President Barack Obama and Secretary of State Hillary Rodham Clinton

Speaking Friday via prerecorded video at the close of an international conference dedicated to the disease, the two said they were committed to building upon progress and taking the lead in ensuring a sustainable and effective response.

“Ending this pandemic won’t be easy, and it won’t happen overnight,” Obama told delegates gathered in the Austrian capital. “But thanks to you, we’ve come a long way _ and the United States is committed to continuing that progress.”

Clinton said the United States believes access to HIV/AIDS prevention, treatment and care should be a universal and shared responsibility and said health was a human right.

“As we push to expand access to these resources, the United States will continue to work with our partner countries and with civil society to help empower citizens to lead the charge in their own countries,” she said.

Washington will host the next international AIDS conference in July 2012.

During this week’s meeting, the more than 19,000 delegates heard promising news about a vaginal gel spiked with the AIDS drug tenofir that has proved capable of blocking the AIDS virus.

They also welcomed an announcement by the World Health Organization that a record 5.2 million people were receiving lifesaving AIDS drugs last year, up from 4 million in 2008.

But the gathering was overshadowed by woes about replenishing the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provides major support for AIDS programs around the world.

Donors meet in October to decide on the fund’s financing level for the next three years amid concerns that a desired $20 billion in pledges won’t be reached.

While some protesters directly targeted the United States, a recent U.N. report showed that the U.S. was the largest donor of international AIDS assistance in 2009, accounting for more than 58 percent of disbursements by governments.

Conference chief Julio Montaner of the International AIDS Society said in his closing remarks that the United States has what it takes to make a difference and thanked Obama for his leadership in changing policies that infringe upon human rights.

“The U.S. has the power to literally change the course of the epidemic,” Montaner said.

Nobel peace laureate Desmond Tutu of South Africa, meanwhile, stressed that HIV prevention, treatment, care and support are a human rights priority.

“To deny treatment is to deny life itself,” Tutu said in a video address.

Over the course of the week, activists have slammed the rich G-8 countries for failing to deliver on a commitment to ensure that everyone infected with HIV and AIDS gets treatment by 2010.

In 2005, G-8 leaders committed to developing and implementing an Africa-focused package for HIV prevention, treatment and care with the aim of getting “as close as possible to universal access to treatment for all those who need it by 2010.” They reaffirmed and broadened their commitment a year later.

But a G-8 accountability report from last month’s summit of world leaders in Canada acknowledged that the “universal access targets with respect to HIV/AIDS will not be met by 2010.”

Earlier Friday, the U.N.’s top investigator on torture and punishment warned delegates that overcrowded prisons are breeding grounds for AIDS.

Often, inmates are held in inhumane conditions in which the HIV virus is spread through the use of non-sterile drug injection equipment, sexual contacts, tattooing and sharing of razors, Manfred Nowak said.

USA Healthcare

GRAND ISLE, La. (AP) _ The mind-boggling news that the oil leak at the bottom of the sea may be twice as big as previously thought could have major repercussions for both the environment and BP’s financial health, killing more marine life and dramatically increasing the amount the company must pay in fines and damages.

Scientists now say the blown-out well could have been spewing as much as 2 million gallons of crude before a cut-and-cap maneuver started capturing some of the flow, meaning more than 100 million gallons may have leaked into the Gulf of Mexico since the start of the disaster in April. That is more than nine times the size of the 1989 Exxon Valdez disaster, previously the worst oil spill in U.S. history.

The larger estimates, while still preliminary and considered a worst-case scenario, could contribute to breathtaking liabilities against BP. Penalties can be levied against the company under a variety of environmental protection laws, including fines of up to $1,100 under the Clean Water Act for each barrel of oil spilled.

Based on the maximum amount of oil possibly spilled to date, that would translate to a potential civil fine for simple discharge alone of $2.8 billion. If BP were found to have committed gross negligence or willful misconduct, the civil fine could be up to $4,300 per barrel, or up to $11.1 billion.

“It’s going to blow the record books up,” said Eric Schaeffer, who led the Environmental Protection Agency’s enforcement office from 1997 to 2002.

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Flash Floods Kill at Least 20 People in Arkansas, Many of Them Campers

CADDO GAP, Ark. (AP) _ Floodwaters that rose as swiftly as 8 feet an hour rushed into a remote Arkansas valley early Friday, killing at least 20 people, many of them campers who became trapped by a devastating wall of water. Dozens more were missing and feared dead.

Heavy rains caused the normally quiet Caddo and Little Missouri rivers to climb out of their banks during the night. Around dawn, floodwaters barreled through the Albert Pike Recreation Area, a 54-unit campground in the Ouachita National Forest that was packed with vacationing families who were probably still asleep when their tents began to fill with water.

The water poured through the valley with such force that it overturned RVs, peeled asphalt off roads, and swept away tents and their occupants.

Two dozen people were hospitalized. Authorities rescued 60 others.

Marc and Stacy McNeil of Marshall, Texas, survived by pulling their pickup truck between two trees and standing in the bed in waist-deep water.

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Barraged With Cries of `Murderer,’ Van der Sloot Taken to Prison on First-Degree Murder Charge

LIMA, Peru (AP) _ Angry Peruvian onlookers shouted “Disgrace!” and “Murderer” at Joran van der Sloot on Friday after a judge ordered him jailed on first-degree murder and robbery charges in the violent killing of a 21-year-old Lima woman.

Prosecutors said the Dutchman, who was taken to a segregated block of an eastern Lima prison, acted with “ferocity and great cruelty” in killing business student Stephany Flores in his hotel room after they met playing poker.

Van der Sloot remains the lone suspect in the 2005 disappearance of U.S. teen Natalee Holloway on the Caribbean resort island of Aruba, and Peru’s criminal police chief says the defendant told interrogators he knows where her body is.

Aruba’s attorney general, Taco Stein, told The Associated Press on Friday he is skeptical Van der Sloot was telling the truth about Holloway’s body. He said Aruban officials will decide whether to sent investigators to Peru to question him once they learn exactly what he is offering.

Lima Superior Court Judge Juan Buendia issued a detention order before dawn for Van der Sloot on the murder charge. He was first taken with other prisoners in an armored truck to Lima’s judicial palace, then alone to the maximum-security Castro Castro prison.

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Rescue Boats Heading to 16-year-old Sailor Drifting in Frigid Indian Ocean on Damaged Yacht

CANBERRA, Australia (AP) _ A 16-year-old sailor on a round-the-world journey alone was drifting in the frigid, rough southern Indian Ocean on Friday as rescue boats headed toward her yacht, damaged by 30-foot waves that knocked out her communications and prompted her to set off a distress signal.

After a tense 20 hours of silence, a search plane launched from Australia’s west coast made radio contact with Abby Sunderland on Friday.

Her boat’s mast was broken _ ruining satellite phone reception _ and was dragging with the sail in the ocean, said search coordinator Mick Kinley, acting chief of the Australia Maritime Safety Authority that chartered a commercial jet for the search.

But the keel was intact, the yacht was not taking on water and Sunderland was equipped for the conditions, he said.

“The aircraft (crew) spoke to her. They told her help was on the way and she sounds like she’s in good health,” Kinley told reporters in Canberra.

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Pope Begs Forgiveness for Abuses by Priests, Vows to ‘Do Everything Possible’ to Protect Kids

VATICAN CITY (AP) _ Addressing the clerical abuse scandal from the heart of the Roman Catholic Church, Pope Benedict XVI begged forgiveness Friday from victims and promised to “do everything possible” to protect children at a Mass celebrated by 15,000 priests from around the world.

While symbolic, Benedict’s pledge failed to satisfy victims groups who said promises were useless without a clear-cut action plan to root out pedophile priests, expose the bishops who protected them and change the Vatican policies and culture that allowed abuse to continue.

His comments came during a Mass at St. Peter’s Square marking the Vatican’s Year of the Priest _ a year marred by revelations of hundreds of new cases of clerical abuse in Europe, Latin America and elsewhere, as well as cover-ups by bishops and evidence of long-standing Vatican inaction.

It was the first time Benedict had spoken of the crisis from St. Peter’s Basilica, the center of the church.

Benedict implied the devil was behind the timing of the scandal, saying the Year of the Priest was supposed to have been a year in celebration of the priesthood and encouragement for new vocations.

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Deafening Noise, Dazzling Color: Africa’s First World Cup Begins Amid National Euphoria

JOHANNESBURG (AP) _ Nelson Mandela would have loved it. The joy, the pulsating music and dazzling colors, the big party to celebrate the world’s embrace of South Africa _ even the scrappy 1-1 draw.

Dashing the hopes of many, the anti-apartheid hero and former president couldn’t make it to the opening of the World Cup Friday. Nearly 92, Mandela is frail, and his family was sent into shock when his 13-year-old great-granddaughter was killed in car crash on the way home from Thursday night’s gala pre-tournament concert.

But Mandela sent a message, via South African President Jacob Zuma, that the revelers should enjoy themselves. They took it to heart.

From the start of the ceremony to the final whistle of the first match, four hours later, Soccer City was abuzz with vuvuzelas _ the plastic horns favored by South African fans that collectively sound like the amplified interior of a beehive.

Most of the crowd of 84,000 wore the yellow jerseys of Bafana Bafana, the host country’s team, with a few pockets of green _ fans of Mexico, South Africa’s foe in the opener.

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Despite Obama’s Assurances, New Health Care Law Will Force Changes in Employer Plans

USA Healthcare Update

WASHINGTON (AP) _ Over and over in the health care debate, President Barack Obama said people who like their current coverage would be able to keep it.

But an early draft of an administration regulation estimates that many employers will be forced to make changes to their health plans under the new law. In just three years, a majority of workers _ 51 percent _ will be in plans subject to new federal requirements, according to midrange projections in the draft.

Republicans said Obama broke his promise. Employer groups were divided.

It’s more evidence that the law will raise costs, said the U.S. Chamber of Commerce. But the Business Roundtable _ representing CEOs of major firms _ saw encouraging signs of flexibility, though it’s withholding final judgment. Some experts believe increased regulation will lead to improved benefits for consumers.

“On the face of it, having consumer protections apply to all insurance plans could be a good thing for employees,” said Alex Vachon, an independent health policy consultant. “Technically, it’s actually improved coverage.”

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Kagan Played Role in Defending Clinton in Jones Sex Suit, But Many Memos to Be Kept Secret

WASHINGTON (AP) _ Bill Clinton’s presidential library won’t publicly release memos and notes Supreme Court nominee Elena Kagan wrote about the sexual harassment lawsuit that triggered Clinton’s impeachment.

Kagan was involved in defending Clinton in the lawsuit brought by ex-Arkansas state worker Paula Jones, according to documents released Friday. Clinton’s testimony for the Jones lawsuit, denying a sexual relationship with White House intern Monica Lewinsky, led to his impeachment.

The library held back several of Kagan’s memos to Clinton’s top advisers in the case, saying that publicly releasing them would divulge confidential advice. They were turned over to the Senate Judiciary Committee that will hold hearings on Kagan’s nomination, however.

It’s clear from files that were made public that Kagan had a hand in the Jones case. In a September 1996 memo, Kagan writes that she’s been in touch with other lawyers on a brief in the Jones lawsuit and, “I am happy with the direction they seem to be taking.”

Earlier that year, she forwards to colleagues a brief written by then-Solicitor General Walter Dellinger supporting Clinton’s bid to postpone the civil trial until after he had left office.

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Allergic Reaction: Feds May Ban Airlines from Serving Peanuts as Mile-High Grub

SAVANNAH, Ga. (AP) _ Federal regulators are considering a snack attack on the nation’s airlines that would restrict or even completely ban serving peanuts on commercial flights.

Advocates say the move would ease fears and potential harm to an estimated 1.8 million Americans who suffer from peanut allergies. Peanut farmers and food packagers, however, see it as overreaching and unfair to their legume.

“The peanut is such a great snack and such an American snack,” says Martin Kanan, CEO of the King Nut Companies, an Ohio company that packages the peanuts served by most U.S. airlines. “What’s next? Is it banning peanuts in ballparks?”

Twelve years after Congress ordered it to back off peanuts, the U.S. Transportation Department gave notice last week that it’s gathering feedback from allergy sufferers, medical experts, the food industry and the public on whether to ban or restrict in-flight peanuts.

The peanut proposals were listed in an 84-page document including several other proposed consumer protections for air travelers. Three options were given: banning serving of peanuts on all planes; prohibiting peanuts only when an allergic passenger requests it in advance; or requiring an undefined “peanut-free zone” flight when a passenger asks for one.

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Nebraska asks Big Ten for Membership, Confident it Will Be Accepted in Another Blow to Big 12

LINCOLN, Neb. (AP) _ Nebraska fans accustomed to making road trips to Columbia, Mo., better get ready to reset their GPS units for Columbus, Ohio.

Nebraska made it official Friday and applied for membership in the Big Ten Conference, a potentially crippling blow to the Big 12 and the biggest move yet in an offseason overhaul that will leave college sports looking much different by this time next year.

Chancellor Harvey Perlman disclosed the plan during a meeting of the university’s Board of Regents, proposing that play in the new conference begin in 2011 after one more year in the Big 12.

The move offers stability “that the Big 12 simply cannot offer,” Perlman said, and the regents unanimously approved a resolution supporting a move to the Big Ten.

Nebraska must be accepted by Big Ten presidents and Perlman said he expected that vote to come soon. The Big Ten confirmed it had Nebraska’s application but offered no timeline for a decision.

President Bill Clinton, Photo by Roger H. Goun July 13, 2007

On his first visit since becoming co-chairman of the committee overseeing more than $5.3 billion in international reconstruction aid, the former U.S. president visited the seaside town of Leogane, next to the Jan. 12 epicenter. Less than a fifth of its buildings survived, and thousands of residents are at risk from floods and high winds.

Clinton arrived on the first official day of hurricane season, with experts warning this year’s could be intense because of warm Atlantic waters and a waning the El Nino effect.

Standing under a blazing sun a few yards from dozens of homeless people and their overheated shelters, Clinton said he was not happy with the pace of recovery so far but expressed optimism that conditions could rapidly improve.

“Our attitude is we want to do all this yesterday. But I do think that you will begin to see much, much more rapid activity,” he told reporters, standing beside his co-chairman on the aid committee, Haitian Prime Minister Jean-Max Bellerive.

Probably the biggest outstanding need is shelter. Tarps are pitched in flood zones, aid groups have been slower to build transitional shelters than originally promised, and disagreements with owners over land rights have slowed efforts.

Meanwhile, more people are streaming into homeless camps because they can no longer pay rent or they need food, medical care and other aid. Camp populations are now estimated at 1.5 million, nearly double some of the earliest post-quake counts.

Clinton visited a trio of small, house-shaped shelters built by CHF International with funding from the U.S. Agency for International Development. Aid workers plan to build 125,000 of the shelters at a cost of $1,300 each.

The tarp, steel and wood homes are quake- and

hurricane-resistent but residents complained they get too hot

inside.

“I’m going to see if there’s any affordable solar-powered fans to put in there,” Clinton said. He also discussed building communal shelters near camps to provide protection in the case of a hurricane or large storm.

Earlier Clinton proposed credit programs for small businesses at a meeting of community leaders and aid officials. The community leaders told him about areas still not receiving aid. Aid workers complained of conflicts over available space for relocation camps. He pledged to help both, by better coordinating the aid effort and negotiating with landowners.

The Interim Haiti Reconstruction Commission was empowered under an 18-month emergency declaration by Parliament passed shortly before most members’ terms expired and the body essentially dissolved. President Rene Preval has veto power over the commission’s decisions.

During his four-hour visit, Clinton pledged $2 million from his personal foundation for recovery _ $1 million for disaster preparedness and the rest to fund the commission’s work. The Haitian government is putting up $1 million for the commission. Its first meeting is Wednesday, at the posh Punta Cana resort in the neighboring Dominican Republic.

The panel is viewed as a check on corruption and inefficiency and a guarantor of aid pledges. The funds the commission will oversee could equal Haiti’s $7 billion annual gross domestic product. Many Haitians were pleased to see power taken away from a government that has lost their trust.

But others have doubts. On Tuesday, several hundred people in Haiti’s capital, Port-au-Prince, protested the commission as infringing on their sovereignty, hoisting signs that read “Down with Clinton” and “Down with Preval.”

Clinton said the commission is not usurping the power of the state.

“I don’t feel myself at odds with the Haitian government. I see that I’m an advocate for it,” Clinton said.

The prime minister quickly echoed: “We need that help.”

In Leogane the official motorcade zigzagged through the collapsed city center, kicking up dust on the cracked brick roads as U.N. peacekeepers from Sri Lanka guarded the way. Some locals shouted for joy when they spotted Clinton, but others barely gave the passing motorcade a passing glance.

More than 20 bills have been introduced and as many as a dozen might be voted on this week as lawmakers face a deadline to pass bills out of their house of origin.

Because of California’s sheer size, its implementation of the new law could serve as a model for other states. The state has 8.2 million uninsured residents, nearly equivalent to the population of New Jersey. The number has ballooned in recent years as Californians lost jobs and health insurance due to the recession.

The bills seek to enact reforms signed into law by President Barack Obama in March. Among other changes, they would prohibit health insurers from denying coverage because of preexisting conditions and create an exchange through which individuals could buy insurance.

A separate bill would take state reforms further than federal requirements by making insurance companies obtain state approval before raising their fees.

The bills are considered works in progress that will change over the course of the legislative session, as the state learns more from the federal government about specific requirements in the law.

Republican lawmakers say the flurry of legislative activity is premature because upcoming elections could shift the balance of power in Congress and result in a repeal of the federal reforms. They also say the exchange, a marketplace through which individuals and small-business owners can buy health insurance at affordable rates, could lead to higher insurance rates because fees will be imposed on insurers to recoup its operational costs.

Despite resistance from members of his own party, Gov. Arnold Schwarzenegger has made health care reform a priority. He introduced his own plan in 2007, but it failed, in part because of concerns about runaway costs to the state in future years.

The Republican governor threw his support behind the national reform plan in April, and his office has been meeting with lawmakers to work through the details.

One of the first steps is to establish an exchange. The idea is to create a consumer-friendly website that could be used to compare and buy health insurance plans, similar to the packages offered by employers.

It also would serve as a place to screen whether an individual is eligible for Medi-Cal, the state’s health insurance program for the poor, or other state services.

The state would use federal money to run the exchange. It would create a new entity to operate it or work with a nonprofit organization, said Jennifer Kent, Schwarzenegger’s deputy legislative secretary.

Under the federal law, states can decide whether their exchanges will act as tough negotiators to get the best rates for customers or play a less intrusive role in the market.

Kent said Schwarzenegger wants to have the exchange created before he leaves office in January, although it would not be fully operational until 2014.

“He really has always grasped the issue, in terms of if you don’t reform this system, because it’s so badly broken it only succeeds to be a drag on the economy,” Kent said.

Legislative leaders have introduced two bills to create the exchange.

Under SB900, the exchange would have a website and online calculator that would allow consumers to compare plans and cost, said Sen. Elaine Alquist, D-Santa Clara, who introduced the bill and is chairwoman of the Senate Health Committee.

“The goal is to get Californians enrolled in a health plan in 30 minutes or less, rather than in hours or days,” Alquist said in an e-mailed response.

Under Alquist’s proposal, the exchange would negotiate and enter into contracts with health plans. It would be run by a board whose members are appointed by the governor and Legislature.

AB1602, a similar proposal introduced by Assembly Speaker John Perez, D-Los Angeles, also is expected to be voted on next week. That bill would create an exchange, eliminate annual and lifetime limits on health care coverage, and raise the age for children to stay on their parents’ insurance to 26, among other provisions.

The state is closely following the example of Massachusetts, which set up its own exchange in 2006. Lawmakers and the governor’s staff have met with Jon Kingsdale, the executive director of Massachusetts Connector, that state’s health insurance exchange, who will consult with California as it develops its own version.

“He runs the largest exchange in the country, but from a scale factor, we are so going to dwarf that,” Kent said.

Still, there is plenty to be learned from Massachusetts, especially when it comes to insurance companies jacking up premiums, said Assemblyman Dave Jones, D-Sacramento.

“Massachusetts thought prices would go down,” he said. “But what happened was, when people were legally required to buy insurance, insurers took advantage of that and raised their prices.”

That’s one reason Jones introduced AB2578, which would require insurance companies to obtain approval from the state Department of Insurance or the Department of Managed Health Care before raising their prices on premiums and copays. He calls it the missing piece of national health care reform.

Anthem Blue Cross proposed raising health insurance premiums by 39 percent before rescinding the increase, and Blue Shield announced an increase of up to 75 percent on small group policy holders.

“I think the public and policy makers have finally had it with these yearly double-digit health insurance and health premium increases,” Jones said.

Other bills seek to ban insurers from denying health insurance or specific treatments to patients with pre-existing conditions.

Children would be protected from this practice under a bill by Assemblyman Mike Feuer, D-Los Angeles. AB 2244 would prohibit health insurers from excluding or limiting coverage to anyone under the age of 19 because of a pre-existing condition. It also would get tough on insurers by declaring that if a company does not sell policies to families with children, it would forfeit its right to sell insurance to large employers.

“We have an opportunity here in California … to be a catalyst for the strongest protections for kids in the nation,” Feuer said.

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Online:

The main health care bills to be considered in the Assembly and Senate this week are AB1595, AB1600, AB1602, AB1825, AB1887, AB2244, AB2470, AB2477, AB2578, SB890, SB900, SB1088 and SB1163.

http://www.assembly.ca.gov

http://www.senate.ca.gov

SAN JUAN, Puerto Rico  _ Environmentalists demanded Tuesday that Puerto Rico’s government order new tests to determine whether coal ash being used for home and road construction in the U.S. island’s south is free of toxic material.

Activists contend the global energy company AES Corp. is selling coal ash containing lead, arsenic and mercury to developers who are using it for residential and transportation projects.

Several municipalities are considering moratoriums on such projects following complaints from residents, and scientists say the government should start testing air and water for possible contamination.

“This is a recipe for disaster,” environmental scientist Neftali Garcia Martinez told reporters. “No one has done any tests to see how these places are being affected.”

Allan Dyer, president for AES Puerto Rico, denied the ash is contaminated. He said the ash product, Agremax, that the Arlington, Virginia-based company sells as filler material for construction projects has been thoroughly tested and complies with local and federal regulations.

“Agremax is safe and nontoxic, and represents no harm to the health of the community or the environment,” he said in a statement.

Pedro Nieves, president of Puerto Rico’s Environmental Quality Board, said the use of coal ash for such projects is authorized because federal studies have shown that heavy metal levels are within safety standards. But he said the agency is collecting information and might issue a new round of studies if needed.

“We are not standing around with our arms crossed,” he said.

In December, the U.S. Environmental Protection Agency delayed a decision on whether to propose reclassifying coal ash as hazardous, which would limit where it could be sent for disposal. The issue was raised when 5.4 million cubic yards of coal ash spilled in Tennessee in 2008, creating one of the worst environmental disasters of its kind in U.S. history.

Nieves said he is monitoring the debate and might change his stance if the EPA issues new regulations.

It is the second time in recent years that AES has faced concerns from environmentalists and government.

In 2007, the company agreed to pay $6 million to clean up industrial waste in the Dominican Republic, whose government filed a lawsuit alleging AES dumped 82,000 tons of coal ash along several beaches.

The lawsuit claimed the ash was shipped from the AES plant in Puerto Rico, which started operating in 2002.

When her gynecologist told her she had high blood pressure, Marie Alcindor had a simple solution: switch doctors. After all, she had gone to him for a different problem, and this was the first time he had ever checked her blood pressure.

“He said, ‘Oh my God, you’re like a bomb waiting to explode.’ I said, ‘I didn’t come here for that, I came here for something else,’” she explained.

Two years later, Marie went to see her general medical doctor, who was also a family friend. “He looked me dead in my face and said, ‘I’ve known you since you were a teenager and you don’t want to die. Would you like somebody to be wiping the dribble from your mouth, would you like to walk with a
dragging foot?’”

This time, she heeded her doctor’s warning. She began the medications he prescribed, even though she didn’t like taking pills. She also began making changes in her everyday life. These behavioral changes, or “lifestyle modifications,” are recommended by the federal government’s National High Blood Pressure Program . The program also recommends these changes for people with “pre-hypertension,” blood pressure that’s above normal but not yet in hypertensive range (120-139 for the top, or systolic, number, and 80-89 for the bottom, or diastolic, number).

Lifestyle changes alone aren’t sufficient for many people with high blood pressure. But combined with medicine, they worked for Marie. After two years, her blood pressure fell to the normal range, and she no longer needs pills. The headaches and shortness of breath that she used to experience have also receded.

High blood pressure is rampant, and it’s one of the most common reasons why people develop strokes, heart problems, and kidney failure. It usually does its damage insidiously, and many people with high blood pressure don’t have any symptoms until they have a stroke or heart trouble. Below are lifestyle modifications recommended by the National High Blood Pressure Education Program (NHBPEP), which have helped people like Marie. Please note that while these lifestyle changes are important, they are not a substitute for medication, if that’s what your doctor recommends.

Lose Weight
If you are overweight, getting your weight to a normal range is one of the most potent things you can do to lower your blood pressure. The NHBPEP recommends that people ideally get their weight down to normal range, which they define as a Body Mass Index (BMI) of 18.5 to 24.9 (there are many on-line tools to help you calculate your BMI, like this one from the National Heart Lung and Blood Institute. If that’s not possible, even losing 10 pounds can help many people lower their systolic blood pressure (the top number) by 5 to 20 points (millimeters of mercury, to be exact). Marie lost 75 pounds by exercising and ending her lifelong habit of eating lunch at McDonald’s and drinking soda. “It was like a wake-up call,” she said. “I just did a 180.”

Following the DASH Diet
The DASH diet consists of fruits, vegetables, low fat dairy products, and foods that are low in fat. According to the NHBPEP, adopting the DASH diet will drop systolic blood pressure about 8 to 14 points in most people. The DASH diet contains a lot of potassium, and people with kidney problems should check with their doctors before adopting it, since they are at risk of developing dangerously high potassium levels. Marie began cooking more fish and vegetables, and learned to include more vegetables and less oil in her favorite Bahamian dishes.

Restricting Sodium
According to the NHBPEP, lowering sodium intake to 2.4 grams a day (about 1 teaspoon of salt) will lower systolic blood pressure by 2 to 8 points. For many people, following an even lower sodium diet – 1600 mg, combined with following the DASH diet, can be as effective at lowering blood pressure as a prescription medicine, according to the NHBPEP. The quickest way to lower your sodium intake is to stay away from canned and processed foods and limit your eating at restaurants. A fuller list of ways to reduce sodium intake can be found in a recent Doctor’s Word column .

Your taste buds will adapt to a low-sodium diet, even though it’s tough at first.“ It was very very hard,” Marie said of her experience cutting sodium from her diet. “But once you give it a week, you start developing a taste for it.”

Aerobic Physical Activity
Brisk walking, or some other regular aerobic physical activity, at least 30 minutes per day, will lower systolic blood pressure by 4 to 9 points, according to the NHBPEP. After getting her heart checked by her doctor, Marie began walking for 30 to 45 minutes every day. She also increased her walking by parking in a more distant space at the grocery store.

Limit alcohol consumption
For men, this means no more than 2 drinks a day, and for women, no more than 1 drink a day. (A drink is one 12 ounce beer, 5 ounce glass of wine,, or 1.5 ounces of whiskey). The NHBPEP says this will lower systolic pressure by 2 to 4 points on average.

Don’t smoke
Smoking can trigger heart problems, and the combination of smoking and high blood pressure is dangerous. It can seem difficult to quit, but it is possible to escape the smoking trap.

Learn to manage how you respond to stressful situations
There’s good evidence that people who respond angrily to stressful situations are more likely to develop heart problems. Marie said she used to have tantrums before when she got frustrated, but now she takes life one day at a time. “You can’t change things, so you have to relax and let it go,” she said.

Keep track of your blood pressure.
Many fire departments will check blood pressure for free, either at regular screenings or on a drop-in basis. Check with your local department. The National Health Lung and Blood Institute has auseful cardthat can help you understand what the reading means.

Don’t skip your medications
Of all the medications doctors prescribe, blood pressure medicine is one of the most important. Skipping a dose on your own can be dangerous. If you’re having side effects, call your doctor or nurse practitioner right away. It’s also important to tell them if you’re worried about paying for prescriptions, since many highly effective, first-line blood pressure medicines are available in generic form, at a relatively low cost.

Making these changes can not only help you live healthier, but also transform other aspects of your life. Marie now works as a health educator, and believes others can succeed at making these changes in their daily lives, if they are motivated. “I’m not only teaching it, I lived it,” she said recently. “I’m not telling you anything I didn’t experience myself.”

Dr. Erin Marcus is associate professor of clinical medicine at the University of Miami Miller School of Medicine. A Doctor’s Word is supported by a grant from the Ford Foundation.

Another birthday is quickly approaching for me. I am now in my early sixties, Yes I am a (Baby Boomer) As I look back at my life, I see the many days that pass me by. This is called age (life).

Age is just a number

We are now living longer, we do many things to keep looking good, and feeling well. This is the goal for all of us. Age is just a number. It is written in the scriptures about a man who lived to the age of 400. {Methuselah.} We too can live to that age, but our lives are cut short due to environmental pollution, the foods we consume, and the water we drink.

Here are a few tips that can help expand your life.

1. First and foremost, we must realize that life is not fair at times, but life is also good.
2. Whenever doubt enters into the picture just take your time and think it through. Remember! Life is too short to waste time hating anyone.
3. Pay off your credit cards each month and spend only on what you need.
4. You cannot win every argument. “Agree to disagree.”
5. It is OK to cry with someone, it’s more healing than crying alone.
6. Start saving for retirement, begin with your first paycheck.
7. I know this may be tough on some of you, but try and make peace with your past.  I can assure you it will clear your mind for the present, and your future.
8. Never compare your life with others. You don’t know what their journey in life is all about. Stay on your path of life, don’t veer off, and know who you truly are.
9. When it comes to going for what you love in life. Pursue it! Dreams do come true.
10. If you are in a relationship that has to be in secret, maybe you should not be in it??
11. Life has many twist and turns. Always remember to count life’s blessings that are bestowed upon you. Everything can change in a blink of an eye.
12. Whenever things get a little hectic, step back and take a deep breath. By doing this you can break the tension that surrounds you.
13. Don’t live a cluttered life. Get your house, and mind in order, rid yourself of anything that isn’t useful to you, beautiful, or joyful.
14. Sex is very important to all, have it often; it not only stimulates the body, but is also good for our most powerful sex organ, {The Brain.}
15. Frame every so-called disaster in your life; say the words “Winter will turn into Spring.” “This too shall pass.”
16. This is a hard lesson for most. Learn to {Forgive} Do not carry grudges; this can wear years off your life. Time heals everything. Give time, time.
17. Never worry what others may think of you.
18. Keep in mind that how good or bad a situation could be. It will change.
19. Laugh at yourself. Don’t take things too seriously, life goes on.
20. Never envy another person; it’s a waste of time. Keep in mind that you already have abundance.
21. Always look your best, and dress your best no matter how you feel.

Gillette Safety Razor Company had a commercial about their blades. “LOOK SHARP, FEEL SHARP, BE SHARP.”

1. You are the director, producer, and leading actor or actress in the show of life. You can always change your part if you don’t like the role you are playing.
2. Believe in miracles, they do happen; they are everywhere waiting for you.
3. Get outside every day. Feel the wind, the warmth from the sun, the rain or snow in your hair.

I hope you’ll try these tips.  It can put changes in your life.

Most important of all, stay focused, and spirituality minded.  All of us are gifted, special, and unique.   Live and love life. We are here for a reason.   Remember age is just a number!

Many Americans are struck with this epidemic that doesn’t know race, or gender, or age. Webster’s Dictionary defines loneliness as an emotional state of mind, standing apart from others, unhappiness, longing for friends or company.  A person experiences a painful awareness of not being able to connect with others and those important needs that are not met.

Be Proactive

Unfortunately there are no over the counter drugs that can fend off, or heal loneliness, but there are proven methods that you can do to overcome this emotontial experience.   You first need to be proactive if you want to rid your self from loneliness forever. Believe in yourself, and build up your confidence. This can only be accomplished by being spiritually minded along with strengthening your inner life.

Recognize that you are an important person. Love yourself, so you can love others. Once you overcome this, others can and will be drawn to you. But you must show confidence in yourself.

There are other ways to overcome loneliness. One way is to reach out to others by volunteering in either church, schools, or charitable organizations to help those who need your assistance.  When you focus on others you will quickly be less likely to worry about your own loneliness.

Make an effort to make new friends with everyone you meet. Avoid rushing into intimate friendships too quickly.  Intimate friendships usually develop gradually as people learn to share their inner feelings.

Use common sense

Value all of your friendships and their unique characteristics rather than believing that only a romantic relationship will revive your loneliness. Join social clubs that share the same interest and values that you do. Make the most of every opportunity for social contact, but use common sense when meeting strangers.

Get off the sofa, go out and engage in what ever activities that suits you.  Remember it should not cost you a lot of money.  It could be a simple walk in the park or a bike ride. The whole idea is to keep your mind occupied so you will have less time to ponder over your loneliness.

Do not look for solutions for loneliness in a sexual relationship. Aside from the risk of sexually transmitted disease (S.T.D.) or unwanted pregnancies, there are other psychological drawbacks of premature sexual activity.

Seek Help

If your loneliness becomes unbearable, do not be afraid to seek help, there is nothing embarrassing about seeking help. Once you ask, you will find that help is on the way.

Loneliness does not have to be a permanent state of mind, it can be cured with a little time and patience and maybe some hard work on your part.

Most important of all do not let your loneliness deprive you from the joy and happiness life has to offer.

After a year of riotous argument, decades of failure and a century of spoiled hopes, the United States is reaching for a system of medical care that extends coverage nearly to all citizens. The change that’s coming will reshape a sixth of the economy and shatter the status quo.

To the ardent liberal, President Barack Obama’s health care plan, passed by the House on Sunday night, is a shadow of what should have been, sapped by dispiriting downsizing and trade-offs.

To the loud foe on the right, it is a dreadful expansion of the nanny state.

To history, it is likely to be judged alongside the boldest acts of presidents and Congress in the pantheon of domestic affairs. Think of the guaranteed federal pensions of Social Security, socialized medicine for the old and poor, the civil rights remedies to inequality.

Change is coming, but in steps, not overnight. The major expansion of coverage to 32 million people _ powered by subsidies, employer obligations, a mandate for most Americans to carry insurance, new places to buy it and rules barring insurance companies from turning sick people away _ is four years out.

In contrast, on June 30, 1966, after a titanic struggle capped by the bill signing a year earlier, President Lyndon Johnson launched government health insurance for the elderly with three simple words, as if flicking a switch: “Medicare begins tomorrow.”

Obama practically needs a spreadsheet to tell people what’s going on and when with the law he will sign after the Senate takes final action this week.

Yet he and LBJ share a distinction: They are the only two presidents to succeed with a transcendent health care law.

“We rose above the weight of our politics,” Obama said late Sunday night in relishing the House victory on a 219-212 vote. “We proved that we are still a people capable of doing big things.”

You can be sure Obama, a student of history, is aware of how LBJ captured the moment when Medicare became law with his pen. That happened in Independence, Mo., in the presence of the very first American to sign up for the program: Harry Truman. The ex-president had ended a world war but could not achieve national health insurance in his time.

“Care for the sick, serenity for the fearful,” Johnson promised that day. “In this town, and a thousand other towns like it, there are men and women in pain who will now find ease.”

Said Truman: “I am glad to have lived this long.”

Ted Kennedy lived long enough to see a goal of his lifetime take shape but not long enough for it to happen. His death last summer was almost the death of the whole plan because a Republican won his Senate seat, changed the voting balance and left despondent Democrats in search of a second wind, which they found.

Why is this so hard? In part, because self-reliance and suspicion of a strong central government intruding into people’s lives are rooted in the founding of the republic, and still strong.

In 1854, President Franklin Pierce vetoed a national mental health bill on the basis that it would be unconstitutional to treat health as anything but a private matter that is none of the government’s business.

Seventy-five years later, the American Medical Association denounced proposals for organized medical services as an “incitement to revolution” at the hands of “Medical Soviets.”

And that wasn’t even about government-run health care. The AMA’s fierce opposition to collectivism included objections to private health insurance, the norm today, and the pooling of doctors into what became health maintenance organizations decades later.

No wonder would-be health reformers were thwarted one generation after another even as they made deep imprints on the nation in other ways.

Teddy Roosevelt couldn’t do it _ and he’s carved into Mount Rushmore.

Franklin D. Roosevelt rewrote the social compact with his job and retirement security and regulatory expansion, all in the jagged teeth of the Depression, then took the nation to war. He made national health insurance a second-tier priority and it eluded him.

Even so, social responsibility for medicine grew.

In 1930, citizens paid nearly 80 percent of the nation’s medical costs from their own pocket. Government at all levels covered a mere 14 percent, with industry and philanthropy picking up the few remaining crumbs. Insurance was barely in the picture.

Federal and state programs now cover half the cost of health care purchased in the country and were expected to go over 50 percent in the next year or two even absent Obama’s plan. By that measure, the government takeover of health care that opponents warn about is happening regardless of congressional action.

Why the creep of government in health care? In part, because individualism isn’t the entire American story. The idea of watching out for each other is also in the nation’s fabric.

Besides, as much as Americans hate overbearing government and higher taxes, give them a federal benefit and then just try to take it away. Today’s hot potato becomes tomorrow’s cherished check.

That’s one reason government programs grow _ and why Democrats dared to push for a less than popular package mere months from congressional elections, when people were telling their leaders to create jobs instead.

Johnson, full of beans after his Medicare victory, realized all of this.

“The doubters predicted a scandal; we gave them a success story,” he crowed a month after the law took effect, as hundreds of thousands of patients entered hospitals for treatment covered by the government and some 6 million children and needy adults began getting benefits.

“Where are the doubters tonight?” he asked. “Where are the prophets of crisis and catastrophe? Well, some of them are signing their applications; some of them are mailing in their Medicare cards because they now want to share in the success of this program.”

Obama can only hope for such a first-blush reception. He took on the cause of universal coverage after a campaign in which he did not promise it, intending only to secure insurance for all children and shrink the pool of uninsured adults. His health care ambition grew in office, quickly.

More than a quarter century before, Ted Kennedy came close to the prize with none other than the Republican president, Richard Nixon, who embraced ideas that mainstream Republicans today cannot tolerate. Nixon was ready to force businesses to provide health insurance to their workers or pay heavy penalties.

Sound familiar? It will.

At its core, Nixon’s proposal is a pillar of Obama’s plan today. Nixon’s willingness to subsidize coverage for the working poor is also seen in the plan, though writ larger.

Back then, Kennedy’s union and liberal allies gambled that by spurning Nixon, they’d get something better later. They didn’t. In similar fashion years after that, President Bill Clinton aimed high and crashed hard.

Clinton no doubt drew on his own failure when, in December, he advised Democrats to pass what they could manage and not make it an all-or-nothing fight. “America,” he said, “can’t afford to let the perfect be the enemy of the good.”

Obama absorbed these lessons.

For him, a system with government as the sole or principal payer of everyone’s medical bills was a nonstarter, nice for the ideologues and other countries but not the American way. He would have liked the option of a government-run plan competing in the marketplace, but didn’t need it.

For months he stood so far back from the legislative nitty-gritty that it was hard to tell what he stood for.

In the end, he stood for more than the incremental steps that succeeded in the past, and for less than the towering ideas that failed.

“This is what change looks like,” Obama said a few moments later in televised remarks that stirred memories of his 2008 campaign promise of “change we can believe in.”

Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.

A second, smaller measure _ making changes in the first _ cleared the House shortly before midnight and was sent to the Senate, where Democratic leaders said they had the votes necessary to pass it quickly. The vote was 220-211.

Obama’s young presidency received a badly needed boost as a deeply divided Congress passed legislation touching the lives of nearly every American. The battle for the future of the health insurance system _ affecting one-sixth of the economy _ galvanized Republicans and conservative activists looking ahead to November’s midterm elections.

Far beyond the political ramifications _ a concern the president repeatedly insisted he paid no mind _ were the sweeping changes the bill held in store for Americans, insured or not, as well as the insurance industry and health care providers that face either smaller than anticipated payments from Medicare or higher taxes.

The nonpartisan Congressional Budget Office said the legislation awaiting the president’s approval would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.

For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.

The second measure, which House Democrats demanded before agreeing to approve the first, included enough money to close a gap in the Medicare prescription drug coverage over the next decade, starting with an election-season rebate of $250 later this year for seniors facing high costs.

Much of the cost would be covered by the pharmaceutical industry, which made a deal months ago with the White House in which it pledged to spend lavishly on television ads to help pass the bill.

It also included sweeping changes in the student loan program, an administration priority that has been stalled in the Senate for months. It would have the government originate all student loans, denying banks and other private lenders of a lucrative business they have long had. Much of the savings would go into increased Pell Grants for needy college students, but black and Hispanic colleges would also benefit.

For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. According to some who met with him, he warned that the bill’s demise could cripple his still-young presidency, and his aides hoped to use the victory on health care as a springboard to success on bills to tackle stubbornly high unemployment that threatens Democratic prospects in the fall.

Obama watched the vote in the White House’s Roosevelt Room with Vice President Joe Biden and dozens of aides, exchanged high fives with Rahm Emanuel, his chief of staff, and then telephoned Speaker Nancy Pelosi with congratulations.

“We proved that we are still a people capable of doing big things,” he said later in the White House East Room. “We proved that this government _ a government of the people and by the people _ still works for the people.

Crowds of protesters outside the Capitol shouted “just vote no” in a futile attempt to stop the inevitable taking place inside a House packed with lawmakers and ringed with spectators in the galleries above.

Across hours of debate, House Democrats predicted the larger of the two bills, costing $940 billion over a decade, would rank with other great social legislation of recent decades.

“We will be joining those who established Social Security, Medicare and now, tonight, health care for all Americans, said Pelosi, D-Calif., partner to Obama and Senate Majority Leader Harry Reid, D-Nev., in the grueling campaign to pass the legislation.

“This is the civil rights act of the 21st century,” added Rep. Jim Clyburn of South Carolina, the top-ranking black member of the House.

Republicans readily agreed the bill would affect everyone in America, but warned repeatedly of the burden imposed by more than $900 billion in tax increases and Medicare cuts combined.

“We have failed to listen to America,” said Rep. John Boehner of Ohio, leader of a party that has vowed to carry the fight into the fall’s midterm elections for control of Congress.

The final obstacle to the bill’s passage was cleared at mid-afternoon when Obama and Democratic leaders reached a compromise with anti-abortion lawmakers whose rebellion had left the outcome in doubt. The White House announced the president would issue an executive order pledging that no federal funds would be used for elective abortion, satisfying Rep. Bart Stupak of Michigan and a handful of like-minded lawmakers.

A spokesman for the U.S. Conference of Catholic Bishops expressed skepticism that the presidential order would satisfy the church’s objections.

Republican abortion foes also said Obama’s proposed order was insufficient, and when Stupak sought to counter them, a shout of “baby killer” could be heard coming from the Republican side of the chamber.

The measure would also usher in a significant expansion of Medicaid, the federal-state health care program for the poor. Coverage would be required for incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014.

The insurance industry, which spent millions on advertising trying to block the bill, would come under new federal regulation. They would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions and from canceling policies when a policyholder becomes ill.

Parents would be able to keep children up to age 26 on their family insurance plans, three years longer than is now the case.

A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion would go into high gear.

Obama has said often that presidents of both parties have tried without success to achieve national health insurance, beginning with Theodore Roosevelt early in the 20th century.

The 44th president’s quest to succeed where others have failed seemed at a dead end two months ago, when Republicans won a special election for a Massachusetts Senate seat, and with it, the votes to prevent a final vote.

But the White House, Pelosi and Reid soon came up with a rescue plan that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both houses pass a fix-it measure incorporating numerous changes.

To pay for the changes, the legislation includes more than $400 billion in higher taxes over a decade, roughly half of it from a new Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000. A new excise tax on high-cost insurance policies was significantly scaled back in deference to complaints from organized labor.

In addition, the bills cut more than $500 billion from planned payments to hospitals, nursing homes, hospices and other providers that treat Medicare patients. An estimated $200 billion would reduce planned subsidies to insurance companies that offer a private alternative to traditional Medicare.

The insurance industry warned that seniors would face sharply higher premiums as a result, and the Congressional Budget Office said many would return to traditional Medicare as a result.

The subsidies are higher than those for seniors on traditional Medicare, a difference that critics complain is wasteful, but insurance industry officials argue goes into expanded benefits.

When this beautiful Caribbean lady started dropping the pounds, her co workers began to talk. There was some buzzing near the water cooler in the lunch room.

“Have you seen Johnnie?”

“No What happened?”

“She is looking good.”

Some wanted to know what she was doing. Others were afraid to come out and ask up front.

Johnnie’s boss, Karen, summoned the courage and asked.

With lots of joy, Johnnie began telling everyone about her new lifestyle change, and the different things that she is learning about this new life style. She told them that since last fall she has changed her routine.

Johnnie told them how she began taking daily walks, eating smaller portions, cutting back on late-night eating—and, most of all, planning her meals a head of time. The bomb shell dropped when Johnnie told them that while she was waiting in the X-ray room waiting her turn for her mammogram, she heard another patient talking about the anti-cancer diet for women her age.

Johnnie said that everyone had to know more—and not just her fellow Caribbean islanders. The Latinos and African Americans and white folks all had the same question.

“Say what? Anti cancer diet?”

A doctor told the women that the anti-cancer diet is similar to the routine for losing weight. Johnnie said this sounded good for her. Actually she could use the one stone to kill two birds, losing weight at the same time she cuts down on her chances of getting cancer.

Johnnie found out that the extra fat in the body can easily turn to cancer cells. She found this to be scary. She resolved stick with her change of life style and get off the yo-yo diets that had taken her weight down in the past only to rise again.

Johnnie likes the life style change, and she’s noticed that she’s feeling better about herself. The clothes in her closet are becoming easier to fit her. She feels happy, and would do anything to keep up this trend. Her mood is getting better. She’s going out more, and not so depressed.

That’s all easier said than done, but there’s no need to panic. Some medical research shows that people who take care of their weight and eat healthy reduce their chances of getting major sicknesses, including cancer. Other studies showed that worry and panic and stress make matters worse.

A key for Johnnie has been taking control of her body…stopping the yo-yo dieting…learning more about herself, foods…and how to eat healthy meals. Educational DVDs helped, and Johnnie also began seeking advice from her doctor’s office and the nurse at her work place.

A key challenge arose because Johnnie likes Caribbean foods. She has now learned to modify many tasty Caribbean dishes by adding less salt and animal fats. She was already eating more green veggies (boiled and raw), but her weakness was sweets, such as coconut drops and gizzardas.  Johnnie’s watch word soon became “moderation”

A change in perspective has also been crucial for Johnnie. She is nearly 40 years old and still in good health—and she wants to keep it that way. She’s learned that she can take off 15 years off her appearance by keeping her weight down and eating the right foods. Johnnie likes these bonus points. Now she looks around and sees that she has a lot of things going for her. She has her work, her health, friends, her church, and her new figure to wear her beautiful clothes.

Johnnie plans to wear her alter back, multi colored, silk blouse that dips down to her waist in the back to the “Jamaican Jump Up” at the Jamaican independence dance, next Saturday night. She’s thinking about her future instead of the past. She is more hopeful for her future, and her health, job and family have taken on new meaning. Her closet is now a friendly place. When she opens it, Johnnie sees possibilities. Johnnie has even started to attend church more often.

Continuing her progress will mean maintaining a balanced lifestyle. Johnnie has added a few other elements to her healthier diet and meal planning. She sleeps at least six hours each night, which helps her body get rid of the stress. She has built an exercise program into her daily routine. She does at least fifteen minutes each day—and she doesn’t get crushed if she takes an occasional day off. Johnnie also mixes up her exercise. She commits herself to an early workout at least three to four days a week. She now knows that most exercise is medicine. In other words, people who stay active are simply healthier, are less likely to experience serious chronic health problems.

Johnnie is learning everyday, and the knowledge she gains is changing her outlook about health. She is also realizing that it is not simply how she looks, or fitting into her clothes that matters. Can she be healthy without wearing a size two? The answer is yes. Johnnie realizes that it is not simply how she looks but the new behaviors that she is engaged in from day to day that truly make her healthy…and happy.

RMJ is the author of “Afraid no More”

www.remajohnson.com

Everything in moderation

I can’t say enough about exercising, which should be done on a consistent basis. Take the stairs, walk to the grocery store, take public transportation, ride a bike, row a boat, dance, just do something to help keep the pounds off. Remember!

As birthdays roll around, forget about the age number.  Remember, age is only a number. It’s the spirit that counts…Being overweight not only makes your clothes tight fitting, but can affect your health in many ways which could be fatal.

Surround yourself with positive people. Keep the negativity at bay. It will only bring you down.   Keep your mind active. I hear too many people say they are bored. Boredom can lead to trouble and depression.

You are never too old to learn. Take classes. Play games like jeopardy, BINGO, chess. Read books that are uplifting.   Don’t be a couch potato and let life pass you by. Get out and enjoy life.  Stop worrying about the past. What is done is done. You can’t go back.

Today is a new day

Laugh! Laughter can cure your immune system. Make yourself a cheerful person.

The only person, who is with us our entire life, is ourselves.  Tears may come and go. Grieve and move on with life.

Love life!  Have what you love, may it be family, pets, collections, music, plants, or hobbies.   Your home is your castle. Treat it as such. Don’t live a cluttered lifestyle.

Cherish your health. Don’t take it for granted; preserve it to the best of your ability. Keep yourself looking good.

My mom always told me to “Put your best Face Forward.” First impressions are lasting impressions. We all had guilt trips but don’t dwell on them.

Tell people you love that you love them and show appreciation for them at every opportunity.

You possess abundance. It may not be monetary it could be excellent health wise. What’s the sense of complaining? Be thankful.

Life is good if you don’t think so, look at people who are no longer with us.

Live and enjoy life to its fullest, take one day at a time.

And I’m one of the lucky ones! The American Association of Retired Persons (AARP) claims that there are 46.3 million uninsured Americans (John Briley, AARP Bulletin Today, September 11, 2009). With approximately 305 million people living in the United States, that means 15% of the population can’t afford to get sick! The figure is not only astoundingly mind-boggling…..it’s a disgrace.

Before delving into the ongoing healthcare reform initiated by President Barack Obama, with bills wending their way through five Congressional committees, we have to appreciate the current landscape. Right-wing Republicans are, by their own admission, hell-bent on making the president fail at every turn. The President should not count on any cooperation from that part of the Republican Party. These Republicans are spreading false rumors, spewing hatred and hoping that the public will be riled up (or scared) enough to say “no” to everything that Obama proposes, without giving it a fair hearing.

Naysayers are claiming that the American healthcare system is fine just the way it is, and that Obama wants to institute socialized medicine. Yes, the healthcare system is great….if you are working! Lose your job and you are one catastrophic illness away from losing your home or your life savings. Even though the U.S. has many good doctors, the country has more infant deaths per capita than Canada, Sweden, France and even Cuba (CDC, NCHS Data Brief, November 2009). And, by the way, those other countries have the dreaded socialized medicine disease!

If socialized medicine was as bad as Republicans want us to believe, then these other countries should be suffering from the plague. The fact is that in countries with government-sponsored healthcare, the citizens are healthier on average than in the United States. The simple reason is that they are able to go to the doctor whenever they are sick without worrying about the financial implications.

Which takes us to the “dreaded” public option scenario in Obama’s original plan. The idea was that the government would administer a healthcare plan that would compete with private industry to help keep costs down and provide more affordable option for the citizenry. Opponents coined the term “ObamaCare” to describe this governmental intrusion into the most hallowed of industries. Insurance companies are scaring people by saying that their premiums will increase. Yes friends, your premiums will increase because these insurance companies are going to increase their premiums in anticipation of more affordable competition. You might remember the credit card companies increasing their rates as legislation limiting interest rates made its way to the Senate this past summer. The legislation failed, but credit card companies still dug the knife deeper into the backs of consumers by keeping their rates high.

Similarly, insurance companies will raise their rates just in case the future brings added competition from the government.

I think all this opposition to the president trying to help those without healthcare insurance points to mean-spirited behavior coming from moderate Democrats and Republicans. The next time any of these politicians decry socialized medicine, ask them what kind of healthcare plan they have. Members of Congress have health insurance for life that is fully paid by the taxpayers. They have no problem accepting this largesse from us. What is wrong with the public having something similar to this? What about Medicare, Medicaid and Social Security? These are government-run programs that are almost untouchable come budget time

So friends, we already have public options. It’s just that these hypocritical and selfish members of Congress want to deny the rest of the public the sort of healthcare benefits that have been extended to them as part of the ruling class.

In a survey conducted by Drs. Salomeh Keyhani and Alex Federman of Mount Sinai School of Medicine earlier this year, they found that 73% of doctors supported the public option, even though the leaders of the American Medical Association (AMA) were against it. The AMA leadership apparently thinks that any government-run program will lead to doctors getting lower fees. Even if this happens, what’s wrong with us giving back a little so that all Americans can have the benefit of affordable healthcare? Again, the selfishness of those who have at the expense of those who have not.

This is one time when I think liberal Democrats should hold out for as long as possible to get this public option into any bill that comes to the floor. They need to turn back the lies about socialized medicine. No system is perfect, but to vilify something that has worked for years in Europe is silly. Europeans have been far better off than Americans for the kind of healthcare system they have had.

Let’s not talk about waiting long to see a doctor. I pay plenty to be part of the vaunted American healthcare system, and sometimes I have to wait a month or more to see a specialist!

In the final analysis, President Obama will have to decide if the campaign promise of a better and more equitable healthcare system is worth fighting for. He’ll have to decide if he’s going to spend the political capital to fight for the public option. I believe a public option would help-working class families—and I believe that despite the drivel coming from the hate-filled right-wingers.

Johnnie had an invitation for a party, but she was very discouraged.

“I have nothing to wear,” she said, lying on her bed in the dark, quite discouraged as she looked at the wardrobe full of dresses and slacks that were all too small.

Then Johnnie’s mind flashed back to happier days as a child, when she loved playing with the colorful yo-yo her mother gave her. Up and down and in and out went the multi-colored circle.

Many holidays had come and gone since then. Johnnie had gone to many dinner parties and eaten a lot of good cooking. Now she looked at her wardrobe, forced to deal with the fact that her gorgeous dresses were hanging in the closet because they were too tight.

Johnnie knew that she had put on more weight.

It’s wasn’t the first time. After months and years of diets and milk shakes, diet bars, starvation diets, and even a membership in the local gym, Johnnie did lose some pounds from time to time. But they always came back. She would lose 10 and gain 15. This went on for years. Up and down, in and out—just like the yo-yo.

Johnnie was discouraged.

When she stood in front of her closet and looked at herself in the mirror, she would say to herself: “I am ashamed, and I thought I was doing so well.”

She thought again of that old yo-yo. Losing five or 10 pounds is never a problem, she thought. But there’s always a holiday season coming up, or a wedding party. The weight comes back. The clothes pile up in the closet.

It’s more than a wardrobe problem, too. Johnnie realized that she’s getting older, and finding out about health problems that are a direct cause of years of build up weight. She decided that it’s time for a real change.

But how?

Johnnie remembered an article in a health magazine she had read recently. It talked about changing eating habits and exercise such as walking. She remembered the health classes that she went to several years ago, where she heard about ‘lifestyle changes’. But she wondered: “How do these ideas come together for me?”

She took another look in the closet full of designer jeans and colorful dresses that she couldn’t wear because they were too tight. She dug down deep inside herself for help.

Self determination came forward. Johnnie went into the cluttered drawer and fished out her motivational poster. She reached for the glue and pasted the poster to the fridge door, covering the coupon that said “Buy One Burger Get One Free.” Then she searched through some old envelops and found a photo from years gone by. Johnnie decided that she would become slim and trim again.

The first step for Johnnie was simple to identify: No more trick diets. Then she found a “buddy”— a friend for support. Working with someone else, or even a small group at times, helped keep her motivated—and kept her from feeling alone, isolated and bored.

Johnnie also changed her routine. She stopped sitting in front of the entertainment box. She started taking walks through her neighborhood. At first she got tired real fast, but little by little her resistance built up.

The third step came when Johnnie cut back on her portions of food at meal time. She soon was eating just half of everything that she used to have on her plate.

These small changes led to more changes—and even some goals. Johnnie decided to do more than just lose some pounds. She committed to getting fit and staying fit. Simply fitting into the clothes in the closet was no longer the goal. Johnnie wanted to be her ideal weight—she decided to dream of being mean and lean. Johnnie has decided that her long- term goal is nothing short of living healthier and longer.

There’s still a lot of work to do. Johnnie now reads more health magazines and wellness books. She even plans ahead for her meals. No more fast decisions—or fast food. Eating has become more enjoyable and meaningful for Johnnie. Her self-education about health and wellness has made her focus on healthy habits, changing her lifestyle.

The pounds are going away and staying away because Johnnie stopped playing games and threw that old yo-yo away.

(More about Johnnie next time).

RMJ is the author of “Afraid no More”

www.remajohnson.com

My 10-year-old son tracks the weather map each day and enjoys the predictability (colder temperatures in the winter) with the unpredictability (50 percent chance of rain). Such is the case for the flu season this year. We have the usual seasonal flu, which peaks in January and February and then nearly goes away in the summer months. And then there is the unpredictability of the H1N1 or swine flu.

The swine flu first occurred in Mexico this past spring and spread to North America. The World Health Organization soon declared it a pandemic. During June and July, it occurred at summer camps, which my children attended, yet luckily none became ill. But when schools began in the south in late August, a surge of cases began to occur. Hospitals had to set up tents in their parking lots as makeshift emergency rooms to triage sick children. The number of people coming into our clinics with flu-like illness was three to four times the usual for that time of year. Nearly all of the cases were suspected to be H1N1.

The H1N1 flu has been unpredictable. Now, according to the Centers for Disease Control and Prevention, the cases of flu-like illness have been decreasing in all parts of the nation.

From early findings, it appears to be very contagious and seems to transmit easily from person to person, unlike the bird flu, but much like the seasonal flu virus.

Additionally, from early findings, it does not appear to be highly virulent among the reported cases in the United States. The virus in most cases causes a mild illness, and most patients recover fully within a week or so, much like the seasonal flu virus and unlike the SARS virus.

It is unclear what will happen when the seasonal flu cases begin to occur in January and February. Will H1N1 cases come back or just go away altogether? Nobody knows, but my son is not worried. Three weeks ago, his school offered the nasal mist vaccine for H1N1. He and all his friends stood in line to be vaccinated. A few weeks earlier, he had his seasonal flu shot.

Studies show that the vaccine for H1N1 is 97 percent effective, and after 22 million doses there are no serious side effects. Also, the rates of flu vaccinations are lower among minority populations. Even though the cases of flu-like illness are decreasing, there is plenty of flu activity to make a non-vaccinated person very sick.

Even as the swine flu epidemic turns into a pandemic, I am reassured for a number of reasons.

First, the pandemic flu preparedness has been unprecedented, with the use of technology and local, state, national and international collaboration. I am on a daily afternoon conference call or webcast at cdc.gov with the Centers for Disease Control and Prevention, and I get routine CDC updates on Twitter.

I tell my son, there is a 50 percent chance of rain– so taking an umbrella–the vaccine–is a good idea.

Dr. Manoj K.Jain is an infectious-disease specialist in Memphis and an adjunct assistant professor at the Rollins School of Public Health at Emory University in Atlanta. He frequently writes health columns for the Washington Post.

Gift of Health is supported by grants from The California Endowment and California Community Foundation.