Doctors can help prevent teen smoking, panel says

Asthma attacks surge during back-to-school time, doctors warn


4 Doctors can help prevent teen smoking, panel says Kim Painter, Special for USA TODAY 12:06 a.m. EDT August 26, 2013 Nearly one in five teens leave high school as smokers, and reducing that number could be as simple as a chat with a doctor. Doctors can play a role in preventing kids from smoking, a panel says. (Photo: Hemera Technologies) Kids will pay attention to smoking warnings from doctors, say recommendations Smoking kills about 443,000 people a year in the United States In 2011, 18% of high school kids and 4% of middle schoolers were smokers SHARE 227 CONNECT 164 TWEET 4 COMMENTEMAILMORE Children and teens may hear about the dangers of smoking from parents, teachers and friends, but they may be less likely to take up the deadly habit if they hear the message from at least one more important person: their doctor. That’s the conclusion of an influential panel publishing new recommendations today in two medical journals, the Annals of Internal Medicine and Pediatrics. In a number of studies, kids were less likely to try smoking if they got some kind of counseling or education from their doctors or other health care providers, says the U.S. Preventive Services Task Force. “We didn’t recommend any particular intervention, because a variety of things seem to help,” says panel member David Grossman, a pediatrician and researcher at the Group Health Research Institute and the University of Washington-Seattle. “The important thing is that the message is coming from a physician and that’s an important voice even to kids.” The report says “even very minimal interventions,” such as a doctor’s office mailing a series of prevention guides to parents and kids, could make a difference. Stopping kids from ever smoking could have a huge health impact, the panel says: Smoking kills about 443,000 people a year in the United States, and 90% of smokers start before age 18. The American Academy of Pediatrics already urges doctors to talk to parents, children and teens about smoking.

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Kirstin Carel, a pediatric allergist at National Jewish Health in Denver. Several factors including the viruses that kids share at school , an increase in pollen allergens and children being off medication during the summer combine to make this time of year especially problematic for children with asthma, Carel said. “For a lot of asthmatics, a virus is a majortrigger,” Carel said. In her practice, most asthma attacks that she sees in the early fall are associated with upper respiratory infections (colds) caused by viruses. People with asthma have sensitive airways, and a virus can cause inflammation in airways and trigger an asthma attack, she said. Many people with asthma are also allergic to pollen, and levels may be high at this time of the year, Carel added. [ 9 Weirdest Allergies ] Another reason attacks spike in the early autumn is that some children quit taking their asthma medication over the summer months. “Most patients need to stick with their usual routine,” Carel said, but some don’t “because they don’t have a regular schedule in the summer, and things get forgotten. If they don’t get backwith the routine soon enough, it’s easy to get sick.” Medications for asthma can prevent asthma attacks that occur in response to certain triggers, but it is important that children have the medicine in their system before facing the factors that can make attacks more likely, Carel said. “I’d like [my patients] to start medication at least two weeks before going back to school,” she said. Asthma is a disease that affects the airways and causes wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Asthma can be controlled by taking medicine and avoiding the triggers that can cause attacks .

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Mobile Doctors CEO, physician charged with Medicare fraud

Magistrate Judge Mary Rowland ordered Ajiri, 42, of Wilmette, held in custody at least until a detention hearing Thursday. Koroma, 63, of Tinley Park, was freed on $50,000 bail but barred from contact with patients. Before the hearing, Ajiri, a former college football and rugby player, stood with his hands cuffed behind his back, joking with supporters in the courtroom. Prosecutors said that Mobile Doctors operates in six states, arranging hundreds of thousands of home visits and contracting with doctors who perform the visits. Current and former employees and doctors told investigators that a typical visit with a patient lasts 10 to 30 minutes and is routine in nature. But according to the charges, Ajiri schemed over the last seven years to increase Medicare billings by falsely claiming the patient visits were more complicated and took longer than they actually did. A former manager of the Chicago office told investigators that Ajiri set up a system so that the two highest fee codes allowed by Medicare automatically kicked in so that patient visits would be worth the doctors’ time and the cost of gas, according to prosecutors. According to the complaint, the manager quoted Ajiri as telling his physicians, “I don’t pay for the ones or twos,” a reference to the lower fee codes. From 2006 to 2012, Mobile Doctors received more than $34 million in payments on claims using the two higher codes, according to the charges. The charges also alleged that Mobile Doctors’ physicians falsely certified that patients they visited were confined to their homes, enabling home health care agencies to claim fees for additional services for patients who were not actually qualified to receive them. Some 16,000 patients had been certified as homebound by the company since 2006, leading to more than 83,000 home health visits, many of them fraudulent, according to prosecutors.

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Canadian woman survives 12 days in the bush

She escaped an attack and vanished, it said, emerging 12 days later. The woman’s uncle said she suffered head and pelvic injuries and will need to undergo reconstructive surgery on her jaw. Her feet are also in bad shape as she had no shoes, he said. The woman remains hospitalized. She survived by drinking river water and eating berries, according to a report by The Canadian Press. Citing RCMP Cpl. Nick Munro, it said investigators believe that the woman was in a truck with four other people when it got stuck. Three of them went for help. When they didn’t return, the woman and a man started walking. He allegedly then hit her in the face and attempted to sexually assault her, The Canadian Press said. The woman reportedly fled and got turned around. She was eventually found by an oilfield worker on a dirt road, The Canadian Press said. He called authorities. Kevin Roy Gladue, 36, is charged with aggravated assault, sexual assault and obstructing a peace officer, the RCMP statement said.

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US physician practices spend 4 times Canadian practices

Additional findings from the study, “U.S. Physician Practices Spend Nearly Four Times as Much Money Interacting With Health Plans and Payers Than Do Their Canadian Counterparts”: On average, U.S. doctors spent 3.4 hours per week interacting with health plans while doctors in Ontario spent about 2.2 hours. Nurses and medical assistants in the U.S. spend 20.6 hours per physician per week on administrative tasks related to health plans, nearly 10 times the time spent by those in Ontario. U.S. clerical staff spend 53.1 hours per physician per week on administrative tasks related to insurance, compared with 15.9 hours in Ontario. Most of the difference comes from the time U.S. clerical staff spend on billing (45.5 hours) and obtaining prior authorizations (6.3 hours). Senior administrators in the U.S. spend much more time per physician than their Canadian counterparts on overseeing claims and billing tasks: 163.2 hours a year in the U.S. compared with 24.6 hours a year in Ontario. ### Study co-authors include Dr.

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Queens Gastroenterologists Open State-of-the-Art Endoscopy Center in Rego Park

“As Queens-focused gastroenterologists, we cater to a broad cross-section of the community,” said Dr. Khan. “Both Dr. Izquierdo and I are at a point where we will soon outgrow our offices, and as such, this is a perfect time to team up and move to a larger, world-class and modern facility.” The five room center includes six pre-op bays and 10 recovery bays, which will be capable of treating over 15,000 patients a year. “While the Center will initially have significant space for additional cases, we envision that the utilization will rapidly increase,” said Dr. Izquierdo. “There are many other Queens-based endoscopists who are similarly looking to upgrade from their Office-Based Surgery practice and move to an Article 28 facility.” QBEC represents Frontier’s second center opening in as many months and its fourth in the past year, highlighting the continued trend in ASC growth and their acknowledgment as a key part of New York’s health care delivery. “The ASC provides a low-cost, high quality alternative to hospital care, while providing superior infection control and life safety standards to a physician’s office,” said Jordan Fowler, CEO of Frontier Healthcare. “Both our partners are thrilled to begin performing cases in this beautiful, state-of-the art facility.” About QBEC QBEC ( is a state-of-the-art ambulatory endoscopy center dedicated to providing high-quality healthcare service, patient care and operational excellence to the Queens community. The center was designed to promote high-quality care and in a personalized, professional environment and cater to all Queens’ residents, including charity care. About Frontier Healthcare Frontier Healthcare partners with groups of physicians to develop and manage ASCs. Frontier manages the largest portfolio of ASCs in New York State, and its network of GI physicians represents over one hundred thousand cases annually across over eighty doctors, including some of the most well respected physicians in the tri-state area.

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Health disparities emerge on modern civil rights front

Like your health care policy? You may be losing it

Many consumers who buy their own health insurance could get a cancellation notice this fall because their current policies don't meet basic standards under President Barack Obama's health care law. They'll have to find replacement plans, state regulators say. (ASSOCIATED PRESS / Charles Rex Arbogast, File)

Individual lives change to change communities The center’s latest program is the Mount Auburn Block by Block model, a resident-led education program that has gone door-to-door in the hilltop neighborhood of 6,700 residents with information on diet and exercise. Besides the new walking groups, cooking classes and other education sessions are planned. Howard Martin, 40, an unemployed diabetic who lives with his elderly parents, earned a stipend by walking the neighborhood to deliver pamphlets. The money was enough to buy medicine to treat his diabetes. “I got involved to save myself,” Martin said. “I don’t get the splitting headaches any more. I’m jogging now. I feel better.” On Aug. 10, the Health Gap and local National Action Network chapter sponsored a screening of the documentary “Soul Food Junkies.” The film examines soul food, such as fried chicken and barbecued pork, as part of black cultural identity and measures its often-negative effects on African-American health. Joyce Edwards, 68, spoke during a post-screening discussion, saying how she changed to a vegetarian diet 10 years ago when she started having to take medicine to treat high blood pressure. “I was always a little chunky thing,” said Edwards, who now makes and drinks carrot juice, “but I lost 20, 25 pounds by changing my diet and starting to walk at least three times a week.” She now looks more optimistically at a longer and better quality life and no longer has to take blood-pressure medicine. Hospitals, churches key players in movement Hospitals and predominantly black churches play vital roles in increasing awareness and decreasing disparities. Overall, 112 black churches regionally have expanded their health ministries in recent years with the help of the Center for Closing the Health Gap.

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In Washington state, the changes will affect more than 400,000 people, said Stephanie Marquis, spokeswoman for insurance commissioner Mike Kreidler. Marquis said she expects the premiums for replacement plans to be similar to current ones, but with better coverage. Your costs involve more than your premiums, Marquis explained. Its also what you would have to pay out of pocket if you had actually used your health plan. Others see an encroaching nanny state. Youre going to be forcibly upgraded, said Bob Laszewski, a health care industry consultant. Its like showing up at the airline counter and being told, You have no choice, $300 please. Youre getting a first-class ticket, why are you complaining? Obamas promise dates back to June of 2009, when Congress was starting to grapple with overhauling the health care system to cover uninsured Americans. Later that summer, public anxieties about changes would erupt at dozens of angry congressional town hall meetings with constituents. If you like your health care plan, youll be able to keep your health care plan, period, the president reassured the American Medical Association. No one will take it away, no matter what. At the time, some saw the promise as too broad, given that health plans are constantly being changed by the employers that sponsor them or by insurers directly. Nonetheless, Democrats in Congress devised a complicated scheme called grandfathering to try to deliver on Obamas pledge.

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UK Doctors To Volunteer With International Disasters, Under New Government Scheme


Doctors, nurses, surgeons, anaesthetists and other staff can now pre-register on the UK’s International Emergency Trauma Register (UKIETR) to indicate their availability to deploy rapidly to the scene of emergencies such as tsunamis, earthquakes and floods. It is hoped that more than 400 medical staff will be registered and trained by 2014, said Ms Greening, speaking on the anniversary of the 2004 Indian Ocean Boxing Day tsunami which killed over 230,000 people in 14 countries. Medics carrying bodies in the aftermath of the 2004 Boxing Day tsunami The UKIETR was established by medical charity UK Med in 2011 and has already deployed surgical team members in support of non-governmental assistance operations in Haiti, Libya and Tunisia. Greening’s Department for International Development and the Department of Health have now incorporated the register into the UK’s official overseas disaster response. The register helps co-ordinate the deployment of volunteers, to ensure that they have the correct skills, training and experience for the specific situation being faced. Greening said: “The UK public has always given generously to appeals in the aftermath of natural disasters overseas. And UK expert volunteers have been there at the forefront when the world needed them, following the Indian Ocean tsunami and the earthquakes in Haiti and Japan. “Now medical personnel can sign up to the UKIETR to help after serious natural disasters. This is one way the UK can help to stop problems spiralling out of control and also helps us to develop our own disaster resilience.” Professor Tony Redmond of UK Med said: “The register is a major step forwards in harnessing the skills and goodwill of UK healthcare workers and bringing them to the immediate benefit of those most in need. “Although not its primary purpose, the experience gained in both training and deployment overseas can only reinforce our response to disasters here at home.” Contribute to this Story:

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Canadian Physicians: No to genital mutilation, yes to decapitation?

BY Stephanie Gray Tweet In a contradiction of great proportion, the Canadian Medical Association (CMA) has passed a motion to foster a public debate on end-of-life care, yet they are closed to debating when the very lives some doctors may end first began. The Globe and Mail reported, At the general council meeting of the [CMA] on Wednesday, delegates called on the federal government to reject attempts by a Conservative backbench MP to amend the Criminal Code so that a fetus is defined as a human being. The CMAs own report said that Quebec physician, Dr. Genevieve Desbiens, who brought the motion, said the aim was to prevent a backdoor attempt to reopen the abortion debate. What is she afraid of? Canadians realizing that where you are does not determine what you are? Canadians realizing that since the pre-born are human and abortion slaughters those humans, that any physician involved with killing would be, uh, I guess guilty of killing? That wouldnt reflect so well on the profession that is supposed to shed blood to heal, not shed blood to kill. And people might want to pick another doctor. Oh waitthey would be forced to, for the doctor wouldnt be available to practice medicine from jail. And it seems incarceration is a concern for this Quebec physician: The Globe reported that Dr. Desbiens also warned that doctors who counsel or provide abortion services could become criminals. Wait a minute: If the pre-born are human, and if abortion dismembers, decapitates, and disembowels those humans, whats wrong with classifying those who do the cold-hearted deed as criminals? Dr. Desbiens attitude is self-serving and lethal. Dont consider whether abortion kills the youngest of our kind. No, just make sure you dont put her or her profession-betraying friends in jail. That wouldnt be very nice. Just let them continue to shred the youngest of our kind in peace. Delivering babies involves working at all hours of the night; killing them, however, is a quick way to make cash during regular business hours. If some physicians wish to choose the latter instead of the former, shouldnt they be allowed? Actually, not according to the CMAs Code of Ethics. Clause 9 of their Code clearly states that physicians must refuse to participate in or support practices that violate basic human rights. And the right to life, which abortion violates, is guaranteed in both our Charter as well as the UNs Declaration of Human Rights. Further, the UNs Declaration of the Rights of the Child goes so far as to say the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth. The UN considers that prenatal protection is so important, that in article 6 of the International Covenant on Civil and Political Rights, a document it adopted, it says capital punishment shall not be carried out on pregnant women. What makes a pregnant woman different from a non-pregnant one? The existence of another individual. And this is where Dr. Desbiens would do well to read her own code of ethics. In Policy 4 of the Quebec Code of Ethics of Physicians it says, A physician must practice his profession in a manner which respects the life, dignity, and liberty of the individual. Now perhaps Dr. Desbiens would say the pre-born arent individuals. Well if they arent, then what are they? And how is her definitionsiding with the Criminal Codethat they arent human until out of the mothers body, at all scientific? She would do well to also heed Policy 6 of the code which says, A physician must practice his profession in accordance with scientific principles. Science clearly teaches that if something is growing its alive, and if you have human parents you are human offspring. Science teaches that life begins at fertilization. Finally, it is worth noting that while some physicians seem okay with killing children, most are not okay with mutilating them: Consider the College of Physicians and Surgeons of BC and Ontario which have policies against female circumcision. Ontario goes so far as to say performance of, or referral for, [female genital cutting/mutilation] procedures by a physician will be regarded by the College as professional misconduct. Lets get this straight: Its professional misconduct to mutilate but okay to decapitate?

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