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Health & Fitness (231)

Police officers who receive crisis intervention training are taught how to recognize when someone with serious mental illness might be having a psychiatric crisis. Considering the overall circumstances, police look for these behaviors in a subject:

- Behavior that doesn't fit the circumstance (example: laughing at a funeral)

- Non-verbal and easily distracted

- Bizarre and disjointed thinking (delusions, hallucinations)

- Suicidal

- Normal coping skills are failing or not evident

- Unaware of self; dirty, disheveled, malodorous

- Unaware of surroundings and possible risk to personal safety

---

Source: Donald Kline, Montgomery County Emergency Service in Pennsylvania

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about ourPRIVACY POLICY and TERMS OF USE.

Thursday, 10 April 2014 06:56
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LONDON (AP) -- Three years ago, doctors reported that zapping a paralyzed man's spinal cord with electricity allowed him to stand and move his legs. Now they've done the same with three other patients, suggesting their original success was no fluke.

Experts say it's a promising development but warn that the experimental treatment isn't a cure. When the implanted device is activated, the men can wiggle their toes, lift their legs and stand briefly. But they aren't able to walk and still use wheelchairs to get around.

"There is no miracle cure on the way," said Peter Ellaway, an emeritus professor of physiology at Imperial College London, who had no role in the study. "But this could certainly give paralyzed people more independence and it could still be a life-changer for them."

In a new study published Tuesday in the British journal Brain, researchers gave an update on Rob Summers, of Portland, Oregon, the first to try the treatment, and described successful results for all three of the other men who have tried it. All had been paralyzed from below the neck or chest for at least two years from a spinal cord injury.

The study's lead author, Claudia Angeli of the Kentucky Spinal Cord Research Center at the University of Louisville, said she believes the device's zapping of the spinal cord helps it to receive simple commands from the brain, through circuitry that some doctors had assumed was beyond repair after severe paralysis.

Dustin Shillcox, 29, of Green River, Wyoming, was seriously injured in a car crash in 2010. Last year, he had the electrical device surgically implanted in his lower back in Kentucky. Five days later, he wiggled his toes and moved one of his feet for the first time.

"It was very exciting and emotional," said Shillcox. "It brought me a lot of hope."

Shillcox now practices moving his legs for about an hour a day at home in addition to therapy sessions in the lab, sometimes wearing a Superman T-shirt for inspiration. He said it has given him more confidence and he feels more comfortable going out.

"The future is very exciting for people with spinal cord injuries," he said.

The study's other two participants - Kent Stephenson of Mount Pleasant, Texas and Andrew Meas of Louisville, Kentucky - have had similar results.

"I'm able to (make) these voluntary movements and it really changed my life," Stephenson said. He said the electrical device lets him ride on an off-road utility vehicle all day with his friends and get out of the wheelchair.

"I've seen some benefits of (the device) training even when it's turned off," he added. "There have been huge improvements in bowel, bladder and sexual function."

The new study was paid for by the U.S. National Institutes of Health, the Christopher and Dana Reeve Foundation and others.

Experts said refining the use of electrical stimulators for people with paralysis might eventually prove more effective than standard approaches, including medicines and physical therapy.

"In the next five to 10 years, we may have one of the first therapies that can improve the quality of life for people with a spinal cord injury," said Gregoire Courtine, a paralysis expert at the Swiss Federal Institute of Technology in Lausanne, who was not part of the study.

Ellaway said it was unrealistic to think that paralyzed people would be able to walk after such treatment but it was feasible they might eventually be able to stand unaided or take a few steps.

"The next step will be to see how long this improvement persists or if they will need this implant for the rest of their lives," he said.

The National Institutes of Health is investing in more advanced stimulators that would better target the spinal cord as well as devices that might work on people who are paralyzed in their upper limbs.

----

Online:

Journal: WWW.BRAIN.OXFORDJOURNALS.ORG

Foundation: WWW.CHRISTOPHERREEVE.ORG

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

Tuesday, 08 April 2014 09:31
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LONDON (AP) -- In a north London hospital, scientists are growing noses, ears and blood vessels in the laboratory in a bold attempt to make body parts using stem cells.

It is among several labs around the world, including in the U.S., that are working on the futuristic idea of growing custom-made organs in the lab.

While only a handful of patients have received the British lab-made organs so far- including tear ducts, blood vessels and windpipes - researchers hope they will soon be able to transplant more types of body parts into patients, including what would be the world's first nose made partly from stem cells.

"It's like making a cake," said Alexander Seifalian at University College London, the scientist leading the effort. "We just use a different kind of oven."

During a recent visit to his lab, Seifalian showed off a sophisticated machine used to make molds from a polymer material for various organs.

Last year, he and his team made a nose for a British man who lost his to cancer. Scientists added a salt and sugar solution to the mold of the nose to mimic the somewhat sponge-like texture of the real thing. Stem cells were taken from the patient's fat and grown in the lab for two weeks before being used to cover the nose scaffold. Later, the nose was implanted into the man's forearm so that skin would grow to cover it.

Seifalian said he and his team are waiting for approval from regulatory authorities to transfer the nose onto the patient's face but couldn't say when that might happen

The potential applications of lab-made organs appear so promising even the city of London is getting involved: Seifalian's work is being showcased on Tuesday as Mayor Boris Johnson announces a new initiative to attract investment to Britain's health and science sectors so spin-off companies can spur commercial development of the pioneering research.

The polymer material Seifalian uses for his organ scaffolds has been patented and he's also applied for patents for their blood vessels, tear ducts and windpipe. He and his team are creating other organs including coronary arteries and ears. Later this year, a trial is scheduled to start in India and London to test lab-made ears for people born without them.

"Ears are harder to make than noses because you have to get all the contours right and the skin is pulled tight so you see its entire structure," said Dr. Michelle Griffin, a plastic surgeon who has made dozens of ears and noses in Seifalian's lab.

"At the moment, children who need new ears have to go through a really invasive procedure involving taking cartilage from their ribs," Griffin said, adding that taking fat cells from patients' abdomens to add to a lab-made ear scaffold would be far easier than the multiple procedures often necessary to carve an ear from their ribs. Griffin added they plan to eventually create an entirely synthetic face but must first prove their polymer scaffolds won't accidentally burst out of the skin.

"Scientists have to get things like noses and ears right before we can move onto something like a kidney, lungs or a liver, which is much more complicated," said Eileen Gentleman, a stem cell expert at King's College London, who is not involved in Seifalian's research.

"Where Seifalian has led is in showing us maybe we don't need to have the absolutely perfect tissue for a (lab-made) organ to work," she said. "What he has created is the correct structure and the fact that it's good enough for his patients to have a functional (windpipe), tear duct, etc. is pretty amazing."

Some scientists predicted certain lab-made organs will soon cease to be experimental.

"I'm convinced engineered organs are going to be on the market soon," said Suchitra Sumitran-Holgersson, a professor of transplantation biology at the University of Gothenburg in Sweden. She has transferred lab-made blood vessels into a handful of patients and plans to offer them more widely by 2016, pending regulatory approval. Still, she acknowledged doctors will have to watch closely for any long-term side effects, including the possibility of a higher cancer risk.

Seifalian estimated about 10 million pounds ($16 million) has gone into his research since 2005 but said he hoped lab-made organs would one day be available for a few hundred dollars.

"If people are not that fussy, we could manufacture different sizes of noses so the surgeon could choose a size and tailor it for patients before implanting it," he said. "People think your nose is very individual and personal but this is something that we could mass produce like in a factory one day."

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

Tuesday, 08 April 2014 09:29
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WASHINGTON (AP) -- An experimental drug has shown encouraging results in treating advanced breast cancer in an early clinical trial, pharmaceutical giant Pfizer reported Sunday.

Pfizer, the world's second largest drugmaker, said the drug prevented breast cancer from worsening for 20.2 months in a trial involving 165 patients. Current medications do so for 10.2 months. The drug, known as palbociclib, is among a new class of cancer drugs that target specific proteins to block tumors.

The outcome wasn't as positive as some initial results reported earlier in the tests, said University of Michigan business professor Erik Gordon, who studies the biomedical industry but isn't affiliated with the trial.

But, he added, "there's been a lot of hope surrounding this class of cancer drugs, and this keeps that hope alive."

Wall Street analysts have been closely watching the tests given the potential market for palbociclib. Breast cancer is the most common cancer to strike women.

"It's good news, but some investors are disappointed, because they expected more," Gordon said. In earlier results, the drug had kept the cancer from worsening for 18 additional months, rather than 10.

The results were presented by the lead researcher, Dr. Richard S. Finn, associate professor of medicine at UCLA, during the annual meeting of the American Association of Cancer Research in San Diego.

The drug will likely need to undergo broader testing with more patients before the Food and Drug Administration will approve it. The FDA sometimes accelerates approval for drugs that show promise.

Other companies, including Eli Lilly and Novartis, have similar medications that are also in clinical trials.

Pfizer's fledgling cancer drug business has been a recent bright spot for the company, which has many older drugs that will soon lose patent protection.

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

Monday, 07 April 2014 06:54
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WASHINGTON (AP) -- Here's more fallout from the health care law: Until now, customers could walk into an insurance office or go online to buy standard health care coverage any time of year. Not anymore.
 
Many people who didn't sign up during the government's open enrollment period that ended Monday will soon find it difficult or impossible to get insured this year, even if they go directly to a private company and money is no object. For some it's already too late.
 
With limited exceptions, insurers are refusing to sell to individuals after the enrollment period for HealthCare.gov and the state marketplaces. They will lock out the young and healthy as well as the sick or injured. Those who want to switch plans also are affected. The next wide-open chance to enroll comes in November for coverage in 2015.
 
It's a little-noted consequence of President Barack Obama's health care overhaul, which requires nearly all Americans to be insured or pay a fine and requires insurers to accept people with health problems.
 
"I have people that can buy insurance, but the companies shut them down. They won't take the applications," insurance broker Steve Bobiak of Frackville, Pa., said. "We're a free country. You should be able to buy anything anytime you want."
 
Those who act now may still be able to get in, depending on where they live. Following the lead of the government marketplaces, some companies are extending off-marketplace sales for a week or a month to help people who hit snags trying to enroll by this week's deadline. Rules vary from state to state.
 
After those extensions, eligibility for coverage during 2014 is guaranteed only for people who experience certain qualifying life events, such as losing a job that provided insurance, moving to a new state, getting married, having a baby or losing coverage under a parent's health plan.
 
The federal law doesn't prevent companies from selling policies to everyone all year. But insurers consider it too risky now that the law prohibits them from rejecting people in poor health.
 
"If you didn't have an open enrollment period, you would have people who would potentially enroll when they get sick and dis-enroll when they get better," said Chris Stenrud, spokesman for insurer Kaiser Permanente. "The only insured people would be sick people, which would make insurance unaffordable for everyone."
 
Bobiak, whose NICA Benefits company helps people buy insurance in New Jersey, Ohio and Pennsylvania, said he learned only a couple of weeks ago that insurers were cutting off new policies.
 
"It's lousy communication out there," he said. "If we don't know, my God, how do they expect other people to know? It's terrible."
 
A survey by the Kaiser Family Foundation in mid-March found that 6 out of 10 people without insurance weren't aware of the marketplace deadline on March 31. The Obama administration, insurance companies and nonprofit groups scrambled to spread the word, often with messages that focused on the cost savings available to many people through the government marketplaces.
 
There wasn't much public discussion about people who prefer to buy policies outside the marketplaces, sometimes finding better deals or options more to their liking.
 
Health and Human Services spokesman Aaron Albright pointed to a cryptic note on the HealthCare.gov website: It says "in some limited cases some insurance companies may sell private health plans outside the marketplace and outside open enrollment" that satisfy the law's coverage mandate. It doesn't say how to find any companies doing that. Albright had no further comment.
 
Gary Claxton, a health law expert at the Kaiser Family Foundation, said it's "highly unlikely" that companies will offer such coverage after the deadline window fully closes. Some do still offer temporary plans, lasting from a month to a year. But those plans don't cover pre-existing conditions and don't get buyers off the hook for the law's tax penalty.
 
Nate Purpura, spokesman for eHealthInsurance.com, which sells policies from 200 companies across the nation, said at this point he knows of none planning to offer major medical insurance after this month, except to people with qualifying life events.
 
For people trying to get an off-marketplace plan through an open enrollment extension, some insurers are selling them through April 15, and others through the end of the month. Purpura said eHealth will offer such plans in at least some areas of these states: Arizona, California, Georgia, Hawaii, Louisiana, Maryland, Michigan, Nevada, New Mexico, Ohio, Oregon, Utah, Virginia and Washington state.
 
Kaiser Permanente will offer extensions that mirror the state or federal marketplace in the area where a plan is sold, Stenrud said. The federal marketplace extension for online enrollment is April 15. But Oregon, for example, is giving marketplace buyers until April 30.
 
After that, Stenrud said, without a qualifying life event, the door closes until Nov. 15.
 
---
 
Follow Connie Cass on Twitter at HTTPS://TWITTER.COM/CONNIECASS
 
© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.
Friday, 04 April 2014 08:41
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Wednesday, 02 April 2014 10:20
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SACRAMENTO, Calif. (AP) -- A blizzard, jammed phone lines and unreliable websites failed to stop throngs of procrastinating Americans from trying to sign up for health coverage by the midnight Monday deadline for President Barack Obama's signature domestic policy initiative.

In Louisiana, wait times for callers lasted up to two hours. Blue Cross Blue Shield of Tennessee received nearly 1,900 calls by midday compared with about 800 the previous Monday. And in California, where enrollments surged toward the Obama administration's original projection of 1.3 million, the deadline day volume forced the state exchange to switch off a key function on its website and encourage people to finish their applications in the days ahead.

Across the nation, the interest in getting health insurance and avoiding a federal tax penalty was made clear in interviews with enrollment counselors and consumers.

"I have not had a physical in over 15 years," said Dionne Gilbert, a 51-year-old uninsured woman from Denver who waited in a 90-minute line to get enrollment assistance. "I told myself, `You need to do this. Your daughter loves you and needs you.'"

The last-minute rush was expected to significantly boost the number of Americans gaining coverage under the new law, and government officials told The Associated Press late Monday that they were on track to sign up more than 7 million Americans for health insurance by the deadline. But the months ahead will show whether the Affordable Care Act will meet its mandate to provide affordable health care coverage or whether high deductibles, paperwork snags and narrow physician networks make it a bust.

The administration has not said how many of those who already have signed up closed the deal by paying their first month's premiums. Also unknown is how many were previously uninsured - the real test of Obama's health care overhaul. In addition, the law expands coverage for low-income people through Medicaid, but only about half the states have agreed to implement that option.

In Washington, the law's supporters already have their sights on Version 2.0 - fixes for the next open enrollment season commencing Nov. 15.

The advocacy group Families USA, which has backed Obama's overhaul from its inception, plans to release a 10-point package of improvements Tuesday that it says the administration can carry out without the approval of Congress. Among the recommendations: more face-to-face sign-ups, coordinating enrollment with tax-filing season to better show the consequences of remaining uninsured, eliminating penalties for smokers as California has done and improving coordination between the exchanges and state Medicaid programs.

"Clearly, the first enrollment period also informed us about different areas where improvements can be made," said Ron Pollack, the group's executive director.

On Monday, supporters of the health care law fanned out across the country in a final dash to sign up uninsured Americans. The HealthCare.gov website, which was receiving 1.5 million visitors a day last week, had recorded about 1.2 million through noon Monday.

At times, more than 125,000 people were simultaneously using the system, straining it beyond its previously estimated capacity. People not signed up for health insurance by the deadline, either through their jobs or on their own, were subject to IRS fines - a threat that helped drive the rush.

The federal website operating in 36 states stumbled early - out of service for nearly four hours as technicians patched a software bug. An afternoon hiccup temporarily kept new applicants from signing up, and the process slowed further as the day wore on. Overwhelmed by computer problems when launched last fall, the system has been working much better in recent months, but independent testers say it still runs slowly.

The administration announced last week that people who started applying for health insurance but were not able to finish before Monday's enrollment deadline will get extra time. A variety of issues led people to seek this extension.

Health insurers and advocates in South Dakota encouraged residents to try to start the process on their own or leave a message at a federal hotline should they have to cancel an appointment with an insurance counselor because of a spring blizzard that dumped up to a foot of snow.

Those who showed up at enrollment events in other states found long lines and technical delays. Even those providing assistance were sometimes stymied.

In Fort Lauderdale, Fla., navigator Allie Stern waited 90 minutes to talk to an operator on a federal hotline. Patty Gumpee, 50, walked away without completing her application because of problems with the website. She made an appointment to try again next week.

"I need the health insurance. I need it for doctors' appointments," said Gumpee, who hasn't had insurance in years and goes to the emergency room when she's sick.

Braxton Rodriguez, a 19-year-old Topeka, Kan., resident, left an enrollment event at the city library frustrated. He was unable to verify an online identification after two weeks of trying. A part-time Wal-Mart worker, he didn't have health insurance and wanted to avoid the tax penalty.

"I'm not impressed with it at all," Rodriguez said of the federal government's website.

At a Houston community center, there were immigrants from Ethiopia, Nepal, Eritrea, Somalia, Iraq, Iran and other conflict-torn areas, many trying anew after failing to complete applications previously. In addition to needing enrollment help, many needed to wait for interpreters.

Others found the process more bearable.

Michael Carradine, a 20-year-old Sacramento State University student, arrived early at a registration hosted by a union and got subsidized health care in about 45 minutes. Carradine said it was important, but admits it was his mother who got him out of bed and encouraged him to get signed up.

"She was like, `We don't want to be fined,'" said Carradine, who enrolled in an Anthem Blue Cross plan with a monthly premium of $106 after subsidies.

Allison Webb hadn't had been insured since 2005 before signing up over the weekend at a Community Health Network clinic in Long Island City, N.Y.

"Luckily, I haven't been sick," said Webb, 29, who works full time for a messenger service that does not provide health insurance.

After choosing a comprehensive medical and dental plan that will cost her about $60 per month, Webb can start going to doctors or a dentist in May.

"I'm glad that I don't have to worry about it anymore," she said.

---

Associated Press writers Ricardo Alonso-Zaldivar in Washington, D.C., John Hanna in Topeka, Kan., Kelli Kennedy in Miami, Carolyn Thompson in Buffalo, N.Y., and Kristen Wyatt in Denver contributed to this report.

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

Tuesday, 01 April 2014 07:00
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