Tuesday, August 02, 2011

The Morning Drill: August 2, 2011

A collection of dentistry and health related links/comments for your day.

No More Co-pay for Birth Control

Health care reform requires new insurance plans to fully cover women's preventive care, which now will include free birth control, yearly wellness visits, breastfeeding counseling and equipment, and screening for gestational diabetes, domestic abuse, HPV, sexually transmitted infections (STIs), and HIV.

Health and Human Services Secretary Kathleen Sebelius today announced the expanded definition of women's preventive care. The ruling closely follows the advice of an Institute of Medicine expert panel, released July 20.

"Today, as part of the Affordable Care Act, we are announcing historic new guidelines that will help women get the care they need to stay healthy," Sebelius said at a news teleconference. "Today we are accepting the recommendations of the Institute of Medicine, so no woman in America needs to choose between paying a grocery bill and paying for the key care that can save her life."

The new requirement does not affect health plans in effect before March 23, 2010. These "grandfathered" health plans include most employer-sponsored plans. However, the majority of employer plans already cover contraception.

Starting August 2012, new health plans will have to offer the expanded wellness coverage without requiring a co-payment. Insurers may "use reasonable medical management to help define the nature of the covered service," according to the Department of Health and Human Services (HHS).

Howard Koh, MD, HHS assistant secretary for health, estimated that by 2013, 34 million U.S. women ages 18 to 64 will receive the benefits spelled out in the new ruling. While preventive care saves money by avoiding or delaying more costly chronic disease care, Koh said the new benefits would mean a "small" increase in premium costs.

The new definition of women's wellness includes access to all FDA approved forms of birth control. The so-called abortion pill RU-486 and similar drugs are not covered.

Religious institutions that offer health insurance to their employees may choose not to offer birth control, according to an amendment to the prevention regulation proposed by the Obama administration. The HHS says it "welcomes comment on this policy."
Smoking, Diabetes, Obesity May Shrink Your Brain
As if there weren't already enough good reasons to avoid smoking and keep your weight, blood sugar levels and blood pressure all under control, a new study suggests these risk factors in middle age may cause your brain to shrink, leading to mental declines up to a decade later.

Evaluating data from 1,352 participants whose average age was 54 in the Framingham Offspring Study -- which began in 1971 -- researchers from the University of California, Davis found that smoking, high blood pressure, diabetes and being overweight were each linked to potentially dangerous vascular changes in the brain.

"We can't cure disease or cure aging, but the idea of a healthy body, healthy mind is very real," said study author Dr. Charles DeCarli, director of UC Davis' Alzheimer's Disease Center. "People should stop smoking, control their blood pressure, avoid diabetes and lose weight. It seems like a no-brainer."

The study is published Aug. 2 in the journal Neurology.
Attention Athletes, Professional and Not: Beware of the Back-to-Workout Injury Blues
Whether you’re a weekend warrior getting ready to play your first round of golf of 2011 on vacation or a NFL player coming back from a lockout, beware: injuries may await you if you’re not careful.

Former NFL quarterback Rich Gannon recently said he expects to see an increase in injuries among returning NFL players, specifically those who haven’t been able to build up position-specific fitness in the workouts held during the lockout. (Eleven Baltimore Ravens experienced injuries on the first official day of training camp last week, though it’s of course not possible to know whether any of those were related to the lockout.)

Meantime, a study published online this summer by the American Journal of Sports Medicine looked at injury patterns among Major League Baseball players and found the highest rate of injuries in April — at the very beginning of the season. The injury rate was lowest in September, at the end of the season. Research among college baseball players has also shown that practice injuries are more likely to occur during the preseason than the regular season, likely because players weren’t as fit coming off their break from athletics.
When Running Up Mileage, 10 Percent Isn’t the Cap
My friend Martin Strauss of Ann Arbor, Mich., was running 60 miles a week when he suffered a stress fracture that put him on crutches for three months. Now that he’s better, he wants to play it safe to avoid another injury. But what’s the best way to do that? How quickly can he ramp up the miles?

Martin decided to follow the 10 percent rule, one of the most widely known in running. It does not specify a starting distance but says you should increase your mileage no more than 10 percent a week. The idea is that this is a safe way to increase your distance without risking injury.

That made me wonder, Where did this rule come from?

Carl Foster, director of the Human Performance Laboratory at the University of Wisconsin in La Crosse, said its origin “is lost in history,” and added, “Whether it is right is undocumented.”

It might be more correct to say “almost undocumented.” There is at least one large and rigorous study of the 10 percent rule, the sort of study that is a rarity in exercise science. Conducted by Dr. Ida Buist, Dr. Steef W. Bredeweg, Dr. Ron L. Diercks and their colleagues at the University of Groningen in the Netherlands, it’s one of a continuing series of studies on how to prevent running injuries.

The injury problem is huge, said Dr. Diercks, head of the sports medicine program at the university — as many as 40 percent of runners are injured, usually to their feet, ankles, knees or legs. At his university’s running clinics, 30 to 40 percent of beginning runners gave up because of injuries.
Enjoy your morning!

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