The theme of National EMS Week 2013 is “EMS: One Mission. One team.” The designation recognizes the hard work of both career and volunteer EMS agencies. To promote the specialized care for the smallest patients, May 22 is recognized as Emergency Medical Services for Children day.
 
The Kentucky Board of Emergency Medical Services encourages the public to use this week as an opportunity to recognize the critical role of EMS responders and agencies. KBEMS oversees credentialing of all EMS Responders and inspections of all EMS agencies and ambulances licensed in Kentucky.
 
KBEMS reported in Kentucky for 2012:
 
• 1,235 licensed ambulances
• 223 total EMS agencies
• 167 Advanced Life Support agencies
 
For more information on KBEMS click here.

In 2011, as Northern Kentucky dealt with a Shigella outbreak and restrictions on children in pools, an interdisciplinary team of Health Department staff was brought together to curb the spread of the illness.
 
Many cases of Shigella are connected to young children who are in child-care settings and people who have swum in public pools. It is more common in summer than winter.
 
After the 2011 outbreak ended, the team continued to meet. Each spring since, our epidemiologists, environmentalists, nurses and public information staff work together to help Northern Kentucky residents translate knowledge of Shigella prevention into practice.
 
The Health Department’s approach this spring includes outreach to local child care centers, schools, libraries, pools and churches. So far, we’ve sent more than 200 letters and fact sheets to parents, school administrators and church staff, providing them with educational materials that illustrate ways to reduce the transmission of Shigella and prevent outbreaks in these settings.
 
This month, we’re visiting many child care centers to provide updated information regarding sanitizing bathrooms and diaper changing tables.
 
In 2011, Northern Kentucky experienced an outbreak of Shigella with 147 cases reported. Compared to previous years, 2012 was mild with 18 cases (we hope that our team’s efforts were a reason for that, but we can’t know for sure). In a typical year, an average of 25 cases are reported.
 
To be successful this summer, our team needs your help. The most effective measures include:
 
• Keeping children with diarrhea out of child care settings.
• Making sure children wash their hands thoroughly after they use the toilet.
• Avoiding swimming for two weeks if you or your child has had diarrhea.
 
Our team has had three summers to fine-tune their approach, but when a community-wide outbreak occurs, it takes a community-wide approach to stop the spread of illness. Let’s join together and share this message of Shigella prevention with our families, friends and neighbors.
 

Lynne Sadler, MD, MPH, is the district director of health for the Northern Kentucky Health Department in Edgewood.

The conference, “Couples Coping with Cancer-related Stress: Translating Research into Practice,” will run from 8:30 a.m. to 6 p.m. at Jewish Hospital’s Rudd Heart & Lung Conference Center, 201 Abraham Flexner Way in Louisville, with a reception afterward at the Frazier History Museum. Sponsors are University of Louisville’s Kent School of Social Work and the James Graham Brown Cancer Center at UofL, a partner of KentuckyOne Health.
 
Researchers from Europe, North America and Australia will talk about coping throughout the disease’s course, coping with diverse types of cancer, ways to promote resilience of couples facing cancer, and translating research into practical ways to help such couples.
 
The sessions are intended for psychologists, social workers, physicians, nurses, couples and family therapists, researchers who work with cancer patients and their families, and other supportive-care providers who help them adjust to living with the many effects of the illness.
 
“There’s a very high relationship between how a patient is coping with illness and how the partner is coping,” said Karen Kayser, UofL’s Renato LaRocca Chair in Oncology Social Work, the only endowed chair in oncology social work in the United States.
 
“People are often at a loss in how to support someone with a serious or chronic illness,” she said. “And the partner’s or relative’s own stress can be overlooked during the cancer experience.”
 
Registration online is recommended by May 31 at a cost of $60 (or $75 with social work continuing education unit certification). Registration includes lunch, refreshments and a reception. For more information, check the conference website or contact Kayser at 502-852-1946 or karen.kayser@louisvile.edu.
 
There also is a preconference course for clinicians from 2-5 p.m. June 20 in Ekstrom Library’s Chao Auditorium on UofL’s Belknap Campus. The Kentucky Association for Marriage and Family Therapy is sponsoring the workshop with Guy Bodenmann, founder of Couples Coping Enhancement Training. For more information, go here.
 
From UofL

Paula Gister (Photo from Baptist Health)

Those who had experienced a heart attack thought that stress was the most important risk factor, followed by smoking and an unhealthy diet. Others who had never had a heart attack thought that the most important risk factor for heart attack was smoking, followed by stress
and obesity.
 
People who had experienced a stroke named high blood pressure, high cholesterol and diabetes as the most important risk factors, followed by stress and obesity. Others who had never had a stroke thought that smoking was most important, followed by stress and obesity.
 
So, how accurate were these individuals in their knowledge of stroke and heart attack risk factors?
 
The risk factors for both are very similar. Although stress, obesity and smoking are mentioned most often by patients as the most important risk factors for both heart attack and stroke, only smoking ranks as an important risk factor. Current smokers are about 1.8 times more likely to have a stroke or heart attack than non-smokers. Former smokers are only 10 percent more likely to suffer those outcomes so it definitely pays to quit.
 
Other important risk factors for stroke and heart attack are diabetes, which carries the highest risk, followed by high blood pressure which increase risks by 2.4 and 1.8 times respectively. Elevated cholesterol increases the risk by 1.3 times.
 
There also are some powerful risk factors important for stroke, but not for heart attack. The risk of stroke is three times greater when an abnormal heart rhythm called atrial fibrillation and/or heart valve disease are present. Patients who have a heart attack or congestive heart failure are also three times more likely to have a stroke.
 
The presence of multiple risk factors increases an individual’s global risk for both of these events so all risk factors must be considered together.
 
You can learn more about your risks for stroke at Baptist Health Lexington’s annual free stroke screening May 24 at Fayette Mall. Located near the interior entrance to Dillard’s from 9 a.m. to 5 p.m., the screening will involve an assessment of blood pressure, pulse, blood glucose and total cholesterol, as well as a check for signs of narrowing in the carotid artery.
 
Knowing your risk factors and working to lower risks that you can do something about can go a long way toward preventing stroke.
 
Paula Gisler is director of the Baptist Health Lexington Neuroscience Center.

Qualifying families can receive up to $5,000 per grant to help pay for medical services and equipment such as physical, occupational and speech therapy, counseling services, surgeries, prescriptions, wheelchairs, orthotics, eyeglasses and hearing aids.
 
To be eligible for a grant, children must be 16 years of age or younger. Families must meet economic guidelines, reside in the United States and have a commercial health insurance plan. Grants are available for medical expenses families have incurred 60 days prior to the date of application as well as for ongoing and future medical needs.
 
Parents or legal guardians may apply for grants here, and there is no application deadline. Organizations or private donors can make tax-deductible donations to UHCCF here. Donations are used for grants to help children and families in the region in which they are received.
 
“The UnitedHealthcare Children’s Foundation is dedicated to improving a child’s health and quality of life by making it easier to access needed medical-related services. The grants enable families to focus on their children’s health instead of worrying about how they’ll pay their medical bills,” said Paul Brophy, COO, UnitedHealthcare Employer and Individual of Kentucky. “Eligible families are encouraged to apply online for a medical grant today and take advantage of this valuable resource.”
 
In 2012, UHCCF awarded more than 1,300 grants—including 29 in Kentucky— worth more than $4.1 million, to families across the United States, for treatments associated with medical conditions such as cancer, spina bifida, muscular dystrophy, diabetes, hearing loss, autism, cystic fibrosis, Down syndrome, ADHD and cerebral palsy. As successful fund-raising efforts continue to grow, UHCCF is hoping to help more children and families in 2013.
 
From UHCCF

Angelina Jolie made news this week when she revealed she had a preventive mastectomy. (Photo from Wikimedia Commons)

With actress Angelina Jolie’s recent disclosure of her BRCA mutation carrier status and decision to have a preventive mastectomy, it seems like an appropriate time to discuss breast cancer risk and genetic testing.
 

One in 8 women, or 12 percent of the female population, will develop breast cancer in their lifetime. Many of the factors that can impact this risk have been identified, including age, ethnicity, lifestyle, family history and genetic conditions. Genetic counselors can evaluate a family history to determine if there may be an increased risk for breast cancer, or a risk for a hereditary form of breast cancer.
 

Only 5 to 10 percent of breast cancers are hereditary, which means they are due to a specific gene that is passed down in a family. The most common cause of hereditary breast cancer is an inherited change, known as a mutation, in the BRCA1 or BRCA2 genes.
 

Normally, these genes work to prevent breast and ovarian cancer. However, if a woman has inherited a changed copy of either gene from a parent, she has a high risk of developing breast cancer and ovarian cancer during her lifetime. The risk may be as high as 87 percent for breast cancer and as high as 44 percent for ovarian cancer. When caused by a BRCA mutation, breast cancers often occur in pre-menopausal women.
 

Genetic testing is available to identify families with hereditary breast cancer due to BRCA mutations. By identifying individuals who carry these genetic changes, genetic counselors are able to discuss increased screening and preventative surgery options with other family members who have inherited the same genetic risk factor. Most insurance companies cover BRCA testing if an individual meets certain family history or personal history criteria.
 

Although the majority of breast cancers are not hereditary, family history alone can impact the risk for breast cancer. Being aware of your family history can be very helpful in determining your risk. Having a first-degree relative (sister, mother, or daughter) who has been diagnosed increases the risk for breast cancer. Breast cancer on your father’s side of the family can also impact your risk.
 

If there is a family history of breast cancer, the general recommendation is for other women to start screening 10 years earlier than the youngest woman’s diagnosis. For example, if a woman has been diagnosed at age 45, other women in the family should start mammograms at age 35. Additionally, if you are found to be at an increased lifetime risk for breast cancer based on family history, a breast MRI may be recommended as well as annual mammogram.
 

It is important to keep in mind that many women with breast cancer have no apparent risk factors. In fact, the vast majority of women who are diagnosed will have no family history of breast cancer. This is why it is critical for women to have an annual mammogram starting by age 40. Discuss breast cancer screening with your physician to determine what would be most appropriate for you.
 
 

Sara Campbell is a genetic counselor at Baptist Health Lexington.