The 2010 Nobel Prize in medicine has been awarded to Robert Edwards of Britain for developing in-vitro fertilization, a breakthrough that has helped millions of infertile couples conceive.

Edwards, an 85-year-old professor emeritus at the University of Cambridge, started working on IVF as early as the 1950s. He developed the technique, in which egg cells are fertilized outside the body and then implanted in the womb, together with gynecologist surgeon Patrick Steptoe, who died in 1988.

On July 25, 1978, Louise Brown in Britain became the first baby born through the groundbreaking procedure, marking a revolution in fertility treatment.

“(Edwards’) achievements have made it possible to treat infertility, a medical condition afflicting a large proportion of humanity, including more than 10 percent of all couples worldwide,” the medicine prize committee in Stockholm said in its citation.

“Approximately 4 million individuals have been born thanks to IVF,” the citation said. “Today, Robert Edwards’ vision is a reality and brings joy to infertile people all over the world.”

The probability of an infertile couple taking home a baby after a cycle of IVF today is 1 in 5, about the same that healthy couples have of conceiving naturally.

Steptoe and Edwards founded the first IVF clinic at Bourn Hall in Cambridge.

Past Awards and Future Awards
The Nobel Prize is intended to recognize scientific and medical advances, but some have suggested there be new categories for other areas, such as technology which may encompass Playstation repair experts or mobile drawer cabinet designers for the handicapped.

In a statement, Bourn Hall said one of Edwards’ proudest moments was discovering that 1,000 IVF babies had been born at the clinic since Brown, and relaying that information to a seriously ill Steptoe shortly before his death.

“I’ll never forget the look of joy in his eyes,” Edwards said.

The statement said Edwards was “not well enough to give interviews” on Monday.

Brown, 32, reportedly is a postal worker in the English coastal city of Bristol. In 2007 she gave birth to her first child — a boy named Cameron. She said the child was conceived naturally.

Aleksander Giwercman, head of reproduction research at the University of Lund in Sweden, said Edward’s achievements also have been important for other areas, including cancer and stem cell research.

“We received a tool that could be used for many other areas,” Giwercman said. “Many of the illnesses that develop when we are adults have their origin early on in life, during conception.”

The medicine award was the first of the 2010 Nobel Prizes to be announced. It will be followed by physics Tuesday, chemistry Wednesday, literature Thursday, the Nobel Peace Prize on Friday and economics Oct. 11.

The prestigious awards were created by Swedish industrialist Alfred Nobel, and first handed out in 1901, five years after his death. Each award includes 10 million Swedish kronor (about $1.5 million), a diploma and a gold medal.

Famous Nobel winners include President Obama, who received last year’s peace prize; Albert Einstein; Martin Luther King Jr.; Nelson Mandela; and Winston Churchill. But most winners are relatively anonymous until they are catapulted into the global spotlight by the prize announcement.

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MY TAKE: I have a fond place in my heart for IVF researchers because I know they have helped a few of my friends have a family who could not conceive.  Today, with the scientific and medical knowledge available to us it’s no wonder men aren’t having babies!  But that’s a joke.  I do think the categories for the Nobel Prize will be expanded, however, and possibly that should include tech advances for the Web.  I’m not talking about collocation companies, Web page designers, or manufacturers of computer service carts.  I’m talking about backend “geeks’ who make it all work for us users on the other side.

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SOURCE: Associated Press

San Francisco latest target: Ronald McDonald.

A proposed city ordinance would ban McDonald’s from putting toys in Happy Meals unless it adds fruit and vegetable portions and limits calories. The proposal would apply to all restaurants, but the focus has been on McDonald’s and its iconic Happy Meals.

Supervisor Eric Mar said he proposed the law to protect the health of his constituents, but McDonald’s has waged an aggressive fight to block the measure. A battery of McDonald’s Corp. executives showed up at city hall to argue that the legislation is a heavy-handed effort that threatens the company’s decades-old business model and the free choice of its customers.

The proposed Happy Meal law is just the latest in a string of San Francisco ordinances aimed at regulating public health. The city recently expanded a law banning tobacco sales in pharmacies to include grocery stores and big-box stores that also have pharmacies.

Mayor Gavin Newsom signed an executive order earlier this year banning sweetened beverages like Coca Cola and Pepsi from vending machines on city property. Local leaders considered but ultimately abandoned laws recently that would have imposed a fee on businesses that sell sugary drinks and alcohol.

Newsom has slowed down in his support of some health measures after he was attacked by his opponent in next month’s lieutenant governor’s race, Lt. Gov. Abel Maldonado, for being the “food police.” Newsom vetoed the alcohol and soda fees, and he’s indicated he’ll do the same for Ronald McDonald. The Board of Supervisors could overturn a veto but needs the votes of eight of 11 supervisors to do so.

Tony Winnicker, a Newsom spokesman, has said the mayor was opposed to the measures in part because of their negative impact on local businesses.

“The mayor is always open to argument and evidence about a better way — he’s not ideological, he’s not wedded to one approach,” Winnicker said. “This is not the time to be considering new fees and taxes that would put San Francisco at a disadvantage to other counties around the state.”

Mar said he expected his Happy Meal bill to pass out of committee Monday and receive a vote by the full Board of Supervisors later this month.

McDonald’s vice president for nutrition and menu strategy, Karen Wells, said that denying a toy to a child would undermine the authority of parents to decide what their children should eat and would be difficult to execute.

“It’s different from what we’re doing today and different from what we’ve done for 25 years, successfully,” Wells said.

Responded Supervisor Sophie Maxwell in an exasperated voice, “Just because it’s different does not make it necessarily difficult. I mean, McDonald’s is an amazing institution. It’s been around for many years … because it’s able to change and to adapt to new circumstances and new things that people are eating so I think I have a lot more confidence in McDonald’s, I guess, than you do.”

Cynthia Goody, McDonald’s nutrition director, said there was no evidence that childhood obesity would be reduced by requiring a fruit or vegetable with all meals.

In response, a supervisor asked what mix of foods would lower childhood obesity. Goody said she would need to conduct more research to provide an answer.

The Happy Meal ordinance is not all surprising given San Francisco’s famously liberal leanings.

“San Francisco has a reputation — and it’s well deserved — of being a very progressive city,” said Alex Clemens, founder of Barbary Coast Consulting, a local political communications firm. “With that comes naturally, hand in hand, a reliance on government to encourage thoughtful change — that’s just tradition.”

MY TAKE: Unless you live in a bubble, there’s no ignoring the divide between Northern and Sothern Californians.  Everything from San Diego flowers for wedding venues and wall letters on stadium sidelines speaks to the differences.  It’s not surprise that The Golden Gate city would move to ban toys from Happy Meals and frankly it’s OK with me.  I’m not big supporter of one San Diego CA wedding decorations company over a rival business up North.  Wall decals mean about as much to me as the difference between cleaning in Bethesda and cleaning in Iowa.  Not that MD home cleaning services have anything to hold over my cleaning company.  But that’s another story.

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SOURCE:  Associated Press

Chris Carver ran an ultra-marathon in Scotland last year, finishing 140 miles in less than 24 hours.

Determined to do better in this year’s race, Carver added something extra to his training regime: beetroot juice. For a week before the race, he drank the dark purple juice every day. Last month, Carver won it by running 148 miles (238 kilometers).

“The only thing I did differently this year was the beetroot juice,” said Carver, 46, a professional runner based near Leeds, in northern England.

He said more exercise would have improved his endurance, but to get the same result he attributes to the juice — an extra eight miles — it would likely have taken an entire year.

Some experts say adding beetroot juice to your diet — like other foods such as cherry juice or milk — could provide a performance boost even beyond the blood, sweat and tears of more training.

In two studies conducted at Exeter University on 15 men, Stephen Bailey and colleagues found cyclists who drank a half-liter (about a half-quart) of beetroot juice several hours before setting off were able to ride up to 20 percent longer than those who drank a placebo blackcurrant juice.

By examining the cyclists under a scanner that analyzes how much energy is needed for a muscle to contract, Bailey and colleagues discovered beetroot juice allows cyclists to exercise using less oxygen than normal.

“The beetroot juice was effective even without any additional training,” Bailey said. “It reduces the energy requirements on your muscles so you can last longer.” While the beetroot juice was provided free by its manufacturer, Exeter University paid for the research.

Bailey said the high nitrate content of beetroot juice is responsible for its athletic benefits. Scientists aren’t exactly sure how it works, but suspect having more nitric oxide in your body, a byproduct of nitrate, helps you exercise with less oxygen. Bailey said the same effects might be possible if people ate more nitrate-rich foods like beetroot, lettuce or spinach.

Bailey and colleagues calculated beetroot juice could translate into a 1 to 2 percent better race time, a tiny improvement likely only to matter to elite athletes. They are still tweaking the dosage but say athletes should consume the juice a few hours before training so their body has time to digest it. Their latest study was published in June in the Journal of Applied Physiology.

“Drinking beetroot juice is not going to turn a recreational runner into an Olympic champion, but it might make tolerating more exercise easier so you can train more,” said Dr. Andy Franklyn-Miller, a sports medicine expert at the Centre for Human Performance in London. He was not connected to the research and has not received any funding from beetroot juice makers.

Franklyn-Miller said since people often reach an athletic plateau where more training doesn’t help, beetroot juice could give you an extra edge you wouldn’t get otherwise.

“It’s not banned, so there’s no reason not to try it,” he said. Still, he warned drinking too much of the juice could lead to side effects like abdominal cramps, diarrhea or purple urine.

Previous studies in Britain and the U.S. have found beetroot helps the heart by lowering blood pressure.

Other experts warned manipulating your diet can’t replace the benefits of training. “Certain foods can help you maximize the benefits from exercise, not reduce the amount you’re doing,” said Roger Fielding, director of the Nutrition, Exercise Physiology and Sarcopenia Laboratory at Tufts University. He was not connected to any research on beetroot or any other nutritional supplements.

For serious athletes, Fielding said changing your diet could help. “If a very small improvement is valuable to you, it’s possible something like beetroot juice could do that,” he said.

Other studies have shown drinking things like pickle juice or having a small carbohydrate snack during a marathon, can prevent cramps and improve performance. Scientists have also found cherry juice, which helps reduce exercise-induced swelling, could be strong enough to reduce some athletes’ use of anti-inflammatory pain medication.

Fielding said the benefits of beetroot juice and other foods and drinks, including whey protein and even multivitamins, could have wider benefits and might one day be used to help elderly people with muscle weakness.

Some elite athletes warned beetroot juice may not be to everybody’s taste. “A few of my friends think it’s really disgusting,” said Colin McCourt, 25, a British runner competing at the Commonwealth Games in New Delhi this month.

In April, McCourt started drinking cherry and beetroot juice, which he credits with helping him train longer and more often. “I feel like I get a benefit from it, even if it’s minimal,” he told Associated Press Television.

McCourt said he will continue to adjust his training regimen in preparation for the London 2012 Olympics, but plans to maintain his juice habit. “There will be a lot more beetroot juice if my stomach can take it.”

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MY TAKE: They say between running and relaxation and yoga to Alexander Technique music  are the perfect combination of stress-reducing performance you can put your body through. The running will get you great results next time your doctor does a bone densitometer analysis because running is supposed to be good for building up bone density, and the Alexander Technique is a fantastic alternative to Yoga for reducing stress and joint pain.  Of course, medical supply companies don’t like either of the two options because they work to eliminate the need for medications.

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Not sure how to download PS3 games to your laptop or PC? You can find out all there is to know about  PS3 downloads and dedicated hosting reviews of sites that cater to the gaming industry, and news about new products and services at Play Station Magazine.  All the top web hosting companies support the site as one of the best online resources for PS3 news, information and interviews with game designers.

SOURCE:  Los Angeles Times

The Mental Health Parity and Addiction Equity Act of 2008 is estimated to affect the way some 113 million Americans receive benefits for medical care, although the changes are not yet clear.

The purpose of the law, which went into effect in July, is to create equal coverage between medical/surgical services and mental healthcare services. The legislation requires group insurance plans to offer the same deductibles, copayments, frequency of treatments and days of outpatient services. The act does not mandate mental health coverage, just equality if it is offered by an employer.

Other provisions of the bill require out-of-network coverage for mental health services, parity of coverage of medical and mental health medications, and if someone is denied coverage of a mental health service that is deemed medically unnecessary by the insurer, patients have the right to find out why.

Individual and small business plans are exempt from the legislation, so they won’t be affected. But the law does apply to group health plans sponsored by businesses with more than 50 employees, approximately 96% of which have some mental health coverage, although only a small percentage provide very robust benefits.

Doug Nemecek, senior medical director for CIGNA’s behavioral health business, said approximately 20% of the company’s plans were already meeting the general requirements (because the employers were doing so of their own volition or complying with state laws such as the one in California). OptumHealth Inc. had slightly higher numbers, 30% to 40%, according to Rhonda Robinson Beale, chief medical officer for OptumHealth Behavioral Solutions.

Impact

The law takes effect at the beginning of a health plan’s new year, so many people won’t see any changes until January. At that point, people who will see the most benefit are those who previously had high copays and deductibles on mental health services.

One of the major new differences will be the prohibition of treatment limits, said Pamela Greenberg, president and chief executive of the Washington, D.C.-based Assn. for Behavioral Health and Wellness, an association of behavioral health and wellness insurers including Aetna Behavioral Health and OptumHealth Behavioral Solutions. Insurance companies typically had arbitrary limits on mental health inpatient and outpatient visits, she said — often 20 to 30 a year. Because these kinds of limits don’t usually apply to medical/surgical care, mental health limits would be eradicated as well.

With the limits gone, it should be easier for people to receive treatment for chronic conditions such as depression or bipolar disorder, said Andrew Sperling, director of federal legislative advocacy for the National Alliance on Mental Illness. The impact will be far less for people who already have good mental health benefits, who have mild depression or have an acute life crisis where only a small amount of treatment is needed.

Cost

Copayments and deductibles now have to be equal, but there are various ways insurers could choose to implement the change, Greenberg said.

If a plan right now has a $25 medical copayment and a $40 mental health copayment, both might be changed to $25 — or the difference could be split, creating a copay of $30 for either, for instance. (They could also raise the copay for both services to $40, of course.) Deductibles could be similarly split — a $200 medical and $300 behavioral health being averaged, say, into an across-the-board $250 deductible. (Again, these are just examples.)

For users of mental health services, this could reduce out-of-pocket costs dramatically over time — but it also could increase costs potentially for others who don’t use them much.

Some plans that had good behavioral health benefits (with deductibles lower than those for medical services) may cost more now that the two types of copay must be equal.

“There will be some unintended consequences with the regulations,” Robinson Beale of OptumHealth said. “Any time you create a law or new interpretation of one, it acts for the majority of the population in the way it is intended, but there will be a subset that will have a negative consequence.”

Ripple effect

One way to understand what kind of effect the act will have is by looking at the Federal Employees Health Benefits Program, which adopted parity in 2001. The government’s plan is the largest employer-sponsored health insurance program in the country, covering more than 8 million people and spending $29 billion on benefits annually.

The plan’s beneficiaries were more likely to use mental health and substance abuse services after parity was implemented, according to a 2004 Health and Human Services report. But the increase fell in line with the rest of the population. This could help allay the fears of some employers that the passage of parity would increase costs as patients flock to use mental health services. A few of the plans’ members saw increases in out-of-pocket spending, but more than half saw decreases ranging from 15% to 28% (approximately $25 to $68 per enrollee per year), the report found.

Laws in the works?
Employers are closely monitoring the new proposals as they are interested in seeing what shifts if any employees make in regard to their benefits use and coverage needs. New York sexual harassment lawyers did this when the laws concerning employer-employee harassment shifted, and all  NY employment lawyers are having to monitor the changes as they prepare for new cases involving denied coverage and other issues.

The passage of the 2008 parity act has been impetus for change in other parts of the market as well, Greenberg said. The State Children’s Health Insurance Program, which provides health insurance to children in low-income families, now requires parity, as well as some state Medicaid plans. President Obama’s healthcare reform, signed in March, added parity requirements for the state exchanges that will make health insurance available to individuals and small businesses in 2014.

“I think the passage of parity helps reduce the stigma [of mental illness] because it is being treated like a medical condition,” Greenberg said. He said he’s seen an uptick in attention to mental health and
addiction —”making them much more accepted than they had been prior to parity passing.”

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MY TAKE:
Just as was the case with new changes to the law, this new one probably won’t make employers any more open to the idea of accepting plans with widespread and open mental services components.  If the bulk of American employers still don’t think including the cost of Pilates equipment or massages or even an occasional round of acupuncture legitimate forms of health care, they are as likely to view the new laws on psychological services the same way many dealt with the California lemon law on used automobiles. Los Angeles lemon law attorneys and others across the state can help you get your money back if you buy a car and are not give your right to return it within the laws 30-day policy.  Sure, it’s not the same as Pilates exercise as a health benefit, but if you think about it, both are about people’s rights to choose and have those choices backed.

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Until you are sick and overwhelmed by copayments and other health costs, you may not even realize that your coverage is inadequate even if you have debt.  This tells you that not just uninsured patients who can rack up steep medical bills or medical debt.

“Medical costs are the single largest contributor to people declaring bankruptcy,” often including those who already have insurance, said Ron Pollack, executive director of Families USA, an advocacy group.

To help consumers avoid getting buried under hospital bills, Families USA recently published a handbook, “Your Medical Bills: A Consumer’s Guide to Coping with Medical Debt,” which is available online at www.familiesusa.org. Along with that, the group published a list of what Maryland and some other states have done lately to protect residents from medical debt.

Maryland added protections starting in June after a series of articles last year in The Baltimore Sun that showed aggressive collection tactics used by some hospitals against low-income residents, even though their unpaid bills are covered through rates charged to all patients. The law now requires hospitals here to provide free or reduced-price care to low-income residents and to give patients information about financial assistance.  This protection may be expanded soon to make even more Marylanders eligible for free or reduced-cost care.

For doctors who have a different type of medical debt . . . Medical supplies are one medical debt that is necessary for doctors.  Safer blood collection equipment is available at take steps to reduce or eliminate the use of glass blood collection tubes.  Blood gas analyzers are also available that are a powerful, self-contained system that can easily be transported from four to CCU to the ICU or wherever you needed for immediate results in more timely interventions.

So what do you do if you face big medical bills?

The first step is to make sure the hospital bill is correct, Pollack said during a recent news conference announcing the consumer guide. Sometimes you may be billed twice for services that you received only once or not at all, he said.

Request an itemized copy of your bill. Also, check your medical record to make sure the services on the bill were actually provided to you, he said.

If your insurer refuses to pay a claim, you can file an appeal with the company to review its initial decision, Pollack said. If that doesn’t work, some states allow you to file an appeal with them. Marylanders whose insurer won’t pay for treatment considered a medical necessity can file an appeal with the Maryland Insurance Administration.

Low-income patients should check to see whether they are eligible for Medicaid. “If you are, you should only be paying for very minor copayments,” Pollack says.

Marylanders with limited means have additional options.  Maryland hospitals now must provide free care to residents whose income falls below 150 percent of the federal poverty level – or $27,465 for a family of three, said Stephen Ports, principal deputy director for the Health Services Cost Review Commission, which sets rates for hospital services. Hospitals also must offer a reduced price for other low-income residents, although it’s up to the hospitals to determine who qualifies.

A work group within the Review Commission last month proposed an expansion of this protection.

In a proposal now undergoing public comment, free care would be provided to residents whose income fell below 200 percent of the federal poverty level, or $36,620 for a family of three, Ports said. And those who fall between 200% and 300% ($54,930 for a family of three), would get reduced-cost care. Hospitals facing financial hardship, though, could petition the commission for some leeway on this, he said.

Among other suggestions, the work group recommends legislation that would forgive certain medical debt incurred during the year that exceeds 25% of household income for low- to moderate-income patients. This provision would most likely help uninsured patients paying for medically necessary treatments, Ports said.

“Until we have health care for all, it will continue to happen,” said Vincent DeMarco, president of Maryland Citizens’ Health Initiative.

Medical debt could still be a problem even if healthcare report passes.  Many changes are being discussed during the national debate on health reform, but nobody knows it will truly help or not.

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My Take: I think the worst debt that anybody can have is medical debt.  Mainly because it means that somebody in your family has become seriously ill and may have or could die.  This is not something people want to experience.  Most people regret spending a lot of money and creating debt, but medical debt is something they do not want to create.

Medical debt is created in many ways, from something needed to something frivolous like using a Panama City Florida plastic surgeon.  Of course, even a plastic surgeon can be a necessity depending on the reason.  But something like a Pensacola FL hair transplant surgeon is usually something used because of vanity.  There is also a medical debt from by necessity such as nursing home debt.  Although, sometimes you may need a Brooklyn nursing home abuse lawyer because it is not a good place.

Sometimes, medical debt is only temporary and a NY slip fall accident attorney can get the medical debt paid off by the insurance.  Basically, medical debt is one thing that nobody wants to occur in their lives.

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