Subject: Studies in the News 07-28 (June 5, 2007)

Studies in the News
Health Care Supplement

Contents This Week

Introductory Material HEALTH
   Potential for new state laws on abortion
   Aging boomers drive health care costs
   AIDS increasing among Black and Latina women
   Pharmacotherapy and down syndrome
   Child death statistics
   Eating disorders among both men and women
   Signs of eating disorders
   No embryos used in new stem cell technique
   Competition could improve health care quality
   Growth rates for health spending
   IT systems for hospital data
   Warnings over privacy of health networks
   State-guaranteed health insurance
   HIV testing practices lacking
   Long-term care costs
   Court upholds prosecution for medical marijuana
   Suit over medical marijuana arrests
   Search and arrests for marijuana
   Evidence to reclassify medicinal marijuana
   State Medicaid program rankings
   Enrollment process for Medi-Cal providers
   Critical shortage of nurses
   Nursing facility improvements
   Oversight of nursing homes criticized
   Comparison of diet types
   Overweight children in rich and poor neighborhoods
   Obesity found in one-third of 3-year olds
   Market incentives for organ and body donations
   Strict organ transplant rules
   Scientists find brain links to smoking addiction
   Covering uninsured with federal tax credits
   Fewer employers offer health insurance
   Hormone therapy and menopause
   Studies in the News, April - May 2007
Introduction to Studies in the News

Studies in the News is a very current compilation of items significant to the Legislature and Governor's Office. It is created weekly by the State Library's Research Bureau to supplement the public policy debate in California’s Capitol. To help share the latest information with state policymakers, these reading lists are now being made accessible through the State Library’s website. This week's list of current articles in various public policy areas is presented below.

Service to State Employees:

  • When available, the URL for the full text of each item is provided.

  • California State Employees may contact the State Information & Reference Center (916-654-0206; with the SITN issue number and the item number [S#].

  • All other interested individuals should contact their local library - the items may be available there, or may be borrowed by your local library on your behalf.

The following studies are currently on hand:



Gonzales, U.S. Attorney General, et al. v. Carhart, et al. U.S. Supreme Court. 05-380. April 18, 2007. 73 p.

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[“The decision clears the way for states to pass new laws designed to discourage women from having abortions. In a 5-4 ruling, the court said the ‘government has a legitimate and substantial interest in preserving and promoting fetal life.’ It was the first time the court upheld a ban on an abortion procedure. Though [the] opinion does not overturn Roe vs. Wade, the 1973 decision establishing a constitutional right to abortion, the majority said it was prepared to uphold new restrictions on doctors who perform them and women who seek them.” Los Angeles Times (April 19, 2007) 1.]

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“The Boomers Are Coming: A Total Cost of Care Model of the Impact of Population Aging on Health Care Costs in the United States by Major Practice Category.” By E. Mary Martini, and others. IN: Health Services Research, vol. 42, no. 1 (February 2007) pp. 201-218.

[“Just by getting older and sicker, baby boomers will prominently contribute to an 18 percent increase in health care costs due to demographic changes by 2050.... The projected change in per capita costs due to aging is most pronounced in kidney disorders, where spending should increase by 55 percent between 2000 and 2050. Per capita spending for heart and vascular conditions ... is projected to increase by 44 percent.” St. Paul Pioneer Press (March 6, 2007) 1.]

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“Racial/Ethnic Disparities in Diagnoses of HIV/AIDS --- 33 States, 2001-2005.” By T. Durant, and others. IN: Morbidity and Mortality Weekly Report, vol. 56, no. 9. (March 9, 2007) pp. 189-193.

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[“Nationally, women made up 27 percent of new AIDS cases in 2005, up from 8 percent in 1985. Minority women are particularly hard hit across the country, with African American women 24 times more likely than white women to contract HIV. AIDS was the leading cause of death for African American women 25 to 34 years old in 2004. And black and Latina women accounted for 82 percent of female AIDS diagnoses in 2004, despite representing only a fourth of U.S. women.” San Francisco Chronicle (March 9, 2007) 1.]

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“Pharmacotherapy for Cognitive Impairment in a Mouse Model of Down Syndrome.” By Fabian Fernandez and others. IN: Nature Neuroscience, vol. 10, no. 4 (April 2007) pp. 411-413.

["In a study that could hold promise for children with Down syndrome, researchers have found that a long-discredited drug can improve the mental abilities of mice with the genetic disorder, which causes mental retardation in humans. The mice were better able to navigate mazes and recognize new objects after receiving the drug, and the gains continued for months after treatment stopped. The researchers ultimately hope to test the drug, known as pentylenetetrazole, or PTZ, in people with Down syndrome. Researchers believe that PTZ and the other compounds may work because they block a neurotransmitter that slows brain function.” San Jose Mercury News (February 26, 2007) 1.]

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Sacramento County Child Death Review Team: Annual Report, 2005. By the Child Death Review Team. (Sacramento County Child Abuse Prevention Council, Sacramento, California) March 2007. 104 p.

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[“Of particular concern to team members is the sharp rise in the number of teenagers killed by firearms in homicides and suicides in 2005. Murder and suicide -- by guns and other means -- accounted for 57 percent of teen deaths in Sacramento County. Another disturbing statistic in the report: the number of children killed by abuse and neglect doubled in Sacramento County between 2004 and 2005.... The study also found that the rate of SIDS -- or sudden infant death syndrome -- fell dramatically for two years in a row.” Sacramento Bee (March 6, 2007) B1.]

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“The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication.” By James I Hudson and others. IN: Biological Psychiatry, vol. 61, no. 3 (February 2007) pp. 348-358.

[“Contrary to the long-held belief that anorexia and bulimia are female afflictions, the first national survey on eating disorders has found that one-quarter of adults with the conditions are men. The study estimated that about 850,000 men had suffered from the disorders and, despite two decades of intense attention to the conditions, had gone largely undetected. This is a very important finding … It suggests a need to move away from gender-based explanations." Los Angeles Times (February 1, 2007) 1.]

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“Is Dieting Advice From Magazines Helpful or Harmful? Five-Year Associations With Weight-Control Behaviors and Psychological Outcomes in Adolescents.” By Patricia van den Berg and others. IN: Pediatrics, vol. 119, no. 1 (January 2007) pp. e30-e37.

[“Teenage girls who frequently read magazine articles about dieting were more likely five years later to practice extreme weight-loss measures such as vomiting than girls who never read such articles found. Girls in middle school who read dieting articles were twice as likely five years later to try to lose weight by fasting or smoking cigarettes, compared to girls who never read such articles. They were three times more likely to use measures such as vomiting or taking laxatives.” Associated Press (January 2, 2007) 1.]

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"Histocompatible Embryonic Stem Cells by Parthenogenesis.” By K. Kim, and others. IN: Science, vol. 315, no. 5811 (January 26, 2007) pp. 482-486.

[“Scientists have found a way to make stem cells from unfertilized eggs, suggesting a potential alternative to controversial and technically difficult embryo cloning. A group reported success with the new method using mouse eggs. Similar experiments with human eggs are under way.... Known as parthenogenesis, a term derived from the Greek for 'virgin birth,' it allows females to produce offspring without need of a male to fertilize the egg.” San Francisco Chronicle (December 15, 2006) 1.]

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“Healthcare Intermediaries: Medical Care Organizations Can, But Do Not, Improve Healthcare Quality.” By Alex Stein. IN: Regulation, Health & Medicine. (Winter 2007) pp. 20-25.

["Medical care organizations (MCOs) such as HMOs and PPOs have become popular in recent decades because of their ability to lower consumer costs while increasing provider throughput. Functioning as healthcare intermediaries, these organizations currently have negative implications for the quality of medical care, but could be utilized to improve that quality.... Singling out the virtual absence of incentives for MCOs and their doctors to compete with each other over the quality of medical care, the author offers a semi-regulatory law reform proposal to unlock that competition."]

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Health Care Costs 101: Snapshot. By the California Health Care Foundation. (The Foundation, Oakland, California) 2007. 24 p.

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[“The growth in health spending was twice the rate of inflation in 2005, resulting in constant pressure on government, employers, and consumers to keep up. Total spending on health reached $2 trillion in 2005 and is projected to reach one-fifth of the gross domestic product by 2016; per person spending on health care increased 77% between 1995 and 2005); the growth rate for prescription drug spending is at its lowest level in 20 years; and while out-of-pocket costs for consumers continue to rise, their share of all health care spending (15%), has declined.” Press Release (April 17, 2007) 1.]

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Hospital Quality Data: HHS Should Specify Steps and Time Frame for Using Information Technology to Collect and Submit Data. By the U.S. Government Accountability Office. Prepared for the Committee on Finance, U.S. Senate. GAO 07-320. (The Office, Washington, DC) April 2007. 54 p.

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[“Our case studies showed that existing IT systems can help hospitals gather some quality data but are far from enabling hospitals to automate the abstraction process. The limitations reported by officials in the case study hospitals included ... the inability of some IT systems to access related data stored in another IT system in the same hospital, which required hospital staff to access each IT system separately to obtain related pieces of information.”]

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Health Information Technology: Early Efforts Initiated But Comprehensive Privacy Approach Needed for National Strategy. By Linda D. Koontz and David A. Powner, Government Accountability Office. GAO 07-400T. (The Office, Washington, DC) February 1, 2007. 23 p.

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[“The Bush administration had a jumble of studies and vague policy statements but no overall strategy to ensure that privacy protections would be built into computer networks linking insurers, doctors, hospitals and other health care providers. The administration had taken only rudimentary steps to safeguard sensitive personal data that would be exchanged over the network. The accountability office said doubts about privacy could slow the adoption and use of electronic medical records.” New York Times (February 18, 2007) 1.]

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Californians Firmly Favor State-Guaranteed Health Insurance. By the Survey and Policy Research Institute, San Jose State University. (The Institute, San Jose, California) January 11, 2007. 4 p.

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[“A new study finds that a majority of Californians say the state should guarantee that everyone has health insurance. Moreover, about six in 10 Californians say the state should guarantee that all children have health insurance.”]

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“The STI and HIV Testing Practices of Primary Care Providers.” By Mitchell Kushner and M. Rosa Solorio. IN: JAMA: Journal of the National Medical Association, vol. 99, no. 3 (March 2007) pp. 258-263.

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[“The percentage of AIDS cases for Latinos in Los Angeles County has increased, from 20% of all new cases in the 1980s, when the epidemic began, to 43% in 2002.... A majority of Los Angeles County primary care practitioners are failing to advise their Latino patients -— who are at high risk for HIV infection —- to get tested.... This study shows how Latinos already in primary care aren't getting the advice they need." Los Angeles Times (March 2, 2007) 1.]

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Cost Of Care Survey: Home Care Providers, Assisted Living Facilities and Nursing Homes. By CareScout. (Genworth Financial, Richmond, Virginia) 2007. 33 p.

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["Among states, California was the eighth-most-expensive for nursing-home care at $87,845 a year. Care in a nursing home or other long-term facility is more expensive in San Francisco than in any other city in California.... The study focused on a range of services that go under the heading of long-term care, from nursing-home services to home health assistance." San Francisco Chronicle (April 4, 2007) 1.]

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Angel McClairy Raich, et al. v. Alberto Gonzalez, et al. U.S. Court of Appeals, Ninth Circuit. 02-04872. March 14, 2007. 36 p.

Full Text at:$file/0315481.pdf?openelement

[“A federal appeals court upheld the U.S. government's authority to prosecute medical marijuana patients in California, but left open the possibility that a gravely ill patient could defend against criminal charges by showing that marijuana was her only shield against excruciating pain or death. Ruling in a case that reached the Supreme Court two years ago, the [Court] rejected an Oakland woman's last constitutional challenge to the use of federal drug laws against medical marijuana patients -- that it violates the fundamental right to preserve one's life and be free of severe pain.” San Francisco Chronicle (March 15, 2007) 1.]

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Americans for Safe Access v. Department of Health and Human Services, et al. U.S. District Court, Northern District of California. C07-01049. Complaint for Declaratory Relief and Permanent Injunction. February 21, 2007. 13 p.

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["Armed with a new study showing the drug can ease pain in some HIV patients, medical-marijuana advocates sued the federal government over its claim that pot has no accepted medical uses.... California is one of 11 states that have made marijuana legal for people with a doctor's recommendation. But because the U.S. government does not recognize pot's medical benefits, federal authorities can still arrest patients." San Francisco Chronicle (February 22, 2007) 1.]

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The People, et al. vs. Gabriel Reed Strasburg, et al. California Court of Appeals, First Appellate District. A114145. March 22, 2007. 9 p.

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[“California's medical marijuana law doesn't protect card-carrying patients from being stopped and searched by police who detect the presence of the drug. The 1996 initiative legalizing medical marijuana, Proposition 215, shields patients only from being convicted of growing or possessing cannabis for their health.... In upholding the search, the appellate panel cited a 2002 California Supreme Court ruling that said medical marijuana patients were not immune from arrest but could use their status as grounds for dismissal of charges or as a defense at trial.” San Francisco Chronicle (March 23, 2007) 1.]

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“Cannabis in Painful HIV-Associated Sensory Neuropathy: A Randomized Placebo-Controlled Trial. By D.I. Abrams, and others. IN: Neurology, vol. 68, no. 7 (February 13, 2007) pp. 515-521.

[“AIDS patients suffering from debilitating nerve pain got as much or more relief by smoking marijuana as they would typically get from prescription drugs -- and with fewer side effects. By contrast, less than one-quarter of those who smoked 'placebo' pot, which had its primary psychoactive ingredients removed, reported benefits, as measured by subjective pain reports and standardized neurological tests. Doctors and advocates of marijuana policy reform said the findings offer powerful evidence that the Drug Enforcement Administration's classification of cannabis as having ‘no currently accepted medical use’ is outdated.” Washington Post (February 13, 2007) 1.]

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Unsettling Scores: A Ranking of State Medicaid Programs. By Annette B. Ramirez de Arellano and Sidney M. Wolfe, Public Citizen Health Research Group. (The Group, Washington, DC) April 2007. 147 p.

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[‘When it comes to Medicaid, where you live makes all the difference. People living in Illinois, Minnesota, New York, Oregon and Washington have the most health care options on Medicaid. But residents of Alabama, Georgia, Mississippi, Oklahoma and Wyoming have the least.... Massachusetts had the top-ranked Medicaid program in the country, followed by Nebraska, Vermont, Alaska and Wisconsin.” The Washington Times (April 20, 2007) C08.]

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Department of Health Services: It Needs to Improve Its Application and Referral Processes When Enrolling Medi-Cal Providers. By the California State Auditor, Bureau of State Audits. (The Bureau, Sacramento, California) April 2007. 71 p.

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[“This report concludes that because of recent policy and administrative changes, the department’s Provider Enrollment Branch has seen a decrease in the number of applications it receives from providers seeking to enroll in Medi-Cal; however, the branch does not process some applications within the time specified by statute. “]

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Nursing Workforce: HHS Needs Methodology to Identify Facilities with a Critical Shortage of Nurses. By U.S. Government Accountability Office. (The Office, Washington, DC) April 30, 2007. 29 p.

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[“Between 2000 and 2004, the number of employed RNs in the U.S. grew by 10 percent, with a total of 2.4 million RNs employed in nursing in 2004. Most of the increase occurred in hospitals and ambulatory care settings; the extent of employment growth varied widely among states.... GAO recommends that the Secretary of HHS identify specific steps and a time frame for implementing an empirical methodology for identifying health care facilities with a critical shortage of nurses.”]

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Department of Health Services: It Has Not Yet Fully Implemented Legislation Intended to Improve the Quality of Care in Skilled Nursing Facilities. By the California State Auditor, Bureau of State Audits. (The Bureau, Sacramento, California) February 2007. 49 p.

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["This report concludes that although Health Services promptly created the reimbursement rate and fee systems, it experienced an eight-month delay in calculating the new reimbursement rates and applying them to claims submitted by facilities.... In addition, we are concerned about Health Services’ continued reliance on contracted services to maintain and update the new reimbursement rate system."]

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Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents. By the U. S. Government Accountability Office. Prepared for the Ranking Minority Member, Committee on Finance, U.S. Senate. GAO–07-241. (The Office, Washington, DC) March 2007. 100 p.

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[“Federal health officials impose only minimal penalties on nursing homes repeatedly cited for mistreatment of patients. As a result, some nursing homes cycle in and out of compliance with federal standards and pose a continued threat to the health and safety of patients. Members of Congress are likely to use the report as a map for legislation requiring stiffer penalties for the most serious violations. Administration officials said they would ask Congress for the power to collect fines more swiftly, without waiting for all appeals to be resolved.” New York Times (April 22, 2007) 20.]

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“Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women: The A TO Z Weight Loss Study: A Randomized Trial.” By Christopher D. Gardner and others. IN: JAMA: Journal of the American Medical Association, vol. 297, no. 9 (March 7, 2007) pp. 969-977.

[“The largest and longest-running comparison of diet plans found the low-carbohydrate Atkins regimen produced greater weight loss than three other popular programs — the Zone, the Ornish and the U.S. nutritional guidelines. The average weight reduction was small, and participants started regaining pounds by the end of the one-year study…. The finding showed that even a small weight reduction can improve overall health, researchers said.” Los Angeles Times (March 7, 2007) 1.]

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Diet, Physical Activity, and Adiposity in Children in Poor and Rich Neighborhoods. IN: Nutrition Journal, doi:10.1186/1475-2891-6-1. (January 2007) 7 p.

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["Children at School A consumed more baked foods, chips, sodas, gelatin desserts, and candies and less low fat dairy, and dark bread than those at School B. Children at School A watched more television and spent more time in front of the computer than children studying at School B.... The School A neighborhood (with lower incomes) was perceived to be less walkable than the School B neighborhood. Children at both schools were overweight and there was no difference in their mean body/mass index scores."]

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"Racial and Ethnic Differentials in Children’s Overweight and Obesity Among 3-Year-Olds." By Rachel Tolbert Kimbro and others. IN: American Journal of Public Health, vol. 27, no. 2 (February 2007) pp. 298-305.

["More than a third of disadvantaged 3-year-olds in Chicago and other major U.S. cities are overweight or obese, according to a new study that supports the notion that the struggle with obesity often begins in early childhood. Hispanic children from low-income families were most at risk, with 44 percent either overweight or obese, compared with 32 percent for white and African-American children from similar households. The study's authors ... also identified several practices that may protect kids from excessive weight gain, including breast-feeding for at least six months and not allowing children to take a bottle to bed." Chicago Tribune (December 29, 2006) 1.]

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Paying for Bodies, But Not for Organs: The Results of the Cadaver Market Imply that Prohibiting Any Kind of Payment for Transplant Organs Is Killing a Lot of People. By David E. Harrington and Edward A. Sayre. IN: Regulation. (Winter 2006-2007) pp. 14-19.

[“Government regulations encourage whole body donations and discourage partial body donations, producing surpluses of cadavers at medical schools and shortages of badly needed organs and other body parts elsewhere. We recommend that donors of organs be offered modest payments, similar to what they would have received had they donated the whole body. We also believe that anatomical gift statutes should be revised to take away the special status of medical schools as the recipients of unclaimed bodies."]

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Requirements for Approval and Re-Approval of Transplant Centers To Perform Organ Transplants: Final Rule. By the Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services. IN: Federal Register, vol. 72, no. 61 (March 30, 2007) pp. 15198-15280.

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[“Federal health officials unveiled strict new standards that could force dozens of organ programs to give up precious federal funding or have it pulled from them. The new rules require that transplant programs perform an average of 10 transplants a year to receive and keep their Medicare funding. Any program served by a single transplant surgeon must notify patients that the surgeon might not be available at the time an organ becomes available.” Los Angeles Times (March 23, 2007) 1.]

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“Damage to the Insula Disrupts Addiction to Cigarette Smoking.” By Nasir H. Naqvi and others. IN: Science, vol. 315, no. 5811 (January 26, 2007) pp. 531-534.

[“An unusual study of people with brain damage, caused in most cases by a stroke, suggests the compulsion to light up might be driven by the same little-studied brain region that helps us make sense of hunger pangs, nervous twitches and all sorts of visceral body signals. Researchers found that longtime smokers who had sustained insula damage had a remarkably easy time giving up cigarettes. Researchers hope that it might also serve as a kind of ‘fuse’ -- a way to switch off the vicious cycle of late-stage addiction, craving and relapse.” San Francisco Chronicle (January 26, 2007) 1.]

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Administering a Medicaid + Tax Credits Initiative. By Lynne Etherede, Health Insurance Reform Project, George Washington University. (National Academy for State Health Policy, Portland, Maine) February 28, 2007. 80 p.

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[“For the past several years, there has been interest in proposals that would cover the uninsured through a combination of new federal health insurance tax credits and expansion of state Medicaid and State Children’s Health Insurance programs.... This report presents the results of a project that focused on the issues and problems of administering such initiatives.... A nationwide 'Medicaid + Tax Credits' initiative to cover 47 million uninsured persons, in more than 50 federal-state programs, would pose unprecedented, large, and complex administrative challenges for both the public and private sectors.”]

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Whose Kids Are Covered? A State-by-State Look at Uninsured Children. By the State Health Access Data Center, University of Minnesota. Prepared for the Robert Wood Johnson Foundation. (The Foundation, Princeton, New Jersey) March 2007. 12 p.

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[“As Congress debates reauthorizing the state Children's Health Insurance Program, a report shows that more working parents are losing their employer-sponsored health insurance and need to rely on public health insurance programs for their children. The national report shows 47 percent of working parents earning moderate salaries are offered health insurance through their employers, a nine percent drop nationally over the past decade.” Detroit News (March 14, 2007) 1.]

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“Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause.” By Jacques E. Rossouw. IN: JAMA: Journal of the American Medical Association, vol. 297 no. 13 (April 4, 2007) pp. 1465-1477.

[“Women in their 50s do not face an increased risk of heart disease if they start hormone-replacement therapy soon after menopause, according to a new analysis…. The new study … analyzed data from the Women's Health Initiative, which was aborted in 2002 after women taking hormone therapy saw increased risks of heart disease, stroke and breast cancer. According to the new research, all women still face increased risks of stroke and breast cancer from hormone therapy. But younger women -- those who start the treatment at the onset of menopause symptoms -- are not at greater risk of heart disease.” San Francisco Chronicle (April 4, 2007) 1.]

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[This section links to items in Studies in the News since the last Health Care Supplement.]


"Health." IN: Studies in the News, (April 2007 - May 2007).

[Includes:  "Hidden tax on health insurance;" "Panel develops nutrition standard for schools;" "California women’s health;" "Health risk of ethanol;" "The state of diabetes complications;" "Weighing the costs of a pandemic;" "Nursing home review critical;" "TV food advertising to children;" "Medicine errors kill thousands;" and others.]

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