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Half (49 per cent) of people with Type 2 diabetes (excluding those treated with insulin) experienced at least one hypo an episode of low blood glucose that can result in symptoms ranging from sweating to a loss of consciousness during a fortnight period, according to a new survey by Diabetes UK.

Sponsored by BristolMyers Squibb (BMS) and AstraZeneca (AZ), the survey questioned 1,954 people with Type 2 diabetes in the UK and provides insight into the prevalence and impact of mild to moderate hypos.

Time off work

Over half (52 per cent) of those surveyed believe mild to moderate hypos affect their quality of life and one in ten reported having to take at least one day off work in the last year as a result of a mild to moderate hypo.

Everyday impact

“Previous research around hypoglycaemia has tended to focus on the impact of severe hypoglycaemia,” said Simon ONeill, Diabetes UKs Director of Care, Information and Advocacy.

“This survey, however, reveals the everyday impact of mild and moderate hypos among people with Type 2 diabetes.

Hypos despite not taking insulin

“Importantly, this survey has also shown us that even people who are not taking insulin are having regular hypos. These people need to be reassessed by their GP to ensure they are taking the appropriate medication.

No structured patient education received

“Almost 90 per cent of people with diabetes in the UK have never received structured diabetes education, which is key to improved selfmanagement and a reduced risk of hypoglycaemia. Its therefore vital that we make this area a priority for improvement. We want to see hypos become the exception rather than the rule.”

Daytoday tasks affected

The survey also revealed that more than one third reported that mild to moderate hypos affect their ability to carry out daytoday tasks, including housework (35 per cent), social activities (37 per cent), sports activities (35 per cent) and sleep (35 per cent). Nearly half of those questioned said they worry about having a mild to moderate hypo (47 per cent) and that their emotional wellbeing is affected (47 per cent).

Hypos and Type 2 diabetes

Type 2 diabetes is treated with a healthy balanced diet and regular physical activity, but medication is often also required. Hypos only occur in people with Type 2 diabetes who have to take certain medications.

Treating a hypo

Treating a hypo is usually simple and requires taking some fastacting carbohydrate, such as a sugary drink or some glucose tablets, and following this up with some longeracting carbohydrate, such as a cereal bar or sandwich.

“Nagging fear”

Tim Page, 53, from Wadhurst, East Sussex, was diagnosed with Type 2 diabetes in November 2003.

He said “I experience hypos fairly regularly, most of which are mild but nonetheless have a huge effect on my life.

“Even the mildest of hypos can leave me feeling weak and disorientated, very tired in fact, exhausted.

Keeping with its mission of offering a comprehensive array of services to patients, The Cancer Institute of New Jersey (CINJ) has expanded its Urologic Oncology Program, which has gained formal recognition as a Section of Urologic Oncology under the Department of Surgery at UMDNJRobert Wood Johnson Medical School. The program provides highly specialized care for patients with tumors of the genitourinary tract including cancers of the prostate, testis, kidney, and bladder. CINJ is a Center of Excellence of UMDNJRobert Wood Johnson Medical School.

CINJs Section of Urologic Oncology is a leader in laparoscopic renal procedures and has extensive experience with robotic prostatectomy, which boasts such patient benefits as shorter hospital stays, lower blood loss, and faster recovery. Leading this effort is Isaac Yi Kim, MD, PhD, associate professor of surgery at UMDNJRobert Wood Johnson Medical School, who is an expert in the area of robotic prostatectomy and developed the Athermal Intrafascial Robotic or AIR prostatectomy. The AIR procedure spares more nerves than the traditional method and leads to faster recovery of sexual function and bladder control. CINJ has developed a Center of Excellence for robotic surgery and Kim and colleagues have performed more than 550 robotic prostatectomies over the last four years alone.

In addition to its extensive prostate cancer focus, the Section of Urologic Oncology is also building on its excellence in bladder and kidney cancers, having just recruited a pair of urologic oncologists with special expertise in these areas. Michael E. Karellas, MD, is a urologic oncologist at CINJ and an assistant professor of surgery at UMDNJRobert Wood Johnson Medical School. Dr. Karellas, who recently completed fellowship training at Memorial SloanKettering Cancer Center (MSKCC), has a clinical interest in the treatment of bladder cancer. Thomas L. Jang, MD, MPH, is a urologic oncologist at CINJ and an assistant professor of surgery at UMDNJRobert Wood Johnson Medical School, who specializes in kidney cancer. Dr. Jang, who also just completed fellowship training at MSKCC, will be responsible for building the programs new prostate cancer database, which will link histological and clinical data from prostate cancer tumors in an effort to further facilitate translational research.

The Section of Urologic Oncology and the Dean and Betty Gallo Prostate Cancer Center offer a wide breadth of clinical trials for patients with tumors of the genitourinary tract as well as several trials studying the prevention of prostate cancer. In addition, the Dean and Betty Gallo Prostate Cancer Center provides a hub for basic and clinical research specific to prostate cancer and serves as a forum for prostate cancer outreach and education activities.

“I am thrilled to welcome Drs. Karellas and Jang to New Jerseys only National Cancer Institutedesignated Comprehensive Cancer Center,” said Dr. Kim. “Their experience complements an already strong team with varied and unique expertise and will help us grow the program even more.”

Additional information about CINJs Urologic Oncology Program can be found at cinj.org/treatment/urologic.html.

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A Michigan man accused of fatally shooting an antiabortionrights protester outside a high school last month has been deemed incompetent to stand trial and committed to the Michigan Department of Mental Health, the New York Times reports.

Harlan Drake is charged with fatally shooting James Pouillion on Sept. 11 in what is believed to be the first slaying of someone protesting abortion rights. On Wednesday, Judge Terrance Dignan of the 66th District Court in Corunna, Mich., ordered Drake to begin psychiatric treatment. If rendered competent, a preliminary examination would be set to determine whether he could stand trial. Dignan wrote that “there is a substantial probability” that Drake, if provided a course of treatment, will be competent to stand trial, according to chief assistant prosecutor Sara Edwards (Chapman, New York Times, 10/1).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

The brain is a complex system made of billions of neurons and thousands of connections that relate to every human feeling, including one of the strongest emotions, fear. Most neurological fear studies have been rooted in fearconditioning experiments. Now, University of Missouri researchers have started using computational models of the brain, making it easier to study the brains connections. Guoshi Li, an electrical and computer engineering doctoral student, has discovered new evidence on how the brain reacts to fear, including important findings that could help victims of posttraumatic stress disorder (PTSD).

“Computational models make it much easier to study the brain because they can effectively integrate different types of information related to a problem into a computational framework and analyze possible neural mechanisms from a systems perspective. We simulate activity and test a variety of “what if” scenarios without having to use human subjects in a rapid and inexpensive way,” Li said.

From previous experiments, scientists have found that fear can subside when overcome with fear extinction memory, but it is not permanently lost. Fear extinction is a process in which a conditioned response to a stimulant that produces fear gradually diminishes over time as subjects, such as rats in auditory fear experiments, learn to disassociate a response from a stimulus. One theory has concluded that fear extinction memory deletes fear memory, and another concluded that fear memory is not lost, but is inhibited by extinction memory as fear can recover with the passage of time after extinction.

“Fear extinction memory is not well understood, and our computational model can capture the neuron response well in rat during auditory fear conditioning with a mixture of mathematics and biophysical data,” said Li. “Our main contribution is that our model predicts that fear memory is only partially erased by extinction, and inhibition is necessary for a complete extinction, which is a reconciliation of the erasure and inhibition theories. Furthermore, our model shows that the inhibitory connection from interneurons to pyramidal cells serve as an important site for the storage of extinction memory.”

For PTSD victims, the fear circuit is disrupted and they cannot retrieve the fear extinction memory. However, the fear extinction memory exists, so the fear memory dominates every time victims get a fear cue. Li and his collaborators are targeting the inhibitory connection in the brain that makes it possible to retrieve the extinction memory. Li hopes that his research can contribute to new drugs that can help PTSD victims.

“Treatment for PTSD patients depends on which connection stores the fear extinction memory and which circuit misfires,” Li said. “With our model, we can figure out what specific connections store fear/extinction memory and how such connections are disrupted in the pathology of PTSD, which may lead to the suggestions of new drugs to treat the disease.”

Li, in collaboration with Satish Nair, professor of electrical and computer engineering who just received a threeyear National Institute of Health grant for further research in fear modeling, and Gregory Quirk, a neuroscientist in the University of Puerto Rico School of Medicine research, has been published in the Journal of Neurophysiology and Psychiatric Annals.

Source
Kelsey Jackson

Australian company, Acrux, announced positive results from a Phase III trial evaluating the safety and efficacy of AXIRON™ in 155 men with testosterone deficiency (hypogonadism), across 26 sites in six countries.

AXIRON™ is applied to the underarm using a unique “notouch” applicator. Upon approval, AXIRON™ would be the first and only pharmaceutical product applied to the armpit in much the same way as an antiperspirant. As well as existing patents that protect AXIRON™ to 2017, Acrux has a new patent that, when granted, will extend protection of this novel, classleading feature until 2026.

Phase III trial results

The trial met its primary endpoint by demonstrating that after four months of treatment with AXIRON™, 84 percent of subjects achieved average blood levels of testosterone within the normal range, exceeding the requirement of 75 percent that was agreed upon by the U.S. Food and Drug Administration (FDA).

After only two weeks of treatment, it was found that 76 percent of subjects had average blood levels of testosterone within the normal range.

The average testosterone level for the responder group after 120 days treatment with AXIRON™ was 504ng/dl (the normal range being 3001,050ng/dl). The average baseline testosterone level in subjects prior to treatment was 190ng/dl.

Four different dose levels of AXIRON™ were tested, and the trial demonstrated that the optimum dose for 75 percent of subjects was 60mg testosterone per day, equivalent to one single application of AXIRON™ to each armpit.

Subjects were permitted to use an underarm deodorant or antiperspirant during the trial. More than half of the men continued to apply an underarm deodorant or antiperspirant as part of their daily routine, and an analysis of these subgroups showed that this had no impact on the efficacy of AXIRON™ treatment.

Analysis of mood, sexual desire, sexual activity and sexual performance before and after four months of treatment showed significant improvement from baseline across all measures.

There were no serious adverse events related to treatment with AXIRON™ and no adverse trends were identified with the biochemical safety measures, including prostate specific antigen, haematocrit, and the ratio of dihydrotestosterone to testosterone.

Fiftytwo men continued treatment for an additional two months specifically to monitor skin safety with six months of continuous use. Eight subjects reported some form of transient application site reaction during the main treatment phase of four months; however, these reported events were all mild or moderate and resolved quickly without any intervention. No patient withdrew due to a skin reaction.

“In terms of the proportion of responders to testosterone replacement using AXIRON™, the pharmacokinetic parameters and the response from this multicenter clinical trial, the results are very exciting and precisely what we had hoped to see,” commented lead investigator Professor Christina Wang, MD, at Los Angeles Biomedical Research Institute and Professor of Medicine at David Geffen School of Medicine at UCLA. “The posttreatment changes demonstrated positive responses in sexual desire, sexual activity, mood and general wellbeing, underpinning the patient reported benefits of this treatment. Patient compliance and acceptance of the unique notouch axilla application technique was very good, as evidenced by the high completer rate,” added Professor Wang.

Earlier this month, Acrux announced it had held a preNDA meeting with the FDA in Washington, DC and the FDA had agreed Acrux may proceed to file a New Drug Application (NDA) in the United States, which Acrux is targeting for the end of 2009.

Acrux has already received strong interest from a number of potential marketing partners for AXIRON™. Following release of the Phase III trial results, formal partnering discussions with interested parties will be progressed in October 2009.

If approved by the FDA, market entry for AXIRON™ could occur in early 2011, and may play an important role in the treatment of patients living with hypogonadism. Based on IMS data, global sales in this market for the year to March 2009 exceeded U.S. $1 billion for the first time, and sales in the U.S. market grew by more than 20 percent. Sales of testosterone gels in the U.S. grew to U.S. $0.7 billion for the year to March 2009.

Last year Acrux published results from market research conducted in both patients and physicians in the USA, in which two thirds of patients confirmed that they would prefer AXIRON™ to their existing gel treatment and 87 percent of physicians said that they would offer AXIRON™ to their patients that currently use gels. Importantly, 94 percent of patients who tried AXIRON™ rated it better than the testosterone gels in its ability to reduce the risk of transference of testosterone to others. In addition, 92 percent of physicians surveyed who prescribe gels as first line therapy rated AXIRON™ as very good or excellent in its ability to reduce the risk of transference to others when compared to the gels.

“We are excited by the AXIRON™ Phase III trial results and are now well positioned to submit our NDA by the end of 2009,” said Dr. Richard Treagus, CEO and Managing Director of Acrux. “These results, along with our recent meeting with the FDA, place us in a strong position as we initiate a process to select marketing partners for what is a unique testosterone delivery system that we believe will be a patient preferred treatment for hypogonadal men,” he said.

About AXIRON™ (testosterone solution) 2%

Testosterone deficiency in men (hypogonadism) is associated with a number of symptoms including lethargy, depression, reduced libido and decrease in muscle mass and bone density. Estimates of men over 50 years of age having testosterone levels below the normal healthy range vary from 10 percent to 39 percent1. However, in the majority of men this remains undiagnosed, with only around five percent to 10 percent of those with the condition receiving treatment. With a high incidence rate and low but growing treatment rates, the male testosterone deficiency market will remain an attractive commercial opportunity. AXIRON™ has been designed to overcome the significant issues and drawbacks associated with the current gel treatments. Large volumes of gel are applied by hand and rubbed on to the abdomen, shoulders or arms. They are considered messy, sticky, slowdrying and may have an unpleasant odour to some patients. One of the biggest drawbacks is the risk of transference to other people through contact with the application site or from residue left on the hands following application. AXIRON™ is a fasterdrying and pleasant smelling solution that is applied to the armpits once daily, using a convenient and ergonomic “notouch” applicator designed in Australia. The armpit is a unique application site for transdermal drug delivery and it offers significant advantages to the patient in terms of convenience and may have a lower risk of transference from patient to others. A factsheet on AXIRON™ is available for download at acrux.com.au.

1 Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years the HIM study. Int J Clin Pract. 2006;60(7)762769

According to a recent study of clinical characteristics of teens who underwent laparoscopic RouxenY gastric bypass surgery from 2002 until 2007, doctors may have a much narrower window of opportunity to reverse morbid obesity in teens than previously thought.

The study, conducted at Cincinnati Childrens Hospital Medical Center, appears in the current online edition of the Journal of Pediatrics.

The study focused on 61 teens who underwent laparoscopic RouxenY gastric bypass at Cincinnati Childrens. The results of the study showed that one year after the study, BMI in the overall group of teens presurgery decreased by 37 percent, however because of their starting weights, the teens were still considered to be morbidly obese. This means that doctors can predict what a patients weight will be oneyear post weight loss surgery.

Lead author of the study, Thomas Inge, MD, PhD, Associate Professor of Surgery and Pediatrics, explains that “Current guidelines for adolescent weight loss surgery suggest that we begin to consider surgery only after a teen is 80100 percent overweight. Our new data show that when we intervene when a patient is between 100 and 150 percent over ideal weight, we can expect successfully resolution of obesity. But by the time the teen is 200 percent over their ideal weight for age, the surgery will reduce their weight substantially, but many of the patients will still remain morbidly obese.

This is the first study in adolescents to specifically show that the postoperative weight is strongly influenced by the patients starting weight. This finding raises a concern that waiting until children are super obese to begin to think of surgery may result in major weight loss, but not resolution of obesity and certain medical problems than intervening at an early stage of the disease. For instance, in those who remain significantly obese following surgery, this excess weight can have negative effects on joints and mobility; the longterm risks of remaining seriously overweight are unknown.

Coauthor Dr. Stavra Xanthakos, Assistant Professor of Pediatrics and pediatric gastroenterologist feels that, “We [doctors] have to do a better job of identifying teens who are gaining enormous amounts of weight quickly and get help for them earlier.” Dr. Xanthakos says that when doctors or parents notice that a teen is beginning to gain weight rapidly, there should be a staged approach to managing the weight problem. “If the weight gain is not effectively stopped with initial nutritional or exercise measures, then even more intensive treatments or programs are indicated, and ultimately some very serious thought has to be given to surgery,” said Dr. Xanthakos.

Mary L. Brandt, MD, Professor and Vice Chair of the Michael E. DeBakey Department of Surgery and a pediatric surgeon at Texas Childrens Hospital worries about these results as well. “We are trying to help teenagers who are at high risk for preventable but lifethreatening diseases such as diabetes or obesity induced liver disease. Bariatric surgery will improve the medical condition of obese teenagers regardless of the starting weight of the patient. But our ability to help these children prevent or reverse their lifethreatening diseases will be even greater if our patients are able to approach a normal weight.”

According to Brandt, “The other major implication of this new data is that many insurance companies will delay surgery for years, usually by requiring documentation of multiple attempts at weight loss. Severely obese teenagers only rarely respond to these kinds of treatments and, despite intense efforts to lose weight, often will gain weight during these efforts. Although it is ethically important for these children to have a least one well supervised attempt to lose weight without surgery, this report shows us that delaying the surgery while trying multiple times may not be in their best interest.”

This study, like others, found that after surgery, patients generally show significant improvement or resolution of cardiovascular risk factors such as blood pressure, cholesterol, and triglyceride levels.

Dr. Inge said that the study indicates that families and communities need to take childhood weight problems seriously and aggressively pursue the best treatment options available for them before the weight problem gets out of hand. “As doctors who take care of kids, we have an obligation to identify those patients who are at highest risk and start explaining treatment options to families earlier before the child or teen gets to be two or three times his or her ideal weight, ” said Dr. Inge.

About Cincinnati Childrens

Cincinnati Childrens Hospital Medical Center is one of 10 childrens hospitals in the United States to make the Honor Roll in U.S. News and World Reports 200910 Americas Best Childrens Hospitals issue. It is #1 ranked for digestive disorders and is also highly ranked for its expertise in respiratory diseases, cancer, neonatal care, heart care, neurosurgery, diabetes, orthopedics, kidney disorders and urology. One of the three largest childrens hospitals in the U.S., Cincinnati Childrens is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health.

President Barack Obama in June 2009 cited Cincinnati Childrens as an “island of excellence” in health care. For its achievements in transforming health care, Cincinnati Childrens is one of six U.S. hospitals since 2002 to be awarded the American Hospital AssociationMcKesson Quest for Quality Prize for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases.

A growing global movement to apologize and make restitution to victims of human rights abuses is now gathering steam in the United States, but it wont be a first for the country, says the president of The Western History Association.

“In reviewing the history of reconciliation in the American West, Ive found three examples of government restitution where we acknowledge weve participated in human rights abuses and offered either an apology, restitution, reparation or all three,” says Sherry Smith, associate director of the Clements Center for Southwest Studies at SMU and an SMU history professor.

The state of Montana granted posthumous pardons to Germans and Austrians convicted and imprisoned under repressive sedition laws during World War I; the U.S. government paid reparations to the heirs of Japanese Americans relocated to incarceration camps during World War II; and in a landmark nativelands case, Arizona returned 6,000 acres to the Hualapai tribe in the 1940s and the U.S. government set up the Indian Claims Commission.

“These are tiny steps considering the magnitude of the problem. But they helped turn the corner of deep injustice,” Smith says. “Its never too late to do the right thing.”

The global move toward reparations and restitution has largely evolved since World War II, beginning with Germany after the Holocaust, Smith says. Since then other nations and some private corporations have apologized or offered reparations to reconcile the past.

Increasingly, governments are responding to victims rights groups that are demanding reconciliation and restitution for slavery, war crimes and other institutionalized abuse. Most recently, the U.S. Senate in June passed a resolution apologizing for slavery although it didnt offer any monetary reparation.

“The United States is in the beginning stages of this movement,” says Smith, noting that historians have been a critical part of the process as they collect victims testimony and verify abuses through documentation.

“To the extent reconciliation includes chronicling and teaching the sometimes troubled past, historians are central to that,” says Smith.

While Smith isnt drawing moral or ethical conclusions, she did say “the work that historians do can have social justice implications. We need to tell the stories of abuse and keep retelling them as part of the reconciliation process. But victims also need more than words. They want acts, too.”

Smith will address “Reconciliation and Restitution in the American West” at the Western History Associations annual conference in October in Denver. More than 900 association members from museums, universities and government agencies attend the conference.

Source
Kim Cobb
Southern Methodist University

The latest research from Family Relations shows that parents in lowincome environments are more prone to depression when there is a lack of social support.

This is especially prevalent in rural regions, where mental health and social resources can be deficient.

Social support mechanisms such as community groups, churches, and school or sportsrelated activities, can act as a barrier against negative thinking and allow parents who are prone to depression, in order to make better, more positive choices and engage in healthy parental practices.

The findings support a holistic care plan for families in need, combining skillbased interventions with social recommendations.

These measures may help to decrease the detrimental effects of economic stress on individual and family functioning.

Cancer Research UK scientists have discovered a molecular flag that predicts survival from prostate cancer at diagnosis, reveals a study published in the British Journal of Cancer.

The research led by pathologists based at the University of Liverpool measured the levels of a protein called heat shock protein27 (Hsp27) in prostate tissue samples taken from 553 men at the time they were diagnosed with prostate cancer. During a 15year followup, the research showed that those men who tested positive for Hsp27 at diagnosis were almost twice as likely to die from prostate cancer, than men who did not have the protein.

These findings suggest that Hsp27 could be used as a potential test to distinguish men with the aggressive forms of the cancer that need immediate treatment from men with slowgrowing forms of prostate cancer, and with which they can live with for many years. At the moment, there are no reliable tests to make this distinction.

Lead author, Professor Chris Foster, a Cancer Research UKfunded scientist at the University of Liverpools School of Cancer Studies, said “We have identified a link between the presence of Hsp27 at diagnosis and a lower survival rate for prostate cancer. Our study shows that this protein marker currently found in tissue samples can give us a reliable and accurate indication of whether individual cancers will become aggressive. Currently, we are working on developing this finding into a blood test to monitor men with prostate cancer in order to determine when their individual disease needs treatment.”

Hsp27 is a key component of signalling pathways that control the movement of cells around the body. The study also suggests that new drugs could be developed to block these signals and halt the spread of prostate cancer cells.

Professor Foster added “If further research shows that blocking these cell message systems is successful, it could provide a new treatment for aggressive forms of prostate cancer.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said “These results are an important step towards tackling the longstanding question of how to treat men with prostate cancer once it has been diagnosed. The need for treatment varies greatly between patients men with nonaggressive cancer can live with it for many years without needing therapy, while aggressive cancers require prompt treatment with combinations of surgery, radiotherapy and chemotherapy. But it is very difficult to distinguish who has which type of cancer.

“A marker molecule which identifies aggressive prostate cancer would help us target active treatment to patients who need it avoiding unnecessary therapy, which can have side effects, to those who dont.” She added “The next stage would be to test this protein in large clinical trials to decide if how useful it could be for diagnosis or treatment.”

Notes

*Hsp27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETSgene rearrangement. British Journal of Cancer. CS Foster et al.

Prostate Cancer

Prostate cancer is the most common cancer in men in the UK, with around 34,000 new cases diagnosed every year. Around 10,000 men die from the disease each year in the UK.

Urban Institute Estimating the Cost of Racial and Ethnic Health Disparities In this brief, researchers analyze the cost burden associated with excess rates of diseases such as diabetes, hypertension, stroke and renal disease among Hispanics and African Americans relative to nonHispanic whites. The study predicts that in 2009, “Medicare alone will spend an extra $15.6 billion while private insurers will incur $5.1 billion in additional costs due to elevated rates of chronic illness among African Americans and Hispanics.” The researchers also estimate that “[o]ver the 10year period from 2009 through 2018 … the total cost of these disparities [will be] approximately $337 billion, including $220 billion for Medicare” (Waidmann, 9/22).

Annals of Internal Medicine Ambulatory Care Among Young Adults in the United States Using crosssectional data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, researchers examined ambulatory care utilization among adults, ages 20 to 29 years. Despite young adults being “the most likely age group to be uninsured and have the highest prevalence of substance abuse, motor vehicle accidents, and sexually transmitted diseases,” the researchers conclude, “Young adults use less ambulatory medical care relative to other groups and infrequently receive preventive care directed at the greatest threats to their health” (Fortuna, Robbins and Halterman, 9/15).

Health Affairs Containing Costs And Improving Care For Children In Medicaid And CHIP This study examines the overall distribution of spending for children in Medicaid/CHIP as measured by the Medical Expenditure Panel Survey. The study found “Ten percent of enrollees (twothirds of whom have a chronic condition) account for 72 percent of the spending” whereas “30 percent of enrolled children,” who are disproportionately African American, “receive little or no care” over a twelvemonth period. “These results highlight the importance of cost containment strategies that reduce avoidable hospitalizations among children with chronic problems and policies that increase preventive care, particularly among African American children,” the authors write (Kenney, Ruhter, and Selden, 9/17).

Kaiser Family Foundation Medicaid and Childrens Health Insurance Program Provisions Americas Affordable Health Choices Act & Americas Healthy Future Act This brief examines provisions related to Medicaid and the Childrens Health Insurance Program (CHIP) in the House TriCommittee bill and Senate Finance Committee bill compared to current law (9/22).

Robert Wood Johnson Foundation Cost Savings and CostEffectiveness of Clinical Preventive Care This report evaluates the economic evidence for investing in preventative care as indicated in costeffectiveness literature. The authors conclude “Based on the literature synthesized in this report, there are relatively few clinical preventive interventions for which there is strong evidence of cost savings. Moreover, many preventive interventions that do save money are already in widespread use (e.g., childhood immunizations), thus limiting the potential for additional savings. For these reasons, it is unlikely that substantial cost savings can be achieved by increasing the level of investment in clinical preventive measures. On the other hand, this review has shown that many preventive measures deliver substantial health benefits given their costs” (Cohen and Neumann, Sept. 2009)

Childrens National Medical Center In a policy statement scheduled to appear in the October issue of the journal Pediatrics, a team of pediatric emergency medicine specialists and other health experts point to a IOM report that found only 6 percent of U.S. hospital emergency departments are fully equipped to properly care for children even though children account for more than 20 percent of all emergency room visits. The authors make “recommendations for appropriate equipment, training, medications, and policies for pediatric emergency care,” according to a Childrens National Medical Center description of the policy statement (9/21).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.