Shingles vaccine available, but expensive, and can be hard to find

Though it's expensive and can be hard to find, a vaccine against shingles is now available to people 60 and up, and in some cases to those 50 and up. Until this year, the vaccine, approved by the U.S. Food and Drug Administration in 2006, was only available to people 60 and older, The Courier-Journal's Darla Carter reports.

The painful, contagious rash, which is caused by a reactivation of the chickenpox virus, affects about 1 million Americans each year. It usually appears on one side of the face or body and results in blisters, fever and pain. It can also result in permanent pain, a condition called post-herpetic neuralgia or PHN.

Though the FDA had approved the vaccine, "Some medical facilities are waiting until action by the U.S. Centers for Disease Control and Prevention before agreeing to provide the vaccine to people 50 to 59. The topic is expected to be discussed at the June meeting of the Advisory Committee on Immunization Practices, which makes vaccine recommendations to the CDC," Carter reports.

The vaccine can cost more than $200, must be frozen and isn't always covered by insurance or Medicare. It is only covered through Medicare Part D, but not Medicare Part B. Many insurance companies are deciding whether or not to cover the vaccine pending the advisory committee's decision.

At Kroger pharmacies, the vaccine is available without a prescription for people 60 and up, but younger patients need a prescription, Carter reports. Take Care Clinics and Walgreens pharmacies require that customers be 60 or older to receive the vaccine. (Read more)

Kicking smoking habit not that hard, Philip Morris CEO says

The CEO of cigarette giant Philip Morris International said kicking the smoking habit isn't that tough, though he acknowledged that cigarettes are bad for one's health and are addictive.

Louis C. Camilleri's comment was made to nurse Elisabeth Gundersen of the University of California- San Francisco, one of many members of anti-tobacco groups who attended Philip Morris' shareholder meeting in New York Wednesday. She said one of her patients told her last week "that of all the additions he's beaten — crack, cocaine, meth — cigarettes have been the most difficult," reports Michael Felberbaum of The Associated Press.

Camilleri, right, responded, "We take our responsibility very seriously, and I don't think we get enough recognition for the efforts we make to ensure that there is effective worldwide regulation of a product that is harmful and that is addictive. Nevertheless, whilst it is addictive, it is not that hard to quit. . . .  There are more previous smokers in America today than current smokers." Camilleri is a longtime smoker.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called Camilleri's comments the "most irresponsible form of corporate double-speak."

Worldwide, there are 1 billion tobacco users, according to the World Health Organization. The U.S. Public Health Service has said about 45 percent of American smokers try to quit every year, but only 4 to 7 percent are successful. About 25 percent of Kentucky adults smoke, the highest percentage nationwide, according to Kentucky Public Health Commissioner Dr. William Hacker. (Read more)

Prescription pill problem in Kentucky, elsewhere under microscope on NPR program

The growing prescription-drug abuse problem in Kentucky and other states was under the microscope Thursday during National Public Radio's "On Point," hosted by Tom Ashbrook.

The Courier-Journal's Laura Ungar, who wrote an extensive series on pain-medicine abuse this year, was one of three journalists who spoke about the epidemic. Dealers visit various pain-management clinics, which have been labeled "pill mills," fill the prescriptions and then sell the drugs at a high profit.

Ungar, left, called the prescription drug trade "akin to the illegal drug trade, where many of our folks in Kentucky are getting drugs that originated in Florida." Indeed, 98 of the nation's top 100 prescribers of drugs Oxycontin and Xanax are in Florida, the journalists conveyed.

One caller to the show, identified as Michelle of Carter County, Kentucky, shared what it was like when her mother was a pain-meds addict. "We would wake up in middle night and have to put her to bed because she was like a zombie," she said. "It was like no one was there."To read more and listen to the show, click here.

Construction, expansion at UK HealthCare boosting Lexington's economy; total payroll now exceeds 8,700

The construction and expansion at UK HealthCare, which comprises the University of Kentucky's College of Medicine and Albert B. Chandler Hospital, is giving Lexington a fiscal boost in an otherwise difficult economy. More than 8,700 people now work at the hospital and medical school.

The school's number of employees has grown by 900 since 2004, topping out at 3,989, reports Margaret Buranen of Business Lexington. In the same period, the number of full-time hospital employees grew from 2,562 to 4,722, an 84 percent jump. The payroll, including salary and benefits, has risen to $677 million, about $300 million more than in 2004.

Another notable change in the past seven years is the ratio of full- and part-time faculty members at the College of Medicine. "The number of part-time faculty members has decreased nearly one-third, while full-time basic science and clinical faculty members have both increased. The net result is a 21 percent increase in faculty members," Buranen reports.

Construction of the new Chandler Hospital has produced a payroll of $72 million in the private construction sector, which translates to 300 full-time jobs during construction. In addition, the fact that UK HealthCare used Kentucky vendors for building materials and supplies whenever possible results in an economic impact of $88.6 million., Buranen reports.

Phase I of the hospital construction includes a parking structure, trauma center and emergency department, which opened in July 2010. The hospital pavilion, which includes two floors of patient rooms, opens May 22 and will be dedicated Sunday. Phase II will cost $230 to $250 million. (Read more)

State health commissioner encourages smoke-free ordinances

Kentucky's public health commissioner said communities are moving in the right direction by enacting smoke-free ordinances and hopes Kentucky can become a smoke-free state. "We have communities in Letcher County, as well as areas in far Eastern Kentucky, Western Kentucky and Northern Kentucky implementing second-hand smoke ordinances because it's dangerous for people who are non-smokers," Dr. William Hacker said.

Hacker, who spoke at the Breathing Clean Air Summit in Owensboro Thursday, said 25 percent of Kentuckians smoke, the highest percentage in the country, reports Jasmin Embers of WFIE-TV in Evansville. "We're ranked number one in lung cancer deaths, so if you're number one in smoking, you can expect to be number one in lung cancer deaths," Hacker said.

Hacker encouraged communities that already have smoke-free efforts or laws to go farther. Change can be seen at Owensboro Medical Health System, which now has four smoking huts on its campus. Those will be eliminated by the end of the year, a move that was decided after employees responded to a smoking survey. "Half of the respondents said they felt that smoking on OMHS grounds contradicted our mission statement to heal the sick and improve health of our community," wellness committee member Gordon Wilkeron said. (Read more)

Fort Campbell using simulated battlefields to assess brain injuries

Doctors at Fort Campbell are using a mock battlefield to assess whether or not soldiers who have suffered a traumatic brain injury are ready to return to combat. The clinic has been recognized by the Department of Defense as a national model.

"Soldiers are making life and death decisions, so doesn't it make sense to use demonstrated competence as the standard for returning someone to duty?" Dr. David Twillie told National Public Radio's Blake Farmer.

In exercises meant to simulate scenarios they face when fighting in Iraq and Afghanistan, soldiers sweep a gravel road for possible roadside bombs, take fire from insurgents and are told to insert chest tubes and tie tourniquets while listening to sound from a scene in Saving Private Ryan. The goal is to assess how well the soldiers handle the stress of the situations. Patients must also take written tests that assess their competence. The combination of both simulated and written assessments is important.

"Very recently we had a soldier that had a desire to stay in, had done well in all our simulations," Twillie said. "But when all the different sights, sounds, smells came back, he just wasn't able to change his focus, and that's very important in combat."

Memory loss, mood swings and difficulties balancing are common symptoms of a traumatic brain injury. About 115,000 soldiers have experienced such an injury, the Defense Department estimates. (Read more)

Eating local: Farm-to-school gaining ground as way to fight childhood obesity and otherwise improve students' nutrition

By Tara Kaprowy
Kentucky Health News

With the faint hue of green appearing in thousands of gardens and farms, the growing season has officially begun in Kentucky. While most of the resulting produce is destined for store shelves and personal pantries, there is growing demand for it to appear in kitchens that haven't seen locally-grown fruit and vegetables for decades but are keys to children's nutrition.

Schools are the newest frontier in sustainable farming, with their collective power not only capable of transforming the agricultural landscape, but also fighting childhood obesity, one of the biggest health crises facing the nation. (Kentucky Department of Agriculture photo: Montgomery County farmer Gayle Arnold picking tomatoes)

This growing trend is called "farm to school," in which school cafeterias serve food grown by local farmers. Across the state, food-service directors in 78 school districts have made their schools Kentucky Proud institutions, meaning they serve local products in their school lunches.

This map shows that nearly 50 counties had some type of farm-to-school program in place in 2010; more have started.

"It's a growing movement," said Tina Garland, coordinator for the Kentucky Department of Agriculture's Farm-to-School Program. "Producers are being added every day. We've got orchards that can turn off their freezers in the fall because the schools buy all of their apples."

John Cain, state co-chair of Kentucky Action for Healthy Kids, attributed the trend to several factors, including efforts to find viable markets for former tobacco farmers, a concern about food security and the obesity epidemic. "We're having to revisit where does our food come from and what does the source of our food have to do with our obesity problem," he said.

This year, 10 school districts will receive $5,000 grants from the Kentucky Department of Public Health's Obesity Prevention Program so they can establish farm-to-school programs. Last year, Jackson, Lee and Owsley counties established their own programs using the grants. Owsley Food Service Coordinator Charolette Thompson served locally-grown watermelons and cantaloupes in her cafeterias. "The students noticed the difference in taste and the better quality in the produce," she said. "They love it."

In Jackson County, in addition to developing ties with farmers, students grew tomatoes, left,  and canned salsa, which will be used in the school cafeteria. They also made jam, which they sold under the label "Jammin' Generals." "Not only did they learn how to grow their own food, they learned how to market it and how to preserve it," said Elaine Russell, nutrition coordinator for the Obesity Prevention Program. (Cumberland Valley District Health Department photo)

This trend is likely to continue, especially since it now has federal support. On April 26, the U.S. Department of Agriculture established a rule that will let schools give preference to local, unprocessed farm products when they buy for the National School Lunch Program and other USDA programs.

While farm to school is gaining traction, it is not a new concept. Julie Tuttle, food nutrition coordinator at Montgomery County Schools, is one of a handful of food-service directors who have been serving locally-grown produce for several years. "We started using apples in 2006," she said. "Now we're up to four producers." (Kentucky Department of Agriculture photo: Students Macy Tabor and Makayla Donathan at Montgomery County High School)

The latest is Marksbury Farms, where Tuttle is buying beef, chicken and pork. Last week, in honor of the Kentucky Derby, Montgomery County High was one of the first Kentucky schools in decades to serve local meat. The students had the option of either burgoo or hot browns, left. "I had one student who came up to me and said, 'I just wanted you to know this is the best school lunch I've had since I've been here,'" Tuttle said. "That's what it's all about, getting those comments from students." (Kentucky Department of Agriculture photo)

Julia Bauscher, director of school and community nutrition services for Jefferson County Public Schools, teamed with Sullivan University to develop recipes, and was able to buy local squash, peppers and zucchini that she and her team processed and froze for year-round use. This year, she is buying local foods from about 12 providers, three of whom have contracts to grow for the schools.

In addition to raising awareness, she's found farm to school improves the reputation of the school cafeteria in general. "This gives everyone something to feel good about and opens everyone's eyes a little more about the program," she said. "And how we really do have to work hard to make this happen."

Farm-to-school programs have been slow to start in many places because they face logistical, legal and other challenges. Many school districts want their suppliers to carry a $1 million liability insurance policy, which they may not be able to afford, and be certified through the Good Agriculture Practices Program, education they may not be able to get.

Farm to school's biggest drawback is that it takes more work. Unlike food delivered to schools by huge providers, locally-raised produce may need to be washed and processed, which takes more staff or volunteers.

"The market has evolved a very convenient system," said Mark Swanson, an assistant professor in the University of Kentucky College of Public Health. He said school food-service directors "have one or two providers they can call and they can get what they need. Farm to school gets a lot more complicated. ... It takes a really motivated person to tackle that on their own."

Swanson said that hurdle can be lowered by social connections in rural communities. He spoke of one farmer who was selling her tomatoes to a Wendy's restaurant. Though she'd had a bad harvest, the restaurant manager was willing to use the product, in part because they went to church together. "He knew that his business arrangement would be cushioned by social ties," Swanson said.

In Owsley County, ties between the school and farmers have become so strong farmers will now host a farmers market on the grounds of the high school there. "It's the social connection with farm to school that gives it the most potential," Swanson said.

Federal procurement guidelines keep schools from paying much of a premium for local products, but "Farmers are pretty uniformly willing to accept a lower price for their produce because of the volume and they can sell it all at once," rather that waiting for single buyers at a farmers' market, Swanson said. "It's a good trade," he said. "It's a whole lot easier."

That was the case for Jeremy Hinton, owner of Hinton's Orchard and Farm Market, and the schools in LaRue County and nearby Elizabethtown, which buy 1,000 of his apples a week.

"It was a cost savings to them over what they were paying at the time," Hinton said. "Even when wholesale apples are available for less, they continue to buy our apples because of the quality and supporting locally grown. . . . Probably the biggest compliment we've gotten is talking to some cafeteria managers who said they're seeing more apple cores in the trash bin instead of apples with one or two bites out of them."

While farm to school is gaining ground in Kentucky, it is more established in the upper Midwest, the Northeast and California. Kelly Crossley, food-service director at Independence School District in Iowa, started her program in 2008. Though she is interested in supporting farmers and shrinking the district's carbon footprint, Crossley's main goal is the same as most food-service directors in the program: healthier eating.

"If you can get kids to eat more fruit and vegetables, hopefully those items will replace something more fattening they would have eaten otherwise," she said. To reinforce the effort, students meet the farmers in the classroom and travel to the farms, and Crossley posts in the cafeteria signs noting where the local foods were grown. Crossley said her staff only casually monitors what students take in the lunch line, not what actually gets eaten, but "The cooks have told me ... that they can tell which kids have been exposed because they're taking more."

Swanson is doing research in Lee County to see if farm-to-school actually improves children's nutrition. He will establish a program and photograph trays of food coming off the lunch line and being returned once the students have eaten. "There's a general assumption that farm-to-school programs work and no one has really studied the effects on nutrition," he said. "The reason I don't sell it on the nutritional benefits is we really don't know."

While the empirical evidence may be short, the anecdotal evidence is strong. Crossley said she witnessed an unforgettable success late last fall in Iowa.

"Brussels sprouts were the only thing left in the garden," she said. "The kids went out and actually harvested them off the trunks. We sautéed them, put a little bit of parmesan cheese on them and we passed them out to the kids. I'm telling you, they ate it up ... That day, we heard stuff like, 'I like Brussels sprouts and I didn't even know it.'"

Bauscher looks forward to the day that happens all over Kentucky. "As more districts become more involved in this," she said, "we ought to be able to create something that's really worthwhile, not only for the students, but for the farmers."