Vaccinations, eye exams, bike helmets and healthy snacks top the back-to-school health tips from physicians at Childrens Hospital of Los Angeles.

Childrens Hospital Los Angeles Top 10 Back to School Health Tips

1. Check with your doctor to confirm that your child has received the recommended vaccinations.

“This year, the single most important health issue for younger children is to make sure they receive their recommended vaccinations,” said Jill Hoffman, MD, a pediatric infectious disease specialist at Childrens Hospital Los Angeles.

Dr. Hoffman warns that California is in the middle of the worst outbreak of pertussis, better known as whooping cough, in more than 50 years. Through Aug. 17, the state has recorded 3,076 confirmed or suspect cases of pertussis, a seven-fold increase from one year ago. The figures could grow this fall as children return to school and are exposed to other students.

“It’s particularly important that all eligible members of the household receive the pertussis vaccine in order to create a ‘wall of immunity’ around the family,” said Dr. Hoffman. “Pertussis can be a particularly serious infection for young infants, leading to hospitalization and occasionally death. Children can begin to receive pertussis vaccine, in the form of DTaP, at age 2 months.”

Because immunity can fade over time, Dr. Hoffman said children over age 7 years, adolescents and adults should be re-vaccinated against pertussis to keep their immunity strong. Both these vaccines also protect against tetanus and diphtheria.

“In addition, everyone over 6 months of age should receive a yearly influenza vaccine,” said Dr. Hoffman. “As we saw last year, influenza can be severe and unpredictable. This year’s vaccine will contain protection against Influenza A H1N1 (pandemic strain), H3N2 and Influenza B. Children age 9 years and younger, who have never received influenza vaccine before will need two doses, four weeks apart, for full protection.”

In addition, be sure children are vaccinated for common infectious diseases such as chicken pox and measles. To see a list of recommended vaccinations for different age groups, the American Academy of Pediatricians (AAP) offers parents an online immunization chart.

2. Get a complete eye exam before your child starts school.

According to Mark Borchert, MD, a pediatric ophthalmologist and the director of The Vision Center at Childrens Hospital Los Angeles, 80 percent of the learning a child does occurs through his eyes and approximately one in four school-age children have some type of vision impairment. School eye exams, while valuable, are necessarily brief and may miss many treatable problems.

“Every child should have a complete eye exam by age three,” said Dr. Borchert. “Some serious eye diseases such as Amblyopia (lazy eye) or strabismus (crossed eyes) are correctable with eye patches or surgery if caught early. Once a child is seven or eight years old, the opportunity to correct the problem may be lost, resulting in permanent vision problems.”

3. Be sure your child wears a properly fitted bicycle helmet.

Last year, 93 bicyclists under age 15 were killed and 12,500 sent to emergency rooms, according to the National Highway Traffic Safety Administration. Head injuries accounted for 63 percent of all bicycle fatalities.

“California state law requires that all children under 18 wear a helmet when they are riding a bicycle, scooter or skateboard. If a child has an accident, a helmet can prevent a serious brain injury,” said Jeffrey Upperman, MD, medical director for the Pediatric Trauma Center at Childrens Hospital Los Angeles.

According to the Bicycle Helmet Safety Institute (BHSI), all helmets sold in the U.S. must meet test requirements from the Consumer Product Safety Administration. Size is a key factor, since children grow rapidly. The helmet should be comfortable, but fit snugly. The BHSI advises that in terms of safety, there is no difference between a $20 helmet and a $120 one.

4. Snacks: plan them, don’t ban them.

A recent study of 700,000 children published in the March 2010 edition of the Journal of Pediatrics, found that 37 percent were overweight and 19.4 percent were obese.

“Childhood obesity is a major health issue. Being overweight may impact a child’s self-esteem, school performance, and physical health. Over time, obesity increases the risk of many diseases, including heart disease, stroke, arthritis, diabetes and cancer,” said pediatric endocrinologist Steven Mittelman, MD, of Childrens Hospital Los Angeles.

By shopping carefully, parents can get their children started in healthy eating habits. Snacking itself is not necessarily bad; young children actually need snacks. Their stomachs are small, so they often can’t get all the nutrients they need in a day through regular meals alone.

Avoid soda drinks and salty, high-calorie prepackaged snack foods. Provide milk or juice and servings of fruit or vegetables instead. Each 12-ounce soft drink can contain approximately 10 teaspoons of sugar. Drinking just one can of soda a day increases a child’s risk of obesity by 60 percent, according to the AAP.

5. Get started early with a school bedtime schedule.

During the summer, many children fall into a vacation rhythm, staying up late and sleeping in. Sleep specialists recommend that parents start gradually imposing an earlier bedtime several weeks before school begins.

“While there is a lot of variation between individuals, children need more sleep than adults,” said pediatrician Michelle A. Thompson, MD, of Childrens Hospital Los Angeles. “Recent studies indicate children ages 6 through 9 should get 10-11 hours of sleep a night. If your child is not getting enough sleep, he may fall asleep in the car or seem grouchy and tired during the day.”

Dr. Thompson said some children will need help establishing bedtime rituals that make them comfortable and drowsy. Parents need to set a regular bedtime and keep it to build consistency in the child’s daily routine.

6. Watch out for back pain caused by backpacks.

Parents need to keep an eye out to be sure children are not having back pain as a result of carrying a backpack to school.

“While there is no clear evidence that heavy backpacks lead to permanent damage, they are associated with back pain in children,” said David L. Skaggs, MD, chief of the Division of Orthopaedic Surgery at Childrens Hospital Los Angeles. “Poor conditioning may contribute to back pain, so parents are encouraged to get their children to do core strengthening exercises to build muscle strength.”

In addition, parents should look for packs with individual compartments and put heaviest items closest to the body. Sharp objects like pencils should be in smaller pockets on the outside. School back packs should have two shoulder straps and your child should use both.

7. Car safety remains a top priority.

September brings an increase in car trips to school, lessons and sports practices. Despite airbags, motor vehicle accidents remain a leading cause of death for children.

“Many of the patients we see in our Emergency Department who were injured in traffic accidents were not wearing seat belts,” said Alan L. Nager, MD, director of the Division of Emergency and Transport Medicine at Childrens Hospital Los Angeles. “All passengers should wear a seat belt or an age-appropriate car safety seat or booster seat.”

Safety experts recommend that all children under age 13 should ride in the rear seat. If you must drive more children than can fit in the rear seat (e.g. a carpool), move the front passenger seat back as far as possible and have the child ride in a booster seat if the seat belts don’t fit properly without it.

Childrens Hospital Los Angeles offers a Child Passenger Safety Class and Child Safety Seat Fitting & Inspections with a Certified Child Passenger Safety Technician. For more information, visit the website at www.CHLA.org to schedule an appointment.

8. Have a family plan for sick days.

“Never send your child to school with a fever,” said pediatrician Yvonne Gutierrez, MD, of Childrens Hospital Los Angeles. “Even if your child says he feels OK, running a fever is an indicator that their immune system is trying to fight off something. When a child is running a fever, he is at his most contagious and this puts children and adults around him at risk. If at all possible, make arrangements for your child to stay home with caregiver.”

Dr. Gutierrez recommends keeping your child home until the fever has been gone for 24 hours without medication. Colds can be contagious for at least 48 hours. If you’re unsure about the best way to treat your child’s cold or flu, ask your doctor, school nurse or other healthcare provider.

9. Fight germs with hand washing and home cleanliness.

“Regular hand washing is one of the single best ways to fight infection,” said infectious disease specialist Lawrence Ross, MD, who serves as Infection Control Officer at Childrens Hospital Los Angeles. “Younger children should be instructed in the importance of proper hand washing before eating and after using the restroom. For situations where hand washing is not possible, consider supplying your child with packets of hand sanitizing gel.”

Germs and viruses can hitch a ride back home from school, so regular cleaning of kitchen and bathroom counters is a good idea, said Dr. Ross. Basic washing of frequently used hard surfaces with cleanser or soap will go a long way towards lowering the germ count.

10. Talk with your child to understand their emotions.

A parent’s responsibility goes beyond supplying food, clothing and entertainment. Parents are also responsible for their child’s emotional and social growth.

According to child and adolescent psychiatrist Julienne Jacobson, MD, of Childrens Hospital Los Angeles, it is important for parents to consistently talk to their children, to know their personalities and be alert to any changes in behavior.

“To maintain a strong connection engage with your kids consistently,” said Dr. Jacobson. “Make a point to spend time with them daily and talk about their activities and interests. Listen to what they say. Let them know you are interested in what they think and how they feel. Let them know they can always feel comfortable talking to you.”

It’s important to be aware of what is appropriate behavior for your child’s age group. Good sources for this information are teachers and other parents. Remember you can ask teachers or school counselors for help or input if you have questions or are concerned about changes in your child’s behavior.

For more Healthy Tips, please go to www.CHLA.org.

HHS Secretary Kathleen Sebelius has announced $159.1 million in grants to health care workforce training programs. These grants build on the multimillion dollar investments made under the Affordable Care Act and Recovery Act to strengthen and grow our primary care workforce. The grants will target three types of programs: Nursing Workforce Development programs; interdisciplinary geriatric education and training programs; and Centers of Excellence programs for underrepresented minority students.

“We cannot build a healthier America if our country continues to face a growing health professions shortage,” said Secretary Sebelius. “A well-trained, educated and diverse workforce is critical to meeting future health care demands, and to reforming the nation’s health care system.”

“These grants target key workforce needs,” said Health Resources and Services Administration (HRSA) Administrator Mary K. Wakefield, Ph.D., R.N. “In addition to training new health care workers, these grants will support efforts to better prepare health care workers to care for our diverse and aging population, improving health care quality for all Americans.”

Nursing Workforce Development

Nursing Workforce Development programs will receive $106 million in grants to support all levels of nursing education.

• Advanced Education Nursing ($42 million) supports 153 infrastructure grants to increase advanced education to train nurses as primary care providers and/or nursing faculty.
• Advanced Education Nursing Traineeship ($16 million) supports 351 schools of nursing and individuals preparing for careers as nurse specialists, requiring advanced education.
• Nurse Anesthetist Traineeship ($1.3 million) funds 83 nurse anesthetist training programs to provide traineeships that pay tuition, books, fees, and a living stipend for registered nurses who have completed at least 12 months in a master’s or doctoral nurse anesthesia program.
• Nurse Education, Practice, Quality and Retention ($29.9 million) supports 108 infrastructure grants to expand the capacity of the nursing pipeline, promote career mobility for individuals in nursing, prepare more nurses at the baccalaureate level, and provide continuing education and training to enhance the quality of patient care.

• Nursing Workforce Diversity ($14.3 million) supports 44 grants that increase nursing education opportunities for individuals from disadvantaged backgrounds, including racial and ethnic minorities underrepresented among registered nurses.
• Faculty Development: Integrated Technology into Nursing Education and Practice Initiative ($2.5 million) supports nine grants for faculty development projects in information and other technologies to expand the capacity of collegiate schools of nursing to educate students for 21st century health care practice.

Interdisciplinary Geriatric Education and Training

Eighty-five awards totaling $29.5 million will fund three geriatric education and training programs at accredited health professions schools.

• Geriatric Education Centers (GEC) ($17.2 million) supports 45 awards to improve training of health professionals in geriatrics; develop curricula relating to treating health problems of the elderly; and support faculty training and continuing education for health professionals in geriatric care.
• Geriatric Training for Physicians, Dentists, and Behavioral and Mental Health Professionals (GTPD) ($8.1 million) supports 13 grants to geriatric training projects that will train health professionals who plan to teach geriatric medicine, geriatric dentistry, or geriatric behavioral or mental health.
• Comprehensive Geriatric Education Program (CGEP) ($4.2 million) supports 27 grants for projects to train and educate individuals in providing geriatric care for the elderly, including curriculum development, faculty training and continuing education for geriatric providers.

Centers of Excellence Grants

Eighteen awards totaling $23.6 million were announced to support Centers of Excellence programs that are designed to improve the recruitment and performance of underrepresented minority students preparing for health professions careers.

The program supports activities to develop an educational pipeline to enhance academic performance of underrepresented minority students. It supports underrepresented minority faculty development, facilitates research on health issues particularly affecting underrepresented minority groups, and provides training to students at community-based health facilities for providing health services to underrepresented minority individuals. The awardees are schools of allopathic medicine, osteopathic medicine, dentistry, pharmacy, and allied health (including designated Historically Black Colleges and Universities (HBCUs); graduate programs in behavioral health; and other public and nonprofit health or educational organizations.

Secretary Sebelius will highlight the grants, which include both new and continuing grants, at the National Health Service Corps Conference today. The National Health Service Corps is another HRSA program that has seen new resources under the Obama administration to invest in America’s health care workforce in underrepresented areas.

State-by-state charts of the grant awards are available at http://www.hhs.gov/news/press/2010pres/08/state_charts.html.

For more information on HRSA’s health professions programs, go to http://bhpr.hrsa.gov/

A team of surgeons from Kleinert Kutz and Associates and the University of Louisville have performed yet another hand transplant at the Jewish Hospital Hand Care Center. Surgeons document the surgery, which was the facility’s first double hand transplant, by using Twitter, to provide short, real-time updates as the procedure takes place.

Breidenbach said, “The patient’s family is very excited about being able to follow the surgery online instead of occasional updates throughout the surgery by hospital personnel. We want others to follow the surgery as well to understand how it all works, identifying and connecting bones, arteries and veins. Our team has already performed five hand transplants over the past eleven years and we have been reconnecting fingers, hands and arms for more than 50 years.”

“We live in a real-time world today where people want to know what’s happening as it is happening,” said Marty Bonick, president and CEO, Jewish Hospital Medical Campus. “This is a chance for us to tell the world about our latest hand transplant as it happens and also take the mystery out of an innovative procedure.”

To follow the surgery, go to www.twitter.com/jewishhospital

The Composite Tissue Allotransplantation program is a partnership of physicians and researchers at Jewish Hospital Hand Care Center, Kleinert Kutz & Associates, and the University of Louisville. The group developed the pioneering hand transplant procedure. The hand transplant is sponsored by the Department of Defense, Office of Naval Research and Office of Army Research to further research in the composite tissue allotransplantation program.

As the unofficial end of summer quickly approaches with Labor Day weekend, many Americans are planning one last hurrah by gathering with family and friends for cookouts and picnics. Essential ingredients for a successful party include sunny weather, good company and delicious – and safe – food. Food safety and quality testing company Intertek offers the following tips for packing the perfect cooler and advice for safe grilling to keep your party food at optimum temperatures during your outdoor celebration.

When packing for a cookout or picnic, it’s best to bring one cooler for beverages and a separate cooler for food. Because beverage coolers are opened more frequently, cold air can escape, causing the internal temperature to rise. Be sure to pack your food cooler with ice packs along with loose ice so it will remain below 40 F, reducing the risk for harmful bacteria to grow.

When grilling food, it is important to use a meat thermometer to ensure proper temperatures. To verify safe internal temperatures, beef and poultry should be grilled to 170 F, while hamburgers are best at 160 F. Additionally, to avoid cross contamination, do not use the same utensils for raw and cooked food.

If you have leftovers, immediately put perishable food away in a cooler containing ice or ice packs. Discard any leftovers that have been outside for more than two hours; however if the temperature exceeds 90 F, discard food left out only after one hour. When in doubt, throw it out.

In what may be one of the first known iPhone 4 “video calling” medical consultations since the phone’s release, surgeons at Valley Presbyterian Hospital near Los Angeles and University of Arizona used the advanced technology to successfully collaborate long distance in “real time” on a wound consultation for a patient.

Using the FaceTime feature on the new iPhone 4, Dr. David G. Armstrong, Professor of Surgery at the University of Arizona’s Southern Arizona Limb Salvage Alliance (SALSA), was able to instantly connect with Dr. Lee Rogers, Associate Director of Valley Presbyterian Hospital’s Amputation Prevention Center, near Los Angeles by video calling. What is essentially a simple phone call, turned into a long distance consultation and second opinion for a patient who recently underwent surgery.

“Video consultation over the Internet has been available for a few years, but its utility in the clinical setting has been limited by the necessity of having a transportable computer, camera, and appropriate software,” said Dr. Rogers. “Now, nearly everyone carries a phone in their pocket. It is this compact accessibility that will lead to the adoption of this technology for medical consultations.”

“While the University of Arizona has had one of the world’s top telehealth systems, the ability to communicate quickly with something that is an afterthought has the potential to alter how we work with our colleagues and patients,” said Dr. Armstrong.

“Just as with the iPod in music and the laptop in computing, it is not the change in technology, but the change in form factor and ubiquity that alters this landscape.”

The use of iPhone 4 technology is just the most recent cutting-edge technology to help surgeons at Valley Presbyterian Hospital’s Amputation Prevention Center, which opened earlier this year.

While many U.S. companies initially hoped they could preserve much of their existing group health plans under the new grandfather provision, a new survey by Hewitt Associates, shows that almost all now believe they will not. Ninety percent of companies said they anticipate losing grandfathered status by 2014, with the majority expecting to do so in the next two years.

Under the “grandfather” provision of the U.S. Patient Protection and Affordable Care Act, companies can maintain many of their current health care coverage provisions and are required to make fewer changes to plan documents and administrative procedures in order to comply with the new law. Companies can lose their grandfather status if they take certain steps such as reducing benefits, significantly raising co-payment charges, significantly raising deductibles or changing insurance carriers.

According to Hewitt’s survey of 466 companies—representing 6.9 million employees—most companies expect to lose grandfather status because of health plan design changes (72 percent) and/or changes to company subsidy levels (39 percent). Employers also cited consolidation of health plans (16 percent), changes to insurance carriers (16 percent) and union negotiations (15 percent) as additional reasons. More than three-quarters of companies (77 percent) said that recently released guidance on preventive care did not impact their decision to maintain grandfathered status.

Hewitt’s survey found that of those companies with self-insured plans, most (51 percent) expect to first lose grandfather status in 2011 and another 21 percent plan to lose status in 2012. This timing is similar for companies with fully insured medical plans, with the vast majority expecting to lose status in 2011 (46 percent) or 2012 (18 percent).

“Employers reviewing their existing health care strategies in light of reform are focused on answering two questions: What changes do I need or want to make to my health care plans? And how can I make them without significantly increasing costs?” said Ken Sperling, leader of Hewitt’s Health Management practice. “After assessing the grandfather provision, large companies realize they already comply with many of the requirements of non-grandfathered plans, so the changes they’ll need to make aren’t likely to add a significant cost or administrative burden. Most large employers would rather have the flexibility to change their benefit programs than be tied down to the limited modifications allowed under the new law.”

The latest data from the Centers for Disease Control’s (CDC) National Health Statistics Reports shows continued use of the nation’s emergency rooms for conditions that could be treated in an urgent care setting.

Of the 116.8 million visits covered by the 2007 Emergency Department (ED) Summary, only 16.4% were actually admitted to a hospital or kept for observation, while the overwhelming majority (62%) were referred to their primary care provider or a specialist for follow up. Another 35% were referred back to the ED “as needed”, presumably because those patients did not have a regular doctor. Over one third of the patients categorized their pain levels as “none” or “mild”; the chief complaints continue to be (as they were in the 2006 data) upper respiratory issues, otitis media (earache), abdominal pain, wounds, and obstetrics complications.

While in the ED, 45.5% of the patients had a procedure, the majority of which were common procedures such as administration of IV fluids, splinting or wrapping, repair of a laceration, or a nebulizer treatment. Urgent care centers can treat the vast majority of these issues and others—issues that don’t require an inpatient stay and are not life or limb-threatening emergencies—at a lower cost and usually a much shorter wait time than the ED. Urgent care centers perform all of those common procedures and are set up to provide referrals back to primary care or specialists. Urgent care centers are open for extended hours, as well as on weekends, providing easy access.

While there will continue to be uncertainty about what seemingly minor conditions truly belong in the ED, and patients should always err on the side of caution, it is clear from the latest CDC data (based on the chief complaints, levels of pain, types of treatment and ultimate discharge plans for most patients) that many ED patients likely could have been treated in an urgent care center.

A team of Allegheny General Hospital (AGH) physicians led by neurosurgical pioneer Peter Jannetta, MD, has made an important new discovery linking the central nervous system to the onset and progression of type 2 diabetes mellitus. Reporting today in the journal Surgical Neurology International, Dr. Jannetta and his colleagues present evidence from a prospective clinical trial that vascular compression of a section of the brain called the medulla oblongata is a factor in some patients with type 2 diabetes and that microvascular decompression surgery (MVD) may be an effective treatment for the condition.

Recognized world-wide as one of the preeminent authorities on diseases associated with vascular compression of the cranial nerves, Dr. Jannetta is credited with developing the MVD technique, which is now generally considered the surgical standard of care for a host of debilitating cranial nerve diseases, including trigeminal neuralgia, hemifacial spasm, vertigo, Meniere’s disease and spasmodic torticollis.

Microvascular decompression is a procedure that involves repositioning compressive arteries in the brain and placing a protective pad between the nerve and artery.

Dr. Jannetta, who serves as Vice Chair of Academics in AGH’s Department of Neurosurgery, and his team have performed more than 6,000 such operations.

Over the past three decades, research by Dr. Jannetta and others has led to observations about the potential role of vascular compression in metabolic syndromes such as hypertension and diabetes.

A disease of epidemic proportions in the United States, type 2 diabetes mellitus is a chronic condition marked by high levels of sugar (glucose) in the blood. Although obesity is a primary risk factor for the disease, it can also develop in those who are not obese, especially among the elderly. Without medical intervention or aggressive lifestyle changes, type 2 diabetes often leads to serious cardiovascular, vision and renal problems.

In a previous, retrospective study of 15 patients with type 2 diabetes who were operated on by Dr. Jannetta for an unrelated right-sided cranial nerve disease, arterial compression of the right anterolateral medulla oblongata was documented in every single case (Stroke 1999:30:1707-10).

The medulla oblongata is the lowermost portion of the brain, continuous with the spinal cord, that is responsible for respiration, circulation and the body’s autonomic reflexes, including function of the pancreas.

“Insulin resistance, or hyperinsulinemia, is central to the development of type 2 diabetes mellitus. We have documented previously that pulsatile arterial compression of the right anterolateral medulla oblongata is associated with autonomic dysfunction that adversely impacts the pancreas and increases insulin resistance. Building upon that knowledge, we hypothesized that decompressing the right cranial nerve X – or the vagus nerve – and the medulla oblongata could result in better glycemic control for patients with this disease,” said Dr. Jannetta.

Ten patients with steadily progressive type 2 diabetes mellitus and visible right lateral medullary compression by arterial loops on MRI were enrolled in the team’s follow up study. Each patient in the trial underwent right retromastoid craniectomy and microvascular decompression. At intraoperative visual evaluation, the vascular compression was even more severe than seen on MRI scans in 9 of the 10 patients, Dr. Jannetta said.

Patients in the study were followed for 12 months post-operatively, during which time no changes in diet, weight or activity level were permitted. In addition to blood glucose monitoring, studies of glycemic control, pancreatic function and insulin metabolism were performed regularly by the team.

Study participants whose glycemic control either improved or did not worsen during the course of the trial were considered “good” responders, while “failed” responders had no slowing in the natural progression of the disease.

Results of the trial showed that seven of the ten patients who underwent MVD experienced significant improvement in their glucose control, based on measurement of diabetes markers (changes in hemoglobin A1c, fasting blood glucose and serum insulin levels) and decrease of diabetes medication dosages. One patient was able to discontinue his diabetic medications entirely.

Dr. Jannetta said body mass index also appeared to be an important factor in who responded well to surgery. Those in the study who had the best outcome from MVD had BMIs classified as overweight while those who did not respond had BMIs in the obese category.

“Diabetes is a tremendously difficult condition to manage and, for patients, to live with. Though our study involves a relatively small sampling of patients, we believe that it represents a major breakthrough in our understanding about the central nervous system etiology of the disease and the potential of surgical intervention as an alternative therapy for a significant subset of patients. The next step is a much larger prospective clinical investigation to further corroborate what we have found,” Dr. Jannetta said.

Commenting on the study in an accompanying editorial, Sunil Patel, MD, Chair of the Department of Neurosciences at the Medical University of South Carolina and Joyce Nicholas, Ph.D., Associate Professor in MUSC’s Department of Biostatistics and Epidemiology, concur on the importance of the AGH team’s work and the need for continued investigation:

“These observations point the way to further questions that need to be answered to conclude definitively that pulsatile arterial compression of the right antrolateral medulla is an independent risk factor for type 2 diabetes mellitus. Like Dr. Jannetta’s earlier observations on essential hypertension, the observations presented [in the current study] are valuable starting points for questions related to the exact location of arterial compression relevant to type 2 diabetes mellitus, the best experimental measure of response, and the subset of patients most likely to benefit from microvascular decompression surgery. We encourage their continued efforts and those of other researchers in addressing the questions raised by this valuable contribution to our understanding of the disease and its treatment.”

In addition to Dr. Jannetta, other AGH physicians who participated in the study include neurosurgeon Ray Sekula, MD, endocrinologist Peter Grondzioski, MD, and research coordinator Lynn Fletcher, RN.

The reviews are in, and retirees give the thumbs up to health insurance exchanges. In an independent survey of 443 retirees who use a health insurance exchange to compare and choose private individual Medicare and supplement plans, 85% of their reviews were positive. Top-rated responses were:

• Health insurance exchanges are a welcome addition to the U.S. health insurance system; and
• Everyone should have access to a health insurance exchange.

When asked the most appealing aspect of health insurance exchanges, the number one cited answer was “Exchanges make it easier to compare and select plans that meet my needs and budget.”

The survey was fielded in June and July 2010 by Extend Health, Inc., which operates the largest private Medicare exchange in the country at www.ExtendHealth.com.

“Our retiree customers are at the leading edge of what is next in healthcare – individuals with access to health insurance through an exchange,” said Bryce Williams, CEO of Extend Health. “These survey results suggest that the exchanges authorized by health care reform legislation passed earlier this year will be greeted with enthusiasm when they go into operation for individuals and small businesses in 2014.”

The questions and detailed results from the survey are as follows:

After overcoming a series of facial reconstructive surgeries for the removal of an 18 pound, melon-sized tumor from her face, followed by a devastating earthquake that resulted in loss of family and homelessness – Marlie Casseus faces another challenge.

“Marlie is having difficulty breathing due to an infection,” stated Janelle Prieto, Director of IKF’s Wonderfund. “She needs to go in to Holtz Children’s Hospital for surgery. She has come so far and has overcome so much – we will not let her die and we are appealing to the community for help.”

In 2005, IKF’s Wonderfund through the generous donations that came in from throughout the U.S., funded a series of facial reconstructive surgeries that removed a massive tumor that covered most of Marlie’s face. The tumor was as a result of Polyostotic Fibrous Dysplasia, a genetic bone disease that can affect any bone in the body. Marlie’s mouth and nasal passages were blocked prior to the initial surgery. She could not speak and was only able to eat and breathe through one narrow passage.

IKF’s Wonderfund is a program of Jackson Memorial Foundation, made possible by Holtz Children’s Hospital. The philanthropic program helps critically ill children, throughout the world, gain immediate access to life-saving and life-changing medical treatments.