Rao bulletin 1 October 2016 html edition this bulletin contains the following articles pg Article Subject
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- Health Care Reform Update 64 ► 604K Vets Facing No Coverage
- What Word Healthy Means ► Government Wants Your Input
- Traumatic Brain Injury Update 56 ► Hearing Loss Impact
- Dietary Supplements Update 03 ► Do you Really Need them
PTSD Update 220 ► Pennsylvania Approves Vet Marijuana Use Bill Gov. Christie, surprising skeptics, on 14 SEP approved a bill that will allow people suffering from post-traumatic stress disorder to use medical marijuana when conventional treatments fail. Patients and their advocates had lobbied for the bill for more than a year, citing statistics that show military veterans with PTSD have a high rate of suicide. "I'm ecstatic, I'm happily surprised, I'm going to go get my card," said Don Karpowich, 57, an Air Force special operations veteran from Morristown with PTSD who has attended several demonstrations at the Statehouse over the last year to push for the bill. Christie had said at several town halls that he did not want to expand the medical-marijuana program. Two years ago his administration turned down a petition submitted by Coalition Medical Marijuana New Jersey to add PTSD to the list of a dozen ailments that qualify for cannabis use. But a month and a half after the bipartisan bill was placed on his desk, Christie signed it with a statement explaining his reasons. Christie cited statistics of the federal Department of Veterans Affairs estimating that 20 percent of veterans who fought in Iraq and Afghanistan over the last decade suffer from PTSD. "Throughout the country, significant resources are being used to research PTSD and increase access to traditional treatments, such as psychotherapy and antidepressant medications," he wrote. "This bill would provide struggling veterans and others with the ability to use medical marijuana to treat PTSD, but only after it has been determined by a physician or psychiatrist that conventional medical therapy is ineffective." Christie said that "requiring conventional medical therapy to be ineffective in treating PTSD before medical marijuana can be prescribed is an appropriate threshold safeguard to deter misuse." He said he will also direct the health commissioner to create new regulations to further prevent misuse, an issue he has raised in the past to explain why he does not favor expanding the program. Many patients and advocates, however, have criticized the Health Department for promulgating too many rules, saying that makes the program unwieldy and prevents people with serious illnesses from qualifying to use cannabis. Some saw Christie's action as being motivated by his role as a key adviser in the presidential campaign of Donald Trump. "I wonder if Trump had something to do with this," Karpowich said. Christie approved the bill only a few days before it would have become law automatically, without his signature, if he did not veto it. He said that "the mere potential for abuse by some should not deter the state from taking action that may ease the daily struggles of our veterans and others who legitimately suffer from PTSD." Assemblyman Vince Mazzeo (D., Atlantic), a primary sponsor of the bill, said that "post-9/11 veterans are the group most affected by PTSD" and that there are about 428,000 veterans in New Jersey. "The VA has stated that it wants each veteran to find the medication with the least amount of side effects that allows them the optimum level of independence. For many, medical marijuana is the drug that best fits that criteria and the only one to provide veterans with significant relief from the anxiety associated with PTSD," Mazzeo said. PTSD is a mental-health condition triggered by a traumatic event such as a physical or sexual assault, childhood neglect or physical abuse, a natural disaster, exposure to combat, or other extreme or life-threatening events, according to the bill. Symptoms can include flashbacks, nightmares, severe anxiety, uncontrollable thoughts about the event, emotional distress, physical symptoms, feelings of numbness or detachment, engaging in dangerous or self-destructive behavior, and experiencing suicidal thoughts. "We know that individuals with PTSD are using marijuana that they are getting from the streets and, unfortunately, they are at risk of purchasing a substance that may be laced with a dangerous additive and of getting a criminal charge," said Sen. Nicholas Scutari (D-Union), another primary sponsor. "This will give them the ability to obtain marijuana legally that is regulated by the government." [Source: The Inquirer | Jan Hefler, | September 15, 2016 ++] ***************************** Health Care Reform Update 64 ► 604K Vets Facing No Coverage More than 600,000 veterans will remain uninsured next year if there isn't movement to further expand Medicaid under Obamacare, according to a report from the left-leaning think tank Urban Institute. The group's report said if the 19 states that haven't expanded Medicaid coverage hold to that position in 2017, it would leave 604,000 veterans without coverage. The report also found that the uninsured rate for veterans and their family members sharply declined from 2013 to 2015. It fell from 11.9 percent in 2013 to 6.8 percent in 2015, a 42 percent drop. "Over this time, veterans also experienced fewer unmet health needs, suggesting that increased coverage translated into improved access to care," according to the report funded by the Robert Wood Johnson Foundation. The decline mirrors a decline in the overall U.S. uninsured rate to below 9 percent. However, coverage gaps remain for veterans, and the report said expansion of Medicaid could help. Declines in veteran uninsurance rates were larger "in the 26 states that had expanded Medicaid under the [Affordable Care Act] by 2014 than in non-expansion states," the report said. A 2012 Supreme Court decision left it up to states to decide whether to expand Medicaid. So far, 31 states have done so and 19 have held out. Most of those 19 states are led by Republican governors. The federal government under Obamacare covers the entire cost of the expansion for the first few years, but then asks for states to shoulder some of the cost. States that have held out have done so due to concerns about long-term costs and opposition to Obamacare. The report said the Department of Veterans Affairs agency is able to provide care to veterans in some cases. [Source: Washington Examiner | Robert King | September 28, 2016 ++] ***************************** What Word 'Healthy' Means ► Government Wants Your Input The U.S. Food and Drug Administration is seeking input from the public on what the word “healthy” should mean when it appears on food packaging. The federal agency requested public comments on the subject 28 SEP and will accept comments at https://www.federalregister.gov/documents/2016/09/28/2016-23365/use-of-the-term-healthy-in-the-labeling-of-human-food-products-request-for-information-and-comments through 26 JAN 2017. Douglas Balentine, director of the FDA’s Office of Nutrition and Food Labeling, explained in a blog post this week that the FDA has already started considering criteria for an updated definition for the “healthy” labeling claim. However, Balentine acknowledges that FDA officials “don’t have all the answers.” For example, Balentine poses questions such as: What current dietary recommendations should be reflected in the definition of “healthy”? What are the public health benefits of defining the term “healthy”? What do consumers expect of foods that carry a “healthy” claim? 
Stephanie Perruzza, a registered dietician at the food company Kind, points out some of the issues with the current definition for “healthy,” telling Money Talks News by email: As it stands, the current regulation precludes foods generally considered to be good for you — like nuts, avocados and salmon — from being labeled as healthy. However, it allows items like fat-free chocolate pudding, some sugary cereals and low-fat toaster pastries to carry the healthy designation. In December, Kind petitioned the FDA to revisit some of its requirements for food labeling, including the “healthy” claim — particularly the amounts of total fat and saturated fat that can be contained in a food labeled as “healthy.” Kind’s petition came after the company received a warning letter from the FDA regarding labeling claims on a few types of Kind snack bars, which are primarily made of nuts and fruit. The letter explained that, under current federal regulations, foods labeled as “healthy” must contain less than 1 gram of saturated fat, among other parameters. Daniel Lubetzky, chief executive and founder of Kind, said in a statement this week that the company is encouraged by the FDA’s progress: “The FDA has posed a number of important questions for comment,” Lubetzky continued, “and in our continued efforts to advocate for public health, we’re actively convening experts to help provide answers grounded in current nutrition science.” [Source: MoneyTalksNews | Karla Bowsher | September 28, 2016 ++] ***************************** Traumatic Brain Injury Update 56 ► Hearing Loss Impact It’s no surprise that some symptoms of traumatic brain injury (TBI) include headaches and memory problems. But hearing loss may also accompany a TBI, either because the injury damages the ear or because there is damage to the part of the brain that processes sound. In addition, loud noises that might just be irritating to people without a brain injury can cause problems such as headaches and fatigue for those with a TBI. Research continues to fully understand the mechanisms associated with hearing loss and auditory and vestibular (important part of the ear for balance) system injuries in individuals with TBI, said Katie Stout, director of clinical affairs for Defense and Veterans Brain Injury Center. In the meantime, there are specialty treatments and rehabilitation strategies available for hearing and balance challenges in individuals with TBI. Becoming aware of how your surroundings can affect your hearing is a key factor in managing hearing problems associated with TBI, according to experts from the Defense Department Hearing Center of Excellence (HCE). “Any sound above 85 decibels has the potential to damage the auditory system. However, the amount of damage is dependent on the loudness and duration of the sound,” said Dr. Lynn Henselman, HCE interim director and audiologist. By way of comparison, a kitchen blender is about 88 decibels. Because service members in particular are often exposed to high noise levels, hearing protection is crucial, especially with a TBI, said Dr. Jeremy Nelson, HCE science advisor and neuroscientist. “What makes patients with a TBI unique is that they come with other factors we need to consider when protecting them,” said Nelson. In general, however, standard hearing protection might mitigate some TBI symptoms. A person should only be exposed to an average of 85 decibels of sounds over the course of an eight-hour day, said Lt. Col. Andy Merkley, Army audiology liaison to HCE. Sample decibel measures of common sounds include: 60 decibels: conversation, dishwasher or clothes dryer 70 decibels: busy traffic, vacuum cleaner, alarm clock 80 decibels: garbage disposal, dishwasher Every time the noise level increases by three decibels, the length of safe listening time is cut in half, Merkley said. An 88-decibel sound should only be listened to for four hours; a 91-decibel sound, for two hours. A simple way to determine whether a noise is too loud is the “three-foot rule,” which means that if you have to raise your voice in order for someone standing within three feet of you to hear you over other noise, your hearing is at risk, Merkley said. Events such as air shows can be hard on anyone’s hearing regardless of whether they have a TBI. A jet flying overhead can be around 119 decibels, Merkley said. [Source: DCoE Public Affairs | Myron J. Goodman | September 28, 2016 ++] ***************************** Dietary Supplements Update 03 ► Do you Really Need them? The supplement business is a multi-billion dollar industry that is not currently regulated like conventional food and drug products by the Food and Drug Administration. Thirty-seven percent of Air Force personnel are currently using supplements as part of a daily morning routine or as part of a workout plan, according to Air Force Medial Operations Agency. The question is, are Airmen doing enough research to validate the need for supplements? According to the FDA, manufacturers and distributors of dietary supplements and ingredients are solely responsible for evaluating the safety and labeling of their products before marketing to ensure they meet all the requirements of the Dietary Supplement Health and Education Act, meaning there is no regulation of the supplement industry. 
Supplements may lack nutrients a body needs that it can only get through eating certain foods. Individuals who are taking supplements may in fact not need what they are taking and what they are taking could produce adverse effects. Kirk Clark, 341st Medical Group health promotions coordinator, said the main concern is individuals taking supplements may not need what they are taking and what they are taking could produce adverse effects. “Big things you see in supplements is they can have interactions with drugs that are prescribed by physicians,” said Clark. “They can also certainly lead to kidney dysfunction as your kidneys now have to filter more.” Different supplements advertise outcomes such as weight gain or loss, depending on the results the distributor is trying to sell. Not researching a supplement, or using it incorrectly, may give the user negative results. The use of supplements is designed to add further nutritional value to the diet, not act as a meal replacement. Matt Lewis, 341st MDG registered dietitian, said people will often spend unnecessary money on a pre and post-workout shake when they could in fact be eating a meal before and after to obtain the same or better results. “If you consume one cup of broccoli you would probably obtain 100 percent of your vitamin C and 10 percent of your vitamin A for your recommended daily allowance,” said Lewis. “This means you would not need those vitamins from supplements that you’re taking. You can get everything you need from the intake of a healthy diet.” Lewis also added that supplements may be lacking other nutrients a body needs that it can only get through eating certain foods. Both Lewis and Clark have seen clients who, for various training reasons, have been encouraged to use supplements as part of their diet due to the amount of energy, vitamins and nutrients their bodies need. The problem occurs when someone assumes that because a dietary regiment works for one person, it will work for all. Clark has two questions he advises people to ask themselves before assuming that supplements is the correct answer. “You need to ask yourself what your end goal is and why you need it,” said Clark. “If you can’t answer the question ‘why?’ without an emotional attachment, then you may not need the supplement.” The two are not attempting to dissuade consumers from using supplements, only encouraging thorough research before spending money on something the body may be able to produce naturally through food or that a body may not actually need. “It is the responsibility of the consumer to decide whether or not a supplement should be used and to know that there may be some negative side effects,” said Lewis. Both encourage visiting the Human Performance Resource Center, Operation Supplement Safety at http://hprc-online.org/dietary-supplements/opss to learn more about supplements. Directory: uploads uploads -> 587 Return function, r i(X) r i(0) r i(1) r i(2) r i(3) 1 0 2 4 6 Thermal Station, I 2 0 1 5 6 3 0 3 5 6 10 uploads -> Department of science and humanities department of mathematics part-a questions and answers uploads -> The Case Against the nypd’s Quota-Driven ‘Broken Windows’ Policing What Is It? uploads -> For want of a nail uploads -> Ownership Models There are two different types of ownership models uploads -> Police Militarization uploads -> City of rising star regular meting thursday, july 14, 2016 uploads -> Township of winfield uploads -> Stop Militarizing Law Enforcement Act of 2014 uploads -> The Black Panther Party’s Ten-Point Program What We Want Now! Download 7.71 Mb. Share with your friends:
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