Drugmakers, health groups bring HPV vaccine to girls in poor countries

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  One dose of the vaccine Gardasil, developed by Merck & Co., is displayed.AP Photo/Harry Cabluck, File

Two multinational drugmakers are teaming up with top global health groups to protect millions of girls in the world's poorest countries from deadly cervical cancer.

Starting with pilot programs in eight Asian and African nations, the ambitious project ultimately is intended to inoculate more than 30 million girls in more than 40 countries by 2020. Given that most women killed by cervical cancer live in developing countries, the project could have a huge impact.

The endeavor was announced Thursday by the GAVI Alliance, a public-private partnership that's worked with drugmakers to deliver affordable vaccines to poor countries to treat childhood illnesses that are big killers.

"This is a transformational moment for the health of women and girls across the world," said Dr. Seth Berkley, CEO of GAVI, which is short for Global Alliance for Vaccines and Immunization.

"A vast gap currently exists between girls in rich and poor countries. With GAVI's programs we can begin to bridge that gap so that all girls can be protected against cervical cancer no matter where they are born," he said in a statement.

Drugmakers Merck & Co. and GlaxoSmithKline PLC initially will provide 2.4 million doses of their vaccines against cancer-causing human papilloma virus - for a fraction of the cost commanded in Western countries.

Merck will supply its Gardasil for $4.50 per dose, and Glaxo its Cervarix for $4.60 per dose. In the U.S., the shots cost well over $100 apiece, and a three-dose series over six months is required.

The vaccines protect against the strains of human papilloma virus, or HPV, that most commonly cause cancer. The virus, transmitted during sex, causes cervical cancer as well as vaginal, vulvar, anal and oral cancers. The vaccines prevent roughly 70 percent of those cancers.

In developed countries, older girls and women routinely get Pap tests to check for cervical cancer or signs of precancerous changes in cervical tissue. They're treated promptly, often before cancer begins, and few die. And increasingly, young girls and now boys as well are vaccinated with either Gardisil or Cervarix, starting as young as age 9 so they're protected well before they become sexually active.

Not so in poor countries.

"They don't have the benefit of screening to catch cancer early, when it can still be treated," Dr. Julie L. Gerberding, president of Merck Vaccines, said in an interview.

As a result, 85 percent of the 275,000 women killed by cervical cancer each year live in poor countries, where HPV is most prevalent.

"It is a disease that has devastating, life-threatening consequences and it is preventable," said Gerberding, an infectious diseases expert who's a former director of the Centers for Disease Control and Prevention. "Our aim is to do what we can to make the vaccine available."

The GAVI project will begin "demonstration projects" administering the vaccines to girls aged 9 to 13, starting in Kenya as early as this month. Then it will be expanded to Ghana, Laos, Madagascar, Malawi, Niger, Sierra Leone and Tanzania.

The goal is for the governments of those countries to show they can set up a national system - with medical staff, clinic supplies, distribution systems and supply management all well organized - to provide the vaccines over the long term. The program also will bring an opportunity to teach the girls about nutrition, sexual health and HIV prevention.

Already, GAVI is planning to provide the shots nationwide in Rwanda, starting next year.

Merck, based in Whitehouse Station, N.J., is providing 93 percent of the shots initially. It's also agreed to provide more shots at an even-lower price in the future, if higher volumes of vaccines are ordered, as that would reduce production costs.

Merck and Britain's GlaxoSmithKline are among the world's biggest makers of vaccines, and both have long provided many for free or at discounted prices to health programs in poor countries.

GAVI also will work with the heavy hitters of global health and development groups, including the CDC, the World Health Organization, UNICEF, the Bill & Melinda Gates Foundation and the World Bank. Other partners include the charities, corporations and 18 wealthy countries that help fund GAVI.

In the U.S., the vaccines have become steady money makers since they were launched a half-dozen years ago, but they haven't turned into the mega-sellers initially envisioned.

That's partly because of their high price here, but also because of political fights. Some conservative groups opposed the vaccines, arguing that giving adolescents a vaccine to protect them against a virus transmitted by sexual activity would encourage it.

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Implantable health sensors being developed to monitor at-home patients

Published May 09, 2013

FoxNews.com

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Scientists in Britain are working to develop a high-tech sensor – capable of being worn on clothing and jewelry or being implanted in the body – that could help doctors or caregivers monitor the health of vulnerable patients, Medical Daily reported.

The system, called Sensor Platform for Healthcare in a Residential Environment (SPHERE), could be used to assist patients who suffer from obesity, depression, stroke, frequent falls, cardiovascular or musculoskeletal diseases.

"Families, carers, health and social services professionals involved in all stages of care will benefit from the system," said lead researcher Professor Ian Craddock, director of the Interdisciplinary Research Collaboration (IRC). "SPHERE will address real world challenges by developing a practical technology to monitor people's health in the home environment."

The technology will compile data by recognizing patterns transmitted through the sensor, detecting minor changes in a patients’ behavior, posture and even whether or not they had taken their medication, Medical Daily reported.

Researchers have been awarded a multi-million dollar grant to develop this inexpensive, accessible system, and they have partnered with technology companies like IBM and Toshiba.

Some British residents have expressed concern over privacy issues related to the device, Medical Daily reported, but researchers insist the technology will offer huge benefits for the country’s aging population.

"Information from these sensors will monitor and track the signature movements of people in their homes and trigger a response in accordance with health needs," Professor William Harwin in the School of Systems Engineering at the University of Reading said. "This will enable health care experts to respond as appropriate."

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Dancer who worked with Michael Jackson says she gave warnings about singer's health

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  March 9, 2007: Michael Jackson delivers his speech to fans during an event "Fan Appreciation Day" in Tokyo.AP

LOS ANGELES –  A dancer who worked with Michael Jackson throughout his career testified on Wednesday that she told the director of Jackson's ill-fated concert tour that she was worried about the singer's health.

Witness Alif Sankey told a jury deciding a lawsuit that the pop star appeared thin and unprepared in 2009 for the rigors of his planned comeback concerts known as "This Is It."

The singer showed up at one rehearsal with shoes that had holes in the soles, missed rehearsals and appeared much thinner than earlier in his career, Sankey testified.

Sankey showed jurors an email she wrote to tour director Kenny Ortega in early June 2009, urging him to try to improve Jackson's health and spirits. She never got a direct reply but testified that Ortega raised the concerns with concert promoter AEG Live.

"Please help me help you to get him back into that Magical Light, please let me help you help him find what was lost, his GRAIL," Sankey wrote to Ortega, who she had worked closely with for a number of years.

Testimony showed Ortega copied Sankey on several email messages that he sent to AEG executives about Jackson's condition and the need for him to receive physical therapy and better nutrition.

"He requires more attention and management," Ortega wrote in one email. "I truly believe he needs nourishment guidance and physical therapy (massage) for his fatigued muscles and injuries. He is not in great physical shape. I believe he's hurting."

Sankey met Jackson while working on his 1987 video for "Smooth Criminal" and was an associate producer and planned to dance onstage during "This Is It."

She was testifying at the trial of a negligent hiring lawsuit filed by Jackson's mother against AEG Live LLC. Katherine Jackson claims AEG failed to properly investigate the doctor who was caring for her son and later administered a fatal dose of the anesthetic propofol to the singer in June 2009.

The promoter has denied wrongdoing and its attorneys have said the singer hid his addiction to propofol. Jackson's former physician, Conrad Murray, was convicted in 2011 of involuntary manslaughter.

Plaintiff's attorney Brian Panish asked Sankey about one message in which AEG executive Paul Gongaware told Ortega that he planned to talk to Murray.

"We want to remind him that it is AEG, not MJ who is paying his salary," the message said. "We want him to understand what is expected of him."

Sankey said she based some of her impressions of Jackson over the years on how he felt when they hugged.

"When I hugged him, he just felt like marble," Sankey said about Jackson early in his career. "But when I hugged, when I saw him briefly in 2006, he didn't feel like that anymore. He felt thin."

On cross-examination, Sankey acknowledged that her impressions were formed from brief interactions with the singer and she never had a long conversation with him.

She was, however, trusted enough to be around Jackson's children, whose privacy he fiercely protected.

Sankey testified that Paris Jackson once shared a secret, saying she didn't want her father to find out about candy stuffed inside her purse.

There were also several tiny pictures inside her purse -- all of her father.

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New herbal handbook helps to inform health care professionals

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It’s an old, shopworn story: A patient goes into the doctor’s office and tells the doctor that they are taking several different kinds of herbs. He has been advised to seek the doctor’s advice. Are these herbs okay to take with my medication, he asks. The doctor has no idea, and suggests that the patient stop taking the herbs – just to err on the safe side. Scenes like this happen every day.

Now, thanks to the recent publication of the new edition of the American Herbal Products Association’s (AHPA) Botanical Safety Handbook, no health professional needs to make an uninformed decision like that ever again. Researched and written by herbal scientist Zoe Gardner, and edited and reviewed by an expert advisory panel of world-class botanical specialists including AHPA President Michael McGuffin, the Botanical Safety Handbook provides a reliable, scientifically validated reference that lets doctors know the current state of science and safety on over 500 common and lesser known herbs.

Years in the making, the more than 1,000-page long AHPA Botanical Safety Handbook provides definitive information on herbs, their standard doses, contraindications, any possible drug interactions, safety of use during pregnancy and lactation, any reported adverse events, toxicity studies, and references for all data cited. The most exhaustive reference of its kind ever assembled, the AHPA Botanical Safety Handbook distills in one place hundreds of thousands of pages of scientific and medical information on herbs – the most widely employed class of health remedies in the world. Without question, the handbook answers the question, “Is it safe?”

As numerous studies have shown, people in the United States are turning to herbs at an unprecedented rate. Reasons for this include dissatisfaction with conventional pharmaceuticals and greatly expanded media highlighting the benefits of herbal medicines. Yet even with decades of steady escalating herbal use, physicians and other health care professionals, including pharmacists, have been slow to learn about this burgeoning category. With the AHPA Botanical Safety Handbook on hand, now every doctor, nurse, pharmacist, clinic and hospital can have readily on hand the definitive guide to recurring herbal questions.

Since 1999, the World Health Organization, the public health arm of the United Nations, has published four authoritative volumes on medicinal plants – the WHO Medicinal Plant Monographs. These volumes give up-to-date information on known uses and benefits of many major herbs. In addition, the American Botanical Council has published numerous books on these traditional medicines, including the ABC Clinical Guide to Herbs. The WHO volumes, combined with the ABC guide and the AHPA handbook, lift the veil of confusion surrounding herbal remedies and firmly establish the deep scientific roots of plant-derived medicines. With this small library, a once uninformed doctor can confidently answer the herbal questions that patients pose every day.

Health experts used to complain that there wasn’t enough science on herbs to give accurate recommendations on their uses and safety. Those days are long gone. Hundreds of thousands of scientific and medical papers and thousands of books have been written on herbal medicines. Now, with the AHPA Botanical Safety Handbook and the other guides described here, no health care professional needs to remain bewildered or uncertain about this globally valuable sector of human health care.

As William Blake famously declared, necessity is the mother of invention. For many years, we have needed definitive botanical safety science, all in one convenient reference, in the hands of health care professionals. With the AHPA Botanical Safety Handbook in print and available, that critically important need has been fulfilled.

The new edition of the AHPA Botanical Safety Handbook is available on Amazon.com.

Chris Kilham is a medicine hunter who researches natural remedies all over the world, from the Amazon to Siberia. He teaches ethnobotany at the University of Massachusetts Amherst, where he is Explorer In Residence. Chris advises herbal, cosmetic and pharmaceutical companies and is a regular guest on radio and TV programs worldwide. His field research is largely sponsored by Naturex of Avignon, France. Read more at MedicineHunter.com.

Chris Kilham

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Health workers with hepatitis B pose little risk to patients

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Peter Nguyen was a promising medical student when his school learned that he had tested positive for the hepatitis B virus. He said he was blackballed by school administrators and forced to halt his studies.

"I knew the stigma" that came with a hepatitis diagnosis, Nguyen said. But he thought that a medical school, of all places, would understand. "I came there expecting help. Instead, I was greeted with discrimination."

Nguyen's prospects of becoming a physician are a lot brighter today. The U.S. Department of Justice recently declared in a legal settlement that hepatitis B patients are protected by federal disability law. And, separately, federal health officials have issued a revised set of guidelines that make it clear that health care workers and students who carry the hepatitis B virus - HBV for short - generally pose little or no risk to patients.

Taken together, advocates say, the new health guidelines and the Justice Department settlement remove barriers to practice, handing HBV-positive health professionals and students a pair of powerful tools to combat discrimination.

"It gives us so much more leverage. We no longer have to wring our hands," said Joan Block, executive director and co-founder of the Hepatitis B Foundation, a nonprofit in Doylestown, Pa. She said Nguyen was among several students who contacted the foundation in 2011 to report they'd either been forced out of school, or had their admissions rescinded, because of an HBV diagnosis.

Hepatitis B is a contagious and potentially fatal liver disease spread through blood and other bodily fluids. The virus that causes it is most commonly transmitted through unprotected sex. Intravenous drug use is another major risk factor.

It can also be passed from an infected mother to her baby at birth, which is how Nguyen contracted it. Even though he'd been vaccinated as a child, the virus was already in his body.

As many as 1.4 million Americans have chronic hepatitis B. It's not clear how many of them are health practitioners. But some 25 percent of medical and dental students - and many practicing doctors, surgeons and dentists - were born to mothers from countries in Asia and other regions of the world where the virus is endemic, according to the U.S. Centers for Disease Control and Prevention.

The CDC last issued guidelines for management of health workers and students with hepatitis B in 1991. A lot had changed in two decades. Universal infant vaccination had slashed the number of new cases by more than 80 percent. New drug therapies had proved effective at reducing the amount of virus in a carrier's blood to very low or undetectable levels, greatly minimizing the risk of transmission.

And there had been only a single case of hepatitis B transmission from a health provider to a patient at least since 1991 - an orthopedic surgeon who was unaware of his hepatitis infection and had a very high amount of the virus in his body. He infected two to eight patients, according to the CDC.

While the old guidelines stated that a hepatitis B diagnosis by itself shouldn't preclude doctors, dentists, nurses and other health professionals from seeing patients, "we were concerned that with a 20-year-old set of guidance, it was not really considered as relevant as it could be," said Dr. John Ward, director of the CDC's Division of Viral Hepatitis.

He said the new guidelines offer a "powerful message that in the great majority of clinical encounters between a health care provider and a patient, there is minimal or no risk of hepatitis B virus transmission."

Released last summer, the updated CDC guidelines were cited by the Justice Department in March as the agency announced a settlement with a New Jersey medical school over claims it violated the Americans with Disabilities Act by excluding two applicants with hepatitis B. While the state-run University of Medicine and Dentistry of New Jersey denied liability, it agreed to admit qualified HBV-positive students and provide training to staff.

It was the first case in which the Justice Department pursued an ADA complaint on behalf of people with hepatitis B.

"This is a historic decision," Block said. "We can now pull out the DOJ settlement and really guide these people: `What you're facing is discrimination, and here are the tools to help.' That's powerful."

Nguyen said he had no idea he was a carrier until he started medical school. That's when he began to feel persistently tired and lost the ability to concentrate. Given a family history of liver cancer - of which hepatitis is the leading cause - his doctor had him tested. It came back positive.

Nguyen alerted the school and said he was told by an administrator that he would never be able to complete the required surgical rotation because "no operating room in the country will let you in."

"That's when I started almost panicking," Nguyen said. "To this point I had been a good student. All the sudden my world was crashing, with all this debt and all the things I had worked for in jeopardy."

He said the school began making life more difficult for him, to the point where he felt he had no choice but to leave.

With successful treatment, the virus is now undetectable in his blood and Nguyen said he is feeling better - and plotting a return to his medical studies. He said he's leaning toward a career in hepatology, so he can help others like him.

The specialty is "definitely at the top of the list," Nguyen said. "I understand the risk and the mental strain. I have a lot of compassion for those individuals."

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New study looks at how expanded Medicaid coverage affects individual health

Published May 02, 2013

FoxNews.com

When the Affordable Care Act comes into play this January, millions of adults will have new health insurance coverage through Medicaid.

The New York Times recently posed this question: How will that change their finances, use of available medical services and ultimately their health?

A new study called the Oregon Health Study in Wednesday’s New England Journal of Medicine may have those answers, The Times reported.

The study looked at thousands of low-income individuals in Oregon who had access to Medicaid and compared them to an identical group of people who did not have access to it.

The study discovered those who had Medicaid ended up spending more on their health care needs, visited the doctor more often and even went to the hospital more. 

However, the study proposes these individuals were not necessarily healthier during the time the research was conducted. This was measured by looking at their blood pressure, blood sugar and other factors. 

The low-income individuals with Medicaid had less depression and felt more secure financially, according to the study.

“There was this view that Medicaid coverage would not do much for the low-income uninsured, either because they had access to charity care or because Medicaid is not good insurance,” said Amy Finkelstein of the Massachusetts Institute of Technology, who worked on the Oregon Health Study. “This rejects that notion entirely.”

There are currently about 50 million people in the U.S. who receive Medicaid – and nearly all of them are poor. However, most states do not provide Medicaid to adults who do not have disabilities or dependent children, even if they are low-income, The Times said.

So the country will spend more by “hundreds of billions of dollars over time,” because of all the newcomers this January, the Times said.

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Celeb chef Curtis Stone shares his health secrets

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Celebrity chef and new dad Curtis Stone knows all too well what it’s like to have a hectic lifestyle.

He is engaged to actress Lindsay Price, and the couple have a son, Hudson, who is a little over a year old. 

Stone was recently at The Culinary  Loft in New York City to chat about his book, What’s for Dinner: Delicious Recipes for a Busy Life.

“We are time poor,” Stone told FoxNews.com. “We are cooking on a budget sometimes, (and) we want to cook with a few ingredients – so what I did is I divided the book. Each chapter is a different day of the week.”

With themes like ‘Time-Saving Tuesdays,’ or ‘One-Pot Wednesdays,’ and ‘Five-Ingredient Fridays,’ Curtis hopes serving dinner will be easier than ever.

One particular theme, ‘Motivating Mondays,’ is reserved for the health-conscious.

“If you start off with a Monday eating a really well-balanced meal, you are much more inclined to wake up Tuesday thinking, ‘I did a really good job yesterday; I’m feeling good; I’m going to carry on,’” Stone said.

Meals in this chapter, like grilled chicken with arugula and zucchini salad with lemon-caper vinaigrette, are high in protein and low in carbohydrates and fat.

Curtis said his secret to keeping in shape is balancing his high-calorie diet with exercise.

“I’ll go for a surf; I take my dog for a hike,” Stone said. “So I think incorporating the exercise into your daily routine as opposed to ‘Goodness, now I got to go to the gym, that’s going to take an hour,’ and making it a chore. That’s not the right way to do it.”

Stone also suggested tempting yourself with healthy foods: Leave out a bowl of fruit instead of chips, and you are more likely to choose a healthy snack.

To learn more about Curtis Stone, check out CurtisStone.com.

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What your looks say about your health

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Good health often is reflected in an attractive, youthful appearance. So you might be tempted to blame aging and stress for facial lines, unsightly fingernails, or hair loss when, in fact, these flaws can signal underlying health issues, says integrative medicine specialist Dr. Molly M. Roberts, of the Institute for Health & Healing, in San Francisco, and president of the American Holistic Medical Association.

"It'll start by whispering, then it'll start talking, and, if you don't pay attention, it'll start yelling and shouting, and then you've got an illness,” she says.

Here are some physical signs that trouble may be lurking beneath the skin's surface.

1. Wrinkles

Although wrinkles are inevitable, they also may be a sign of osteoporosis.

Is your furrowed brow and grooved mouth ratting out your bones? Surprising new research reveals an association between wrinkles and bone health in early-menopausal women.

The worse the wrinkling, the greater the risk of lower bone density. Most wrinkles are the result of aging, but excessive exposure to cigarette smoke or the sun can speed the process.

2. Swollen feet

Shoes too snug? Many conditions, including sprains, strains, injuries, and infections, can cause feet and ankles to balloon. Pregnancy, obesity, and certain medications may cause fluid retention in the lower extremities.

So can certain diseases. If you're one of the 5 million Americans with heart failure, you may be retaining fluid because of your heart’s poor pumping action. Swelling in the legs, ankles, and feet is a classic symptom of this condition.

3. Pitted nails

If you avoid the manicurist because your nails are a mess, maybe you need to see a doctor. Nails that are pitted, deformed, or discolored (yellow-brown), or nails that thicken or separate from the nail bed, can point to many health problems.

Nail changes are common in people with psoriasis, a chronic skin condition; psoriatic arthritis, a related joint condition; and alopecia areata, a type of patchy hair loss.

Pitting has been reported in patients with Reiter’s syndrome, a type of arthritis, and incontinentia pigmenti, a genetic skin condition.
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More From Health.com:
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4. Large hands and feet

You would worry, and rightly so, if a loved one developed a protruding jaw, a prominent forehead, and out-of-proportion hands and feet. All are classic signs of acromegaly, a hormonal disorder that occurs in adults when the pituitary gland makes too much growth hormone.

But would you notice the person's change in appearance? Because it's such a rare disorder—and because changes in bone and soft tissue occur slowly over time—it doesn't dawn on people and often goes undetected, says Dr. Andrea Utz, director of the Vanderbilt Pituitary Center at Vanderbilt University Medical Center, in Nashville.

5. A foul mouth

Bad teeth and gums aren't just signs of poor oral hygiene. Your mouth could be saying nasty things about your heart and bones.

In 2010, Scottish researchers reporting in the British Medical Journal found that tooth brushing lowers the risk of heart disease. Compared with twice-a-day brushers, people who brushed less frequently had a 70 percent greater risk of heart disease or death from heart disease. Tooth loss also can signal osteoporosis. Missing teeth may mean jawbone density can no longer support a mouthful of pearly whites.

6. Facial flush

You might look red in the face, but it's nothing to be embarrassed about. Facial redness with acne-like skin sores are common symptoms of rosacea, a chronic skin condition.

Although the exact cause is not known, people with rosacea appear red and flushed in the face due to blood-vessel enlargement. Over time, bumps and pimples may form and the nose may grow bulbous.

7. Dark skin patches

A ring of dark skin at the back of the neck may look like it's crying out for a good scrubbing. But in reality, it may be acanthosis nigricans, a condition in which the skin appears darker and thicker—even velvety—along body creases.

People with insulin resistance, diabetes, obesity or, in rare cases, cancer, can develop these dark patches. Although not a definitive sign of diabetes, “It makes you think twice and do more workup,” says Heather Jones, a nurse practitioner at Oregon Health & Science University, in Portland, and a member of the Dermatology Nurses Association board of directors.

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HEALTH 'MENACE':HIV Tests Urged for 7,000 Patients of Oral Surgeon

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  March 28, 2013: This photo shows Dr. W. Scott Harrington’s dental practice, located Tulsa, Okla.Fox23.com

Thousands of patients of an Oklahoma dentist are being urged to get tested for HIV and hepatitis after public health officials found evidence of practices that could have exposed patients to the viruses. 

The Oklahoma and Tulsa health departments said Thursday approximately 7,000 people who were treated at clinics operated by Dr. W. Scott Harrington could have been exposed to Hepatitis B, hepatitis C, and HIV, the virus that causes AIDS, calling the dentist "a menace to public health."

State and county health inspectors went to Harrington's practice after a patient with no known risk factors tested positive for both hepatitis C and the virus that causes AIDS. 

The agencies found "major violations" of the Oklahoma Dental Act and numerous violations of health and safety laws during an investigation into Harrington's practice. These included employees using dirty equipment, reusing needles and administering drugs without a license.

"This is an unprecedented event," Susan Rogers, executive director of the state Board of Dentistry, said in an interview. "To my knowledge, this has never happened before as far as a public notification of a (hepatitis C) case involving a dental office."

The Oklahoma Board of Dentistry said the inspectors discovered multiple sterilization issues at Harrington's offices, including the use of a separate, rusty, set of instruments for patients who were known to carry infectious diseases.

"The CDC (Centers for Disease Control and Prevention) has determined that rusted instruments are porous and cannot be properly sterilized," the board said in a 17-count complaint against the dentist.

Officials are sending letters to 7,000 people who are known to have been patients of Harrington, but they noted that they do not have information for patients before 2007. The letters urge the patients to be tested for hepatitis B, hepatitis C and HIV. -- viruses typically spread through intravenous drug use or unprotected sexual contact, not occupational settings.

"It's uncertain how long those practices have been in place," Snider said. "He's been practicing for 36 years."

Harrington could not be reached for comment Thursday. A message at his Tulsa office said it was closed and the doctor's answering service referred callers to the Tulsa Health Department. Phone numbers listed for Harrington were disconnected. A message left with Harrington's malpractice attorney in Tulsa, Jim Secrest II, was not immediately returned.

Harrington's practice in Tulsa is in a tony part of town, on a row of some of the city's most upscale medical practices. The white-and-green stucco, two-story dental clinic has the doctor's name in fancy letters on the facade.

Inside, the Dentistry Board said, Harrington ran a clinic that paid little attention to ensuring items were sterile. Dental assistants needing an extra dose of an anesthetic would re-insert used needles into drug vials, drug vials were used on multiple patients, the office had no written infection-protection procedure and Harrington told officials he left questions about sterilization and drug procedures to his employees.

"They take care of that, I don't," the board quoted him as saying.

The doctor is also accused of letting his assistants perform tasks only a licensed dentist should have done. Also, the complaint says that the doctor's staff could not produce permits for the assistants when asked for them.

Rogers said that as an oral surgeon, Harrington routinely does invasive procedures that involve "pulling teeth, open wounds, open blood vessels." The Dentistry Board complaint said Harrington and his staff told investigators that a "high population of known infectious disease carrier patients" received dental care from him.

According to the complaint, a device used to sterilize instruments wasn't working properly. A test is supposed to be performed monthly and sent to a lab to determine that the equipment is successfully sterilizing instruments, but "no such test had ever been performed in the 6 years one dental assistant had been working at the office," the complaint said.

The doctor also apparently used outdated drugs, as one vial found this year had an expiration date of 1993, and didn't properly keep track of drugs, the complaint said. It noted that a drug cabinet was unlocked and unattended during the day and that dental assistants administered IV sedation for procedures without the doctor being present.

It also said that although U.S. Drug Enforcement Administration records show Harrington had not received morphine from a distributor since 2009, the drug logs kept by his assistants said morphine had been used on patients intermittently throughout 2012.

Officials said patients will be offered free medical testing at the Tulsa Health Department's North Regional Health and Wellness Center.

Most people who become infected by hepatitis C get it by sharing needles or other equipment to inject drugs, according to the CDC's website. The infection can last a lifetime and lead to scarring of the liver or liver cancer.

Most people who get hepatitis B have it for a short time, though it can cause a long-term infection that can damage the liver. It can be transmitted through unprotected sex and sharing needles.

The Associated Press contributed to this report. 

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Dr. Manny: Marriage equality has health benefits for all

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As a practicing physician for the past 30 years, I know one fact to be true: Marriage benefits the family.

I have worked in very busy medical centers, and I have seen numerous patients take on debilitating health problems by themselves.  Many times, their isolation makes things much more difficult.  

To have a support system through marriage means the world when you’re sick.  It means you have someone to listen to your problems, to offer advice; and ultimately, to be your health advocate.

If we look at some of the health benefits of marriage, we find that married individuals recover better after surgery, are less likely to have heart attacks, and are more likely to live longer and be healthier overall.  Also, a study published in the American Journal of Public Health found that married gay and lesbian couples are much more likely to have better mental health than their unwed counterparts.

And marriage isn’t only valuable for the individuals involved, as its health benefits extend to the rest of the family.  Recently, the American Academy of Pediatrics said children thrive when they have two married parents who love them and can provide them with a nurturing environment, irrespective of the parents’ sexual orientation.

In my personal specialty, I see the power of marriage in bringing new life into this world.  I have delivered babies for heterosexual couples, as well as babies for many lesbian couples.  Regardless of a couple’s sexual orientation, the beauty of a newborn child is equally astounding to everyone.

So my message to the Supreme Court, as they deliberate on how to move forward on Proposition 8, is that marriage equality could be quite healthy for our society.  Isolation and inequality are detrimental to our health, ultimately bringing about depression, sadness and anxiety.

I know nobody listens to a practicing doctor like myself anymore, especially since we live in a lawyer’s world, but the facts are the facts.  Marriage is healthy for everyone, especially for our children. It is time we make the world a more equal and joyful place.

Dr. Manny Alvarez

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Vital health screenings every mom needs

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You always make sure to get your child to the doctor for his well visits, and maybe you even push your spouse to get a yearly physical – but are you up to date on your own health check-ups? Find out the latest guidelines and recommendations that will keep you healthy, strong, and full of energy.

Pap smear and HPV test

A pap smear is one of the most important tests you need, as it is the screen doctors use to identify precancerous cells that could lead to cervical cancer. In the future, using DNA from pap smears may even be used to screen for endometrial and ovarian cancers, according to a recent study published in Science Translational Medicine.

Previously an annual test, new recommendations issued in 2012 now call for a pap smear every three years for women ages 21 to 29. For women 30 and older, recommendations call for a pap smear every three years or a pap smear and an HPV test every 5 years. It’s important to speak with your doctor about how often you should get these tests depending on other risk factors.

Well-woman visit

Despite the new pap smear guidelines, visiting your OB-GYN for an annual well woman visit is still necessary, according to Alyssa Dweck, a board-certified obstetrician and gynecologist and co-author of V is for Vagina.

Your doctor will do a pelvic exam to look for abnormalities of the external genitalia, cervix, uterus and ovaries. You will also have a breast exam which is recommended every one to three years for women ages 21 to 39, and yearly for women 40 and older. A well-woman visit is also a great opportunity for your doctor to evaluate your overall health and address any concerns you may have.

Sexually Transmitted Infections

Chlamydia and gonorrhea are two STIs that can cause serious damage to the reproductive system if they’re not treated. “These are often silent infections where women have no symptoms,” Dweck said.

Since they’re most common in women ages 15 to 24, yearly screening until age 25 are recommended. Depending on your risk, your doctor may also recommend regular screening for other STIs, including HIV.

Mammogram

Starting at age 40, you should get a yearly mammogram to screen for breast cancer. However, depending on your genetic and family history – as well as other risk factors – your doctor may recommend getting a mammogram earlier.  

Cholesterol

One in four women die from heart disease each year, so keeping your cholesterol levels in check is important for a healthy heart. A blood test which screens for both LDL (bad cholesterol) and HDL (good cholesterol) levels and triglycerides should be checked once a year, according to Dr. Rose Kumar, a board-certified internist, founder and director of the Ommani Center for Integrative Medicine, and author of Becoming Real. If your levels are elevated, you should be tested six months after you’ve made lifestyle changes or have been prescribed medication.  

Thyroid

“The thyroid gets sluggish in association with the hormonal changes that occur,” said Kumar.  She added that anytime estrogen or progesterone change, particularly after giving birth or during perimenopause, a thyroid test that establishes a normal thyroid hormone level is ideal. If you’re breastfeeding, have postpartum depression, or you’re tired or have gained weight, it’s important to have your thyroid level checked as well.  

Vitamin D

Vitamin D is essential for strong bones and healthy skin – and some studies suggest may even prevent certain cancers.  All women are at risk for being vitamin D deficient, particularly breastfeeding moms, according to Kumar. “A lot of the calcium is coming out of their bones in order to supply calcium for the child,” she said. High levels of vitamin D can be toxic, so speak with your doctor about your diet and about adding a supplement.

Julie Revelant is a freelance writer specializing in parenting, health, food and women's issues and a mom. Learn more about Julie at revelantwriting.com.

Julie Revelant

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NYC health officials warns of new, deadly meningitis strain

Published March 22, 2013

Associated Press

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The New York City health department has issued new recommendations for vaccinating against a new and lethal strain of bacterial meningitis.

It says the symptoms come on quickly and the disease can be fatal if not treated immediately.

It's only been seen in men. The patients often contract it through anonymous sexual encounters with other men. That makes it hard to trace the infection's path.

The standard meningitis vaccine is effective against the new strain. The health department is advising it for men regardless of HIV status who regularly have contact with other men they meet online, at a bar or party.

The health department says 22 cases have been reported since 2010, including 13 last year and four this year. Seven have been fatal.

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Dr. Manny: Forcing employees to undergo health screenings for insurance is wrong

By Dr. Manny Alvarez

Dr Manny's Notes

Published March 20, 2013

FoxNews.com

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Should employees be forced to undergo health screenings to get coverage under their employer’s insurance plan?

I say "No." However, this trend is on the rise, thanks to health care reform.

Since the implementation of the Affordable Care Act, many companies are forcing its employees to undergo a physical examination in order to get health insurance, or be levied with a surcharge. I received a letter from my employer at the hospital stating that I needed to see a physician in the human resources department, or I would be forced to pay a penalty of $50 extra each month.

Companies like CVS Caremark are also asking workers to undergo health screenings to measure weight, body fat, glucose levels and other vitals, or pay up to $600 more a year for their health insurance. The reason this is happening is because companies are desperate to try to find ways to cut costs, or perhaps, disqualify some employees from standard policies and recommend they instead look for coverage through a public exchange.

In my opinion, this is fundamentally wrong. It takes away the privacy of the individual, and it’s a form of discrimination. I don’t have a problem with companies promoting healthy habits for its employees – which happens sometimes, almost to the point of harassment.

Yes, people should lose weight, eat healthier, stop smoking and incorporate exercise into their daily routine – we’ve been telling them that for years. But to force them by making them pay, knowing full-well that financial penalties could compromise an individual’s ability to provide for their family is just plain wrong.

Unfortunately, I know this will one day be the norm in our country as we watch our freedoms disappear.

Dr. Manny Alvarez

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Renew your health vows this spring

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For millions of people across the country, this has been an exceedingly long winter. 

Between frequent bouts of snow, biting cold and the overriding sense of malaise, spring can’t come soon enough. Luckily, it starts Wednesday (on the calendar if not outside your front door), and there’s no better time to leap into the season of renewal than by renewing your vows to your body.

Get moving: There is literally no better time to kick off an exercise routine – or kick it into high gear. The days are getting longer, and chances are it’s still light outside when you get home from work. 

It’s the perfect opportunity to start running outdoors, in your neighborhood or at a local track. Not only can running improve your cardiovascular health, strengthen your bones and muscles, and boost your energy levels, but it also has psychological benefits: A study out of the University of Glasgow last year showed that running in a natural environment – like a park, the beach, or the woods – lowers your odds of experiencing mild depression, helps you sleep, and keeps stress in check. If you can’t run, walk or ride your bike – anything to enjoy that sweet springtime air. And don’t forget to take your pup along – they’ve been cooped up all winter, too.

Greens: Clean, healthy eating should be a priority all year round, but spring is a preview into the delicious growing season ahead, full of fruits and vegetables that will delight your palate through fall. Seize the opportunity to try something new, like a salad made not with plain old iceberg lettuce, but with delectable greens like arugula, dandelion, watercress, or purslane. Never heard of purslane? It has a mild, peppery flavor, and is rich in potassium, calcium, omega-3 fatty acids and fiber. Give it a whirl.

Beans: For those days when winter just won’t quit and the chill in your bones remains, forget the old standby soups like chicken and split pea, and make yourself a green mung bean soup. Typically used in Asian cooking, mung beans are incredibly versatile and uncannily nutritious. They contain copious amounts of fiber, protein, magnesium and folate. Unlike some beans, they are easily digestible. Check out Susan Ciminelli's recipe from her book: the Ciminelli Solution, Mung Bean Vegetable Soup.

Purify: Not only is spring’s arrival the perfect time to dust those cobwebs off your shelves, but it’s also a great excuse to purify the water and air in your home – two essential systems that sustain us, but which we don’t often clean with the same rigor as our toilet seats. Install water purification systems in your sinks and showers to remove potentially harmful contaminants like lead and chlorine. Air purifiers remove germs, mold, bacteria and dust from the air you breathe, which is particularly important during allergy season, when at least one person in your house is probably sneezing up a storm.

Take stock: Out with the old, in with the green. Now’s the perfect time to peek into your storage closet, under your sink, or in the garage to get rid of old, toxic cleaning products and other agents used around the home, and replace them with greener counterparts. Not only will your home be as clean as a whistle, but you won’t experience any of the negative health symptoms – like headaches – that conventional cleaners can inflict. What’s more, you’ll greatly diminish the odds that a child will ingest a poisonous substance, and require medical attention. Spring cleaning is an arduous task – don’t make it harder on your body by inhaling noxious fumes as you work!

Like many eagerly anticipated events, spring will be over before you know it. Get a jump on detoxifying your home and your body by starting early, and you'll have time to enjoy spring's bounty well before summer arrives.

Note: Information provided herein is not intended to treat or diagnose any health condition. As always, consult your health care provider with any questions or health concerns.

Deirdre Imus, Founder of the site devoted to environmental health, dienviro.org, is President and Founder of The Deirdre Imus Environmental Health Center™ at Hackensack  University Medical Center and Co-Founder/Co-Director of the Imus Cattle Ranch for Kids with Cancer. She is a New York Times best-selling author and a frequent contributor to FoxNewsHealth.com, and Fox Business Channel. Check out her website at dienviro.org. 'Like' her Facebook page here.

Deirdre Imus

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The most notorious health myths

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We are bombarded with health tips every day, but some of those messages may be harmful if you don’t get the facts straight.

Dr. Jacob Teitelbaum, author of Real Cause Real Cure, spoke with Dr. Manny Alvarez, senior managing health editor for FoxNews.com, about some of the most notorious health myths.

Myth #1: Arthritis medication is the best treatment for arthritis.

According Teitelbaum, more than 30,000 unnecessary deaths occur each year from arthritis medications.  

“If you take a look at things like ibuprofen or the standard arthritis medication, 16,500 bleeding ulcer deaths a year in the United States from those medications – and the doubling and tripling of heart attack and stroke risk.”

While Teitelbaum says it’s better to be on medication than to be in pain, there are natural remedies for arthritis that are much safer.  End Pain, which is a mix of willow bark and boswellia, has shown to be twice as effective as ibuprofen in studies, Teitelbaum noted.  Also, Curamin and boswellia were found to be more effective than Celebrex.  And rather than getting side effects, the natural remedies provide side benefits – such as decreasing the risk of Alzheimer’s disease and the risk of cancer.

Myth #2: You need to take calcium to treat osteoporosis.

A very controversial claim Teitelbaum makes is that taking calcium is for osteoporosis can actually do more harm than good.

“Osteoporosis is not calcium deficiency, and the calcium has very little benefit,” he said.  “But recent studies show that it can increase heart attack deaths up to 31 percent – which is massive.”

Instead of taking unnecessary calcium, Teitelbaum says to simply drink more milk and other natural sources of the element.  But more importantly, since the calcium isn’t exactly needed, individuals with osteoporosis can take minerals, such as Strontium – which has been shown to be almost twice as effective as medications.  Magnesium, vitamin D, boron and other nutrients help increase bone density and the production of healthy new bone.

Myth #3: Antacids are necessary to treat indigestion.

Many Americans suffer from indigestion, and numerous medications purport to relieve symptoms from the embarrassing condition.  However, Teitelbaum says that antacids don’t exactly treat the source of the problem.

“Indigestion is not too much stomach acid; it’s poor digestion,” Teitelbaum said.  “If you don’t have what you need to digest your food, you eat this big mega-meal, and an hour later, it’s still sitting in your stomach.”

In order to aid digestion, Teitelbaum suggests taking digestive enzymes, such as Digest Gold.  Whatever brand you use, make sure they are 100 percent plant-based enzymes.  Probiotic culture found in yogurts and supplement are also helpful in the lower abdomen, relieving gas, bloating, diarrhea and constipation.

Myth #4:  Avoid the sun.

Teitelbaum said the myth that people should avoid the sun at all costs probably results in tens of thousands of unnecessary cancer deaths each year.

“Most of the deadly skin cancers, called melanomas, are not in sun-exposed areas,” he said.  “They’re increasing because of poor immune function, from poor sleep, poor nutrition and other factors.”

The skin cancers caused by sunshine are usually not the dangerous kinds, Teitelbaum said.  Instead, sunshine is critical for vitamin D, an important hormone and vitamin.  Without vitamin D, individuals can have an increased risk of breast cancer, autoimmune disease, multiple sclerosis and diabetes.

Also, Teitelbaum has simple advice to balance damage versus benefit when it comes to the sun: “Avoid sunburn, not sunshine,” Teitelbaum said.

Myth #5: Heart failure is a death sentence.

One of the biggest causes of death for many Americans is heart failure, but the condition does not necessarily mean a person’s time is up.

“It’s very easy to improve heart muscle function using natural remedies that play very well with the medication,” Teitelbaum said.  “Certainly blood thinners that you want to get through doctors are okay before you add anything to those, but things like Coenzyme Q10, 200 mg a day will markedly improve heart function.”

Ribose, a simple energy nutrient, can help heart function, along with Acetyl Carnitine, magnesium and B-vitamins.  Ultimately these supplements help improve muscle function.

“The heart beats more efficiently, and therefore the symptoms often go away,” Teitelbaum said.

Myth #6: Thyroid screenings are accurate.

When it comes to the thyroid screening methodology doctors use today, Teitelbaum says doctors don’t understand what ‘normal’ means.  He says it means you’re not in the highest or lowest 2 percent of the population.

“You have to treat the person, not just the blood test,” Teitelbaum said. “People whose thyroid levels are in the low-normal range, versus high-normal, have a 69 percent increased risk of dying of heart attack.  People with mild, low thyroid – where many doctors say we don’t need to treat it – if you do treat it, their heart attack risk goes down by more than 30 percent.”

Patients who are treated for mild to low thyroid often see increased energy levels, weight loss, and healthier skin and hair – among other benefits, Teitelbaum added.

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State health agencies check hundreds for rabies after transplant death

Public health agencies in five states are assessing the rabies risk for hundreds of people who may have had close contact with an infected organ donor and four transplant recipients, one of whom died, officials said Saturday.

About 200 medical workers, relatives and others were assessed for potential exposure in Maryland, where the man who received an infected kidney died, state veterinarian Katherine Feldman said. She said fewer than two dozen were urged to get the rabies vaccine as a preventive measure.

In Florida, about 90 people were identified as potentially exposed, and three were offered the rabies vaccine as of Friday, state health department spokeswoman Ashley Carr said.

Illinois Department of Public Health spokeswoman Melaney Arnold said the only potential exposures there were people who worked with the patient or the transplanted organ. She said only the organ recipient is receiving rabies treatment.

Health officials in Georgia and North Carolina are also involved in the epidemiological investigation prompted by the Maryland man's death from rabies in late February, nearly 18 months after he got the kidney from a donor in Pensacola, Fla. However, officials in those states didn't respond to requests from The Associated Press about the number of people they're assessing.

Doctors in Florida didn't test the 20-year-old donor for rabies before he died in September 2011. His heart, liver and other kidney went to recipients in Florida, Georgia and Illinois. They started getting the vaccine this month, and none has had rabies symptoms. A rabies expert unconnected to the case, Dr. Rodney Willoughby of Milwaukee, said they have a strong chance of surviving since they haven't shown any symptoms.

Health officials say the virus can be spread through the infected person's saliva and mucous membranes, but human-to-human transmission is rare. The federal Centers for Disease Control and Prevention in Atlanta says there has been only one documented instance of transmission by a bite in the U.S.

Feldman said Friday that the search for potential exposure subjects in Maryland was wrapping up. She said medical workers typically take precautions, and "we don't share saliva with that many people in our day-to-day goings about."

CDC spokeswoman Melissa Dankel said investigators are still trying to learn how the transplant donor got infected with the raccoon rabies virus that was found in his brain tissue and that of the Maryland man. She said the donor was an outdoorsman who might have been bitten by a wild animal in his native North Carolina before moving to Florida and beginning training as an Air Force aviation mechanic 17 weeks before his death.

He visited a clinic at the Pensacola Naval Air Station in August 2011 for abdominal pain and vomiting and was transferred to a civilian hospital four days later, said Defense Department spokeswoman Cynthia Smith. He later developed encephalitis, a brain inflammation that can have a host of causes, including rabies, but he wasn't tested for the disease, CDC officials say.

Smith said the airman died of severe gastroenteritis — inflammation of the stomach and small intestine — complicated by dehydration, electrolyte abnormalities and seizure. The Florida Department of Health said he died of encephalitis of unknown origin.

Federal rules require organ banks to disclose any known or suspected infectious conditions that might be transmitted by donor organs. CDC officials say they don't know what information was communicated.

Federal guidelines published last year for evaluating organ donors with encephalitis urge "extreme caution" if the suspected cause is a viral pathogen, such as rabies.

Dr. Michael Green, a University of Pittsburgh professor who heads the committee that wrote the guidelines, said the guidelines hadn't been published when the Florida patient died. He also said rabies transmission through solid organ transplants is rare. There have been just two other documented instances worldwide — one in Germany and a 2004 U.S. case in which all four recipients died. The CDC says there have been eight documented instances of rabies being transmitted by transplanted corneas.

"Nonetheless, if asked whether or not I would use organs where concern for rabies was active in the potential donor, I would urge extreme caution before using organs from this person," Green said.

One of the patients who died in the 2004 case was 18-year-old Joshua Hightower, of Gilmer, Texas, after a kidney transplant. He had kidney problems since he was a child. His mother, Jennifer, said Saturday that if rabies is suspected in a transplant donor, doctors should go ahead and transplant the organs, and then give recipients the rabies vaccine.

"The word has got to get out there and something's got to change," she said. "These people, like my son, he thought the transplant was going to give him a new life and a new opportunity to move forward, and it killed him — over somebody's negligence and their plain old stupidity, and that's what it is."

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Is the Middle East brewing the perfect storm for a health epidemic?

The turmoil in the Middle East is not just creating human tragedy, where the indiscriminate use of force by terrorists and dictators is causing a huge displacement of families and destroying cities and neighborhoods.  

To me, the scariest aspect of this region is that it could be brewing a catastrophic event of global proportions.  I’m talking about infectious disease outbreaks, which can spread throughout the world.

The Centers for Disease Control and Prevention warned U.S. health officials Thursday of a deadly new virus originating in the Middle East.  This virus is in the coronavirus family, and it seems to be creating severe respiratory distress, similar to that of the severe acute respiratory syndrome (SARS) virus, which first emerged in Asia in 2003.  

RELATED: CDC warns health officials to be alert for deadly new virus

Symptoms of the infection include severe acute respiratory illness with fever, cough and shortness of breath.  Perhaps the most worrisome aspect of this virus is that of the 14 people so far infected, eight have died.  

We have been reporting over the last several years how even in developed nations, we’re losing the battle against viruses and bacteria.  Scientists have been warning us for years, and now we see that simple bacteria, which was easily treatable in the past are now almost impossible to treat.

More problematic, however, is the mutation of these viruses.  Over the last several years, we have seen multiple viruses that have mutated from animals to people and have created an international scare because of their potentially deadly effects.

Right now, the Middle East is the perfect storm for such an outbreak.  With crowded refugee camps, limited running water in many areas, the destruction of sanitary infrastructures, and limited access to physicians,  this region’s hospitals and governments presently don’t have the tools to monitor infectious outbreaks and alert the rest of the world.  

I recently spoke to Dr. Abdulla Al-Khan, an international health consultant and director of the Center for Abnormal Placentation at Hackensack University Medical Center in New Jersey, about how this coronavirus may impact the country of Bahrain.

“In Baharain there (have) not been any documented cases, but I have heard that there has been over the last couple of weeks two mortalities from influenza-like illness,” Al-Khan said. “Whether that was the SARS (virus) or whether it was the corona variant virus of it, I'm not too sure. But I think this is why it is important for the country and the people to understand: Let's focus on important things. Let's focus on issues that are more important to the children of Baharain, to the region, as opposed to these political issues. Because ultimately politics and medicine, in a way we don't want it to mix, but it ultimately does, because it all has a domino effect.”

And the domino effect doesn’t stop overseas. The days where health outbreaks abroad were an anecdote in a scientific journal are long gone.  What could happen in one part of the world in the morning could be spreading to our shores in the evening.

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Survey finds most large employers will keep health insurance benefits after Affordable Care Act

Most large employers don't expect to send their full-time employees to government health exchanges for insurance during the next five years, but some retirees and part-time workers will end up there, a new survey has found.

The outlook for corporate insurance in the long term is less certain.

Only about 26 percent of large employers surveyed were very confident their company will offer healthcare benefits in 10 years. That is a slight increase from last year's 23 percent, but a sharp drop from 73 percent five years ago.

About one-half of the people in the United States who have health insurance receive it from their employers. Most of the rest are enrolled in individual plans or government Medicare and Medicaid programs.

More people are expected to buy health insurance at government-run electronic marketplaces, which will start selling plans for 2014 later this year as part of the 2010 U.S. Affordable Care Act.

Related: ObamaCare Gold Rush: Winners and losers

Consultancy Towers Watson and the National Business Group on Health conducted the annual survey of more than 500 of the nation's largest employers, who self insure, or pay for employee healthcare treatments. The companies were surveyed between November and January, a time when 2013 health plans went into effect and as companies plan for 2014.

During the next five years, 60 percent of large employers said it was not at all likely they would discontinue health care plans for full-time employees and send them to the government exchanges with a financial subsidy for insurance.

Also, 82 percent said they think it was highly unlikely they would direct full-time employees to exchanges without a subsidy.

The Affordable Care Act has implemented a wide range of new rules. More services must be included in plans. Also, companies will need to offer health care insurance to all employees who work more than 30 hours per week or be forced to pay a tax. Because the tax is less than the cost of health care for them, some companies may pay the tax instead.

"There will definitely be employers who will be looking to move certain segments of their workforce towards the public exchanges and those segments could be early retirees and they could be part-timers working under 30 hours," said Randall Abbott, senior consultant at Towers Watson.

Among companies where 20 percent or more of their workforce are part time, 29 percent said it was highly likely that in the next five years they would end health care benefits for employees working less than 30 hours per week. Sixty-seven percent said it was unlikely.

Costs keep rising 
The survey found the average premium cost for employers and employees combined rose about 6 percent in 2013 from 2012. Employees paid, on average, $2,888 in annual premiums, up about 8.7 percent from 2012.

Related: Rate shock: How ObamaCare is causing a surge in insurance premiums 

Total spending on healthcare in the United States was about $2.7 trillion, and is rising at a rate of about 6 percent a year, although last year it was only about 4 percent.

Companies trying to cut health care spending have turned to wellness initiatives, such as charging smokers surcharges. Also, health plans are discouraging health care overspending by employees by putting more of the costs on them.

For instance, instead of paying a monthly premium and a co-pay for doctor visits, many employees may pay a lower monthly premium and then pay for the doctor visit out of a special tax-free savings account until they reach a higher-than-usual deductible.

These consumer-directed health plans in which employees have a tax-free health spending account made up 30 percent of most large employers' health plan enrollment in 2013, up from 25 percent in 2012, the survey found.

Related: Will your doc become extinct under ObamaCare?

About 53 percent of employers offer the plans now and 67 percent plan to do so in 2014. It will be the only option at 23 percent of employers in 2014.

In addition to cutting spending, employers cite the Affordable Care Act's 2018 excise tax as the motivation for the plans, according to Abbott of Towers Watson. The tax, often called the Cadillac tax, is expected to apply to companies that offer high-priced plans as a way to discourage overspending on health care.

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10 vital health screenings your child needs

From the moment your child is born, he or she will have a series of tests to make sure everything is healthy and developing normally. Sure, height and weight are no-brainers, but what about all the other health screenings? Find out which ones are really important and what you need to know about them.

1. Newborn screens

The Apgar score, the first test your baby will ever have immediately after birth, evaluates your baby’s color, heart rate, activity, muscle tone and response to stimulation.  Named after American pediatric anesthesiologist Dr. Virginia Apgar, this test helps to determine if the baby is depressed, under stress or lacking oxygen—and if intervention is needed.

The metabolic screen—a heel prick test—is another important test that is done within 48 hours after birth. Your baby’s blood will be screened for a host of metabolic and genetic disorders like hypothyroidism and sickle cell disease.  “Although these conditions are rare, they can be devastating,” said Dr. J.J. Levenstein, a board certified pediatrician and founder of MDMoms.com, who says picking them up early is key.

A brainstem auditory evoked response (BAER) test, also done in the hospital, evaluates your baby’s hearing from the brain stem level, is non-invasive and can detect congenital deafness early on.

2. Head circumference

Measured at every well visit from birth to 2 years old, your baby’s head circumference is one of the most important tools available to the pediatrician. If your baby’s growth slows, it could mean that the seams of the skull are fusing too early or that he has a congenital infection or a developmental delay.

Rapid head growth, on the other hand, could indicate a serious condition like Hydrocephalus. “That why those regular, frequent visits and us charting those numbers meticulously—despite the baby’s protests – are so important,” Levenstein said.

3. Developmental

During infancy and toddlerhood, your pediatrician will ask about key developmental milestones, like eye contact, social interaction and play. At 18 and 24 months old, a questionnaire called the M-CHAT (Modified Checklist for Autism in Toddlers) will screen for autism. As your child gets older, his behavioral and social development will constantly be evaluated as well.

4. Height and Weight

At every well visit, these two measurements will be charted to determine BMI (body mass index), which is the best way to identify a child’s risk for being overweight or obese.  On the flip side, BMI can also point to a potential eating disorder. Your doctor will also ask about your child’s diet, eating habits, and exercise. “It’s non-invasive but lets us have a visual representation of how a kid is doing,” Levenstein said.

5. Hemoglobin

At 1 year and 2 years old, your child’s hemoglobin will be tested to make sure he’s not deficient in iron. “If you are anemic, your brain doesn’t work well and you can lose IQ points over time,” said Levenstein, who added that anemia can also affect your child’s activity. “It’s a big stressor on the heart, the brain, the cardiovascular system and even on growth.”

6. Lead

Approximately four million homes house kids who are being exposed to lead, according to the CDC. Lead exposure can affect your child’s IQ and high levels can be toxic. At 1 year and 2 years old, your child’s pediatrician will ask about your home environment, toys your child plays with and what your baby puts in his or her mouth. A blood test to determine lead exposure may also be ordered.

7. Vision

The American Academy of Pediatrics recommends children see an eye doctor every year between the ages of 3 and 6 – and then every other year. Starting at 9 months old, your pediatrician might suggest your child be screened with the Visual Evoked Potential machine, which presents a series of images.  “It can measure the electrical activity of the brain in the vision center and see if there is equal activity on both sides,” Levenstein said.  “It can be a very nice early screening tool to see if a child needs an ophthalmology visit sooner rather than later.”

8. Scoliosis

Scoliosis, an abnormal curvature of the spine, affects approximately five to seven million people in the U.S., according to the American Chiropractic Association.  The condition usually shows up between the ages of 10 and 15. As soon as your child can touch her toes, she should be screened for the condition, because it could become more severe later on in life, Levenstein advised.

9. Safety

Questions about your child’s safety are just as important as other health screenings and should be asked at every visit, Levenstein said. Your child’s doctor may ask about pets in the home, medications used by other family members, where your baby’s crib is placed, if you have a pool, and if there are guns in the home.

Your pediatrician may also talk to you about bullying, your child’s sexual behavior, and if you have concerns about drug use and academic performance. “The screening never stops,” Levenstein said.

10. Diabetes

Screening for diabetes is not routine, but it’s definitely on the minds of physicians, since obese adults are more likely to be pre-diabetic. In fact, kids with both type 1 and type 2 diabetes have increased more than 20 percent since 2001, according to the SEARCH for Diabetes in Youth study.

If your child is losing weight or has excessive urination, your pediatrician may test him or her for type 1 diabetes. Kids with type 2 diabetes usually gain weight, are sluggish and are not active. If your child has acanthosis nigricans – or a darkening and velvety texture of the skin around the neck or under the armpits – he or she should be screened for high levels of insulin, lipids and cortisone.   

Julie Revelant is a freelance writer specializing in parenting, health, food and women's issues and a mom. Learn more about Julie at revelantwriting.com.

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Financial health Gunners' priority

Profits ... Arsene Wenger is under pressure to secure trophies. Source: Glyn Kirk / AFP

Arsene Wenger will face renewed calls to splash out on new signings after Arsenal announced a pre-tax profit of £17.8 million ($A26.23 million) in their half-yearly financial results on Monday.

Wenger has been criticised repeatedly in recent years for failing to spend big money on new players while Arsenal's results on the field continue to suffer.

The Barclays Premier League club's latest healthy financial report, to the end of November 2012, will only add to the pressure on the Gunners' boss to loosen the purse strings after eight years without a trophy and embarrassing exits from the FA and League Cups against lower league opposition this season.

The profit, down on £49.5 million ($A72.95 million) for 2011 and achieved by the £24 million ($A35.37 million) sale of Robin van Persie to Manchester United, accompanies an increased figure of £123.3 million ($A181.71 million) in cash reserves.

The Arsenal Supporters' Trust (AST) claimed the figures highlight the need for the club to spend more money on the team.

"Arsenal fans have contributed to this financial health through paying some of the highest ticket prices in world football. AST members want to see this money used for more, and better, investment in the team,'' an AST spokesman said.

However, rather than promise to break the bank of star players, Arsenal chairman Peter Hill-Wood insisted financial stability was the foundation of their regular presence in the Premier League's top four and the Champions League.

"Our desire is to make everyone connected with Arsenal proud of the club. We know that comes through winning trophies but also through the way we do things and that will remain our constant guide,'' Hill-Wood said.

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