Billings health care providers watching Medicaid expansion closely

With Montana's 2015 Legislature nearing the midpoint, health care organizations in Billings are monitoring bills to provide coverage for uninsured Montanans, funding for mental health services and immunization regulations.

Billings Clinic, St. Vincent Healthcare and RiverStone Health representatives are watching closely the effort to expand Medicaid to as many as 70,000 Montanans.

"The problem has been spelled out that its roughly 70,000 Montanans who are eligible, so theyre going uncovered," said Mike Foster, regional director of advocacy for St. Vincent Healthcare. "We try to position ourselves as being a strong proponent of finding a way that works so we can get that coverage."

Democratic Gov. Steve Bullock proposed a plan to accept about $700 million in federal funds that would expand Medicaid a federal program that provides health insurance to seniors and low-income citizensto as many as 70,000 residents whose income is up to 138 percent of the national poverty level.

Republicans in Helena, however, largely oppose the plan and argue that Medicaid coverage shouldn't go to childless, able-bodied adults. Nancy Ballance's House Bill 455, which would revise Medicaid laws to cover parents who earn up to 100 percent of the federal poverty level, 700 poor and disabled people already lined up for spots in home care and a handful of military veterans who don't get other forms of coverage.

That plan, they say, would cost about $32 million and would extend coverage to another 10,000 to 15,000 Montanans.

Representatives from Billings-area health organizations generally said they prefer Bullock's proposal,House Bill 249, which will be presented by Democratic Rep. Pat Noonan of Ramsay on March 6 before the House Human Services Committee.

"It's an opportunity for a healthier, more prosperous Montana," said Barbara Schneeman, RiverStone's director of communications and advocacy. "Many of the people who would be eligible for the expansion would be the working poor, and they often don't have health coverage or sick leave. When they get sick, they're unable to work, they don't get paid."

More than half of the patients seen in Montana community health centers are uninsured, Schneeman said, and about 8,000 people who received care at RiverStone last year would be eligible for coverage under the expansion.

JJ Carmody, Billings Clinic's director of reimbursement, and Heidi Duncan, the clinic's director of health policy, said that both plans use federal Medicaid money and that Montana hospitals have contributed a notable amount of money into the federal dollars that would end up back in Montana.

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Billings health care providers watching Medicaid expansion closely

Health care students at Missoula College find jobs aplenty

Its no secret that job growth within the health care industry is booming as the American population ages.

According to the U.S. Department of Labor, employment of registered nurses is projected to grow 19 percent - an increase of 526,800 jobs - from 2012 to 2022, faster than the average for most other occupations.

The number of jobs for Licensed Practical Nurses (LPNs) is expected to grow by a whopping 25 percent in that same time frame, an increase of 738,400 jobs.

A national emphasis on preventative care, growing rates of chronic conditions such as diabetes and obesity, and baby boomers who are living longer, more active lives have all led to an increased demand for health care professionals.

In Missoula County, that trend has far-reaching implications, as the local economy is dependent on the health care industry and hundreds of college students are receiving the training necessary to enter the field.

According to a recent study by the Bureau of Business and Economic Research at the University of Montana, 17 percent of the countys economic base depends on the medical sector.

The health care industry generates more than $545 million in labor earnings every year, making it by far the largest source of income in Missoula County's economy, according to a report by economist Larry Swanson, director of the OConnor Center for the Rocky Mountain West.

Since 2001, the health care industry has grown much more explosively than any other sector in Missoula, increasing personal income by $232 million.

The single occupation in Missoula with the highest projected growth until 2020 with an additional 2,000 jobs expected at least is registered nursing. Those jobs pay a median of $56,790 per year in Montana, but require a high level of education and training.

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Health care students at Missoula College find jobs aplenty

Living in the genetic comfort zone

IMAGE:Laboratory fruit flies live in special glass containers. view more

Credit: Photo: Michael Bernkopf/Vetmeduni Vienna

The information encoded in the DNA of an organism is not sufficient to determine the expression pattern of genes. This fact has been known even before the discovery of epigenetics, which refers to external modifications to the DNA that turn genes "on" or "off". These modifications do not change the DNA sequence, but instead, they affect how genes are expressed. Another, less known mechanism called canalization keeps organisms robust despite genetic mutations and environmental stressors. If an organism experiences environmental or genetic perturbations during its development, such as extreme living conditions or genetic mutations, canalization acts as a way of buffering these disturbances. The organism remains stable and can continue to develop without recognizable changes.

A comfort zone in the fly genome

Christian Schltterer at the Institute of Population Genetics and his colleagues studied the mechanism of canalisation in fruit flies. The researchers subjected two genetically distinct strains of fruit flies, Oregon and Samarkand, to different temperatures (13C, 18C, 23C and 29C). Subsequently, they analysed the variation in gene expression in response to the different temperatures. The results revealed a homogenous pattern of gene expression among the two strains at 18C. No matter whether the flies were from the Oregon or to the Samarkand strain, their gene expression was almost indistinguishable.

"The flies' genetic comfort zone appears to be located at 18C. "As soon as the flies leave the comfort zone, move to either higher or lower temperatures, the gene expression of the two strains varies dramatically" Schltterer explains.

Buffering the genotype

The effect of canalization was first described in 1942, when researchers pointed out that organisms remain stable in their external appearance despite different environmental circumstances or genetic mutations. This sort of developmental buffering helps to stabilize organismal growth.

"If an organism develops along the canalization pathway, or along the comfort zone, mutations can accumulate without being expressed. Once an organisms leaves the canalized range, those hidden genetic variations can be expressed and become visible. The phenomenon is called decanalization", Schltterer explains.

Decanalization as the origin of complex genetic disease

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FDA and National Alliance for Hispanic Health Release Genes, Culture, and Health Report

Washington, DC (PRWEB) February 26, 2015

Today, the National Alliance for Hispanic Health, in collaboration with the U.S. Food and Drug Administration, released the report Genes, Culture, and Health: Ensuring the Best Health Outcomes for All. The report reviewed available research and found that while dramatic advances are being made in genetics and their clinical applications, the promise of personalized medicine is not being realized by all.

A lack of inclusion in genetic research is creating a genomic divide putting the frontiers of science and medicine at risk. Without a dramatic reversal in the quality of genetic studies, the benefits of personalized medicine will not be realized by all, said Dr. Jane L. Delgado, President and CEO of the Alliance.

Ensuring that all patients benefit from discoveries in genetic science and personalized medicine is critical to our nations health. The FDA is committed to working with diverse partners on the road forward for access to the best science and treatment, said Dr. Jonca Bull, Director of the U.S. Food and Drug Administrations (FDA) Office of Minority Health. Dr. Bull added, The report issued today is an important update on the status of genetic research and personalized medicine. It calls on all of us to do a better job on inclusion to improve our understanding of how medical products will work in the populations intended to use them.

Among the key findings of the report released today

Downloadable copies of the Genes, Culture, and Health report and key findings are available online at the Alliance website (http://www.hispanichealth.org) and consumers can get information on how to have a discussion with their health provider on the role of genetics in their and their familys health by calling the Alliances bilingual Su Familia Helpline at 1-866-783-2645.

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The National Alliance for Hispanic Health is the nation's foremost science-based source of information and trusted non-partisan advocate for the best health outcomes for all. The Alliance represents thousands of Hispanic health providers across the nation providing services to more than 15 million each year. For more information, visit http://www.hispanichealth.org, call the Alliances Su Familia Helpline at 1-866-783-2645, or find us on Facebook at healthyamericas or on Twitter at health4americas.

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FDA and National Alliance for Hispanic Health Release Genes, Culture, and Health Report

Pancreatic cancer patients who benefit from personalized treatment identified

Cancer researchers at Indiana University report that about 15 percent of people with pancreatic cancer may benefit from therapy targeting a newly identified gene signature.

Using data from the Cancer Genome Atlas, Murray Korc, M.D., the Myles Brand Professor of Cancer Research at the Indiana University School of Medicine and a researcher at the Indiana University Melvin and Bren Simon Cancer Center, and colleagues found that a sub-group of pancreatic cancer patients who possess a strong angiogenic gene signature could benefit from personalized therapies that cut off the pathways that feed the cancer's growth.

This particular gene signature enables abnormal blood vessels to form in tumors, which feeds the tumor's growth.

The finding, published online Feb. 25 in the journal Oncotarget, is new because the prevalence of this signature was not previously known. The authors also demonstrated for the first time that endothelial cells, the main type of cell found in the inside lining of blood vessels, can produce molecules that directly stimulate the growth of pancreatic cancer cells.

"We showed that endothelial cells can stimulate the growth of pancreatic cancer cells and that by silencing or inhibiting certain pathways -- JAK1-2 and STAT3 -- we can alter that effect," Dr. Korc explained. "We demonstrated that it is possible to target these pathways and prolong the survival of genetically modified mice whose pancreatic cancers also have a strong pro-angiogenic gene signature."

Thus, for people with a strong pro-angiogenic gene signature, the finding suggests that they may benefit from targeted therapy that is directed against one of these pathways.

An important feature of the study was to demonstrate that it is possible to implant in mice small biopsy samples obtained from patients undergoing endoscopic procedures and to generate human tumors in these mice. When the original human tumor had evidence for angiogenesis, the implanted human tumor also exhibited angiogenesis in the mouse. Additional studies are necessary to confirm that these approaches could guide the design of precision medicine using targeted therapies, Dr. Korc said.

The need for new therapies for pancreatic cancer patients is great as only 7 percent of people with the disease survive more than five years after diagnosis. According to the American Cancer Society, there will be an estimated 48,960 new cases of pancreatic cancer and 40,560 deaths from the disease in 2015.

Co-authors of the study were Jesse Gore, Ph.D.; Stuart Sherman, M.D.; Harvey Cramer, M.D.; Hai Nguyen, M.D.; Kelly Craven, Monica Cheng, and Julie Wilson, all of IU School of Medicine, and Gregory Cote M.D. M.S., formerly of IU School of Medicine and now at the Medical University of South Carolina.

The study was made possible, in part, by grant CA-075059 awarded by the National Cancer Institute of the National Institutes of Health.

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Pancreatic cancer patients who benefit from personalized treatment identified

Masculine appeal

A new take on the urban male wardrobe this season

As seasons trends come and go, it might not be practical to do a complete wardrobe overhaul but its always refreshing to update with a few key pieces. Channel the stylish urban male with H&M menswear collection for spring/summer 2015. Blousons, biker jackets, parkas, denim jackets, and blazers are paired with tech zip-ups, heat-sealed shirts, and scuba-look sweatshirts for a modern-day take on city dressing.

H&M menswear spring/summer 2015 collection

The urban mens wardrobe is always evolving. For spring at H&M its a strong look that combines updates to modern essentials with sportswear-inspired pieces in innovative fabrics. The feel of the city comes across in a graphic palette in shades of black, gray and white, with pops of green for a contrasting statement, says Andreas Lwenstam, H&Ms head menswear designer.

Themes include fresh twists on urban classics, like a cotton denim jacket in black or white; a half-lined blazer in memory-effect fabric; a metallic or linen pilot jacket, and a lived-in leather biker jacket. Technical fabrics add futurism, such as an apple-green mesh zip-up pilot jacket or a sweatshirt in scuba-look fabric printed with sci-fi imagery.

Skinny jeans are patched at one knee, while tailored pants are cropped, and sweatpants are in jersey or imitation leather. Essentials have new energy, such as a crisp white poplin shirt with a heat-sealed pocket, an apple-green tech-knit sweater, and scoop-neck or leather T-shirts. Key accessories in the collection include the leather tote bag, classic black lace-ups, and sneakers.

The H&M menswear spring/summer 2015 collection will be sold in 150 stores worldwide as well as online from March. Go to hm.com

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Masculine appeal

Vaccination Debate: Public Safety vs. Personal Freedom | Meet The Press – Video


Vaccination Debate: Public Safety vs. Personal Freedom | Meet The Press
The recent measles outbreak has sparked a debate over public safety versus personal freedom. Why is the anti-vaccine minority so opposed to vaccinating their children. Subscribe to NBC News:...

By: NBC News

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Vaccination Debate: Public Safety vs. Personal Freedom | Meet The Press - Video

Attorneys in Freedom Industries bankruptcy: 'We just can't wait any longer'

Lawyers for Kanawha Valley residents and businesses pressed Thursday for some action to free up $3 million in Freedom Industries insurance money, a move they said they hope will help compensate victims of the January 2014 Elk River chemical leak and allow attorneys to begin pursuing other litigation over the leak.

About 20 lawyers representing various groups of leak victims said they want the companys insurance payment so that money can be split among their clients right away.

Nitro lawyer Harvey Peyton said he has clients who are small businesses that lost what to them were significant sums of money because of the Freedom leak and the resulting water crisis.

Weve wasted a year now, waiting for this to be resolved, Peyton said. We just cant wait any longer.

Peyton was among the lawyers who turned out for a court-sponsored meeting in which Charleston lawyer Jim Lane, a court-appointed claims manager in the Freedom bankruptcy, was trying to gather views from various parties to assist U.S. Bankruptcy Judge Ronald Pearson in finding a way to resolve the bankruptcy proceeding.

With no clear plan for bringing the case to a close, Pearson set up but did not attend Thursdays meeting at the federal courthouse. Pearson has scheduled a hearing for Tuesday to hear a report from Lane and consider proposals for a path forward.

In a memo distributed at Thursdays meeting, Lane noted that Freedom has about $1.5 million in the bank but owes lawyers and environmental services professionals $3.2 million for work performed since the company declared bankruptcy. Freedom also owes various vendors and other parties about $6 million in pre-bankruptcy bills and 3,800 claims filed against Freedom over the chemical leak total about $200 million, Lane said in the memo.

Charleston lawyer Bill DePaulo questioned when someone involved in the bankruptcy perhaps the appointed committee of Freedoms creditors would begin pursuing investigations and potential lawsuits to recover more money for the bankruptcy estate, perhaps from former corporate owners and managers, some of whom are now facing criminal charges.

If part of the judges question is how do we cut the pie, another question is how big is the pie? DePaulo said. We need to be aggressively pursuing assets.

So far, no legal actions on behalf of the bankruptcy estate or creditors have been take concerning potentially fraudulent transfers of Freedoms funds or against former company officials over their management of the Elk River chemical operation. Such actions have basically been frozen for months, with the courts informal approval, while officials focused on cleanup of the Freedom facility, located just upstream from the regional drinking-water intake. Criminal charges filed against at least one former Freedom official Gary Southern allege that Southern tried to cover up his role at the company to protect his personal wealth from the bankruptcy case and civil lawsuits filed over the chemical leak.

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Attorneys in Freedom Industries bankruptcy: 'We just can't wait any longer'

Learning the Lessons of Art Freedom at Garage

Vladimir Filonov / MTThe Grammar of Freedom / Five Lessons exhibit is put together with the help of Ljubljanas Moderna Galerija.

Freedom is onthe curriculum atthe Garage Museum ofContemporary Art with "Grammar ofFreedom / Five Lessons," anexhibition based around five ways oflooking atart's role inthe search forfreedom.

TheGarage museum incollaboration with theModerna Galerija inLjubljana, Slovenia has put together anexhibition that shows work bymore than 60 artists andart collectives. Themain part ofthe exhibition is made up ofworks fromthe Arteast 2000+ collection, brought over fromSlovenia.

Thethemes ofthe lessons, said Snejana Krasteva, one ofthe curators forthe exhibition, are strategies common toboth Russian andEuropean artists: "What is interesting is tolook atwhat is similar. Even if people don't speak thesame language."

"These [art] forms have emerged ina very different context thelack ofan art market meant that people had different motivations fordoing art," said Krasteva.

TheArteast 2000+ collection was thefirst museum initiative tofocus onthe postwar avant-garde Eastern European artists inan international context. Inturn, theGarage exhibition is afirst forRussia. "This country has never had anexhibition that considers Russian artists inthe context ofthe Eastern European scene," said Kate Fowle, chief curator atGarage.

Oppression, lack ofinfrastructure andCold War tensions are afew ofthe "parallel legacies" that Russia andcountries ofEastern Europe enjoy, Krasteva said.

"This lack ofinfrastructure andlack ofsupport encouraged artists toengage inself-organization andassume therole ofart institutions," Krasteva said. This was particularly true inthe Soviet Union, where, unlike their Eastern European counterparts, Soviet artists had almost no contact with theWestern art world. Tight restrictions onthe postal service inthe U.S.S.R. limited correspondence andexchange ofideas. Lesson four inthe exhibit "The Practice ofSelf-Organization as Resistance" comes out ofthis isolation.

Theexhibition opens with the"grandmother ofperformance art," Serbian artist Marina Abramovic andher 1974 performance "Rhythm 0" as thefirst subject in"Lesson 1: TheBody as aTool forLiberation." Inthe original installation inGalleria Studio Morra inNaples, seventy-two objects including aloaded gun were laid out ona table touse as theaudience wished onthe body ofthe artist. This lasted six hours andended with theartist holding agun toher head. "That was theheaviest piece I ever did because I wasn't incontrol. Theaudience was incontrol," Abramovic once said.

Vladimir Filonov / MT

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Learning the Lessons of Art Freedom at Garage

Virginia in forced sterilisation payout

Virginia is to pay survivors of a forced sterilisation programme $25,000 (22,300) each in compensation under a measure approved by the US state's legislature.

Virginia forcibly sterilised those it viewed as social misfits or mentally deficient, among others, from the mid-1920s to the mid-1970s,when the programmeofficially ended.

More than 8,000 people were sterilised.

Only about 11 people who underwent sterilisation are known to be still alive, and the fund totals $400,000.

"I think it's a recognition when we do something wrong we need to fix it as a government," said Delegate Patrick Hope, a Democrat from northern Virginia's Arlington County.

"Now we can close this final chapter and healing can begin."

Mr Hope said that if other sterilisation victims came forward, they would need to be compensated.

He said the state's eugenics programme was the model used by Nazi leader Adolf Hitler aimed at creating a master race.

The eugenics movement claimed to improve human genetic features through selective breeding and sterilisation.

North Carolina was the first US state to compensate victims for forced sterilisations, setting aside $10 million as compensation in 2013.

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Virginia in forced sterilisation payout

Former Marine among sterilization victims getting compensation from Virginia

RICHMOND, Va. Lewis Reynolds didn't understand what had been done to him when he was 13.

Years later, after getting married, the Lynchburg man discovered he couldn't father children. The reason: He had been sterilized by the state.

Reynolds was among more than 7,000 Virginians involuntarily sterilized between 1924 and 1979 under the Virginia Eugenical Sterilization Act.

Advocates for the surviving victims won a three-year fight Thursday when the Virginia General Assembly budgeted $400,000 to compensate them at the rate of $25,000 each.

It's welcome news, Reynolds said.

"I think they done me wrong," he said. "I couldn't have a family like everybody else does. They took my rights away."

Eugenics is the now-discredited movement that sought to improve the genetic composition of humankind by preventing those considered "defective" from reproducing. Virginia's Sterilization Act became a model for similar legislation passed around the country and the world, including Nazi Germany. Nationwide, 65,000 Americans were sterilized in 33 states, including more than 20,000 in California alone, said Mark Bold, executive director of the Christian Law Institute, which has been advocating the cause of the Virginia victims since 2013.

Virginia is the second state to approve compensation for victims of the eugenics program. North Carolina approved payments of $50,000 for each victim in 2013.

But the money from the state comes too late for most of those who were sterilized in Virginia, Bold said. There are only 11 known surviving victims, he said. Two have died in the past year, he said. Those who are left greeted the news with tears and hugs, Bold said.

The Virginia sterilizations were performed at six state institutions, including what is now known as Central Virginia Training Center in Lynchburg. When Reynolds was sterilized there, it was called the Virginia Colony for the Epileptic and Feeble Minded.

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Former Marine among sterilization victims getting compensation from Virginia