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Teen pregnancy rate up for 1st time in more than 10 years
The nation's pregnancy rate for teens ages 15 to 19 increased in 2006, after more than a decade-long decline, according to a January report by the Guttmacher Institute, a nonprofit that conducts research on reproductive health. The report found that after falling 41% between 1990 and 2005, the pregnancy rate among this age group climbed 3% to 71.5 pregnancies per 1,000 women in 2006. The teen abortion rate also increased for the first time in more than a decade, inching up 1% from 2005 to 2006. "It's a serious concern. Whether this is going to be a blip or a trend, we still don't know," said Janet Realini, MD, MPH, president of Healthy Futures, a San Antonio, Texas, nonprofit that works to prevent teen and unwanted pregnancies in the city. "It means we have to redouble our efforts and use what works." Physicians, Dr. Realini said, can play an important role by educating adolescent patients and their parents about preventing pregnancy and helping them access contraception. She [Read more]
Smokers need not apply at Tenn. health system
If you smoke and are looking for job at Memorial Health Care System, you might want to hold off on filling out an application. As of Feb. 1, the Chattanooga, Tenn.-based organization -- composed of two acute-care hospitals, home health services, an imaging center, satellite facilities and a physician practice management company -- stopped hiring those who use tobacco or other nicotine products if those substances were detected in the post-offer health screening. The health care system did not respond to requests for comment, but according to its Web site, the step was taken to "further our mission of building healthier communities" (www.memorial.org/about_us_careers.html). Memorial follows in the footsteps of the Cleveland Clinic, which stopped hiring smokers in July 2007. Thousands of other companies have similar rules. Such policies are not legal in all states. Institutions that want to follow suit should check local laws. Memorial's actions elicited mixed responses from [Read more]
Hormone therapy showed no heart benefits for women
Postmenopausal women who took combination hormone therapy did not have a lower risk of coronary heart disease during the first two years of treatment, according to an article in the Feb. 16 Annals of Internal Medicine. When considering whether to prescribe estrogen plus progestin hormone therapy, study author Sengwee Darren Toh, ScD, suggests that physicians use the lowest dose that helps for the shortest duration possible. That approach is consistent with the Food and Drug Administration's recommendation. "Coronary heart disease is one of many outcomes [physicians] should consider when initiating hormone therapy," said Toh, an instructor in the Dept. of Population Medicine at Harvard Medical School in Boston and Harvard Pilgrim Health Care Institute, an affiliate of the school. Researchers analyzed the short-term effects of the combination treatment on coronary heart disease using data from 16,608 postmenopausal women ages 50 to 79 with an intact uterus at baseline. The women [Read more]
Neurosurgeons may limit Medicare participation
Neurosurgeons say they are very concerned about the current Medicare payment system and fear that beneficiary access will be affected unless the rate formula is fixed. A national survey of about 680 neurosurgeons revealed that while most participate in Medicare, many have been or are considering limiting the scope of their involvement. Nearly 40% of neurosurgeons said that if payments continue to decline, they will see fewer new Medicare patients; 18% would not take any new patients. The survey results were released Feb. 10 by the American Assn. of Neurological Surgeons, the Congress of Neurological Surgeons and the Council of State Neurosurgical Societies. More than half of neurosurgeons say they will stop providing certain services, and nearly 53% will reduce the time they spend with Medicare patients, the survey found. "These results really do paint a bleak path we are going down," said Troy M. Tippett, MD, AANS president. "Many neurosurgeons in our survey indicated that if [Read more]
PhRMA leader Tauzin resigns
Billy Tauzin, president and CEO of the Pharmaceutical Research and Manufacturers of America, announced on Feb. 12 that he would step down at the end of June, about five years after he took the job. "I now believe it is time I move on and hand the mantle of leadership of this great organization to others as passionate as myself, and to explore the many other interests I would like to pursue," Tauzin said in a statement, adding that he only committed to the position for 5½ years. Tauzin, a cancer survivor, said he is in good health. His resignation comes after a pivotal year for health system reform in which PhRMA played a major role. Tauzin negotiated a deal last summer with Senate Finance Committee Chair Max Baucus (D, Mont.) and the White House to trim drug costs for seniors by $80 billion over a decade -- an agreement that enabled the organization to back reform but that has proven to be controversial. PhRMA spent millions of dollars on ads supporting the Obama administration' [Read more]
Flu-shot mandate nets 98% vaccination rate in Mo. health system
A St. Louis-area health system achieved 98% influenza immunization among its 26,000-plus employees after making the vaccine mandatory in 2008. The results at BJC HealthCare were documented in a Feb. 15 study in the journal Clinical Infectious Diseases. The system already had seen its vaccination rate improve from 54% to 71% in 2007 with a policy requiring its employed doctors, nurses, other health professionals and employees to get immunized or sign a statement declining the shot. Nationally, the flu-shot rate among health care workers has hovered at just below 45%, according to the Centers for Disease Control and Prevention. But BJC officials were eager to push the immunization rate up higher and faster and opted for a mandate, said Hilary M. Babcock, MD, MPH, lead author of the study (www.journals.uchicago.edu/doi/abs/10.1086/650752). "Our goal is not to put all of our time and effort into getting declination statements," said Dr. Babcock, medical director of occupational [Read more]
Senate fails to stop 21% Medicare pay cut -- for now
The Senate adjourned for the weekend on Feb. 26 without approving a measure that would have stopped a 21% Medicare physician pay cut from taking effect March 1. The House on Feb. 25 had passed legislation that would have extended a number of expiring unemployment benefits and delayed the Medicare cut until March 28. But Senate Democratic leaders were repeatedly blocked in their attempts to obtain unanimous consent to pass the "extenders" bill. Sen. Jim Bunning (R, Ky.) objected each time on the basis that the $10 billion total cost of the bill -- roughly $1 billion of which would go toward the doctor pay freeze -- would add to the federal deficit. The American Medical Association, which has been pushing lawmakers for a permanent repeal of the formula that helps determine Medicare pay, said the Senate had failed Medicare beneficiaries and opened the door to a "Medicare meltdown." "Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who [Read more]
Obesity rates stabilizing
Although obesity prevalence remains high among adults in the United States, the rate of growth has slowed over the past decade, according to the Centers for Disease Control and Prevention's National Center for Health Statistics study. A similar trend has emerged among children and adolescents, indicates a separate study, also conducted by NCHS. Both reports, and a related editorial, were posted online Jan. 13 as early release articles by the Journal of the American Medical Association (jama.ama-assn.org/). Approximately 33.8% of adults were obese (having a body mass index of 30 or higher) during 2007-08, up from 30% in 1999-2000, according to the NCHS. School-age children experienced a smaller upswing in obesity rates (BMI levels for age at or above the 95th percentile), climbing from approximately 16% in 1999-2002 to 17% in 2007-08. One exception: 6- to 19-year-old boys at the heaviest weight levels became heavier. Still, researchers said the increase in the obesity pre [Read more]
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