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How In-Home Health Care Could Be Safer

With more people turning to in-home care providers as an affordable alternative to hospital care or nursing homes, there is an increasing demand for workers. From 2010 to 2020, the home health care industry is projected to grow by almost 70 percent. In order to properly compensate and protect this growing group of in-home health care workers, laws protecting their employment rights must evolve with the times. 
Implementing the Fair Labor Standards Act

In the early days of in-home healthcare, domestic workers were typically friends, family and neighbors of the ill, disabled or infirm. But as the U.S. population ages and the number of senior citizens grows, the need for domestic service workers continues to increase. According to research by the National Association for Homecare and Hospice (NAHC), about 12 million Americans were receiving in-home health care in 2010. And finding the right care provider is getting more difficult, too. Demographic trends show that more Americans are moving further from their loved ones than in past generations. 

In 1974, the Fair Labor Standards Act (FLSA) extended to protect domestic service workers. But, as this industry evolves to fit the needs of its growing patient population, so must the laws adapt to providers’ needs. Since its enactment in 1938, the FLSA has remained a reliable support system for workers in almost every industry. If passed, this act will meaningfully impact millions of in-home health care providers and the families they serve. 

How the Fair Labor Standards Act Works

In 1974, Congress amended the FLSA to cover domestic workers. As it stands today: 

  • Companion” workers, or nonprofessional workers, tending to the sick or infirm and performing domestic duties (e.g., cooking, cleaning and laundry) need not be paid the minimum wage or overtime, as long as their domestic responsibilities do not exceed 20 percent of their total time worked each week.
  • Professionally trained domestic workers, such as nurses, nurses aids and physical therapists, are exempt from the FLSA minimum wage and overtime requirements and instead receive a salary.
  • If the companion worker or professional domestic worker is living in the home, they are entitled to receive minimum wage, but are exempt from overtime pay.

According to the United States Bureau of Labor Statistics, under the current FLSA regulations, home health care workers make around $20,000 annually and many do not receive benefits, such as health insurance, paid time off and retirement plans. 

Changing Regulations to Meet Today’s Needs

In 2011, after spending a day with home health care worker Pauline Beck, President Barack Obama announced that the Department of Labor was proposing a change to the FLSA requirements to include minimum wage and overtime protections for in-home care workers. 

“…As the homecare business has changed over the years, the law hasn’t changed to keep up,” said President Obama in the speech. “So even though workers like Pauline do everything from bathing to cooking, they’re still lumped in the same category as teenage babysitters when it comes to how much they make. That means employers are allowed to pay these workers less than minimum wage with no overtime.”

If passed, the proposed rules for the Application of the FLSA to Domestic Service would:

  • Clearly define tasks performed by exempt home health care workers.
  • Define “companionship services” as fellowship and protection activities, which may include playing cards, watching television, visiting with friends and neighbors, taking walks, or engaging in hobbies.
  • Limit the types of responsibilities that render the home health care worker exempt from FLSA requirements.
  • Amend the recordkeeping requirements for live-in home health care workers. 
  • Limit the exemption to those employed by the family or someone living in the home.
  • Entitle workers employed by a third party, such as a staffing agency, to minimum wage and overtime pay.

Republican and Organization Opposition to the Proposed Amendment

In June 2012, several Acts were introduced by representatives in opposition of the DOL’s proposed rules. Garnering support from NAHC, the Companion Exemption Protection ActEnsuring Access to Affordable and Quality Companion Care Act, andProtecting In-Home Care from Government Intrusion Act maintain current exemptions and keep the DOL from moving forward with its amendments. 

“This proposed change to a decades-old rule would take that opportunity away from many families by driving up costs and could force them to put loved ones in institutionalized care facilities,” said Senator Mike Johanns (R-NE) in a press release. “The cost of such care is often more expensive and paid through Medicaid – further straining state budgets.”

The NAHC adds to the argument by stating that the DOL’s proposed rules are based on inaccurate data from Medicare and Medicaid and will reduce the availability of care while increasing costs. 

An Uncertain Future for In-Home Health Care 

The comment period on the DOL’s proposed amendment closed in the spring of 2012, and the rule has yet to be finalized. If the changes are implemented, in-home health care workers will finally get compensation in accordance with today’s standards. 

For more information on the proposed rule and its progress, visit the DOL Wage and Hour Division website.

Why We Need to Save U.S. Poison Control Centers

The national network of Poison Control Centers (PCC) is made up of 57 site specific operations. Even though these centers directly and indirectly save countless lives each year, many of the nation’s PCCs may be closing in the next few years. With a 36% decrease in funding in 2012 alone, poison centers across the nation are struggling to stay open. In order to ensure the continuation of PC services, the national network may be forced to consolidate into a single center. The close of local poison control centers will not only limit options available to families that find themselves in poison emergencies, but also deprive U.S. medical staff of the invaluable training materials and programs the PCC creates and offers each year.  

In 2010, there were over 10,000 calls taken each day by the 57 PCCs across the United States. And it’s not just patients that are served. Hospitals and 911 call centers often consult the expertise of their local poison control center. In addition to always having a toxicologist on staff, local poison center staff can include physicians, nurses and pharmacists who are specially trained in poison control. In fact, the PCC staff is utilized to train new health care students.

Keeping poison control centers open often eliminates unnecessary trips to the emergency room. According to a report on the value of Poison Control Centers, for every $1 spent on PCCs, $13.39 is saved in health care costs and productivity, a savings of $1.8 billion a year.  With one phone call, a PCC lab can identify an ingested or inhaled substance as a poison, and offer appropriate treatment.  In many cases, appropriate treatment means avoiding the hospital and staying at home. Almost 75% of PCC cases are treated at home. Proponents for keeping the PCCs open cite the significant long-term cost savings.

Regional Resources Band Together

The nation’s 57 regional PCCs pool their resources with the American Association of Poison Control Centers network. The AAPCC sets the standard for poison center operations and certifies specialists in poison information. Within this organization, the PCCs collaborate and support one another, sharing pertinent information that makes poison control that much more effective. 

The AAPCC provides many basic services and resources. In addition to offering a poison emergency hotline and 24-hour board certified toxicologist to answer incoming questions, the AAPCC proactively publicizes alerts about the latest or most pertinent poisoning news such as safety when using generators during storms, and protecting children from laundry detergent packages and energy drinks. Details on the latest drug abuse trends like bath salts and synthetic marijuana are also provided.

Prevention services for parents and children are enumerated, with reminders about keeping the entire home safe. For medical professionals, the site offers a reminder that PCCs offer consultations about everything from drug interactions to recommended treatments. PCCs are staffed by experts in poison control and are excellent resources.

As a teaching tool, the AAPCC is quite effective. The site offers a Poison Control in Action training program for adults and a non-judgmental forum for teens. PCC resources for teens is open minded and realistic. There are also specific training materials for certain professionals and caregivers. For instance, babysitters will find clear and extensive guides to common household poisons,child safety, and emergency poisoning procedure.  

The AAPCC is also passionate about openly informing teens of the dangers and draws of drug abuse. PCC literature empowers young people to make the most informed choices possible. There is also an Unquestionable Answers section on the PCC site that discourages readers from researching drugs and chemicals online. Even if someone is going to opt to experiment with a certain drug, the PCC is eager to provide the most authoritative answers available. 

The AAPCC’s largest industry contribution is likely its National Poison Data System (NPDS). The NPDS is currently the only cohesive poison information and surveillance database in the United States. The database holds over 50 million case records, and is updated by each of the 57 control centers approximately every 20 minutes. This data is used by many organizations to establish patient care guidelines, to identify products for reformulation, to direct toxicological studies, and to further educate the public about poison dangers.

What You Can Do

To learn more about the future of the AAPCC, and how you can help keep your local poison center open, register for the AAPCC advocacy network. Use this link to send a letter to your elected officials telling them to support funding for poison centers.

If you have a poisoning emergency, please call 1-800-222-1222.

Amateur Student Scientists are Solving Big Problems, Like Anthrax

The answers to some of the biggest questions in science often turn out to be far simpler than researchers originally hypothesize. As a result, inexperienced but open-minded students frequently make meaningful scientific breakthroughs. Today, young student scientists are encouraged to think big and pursue their own projects.

Historic Student Scientists

Louis Braille
created his famous 
raised dots system of reading and writing, now used by the visually-impaired around the world, when he was 15 years old.

Anton van Leeuwenhoek
began making great improvements to the microscope when he was only 16.

Cyrus McCormick
began inventing when he was only 15, and created his famous reaper
when he was 22.

Blaise Pascal
famous for his contributions to mathematics, invented a 
mechanical adding machine was he was 19.

George Westinghouse
was awarded his first patent for the steam engine when he was 19.

Important Student Researchers Today


In 2006, high school student Marc Roberge experimented with a common clothing iron on sealed envelopes and proved his hypothesis that the hot steam would kill anthrax-like bacteria. Needing to complete a project for his AP biology course, Roberge remembered the theory of a former Soviet Union scientist who suggested that hot steam would kill anthrax. Roberge used a harmless surrogate bacteria routinely used by anthrax researchers to conduct his research. Marc found that the steam from an iron set to its highest setting (about 400° F) could actually kill the anthrax-like bacteria. His discovery was so important, it was published in the Journal of Medical Toxicology.

Composite Structures

Brigham Young University undergraduate Mark Jensen recently developed a new method for making composite lattice pole structures. Called IsoTruss, Jensen’s machine weaves lightweight composite fibers into a strong braid that may one day replace steel beams in construction. Jensen and his partner turned his invention into a business, Altus Poles LLC.

Drug Testing

In 2010, a graduate student from Harvard and MIT engineered human liver cells into mice to make testing new drugs easier. Bridging the gap between animal studies and clinical trials, Alice Chen’s invention protects human subjects by eliminating under-reporting of the toxicity of a drug to humans. Today, Chen is using her humanized mice to study the effects of malaria and Hepatitis C on humans.

Electronics Printing

Graduate student Brett Walker of the University of Illinois at Urbana-Champaign has created a less expensive and simpler ink for printing electronics. Walker’s reactive silver ink has no particles, but rather is a silver acetate and ammonia solution. The silver remains a liquid in the solution until the remaining liquids evaporate, leaving the conductive silver behind. The ink takes minutes to make, remains stable for weeks, and allows for easier pattern printing through very fine nozzles.

Predicting Flight Turbulence

Ohio University computer science graduate students Chad Mourning and Scott Nykl developed a new altimeter that predicts flight turbulence and helps pilots avoid the wake vortices created when planes takeoff and land. Entrepreneurial as well as techie, these young scientists have started their own business to launch this potentially life-saving technology.

Surgical Innovations

Undergraduate students at Johns Hopkins University invented the Quick-Stitch, a more efficient and safe, disposable tool for suturing in gastrointestinal surgery. Leslie Myint, Daniel Peng, Stephen Van Kooten, Sohail Zahid, Andyg Tu, Haley Huang, Anvesh Annadanam and Luis Herrera won the 2012 Collegiate Inventors Competition Undergraduate First Prize with their pliers-like device that regulates the tension of stitches to avoid ischemia and hernias that can occur after such surgeries.

Wiffle-Ball Drug Delivery

Immune systems often interfere with life-saving drug therapies, such as in cancer treatment. University of California, San Diego graduate student Inanc Ortac developed a method of hiding the drug from the body’s immune system. Based on a wiffle ball design, the structure is one millionth the size of an actual wiffle ball and protects the drug inside a cage-like structure until it reaches the tumor. Ortac won the Graduate First Prize of the 2012 Collegiate Inventors Competition for his unique solution to a thorny problem.

Sadly, despite the diverse research opportunities open to science-minded students, enrollment in technical and scientific in many U.S. college degree programs is declining. Students interested in making a contribution and innovating can explore opportunities available through these resources:

Mentornet connects mentors with students, postdocs and protégés in the hard sciences and engineering. Its mission is to diversity the global workforce in technical, science and engineering fields.

Scientific American has featured a number of articles that discuss the latest developments and career trends in STEM (Science, Technology, Engineering and Math) fields.

SMART Scholarship is a program that provides full tuition, stipends, paid summer internships, mentoring and employment placement as part of the National Defense Education Program.

The Hazards of Holidays

If you’ve heard it once you’ve heard it a thousand times: The holidays are the most wonderful time of the year. No matter what you celebrate, there’s something nice about the light, cheerful feeling that tends to take to the air around the holidays. But before you get too swept away in the spirit of the season, pause your tree-trimming, candle-lighting, and merriment for a moment and consider: There’s a lot that can go wrong around the holidays. If you thought not receiving the gifts on your wish-list was traumatic, consider the possibility of your Christmas tree catching on fire. And with 91% of holiday trips being done by automobile, imagine the increase in your chances of getting into a jolly little fender-bender. Besides the likeliness of certain types of accidents, there’s also the emotional trauma of the season to consider. Most people are dealing with financial stress and the pressures of giving, or the emotional pressure that comes from visiting family. The following infographic takes a look at some of the most important reasons that, sometimes, the most wonderful time of the year can also be extremely hazardous to your health.

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Holiday Hazards Infographic

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Protecting the Privacy and Health of Human Research Subjects in the Digital Age

Whenever people are used as guinea pigs in academic or clinical research, they are officially called human research subjects. Although research using human subjects has been regulated for years, protections for their health and privacy have greatly improved in the web 2.0 era.

Conducting Research on Humans

Since the dawn of civilization, mankind has realized the value of medicine. Up until the mid-1900s, however, there were few if any requirements that medicinal products be effective. After the thalidomide tragedy of the 1950s, governments began enacting laws to ensure medicines were safe. To achieve this goal, some people had to take the risk of trying potential new drugs in order to demonstrate their efficacy.

This human subject research frequently leads to astounding medical breakthroughs. Consider the recent work on developing a vaccine for AIDS. Were it not for the tens of thousands of human volunteers, this important and necessary medicine would never have been developed.

Nonetheless, this research is not without risk. In recent years, some of the more high-profile research-related injuries include treadmill-induced ankle injuries, hyperstimulation of the ovaries after egg donation, injuries from testing a medicine or device, spinal headaches from lumbar punctures and injuries from investigator error.

Regulating Research on Humans

After the infamous Tuskegee Study, The Belmont Report of 1979 was created to establish guidelines for conducting research on humans. The report was divided into three areas: to distinguish between medical practice and biomedical research, to establish ethical principles, and to identify applications to help achieve the guidelines.

Boundary between Practice and Research

The practice of medicine was said to be those interventions that had a high likelihood of enhancing patient well-being and includes the common practices of diagnosis, preventative treatment and therapy. Research, on the other hand, is intended to test a theory and add to the body of knowledge.

Ethical Principles

The report directs that human subject research should be guided by the principles of respect for persons, beneficence and justice.

Respect for persons anticipates that people should be treated as capable of making decisions for themselves; but people who cannot should be protected.

Beneficence includes both the Hippocratic oath’s “do no harm,” as well as the goals of maximizing potential benefits and minimizing potential harms.

Justice involves giving each person his fair, although not necessarily equal, share of benefits and burdens.


The report identified informed consent, assessment of risk and benefits and selection of subjects as the best methods for implementing the ethical principles.

Informed consent generally requires that researchers provide sufficient information, in a manner that suits the subject’s intelligence and maturity. The consent should ensure the subject knows the procedure is unnecessary for their health, and that its effects may not be completely known.

Assessment of risks and benefits typically requires a greater benefit to justify the risk.

Applying principles of justice, researchers make potentially beneficial, as well as potentially dangerous, research open to all classes of subjects. That said, justice demands that those who are better situated to bear burdens, such as adults compared to children, should do so.

“Common Rule”

In 1981, the Department of Health & Human Services (HHS) and the Food and Drug Administration (FDA) built upon the Belmont Report in making the “Common Rule” for protecting all human subjects. More than one dozen agencies have adopted this rule for their research and grants.

Last updated in 1991, the Common Rule shares many of the Belmont Report’s principles and applications, including informed consent. In addition, the rule requires that each institution establish an independent oversight board, known as an Institutional Review Board (IRB), that reviews research proposals to ensure the balance of risks and benefits is appropriate; they are also set to supervise ongoing human subjects research.

Web 2.0 Regulations

In 2011, HHS began enhancing human subjects research regulations to address modern practices. Previously not covered in the Common Rule, uniform privacy standards were established and now apply even to those studies that had been completely exempt from human subjects regulations.

Informed consent regulations were beefed up with requirements for greater specificity in the disclosure of information. Additionally, the old practice of simply removing identifying information from biospecimens to eliminate the need for informed consent has been prohibited. Now, consent must be given for the use of this material, as well.

Greater protections for human health have also been addressed with the creation of a single website where all adverse events are reported. All agencies will have access to this data more easily and more quickly.

Given the grave risk of injury posed by untested products and practices, human subjects research is necessary for the protection of public health. Thankfully, selfless volunteers continue to help researchers conduct this necessary work. Recent changes to the regulations that protect these volunteers will further encourage others to participate, while continuing to safeguard their privacy and health.

The 5 Best Open Online Courses in Public Health and Policy

Workers in the public health field protect and improve the health of communities by conducting research on disease and injury prevention, promoting healthy living and preventing health problems before they occur. Hailing from a wide range of disciplines, public health professionals include epidemiologists, behavioral scientists, environmental health specialists, educators and even policy advisors working with lawmakers. With the wealth of open source courseware available, it has never been easier to study public health and policy.

Best Open Public Health Classes

Environmental Politics and Law

Requiring no registration, students interested in public health policy can learn from the best with this course offered online for free through Yale University. Covering a wide range of topics from plastics and pesticides to consumer products and drinking water standards, students learn about the importance of strong policies and laws in the protection of public health.

Fundamentals of Epidemiology I and II

Offered through the Johns Hopkins Bloomberg School of Public Health (JHSPH), the two fundamentals courses introduce the basics of biostatistics and epidemiology. Foundational principles and methods of the field are covered, including classical statistics and methods of summarizing and displaying data. Part II focuses on tailoring study design to researching particular public health issues.

Introduction to Integrated Water Resource Management

Over three million people die each year from water-related diseases. With this course offered by the United Nations University, students learn how to establish and implement an integrated plan for managing precious clean water resources. Including guidance on how to best establish effective policies and procedures, this practical guide provides needed instruction on how to manage this vital resource.

One Health: Interdisciplinary Approaches to People, Animals and the Environment

With this course, Tufts University focuses on the complex relationship between the world’s diverse organisms and their environments. Particular areas covered include the emergence and re-emergence of disease as new habitats are cleared and climate changes; the ways in which ecosystems are compromised by the pressure of increased human population; and the ways in which genetically engineered organisms spread and impact the environment.

The Black Death

The great intellectual George Santayana said, “Those who cannot remember the past are condemned to repeat it.” For this reason, public health professionals study mankind’s history of confronting epidemics and other public health disasters. With this lecture offered by Gresham College, students can download the transcript, video or audio lecture and even view a PDF presentation. Ranging from the sixth century to the nineteenth, students learn how differing community responses to the bubonic plague set the stage for the development of public health initiatives.

Best Online Open Courses

Students interested in the field of public health should explore a broad range of academic disciplines. A number of prominent universities and even a few private organizations have free open courseware and classes.

Coursera offers free courses from 33 universities including Stanford, The Ohio State University, the University of Michigan, CalTech and Duke. Students can find classes in a wide array of disciplines including Food and Nutrition, Music, Film and Audio Engineering, Statistics, Data Analysis and Scientific Computing.

Edx free classes come from such prestigious schools as Harvard, Berkeley and MIT. Course offerings focus on the hard sciences including computer science, programming and graphics, artificial intelligence and chemistry. Notably, a course in Quantitative Methods in Clinical and Public Health Research is offered, as well. Edx cautions that in the future, there may be a fee for obtaining certification.

Udacity course offerings are similar to those found on Edx, with a strong focus on the hard sciences. Students can take beginner, intermediate and advanced courses in computer science, programming, software and web development and testing, artificial intelligence and cryptography. Unlike Coursera and Edx, Udacity is a private venture where courses are taught by roboticists, educators and engineers.


Any sort of injury, from a little scrape to a serious bone-break, is a nuisance. But some types of injuries are far more traumatizing to deal with than others. If you or a loved one has ever had the misfortune to suffer from a concussion, you know that this particular injury can be highly painful, lingering, and difficult to deal with. Concussions can be the result of many varying accidents, and they happen more frequently than many people realize. There are 3.8 million concussions in the US every year, and many of them happen as a result of youth sports-related injuries. In the past, concussions were often dismissed to the tune of “walk it off,” and concussed individuals typically didn’t receive the proper treatment. In recent years, however, the true danger of any sort of concussion, from serious to mild, has become more widely recognized among healthcare professionals. Concussions can have a longer, more lingering effect than many people previously realized, and the legacy left by a severe concussion is something medical professionals are seeing more and more in the world of sports. A great deal of NFL players, for instance, are more aware of concussion symptoms, as well as how these symptoms may play out later in life. You may not be a head-injury prone athlete, but if you have any loved ones who are involved in contact sports, the following infographic provides helpful insight into the medical field’s growing awareness of the danger of a concussion.

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Concussion Infographic

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8 Ways Obamacare Is Already Helping Health Care

Since it was signed into law on March 23, 2010, the Affordable Care Act, also known as “Obamacare,” has helped to improve the health care of millions of Americans. To his detriment, in the months leading up to the Presidential election the GOP presidential candidate was relentless with his descriptions of the new law as “government health care” that would cause “up to 20 million people to lose their insurance.” One reason the Republicans may have to rethink this sort of rhetoric is the simple fact that the Affordable Health Care Act is actually benefiting so many of their constituents. Here are eight ways Obama care is already helping the health care of our nation.

  1. Closing the “donut hole”:

    The prescription drug coverage plan offered by Medicare (Part D) requires its members to pay 25% of the cost of drugs after paying a relatively low deductible. However, after paying out a certain amount (in 2012, that amount is $2,930), Part D members are required to pay the full cost of prescription drugs until they reach another much higher spending limit. This coverage gap is commonly referred to as “the donut hole,” and it creates a serious financial burden on seniors dependent on prescription medication. Under the Affordable Care Act, Medicare recipients who reach “the donut hole” now receive a 50% discount on brand-name drugs and a 14% discount on generic drugs. These discounts will continue to increase over time until 2020 when “the donut hole” will be completely closed.

  2. Free coverage for wellness and preventive care:

    Thanks to the Affordable Care Act, many preventive health care services are covered for Medicare recipients with no copay or deductible. In 2011, more than 32.5 million Medicare members used these free preventive services. People on Medicare are also now entitled to a free annual wellness visit to their primary care physician.

  3. Children cannot be denied health insurance because of a pre-existing condition:

    Children are also already benefiting from the Affordable Care Act. As of 2010 (when the act was signed into law), children 19 or younger cannot be denied health insurance due to a pre-existing condition. The law also prevents insurance companies from removing a young adult up to age 26 from his or her family’s health insurance plan. College students who can’t afford health coverage can remain on or be added to their parents’ plan.

  4. Tax credits for small businesses:

    The Affordable Care Act provides a variety of tax credits to small businesses that elect to offer health insurance to their workers. The new law does not mandate employee health insurance, but businesses will be penalized if they do not provide coverage to their employees. In 2014, state-based Small Business Health Options Program Exchanges will be available to small businesses, and again, tax credits will be available to those who choose to provide insurance for their employees through these exchanges. Much more information for business owners is available on the IRS website.

  5. Eliminated lifetime insurance maximum payouts:

    Before the Affordable Care Act, a person suffering from a serious, long-term illness would lose their insurance coverage after they’d hit their insurance plan’s limit (or “lifetime limit”) on the dollar amount covered by the plan. But thanks to the new law, insurance companies can no longer place a lifetime limit on a person’s health coverage and annual caps on coverage will be eliminated by 2014.

  6. Insurance for those with pre-existing conditions:

    In our country, until recently, if you had a pre-existing condition including heart disease, high blood pressure, type 2 diabetes, asthma, or even a previous accidental injury, when it came to getting health coverage, you were basically screwed. Health insurance companies are well-known for denying coverage to people with pre-existing conditions. The Affordable Care Act now provides temporary insurance, also known as the Pre-Existing Insurance Plan, to people who have been denied coverage due to a pre-existing condition. In 2014, insurance companies will no longer be able to deny anyone coverage because of a pre-existing condition.

  7. End of rescissions:

    Wouldn’t you agree that getting dropped by your insurance plan when you get sick sort of defeats the whole purpose of health coverage? Insurance companies used to use the pretense of a rescission, that is, a claim that a member isn’t honoring his or her end of a contract, in order to stop coverage for someone who was getting too sick too often. As of 2010, the new law states that insurance companies will no longer be able to rescind a member’s coverage if he or she gets sick.

  8. Addresses quality of care in nursing homes:

    Quality of care in nursing homes continues to be of great concern for both seniors and their loved ones. Stories of physical abuse and neglect in homes are unfortunately not uncommon, and more advocacy for nursing home residents is needed. The Affordable Care Act requires that nursing homes provide consumers with much more information about their facilities, including identities of owners and operators, data about staffing, and staff hours of care provided. Elder abuse training is required for nursing home workers who care for patients with dementia. And in the case of neglect and abuse, it is now easier to file a complaint about care in a nursing home.

11 Awesome Fitness Experts to Follow on Twitter

It’s time to get moving! If you love living a healthy lifestyle and you’re active on social media, there are many communities and experts that will speak to your interests. Exercise buffs and fitness freaks are especially active on Twitter, and you don’t have to go far to find them. Add these 11 awesome fitness experts to your Twitter lists today!

  1. @BornFitness

    Adam Bornstein is a social media darling and the former editorial director of Lance Armstrong’s Livestrong.Com. The fitness buff has worked in media for a long time and was the fitness editor of Men’s Health magazine. Author of several fitness books, the tweeter posts great links, thoughts, and questions for his audience.

  2. @JoeDowdellNYC

    Joe Dowdell is a long time trainer to the stars, and everyone wants to know what the fitness expert has to say. Follow him for articles and videos about exercise, nutrition, and improving your personal strength. The elite trainer tweets videos and tips for the general public. If you follow Joe Dowdell, you’ll get the star fitness treatment.

  3. @JenSinkler

    Jen Sinkler is the editorial director of fitness content for Experience Life magazine and a self-proclaimed "workout connoisseur." She’s a fan of balancing life, nutrition, and work to have a truly healthy and powerful life. Sinkler also believes that women can (and should!) do the heavy lifting — she often shares tweets about intense workout sets with large weights.

  4. @GirlsGoneSTRONG

    If you’re a woman who works out, you’ll love this Twitter feed. Workout tips, before and after photos, and insights on how to get the most from your workout make up this link-filled Twitter feed. It’s not just for women, either. The feed has plenty of information and motivation for anyone trying to break a sweat. Nutrition and healthy eating are a main focus, too.

  5. @Gunnar

    Everyone knows Gunnar Peterson, and everyone wants a piece of what the Beverly Hills personal trainer has to offer. The trainer is friends with celebrities and other fitness experts, and they often show up in his Twitterfeed. He hosts a feed called The Gunnar Challenge, where participants are encouraged to weigh in and report their workout progress. Not only is he great on Twitter, but Gunnar will whip you into shape!

  6. @BandanaTraining

    Filled with eating tips, cute pictures, and great links and re-tweets, Bandana Training is poised to make exercisers of us all. With intelligent tips on how to build muscle and burn fat, the trainer will also design a workout program for you online. Maybe he’s not a household name yet, but we’d bet it won’t be long.

  7. @AshleyBorden

    She’s a personal trainer in Los Angeles who is often called upon by fitness experts and media professionals. A pro at fitness tips, tweaks, and advice, Ashley Borden infuses her Twitterfeed with topical observations, as well. Mixed martial artists will like lots of her links and ideas, as she’s both a practitioner and a fan.

  8. @BobbyStorm

    Bobby Strom is known as a trainer’s trainer in Hollywood. He tweets great life advice for those wanting to incorporate fitness into their routine, as well as sharing pictures, information, and relevant exercises. Although you’ve never heard of him, if you pay top dollar for an elite Hollywood trainer, Bobby Strom has probably helped them learn how to teach you. The tattooed trainer can get anyone fit!

  9. @MyTrainerBob

    The famous face from The Biggest Loser has taken social media by storm. Bob Harper is not only a tweeter, but an author, TV personality, and trainer. He’s tough, he’s funny, and he’s got a sweet heart. And if you’re looking to break a sweat, you should start with Trainer Bob.

  10. @BodyForWife

    He’s a syndicated fitness columnist for the Chicago Tribune, the LA Times, and more. With an upcoming book in 2013, the babe with the buff bod will be more popular than ever. James Fell is his real name, but he’s rising to great heights. He even has a column for famed Internet hangout

  11. @KellyOlexa

    The founder of FitFluential is one of the most connected fitness experts in the country. Based in Chicago, Kelly often tweets about healthy eating, fitness fixes, and her food choices. She’s fresh, fun, and fearless — in other words, FitFluential.

How Diabetes Became a Global Epidemic

The rate of type two diabetes continues to rise around the world, and many experts agree that it has become a global health crisis.

Worldwide, the rate of diabetes increased by about 8 percent in men and nearly 10 percent in women from 1980 to 2008, according to a 2011 study published in the journal Lancet. The study, which tracked diabetes trends in 200 countries over the past three decades, found that nearly one in ten adults worldwide have some form of diabetes.

The primary causes of this preventable disease are related to a poor diet and lack of exercise. Educating the world population on the importance of a healthy lifestyle is the best way to avert this public health crisis. Preventative care is the easiest way to keep individuals, families and communities healthy and active.

Global Rise in Diabetes

Diabetes is the condition in which the body does not properly process food for use as energy, and it manifests in the body in two ways, according to the U.S. Center for Disease Control and Prevention. Type one diabetes is an autoimmune disease that begins in childhood and requires an individual to take insulin. Type two diabetes accounts for 90 to 95 percent of all diagnosed diabetes cases, according to the CDC and is controlled by insulin, pills and in some cases by weight loss and exercise. Type two diabetes usually comes on after the age of 25.

According to the results of the Lancet study the disease is most common in the islands of the South Pacific, Saudi Arabia, China, and India. Among high-income countries the rise in the US is the steepest.

The study found that between 1980 and 2008, the number of diabetics more than doubled from 153 million to 347 million. About 30 percent of that increase came from a rise in disease across all age groups. About 30 percent came from population growth, and about 40 percent came from an aging world population since diabetes is more common in older people.

A CDC report found that diagnosed cases of diabetes grew by 50 percent or more in 42 U.S. states, and by 100 percent in more in 18 states, particularly in southern states from 1995 to 2010. In 2010, the CDC found that 18.8 million Americans had been diagnosed with diabetes and another 7 million had undetected diabetes.

Today, there are an estimated 371 million people living with diabetes, which is up from 366 million a year ago, according to a recent report from the International Diabetes Foundation. The report projects that as many as 552 million people will be diagnosed by 2030. The same report found that 80 percent of people with diabetes live in low and medium income countries, and the greatest number of people with diabetes are in the 40 to 59 age group.

Expensive Problem

The cost of diabetes is likely to become a crippling economic burden around the world. The Lancet study warned that health systems around the globe will likely be faced with expensive treatments for diabetic medical conditions including heart attack, kidney failure, blindness and infections.

According to the CDC, diabetes is the seventh leading cause of death in the U.S. The IDF estimates worldwide diabetes cost at least 465 billion dollars in healthcare expenditures in 2011, which accounted for 11% of total healthcare expenditures in adults ages 20-79 years old.

Tackling the Problem

Widespread research points to preventive care and education as the best tools to slow the diabetes epidemic. Lifestyle changes that include exercise, healthy eating and losing weight are critical to prevention. The American Heart Association says these efforts can dramatically reduce the progression of type two diabetes and are important in controlling type one diabetes.

The AHA recommends paying close attention to food labels and portion sizes, and limit simply carbohydrates such as table sugar, cake, soda, candy and jellies that can increase blood glucose.

Physical activity is critical to prevention. Thirty minutes of exercise most days of the week and losing five to seven percent of body weight can lower risk of developing diabetes by about 50 percent, and the risk decreases as more pounds are shed, according to the AHA.

The USDA Dietary Guidelines for Americans, released in 2011 emphasize three important guidelines to tackle health problems. The USDA recommends a weight management strategy that balances calories and physical activity. It encourages a diet based on fruits, vegetables, whole grains, fat-free and low-fat dairy products and seafood with limited consumption of high concentrations of salt, saturated fats, trans fats, cholesterol, added sugars and refined grains.

Diabetes in Society

Slowing the rise of diabetes the world over will take a concentrated effort to expand and promote educational and preventative resources. Promising efforts around the globe are making a difference.

The IDF’s education initiative Diabetes Conversations is a global program aimed at improving access to self-management resources, and providing the right training and tools for health professionals in their native tongue.

The American Diabetes Association has a list of several programs that can be implemented in the workplace, as well as specific programs for African American, Latino and Native American populations.

The CDC features an interactive map to find prevention and control programs for each state including information on state laws requiring health care providers to cover some diabetes related costs.

The stress of a busy lifestyle isn’t reason to put off eating right and staying active. Preventing and beating type two diabetes can be done with just a little effort. Individuals, families and even communities can prevent and even reverse the onset of this disease with a concentrated effort to eat right and be active.