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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Friday, November 9, 2007

Decline in smoking rates stalls as anti-tobacco campaigns lose funding, CDC says

After seven years of decline, smoking rates across the nation are stuck at about 21 percent, where they have been from 2004 to 2006, federal officials said, a leveling-off possibly linked to greater marketing efforts by tobacco companies and fewer anti-smoking dollars for public health campaigns, the Los Angeles Times and other news outlets say today.

smoking%20ad%20150.bmpThe trend in smoking rates mirrors what has also happened in Massachusetts, according to a story in the Globe in July. Cigarette sales increased after the state dropped its tough anti-smoking ads (like the one at left) in 2001, Stephen Smith reported after the state Legislature voted to reinvigorate the tobacco-control program. Its budget was boosted to $12.75 million for next year, from $8.25 million this year.

A CDC official blamed reduced spending on anti-tobacco campaigns and bigger marketing budgets from cigarette companies for the national numbers.

"What is happening doesn't have to happen," Dr. Matt McKenna, director of the CDC's Office on Smoking and Health, told the LA Times yesterday. "With appropriate support and efforts and counter-marketing, tens of thousands of people don't have to die."

Posted by Elizabeth Cooney at 11:39 AM

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Tuesday, November 6, 2007

DPH offers advice about MRSA bacterial infection

By Stephen Smith, Globe Staff

The state Department of Public Health today issued advice to schools and parents about a potentially dangerous germ that has infected a handful of students in recent weeks.

The bacteria, known as Methicillin-resistant staphylococcus aureus, cannot be treated by first-line antibiotics. However, the germ rarely results in serious, long-lasting health problems, specialists said.

For that information, go to the DPH website.

Posted by Karen Weintraub at 02:58 PM

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Monday, November 5, 2007

We're number 9, health survey says

Massachusetts slipped to ninth place in national health rankings released today, down two spots from last year.

Compiled by the United Health Foundation, the American Public Health Association and the Partnership for Prevention, the report said the overall healthiness of all states has declined by 0.3 percent. The national standings have stagnated since 2000, the report said, after steady improvements from 1990, the survey's first year.

Vermont came in first, followed by Minnesota, Hawaii, New Hampshire and Connecticut in the top five. Mississippi ranks as the least healthy state, along with Louisiana, Arkansas, Oklahomaand Tennessee in the bottom five.

In Massachusetts, both infectious disease and smoking rates declined. But more children were living in poverty and more people had no health insurance, the report said in its assessment of significant changes. The rating of insurance coverage was based on 2006 data, before Massachusetts' new healthcare law requiring near-universal coverage went into effect on July 1.

The rankings' 20 measures of health include obesity, tobacco use and violent crime as well as cancer and cardiovascular deaths.

Massachusetts scored well for its high levels of immunization coverage, low rates of obesity, and ready access to primary care, but the report said the state faces challenges with high prevalence of binge drinking, preventable hospitalizations and violent crime.

The percentage of children in poverty grew from 11.6 percent to 13.6 percent and the rate of uninsured people rose from 9.2 perent to 10.4 percent, according to the report. Infectious disease cases fell from 23.7 per 100,000 to 20.9 and the prevalence of smoking dropped from 18.1 percent to 17.8 precent.

Posted by Elizabeth Cooney at 02:00 PM

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Thursday, October 25, 2007

Boston pushing lead-poisoning prevention

As toys continue to be recalled for their high levels of lead paint -- including one announced by Mattel Thursday -- the City of Boston is promoting its lead poisoning prevention campaign with an event next month.

A daylong Lead Safe Awareness Resource Fair will highlight the city's home-deleading programs and also test toys for lead. The event will begin at 9:30 a.m. Saturday, Nov. 3, at the First Parish Church, 10 Parish Street, Dorchester.

lead%20billboard%20200.bmpThe fair is part of an effort by the Boston 2010 Project to eliminate lead poisoning that also includes billboards left), mailings to property owners, and outreach to churches and community organizations.

Cases of childhood lead poisoning in Boston have fallen from 1,300 in 2000 to 460 last year, according to city figures. The neighborhoods with the most cases are Dorchester, Roxbury, Mattapan and Hyde Park. Lead paint use was banned in the United States in 1978, but older homes may still contain lead paint whose flakes children can breathe or eat, causing potential mental and physical problems.

For more information about deleading homes, call (617) 635-4663. To register for the fair, call (617) 279-2289, ext. 513.

Posted by Elizabeth Cooney at 03:49 PM

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Monday, October 22, 2007

State to kick off flu-prevention campaign tomorrow

State and town officials plan to roll up their sleeves tomorrow to get a flu shot, part of a campaign to promote prevention in a year when more flu vaccine is available than ever before.

Massachusetts Department of Public Health Commissioner John Auerbach, Secretary of Elder Affairs Michael Festa, and Brookline Health Director Alan Balsam will receive their flu shots at 10 a.m. tomorrow at the Brookline Senior Center.

According to the state health department, there are 132 million doses of flu vaccine available in the United States for this winter's flu season, more than in past years. Massachusetts has bought 700,000 doses.

Posted by Elizabeth Cooney at 02:20 PM

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Tuesday, October 16, 2007

Community partnerships needed to recruit minority patients to cancer clinical trials

Higher cancer rates among ethnic and racial minority groups cannot be attacked without increasing their representation in clinical trials, community health workers and health care providers heard today.

"The solution is to build community-academic partnerships," Dr. Claudia Baquet, director of the University of Maryland Comprehensive Center for Health Disparities, told about 100 people at a conference at the University of Massachusetts - Boston also sponsored by the Harvard School of Public Health and community outreach organizations. "Notice I said 'community' first."

About 3 percent to 5 percent of all cancer patients participate in clinical trials that study ways to prevent, diagnose and treat cancer. Fewer than 1 percent of African-American patients do.

Historic barriers, including lack of trust or limited access to health care, aren't the only reasons, Baquet said. Patients need to hear from their health care providers that they might have the option of joining the studies, which are typically run by researchers at academic medical centers.

"It's a total myth that underserved communities have no interest in research," she said. "It's just that it has not been presented in a way that they can consider the benefits."

Groups like the Cherishing Our Hearts and Souls Coalition, which works to improve health among African-Americans in Roxbury, is an example of efforts to make research better reflect different populations, she said. The group is one of three pilot programs in the US funded by the Lance Armstrong Foundation with the goal of including more minorities in research.

Trust is still an issue, Tarma Johnson, director of clinical health services at Mattapan Community Health Center, said at a separate session for primary care practitioners. She was involved in recruiting patients for a clinical trial about vitamin D led by Boston University School of Medicine researcher Dr. Michael Holick. The patients were interested in what she told them, which could apply to cancer studies, too.

"The information came from the health center, not the hospital, because they trust us," she said.

Posted by Elizabeth Cooney at 02:37 PM

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Thursday, October 11, 2007

Tainted pot pies blamed for 5 salmonella cases in Mass.

By Stephen Smith, Globe Staff

Four adults and one toddler in Massachusetts have fallen ill with salmonella in recent months after eating tainted, frozen pot pies, state health authorities announced today.

All five recovered, but an 82-year-old woman from Bristol County was hospitalized for two days because of complications from the bacterial illness. The other patients who became ill were a 2-year-old boy and a 46-year-old man from Bristol County, a 29-year-old woman from Suffolk County, and a 23-year-old man from Franklin County. Their illnesses happened between May and September.

Tests at the state laboratory in Jamaica Plain showed that the type of salmonella that infected the five Massachusetts victims matches a strain blamed for more than 130 cases of the disease in 30 states. The Massachusetts patients had eaten Banquet brand pot pies that authorities have recalled.

Because of the salmonella contamination, consumers have been told not to eat Banquet pot pies or generic store brands that bear the code or plant number 5009 or P9. Products with that code should be discarded or returned to where they were purchased.

More information is available at the state Department of Public Health's web site, as well as from the US Centers for Disease Control and Prevention. Information is available via telephone from the Department of Public Health's Division of Epidemiology and Immunization at 617-983-6800 or the Food Protection Program at 617-983-6712.

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Posted by Karen Weintraub at 04:10 PM

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Wednesday, October 3, 2007

'Brain-eating amoeba' unlikely here, experts say

By Elizabeth Cooney, Globe Correspondent

Sundayís "brain-eating amoeba" story has been among boston.comís most e-mailed stories all week, but thatís about as close as the parasite may come to us, state and national health experts said.

Six people have died this year after an amoeba called Naegleria fowleri infected them while swimming in Florida, Texas and Arizona. Thatís a spike compared to the 23 deaths from 1995 to 2004, a trend that may continue with rising temperatures, epidemiologist Michael Beach of the US Centers for Disease Control and Prevention said in an interview.

The microscopic parasite, which lives in the bottom of warm, freshwater pools, can crawl into the brain via the olfactory nerve, the pathway from the nose to the brain that is crucial for our sense of smell. Once there, it can cause inflammation that destroys brain tissue. Symptoms typically start with a stiff neck, headache and fever, and death usually follows after three to seven days.

"This is a heat-loving bug that you really find only in hot springs or in southern tier states," Beach said. "We know we tend to see an increase in cases after an extended heat wave, and that's what we think happened this year."

A similar burst occurred in 1980, when eight people died, he said.

"Itís a very rare disease," Dr. Alfred DeMaria, the Massachusetts director of communicable disease control, said in an interview. ďWeíve never had a case in Massachusetts. We donít have that kind of environment."

People shouldnít be swimming in the kind of water where this parasite lives, DeMaria said, making it a good idea to stick to clean beaches, salt water and chlorinated pools.

"We wouldnít expect to see it here," DeMaria said.

Beach said there has not been an overall increase in the number of cases, despite the spikes that follow heat waves in states in the swath from Florida to California. But as temperatures rise because of global warming, so does concern.

"These are extremely tragic deaths," Beach said. "One has to consider with temperatures going up, the organism will compete better and we may see more cases. We want to track this."

Posted by Elizabeth Cooney at 07:42 PM

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Medford man diagnosed with West Nile

By Stephen Smith, Globe Staff

A 49-year-old Medford man is hospitalized with West Nile virus, the third person to contract the mosquito-borne illness this year in Massachusetts, state public health authorities reported today.

The man, who was not identified because of patient confidentiality laws, became ill at the end of September.

So far, more than 2,500 cases of West Nile have been confirmed this year in the United States, with most of the infections contracted west of the Mississippi River. In the most severe cases, West Nile virus can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

Separately, New Hampshire health authorities announced today that they have detected fresh evidence that another disease spread by mosquitoes, Eastern equine encephalitis, is still circulating. Infected mosquitoes were found in four towns, Brentwood, Fremont, Kingston, and Newton.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 04:14 PM

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Tuesday, October 2, 2007

Boston wins federal grant to address gaps in healthcare

By Stephen Smith, Globe Staff

Boston will receive more than $4 million in federal money over the next five years to address gaps in healthcare and to export the advances it has already made to other New England cities, Mayor Thomas M. Menino announced today.

The US Centers for Disease Control and Prevention has designated the city as a Center of Excellence in the Elimination of Disparities, with an emphasis on investigating the health status and medical treatment received by black residents who suffer from cardiovascular disease and breast and cervical cancer. African-American women in Boston are more likely to die from breast cancer than women of any other race or ethnicity.

Two years ago, Menino declared that the most pressing medical issue confronting the city was the persistent gap in health status and treatment that exists among racial and ethnic groups. At that time, the Boston Public Health Commission released a sweeping study on the subject and, later, ordered hospitals to begin collecting detailed information about all patients to better determine why disparities remain.

"We have a pretty good record on this," Menino said in an interview. "But we have to do more."

Posted by Karen Weintraub at 02:55 PM

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Monday, September 24, 2007

Walk-in clinics rank lower on patient satisfaction in Canadian study

Talking about the healthcare systems in Canada and the United States has always been a case of compare and contrast, and not just for Michael Moore in "Sicko." A study published today on what patients in Ontario thought about where they received urgent care may be relevant to the current Massachusetts debate on allowing walk-in clinics inside retail stores, but with some caveats.

Like its neighbor to the south, Canada is also suffering from a shortage of primary care physicians. But unlike doctors in the United States, some physicians in Ontario are required by their contracts to provide care after hours, usually until 8 p.m. on weekdays and for a half-day on the weekends. The majority of family practice doctors in the province are moving toward that model, study author Michelle Howard of McMaster University in Hamilton, Ontario, said in an interview.

Even so, some patients still go to independent walk-in clinics or hospital emergency departments for urgent care. A study in today's Annals of Family Medicine surveyed them on which kind of care they liked the best.

Seeing or speaking on the telephone with one's own family physician scored the highest, followed by going to the after-hours clinic affiliated with their doctor. Next came the emergency departement and then a health information telephone service staffed by nurses. Walk-in clinics finished last.

"It wasn't surprising that people were more satisfied if they had gone to their own family physician," Howard said. "I think this lends support to the idea that the (after-hours) service is really valued by patients."

The walk-in clinics in the study were standalone venues staffed by doctors, so they are different in two respects from the MinuteClinics that CVS Corp. hopes to set up inside its drug stores with nurse practitioners or physician assistants seeing patients. The Massachusetts Department of Public Health has held two public hearings on proposed rules governing retail clinics and will bring its findings before the Public Health Council in November at the earliest.

Howard said the Canadian survey of 1,342 patients in Thunder Bay, Ontario, was part of a larger study to test the hypothesis that if family physicians are available after hours, people might be less likely to go to a hospital emergency department. That study is not yet complete.

Posted by Elizabeth Cooney at 06:00 PM

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Monday, September 17, 2007

2 diagnosed with West Nile virus

By Stephen Smith, Globe Staff

A 53-year-old Arlington man and a 48-year-old Worcester woman have been diagnosed with West Nile virus, the first known cases of the mosquito-borne illness contracted in Massachusetts this year, health authorities said today.

Both the man and the woman became sick in August, and both are now at home recovering, said Donna Rheaume, a spokeswoman for the state Department of Public Health.

Three other people were diagnosed earlier in the summer with West Nile while in Massachusetts, but in two cases, the patients were visitors who had been infected in their home state. The third case involved a Boston man exposed to the virus while outside of Massachusetts.

So far this year, nearly 1,400 cases of West Nile have been documented in the United States, with most reported from states west of the Mississippi River.

In the most severe cases, West Nile virus can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 02:51 PM

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Wednesday, September 12, 2007

Dry summer has been bad news for mosquitoes

By Stephen Smith, Globe Staff

A dry summer has yielded at least one benefit: fewer mosquitoes carrying highly lethal Eastern equine encephalitis.

A state health report presented today shows that through Friday, disease trackers had found only 22 pools of mosquitoes carrying the virus. That compares with 121 pools of infected mosquitoes through the same period last year.

Dr. Alfred DeMaria, the state's director of communicable disease control, attributed the decline to the lack of rainfall, which is necessary for mosquitoes to breed robustly. The lack of rain, DeMaria said, has been most pronounced in the southeastern corner of the state, long recognized as a hotbed of Eastern equine activity.

Another mosquito-borne ailment, West Nile virus, appears to be at a level similar to last year, DeMaria said.

Eastern equine is the deadliest of all ailments spread by mosquitoes, killing one-third to one-half of people who contract the illness. No human cases of Eastern equine have been reported in Massachusetts this year.

Three cases of West Nile have been documented in the state, but investigators said they do not believe any of those infections was acquired in Massachusetts. Two of the people with the disease were visiting Massachusetts and appear to have contracted the virus before arriving in the Bay State. Investigators said the third patient, a Boston man, was exposed while in Montana.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 02:15 PM

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Ban proposed on toy jewelry containing lead

By Stephen Smith, Globe Staff

State health regulators this morning called for a ban on necklaces, bracelets, and other toy jewelry containing dangerously high levels of lead.

Tests performed by the state Department of Public Health found that some of the trinkets, which investigators purchased in stores across Massachusetts, possessed lead levels thousands of times higher than permitted. High lead levels in children have been linked to learning problems and other medical conditions.

State law forbids lead in paint applied to toys and jewelry but neither Massachusetts nor federal regulations cover lead in the metal and plastic contents of toy jewelry, leaving children vulnerable, Suzanne Condon, director of the state's Bureau of Environmental Health, said during a meeting of the state Public Health Council.

"I can remember as a child putting my necklace in my mouth," Condon said. "It's a rare thing if you don't see children with these things in their mouth."

Condon said 79 pieces of toy jewelry were tested and more than 10 percent had high rates of lead. That finding led health regulators to draft the proposed ban, which must be approved by the Public Health Council.

Members of the panel this morning expressed enthusiasm for the prohibition and suggested that regulators consider expanding it to other products potentially containing lead. If the ban is adopted, the state plans regular spot checks to make sure dangerous products aren't being sold, Condon said.

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Thursday, September 6, 2007

Advocate joining state Department of Public Health

By Stephen Smith, Globe Staff

Making the shift from advocate to official policy maker, the executive director of the Massachusetts Public Health Association announced this week that he is leaving that group to become a senior adviser to Massachusetts Public Health Commissioner John Auerbach.

Geoffrey Wilkinson, who has led the association of state and local public-health officials for more than five years, said in an e-mail that he expects to be involved in helping the state Department of Public Health develop a regional system for public health. Now, the state has separate boards of health in its 351 cities and towns, with widely varying degrees of expertise. Since being named public health commissioner earlier this year by the administration of Governor Deval Patrick, Auerbach has made establishing more centralized regional networks a priority.

Geoffrey%20Wilkinson.jpg

Wilkinson, who will earn $87,000 a year, said he will also be involved in strengthening the state's cadre of community health workers.

Posted by Karen Weintraub at 11:34 AM

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Wednesday, September 5, 2007

Health officials to consider revising retail clinic rules

By Felicia Mello, Globe Correspondent

State health officials said they would consider revising proposed rules to allow the opening of medical clinics in retail stores in response to concerns raised by doctors groups at a public hearing today.

Physicians testified that the regulations did not do enough to prevent infections at the clinics or to ensure that patients receive consistent medical treatment from providers who know their histories. Pediatricians said the clinics should not be allowed to treat children under 2 years old, to avoid confusion with immunization records.

The state Department of Public Health developed the rules after the pharmacy chain CVS asked for permission to open up to 30 "MinuteClinics" in the Boston area. Nurse practitioners in the clinics would provide rapid care for minor ailments such as bladder infections and poison ivy.

Regulators also heard from nurse practitioners and a patient who supported the clinics.

"We received a good deal of thoughtful testimony both in favor and in opposition to the regulations, and those that were opposed made very helpful suggestions on how to make the regulations better," Paul Dreyer, director of the department's Bureau of Quality Assurance and Control, said after the hearing. He said department staff would look at setting a minimum age for clinic patients and requiring clinics to answer after-hours phone calls.

The state Public Health Council could vote on the rules as early as November.

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Tuesday, September 4, 2007

Fenway Institute wins NIH grant to study LGBT health

The Fenway Institute at Fenway Community Health has won a five-year, $1 million government grant to study the health of the lesbian, gay, bisexual and transgendered population.

Researchers will look at the transmission of HIV, characteristics of families and households, and the demographics of health, illness, disability and death among LGBT people. The funding comes from the National Institute of Child Health and Human Development.

In addition, graduate students will be trained to study LGBT issues at the Boston University School of Public Health. Researchers will also work with the Inter-University Consortium for Political and Social Research at the University of Michigan to create an Internet-based library of LGBT health studies that will be accessible to the public.

Co-principal investigators of the grant are Judith Bradford, co-chair of the Fenway Institute, and Ulrike Boehmer, assistant professor of social and behavioral sciences at the BU School of Public Health.

"We know that health disparites due to sexual orientation exist, but few population-based studies on LGBT health have been conducted and the data are not readily accessible," Boehmer said in a statement announcing the grant.

Posted by Elizabeth Cooney at 06:20 PM

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Second West Nile case reported in Massachusetts

By Stephen Smith, Globe Staff

A 54-year-old Boston man has been diagnosed with West Nile virus, which health authorities said today they believe he contracted while visiting Montana.

The man, who was not identified because of patient confidentiality laws, is recovering, said Donna Rheaume, a spokeswoman for the state Department of Public Health. This is the second human case of West Nile reported in Massachusetts this year.

Last month, a man vacationing on Martha's Vineyard tested positive for the mosquito-borne illness, although disease investigators said he most likely was exposed in Missouri before coming to Massachusetts.

So far this summer, 741 cases of West Nile have been reported nationally, with the majority of illnesses happening west of the Mississippi River. Montana, where the Boston man visited, has reported 37 cases.

In the most severe cases, West Nile virus can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellents such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

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Wednesday, August 29, 2007

State unveils website targeting youth smoking

By Stephen Smith, Globe Staff

Who knew public health could be so hip?

State authorities tomorrow will unveil a glowing, gyrating website called the84.org that's targeted at adolescents, with film clips of antismoking ads made by kids, and an invitation to "peep" or see the winners. It's designed to dissuade youths from smoking -- and to encourage them to quit if they've already started.

The website is part of a broader campaign by the state Department of Public Health that also includes awarding about $200,000 to 18 organizations committed to the fight against teen smoking.

So why call the website the84.org?

"Because 84 percent of teenagers in school don't smoke," said John Auerbach, the state's public health commissioner. "This came from the young people themselves. The impression many young people have is that the majority of teenagers smoke.

"They felt it was important to have a name that suggested the vast majority of young people don't smoke -- that the norm is not smoking."

State statistics show that 7.1 percent of middle-school students and 20.7 percent of high-school students have smoked in the past month.

The effort to reduce youth smoking is the first initiative to benefit from increased funding the Legislature committed to tobacco control this year. The program's budget grew from $8.25 million in the last budget year to $12.75 million this year. Still, that's a small fraction of what the state spent in 2000, when the budget stood at a high of $54.3 million.

Posted by Karen Weintraub at 06:23 PM

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Friday, August 24, 2007

Beth Israel Deaconess to train medical microbiology fellows

Beth Israel Deaconess Medical Center will launch two new fellowship programs in medical microbiology, the hospital said.

Both are designed to teach doctors to understand bacterial agents, parasites and viruses and to run academic, hospital or public health laboratories. The fellows will train at Children's Hospital Boston and the Massachusetts Department of Public Health as well as Beth Israel Deaconess.

Posted by Elizabeth Cooney at 10:13 AM

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Thursday, August 23, 2007

Man, 81, infected with West Nile Virus

By Globe Staff

An 81-year-old man from Missouri may be the first person in Massachusetts to be stricken this year with West Nile Virus, though health officials say he was likely infected in his home state.

The man, whose name was not released, traveled from Missouri to Martha’s Vineyard on Aug. 5 and became ill six days later.

According to the Massachusetts Department of Public Health, the man was most likely exposed to the virus in Missouri, where there have been five reported cases this year. It is possible, however, that he was exposed in Massachusetts.

Posted by Karen Weintraub at 03:05 PM

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Wednesday, August 22, 2007

Public health agency names medical director

By Stephen Smith, Globe Staff

A researcher whose work has focused on children's health and healthcare disparities was today named medical director of the Massachusetts Department of Public Health.

Dr. Lauren Smith, a pediatrician by training, will oversee programs regarding early childhood health and also be part of the public health department's team monitoring the quality and cost effectiveness of healthcare reform in the state, according to agency spokeswoman Donna Rheaume. Smith will also lend her medical expertise to issues such as whether the state should allow walk-in clinics in drug stores.

Dr.%20Lauren%20Smith.jpg

Smith is an associate professor of pediatrics at the Boston University School of Medicine and medical director of the Medical-Legal Partnership for Children at Boston Medical Center, which unites doctors and lawyers to help families meet the basic needs of children. Smith's research has examined how social, economic, and demographic factors influence children's health.

For the past two years, Smith, who received her undergraduate degree from Harvard and her medical and public health degrees from the University of California, has spent the past two years as a health policy fellow in the office of House Speaker Salvatore F. DiMasi.

Smith's position is new. She will be paid $130,000 a year and will begin working part-time immediately and full-time in January.

Posted by Karen Weintraub at 11:06 AM

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Monday, August 20, 2007

Patient safety leader applauds Medicare policy to not pay for hospital errors

By Elizabeth Cooney, Globe Correspondent

A leader of the patient safety movement supports Medicareís decision to not cover hospitals' costs of treating preventable errors, saying itís time to go beyond altruistic efforts at improving outcomes.

"I would have preferred it to have been positive rather than punitive, but the time has passed for that, Iím afraid," Dr. Lucian Leape of the Harvard School of Public Health said in an interview. "Weíve got a lot of solutions out there and the thing that is so frustrating is they havenít been implemented."

Under the new regulations, Medicare will not pay the costs of treating patients harmed by errors, injuries and infections that occur in hospitals.

The list of conditions includes pressure ulcers (bedsores), injuries from falls, and infections, most commonly from the use of catheters in the bladder or lines inserted into blood vessels. Hospital-acquired infections lead to 99,000 deaths a year, according to an estimate by the US Centers for Disease Control and Prevention.

Leape was an author of the landmark Institute of Medicine report "To Err is Human" in 1998 that said as many as 98,000 people die each year from hospital medical errors. Since that time, the picture has improved, he said -- citing the Cambridge-based Institute for Healthcare Improvement's "100,000 Lives Saved" campaign -- but not enough.

"That progress has been made in the absence of any financial incentives or penalties," he said. "It has been done because a lot of good people Ė- doctors, nurses, administrators and others -Ė have wanted to do the right thing and reduce injuries. That just hasnít been enough, so people are beginning to pull the other lever, pulling the financial incentives in."

The Medicare move wasnít a surprise to hospitals, Karen Nelson, vice president of clinical affairs at the Massachusetts Hospital Association, said in an interview, calling it consistent with a trend toward pay for performance and public reporting of patient outcomes.

"This is sort of the flip side: non-payment for non-performance," she said. "The new angle to this is an implied causation. We hope that the final rules that come out are clear and easy for hospitals to apply in terms of documenting, to ensure that the attribution is correct."

That might mean getting urine samples before a patient is admitted to determine whether a patient already has a urinary tract infection, she said, a practice in place now but not used for every patient.

John Auerbach, commissioner of the state Department of Public Health, applauded the Medicare policy, but said it was only one part of a solution that will also involve the state and individual hospitals.

"I think it's an excellent policy and we need a range of different approaches in terms of eliminating these infections and injuries," he said in an interview. "Reimbursement is one of them, providing technical assistance and education is another one, and requiring public reporting of these infections and injuries is a third. If we employ them all, it will end up being the best thing for the patient."

Posted by Elizabeth Cooney at 06:21 PM

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Friday, August 10, 2007

Health workers win discrimination case 13 years after they lost jobs

Five Boston health workers will finally receive monetary awards stemming from a 2000 discrimination ruling, for what one of the employees said was "being treated like a criminal" when they were laid off 13 years ago.

Today the Supreme Judicial Court ruled that five black women who worked for the Healthy Baby/Healthy Child Program run by the Trustees of Health and Hospitals and the City of Boston were treated differently than a white man who was laid off at the same time.

After a series of appeals and reviews, the payments, with interest dating back to 1994, will more than double the $20,000 to $30,000 each woman originally would have received.

Gloria Coney, Marlene Hinds, Victoria Higginbottom, Belinda Chambers and Betty Smith lost their jobs in July 1994. Given no notice of the layoffs, they were monitored as they gathered their belongings and not allowed to speak to their co-workers. One woman had her lunch bag searched while she packed, a court summary says.

Coney "felt humiliated, mortified and angry at being treated like a criminal," the document says, and she believed her employer had acted on a presumption "that black women steal things."

A white male worker was told in advance that he would be laid off and was allowed to walk around the office freely before he left.

The city argued that because the white man's job was different his layoff was carried out in a different manner.

The Massachusetts Commission Against Discrimination ruled that the city agency had discriminated against the women based on their race and gender. It awarded them damages for emotional distress, plus attorney's fees and costs.

The initial MCAD ruling was appealed or reviewed five times.

Posted by Elizabeth Cooney at 06:58 PM

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Tuesday, August 7, 2007

Mosquitoes with Eastern equine virus found in SE Mass.

By Stephen Smith, Globe Staff

For the second time this summer, mosquitoes carrying Eastern equine encephalitis have been detected in Massachusetts. The infected insects were discovered in Seekonk, in far Southeastern Massachusetts.

The earlier batch of mosquitoes carrying the viral ailment was found in Raynham, not far from Seekonk. In past summers, Eastern equine encephalitis has been rampant in the marshy terrain of Southeastern Massachusetts.

No human cases of the disease have been reported this year in the state. Last year, two people died from the disease and three others were infected but survived.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

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Thursday, August 2, 2007

Mosquitoes with West Nile found in Medford

By Stephen Smith, Globe Staff

For the third time this summer, mosquitoes infected with West Nile virus have been found in Massachusetts, public health authorities announced today. The latest batch of disease-carrying insects was collected in Medford. Earlier, mosquitoes carrying the potentially lethal virus were discovered in Berkley and Marlborough.

Traditionally, West Nile begins circulating widely in mosquitoes in August, increasing the threat of infections in people. No human cases of West Nile have been reported this year in Massachusetts; last year, three people contracted the illness in Massachusetts; all survived.

So far this year, most of the 185 human cases of the disease in the United States have been reported west of the Mississippi River. California has the most, with 42. In the most severe cases, the infection can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 02:45 PM

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Tuesday, July 31, 2007

Summer's first mosquitoes with West Nile found in state

By Stephen Smith, Globe Staff

For the first time this summer, mosquitoes infected with West Nile virus have been found in Massachusetts. The virus-carrying insects were found in Berkley, in Southeastern Massachusetts, state health authorities announced today.

The mosquitoes were collected Thursday as a part of routine sampling conducted each summer and fall. A bluejay infected with West Nile was found last week in Marlborough, in the MetroWest region.

No human cases of the mosquito-borne disease have been reported this year in the state. Last year, three people contracted the illness in Massachusetts; all survived.

So far this year, most human cases of the disease have been reported west of the Mississippi River, with South Dakota reporting 28 cases and California reporting 27 cases. In the most severe cases, the infection can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 02:59 PM

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Monday, July 30, 2007

Bigby names new DMH commissioner

JudyAnn Bigby, state secretary of Health and Human Services, today named new commissioners of the Department of Mental Health and the Massachusetts Commission for the Blind and a new director of Medicaid.

Barbara Leadholm will return to the mental health agency after 10 years in the private sector as a vice president at Magellan Health Services, a company that manages behavioral health care for large health plans. At the Department of Mental Health, she was assistant commissioner for policy and planning from 1990 to 1993 and then Metro South Area director until 1996.

In a joint interview, Bigby and Leadholm sounded the same theme of integrating services for medical and behavioral health Ė a term Leadholm said she prefers to "mental health" because it includes problems such as substance abuse. They also said distinctions between private and public insurance are not as important as building a coherent system of care.

"Barbaraís background brings a special combination of experience that will serve us and the Department of Mental Health well as we look at strategies for optimizing services and ensuring quality, looking at the type of outcomes that we want to see that really focus on the individual, not just on mental illness," Bigby said. "We want to ensure that we have a unified set of standards and principles."

Leadholm had previously worked at the former Department of Welfare as director of chronic and specialty hospitals, director of CommonHealth and special populations, and provider manager for mental health and mental retardation. She holds a master's degree in psychiatric nursing from Boston College and an MBA from Boston University.

"Iíve got about 30 years of experience working both in the public sector as well as the private sector. That allows me to have a broad perspective," Leadholm said. "We want to look at how we can work together to make sure the system makes sense for more people. Itís very confusing for anyone who has a child with a serious emotional issue or a family facing schizophrenia for the first time. I donít think it matters whether you have private insurance or whether you look to the state for assistance."

Bigby also appointed Janet LaBreck head of the Massachusetts Commission for the Blind, where she has worked for 22 years, the last six as regional director for Central Massachusetts. Before then she was a vocational rehabilitation counselor and an independent living coordinator. She earned a bachelor's degree from the University of Massachusetts-Boston and a master's in education at Springfield College.

Thomas Dehner, who has been acting director of Medicaid since January 2006, has been named director. He is responsible for MassHealth, the state's Medicaid plan, and its $8 billion budget.

He had been deputy Medicaid director and before that chief of staff for the state Division of Medical Assistance. From 1999 through 2003 he was deputy general counsel for the Senate Committee on Ways and Means.

Posted by Elizabeth Cooney at 05:07 PM

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Friday, July 27, 2007

First bird with West Nile detected in Massachusetts

By Stephen Smith, Globe Staff

For the first time this summer, a bird carrying West Nile virus has been found in Massachusetts. The infected blue jay was detected in Marlborough and tested positive yesterday.

No human cases of the mosquito-borne disease have been reported this year in the state. Last year, three people contracted the illness in Massachusetts; all survived.

So far this year, most human cases of the disease have been reported west of the Mississippi River, with California reporting 27 cases, the most in the nation.

In the most severe cases, the infection can cause a high fever, headache, neck stiffness, stupor, coma, tremors, convulsions, muscle weakness, and paralysis. The US Centers for Disease Control and Prevention estimates that one of every 150 people infected with West Nile develops severe symptoms.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 11:11 AM

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Thursday, July 26, 2007

State advises consumer caution on potentially tainted canned goods

By Stephen Smith, Globe Staff

Massachusetts health authorities today advised consumers to discard any recalled products made by Castleberry's Food Co., even if the canned products look and smell safe.

Four people in Indiana and Texas fell ill with botulism after eating Castleberry's Hot Dog Chili Sauce; no botulism cases have been reported in Massachusetts.

The company is recalling a long list of products, sold under a variety of brand names, including chili with and without beans, beef stew, corned beef hash, and barbecue beef. Some dog food made by the company is also being recalled. For a full list of the recalled products, go to http://www.castleberrys.com/news_productrecall.asp.

Products found on Massachusetts store shelves are being removed and destroyed, the state Department of Public Health said.

Posted by Karen Weintraub at 06:46 PM

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Tuesday, July 17, 2007

State signals its open to retail medical clinics

By Liz Kowalczyk, Globe Staff

State public health officials are moving to allow medical clinics to open in retail stores, but are delaying a decision on whether to let CVS Corp. open 20 to 30 "MinuteClinics" in the Boston area.

The state announced today that it will propose new regulations by Aug. 8 to permit the operation of "limited scope" medical clinics. But the plan postpones the Department of Public Health's decision about whether to allow CVS to open primary care clinics in its pharmacies, beginning in Weymouth. CVS had hoped to open its first clinics this fall, but the start date could be delayed because the company will have to reapply under the new regulations.

The company indicated in a statement today that it would reapply.

Still, the announcement indicates that Massachusetts health officials are open to allowing retail medical clinics -- and other types of smaller clinics run by community health centers or hospitals -- to help ease emergency room overcrowding, provide better access to basic medical care, and as a convenience to consumers.

"What we believe is that there is enough evidence that the provision of limited clinical services in what might be called non-traditional settings has benefit that is worthy of consideration," said public health commissioner John Auerbach.

Retail medical clinics are taking off nationally, with about 400 in drugstores, discount chains, and supermarkets in other states.

At MinuteClinics in other states, nurse practitioners and physician assistants typically spend about 15 minutes with a patient, treating 20 or so common conditions, such as bladder infections, strep throat, and poison ivy, giving pregnancy tests and vaccines, removing stitches, and writing prescriptions. The clinics usually charge $59 a visit, and CVS officials said they are negotiating with Massachusetts health insurers to cover their members' visits.

The average wait is 20 minutes, company officials said, and MinuteClinics don't require appointments and have evening and weekend hours. Their motto: "You're sick. We're quick!"

In its application, CVS asked the health department to waive some of the state's current requirements for licensing clinics. For example, none of the conditions treated at MinuteClinics require blood tests, so the company does not believe it should have to comply with requirements for blood collection equipment and facilities.

But groups representing doctors, hospitals and community health centers had objected to giving CVS special consideration, and called for a public hearing on the proposal. They also had raised concerns about how patient safety and infection control would be monitored in the clinics. Today, the groups praised the health department for deciding to propose uniform rules that apply to all applicants and to hold a public hearing, probably sometime in the fall.

Auerbach said that, rather than granting numerous waivers to CVS, issuing new regulations would make the requirements clear to any entity that wants to apply to operate a limited-service clinic. For example, he said, a community health center could apply to open a satellite clinic in a homeless shelter.

James Hunt, president of the Massachusetts League of Community Health Centers, said he would encourage members to apply. But he said the organization remains opposed to retail clinics because they "fragment care," encouraging people to get treatment outside their regular doctor's office or health center, which are most familiar with their medical history.

The new regulations could include provisions requiring medical clinics to report a patient's visit quickly to the patient's regular doctor, Auerbach said.

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Thursday, July 12, 2007

Death rates from cancer fall slightly in Massachusetts

The number of people dying of cancer has fallen slightly in Massachusetts while the number of newly diagnosed cases has stayed about the same. But racial and ethnic disparities remain, in both the risk of developing cancer and dying from it, a new state report says.

The change in mortality rates was small but significant, according to the state Department of Public Healthís latest study, which covers 2000 through 2004.

In 2000, the mortality rate from 24 types of cancer was 205.8 deaths per 100,000 people. In 2004 it declined to 187.9 deaths per 100,000 people. The incidence of new cases declined each year, but the decrease was not statistically significant.

"The report shows that progress is being made. When we focus on prevention, as in reducing tobacco use, or focus on screening for early identification and treatment, we can save lives," DPH Commissioner John Auerbach said in an interview today. "On the other hand, cancer remains the second leading cause of death in Massachusetts and many people are still engaged in behaviors that put them at risk."

Half of all cancers could be avoided if people didnít smoke, adopted a healthy diet, increased their physical activity and cut their alcohol use, DPH said. About 18 percent of people in the state smoke.

Lung cancer is the most common cause of death from cancer in both men and women. The lung cancer death rate fell by 11 percent for men, but for women it stayed the same.

Breast cancer, the most common cancer in women, fell both in new cases (by 7 percent) and in deaths (by 10 percent). Prostate cancer, the most common cancer in men, also dropped in new cases (by 19 percent) and in deaths (by 24 percent).

But racial disparities persist. The incidence of both prostate and liver cancers was higher for black men than for other men. Asian men had the highest liver cancer incidence and mortality.

There were more cases of breast cancer among white women, but both black and white women died at a higher rate than Asian and Hispanic women. Black and Hispanic women had more cases of cervical cancer.

"Not all adults who should be screened for cancer are receiving screening, and certain populations bear a heavier burden of disease, particularly black and Latino people," Auerbach said. "We hope that expanding access through health care reform will be helpful in part to eliminating these disparities."

Posted by Elizabeth Cooney at 06:14 PM

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Wednesday, July 11, 2007

Statewide trans-fat ban gains key supporters

By Stephen Smith, Globe Staff

A statewide ban on artery-clogging trans fat lost its biggest potential roadblock today when the leading association of restaurateurs told legislators it will not fight the measure.

Massachusetts would become the first state to order restaurants to remove trans fat, a staple of frying oils and baked goods that has been linked to heart disease in humans and to diabetes and obesity in animal studies.

New York City approved a similar ban last year, a move that has inspired campaigns across the nation to consider similar regulations. The ban took effect last week amid little complaint.

A prohibition here would represent one of the most sweeping public-health initiatives in the state since smoking was banned from restaurants and bars in 2004. The tobacco rule faced ferocious opposition for more than a decade, most notably from the 5,500-member Massachusetts Restaurant Association, which argued initially that it would hurt business.

But today, Restaurant Association President Peter G. Christie told lawmakers that a statewide trans-fat ban would be preferable to a patchwork of local regulations. In May, Brookline became the first town in Massachusetts to embrace a trans-fat ban, although restaurants have until November of next year to comply. Boston and Cambridge have also considered bans.

"If it's decided that we need to take these things out of our foods in restaurants for health interests, we'll be willing to work with you," Christie told the Legislature's Joint Committee on Public Health.

Christie said he has "tremendous respect" for the state Department of Public Health, and if the agency says that trans fats are "bad and we have to get rid of them from our restaurants, the question would only be how and when."

The Department of Public Health, backed by research from Harvard and elsewhere, strongly supports reducing trans fat in diets. Public Health Commissioner John Auerbach championed a trans-fat ban in Boston where he was the top health official before moving to the state office this spring.

"We know that trans fats are harmful, significantly increasing the risk of heart disease," Auerbach said in a statement today. "Innovative approaches are needed to both educate the public about the dangers and to reduce the availability of foods with trans-fat content."

The Restaurant Association's stance sends such a powerful signal about the prospects for a statewide law that Boston now will probably wait to see what happens in the Legislature before pursuing a city ban, said Barbara Ferrer, who succeeded Auerbach as executive director of the Boston Public Health Commission.

"It's very encouraging to hear that the Restaurant Association is agreeing not to oppose a statewide ban," Ferrer said. "It says to me there's a fair amount of agreement that trans fats are not healthy, don't belong in the food, and the restaurant industry is taking a progressive position."

Ultimately, the ban's fate in the Legislature will hinge on the opinions of House Speaker Salvatore F. DiMasi and Senate President Therese Murray, neither of whom would commit to a position today. The ban was proposed by State Representative Peter J. Koutoujian, a Waltham Democrat, who is House chairman of the public health committee.

In one sure sign that trans-fat bans are winning widespread acceptance, the most vocal support at today's hearing came from two restaurant owners.

John Donohue, owner of Donohue's Bar and Grill in Watertown, told the committee that he decided in November to remove trans fat from all of his dishes, including french fries and chicken fingers, switching to a healthier brew of frying oil.

"Many of the consumers were dazed and confused because they didn't know I had changed," Donohue said. "They noticed zero difference. I've had a very popular reaction from my customer base."

Artificial trans fat had become a fixture of restaurant kitchens because it costs less, extends the shelf life of some baked goods and improves the texture of others.

Restaurateurs report that cooking with other oils has been less challenging than they expected, and that while they may pay more for healthier oils, they expect prices to drop as more cafes make the switch.

State Representative Alice K. Wolf, vice chairwoman of the committee, described the push to eliminate trans fat as "a train that's left the station.

"I'm very struck by the health data about how serious the health impacts are," said Wolf, a Cambridge Democrat. "It's not so cool to fight against public health measures if you have good data behind them."

Dr. Dariush Mozaffarian, a Harvard School of Public Health cardiologist and epidemiologist, detailed the health dangers of trans fat for the lawmakers, explaining how the artificial form raises the bad kind of cholesterol and lowers the good kind, something no other kind of fat does.

Research conducted at Harvard has shown how trans fat hurts the heart and increases the chances of suffering cardiovascular disease. Scientists estimate that having as little as 40 calories of trans fat a day can boost the risk of a heart attack by 23 percent.

A typical fast-food meal of chicken nuggets and french fries, if it's prepared in artificial trans fat, can easily contain more than 100 calories of the substance, Mozaffarian said.

Primate studies have also shown consuming trans fat can elevate the risk of a condition that is a precursor to diabetes and pack dangerous fat around the belly, the Harvard researcher said.

Trans fat, he said, "has no nutritional benefit, it has great potential for harm, and it can be easily replaced."

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Friday, July 6, 2007

Mosquitoes found with Triple-E

By Stephen Smith, Globe Staff

For the first time this summer, mosquitoes infected with Eastern equine encephalitis have been detected in Massachusetts.

The state Department of Public Health announced today that the disease-carrying insects were found Wednesday in Raynham, in Bristol County. No human cases of the viral illness have been reported so far this summer.

Last year, five people contracted Eastern equine encephalitis, two of whom died.

The virus kills one-third of its victims and half of those who survive suffer permanent neurological damage. There is no cure; survivors often require lengthy hospitalization.

The department has put together videos about the dangers of EEE and ways to prevent it.

Posted by Karen Weintraub at 02:44 PM

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Thursday, July 5, 2007

Potentially tainted toothpaste found on Massachusetts shelves

By Stephen Smith, Globe Staff

Massachusetts public-health authorities announced today that they have discovered tubes of toothpaste that may contain a dangerous chemical on store shelves in Boston and 11 other cities and towns.

The discovery comes as federal regulators report that some toothpaste made in China and elsewhere abroad contains diethylene glycol, a substance used in antifreeze. Long-term exposure to the chemical can cause kidney and liver problems.

The state Department of Public Health urged consumers not to use toothpaste falling into these categories:
-- If it is labeled "Made in China." The US Food and Drug Administration has identified a variety of brands made in China, including Cooldent, Dr. Cool, Everfresh Toothpaste, Superdent, and Oral Bright.
-- If is labeled as "Colgate" that is made in South Africa. Colgate officials have said their company does not import toothpaste from South Africa. The warning from health authorities does not apply to Colgate toothpaste made in the United States.
-- If the labeling is not in English.

Investigators from local health departments found about 160 tubes of toothpaste fitting those descriptions in shops in Amherst, Arlington, Boston, Cambridge, Dedham, Lawrence, Lowell, Malden, Somerville, Sturbridge, Wellesley, and West Springfield. It is not known whether any of the tubes contains diethylene glycol, a spokesman for the state Department of Public Health said.

The state agency has asked local health authorities to inspect stores to determine if they carry the potentially contaminated toothpaste and to ask shop owners to discard it.

Consumers with questions or concerns should contact their local board of health or the Food Protection Program at the state Department of Public Health, at 617-983-6712.

Posted by Karen Weintraub at 03:26 PM

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Tuesday, July 3, 2007

Some funding restored for chronic illness management

By Alice Dembner, Globe Staff

A program that helps low-income patients manage chronic illnesses will receive $1 million in state funding this fiscal year, under the compromise budget approved by the Legislature on Monday.

The funding for CenterCare is a big drop from the $2.7 million allocation last year, but it is not as deep as Governor Deval Patrick and the House of Representatives had proposed. Patrick is reviewing the entire state budget and could veto money for the program, which is run through 30 community health centers statewide.

But CenterCare supporters said they were lobbying hard to ensure that doesn't happen, and plan to seek more money in a supplemental budget later in the year.

"It's still at less than half strength," said Patricia Edraos, policy director of the Massachusetts League of Community Health Centers. "But it gives us something to build on."

Even if the governor approves spending the money, it's unclear how much would go to a branch of the program at Holyoke Health Center, the subject of a Globe story on June 19. The center has helped hundreds of patients with diabetes adopt healthier lifestyles and reduce their blood sugar levels.

Posted by Karen Weintraub at 04:36 PM

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Thursday, June 14, 2007

Provider groups object to MinuteClinics in CVS stores

By Liz Kowalczyk, Globe Staff

Wait a minute!

Five medical-provider groups say they have major objections to CVS Caremark's plan to open 20 to 30 MinuteClinics in Boston-area stores by the fall.

In a letter this week to state public health Commissioner John Auerbach, the groups called for a public hearing on the proposal; they said his department should not waive certain clinic requirements for CVS without a hearing and vote by the Public Health Council. CVS wants a waiver of many normal clinic licensing requirements, such as having blood collection equipment because the clinics won't do blood tests.

The groups objected to granting waivers of "basic public health protections and standards of care to a for-profit company in order to reduce the economic burden to that company in competing with other health care providers. ..." They said a waiver would be unfair to medical providers struggling to meet regulations.

Groups that signed the letter are the Massachusetts Medical Society, Massachusetts Academy of Family Physicians, Massachusetts Chapter of American Academy of Pediatrics, Massachusetts Hospital Association, and Massachusetts League of Community Health Centers.

The Department of Public Health did not make any promises about whether it would hold a public hearing before deciding on CVS's application. "The Commissioner will certainly consider the request from these organizations," the department said in a written statement. "We recently organized a meeting to hear from both proponents and opponents of the proposal and we value the input that we received."

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Wednesday, June 13, 2007

Family members rate Mass. nursing homes highly

By Stephen Smith, Globe Staff

Nine out of 10 families that have a relative living in a Massachusetts nursing home would recommend the facility to other relatives and friends, according to a state survey released today.

The survey, which was conducted from February through April and drew nearly 21,000 responses, gave nursing homes good grades in categories ranging from the quality of staff to the quality of food. When asked to rate their overall satisfaction with their relatives' nursing home, family members on average gave scores above 4 (satisfied) on a scale of 1 (very dissatisfied) to 5 (very satisfied).

The Massachusetts Legislature ordered that the Department of Public Health conduct the survey as a way of measuring quality in the state's roughly 450 nursing homes, which have about 42,000 residents. The survey was first conducted on a more limited basis in 2005, and this year for the first time, it applied to all nursing homes.

About 60 percent of families who were sent surveys completed them. Among six specific categories evaluated, staff fared best, winning high marks for delivering medication on time and respecting cultural and ethnic differences.

Scores were reported separately for facilities that participated in the earlier survey and those that were evaluated for the first time this year. Among facilities being graded for the second time, staff in 2007 received a satisfaction score of 4.19, essentially identical to the earlier mark. Staff at facilities participating for the first time in the survey received a score of 4.11.

The lowest marks were in the activities category, which includes recreation and religious services, ranging between 3.75 and 3.86.

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Friday, June 8, 2007

Cancer clinic workers diagnosed with whooping cough

By Stephen Smith, Globe Staff

Two nurses and an auditor in an outpatient cancer clinic at Cape Cod Hospital in Hyannis have been diagnosed with whooping cough, hospital and state public health authorities said today.

The hospital is contacting patients potentially exposed to the hospital workers and providing them with antibiotics, said Donna Rheaume, spokeswoman for the state Department of Public Health.

Whooping cough is a highly infectious bacterial disease transmitted by coughing and sneezing. Typically, the disease arrives with symptoms similar to those of the common cold, but then progresses to spasms of coughing.

At its worst, a rattling, rib-cracking cough can linger for months and cause patients to lose sleep and weight. Studies have shown that 62 percent of adults with pertussis are still coughing three months after symptoms appear.

While symptoms can be persistent, the disease rarely kills otherwise healthy adults. But like any infection, it can pose a more significant threat to patients with chronic illnesses and impaired immune systems -- such as those with cancer.

Children have been routinely vaccinated against whooping cough for decades, but specialists know that the effectiveness of the shot wanes over time, leaving adults and some teens vulnerable to the infection unless they get a booster shot.

Posted by Karen Weintraub at 01:23 PM

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Thursday, May 24, 2007

Less is more, public health commissioner says

By Stephen Smith, Globe Staff

With apologies to Hillary Rodham Clinton: When it comes to public health, it takes a village.

But 351?

That's the question the state's new public health commissioner, John Auerbach, is asking. Massachusetts now has a crazy quilt of 351 public health boards -- one for every city and town. Some are so small that on certain afternoons, especially Fridays, they simple close down.

Auerbach told the state's Public Health Council today that he intends to explore the feasibility of creating regional public health networks to maximize expertise and assure responsiveness.

"There has to be a solution other than the current way of functioning," Auerbach said in an interview. "Most other states have already figured this out. We're the exception."

Florida, for example, which has three times the population of Massachusetts and considerably more land mass, has 67 county health departments.

Posted by Karen Weintraub at 01:53 PM

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Friday, May 18, 2007

State lab gets new boss

By Stephen Smith, Globe Staff

Maybe Al DeMaria can finally get a little rest now.

DeMaria has been holding down multiple jobs at the Department of Public Health: the state's director of communicable disease control, chief medical officer and head of the State Laboratory Institute in Jamaica Plain. DeMaria's is a well-known face at the agency and on TV, especially when viruses or bacteria go on a rampage.

Now, the lab, which analyzes blood samples and other material taken from patients, is getting a full-time director -- and DeMaria is getting a break.

In June, the veteran chief of a comparable lab in Iowa will become director of the 113-year-old Massachusetts facility, which would play a pivotal role in the event of a global influenza epidemic or amid a biological or chemical threat. Mary J.R. Gilchrist, director of the University of Iowa's Hygienic Laboratory for the last 11 years, is a nationally recognized microbiologist and author of more than 100 textbook chapters and other publications.

DeMaria will continue -- perhaps better-rested -- as disease chief and medical director at the health agency.

Posted by Karen Weintraub at 11:13 AM

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Wednesday, May 2, 2007

Report details broad sweep of norovirus in Boston

By Stephen Smith, Globe Staff

The wave of gastrointesinal illness that swept Boston in recent months spawned 18 outbreaks in colleges, day care centers, and healthcare facilities, ranging from eight cases to 438, according to a report released today by the Boston Public Health Commission.

Disease trackers from the city confirmed that the illnesses were caused by norovirus, the same germ that ignited outbreaks across the nation this past winter.

Boston's sophisticated disease tracking system found that the number of patients showing up at emergency rooms complaining of gastrointestinal ailments was significantly higher from December 2006 through April 2007 than the comparable period a year earlier. Over a 19-week period, an average of 95 patients a day flocked to ERs with norovirus symptoms, compared with 78 a day the year before.

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Monday, April 30, 2007

Tufts Health Plan loosens restrictions on obesity surgery

By Elizabeth Cooney, Globe Correspondent

Tufts Health Plan has quietly loosened its restrictions on weight-loss surgery, expanding who can get insurance coverage for the operations and shrinking how much time patients must first spend in a counseling program.

The restrictions were criticized by the state Department of Public Health, patients and surgeons even before they went into effect in March.

In a statement issued yesterday in response to questions about its new policy, Tufts said it was committed to offering its members the best chance for long-term success.

"Working most closely with bariatric surgeons at Tufts-New England Medical Center, we jointly agreed to guidelines for the coverage of bariatric surgery," the statement said.

Tufts spokeswoman Catherine Grant said the plan would not elaborate on the reasons for the change.

The revised rules, effective as of April 16, appear to address some of the concerns raised by Nancy Ridley, associate public health commissioner, who in February sent a letter to Tufts president and CEO James Roosevelt Jr. saying the restrictions were "contrary to evidence-based guidelines" that the department had crafted for obesity surgery. She warned him that the agency could review denials of coverage.

Under the revised rules, Tufts will pay for obesity surgery for members with a body mass index above 35 if they also have diabetes, hypertension or sleep apnea that requires medical treatment. Under the original rules, the minimum BMI for such patients was 40.

The health plan also dropped limits on the types of obesity surgery patients could qualify for. Now patients eligible for coverage can undergo either laparoscopic gastric banding or gastric bypass surgery.

Before surgery, members now must join the health plan's lifestyle modification program, called iCanChange, for six months, down from 12 months under the original rules. They can continue the behavioral program for 12 months if they wish, rather than go on to surgery, the plan said.

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Wednesday, April 25, 2007

Leading legislator supports lifting stem cell research rules

By Stephen Smith, Globe Staff

A leading legislative voice on health affairs today applauded public-health authorities for moving to scrap restrictions on stem-cell research -- and took some not-so-subtle swipes at the former administration of Mitt Romney.

State Representative Peter J. Koutoujian, chairman of the House Committee on Public Health, urged the state's Public Health Council to follow the recommendation of administrators to abandon stem-cell regulations adopted last August under the Romney administration. Governor Deval Patrick last month also decried the restrictions.

"It is wonderful to be working with a new administration with a commitment to public health," said Koutoujian, a Waltham Democrat. And he said that as the Public Health Council considers rolling back the restriction, it should engage in a discussion driven by scientific evidence "rather than one that would be pressured by an external political agenda."

Critics charged that politics figured prominently in the Romney administration's directive to limit stem-cell research.

Scientists worried that the regulations adopted last summer could subject them to criminal penalties if they engaged in certain kinds of laboratory work.

The Public Health Council, the panel that sets health policy in the state, also got a primer today on stem cell research from Dr. David T. Scadden, who specializes in the field at Massachusetts General Hospital and Harvard Medical School.

The council won't vote on the proposal to lift the regulations until at least this summer, after a series of public hearings.

Posted by Karen Weintraub at 02:54 PM

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Thursday, April 19, 2007

Boston gets $500,000 for anti-obesity campaign

By Stephen Smith, Globe Staff

A coalition leading the fight against obesity in Boston won a $500,000 grant today, money that will be used to draft a citywide battle plan and to expand public space for physical activity.

The two-year grant was awarded by the W.K. Kellogg Foundation to the Boston Food and Fitness Collaborative, a 52-member association that includes hospitals and health centers, city agencies, and activist groups. The collaborative intends to make affordable produce available to residents as well as improve walking and bicycling trails, according to the office of Mayor Thomas M. Menino.

In two years, the coalition could receive an addition $3.5 million from the Kellogg Foundation to further implement strategies emerging from the citywide plan to combat obesity.

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Wednesday, April 11, 2007

Public health expansion slashed in House proposal

By Stephen Smith, Globe Staff

The House Ways and Means Committee today dealt a serious setback to Governor Deval Patrick's proposal to significantly expand public health services, eliminating or scaling back several of the governor's key initiatives.

The House budget contains no money for cervical cancer vaccines for girls, while Patrick had proposed spending $12.5 million to inoculate about 42,000 11- and 12-year-olds.

"I'm disappointed," said John Auerbach, the state's new public health commissioner. "I believe that making the vaccine available would have been a valuable public health initiative, given the data that show that this vaccine can be very helpful in terms of preventing cancers."

The governor's call to substantially reinvigorate the state's decimated Tobacco Control Program was also dealt a blow: The House budget contains only $8.2 million for anti-smoking campaigns, compared with Patrick's request for $16.2 million.

The House plan was released on the same day that a national leader in tobacco-control efforts visited Beacon Hill to press his case for restoring the state's once-vaunted campaign to reduce the leading cause of preventable deaths. Matthew Myers, president of the Campaign for Tobacco-Free Kids, presented Patrick and state health officials with a report showing that sales of cigarettes increased in Massachusetts last year, even as they declined nationally.

"We're deeply disappointed that the House has done so little in the face of such strong evidence about an increase in sales," Myers said.

Overall, the House spending plan for public health programs falls $31.6 million short of Patrick's proposal, according to an analysis by the Massachusetts Public Health Association. The interest group review shows that the budget of the Department of Public Health would remain essentially flat under the House proposal.

Posted by Karen Weintraub at 06:08 PM

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Tuesday, April 10, 2007

Two new state health officials appointed

By Stephen Smith, Globe Staff

The former chief of the state's HIV/AIDS Bureau and a top United Way official were appointed assistant secretaries of health today by Dr. JudyAnn Bigby, Massachusetts's health secretary.

Jean McGuire, who was an assistant commissioner in the Department of Public Health from 1997 to 2003, is the new assistant secretary for disability policies and programs. McGuire presided over the AIDS division at the public health agency before leaving for a position at Northeastern University. Early in her career, McGuire's work focused on special education and rehabilitation of adults with significant disabilities.

Marilyn Anderson Chase will be assistant secretary for children, youth, and families. Chase spent 10 years as senior vice president for community impact at the United Way of Massachusetts Bay.

Posted by Karen Weintraub at 05:08 PM
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