High levels of arsenic found in fruit juice

High levels of arsenic found in fruit juice

What is Perimenopause?

Perimenopause, often referred to as pre-menopause or menopausal transition, is the time when natural changes occur in the body that lead to permanent infertility, or menopause. These changes usually begin to occur when a woman is in her 40's, however some women can experience it as early as their 30's. Once a woman goes 12 months consecutively without a period, menopause is reached and perimenopause is over. On average, women reach menopause at age 51.

The most common symptoms of perimenopause are menstrual irregularity, hot flashes, bone density loss, decreasing fertility, mood changes, sleep problems, vaginal dryness and infections, and bladder problems. If a woman experiences symptoms that interfere with her life or well-being, it is important that she make and appointment to visit her doctor.

Available treatments you can ask your doctor about include oral contraceptives, laser treatment to reduce or end menstrual flow, and progestin therapy. At home, it is important that women eat a nutritious diet, get regular exercise, and practice stress reduction techniques.

Perimenopause and menopause is a normal phase in a woman’s life, however, if you ever have questions or concerns, please don’t hesitate to ask questions!!!

For more information on perimenopause and/or menopause, please ask your doctor, or log onto www.evchc.org to find out how to make an appointment at one of our clinics.

Day-After-Thanksgiving Soup

Two Tasty After-Thanksgiving Dishes!

Just a little something to make you laugh...

Have a Healthy Thanksgiving

Christmas Holiday Toy Drive

The holidays are almost here and East Valley is once again making preparations for the adoption of 50 families that have been identified as our neediest patients. The families are being selected from both our Pomona and West Covina clinics and were chosen because they are experiencing serious financial difficulty and are unable to purchase gifts for their children this year.

If you are able to help one or more of the identified patients, please bring an unwrapped toy to the front desk of either the Pomona or West Covina clinic, or you can also send a check or money order to:

East Valley Community Health Center

C/O Shawna Maliglig

680 Fairplex Drive

Pomona, CA 91768

Please write “Christmas” on the memo line of your check.

I understand that economically it is a difficult time, however these patients and their families would not have any Christmas gifts if it were not for the spirit of giving. Thank you for making the holidays a little brighter for those in need.

5-Ways East Valley Helps Everyone in the Community:

1.  East Valley helps to decrease overcrowding in local emergency rooms so people with real emergencies can receive faster, higher quality care.

2.  East Valley provides STD/HIV testing, treatment, and counseling in order to decrease the spread of sexually transmitted diseases, including HIV.

3.  East Valley educates teens about pregnancy and STD prevention.

4.  East Valley provides jobs for over 200 people.

5.  East Valley gives all people an accessible option for quality, low-cost healthcare, should they ever need it.

Round 2 Recipe -Thanksgiving Quesadilla with Cranberry Cream Dipping Sauce on the Food Network

Round 2 Recipe -Thanksgiving Quesadilla with Cranberry Cream Dipping Sauce on the Food Network

This is a good recipe for after Thanksgiving snacks. Substitute regular sour cream for fat-free or light sour cream and use low-fat cheese to make it a bit healthier. Enjoy!

Why get tested?

There are many reasons to get an HIV test. A few are:
• You’re sexually active and are concerned about your health.
• You’ve had unprotected oral, vaginal, or anal sex.
• You and your sexual partner(s) want to know each other’s status.
• You’ve had a sexual partner who is HIV positive.
• You have injected drugs or other substances.
• You just want to know.

 East Valley provides HIV education, testing, counseling, and case management to those in need. To help us continue to provide these vital services, please click on the donate button at the top of the page or log onto www.evchc.org. Thank you in advance for your contribution!

Kotex tampons recalled over bacterial contamination

Kotex tampons recalled over bacterial contamination

Cancer Symptoms

20 Cancer Symptoms Women Are Most Likely to Ignore

By Melanie Haiken, Caring.com senior editor

Routine tests like pap smears and mammograms are important, but don't rely on tests alone to protect you from cancer. It's just as important to listen to your body and notice anything that's different, odd, or unexplainable. Although many of these symptoms could be caused by less serious conditions, they're worth getting checked out if they persist. You don't want to join the ranks of cancer patients who realize too late that symptoms they'd noticed for a long time could have sounded the alarm earlier, when cancer was easier to cure.

1. Wheezing or shortness of breath

One of the first signs lung cancer patients remember noticing when they look back is the inability to catch their breath. "I couldn't even walk across the yard without wheezing. I thought I had asthma, but how come I didn't have it before?" is how one woman described it. Thyroid cancer can also cause breathing problems if a nodule or tumor begins to press on the trachea, or windpipe. Any breathing difficulties that persist are reason to visit the doctor.

2. Chronic cough or chest pain

Several types of cancer, including leukemia and lung tumors, can cause symptoms that mimic a bad cough or bronchitis. One way to tell the difference: The problems persist, or go away and come back again in a repeating cycle. Some lung cancer patients report chest pain that extends up into the shoulder or down the arm.

3. Swallowing problems or hoarseness

Most commonly associated with esophageal or throat cancer, difficulty swallowing is sometimes one of the first signs of lung cancer, too. A hoarse or low, husky voice or the feeling of something pressing on the throat can be an early indicator of thyroid cancer or a precancerous thyroid nodule, as can the feeling of having something stuck in your windpipe.

4. Frequent fevers or infections

These can be signs of leukemia, a cancer of the blood cells that starts in the bone marrow. Leukemia causes the marrow to produce abnormal white blood cells, which crowd out healthy white cells, sapping the body's infection-fighting capabilities. Often, doctors diagnose leukemia only after the patient has been in a number of times complaining of fever, achiness, and flu-like symptoms over an extended period of time.

5. Swollen lymph nodes or lumps on the neck, underarm, or groin

Enlarged lymph nodes indicate changes in the lymphatic system, which can be a sign of cancer. For example, a lump or an enlarged lymph node under the arm is sometimes a sign of breast cancer. A painless lump on the neck, underarm, or groin can be an early sign of leukemia.

6. Bloating or abdominal weight gain -- the "my jeans don't fit" syndrome

While this might sound too common a phenomenon to be considered a cancer symptom, consider this: Women diagnosed with ovarian cancer overwhelmingly report that unexplained abdominal bloating that came on fairly suddenly and continued on and off over a long period of time (as opposed to occurring a few days each month with PMS) was one of the main ways they knew something was wrong.

7. Feeling full and unable to eat

This is another tip-off to ovarian cancer; women say they have no appetite and can't eat, even when they haven't eaten for some time. Any woman who experiences noticeable bloating or weight gain numerous times (the diagnostic criteria is more than 13 times over the period of a month) -- especially if it's accompanied by pelvic pain or feeling overly full -- should call her doctor and ask for a pelvic ultrasound.

8. Pelvic or abdominal pain

Taken by itself, pelvic pain can mean a lot of things. In fact, because it's a common symptom of fibroids, ovarian cysts, and other reproductive tract disorders, doctors don't always think of cancer when you describe pelvic pain. Make sure your doctor looks at all possible explanations and does a full exam, since pain and cramping in the pelvis and abdomen can go hand in hand with the bloating that often signals ovarian cancer. Leukemia can also cause abdominal pain resulting from an enlarged spleen.

9. Unusually heavy or painful periods or bleeding between periods

Many women reported this as the tip-off to endometrial or uterine cancer. Unfortunately, many women also said their doctors weren't responsive, overlooking or misdiagnosing their complaints as normal perimenopause. Ask for a transvaginal ultrasound if you suspect something more than routine heavy periods.

10. Rectal bleeding or blood in stool

"I thought it was hemorrhoids" is one of the most common things doctors hear when diagnosing colorectal cancer. Blood in the toilet alone is reason to call your doctor and schedule a colonoscopy.

Retrieved from: http://health.msn.com/health-topics/cancer/20-cancer-symptoms-women-are-most-likely-to-ignore

East Valley provides early cancer detection services to men and women. Many people who come to the clinic have little to no income and need services like ours. To help East Valley continue to provide these services for those in need, please click donate on our blog. For more information about our services, please visit us at http://www.evchc.org/. Thank you for your support!

Sexually Transmitted Disease Facts

• Chlamydia is the #1 STD among teens.
• Chlamydia, Gonnorhea, and Syphilis are all curable but if they are not treated in time could lead to long-term health problems including infertility, blindness, and even death.
• Condoms should be worn during every sexual act and protect against most STDs.
• A mother with an STD can pass it to their baby during childbirth.
• There are two types of Herpes, 1 & 2, and most people have type 1 which are commonly known as cold sores or fever blisters.
• Some strains of HPV cause genital warts, and others can cause cervical cancer. Although the warts can be ugly, the HPV that causes cervical cancer is much more serious.
• You don't have to "sleep around" to get an STD, because many people can get it from a cheating partner or from the first time they have sex. It only takes one time!

East Valley tests and treats people of all ages for STDs. To stop the spread of STDs, it is vital that everyone get tested at least every 6 months. For more information about our services or to help support our STD education and prevention efforts, please visit our website at http://www.evchc.org/ or click donate above. Thank you for your support. The health of our community depends on it!

Judge blocks graphic cigarette label images

Very interesting article about the FDA trying to mandate disturbing images on cigarette packages. If you get a chance, read the comments after the article too!

Judge blocks graphic cigarette label images

Press Announcements FDA: 35 innovative new drugs approved in fiscal year 2011

Press Announcements FDA: 35 innovative new drugs approved in fiscal year 2011

FDA: Moldy applesauce repackaged by school lunch supplier

I came accross this article and thought it might be of interest to some of you.

FDA: Moldy applesauce repackaged by school lunch supplier

Health Care Reform (2)

Accountable Care Organizations: Improving Care Coordination for People with Medicare

The Affordable Care Act includes a number of policies to help physicians, hospitals, and other caregivers improve the safety and quality of patient care and make health care more affordable.  By focusing on the needs of patients and linking payments to outcomes, these delivery system reforms will help improve the health of individuals and communities and slow cost growth.

On March 31, 2011, the Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).  ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities.  The Medicare Shared Savings Program will reward ACOs that lower growth in health care costs while meeting performance standards on quality of care and putting patients first.  Patient and provider participation in an ACO is purely voluntary.
Need for and Benefits of Coordinated, Accountable Care
Today, more than half of Medicare beneficiaries have five or more chronic conditions such as diabetes, arthritis, hypertension, and kidney disease. These patients often receive care from multiple physicians. A failure to coordinate care can often lead to patients not getting the care they need, receiving duplicative care, and being at an increased risk of suffering medical errors.  On average, each year, one in seven Medicare patients admitted to a hospital has been subject to a harmful medical mistake in the course of their care.  And nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days – a readmission many patients could have avoided if their care outside of the hospital had been aggressive and better coordinated.
Improving coordination and communication among physicians and other providers and suppliers through Accountable Care Organizations will help improve the care Medicare beneficiaries receive, while also helping lower costs.
According to the analysis of the proposed regulation for ACOs, Medicare could potentially save as much as $960 million over three years.
About Accountable Care Organizations
Under the proposed rule, an ACO refers to a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve with Original Medicare (that is, those who are not in a Medicare Advantage private plan). The goal of an ACO is to deliver seamless, high quality care for Medicare beneficiaries.  The ACO would be a patient-centered organization where the patient and providers are true partners in care decisions.
The Affordable Care Act specifies that an ACO may include the following types of groups of providers and suppliers of Medicare-covered services:

• ACO professionals (i.e., physicians and hospitals meeting the statutory definition) in group practice arrangements,
• Networks of individual practices of ACO professionals,
• Partnerships or joint ventures arrangements between hospitals and ACO professionals, or
• Hospitals employing ACO professionals, and
• Other Medicare providers and suppliers as determined by the Secretary.

In the proposed rule, the Secretary has made clear that certain critical access hospitals are eligible to participate in the Shared Savings Program. The law requires each ACO to include health care providers, suppliers, and Medicare beneficiaries on its governing board. The ACO must take responsibility for at least 5,000 beneficiaries for a period of three years, also suggested in the law.
Sharing Savings
Under the proposed rule, Medicare would continue to pay individual health care providers and suppliers for specific items and services as it currently does under the Original Medicare payment systems.  CMS would also develop a benchmark for each ACO against which ACO performance is measured to assess whether it qualifies to receive shared savings, or to be held accountable for losses.  CMS is also proposing to establish a minimum sharing rate that would account for normal variations in health care spending, so that the ACO would be entitled to shared savings only when savings exceeded the minimum sharing rate.  The amount of shared savings depends on whether on an ACO meets or exceeds quality performance standards. The proposed rule would provide for additional shared savings for ACOs that include beneficiaries who receive services from a Federally Qualified Health Center or Rural Health Clinic during the performance year.
CMS is proposing to implement both a one-sided risk model (sharing of savings only for the first two years and sharing of savings and losses in the third year) and a two-sided risk model (sharing of savings and losses for all three years), allowing the ACO to opt for either model.  This will help organizations with less experience with risk models, such as some physician-driven organizations or smaller ACOs, to gain experience with population management before transitioning to a risk-based model, while also providing an opportunity for more experienced ACOs that are ready to share in losses to enter a sharing arrangement that provides a greater share of savings, but at the risk of repaying Medicare a portion of any losses.
Measuring Quality Improvement
The proposed rule links the amount of shared savings an ACO may receive to its performance on quality standards.  The rule proposes quality measures in five key areas that affect patient care:

• Patient/caregiver experience of care;
• Care coordination;
• Patient safety;
• Preventive health; and
• At-risk population/frail elderly health.

The proposed rule sets out proposed performance standards for these measures and a proposed scoring methodology, including proposals to prevent providers in ACOs from being penalized for treating patients with more complex conditions.
Improving Care for Patients 
Any patient who has multiple doctors probably understands the frustration of fragmented and disconnected care: lost or unavailable medical charts, duplicated medical procedures, or having to share the same information over and over with different doctors.  Accountable Care Organizations are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions.  People with Medicare will have better control over their health care, and their doctors can provide better care because they will have better information about their patients’ medical history and can communicate with a patient’s other doctors.  Medicare beneficiaries whose doctors participate in an ACO will still have a full choice of providers and can still choose to see doctors outside of the ACO. Patients choosing to receive care from providers participating in ACOs will have access to information about how well their doctors, hospitals, or other caregivers are meeting quality standards.
Antitrust Guidance for Providers in ACOs
The Department of Justice (DOJ) and the Federal Trade Commission (FTC) have worked together to facilitate the creation of ACOs by giving providers the clear and practical guidance they need to form innovative, integrated health care delivery systems without running afoul of antitrust laws.  In conjunction with the proposed rule for the Shared Savings Program, the two agencies have issued a joint Proposed Statement of Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program (“Antitrust Policy Statement”).  Under the proposed Antitrust Policy Statement, the agencies are proposing to establish different levels of antitrust scrutiny depending on the specific ACO arrangement.  For example, DOJ and FTC are proposing to give rule of reason treatment to an ACO if, the ACO uses the same governance and leadership structure and the same clinical and administrative processes in the commercial market, as it uses to qualify for and participate in the Shared Savings Program. For more details, visit www.ftc.gov/opp/aco/.
One Part of Quality Improvement
ACOs are just one piece of a broader effort by the Obama Administration to improve the quality of health care for all Americans.  On March 21, HHS announced the first-ever National Quality Strategy, which will serve as a tool to better coordinate quality initiatives between public and private partners.  In addition, the Affordable Care Act established a new Center for Medicare and Medicaid Innovation that will test innovative care and service delivery models.  CMS is currently exploring how the Innovation Center will test alternative payment models for Accountable Care Organizations.
Before the rule is finalized, CMS will review all comments from the public and may make changes to its proposals based on those comments.
To read the Notice of Proposed Rule-making for ACOs, visit http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1.
To read the press release, visit http://www.hhs.gov/news/press/2011pres/03/20110331a.html.
Posted on: March 31, 2011
Last updated: October 26, 2011

http://www.healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.html

5 Pain-Relieving Yoga Poses

5 Pain-Relieving Yoga Poses Fitbie