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Trump's travel ban could lead to increased doctor shortages in rural areas, says AMA


President Trump's temporary travel ban and promised "extreme vetting" of immigrants from Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen, and perhaps other majority-Muslim nations, could hurt medical education in the U.S., leading to increased doctor shortages in rural areas and inner cities, says a study by researchers at the University of Pittsburgh, published in The New England Journal of Medicine.

Data from 2015 by the Educational Commission for Foreign Medical Graduates (ECFMG) shows that 24 percent of all practicing physicians in the U.S. are from other countries. The 2016 Main Residency Match found that 7,460 international medical graduates—21 percent—were not U.S. citizens.

While there are no published numbers available on the country of origin of U.S. doctors, a 2014 report by ECFMG and the National Resident Matching Program found that in 2013, "753 applicants whose country of citizenship at birth was Iran, Iraq, Libya, Sudan, or Syria; 299 of these (40 percent) were matched into a U.S.-based residency program." (Map: Health professional shortage areas)

"If the ordered ban expands to include other countries with a Muslim majority population, the number of potentially affected applicants will increase significantly," researchers said. "In 2013, there were 2,101 applicants from 11 different countries with Muslim majority, of which 40 percent were matched into a U.S.-based residency program."

International medical graduates "who train on a J-1 visa (a non-immigrant visa sponsored through the ECFMG Exchange Visitor Sponsorship Program) are required to return to their home country for two years or obtain a J-1 waiver clinical job in order to stay in the U.S.," the study says. J-1 waivers are usually granted through a program that "can extend a physician's stay in the U.S. if they commit to serving in rural areas and inner-cities. "In 2014–2015 there were 9,206 sponsored J-1 physicians from 130 countries, and 6 of the top 10 countries of origin—accounting for a total of 1,879 J-1 physicians—have Muslim majority populations."

Parija Kavilanz reports for CNN, "The American Medical Association, which represents medical doctors across the country, sent a letter Wednesday to the Department of Homeland Security asking for clarity on the visa ban." The letter said: "While we understand the importance of a reliable system for vetting people from entering the United States, it is vitally important that this process not impact patient access to timely medical treatment or restrict physicians and international medical graduates (IMGs) who have been granted visas to train, practice in the United States."

The AMA said the ban would worsen access to health care in rural areas, noting that foreign medical graduates are more likely to serve in poor, under-served communities, Kavilanz writes.

Matthew Shick, director of government relations and regulatory counsel with the American Association of Medical Colleges, told Kavilanz, "There could very well be a patient in a rural area who had an appointment with their doctor this week and the doctor was not allowed back into the country . . . at a time when the United States is facing a serious shortage of physicians, international medical students are helping to fill an essential need."

Written by Tim Mandell Posted at 2/02/2017 12:55:00 PM


Younger and low-income adults most likely to sample e-cigarettes, Kentucky Health Issues poll shows

 Different Types of ECIGSDifferent Types of ECIGS

Despite federal government and health professional’s warnings that e-cigarettes, or “e-smoking,” can be harmful, nearly 40 percent of adults ages 18-45 in Kentucky have tried an e-cig, according to the latest Kentucky Health Issues Poll (KHIP).

Kentuckians with lower incomes also were about 74 percent more likely to have tried vaping than those with higher incomes.

More than 60 percent of current smokers have tried an e-cig, the report found, but even 7 percent of lifetime nonsmokers have tried one.

KHIP is an annual poll of Kentucky adults’ opinions on health issues; it is funded jointly by the Foundation for a Healthy Kentucky and Interact for Health.

“Research suggests that e-cigs may be a gateway to using other forms of tobacco, and they can be just as harmful,” said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky. “They expose users to toxic chemicals, including nicotine, which long has been proven to be addictive and responsible for a wide range of health issues. E-cigs are simply not a safe alternative to smoking, especially for young adults and nonsmokers.”



The rate of Kentuckians who have tried e-cigarettes – one in four adults – remains statistically unchanged from the last time KHIP asked the question in 2014. Nationwide in 2014, however, only 12.6 percent of adults had ever tried an e-cig. No updated national numbers are available at this time.

KHIP also asked opinions about the safety of e-cigarettes. About three in 10 Kentucky adults thought e-cigs were safer than tobacco cigarettes, and 19 percent thought they were less safe. A much larger proportion – 45 percent – thought there was no difference in safety between the two.

The Centers for Disease Control and Prevention (CDC) issued a report last December stating that the use of e-cigarettes by youth and young adults often leads to cigarette smoking, other tobacco use and nicotine addiction, with all the health dangers associated with nicotine addiction. The agency raised concerns that e-cig marketers have been using tactics that attract youth and young adults and said that the incidence of this age group trying e-cigs doubled from 2013 to 2014, the latest date for which data was available. The U.S. Surgeon General has called the rising use of e-cigarettes among young adults a “major public health problem.”

A copy of the KHIP e-cigarette report is available here.

From Foundation for a Healthy Kentucky Communications



Lawrence Co. Animal ShelterLawrence Co. Animal Shelter

JANUARY 26, 2017 - written by WADE QUEEN

First it was the school children getting a mysterious rash outbreak in the Louisa East Building in the last few days. Now there is also an illness sweeping the dogs at the Lawrence County animal shelter.

Volunteer workers with the Lawrence County Humane Society say they are urgently in need of financial help from the local community.

Several puppies at the shelter have broken out with the parvo virus over the past week. These sick dogs are being treated but money is needed for the veterinarian bills that the animal shelter will incur with the extensive treatment that the dogs will need to get them back to health.

The Canine parvovirus type 2 (CPV2, colloquially parvo) is a contagious virus mainly affecting dogs, and thought to originate in cats. The current consensus is that the feline panleukopenia mutated into CPV2. Parvo is highly contagious and is spread from dog to dog by direct or indirect contact with their feces. Vaccines can prevent this infection, but mortality can reach 91% in untreated cases. Treatment often involves veterinary hospitalization. Canine parvovirus may infect other mammals; however, it will not infect humans

Canine parvovirus is a particularly deadly disease among young puppies, about 80% fatal, causing gastrointestinal tract damage and dehydration as well as a cardiac syndrome in very young animals. It is spread by contact with an infected dog's feces. Symptoms include lethargy, severe diarrhea, fever, vomiting, loss of appetite, and dehydration. Dogs, cats and swine can be vaccinated against parvovirus.

Anyone who would like to make a money donation to the Lawrence County Humane Society for the treatment of the dogs can do so on PayPal at This email address is being protected from spambots. You need JavaScript enabled to view it. or by mail to PO Box 1331 Louisa, KY 41230.



The Lawrence County Health Department invites the community to participate in a community forum to address the development of a Harm Reduction Syringe Exchange Program in Lawrence County.

This meeting is open to the public. The meeting will be held on Tuesday, January 31 at 6 pm at the Lawrence County Court House, 122 South Main Cross Street, Louisa, Kentucky. Participating panelists include Dr. Tom Frazier of Three Rivers Gastroenterology; Tim Robinson, CEO, Addiction Recovery Care; Maria Hardy, Public Health Director, Ashland-Boyd County Health Department. Following panelist presentations there will be a question and answer session.

Investigation into problem is ongoing

"...Mr. Klein asked for a follow up for today. I want to supply the information to all of you.

At Louisa East, we had 2 additional students today that had symptoms that were like the students from yesterday. We also had 2 students that went home yesterday that returned today, but were still were having symptoms. Those two students went home also.

Finally, we had 4 other students that went home that our school nurse felt were ill for other reasons.

We are very thankful that the Lawrence County Board of Education made it a priority to fund school nurses. Their work has been very valuable in providing care for all our students, as well as managing the medications and illnesses that occur everyday. We will continue our sanitizing process again tonight.

Mrs. Prince and her staff have kept us "up-to-date" and have also done a great job caring for our students."

All IN,

Robbie L. Fletcher, EdD
Superintendent, Lawrence County Schools