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In a long-anticipated announceemnt, the Food and Drug Administration said today it is assuming regulatory authority over electronic cigarettes, which have become a growing concern among youths, especially in rural areas, 

e cigs banned for anyone under 18Tripp Mickle reports for The Wall Street Journal. FDA's new tobacco regulations will prohibit sales of e-cigarettes and all tobacco products to anyone under 18. Health warnings will also be placed on packages, saying, “WARNING: This product contains nicotine. Nicotine is an addictive chemical.” Rules also will "require manufacturers to submit products for approval." 

FDA "rules have the potential to upend the $3.5 billion e-cig industry," Mickle writes. "Many of the small vape shops, device manufacturers and liquid nicotine producers won’t be able to afford the FDA’s approval process, which could cost anywhere from $2 million to $10 million per item, according to the regulatory consulting company SciLucent LLC."

Greg Conley, president of the American Vaping Association, an industry-funded advocacy group, told Mickle, “This is going to be a grim day in the history of tobacco-harm reduction. It will be a day where thousands of small businesses will be contemplating whether they will continue to stay in business and employ people.”

By Tim Mandell
Institute for Rural Journalism blog



Providing support and comfort in various ways to mothers giving birth is what the Fort Logan Hospital’s Birthing Spa aims to do, according to the unit’s medical director Dr. James Miller.

Ephraim McDowell Fort Logan Hospital is the first in the state to offer an alternative option for pain relief to women in labor in the form of nitrous oxide – more commonly known as “laughing gas.” 

Providing support and comfort in various ways to mothers giving birth is what the Fort Logan Hospital’s Birthing Spa aims to do, according to the unit’s medical director Dr. James Miller.

Miller said the use of nitrous oxide during labor was fairly common in the 1950’s but when epidural anesthesia came into play, laughing gas seemed to fall by the wayside. 

Now, Fort Logan Hospital’s Birthing Spa is bringing it back as a safe, new option for pain relief and in turn allowing mothers more control over the entire birthing experience. 

“We in our unit found, when we started hearing again about the nitrous oxide, that it just fit really well with our philosophy of trying to offer choices to moms,” Miller said. 

Miller said while epidural anesthesia still seems to be the most prominent pain management option offered to women in labor, the positive benefits have yet to be made evident. 

“Epidurals cost a lot and haven’t shown the benefits. And they changed labor from a low-risk setting to a high-risk setting,” Miller said. “With an epidural, we know that it drops the mom’s blood pressure, so they have to have an IV ahead of time and load up on fluids to try to prevent the drop in blood pressure, and then it can still happen. Then you have to monitor the baby’s heart tones.”

Miller said water births on the other hand have proven to show benefits such as lower cost and shortening the length of labor by naturally relaxing the mother

“When we remodeled and built the new hopsital eight years ago I wanted to change the name to ‘birthing spa’ and we’re really the only unit in the nation that uses that term,” he said. 

It’s that variety of resources and ongoing support from the entire unit’s medical staff that brings expectant mothers from all over to Fort Logan Hospital, Miller said. 

“That was the idea, we try to pamper women and offer a variety of support services that will help them through labor and we’re really good at it,” he said. “That’s kind of how we’re built and designed. The nurses have developed skills to almost function as a ‘doula.’”

Miller said there are several pain management options to choose from, for example if a mother doesn’t want an epidural there is IV medication and if a mother doesn’t want IV medication she can choose to use nitrous oxide. 

“The nitrous oxide just seemed like it was one more thing we could offer,” he said. “We can try the tub, the walking, the garden, the massage chair and position changes, all of those kinds of things.”

As he prepares mothers for child birth, Miller said he tells them there is going to be about a three-hour period where they are going to wish they could quit and go home and the nitrous oxide could help during that time period. 

“The nitrous oxide seems like it would come in handy during that time to help lessen anxiety and relax them and make them experience less pain,” he said. 

Nitrous oxide isn’t incredibly potent and it won’t take away all of the pain but it relaxes mothers enough to where they are less bothered by the pain, he added. 

“It’s very fast acting so when the pain is starting to contract, they start breathing the medicine and within seconds it takes effect and then as the pain resolves, they take the mask away and the medicine wears off that quickly too. So they don’t need any relief in between pain.”

In a statement released by the hospital Shannon Goff, director of the Birthing Spa, said the unit is excited to offer new pain management for mothers-to-be. 

“The patient controls it herself, so she can use it as much or as little as she feels necessary,” Goff said. 

According to the release, women can also use the nitrous oxide earlier in their labor than they would typically get an epidural. 

Miller said he expects other hospitals to adopt the use of nitrous oxide again at some point but he’s not sure that all will since it requires a more hands-on presence from medical staff. 

“There’s a lot of hands on help and it’s just a really different experience altogether,” he said. “Birth is very challenging but it’s an engineering marvel. We’ve found that the simple things that support mom seem to work the best and don’t delay the process.”

By Abigail Whitehouse
Interior Journal

Dispose of unused or expired drugs at most State Police posts from 10 a.m. to 2 p.m.

Kentuckians can get rid of their unused or expired prescription drugs Saturday, April 30 from 10 a.m. to 2 p.m. as part of National Drug Take-Back Day. The service is free and anonymous, no questions asked. Most collections will be made at Kentucky State Police posts.

"The goal of these programs is to reduce the volume of drugs that could end up on the streets and then used illegally," says the Kentucky Office of Drug Control Policy website.

All but two of the 16 KSP Posts will have "Take Back" locations on-site. Post 11 will have its collection at the Laurel County Health Department in London, and Post 8 will have a location at the Morehead Covention Center.

Sgt. Michael Webb, KSP spokesperson, said in the news release that the the program is designed to be easy for citizens and offered the following tips for those interested in participating:

* Participants may dispose of a medication in its original container or by removing the medication from its container and disposing of it directly into the disposal box located at the drop off location.

* All solid-dosage pharmaceutical products and liquids in consumer containers will be accepted.

* Liquid products, such as cough syrup, should remain sealed in original containers.

* The depositor should ensure that the cap is tightly sealed to prevent leakage.

* Intravenous solutions, injectables and syringes will not be accepted due to potential hazard posed by blood-borne pathogens.

* Illicit substances such as marijuana or methamphetamine are not a part of this initiative and should not be placed in collection containers.

Not including this Take-Back Day, "Kentucky has collected a total of 59,719 pounds of unused and/or unwanted prescription medications at all Drug Take-Back events and locations since October 2011," says the ODCP website. For more information about the Take-Back program, contact KSP at 502-782-1780 or click here.

Posted by Melissa Patrick 

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.


Economic benefits of smoke-free laws are almost immediate 

By Melissa Patrick
Kentucky Health News

More Kentucky localities are likely to see efforts for smoking bans, as a statewide ban appears less likely and leading advocates are saying to go local.

Stanton Glantz

Stanton Glantz, one of the nation's leading advocates of smoke-free policies, said at the Kentucky Center for Smoke-Free Policy's spring conference April 28 that California initially had trouble passing a statewide indoor smoke-free law, which forced advocates to move their efforts to the local level. By the time the statewide law passed, 85 percent of the state was covered by local ordinances.

"I'm glad it worked out that way, because we are really talking about values and social norms and community norms and you just can't impose that from the outside," Glantz said during his keynote address. "And so all of these fights that you are having in all of these towns. ... In the end, when you win, you've won. And the fight itself is an important part of making these laws work."

Ellen Hahn, a University of Kentucky nursing professor and director of the smoke-free policy center, also encouraged her colleagues to shift their efforts to localities, saying the political situation doesn't support a statewide law. New Republican Gov. Matt Bevin doesn't support a statewide ban on smoking on workplaces, saying the issue should be decided locally.

"We are in a very difficult political climate in Frankfort," Hahn said in her opening remarks."We all know it. We all recognize it. And while we would all like to see Frankfort do the right thing – and it will someday, I promise – it is not the time to let somebody else do it. It is the time to go to your local elected officials and say we want this."

Advocates made some headway last year when a smoking-ban bill passed the House, but it was placed in an unfavorable Senate committee and never brought up for discussion. This year's House version of the bill, in an election year with Bevin in the governor's office, was dead on arrival.

Glantz, a University of California-San Francisco professor and tobacco-control researcher, looked at the bright side: "You're in a tough political environment, but you are really doing pretty well." He reminded the advocates that one-third of the state is covered by indoor smoke-free ordinances, with 25 of them comprehensive and 12 of them including electronic cigarettes. He also commended the Kentucky Chamber of Commerce for supporting statewide and local bans.

What's next

Glantz urged the advocates to "empower and mobilize" the 73 percent of Kentuckians who don't smoke and get them to help change the social norms. Two-thirds of Kentucky adults support a comprehensive statewide smoking ban, according to latest Kentucky Health Issues Poll, and have since 2013.
“The whole battle is a battle about social norms and social acceptability, and once you win these fights, and you have a law that’s sticking – which takes a while – you don’t go back,' he said. "And the tobacco companies understand that, and that is why they are fighting us so hard.”
Glantz armed the smoke-free warriors with research data to support smoke-free laws, including: they decrease the number of ambulance calls; hospital admissions for heart attacks, stroke, asthma and chronic obstructive pulmonarydisease; and the number of low-birth-weight babies and complications during pregnancy.

"In Kentucky communities with comprehensive smoke-free laws, there was 22 percent fewer hospitalizations for people with COPD," Glantz said, citing one of Hahn's studies. "That is a gigantic effect, absolutely gigantic, at almost no cost and it happened right away."

He noted that politicians are usually most interested in this short-term data, but he also cited long-term statistics about how smoke-free policies in California have decreased heart disease deaths by 9 percent "in just a few years," and lung cancer by 14 percent in about 10 years. Kentucky leads the nation in both of these conditions.
"I would argue that the economic argument is actually on our side," Glantz said, noting that economic benefits of smoke-free laws are almost immediate, especially because "every business, every citizen and every unit of government" is worried about health care costs. He also cited research that found "as you pass stronger laws, you get bigger effects.'
Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.



Three Rivers Medical Center,  Echocardiography Laboratory receives accreditation by IAC

Cardiovascular diseases are the No. 1 cause of death in the United States. On average, one American dies every 39 seconds of cardiovascular disease – disorders of the heart and blood vessels. The American Heart Association estimates that the direct and indirect cost for cardiovascular disease in the U.S. for 2010 was $503.2 billion. 

Early detection of life threatening heart disorders and other diseases is possible through the use of Echocardiography procedures performed within hospitals, outpatient centers and physicians’ offices. While these tests are helpful, there are many facets that contribute to an accurate diagnosis based on Echocardiography testing. The skill of the Echocardiography sonographer performing the examination, the type of equipment used, the background and knowledge of the interpreting physician and quality assurance measures are each critical to quality patient testing.

Three Rivers Medical Center,  Echocardiography Laboratory located in Louisa, KY has been granted a three-year term of accreditation in Echocardiography in the area of Adult Transthoracic by the Intersocietal Accreditation Commission (IAC). 

Accreditation by the IAC means that Three Rivers Medical Center,  Echocardiography Laboratory has undergone a thorough review of its operational and technical components by a panel of experts. The IAC grants accreditation only to those facilities that are found to be providing quality patient care, in compliance with national standards through a comprehensive application process including detailed case study review.

IAC accreditation is a “seal of approval” that patients can rely on as an indication that the facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of Echocardiography.  When scheduled for an Echocardiography procedure, patients are encouraged to inquire as to the accreditation status of the facility where their examination will be performed and can learn more by visiting

IAC accreditation is widely respected within the medical community, as illustrated by the support of the national medical societies related to Echocardiography, which include physicians and sonographers. Echocardiography accreditation is required in some states and regions by the Centers for Medicare and Medicaid Services (CMS) and by some private insurers. However, patients should remain vigilant in making sure that their Echocardiography procedures are performed within accredited facilities, because for many facilities accreditation remains a voluntary process.