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Long-Term Care Proposal Draws Opposition
The insurance industry opposes a long-term care proposal called the CLASS Act, currently included in two major health care reform measures.
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Massachusetts' Individual Mandates, Insurance Exchanges Are Examples For National Plan
"Three years into its experiment with near-universal health care, Massachusetts has some "dos and don"ts" for the nation as it grapples with the best way to cover tens of millions of uninsured Americans," the Associated Press reports. "Do require that virtually everyone have health insurance, the overriding goal in Massachusetts. Don"t ignore rising costs, the single greatest threat to the law"s long-term affordability."
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Bill Fuels Debate Over Universal Screening For Postpartum Depression
A bill (HR 20, S 324) in Congress that would mandate funding for research, services and public education related to postpartum depression has sparked debate over whether all women should be screened for the condition, Time reports. The Melanie Blocker-Stokes Postpartum Depression Research and Care Act, also known as the Mothers Act, passed the House and is before the Senate. The bill does not specifically include funding for PPD testing, though an earlier version did; regardless, critics say it would still lead to greater screening. According to Time, the issue at the center of the debate is whether PPD screening identifies actual cases "or simply contribute[s] to the potentially dangerous medicalization of motherhood." Ingrid Johnston-Robledo, director of women"s studies at the State University of New York, said that experts on both sides of the debate agree about increased support for women. "The problem with women"s reproductive health issues is that they tend to be ignored or exaggerated," Johnston-Robledo said. She added, "We need to find a way to come down in the middle: acknowledge women"s depression but not assume that all women who struggle with the transition to motherhood are depressed."Critics of the bill argue that mental health screenings are notorious for giving false positives. They also contend that increased testing is a bid by pharmaceutical companies to sell more medication to women who do not need it. Some psychologists argue that universal PPD screening would be misdirected because the greatest risk factor for the condition is previous depression, not giving birth. Paula Caplan, a clinical and research psychologist, said, "(We) should be addressing the social factors causing women to be upset after they give birth, not locating the problem within the women."Some proponents of PPD screening say it is not supposed to be used as a diagnostic tool but as a way to identify which patients require further evaluation. According to Time, studies suggest that PPD affects as many as one out of seven women who have recently given birth and that leaving it untreated exposes women and their infants to unwarranted risk. Katherine Wisner, a psychiatrist at the University of Pittsburgh Medical Center, said, "Postpartum depression is not a benign, uncommon thing." She added, "We screen all infants for (the genetic disorder) phenylketonuria, which is extremely rare. Why don"t we screen women for this?" (Elton, Time, 7/20).
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DNA Damage From Environmental Exposures May Occur In As Little As Three Days

Exposure to particulate matter has been recognized as a contributing factor to lung cancer development for some time, but a new study indicates inhalation of certain particulates can actually cause some genes to become reprogrammed, affecting both the development and the outcome of cancers and other diseases. The research was presented on Sunday, May 17, at the 105th International Conference of the American Thoracic Society in San Diego. "Recently, changes in gene programming due to a chemical transformation called methylation have been found in the blood and tissues of lung cancer patients," said investigator Andrea Baccarelli, M.D., Ph.D., assistant professor of applied biotechnology at the University of Milan. "We aimed at investigating whether exposure to particulate matter induced changes in DNA methylation in blood from healthy subjects who were exposed to high levels of particulate matter in a foundry facility." Researchers enrolled 63 healthy subjects who worked in a foundry near Milan, Italy. Blood DNA samples were collected on the morning of the first day of the work week, and again after three days of work. Comparing these samples revealed that significant changes had occurred in four genes associated with tumor suppression. "The changes were detectable after only three days of exposure to particulate matter, indicating that environmental factors need little time to cause gene reprogramming which is potentially associated with disease outcomes," Dr. Baccarelli said. "As several of the effects of particulate matter in foundries are similar to those found after exposure to ambient air pollution, our results open new hypotheses about how air pollutants modify human health," he added. "The changes in DNA methylation we observed are reversible and some of them are currently being used as targets of cancer drugs." Dr. Baccarelli said the study results indicate that early interventions might be designed which would reverse gene programming to normal levels, reducing the health risks of exposure. "We need to evaluate how the changes in gene reprogramming we observed are related to cancer risk," he said. "Down the road, it will be particularly important not only to show that these changes are associated with increased risk of cancer or other environmentally-induced diseases, but that, if we were able to prevent or revert them, these risks could be eliminated." Session # A45: "Genetic Basis for Environmental and Occupational Respiratory Diseases" Abstract # 2589: "Effects of Particulate Matter Exposure on p16, p53, APC and RASSF1A Promoter Methylation" Keely Savoie American Thoracic Society


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