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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