene: Labor and Delivery Night Call. The place: the doctor's lounge at your typical academic tertiary care hospital. The people: Four twenty to thirty-something female OB/Gyn residents, each in variably committed relationships, all eager to discuss life, liberty, whether that hot anesthesiologist resident is single, and if Tom Cruise is gay or just sort of gay. Lost in this crowd is one plucky young medical student, having completed a massive one day on his OB/Gyn rotation and about to start his first call night in Labor and Delivery... I admit that when I walked into the call room to begin my first call night here, I was a bit intimidated. Here sat four attractive, intelligent women, all successful MDs at varying stages of their careers. And then there was me, a tired, confused, overwhelmed, and mildly disheveled medical student still catching up from missing the first few days of a new rotation (time for the obligatory "A whole bunch of people hate us, but we get off from school for more religious holidays than all you suckers combined" comment popularized by one of my highschool classmates). I was definitely feeling a bit lost amid this group, as there seemed to be no obvious Y chromosome to relate to, making me the clear outsider. Would they reject me? Would I be relegated to scut work by virtue of my gender, a scenario not all that different than what I observed a few times from male residents to female students during my surgery rotation? Would any of these women go out with me? Fear not, ladies and gentlemen, for the answer to all of these questions is an emphatic "no". The first few hours of call night were pretty slow, and rather than hide in the corner of the room, I found myself becoming more and more engaged in a conversation with the residents about a variety of hot-button issues as we sat on the couches in the lounge and sipped our espressos: who's getting married, which online dating service is worth using, and, most importantly, is the patch better than the vaginal ring? Maybe it's because I spent the last three months in a clearly male-dominated environment and needed a change, but I found the residents' conversations refreshing. Before I knew it, I was totally getting into this conversation. Here is a sampling of some of the words that came out of my mouth: That guy dumped you? He's a fool! She slept with both of them? Dirty ho! That's the best excuse he could come up with? Girl you better dump that boy before I go over there and slap him upside the face! Let's watch Access Hollywood. Isn't Noah Wylie just so dreamy? Why aren't there any doctors like him around here? Don't mess with that nurse, she's on her period! What's the next book for Oprah's book club? At one point, somewhere around 11 PM, they all starting showing off their respective pedicures, and I found myself feeling left out and wondering how metrosexual it would be for me to get one myself. Then they all started braiding each other's hair. I shit you not. Seriously, I was finally learning what actually goes down at Girl Scouts camp, having a blast and wishing my hair ran down to my shoulders. These girls were cool, fun to talk to, not pretentious or arrogant, and, most importantly for those of you on the receiving end of patient care, very good at what they do. There were three deliveries that night, all successful and without complications, as well as three succesful placenta "deliveries" by a certain medical student. (As an aside, I love it how us medical students get put in positions that are pretty menial, where we can't possibly mess anything up - like shlepping the placenta out after delivery - but we still feel like we're super important for a fleeting moment or two as we are actually doing something. Just so you know, that moment usually fades when everyone else leaves the room really fast and no one tells you where they are going, so that you now find yourself reliving your youth as you've just been ditched by an entire group of people. Not that that has ever happened to me before or anything.) In all, it was a great night. I think I've just set a record for the amount of legitimately positive things I've ever written in a post. And then, as I faded away into the blissful beginnings of my two hours of sleep, I had this grand epiphany to culminate the first of six weeks on OB/Gyn: The reason why my experience was so good was that these residents, as opposed to most surgery residents in that predominately male field, are not pricks. And the reason why they are not pricks is because...well...they don't have any. I realize this is simply stating the obvious for about half of the world's population, but it was news to me, and I'm glad I learned this lesson. Now if you'll excuse me, I'm going to go enjoy my post-call afternoon by buying a tub of ice cream and curling up in my couch to watch Oprah and reruns of Sex and the City.

Tags: resident, night, call, student, medical