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Thousands Of Pennsylvania Graduates Need Health Insurance Options
Employers will hire 22 percent fewer college graduates in 2009 than they did last year, according to the National Association of Colleges and Employers. That means thousands of Pennsylvania college students graduating this spring may be without health insurance coverage due to unemployment or time elapsing before starting a new job.
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Herpes Drug Acyclovir Does Not Reduce Risk Of HIV Transmission, Does Slow HIV Progression, Study Says
The drug acyclovir, which suppresses herpes simplex virus-2, does not reduce the risk of HIV transmission when taken by HIV-positive people who also have herpes, according to a study conducted by researchers at the University of Washington, United Press International reports. According to United Press International, genital ulcers associated with HSV-2 are known to increase the risk of HIV transmission. The study was conducted among 3,408 discordant couples, in which one member is HIV-positive and the other is not, at 14 sites in seven African countries: Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia. The primary results of the study found that 41 new HIV cases occurred in the couples in which the HIV-positive member took acyclovir, compared with 43 new infections among the couples who did not take the drug. The results were not statistically significant, according to the researchers (United Press International, 5/13). However, the study did find that acyclovir can slow progression of HIV by 17% in HIV-positive people who also have HSV-2 and whose CD4+ T cell counts are too high to begin antiretroviral therapy. "Although the primary outcome of reducing HIV transmission was not observed, the study yielded important information that will inform HIV prevention research in a number of ways," Connie Celum, a professor of global health and medicine at the University of Washington"s Division of Allergy and Infectious Diseases, said. She added that the "findings will bear fruit for both the HIV prevention and vaccine fields for years to come." The study, called the Partners in Prevention HSV/HIV Transmission Study, was funded by the Bill & Melinda Gates Foundation (University of Washington release, 5/8).
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Advocates Say Rise In Inquires About Adoption, Abortion Linked To Recession
Several large adoption agencies are reporting an increase in the number of women with unintended pregnancies who are considering adoption, a trend that some advocates say is tied to the recession, USA Today reports. Scott Mars of American Adoptions said that he has observed a 10% to 12% increase in the past year in the number of women asking about adoption and a 7% to 10% increase in actual placements. Mars said that the economy has led women to "take a second look at adoption." Adam Pertman of the Evan B. Donaldson Adoption Institute, a research group, said, "Finances are one of the major reasons women feel compelled to place their children for adoption." According to USA Today, more women also are considering delaying pregnancy or inquiring about abortion because of financial factors. A recent Gallup poll found that the economy has prompted one in 10 married women to delay pregnancy. Vicki Saporta of the National Abortion Federation, which represents abortion providers, said that calls to the group"s hotline have increased nearly threefold since 2008 and that many of the calls have come from women who have experienced job loss in their families.According to Joan Jaeger of the Chicago-area adoption agency The Cradle, about 30% more women are asking about placing a child for adoption than in 2008. She noted that many of the women inquiring about adoption are in their 20s and have at least one child. Joseph Sica of Adoption by Shepherd Care said he has seen a "dramatic increase in girls calling us from the hospital" who are interested in placing a child for adoption. Sica said that many of these women expect to receive assistance in raising their infants but inquire about adoption after they give birth and find that little help is available. He said that in 2008 his agency facilitated 14 such adoptions, an increase from 11 in 2007 and four in 2006. However, Chuck Johnson -- chief operating officer of the advocacy group the National Council for Adoption -- said that the percentage of women who place a child for adoption remains low overall, which he attributed to access to legal abortion and greater societal acceptance of single parenthood. Data from the National Center for Health Statistics show that before abortion became legal in 1973, one in five never-married white women and one in 10 never-married women overall placed a child for adoption after giving birth. Since then, that rate has "plummeted," USA Today reports. A 2002 survey, the most recent available, found that only 1% of such women placed a child for adoption (Koch, USA Today, 5/19).
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Income, Education, Important Factors In Heart Disease Risk

Doctors who ignore the socioeconomic status of patients when evaluating their risk for heart disease are missing a crucial element that might result in inadequate treatment, according to a University of Rochester Medical Center study published in the June 2009 American Heart Journal. The current model that most doctors use to assess risk, known as Framingham Risk Scoring (FRS), does not accurately predict whether a person of low income and/or less than a high school education will develop heart disease or die in the next 10 years, the study found. The FRS tool is limited to measuring data such as overall cholesterol and bad cholesterol levels, blood pressure, age and smoking status. When socioeconomic factors were added into the FRS risk assessment, however, the proportion of low-income and low-education patients at risk for death or disease during the next 10 years was nearly double that of people with higher socioeconomic status. Thus, from a clinical perspective, asking about socioeconomic status when evaluating risk factors potentially increases the number of patients eligible for cholesterol-lowering medications, aspirin therapy, and supervised changes in diet and exercise, by about 15 percent, the study said. "To our knowledge, this is the first study to examine the effect of adding socioeconomic status to the typical risk assessment in the United States," said lead author Kevin Fiscella, M.D., M.P.H., professor of Family Medicine and Community and Preventive Medicine at URMC, and a national expert on disparities in health care. "We have overwhelming evidence that cholesterol-lowering pills greatly reduce mortality," Fiscella added. "Our study clearly implies that we should recalibrate the threshold for deciding who"s eligible for statins, by including socioeconomic status as another risk factor." Lower SES was defined as having less than a high school education or living on an annual income of approximately $16,000 for a single person or $27,000 for a family of three. Socioeconomic status impacts health in a variety of ways, Fiscella said, including the effects of chronic stress due to being poor, living in less safe environments, and having less access to health care. Researchers used population data from two s to study whether the FRS consistently underestimated cardiac disease risk among this group of patients. One group consisted of 12,562 men and women from an ongoing Atherosclerosis Risk in Communities (ARIC) study, and the other group included 10,300 adults from the National Health and Nutrition Examination Survey linked to the National Death Index. About 30 percent of the people in both samples met the criteria for low socioeconomic status. The data showed that when medical factors alone (blood pressure, cholesterol, etc.) are used to predict risk of heart disease, persons of higher and lower economic had similar risks. However, the observed cases of heart disease or death among people of lower socioeconomic status were greater, and the discrepancy was not cleared up in the statistical analysis until socioeconomic status was added as a risk factor. "Ignoring the risk of lower income and education when making treatment decisions may exacerbate existing health care disparities, which have been increasing over time," Fiscella said. The National Heart Lung and Blood Institute of the National Institutes of Health funded the study. Leslie Orr University of Rochester Medical Center


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