Nationwide, the uninsured rate fell from 17.3 percent in 2013 to 11.7 percent through the first half of this year, following two years of sign-ups for private health insurance on the Obamacare exchanges and for expanded Medicaid benefits, the pollsters found. The contrast between Obamacare-friendly states and those hostile to the law is stark. Rhode Island has the lowest uninsured rate, 2.7 percent, while Texas comes in last at 20.8 percent.
States have the option of establishing health insurance marketplaces of their own, such as Covered California and Kentucky's Kynect; to partner with federal authorities, as Delaware, Illinois and others did; or to leave the task entirely to the U.S. Department of Health and Human Services, which the majority of states did. States also can choose whether to offer Medicaid coverage to more poor adults under the law, which 30 states and the District of Columbia have done.
The consequences of those choices are clear in the Gallup findings: States that set up exchanges or collaborated with the federal government and also expanded Medicaid saw a much bigger drop in the share of residents without health insurance.
In the 22 states that had done both things by Dec. 31, the uninsured rate declined by 44 percent, and now is 8.9 percent. In states that did neither, the drop was 28 percent, and the uninsured rate is currently 13.4 percent. Collectively, the 28 states that are resisting the Affordable Care Act already had higher uninsured rates prior to the law's enactment than the 22 that have accepted it.
People in the medical community are coming around to treating exercise as a safe and powerful medicine. Here's a high level paper on EDD in children.
If exercise is medicine and a prescription of ‘exercise as medicine’ is expected, then why is medical education limited with instruction in exercise science? A recently published survey of sports and exercise medicine practitioners indicated that there was no substantive teaching of sports and exercise medicine in the core medical curricula in Australia, Canada, Greece, Italy, the Netherlands, New Zealand, South Africa, or the USA.28 Physician training from medical school through specialty training may be limited in exercise science education as it applies to chronic illness, injury and obesity treatment and prevention despite a notable increase in interest from medical students.28 Currently, dollars are diminishing in support of physical activity (PA) for children, physical education is viewed as expendable in some communities, and there are no plausible means for reimbursement of physical activity interventions by trained healthcare and fitness professionals.
At this time, the health care balance scale is tipped significantly towards medical treatments and many physicians are looked upon as the source to implement preventative strategies. Unfortunately, physicians may be void of a referral base when faced with a physically inactive child diagnosed with EDD in need of care by a pediatric exercise specialist. Less than 2% of the over 300 United States colleges and universities offer a course in pediatric exercise within their curricula. In addition, less than 50% of physical therapy education programs in the United States require exercise science prerequisites.23 Moreover, only 7% of professional pediatric physical therapy education programs require a pediatric clinical education placement, therefore many practicing physical therapists have limited pediatric experience to develop health and wellness exercise programming for children.56 Thus, while we encourage physician referral to a pediatric exercise specialist, current educational curricula may limit the development of professionals trained with background to provide potential outlets for physician’s to target these referrals.
Confounding the potential for early identification and treatment of risk factors in youth with EDD, the current symptom-reactive health care system is not focused on prevention, but rather the treatment of the disease. This approach has been largely unsuccessful in the promotion of physical activity and the management of obesity and related disorders. This view is supported by the troubling increase in the prevalence of pre diabetes/diabetes from 9% to 23% in US adolescents aged 12 to 19 years.36 If exercise is medicine, then physicians and pediatric exercise specialists should be reimbursed for the evaluation and treatment of children with EDD with the goal of decreasing the likelihood of adverse health consequences later in life while reducing the future economic burden of lifestyle-related illnesses. Future prospective investigations are warranted to evaluate these contentions.
A little known sexually transmitted infection can boost the survival of patients infected with HIV—a more dangerous virus, researchers say. GB virus C (GBV-C) is the only known case of a potentially beneficial STI in humans. But it’s an example of a phenomenon that scientists are beginning to see elsewhere: STIs that are good for your health. What’s more, the health benefits of these helpful STIs could have given a boost to the evolution of promiscuity, scientists say. “There is a common perception that STIs are harmful,” says Chad Smith, an evolutionary ecologist at The University of Texas at Austin. But in a survey of the scientific literature, Smith and his colleague Ulrich Mueller found four documented cases of beneficial STIs in humans, aphids, mosquitoes and fungi.
It may be that a sixth basic taste has joined sweet, sour, bitter, salty and umami - fat. The new taste is called oleogustus, although one suspects it may just be called fat as umami is often called savory.
Cordelia A. Running1, Bruce A. Craig2 and Richard D. Mattes3 1 Department of Food Science, Purdue University, West Lafayette, IN 47907, USA, 2 Department of Statistics, Purdue University, West Lafayette, IN 47907, USA, and 3 Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
Considerable mechanistic data indicate there may be a sixth basic taste: fat. However, evidence demonstrating that the sensation of nonesterified fatty acids (NEFA, the proposed stimuli for “fat taste”) differs qualitatively from other tastes is lacking. Using perceptual mapping, we demonstrate that medium and long-chain NEFA have a taste sensation that is distinct from other basic tastes (sweet, sour, salty, and bitter). Although some overlap was observed between these NEFA and umami taste, this overlap is likely due to unfamiliarity with umami sensations rather than true similarity. Shorter chain fatty acids stimulate a sensation similar to sour, but as chain length increases this sensation changes. Fat taste oral signaling, and the different signals caused by different alkyl chain lengths, may hold implications for food product development, clinical practice, and public health policy.
But this success story is beginning to look more complicated: some hospitals have been unable to replicate the impressive results of initial trials. An analysis of more than 200,000 procedures at 101 hospitals in Ontario, Canada, for example, found no significant reductions in complications or deaths after surgical-safety checklists were introduced2. “We see this all the time,” says David Urbach, a surgeon at the University of Toronto who led the Ontario analysis. “A lot of studies that should be a slam dunk don't seem to work in practice.” The stakes are high, because poor use of checklists means that people may be dying unnecessarily.
A cadre of researchers is working to make sense of the discrepancies. They are finding a variety of factors that can influence a checklist's success or failure, ranging from the attitudes of staff to the ways that administrators introduce the tool. The research is part of the growing field of implementation science, which examines why some innovations that work wonderfully in experimental trials tend to fall flat in the real world. The results could help to improve the introduction of other evidence-based programmes, in medicine and beyond.
The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide
Background: A plant-based diet protects against chronic oxidative stress-related diseases. Dietary plants contain variable chemical families and amounts of antioxidants. It has been hypothesized that plant antioxidants may contribute to the beneficial health effects of dietary plants. Our objective was to develop a comprehensive food database consisting of the total antioxidant content of typical foods as well as other dietary items such as traditional medicine plants, herbs and spices and dietary supplements. This database is intended for use in a wide range of nutritional research, from in vitro and cell and animal studies, to clinical trials and nutritional epidemiological studies.
Methods: We procured samples from countries worldwide and assayed the samples for their total antioxidant content using a modified version of the FRAP assay. Results and sample information (such as country of origin, product and/or brand name) were registered for each individual food sample and constitute the Antioxidant Food Table.
Results: The results demonstrate that there are several thousand-fold differences in antioxidant content of foods. Spices, herbs and supplements include the most antioxidant rich products in our study, some exceptionally high. Berries, fruits, nuts, chocolate, vegetables and products thereof constitute common foods and beverages with high antioxidant values.
Conclusions: This database is to our best knowledge the most comprehensive Antioxidant Food Database published and it shows that plant-based foods introduce significantly more antioxidants into human diet than non- plant foods. Because of the large variations observed between otherwise comparable food samples the study emphasizes the importance of using a comprehensive database combined with a detailed system for food registration in clinical and epidemiological studies. The present antioxidant database is therefore an essential research tool to further elucidate the potential health effects of phytochemical antioxidants in diet.