In Making Sense of Allergies, a guide published today by Sense About Science, allergy specialists and charities warn that essential information and life-saving actions are being diluted in a sea of over diagnosis.

There has been a rapid rise in allergies across developed countries. The percentage of children diagnosed with allergic rhinitis and eczema have both trebled in the last 30 years4. Allergies are now better diagnosed and their incidence in populations has risen. But there is concern that allergy has also become a catch-all diagnosis for unexplained symptoms, and this rise has been accompanied by a lot of non-medical diagnosis and treatment.

Question: When do you start brushing your baby’s baby teeth with toothpaste?  I will be taking my son to see the dentist for his fist appointment.  He has about five teeth in now.  What to make sure they are looking good and coming in correctly.  But until now I have not use toothpaste just baby teeth wipes.  So I would love to hear when other people changed to brushing with paste.

Answer: You can start to use toothpaste that does not have fluoride in it. However you should not use toothpaste with fluoride until your baby knows how to spit.  Normally around the age of two.

Philadelphia, PA, June 8, 2015 – Barrett’s esophagus (BE) develops in a subset of patients with gastroesophageal reflux disease (GERD) and can increase the risk of developing cancer of the esophagus. Although periodic surveillance for cancer is recommended for BE patients, these examinations may fail to identify pre-cancerous dysplasia and early cancers. A report in the Journal of Molecular Diagnostics describes a test using next-generation sequencing (NGS) to detect genomic mutations in precancerous esophageal tissue, which may improve cancer surveillance and early detection in patients with BE.

For the same reason you do not take your child to your own physician, you take him/her to a pediatrician. Children are not miniature adults. Their bodies are very different, and so are their teeth. A pediatric dentist has expertise in those differences.

Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships’ impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes.

There are no set rules for when a child should have their first set of dental X-rays. Some children who may be at higher risk for dental problems (for example, those prone to baby bottle tooth decay or those with cleft lip/palate) should have X-rays taken earlier than others. Usually, most children will have had X-rays taken by the age of 5 or 6. As children begin to get their adult teeth around the age of 6, X-rays play an important role in helping your dentist to see if all of the adult teeth are growing in the jaw, to look for bite problems, and to determine if teeth are clean and healthy.

A looming question for policy makers is how growing diversity of the US elderly population and greater use of home and community-based services will affect demand for long-term care workers. We used national surveys to analyze current use and staffing of long-term care, project demand for long-term care services and workers through 2030, and assess how projections varied if we changed assumptions about utilization patterns. If current trends continue, the occupations anticipated to grow the most over the period are counselors and social workers (94 percent), community and social services workers (93 percent), and home health and personal care aides (88 percent).

Alternative projections were computed for scenarios that assumed changing racial and ethnic patterns of long-term care use or shifts toward noninstitutional care. For instance, if Hispanics used services at the same rate as non-Hispanic blacks, the projected demand for long-term care workers would be 5 percent higher than if current trends continued. If 20 percent of nursing home care were shifted to home health services, total employment growth would be about 12 percent lower. Demographic and utilization changes would have little effect on projections of robust long-term care employment growth between now and 2030. Policy makers and educators should redouble efforts to create and sustainably fund programs to recruit, train, and retain long-term care workers.

Here are some topics your dentist may discuss with you at your baby’s first dental appointment. 

* Good oral hygiene practices for your child’s teeth and gums and cavity prevention
* Whether or not fluoride treatment is needed
* Their oral habits (thumb sucking, tongue thrusting, lip sucking)
* Their developmental milestones
* The dental may go over teething issues with you
* Proper nutrition
* Dental appointments: Many dentists like to see children every six months to build up the child’s comfort and confidence level in visiting the dentist, to monitor the development of the teeth, and promptly treat any developing problems

Using Medicare cost reports, we examined the fifty US hospitals with the highest charge-to-cost ratios in 2012. These hospitals have markups (ratios of charges over Medicare-allowable costs) approximately ten times their Medicare-allowable costs compared to a national average of 3.4 and a mode of 2.4. Analysis of the fifty hospitals showed that forty-nine are for profit (98 percent), forty-six are owned by for-profit hospital systems (92 percent), and twenty (40 percent) operate in Florida. One for-profit hospital system owns half of these fifty hospitals.

While most public and private health insurers do not use hospital charges to set their payment rates, uninsured patients are commonly asked to pay the full charges, and out-of-network patients and casualty and workers’ compensation insurers are often expected to pay a large portion of the full charges. Because it is difficult for patients to compare prices, market forces fail to constrain hospital charges. Federal and state governments may want to consider limitations on the charge-to-cost ratio, some form of all-payer rate setting, or mandated price disclosure to regulate hospital markups.

Question: My son is a year old and he now has four teeth. I will be taking him in for his first dental appointment.  I am already being told that I should have taking sooner.  So now I want to have some idea as to what is the first dental would be like.  What dose the dentist do? What kind of questions should I ask? Any advice would help.

Answer: During the exam, the dentist will check your child’s existing teeth for decay, examine your child’s bite, and look for any potential problems with the gums, jaw, and oral tissues. If indicated, the dentist or hygienist will clean any teeth and assess the need for fluoride. He or she will also educate parents about oral health care basics for children and discuss dental developmental issues and answer any questions.

Physician groups are growing larger in size and fewer in number. Although this consolidation could result in improved patient care, the resulting increase in market concentration also could allow larger groups to negotiate higher physician fees from private insurers.

In the period 2001–10 the average professional fee for total knee arthroplasty was $2,537. During this time, in markets that moved from the bottom quartile of concentration to the top quartile, physician fees paid by private payers increased by $168 per procedure. The increase nearly offset the $261 decline in fees that we observed, absent changes in market concentration. These findings suggest that caution should be used in implementing policies designed to encourage further group concentration, which could produce similar effects.

Question: My son is four and I took him to the dentist and was told he had three cavities in his baby teeth.  He said that I will need to get them filled.  I told him I would talk it over with my husband.  The thing is I am a single mom, with no dental insurance. Is there really any need to have the dentist do a filling on his baby teeth?  Given enough time his baby teeth are just going to fall out anyway.  I do not see the point when I don’t have the extra money.

Answer: If the cost of dental services are too much then buy dental insurance. If not for you at least for your baby. Try checking out the plans this website has to offer. All you have to do is enter your zip code at the top of the screen in order to pull up all our dental insurance plan options.   As for your questions about fixing or not fixing your son fillings. Here are some of the things that may happen to your son if you do nothing. It is up to you to decide if it is still worth the risk.

1) The tooth decay will only get worse

2) If your sons teeth are not now, they may over time start causing him pain. Having his teeth hurt whenever he is eating or drinking or just plain sleeping.

3) let the cavity or cavities get big enough he may start having his baby teeth fall out too early. Which makes the risk higher for his adult teeth to come in incorrectly.

4) If your son cavities go untreated, he may get an abscess causing him to have an infection in his mouth and face. If that happens you run the risk of not only having his dental health affected but his over all health effected as well.

5) Keep in mind that on average kids start to loss there baby teeth around the age of six. A lot can happen in two years. By doing nothing now may indeed cost you more money latter.

Long-term care hospitals are postacute care facilities for patients requiring extended hospital-level care. These facilities are reimbursed by Medicare under a prospective payment system with a short-stay outlier policy, which results in substantially lower payments for patients discharged before a diagnosis-related group–specific short-stay threshold. Using Medicare data, we examined the impact of the short-stay policy on lengths-of-stay and Medicare reimbursement among patients in long-term care hospitals who require prolonged mechanical ventilation.

After accounting for case-mix and facility-level differences, we found that discharges for reasons other than death in the period 2005–10 were most likely to occur on the day of or immediately after the short-stay threshold; this held true regardless of facility ownership. In contrast, live discharges in 2002—the year before the prospective payment system started phasing out cost-based payment—were evenly distributed around the day that later became the short-stay threshold. Our findings confirm that the short-stay outlier payment policy created a strong financial incentive for long-term care hospitals to time patient discharges to maximize Medicare reimbursement. The results suggest that the new very-short-stay policy implemented in December 2012 could have a similar effect.

Question: I just had a baby girl.  I have already added her to my health insurance policy that I receive though work.  I am wondering however,  just when I need to add her to my dental insurance?  Open enrollment comes up again in March.

Answer: Do you have any other children? If so, then in theory you may already have a family plan for your dental. Generally speaking dental insurance does not go up in cost whether you have one child or two. Check with you dental insurance provider and confirm if this is the case for you. If so you might as well add her now.

Did you know that Medicare beneficiaries can now obtain a replacement Medicare card if they have lost, damaged, or simply need to replace it by using their my Social Security account online? This is the newest expansion on Social Security’s online services through its my Social Security portal.

This is a new convenience for beneficiaries, and any my Social Security account holder can make this online request. To do it, just log on to your account, and select the “Replacement Documents” tab, and then select “Mail my replacement Medicare card.” After requesting a card, it will arrive in the mail in approximately 30 days.

According to Social Security, more than 19 million people have currently created an online personal account. In addition to the new service, you can use your account to change your address, adjust your direct deposit, obtain a benefit verification letter, or request a replacement SSA-1099. If you are still in the workforce, you can verify your earnings, and obtain estimates of your future benefits.

Question: When a baby cut a tooth can that tooth  come through rotten?   My friend baby is just getting her teeth in and her teeth are already getting bad . She does not know why this is happening.  Can her baby just be born with bad teeth?  If so can they be fixed. ?  Just wanting to be able to get her some information that may be helpful to her.

Answer: You may want to suggest to your friend to see a pediatric dentist. A pediatric dentist specialize in baby dental care. She may want to check with the dentist to see if the baby has baby bottle tooth decay(BBTD). A toddler can develop BBTD when the baby has prolonged contact with almost any liquid other than water.   Things your friend my want to avoid is letting her baby sleep with a baby bottle, or letting the child have a baby bottle when she is not feeding. These are examples of how a baby can get BBTD. Baby bottle tooth decay is one way for a baby to have bad or rotten teeth.

However, check with the dentist to confirm.  Another reason for bad baby teeth can be that the teeth do not have the enamel that would normally protect the teeth from decay. This too is something your friend can ask her dentist about. If that is a causing factor see about having sealants. Sealant would then help protect the teeth in question.