If you’ve been second guessing your vacation plans because of the H1N1 influenza outbreak, you’re not alone. According to a recent TripAdvisor.com poll of 2,857 users of the site, one-fourth of respondents said they were changing their plans because of the virus. Experts say it’s too early to access the fallout from the outbreak, which has spread to 12 countries, but one area is already feeling the crunch—the airline industry.
Instead of gearing up for the summer travel season, many airlines are being forced to reduce their flights to Mexico, the epicenter of the outbreak, and nearly every U.S. airline with routes to Mexico have extended the period that customers can change their travel plans without a penalty. “It (the outbreak) couldn’t come at a worse time for the travel industry,” said Matthew Jacob, an analyst with Majestic Research LLC. “It had seemed like things were starting to recover. This will probably set that back a little.”
Continental, with the most Mexico flights at 450 a week, announced that beginning May 4, it will be reducing the number of flights and switching to smaller planes on some routes. Weekly flights to Cancun will drop from 98 to 46, then to 40 the following week, according to spokeswoman Julie King. Weekly flights to Mexico City will be cut from 116 to 78, and to 60 the subsequent week. “We were already experiencing soft market conditions due to the economy,” said Continental chief executive Larry Kellner, “and now our Mexico routes in particular have extra weakness.” The airline is allowing passengers to postpone trips to Mexico without penalty for all flights departing the U.S. through May 15.
United Airlines says they will continue to serve all four of its destinations but will reduce its weekly round-trip flights between the U.S. and Mexico from 61 to 24 in May and from 90 to 52 in June. Its nonstop flights from Denver to Mexico are being canceled in May, but will resume to two per week for Cancun, Puerto Vallarta and Los Cabos in June. John Tague, United’s chief operating officer, said the airline is “adjusting our schedule to match customer interest.” The carrier says they will monitor demand and make further adjustments as needed. United is issuing waivers for tickets purchased by April 26th for travel to, from, or through Mexico through May 31.
Delta, the world’s biggest airline, plans to cut some of its 350 weekly flights to Mexico, spokeswoman Betsy Talton said in a statement, but that the company still plans to provide service to all of its 11 Mexico destinations. For flights leaving through May 16, Delta will allow you to exchange your tickets to Mexico for another destination altogether without a change fee.
US Airways says it will reduce flights by 38 percent in two phases between May 10 and July 1 and then re-evaluate to see if further cuts are needed in July and August. US is providing a one-time option to re-schedule or re-route for those who are ticketed and traveling to, from or through Mexico City and will waive the standard change fee, advance reservation and ticketing requirements. AirTran Holdings said it has reduced its total flights to Mexico from 16 to 14. They will waive change fees for passengers who want to alter their travel scheduled to or from Cancun through May 31.
On the other hand, American Airlines, the second-largest U.S. carrier flying to Mexico, hasn’t trimmed Mexico flights. Tim Smith, a spokesman for the airlines, said the airline is “monitoring and evaluating demand” on a regular basis. American “does not plan to make any changes unless given a directive from the CDC,” the Association of Professional Flight Attendants told its members in a message. “At this time, all flights are scheduled to depart regardless of flight loads.” But the airline is taking precautions, such as issuing medical kits consisting of masks, gloves and medical equipment to cabin crews and allowing flight attendants to wear both gloves and a mask while working flights in and out of Mexico. For those who still feel skittish about travel to Mexico, American has activated its “storm policy,” which allows passengers to change routes or dates without charge and is also offering refunds for all tickets to Mexico for flights through May 31.
Some global airlines have also reduced links to Mexico. Canada’s largest carriers, Air Canada and WestJet Airlines have suspended all flights to Mexico, as did Cuba, Ecuador and Argentina. Germany’s Deutsche Lufthansa announced plans to cut flights and drop routes and says the planes that do fly to Mexico will have a doctor on board. “The doctor is there to answer passenger questions and to identify suspicions of flu during flight and to act to handle the situation before landing,” said Thomas Jachnow, a Lufthansa spokesman in Frankfurt.
Alaska Airways said it will remove blankets and pillows from all its planes and British Airways is handing out face masks to passengers so they can comply with a request by Mexican authorities that passengers cover their faces as they go through Mexican airports.
Brian Hoyt, a spokesperson for Orbitz, a travel booking and comparison site, said overall “people are still flying.” He said their site is suggesting alternative destinations with similar climates, such as Las Vegas or the Caribbean. “Travelers should take precautions, but they should let science, meaning the Centers for Disease Control and the World Health Organization, dictate their decisions,” said Hoyt. “Right now the only place they’re saying to be careful is in Mexico.”
However, that recommendation could change at any time, so if you are planning to travel, be sure to check with your airline for their current policies or access Orbitz’s list of airlines and their status.
Thursday, May 7, 2009
Influenza Outbreak Changes the Friendly Skies
Drug Use for Mental Illness on the Rise
Although mental illness has not always been treated as a medical condition, increasing knowledge and greater conceptual sophistication have brought with them significant change. Both the acknowledgment of mental illness by medical science and its quest for successful treatment of these disorders have marked milestones in the journey toward improving these aspects of the human condition. However, there remains a great deal of research to be done regarding the causes and treatment of mental illness.
Mental health disorders affect an estimated 22 percent of American adults each year due to very complex causes that often involve a combination of genetics, biology, and uncontrolled life experiences. Studies have shown that mental disorders are linked to physical changes in the brain and that some mental illnesses run in families, indicating a genetic association. Millions of Americans suffer from various forms of mental health issues ranging from social anxiety and obsessive-compulsive disorder to drug and alcohol addiction to personality disorders. However, successful treatment options including medications and psychotherapy as well as other treatments are available.
Since 1996, the number of Americans who use prescription drugs for the treatment of mental illness has been on the rise. In fact, among seniors 65 and older, the use of psychotropic drugs such as antidepressants, antipsychotics and Alzheimer's medicines doubled between 1996 and 2006. In addition, the 10-year period revealed an increase of 73 percent among adults and 50 percent among children in drug use for the treatment of mental illness. This accounts for one in 10 adults and one in 20 children having reported prescription mental health drug use in 2006.
According to health policy researchers Sherry Glied of Columbia University and Richard Frank of Harvard Medical School, the drug usage increase may be due in part to the expansion of insurance coverage for these drugs as well as a broader familiarity with them among primary care physicians. Their report appears in the journal Health Affairs and is titled "Better But Not Best: Recent Trends In The Well-Being Of The Mentally Ill." Glied said, “What we generally find is there has been an increase in access to care for all populations.” She went on to explain, “Mental health has become much more a part of mainstream medical care.”
The researchers gathered their data from several large U.S. public health surveys that included the National Center for Health Statistics, the Agency for Healthcare Research and Quality, the Substance Abuse and Mental Health Services Administration and the Social Security Administration.
Glied voiced concern regarding the little progress that has been made in the access to care for people suffering from more serious mental illnesses. The study found that treatment for older adults having mental limitations and requiring assistance with dressing, eating, or bathing dropped over the 10-year period between 1996 and 2006. Frank agreed by saying, “seniors are most concerning to us.” These patients have been the most under-treated and although many are now getting psychiatric medication, access to specialists is declining among the seriously impaired. In addition, with approximately 7 percent of Americans suffering from serious mental illness ending up in jail or prison each year, the researchers noted, “New policies are desperately needed to reduce the flow of people whose primary problem is a mental disorder into the criminal justice system.”
With the 2008 federal parity law came the requirement employers to provide equivalent insurance coverage for both physical and mental illness in an effort to improve access to care. However, concerns remain that the ongoing recession will leave a growing number of Americans uninsured and this could leading to less mental health coverage for many in the near future.
Researchers Put Another Piece of the Autism Puzzle in Place
What has more than 65 years of research uncovered about autism? Not its cause, not a cure, not a means to prevent it, not a fully effective treatment. Researchers have identified a number of genes associated with the disorder and some studies suggest that people with autism have abnormal levels of serotonin and other neurotransmitters in the brain. Other studies of people with autism have found irregularities in several regions of the brain. But intriguing new research by scientists at the University of North Carolina actually pinpoints the time when these brain anomalies occur, findings that experts say are critical in developing new ways to treat and diagnose autism earlier.
For the study, Dr. Matthew W. Mosconi and his colleagues at UNC took magnetic resonance imaging (MRI) scans of 50 children with autism and 33 controls—22 typically developing children and 11 who were developmentally delayed—between 18 and 35 months and again between 42 and 59 months. Participants also underwent tests that looked for certain behavioral features of autism. The researchers found that at both time points, the amygdala region of the brain, which is associated with controlling emotions, regulating attention and reading social cues from eye contact, in the children with autism was larger than the toddlers in the control group. “The amygdala plays a critical role in early-stage processing of facial expression and in alerting cortical areas to the emotional significance of an event,” the authors wrote. “Amygdala disturbances early in development, therefore, disrupt the appropriate assignment of emotional significance to faces and social interaction.”
The researchers said after observing the children that the enlarged amygdala appeared consistent with something called joint attention, or the ability of a young child to follow another person’s gaze and to share attention with others; behaviors thought to predict later social and language function. “We would basically try to get the child to look one way, we’d turn and point to a clock and see whether or not the child would notice it,” explained Dr. Joseph Piven, director of UNC’s Neurodevelopmental Disorders Research Center and one of the study’s authors. “The two-year-olds without autism would see your face, see where you are looking and join you but the children with autism, with large amygdalas, would not.”
“We believe that children with autism have normal-sized brains at birth but at some point, in the latter part of the first year of life, it (the amygdala) begins to grow in kids with autism,” said Piven. “Once we understand the neurological circuits, we may be able to detect if a child has problems in those circuits as early as 6 months of age. We need to let the pattern of early brain development guide us to predict who is at higher risk and who would benefit from early intervention.”
The team continues to follow study participants to determine whether amygdala growth rates continue at the same rate, speed up or slow down in children with autism after age four. “Studying this relationship as these children develop will shed important light on the neurobiological basis of autism,” Piven said. UNC researchers are also recruiting 500 infants who are also sibling of children with autism for a follow-up to their initial findings. “By tracking the behaviors and brain volume growth from birth in high-risk babies, we can pinpoint when the brain first begins to grow larger than normal and provide therapy or medications to limit the growth or symptoms a lot earlier than we are doing now,” said Piven.
“What they’re doing at UNC is really starting to define in the brain what’s going on with someone who has autism,” said Scott Badesch, chief executive of the Autism Society of North Carolina. “That gives us an ability as providers to address those needs.” Badesch said recent scientific findings, including an announcement last week about a new genetic clue for up to 15 percent of cases, are offering hope to families struggling with the disorder. “We’re beginning to find things, and the next question is what, if anything, we can do regarding treatment or a cure.”
Gender Parity Issue to be Corrected by Health Insurance Industry
Discrimination on the basis of gender is nothing new. Women have been fighting for equal rights, equal pay, and equal treatment by employers and society alike since the dawn of time. But many people do not realize that insurance companies have been charging women higher coverage rates than men, and some members of the United States Senate have chosen to address the issue through the initial stages of drafting legislation to stop it.
On Tuesday, May 5, the Senate Finance Committee met to discuss health care reform, specifically a closer federal regulation of the industry as a whole. Though a number of topics were brought to the floor, including single-payer health insurance plans and public versus private health care companies, it was a focus on gender parity and the need for action that seemed to resonate with most members of the committee.
President of America’s Health Insurance Plans Karen Ignagni was present to testify at the hearing and discussed the need for an end to gender discrimination regarding health insurance policy rates. Since many lawmakers already agree that bias on the basis of health history is unethical and discriminatory, it is more than fair that insurance companies give gender the same fairness. Though Ignagni’s overall point was to address the push for a massive overhaul of the insurance industry that could allow a federally sponsored plan to compete with private insurers, the gender parity issue was of specific importance.
Insurance companies are open to equaling the rates of men and women who apply for health care coverage, though the concession is in exchange for nixing the idea of a government-sponsored insurance company.
Senator John Kerry (D-MA) was particularly keen on sponsoring legislation that would address gender discrimination in the insurance market. “The disparity between women and men in the individual marketplace is just plain wrong,” he said, “and it has to change.”
He attended the committee meeting armed with research to show that women are often charged with higher premiums based purely on gender. In fact, this disparity currently affects the premiums paid by 5.7 million women in the United States, many of whom are self-employed and purchase individual coverage. It has previously been noted in studies that in California, women pay up to 39 percent more than men for individual policies. In addition, it was pointed out during the hearing that costs for women often increase during childbearing years, and some policies refuse to cover maternity care at all.
Employer-based plans are currently prohibited from charging women higher rates than men or eliminating maternity care from plans. In addition, ten states already ban the discriminatory practice -- Maine, Massachusetts, Minnesota, Montana, New Hampshire, New Jersey, New York, North Dakota, Oregon, and Washington. But many agree that a federal law to eliminate the discrimination across the board is needed.
The bill is currently being drafted, and lawmakers hope to introduce it to the Senate by the summer of 2009.
New Testosterone Injections Work as Male Contraceptive
Pregnancy is a big step in life for any couple. Until now, there have only been a few ways to prevent pregnancy and most of them are centered around the female. Now, there is a new monthly injection of testosterone that works as a contraceptive in men, allowing the responsibility of birth control to be shared among the sexes.
For years, scientists have been looking for a contraceptive to be the male equivalent to the Pill. The trials that were conducted in the 1990s found that weekly injections of testosterone reduced the sperm counts for 98 percent of the men, and the effects disappeared when the injections were stopped. However, the researchers thought that the weekly injections would be considered too unpopular and troublesome with men to be a very useful method of contraception.
Since then, researchers have been experimenting with injections that are oil-based. They combined the testosterone with tea seed oil which means that once it was injected, it was absorbed very slowly by the body. This also means that the effect of a single injection could last for much longer.
A new, large-scale study has looked at how well the monthly injections of testosterone has worked as a contraceptive and how safe they really are. The recent study looked at approximately 1,045 Chinese men that were between the ages of 20 and 45, had fathered at least one child in the two years prior to the study, and were in a stable relationship.
For six months, the men that participated in the study took monthly injections of testosterone in their buttocks. After that time, most of the men had very low sperm counts. However, the testosterone injections failed to lower the sperm count in about 5 percent of the men.
If the injections were successful, the men continued to take them for two years. However, many of the participants dropped out over time, so only 733 actually completed the trial. Also during the trial, the sperm count rose again for just over 1 percent of the men, and there were nine pregnancies during the two years. Overall, after the first year of the study, there was 1 pregnancy for every 100 men that participated. At the end of the second year, the pregnancy rate was fractionally higher at 1.1 per 100 men.
Condoms, when they are used perfectly, have about a 2 in 100 pregnancy rate a year. With the female contraceptive pill, the pregnancy rate is approximately 0.3 in 100. It is very important to remember that most of the contraceptives are a lot less effective in the real world than these ‘"perfect use" figures suggest, because people can forget to take a pill or the condom can fail to work properly.
An important question is whether the men’s sperm count rose again after the testosterone injections were stopped. For most of the men it took approximately 200 days for their sperm count to return to normal, however, 17 of the men still had not recovered their fertility after one year. Most of the men who participated had a normal sperm count after an extra three months, but two of the men were still not producing sperm after this time period.
The side of effects of the injections included tenderness at the injection site, a rash or acne, and some men experienced changes in their sex drive. These changes varied from man to man, but the most common side effect was a sex drive that was higher.
The next question is, what does this mean for me? The injection is currently being tested in Phase III trials, which are considered the largest scale human trials that are carried out before a new drug is released to the market. If a new medication is safe and effective in Phase III trials, its manufacturer can then apply to the appropriate regulatory agency for a license to manufacture and sell the product. There is no definite timescale, but it is usually a few years from the successful completion Phase III trials to the launch of the new product.