Philanthropist Christy Brown gives U of L $5 million for institute to study environmental conditions that affect human health

Christy Brown, U of L President Neeli Benapudi and Dr. Aruni
Bhatnagar, director of the Envirome Institute. (U of L photo)

With a $5 million gift from leading Louisville philanthropist Christina Lee Brown, through the Owsley Brown II Family Foundation, the University of Louisville has established an Envirome Institute in its School of Medicine to "develop integrated knowledge of the environmental determinants of health."

The name of the institute is not missing four letters. The word "envirome" is a knock-off from "genome," which is the "map of our genetic code, revealing how our genes relate to our health, and potentially our susceptibility to disease," the university says in a press release. "Built on a new vision of health, the Envirome Institute pioneers actionable knowledge about all forms of health and how they are affected by the environment beyond genomics. This gift from Brown catalyzes existing resources and adds new capabilities toward the ambitious, long-term mission of studying the human envirome with the same precision and rigor applied to decoding the human genome."

What's an envirome? Wikipedia says it "includes all of the environmental conditions required for successful biological life that affect human health. In genetic epidemiology, an envirome the total set of environmental factors, both present and past, that affect the state, and in particular the disease state, of an organism."

The Envirome Institute is the successor to the university's Kentucky Institute for the Environment and Sustainable Development. "Like KIESD, the institute will support research and applied scholarship, teaching and educational outreach activities, but with greater emphasis on community engagement and health," the university said. "The Envirome Institute is the first institute dedicated to the study of the human envirome. Taking a holistic approach to researching how the human-environment interrelationship impacts peoples’ lives, the institute will build on the pioneering work of Dr. Aruni Bhatnagar, the institute’s director, in the field of environmental cardiology. The institute will incorporate community engagement and citizen science to introduce a singular, new approach to the study of health."

The university has also created a Center for Healthy Air, Water, and Soil as part of the Envirome Institute. Brown had previously created a private nonprofit called the Institute for Healthy Air, Water and Soil. Its work will shift to the center, which "will support outreach activities to promote collaborations and interactions with the community for information exchange, partnership in scientific studies, dissemination of environmental information to the community and consultation by the community on issues relevant to the environment and health," the university said.

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Weekly newspaper tells the story of a transgender woman, 19

Crystal Stine Hahn (CMW Photography)

The Lebanon Enterprise, which under Editor-Publisher Stevie Lowery has a record of tackling sensitive subjects, broke new ground last week with a story about a 19-year-old transgender woman.

The story by reporter Emily LaForme is mainly about the experiences of Crystal Stine Hahn, 19, and started out by calling her "smart, honest, kind, bold… brave."

But it touches on some health aspects, and is an example of how to report and write about a sensitive subject, as some health topics are. It gets to a key point very quickly:

Born in a male body, Crystal, formerly known as Christian, always knew there was something wrong, but it took years to put those feelings into words. And, it took nothing short of fate to place the right champion into her life to answer her cries for help - her stepmother, Lebanon native Jeri Stine Hahn.
“She came to me and said there was something wrong with her, and that she needed to go to the doctor,” said Jeri. “I asked her what was wrong, and she wouldn’t say right away.”
Crystal eventually professed that she didn’t feel right in her body.
“She finally told me there was something wrong ‘down there,’” Jeri said. “I asked her if she wanted the doctor to make it bigger.”
Crystal said no.
“I finally said, ‘Do you want the doctor to take it away?’ Jeri said. “And, she said ‘yes.’” 

Hahn at 11, then named Christian

Crystal Hahn began her transition, which is still continuing, in the fifth grade in Lawrenceburg, LaForme reports: "Most of the staff and students were accepting, she said, but there were still lingering tensions between the community and extended family, so they opted to move to Lexington for a fresh start." At first she told no one but "a select few teachers" that she was transgender, but "keeping such a big secret was weighing heavily on her and her relationships with classmates, so she came out to her entire school in the ninth grade."

Hahn explained to LaForme, “I can’t date a boy without disclosing that to them, and I was tired of lying to my friends and not being true to myself. My parents were worried it would make my life harder, but I felt like my life was harder by lying to myself and to everyone else.”

Jeri, Crystal and stepfather Marty Hahn

The Enterprise shows it knows its audience with this paragraph: "Wrapping your head around the existence of transgender people is still not easy for everyone. However, thinking about the idea that some people are born with an extra finger, or no hands, or even conjoined with their twin, makes the idea that someone could have been born with the wrong sexual organ not seem so outlandish."

And the weekly paper, published by Landmark Community Newspapers, lists eight "important terms to know, from glaad.org and transstudent.org," and Jeri Hahn's tips for parents of transgender Kentucky children. Here they are:

Terms to know
Transitioning: Altering one's birth sex is not a one-step procedure. It is a complex process that occurs over a long period of time. Transition can include some or all of the following personal, medical and legal steps: Telling one's family, friends, and co-workers; using a different name and new pronouns; dressing differently; changing one's name and/or sex on legal documents; hormone therapy; and possibly (though not always) one or more types of surgery. The exact steps involved in transition vary from person to person. Avoid the phrase "sex change.”

MTF: male to female

FTM: female to male

Transgender: An umbrella term for people whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth.

Top surgery: Chest surgery such as double mastectomy, breast augmentation, or periareolar (keyhole) surgeries.

Bottom surgery: Genital surgeries such as vaginoplasty, phalloplasty, or metoidioplasty.

Gender dysphoria: Anxiety and/or discomfort regarding one’s sex assigned at birth.

Body dysmorphia: A disorder characterized by persistent and intrusive preoccupations with an imagined or slight defect in one's appearance.

Tips for parents

* Educate yourself by reading as much as you can about the transgender diagnosis. 

* Allow your child to dress in a way that he/she is comfortable and not in a way that makes you comfortable.

* Also allow your child to play with opposite-gender toys if they enjoy them. 

* Call Cincinnati Children's Hospital's gender clinic to make an appointment with a gender specialist if your child is displaying insistent, consistent and persistent cross gender play or dress. This consistent behavior is usually not a "phase.”

* Health insurance plans are beginning to cover cross-gender surgeries.

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Fewer Ky. teens smoke, but the rate is still high, and new vaping products like the Juul create worry that this trend will reverse

By Melissa Patrick
Kentucky Health News

Kentucky's high-school students continue to smoke at higher rates than their national counterparts, but the good news is that their rates continue to drop. The bad news: An influx of new vaping products could reverse this downward trend.

2017 Youth Risk Behavior Survey

The recently released 2017 Youth Risk Behavior Survey found that 14.3 percent of Kentucky high-school students reported smoking cigarettes; 14.1 percent said they smoked e-cigarettes, 10.6 percent used smokeless tobacco; 11 percent smoked cigars; and 26 percent of those who reported using tobacco products use more than one product.

All of these numbers are "significantly higher" than the national averages for the same measures, which Foundation for a Healthy Kentucky President and CEO Ben Chandler says is a real problem, because most adult smoking habits are "hard-wired" by the age 18 -- and Kentucky has the second highest adult smoking rate in the nation, 26 percent.

"The cigarette smoking rate for Kentucky high schoolers remains 62 percent above the national average, and nearly twice as many use smokeless tobacco. A third more Kentucky youth are dual users, which exacerbates their exposure to nicotine and the damage tobacco use does to their developing brains," Chandler said in a news release.

Chandler commended the state's efforts to keep young people from smoking, but cautioned that Kentucky's progress is slower than other states.

"We have proven measures to ensure the trend in youth tobacco use continues downward, but we have to have the courage to enact them and the common sense to fund them," he said. "We need smoke-free laws, higher tobacco taxes, including taxes on new tobacco products, and more youth tobacco prevention funding."

A look at some of the state's most recent anti-smoking efforts shows there is room to do more to protect children from smoking:

• Only 70 of the state's 173 school districts have adopted tobacco-free school policies and only 49 of those have included electronic cigarettes in their policies, Elizabeth Anderson-Hoagland, youth tobacco-policy specialist with the state health department, told Kentucky Health News.
• Bills to require school properties and school events to be tobacco-free were introduced but not called up in the legislature's education committees this year. The Senate passed a similar bill last year, but the House didn't take it up. A recent Kentucky Health Issues Poll found that 87 percent of Kentucky adults support such a law, and the poll has shown consistent support for such policies since 2013.
• A strong lobbying effort by the Coalition for a Smoke-free Coalition to get lawmakers to raise the cigarette tax by $1, to $1.60 per pack, failed. The coalition, chaired by Chandler and staffed by the foundation, said among other health benefits, such a hike would have kept more than 23,000 Kentucky teens from ever smoking and would have resulted in over 29,000 adults quitting. The tax was raised 50 cents, to $1.10, but Chandler said tobacco companies will be able to ease its impact with coupons and discounts.
• Though 71 percent of Kentucky adults support a statewide smoking ban, the last bill to get any traction on this issue was introduced in 2015, when the House passed a ban that was not called up in the Senate. Republican Gov. Matt Bevin, who took office in December 2015, has said this should be a local decision, so it's not likely such a bill would pass while he is in office. Only 35 percent of Kentuckians are protected from exposure to secondhand smoke by local smoke-free ordinances, according to the Kentucky Center for Smoke-free Policy.

On top of all of that, Chandler said he worries that teens' use of electronic cigarettes will undermine all the progress the state has made. About 45 percent of the state's high school students in the survey said they had ever tried an electronic vapor product.

A vaper uses a Juul device. (Photo by Adrian Leuthauser, Kentwired)

"And the explosion in teen popularity of new e-cigarette products threatens to undermine all the progress we've made by hooking teens on nicotine products that are proven gateways to smoking," Chandler said. "How sad it would be if we ended up back where we were a generation ago!"

One such product is the Juul device, a highly popular vaping tool that packs a powerful nicotine punch, with dozens of flavors that attract teens. And because it is small and looks like a USB drive, they are easy to hide them from parents and teachers.

The sale of these products to minors has become such a problem that the Food and Drug Administration conducted a nationwide undercover "blitz" to crack down on their sales. "They are a huge problem in the schools because they are so easy to conceal," Hoagland said. "Teens themselves are saying they are a problem, as well as administrators."

Chandler concluded, "Tobacco-related illness already costs the commonwealth 8,900 lives and $1.92 billion a year in health care expenditures. And even with the progress we've made, 119,000 kids currently under age 18 will die prematurely from smoking. That's nearly a thousand kids per county in Kentucky!"

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63 percent of Kentucky's children get their health insurance through Medicaid or the Children's Health Insurance Program

By Melissa Patrick
Kentucky Health News

More than 60 percent of American children are enrolled in Medicaid or the Children's Health Insurance Program, according to the Centers for Medicare and Medicaid Services data.

Photo: thenationalcouncil.org

Kentucky's numbers were just a bit higher, with 63 percent of the state's 1 million children enrolled in one of the two programs. That amounts to 642,364 children. Nationally, the programs cover 46.3 million of more than 74 million children.

"Kentucky leaders have taken several steps in recent years to make it easier for children to enroll and stay enrolled in health coverage, which has led to vast increases in the number of children with health insurance," Terry Brooks, executive director for Kentucky Youth Advocates, said in an email.

Brooks added, "Research shows us that, in addition to making it easier for children to enroll in coverage, providing affordable health coverage for parents is an important way to improve overall family health and reduce the number of uninsured children."

Children are eligible for Medicaid if they are between the ages of 1 and 18 with a family income up to 159 percent of the federal poverty level. They are eligible for CHIP, as the Children's Health Insurance Program is commonly called, with a family income between 160 percent and 213 percent of the poverty level.

The two programs have the same benefits, including doctor visits, dental care, hospitalization, outpatient services, psychiatrists, laboratory tests and X-rays, vision exams, hearing services, mental health services and prescription medicines.

Nationally in 2017, about four times as many children were enrolled in Medicaid as in CHIP, 36.9 million and 9.5 million, respectively. In Kentucky, nearly six times as many children were enrolled in Medicaid as in K-CHIP in 2017, 545,985 and 96,379 respectively.

Kentucky has a relatively high share, 25 percent, of children living in poverty (annual income of $24,036 or less for a family of four); 12 percent are in deep poverty (annual income of $12,018 or less for a family of four), according to the 2017 Kentucky Kids Count report.

In 2016, the most recent year for which state-by-state age population data are available, 38 states had more than half of their children enrolled in one of the programs at some point during the year, Philip Bump of The Washington Post reports.

Bump notes that North Dakota was the only state that had fewer than one-fourth of its children enrolled in either CHIP or Medicaid at some point during the year; and New Mexico, with more than 80 percent of its children enrolled in one of the two programs at some point, had the highest percentage of enrollment.

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WellCare says it reduced opioid dispensing 55% among 1,300 Kentucky Medicaid members targeted due to risk for addiction

WellCare Health Plans, one of the insurance companies that manages care for Medicaid patients in Kentucky, says it cut opioid prescriptions among a targeted group of Kentucky members by more than half.

Bill Jones, president of WellCare of Kentucky, wrote in an op-ed for newspapers, "WellCare identified 1,300 members who, based on their refill patterns and other factors, appeared to be at risk for developing an opioid addiction. These members were connected to one pharmacy, one physician and one care manager — a team approach in which everyone on the team was aware of the entire case history. The result: opioid dispensing dropped by 55 percent."

Jones added, "This kind of innovative approach is successful because it addresses opioid abuse at the root, helping people – many of whom are living with pain – find a healthy path forward that works to lower the risk of opioid addiction."

WellCare says it has taken other steps to fight the problem. Jones said the company donated $35,000 to support addiction recovery programs in the state, most of it to Addiction Recovery Care, which operates seven residential facilities in Eastern Kentucky.

"In Illinois, WellCare has implemented programs to encourage doctors to refer members to substance abuse treatment if they are at-risk for addiction – and to encourage members to keep follow-up appointments," Jones wrote. "In another intervention program, WellCare helped educate Medicare members on alternative treatments, conducted proactive outreach out to prescribers and connected members to WellCare’s behavioral health case management teams for support. As a result, between 2015 and 2017 opioid utilization dropped by 43 percent."

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Federal judge says he will rule in Medicaid lawsuit by June 30; changes are set to start rolling out, county by county, on July 1

After hearing oral arguments Friday, a federal judge in Washington, D.C., said he will rule by June 30 whether federal law allows states to require people in Medicaid to work or take schooling -- the most controversial part of a Kentucky Medicaid revamp that is scheduled to begin in Campbell County July 1 and be underway in all but eight counties by December.

U.S. District Judge James Boasberg noted the July 1 date after listening to lawyers for the state, the federal government and 16 Kentucky Medicaid beneficiaries who sued the U.S. Department of Health and Human Services, claiming that the Centers for Medicare and Medicaid Services waiver allowing Kentucky's changes is illegal.

The plaintiffs said the plan's work and reporting requirements would be "onerous" and "would end up limiting access to health insurance, the prime objective of Medicaid," Lesley Clark reports for the Lexington Herald-Leader. Ian Gershengorn, an attorney with the National Health Law Program, told Boasberg that "The obvious intent is to undermine Medicaid."

"Government lawyers argued that states would be more likely to embrace Medicaid expansion if they could impose similar restrictions," Clark reports. Boasberg "could put all these expansion programs on the chopping block," Deputy Assistant Attorney General Ethan Davis, representing HHS, told him.

Kentucky was the first state to get a waiver for a work-or-education requirement. "The outcome of the case could affect the fate of similar Medicaid work requirements approved by the CMS in Arkansas, Indiana and New Hampshire," Dickson reports. "Arizona, Maine, Mississippi, Michigan, Utah and Wisconsin are seeking similar waivers." Virginia is expected to join the group, following legislative enactment that wouldn't have passed without agreement on a work requirement.

Opponents of the changes "said they don’t believe HHS’s argument," Nathaniel Weixel reports for The Hill, a Washington publication. Boasberg, an appointee of Barack Obama, "appeared skeptical of the arguments used by the defendants, and his questions largely ignored them."

Boasberg pressed Davis to explain how "community engagement" requirements such as work or schooling help with health care, "adding that promoting health and medical assistance are 'two different things'," Clark reports. "Davis said the program includes a boost for addiction treatment and noted that 'a variety of studies' have shown a relationship between health and community involvement."

"The goal here is not to have benefits cut," Davis said, adding that saving money wasn't a goal of the waiver, but "a happy side effect." The state has estimated that in the next five years, estimated Medicaid spending of $37.2 billion would be reduced to $35 billion, because the program would have 95,000 fewer members with the waiver than without it -- partly from members' failure to meet new requirements. (Tens of thousands of Kentuckians go on and off Medicaid each month.)

Initially, Bevin said the plan was the only way the state could afford to continue expansion of Medicaid to people with incomes up to 138 percent of the federal poverty level, implemented by his Democratic predecessor, Steve Beshear, in 2014. "More recently, however, Bevin has told reporters that he doesn't know 'nor do I really care' what the cost savings would be," Clark notes. "The more important goal is helping dependent people to become healthy and productive, he said."

Nevertheless, Bevin's deputy general counsel, Matthew Kuhn, told Boasberg that the plan would keep the state from spending money it "does not have," and "this is the only way we could afford to have expanded Medicaid."

Bevin has said that without work requirements, he would eliminate the expansion, which at last count covered 493,000 Kentuckians. A county-by-county spreadsheet of enrollment in Medicaid, as of January 2018, is at http://www.uky.edu/comminfostudies/irjci/MedicaidbycountyJan2018.xlsx.

"Gershengorn argued that Medicaid, unlike some other forms of public assistance, is not a job-training program, and the Trump administration lacks the authority to transform it into one," Clark reports.

Gershengorn argued that the waiver "did not support the Medicaid Act's purpose of furnishing medical assistance," Virgil Dickson reports for Modern Healthcare. Gershengorn said, "Unlike some other public assistance programs, Medicaid is not a jobs-training program, and the administration does not have the authority to turn it into one. The rule of law requires that the president adhere to and uphold federal law, not subvert it."

Weixel writes, "The work requirements get the most attention, but Kentucky’s waiver was notable for other reasons. It was the first state to charge premiums up to 4 percent of a person’s income. The current limit has been 2 percent. Kentucky was also the first state to lock people out of coverage for up to six months for failure to timely renew their coverage or to alert the state if their income or family circumstances have changed. Beneficiaries can also be locked out if their income is at least 100 percent of the poverty level and they fail to pay premiums. The Trump administration lawyers argued the lockouts are much more flexible than some that were approved under the Obama administration."

The American Medical Association said Thursday that it opposes lockouts. “Discontinuing health care for thousands of our most vulnerable citizens for failure to meet administrative burdens is a cruel, bureaucratic response to our neediest patients,” AMA board member William McDade said in a press release. “As physicians, we recognize that many of our Medicaid patients lead complicated, difficult lives, and we should value empathy over rigid adherence to red tape.”

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Military members are providing free screenings and medical care in Breathitt, Owsley, Lee and Estill counties through June 24

The Kentucky Air National Guard is leading an effort to provide free medical screenings and care at four adjoining counties in Eastern Kentucky through June 24.

Starting June 15, the guard's 123rd Medical Group, Navy Reserve and active-duty Air Force and Navy personnel will offer medical screenings, non-emergency treatments; physical examinations for student athletes; dental exams, cleanings, fillings and extractions; eye exams, and single-prescription eyeglasses.

Clinics are being held at Lee County High School in Beattyville, Owsley County High School in Booneville, Estill County High School in Irvine and Breathitt County High School in Jackson, from 8 a.m. to 4 p.m. Monday through Saturday, and noon to 4 p.m. Sunday.

Residents of other counties can receive screenings and care, as long as they are at least 2 years old. Insurance cards and identification are not being required.

The 215 military members in "Operation Bobcat" will see patients on a first-come, first-served basis. A similar effort in Western Kentucky in 2016 provided more than 13,000 medical, dental and optometric procedures. More than 1,500 pairs of prescription eyeglasses and $20,000 worth of medications were provided free, according to a news release from the guard.

The Kentucky Department for Local Government, which is cosponsoring the program, is hosting a resource center with information on wellness, nutrition and immunizations.

The program is designed to simulate how military medical responses are conducted in times of crisis, conflict or disaster, the guard said in a news release.

“This kind of training helps hone our expeditionary skills so we’re ready to deploy at a moment’s notice to provide care anywhere in the world,” said Lt. Col. Amy Mundell, a medical administrative officer in the Guard’s 123rd Medical Group.

Local Government Commissioner Sandra K. Dunahoo said, “We’re very pleased to support a program that gives our military health-care troops essential training in field operations and logistics, keeping their skills sharp so they can be prepared to respond wherever they’re needed. At the same time, the program will be providing crucial services to citizens of the commonwealth who may not have ready access to care. This is a win for everyone.”

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Woman who lost 100 lbs. gives message of hope to the 68% of Kentuckians who are overweight: 'If I can do it, anyone can do it'

Liz Hopkins before and after losing 100 pounds
(Photos submitted to the Owenton News-Herald)

It took back surgery and the very real chance that she would eventually have to have it again to motivate a 250-pound, 40-year-old Kentucky woman with a list of health issues to decide to lose 100 pounds — and she says if she was able to do it, then so can you.

Liz Hopkins, a registered nurse from Owenton who works in Lexington, told Molly Haines of the The News-Herald in Owenton that she had struggled with her weight since she was a teen, but it wasn't until her 30s that her unhealthy eating habits and sedentary lifestyle caught up with her.

“I had developed high blood pressure; I had osteoarthritis in both of my knees, but the back surgery really scared me,” she told Haines. “That was rock bottom.”

Hopkins had her back surgery for a herniated disk February 2017 and told Haines that her surgeon told her that if she didn't lose "a significant amount of weight," she had a 96 percent chance of having to repeat it.

“But [the surgeon] also said she didn’t think I could lose the weight,” Hopkins said. “She didn’t mean that in a nasty way, she just meant, 'I don’t think you’ll be able to lose the amount that you need to lose not to have chronic issues.'”

Fast forward to June 1: Hopkins is 100 pounds lighter.

How did she do it? In addition to resisting the urge to pull into one of the 32 fast-food restaurants that she passes daily between Owenton and her job in Lexington every day, Hopkins told Haines that she joined her local gym and started exercising every morning from 5 to 6 a.m., with 30 minutes focused on cardio and 30 minutes on weightlifting.

Hopkins said she was encouraged by a friend to join the gym and said that while she was initially "intimidated" and worried that she would be harshly judged, what she found was the opposite.

“When I started I was welcomed by everyone,” she told Haines. “The atmosphere is so positive, and I’ve made some really good friends since joining because everyone wants everyone to succeed. There’s no competition, we all want each other to succeed — whatever success looks like for you individually.”

Hopkins noted that getting her workout in early works for her because it doesn't take time away from her family or work, and also helps her to make better food choices throughout the day.

“I have committed my life to taking care of other people, but somewhere along the way I forgot to take care of Liz,” Hopkins said.

Since beginning her weight-loss journey, Hopkins told Haines that she finds herself taking 15-minute walks after nearly every meal, even at work, and also attends a Zumba class on weeknights when her schedule allows.

“I feel like I have come back to life,” she said. “Before I had no energy, I had high blood pressure; I had to take Zantac for indigestion and heartburn at least twice a day. I had to take Ibuprofen and Tylenol for knee pain, back pain — my back hurt, I didn’t feel like doing anything. I came home and sat in a recliner, that was my life. Now, I have so much energy, and I feel like not only am I better at my job, I’m more active physically at work and at home.”

With the weight gone, Hopkins told Haines that she no longer needs her blood-pressure medicine or the over-the-counter medicines for her aches and pains. She added that her goal is to maintain the weight loss while continuing to strengthen and tone her body.

“The other thing I’m looking forward to is rollercoasters again,” she told Haines. “I had gotten so huge that it was a struggle for me to get strapped into the seat, so this summer I’m looking forward to riding rollercoasters because I’ll be able to fit in them a little bit easier. Just being more active, feeling good, being a good wife and mom and trying to continue to be an inspiration for anyone that’s interested in it, and thinks that they can’t. I know it’s cliche, but if I can do it, anyone can do it.”

Hopkins' story of being overweight, with a long list of health issues, could be told over and over in Kentucky, where 68 percent of adults are overweight and 34 percent of those are obese. The difference is that she did something about it, and her story can serve as an example and an inspiration.

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Beshear sues Walgreens, alleging it worsened opioid epidemic by not reporting unusually large drug shipments top Kentucky

Attorney General Andy Beshear is suing Walgreens for "allegedly failing to legally monitor its own operations that shipped and dispensed large quantities of opioids through its more than 70 locations statewide . . . directly contributing to the state's drug epidemic," his office said in a press release.

Walgreens is not only the nation's second-largest pharmacy chain, it is also a distributor of pharmaceuticals, "a unique positon," the release said. The lawsuit, filed June 14, involves both roles. It accuses Walgreens for "failing to legally report to state and federal authorities the suspiciously large orders it received for prescription opioids," the release says.

The suit alleges, "Walgreens pharmacies filled so many opioid prescriptions, that the numbers of opioids dispensed by Walgreens pharmacies were unreasonable on their face. Acting as a distributor, Walgreens received orders for those opioids from its own stores. Upon information and belief, those opioid orders were suspicious on their face due to the unreasonable numbers of opioids being dispensed at the store level, but were nevertheless shipped, rather than flagged, halted and reported."

The company declined to comment, according to several news-media reports. 

Beshear said he filed the suit in in Boone County because of the large number of Kentuckians who have died from overdoses in Northern Kentucky. He has filed five similar suits.

The release said Beshear is working with CVS Health, the nation's largest pharmacy chain, to created places for safe disposal of drugs at pharmacies in Elizabethtown, Frankfort, Georgetown, Lexington, Louisville and Paducah.

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New clinical trial at UK takes personalized approach for rare type of Lou Gehrig's Disease in Appalachian Kentucky

http://uknow.uky.edu/research/new-clinical-trial-takes-personalized-approach-rare-type-als-appalachia

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People with positive attitudes about aging live longer and have better health; Kentucky seniors' health is ranked 48th in nation

How you think about growing old can influence how well you age, says a growing body of scientific research and global data collected and analyzed by nonprofit journalism organization Orb Media. That's especially relevant in Kentucky, where seniors' health ranks 48th among the 50 states, according to America's Health Rankings.

"Individuals with a positive attitude towards old age are likely to live longer and in better health than those with a negative attitude. And those with a negative view of aging are more likely to suffer a heart attack, a stroke or die several years sooner," Jim Rendon and Olufemi Terry write for Orb. "Older people in countries with low levels of respect for the elderly are at risk for worse mental and physical health and higher levels of poverty."

Projected percentage of country population over 65 in 2050. Source: United
Nations World Population Prospects. (Orb Media graphic)

Why does it matter?

Orb reports that if population trends continue, by 2050 nearly one of six people in the world will be over 65, and close to half a billion will be older than 80. In 2050, seniors would make up nearly 16 percent of the world's population, compared to today's 8 percent.

In the U.S., the Census Bureau estimates that one in five people will be over the age of 65 by 2030, and by 2035, seniors will outnumber children younger than 18.

Those are the basic figures, reflecting quantity, but what about quality of life for those people? Research shows that a simple shift in attitude can make a difference in how well we age, especially in a world that often has negative views about growing older.

A World Health Organization analysis found that 60 percent of people surveyed across 57 countries reported relatively low levels of respect for older people. A separate Orb analysis found that the level of respect for seniors varied "significantly from country to country."

Of the 58 countries ranked in the Orb study -- in order of how they respect their elderly, with 1 being "very low" and 5 being "very high" -- the United States ranked 50th, scoring 3.29.

Becca Levy, a professor of epidemiology at the Yale School of Public Health, and a leading researcher in the field, has found "Those with positive views about old age live longer and age better," Orb reports. "They are less likely to be depressed or anxious, and they show increased well-being and recover more quickly from disability. They also are less likely to develop dementia and the markers of Alzheimer’s disease."

"In one study, Levy found that Americans with more positive views on aging who were tracked over decades lived 7.5 years longer than those with negative views," Orb reports, adding that studies in Germany and Australia have found similar results. In addition, other studies have shown that "the cells of those who have more positive views of the elderly actually aged more slowly than those who had negative views."

Levy told Orb that people with negative views of aging have higher levels of stress, which has been linked to a range of health problems. She added that those with more positive views of aging are also more likely to exercise, eat a balanced diet and go to the doctor. She also said people can decide for themselves how they think about aging, and that her research has found that people who who watch less TV, participate less in social media, and have more resistant personalities are more likely to hold more positive views of aging.

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McConnell gets hemp in Farm Bill, after argument with Iowa senator about inclusion of cannabinoids, including CBD oil

McConnell at the meeting (Associated Press photo by Jacquelyn Martin)

The Senate version of the Farm Bill contains Majority Leader Mitch McConnell's legalization of industrial hemp, but not without a dissent from another powerful senator who says it goes too far on a health-care issue.

The Senate Agriculture Committee passed the bill 20-1, and McConnell vowed to bring it to the Senate floor before July 4. The lone "no" vote came from Judiciary Committee Chair Charles Grassley of Iowa.

"Grassley’s objections to the farm bill appeared to be largely based on its language around industrial hemp," reports Marianne Goodland of Colorado Politics. Grassley "said he believed any language around industrial hemp ought not be included in the Farm Bill, but rather belongs in another bill that would go through his committee."

At issue is McConnell's language defining hemp, which includes cannabinoids, including CBD oil, which is used for a variety of medical conditions, especially in epileptic children. "However, the Food and Drug Administration has not approved those uses," Goodland notes. "Grassley argued that CBD oil is not an industrial hemp product."

The bill would let “any snake oil salesman” sell CBD without safety assurances, putting children at risk, Grassley argued. McConnell "said the bill incorporated suggestions made by the Judiciary Committee, the FDA and the Justice Department, including that the agriculture secretary could consult with the attorney general on state plans for hemp production. The bill, McConnell added, does not make hemp a legal commodity, and it also improves the integrity of the hemp program, to ensure that states and Indian tribes conduct proper oversight over their own hemp programs."

McConnell, making a rare appearance as a member of the committee, "said hemp could fill the market niche left when farmers in his state stopped growing tobacco," AgWeek reports, quoting him: “Younger farmers in my state are particularly interested in going in this direction, so I think it’s time for America.”

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Newspaper editor writes about dealing with depression

By Jesse Jones

The Eagle Post

Don’t read this alone in the dark. That thing under your bed might get anxious. The monsters that come to life when the lights go out would know. The dead-eyed woman on the ceiling above you might get angry.

Here goes anyway: There are things in this world far scarier than an imagination’s creations.

I slept in the same bed as my mother until I was 9 years old. Nothing terrified me more than unexplained noises, the bleak emptiness of my dark room and the creatures my mind imagined lived there.

In middle school I got punched in the face for the first time. I remember it, clear as day. The kid in front of me in math class warned me, said I had better quit bumping his chair or else. I forgot his warning. He didn’t.

The thing about getting really hit for the first time is that it dispels the anticipation. Before, you worry. Will it hurt? Would I black out, and everyone make fun of me forever?

I rubbed my cheek for a couple days, but I lost the fear of being hit. It wasn’t as bad as I imagined.

There was no blow to take to get rid of my fear of the dark. Goosebumps would raise on my skin at the thought, and a little shiver would make its way down my spine. The things I imagined lived in that blackness terrified me. I grew up, I learned to sleep in my own bed. I knew there wasn’t really anything awaiting me just beyond my vision. The fear, however, took longer to go away.

In my first house out on my own, the air conditioning flipped off for whatever reason six times a week. Turning it back on meant a trip down to the unfinished basement to the circuit breaker. There were no windows. Weird noises were commonplace. It was a nightmare’s playground.

I would have been OK, except every single light was set up to be turned off down there. There were no switches at the top of the stairs. It was a horror movie opening credits death waiting to happen. I was in my early 20s, but it didn’t stop the dread. It didn’t stop me from flicking the switch and racing up the stairs in pitch blackness as fast as my dignity would allow.

I don’t fear the darkness anymore. It’s comfortable, it’s quiet. Wanna know my secret to not being afraid of the things that go bump in the night?

Depression.

It’s hard to talk about. It was tough to write that word. There’s a stigma that’s associated with people who have had it. However, it seems someone famous is killing themselves every other day. It’s not talked about, but it happens just as much in the southern Pennyrile.

I hope you’re reading these words. Bad times can overcome anyone. I remember the first time I sat alone in the dark and wishing, hoping that there was a boogeyman just around the corner. I was struggling with an emptiness inside, a feeling of worthlessness and terrifying thoughts about the bottle of pills in my lap. I was more afraid of being inside my own head than the supernatural. I remember taking a nighttime walk on a poorly-lit street and seeing a car that didn’t see me at first veer into the lane I was walking in. I didn’t move. In some ways that still haunt me, I wanted it to hit me. I never thought about the fantastical things my head used to imagine would have been on that road.

I don’t write this for you to feel sorry for me. Depression is an incredibly common ailment many of us struggle with. Like cancer, it doesn’t care what color you are, what kind of car you own or how successful you are. It takes away who you are.

I don’t know you. But these feelings you have, you’re not alone in them. There is no small victory that can make that go away. I’m sorry.

Even if you have no one to talk to, though, remember that there are options. There are people to help. Before you take that final step, please call 1-800-273-8255. Personally, I used their online, anonymous chat to talk through the worst of my times. Depression isn’t a competition, but I know if I can survive, there’s hope for you too. You don’t have to be afraid of the darkness, even if it’s just the darkness inside your own head. That’s this week’s small victory.

Jesse Jones is editor of The Eagle Post, the Army newspaper for Fort Campbell.

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