Friday, December 09, 2011

Early Intervention Program Reduces Youth Substance Abuse in WV

A pilot program in Logan and Mercer counties is cutting down on youth substance abuse in the Mountain State.

WV’s Substance Abuse Early Intervention Program (EIP) targets youth ages 12-18 who have just begun to use alcohol, tobacco, or other substances and/or are engaging in delinquent behavior often associated with
substance use. Since its inception in 2010, 65 youth have completed the program, which enhances accurate understanding of the risks of alcohol, tobacco, & other drug (ATOD) use and develops ATOD refusal skills.

The program also provides an alternative option for youth who may be on their way into the juvenile justice system.

“WV’s Early Intervention Program is appropriate for youth who fall BETWEEN the stages of needing primary prevention services and those who need actual substance abuse treatment,” says Jamie Albert, WV EIP Statewide Coordinator. “Youth in need of counseling, therapy or other treatment services are NOT appropriate candidates for the EIP.”

Youth are referred to the local programs by the WV Department of Health & Human Resources (WV DHHR), school personnel, the court system, and parents. EIP Specialists conduct a screening assessment with referred youth to confirm eligibility to participate. Youth who opt to participate and their parents attend separate two-hour orientation sessions. Youth then experience a 12 hour evidence-based prevention education course. Classes are usually six two-hour sessions over a two week period. The curriculum addresses the consequences of substance use and decision making skills. A parenting and wellness workshop is also available to parents.

WV’s EIP is based on a similar statewide initiative in Kentucky, which has proven to prevent teen substance use. A recent evaluation report on the pilot programs in Logan and Mercer counties confirms increased risk perceptions of substance abuse, increased disapproval substance abuse, and decreased intentions to further use drugs. The report is available at www.prevnet.org/earlyintervention/default.aspx.

WV’s EIP is funded by Drug Free WV grants (Purdue Pharma Asset Forfeiture Funds) and a federal Projects of Regional and National Significance grant. The program is administered by the WV Prevention Resource Center, an affiliate of Marshall University. Local contractors facilitate the EIP at the county level.

Bon Appétit: Shepherd Pie

Ingredients:

  1 pound ground beef
  1 (14.5 ounce) can green beans, drained
  1 (10.5 ounce) can cream of mushroom soup
  1/2 onion, diced
  1 cup shredded Cheddar cheese
  2 cups mashed potatoes

Directions:

Preheat an oven to 350 degrees F (175 degrees C).

Cook and stir ground beef in a skillet over medium-high heat until beef is browned, about 10 minutes.

Drain fat.

Mix in green beans, cream of mushroom soup, and onion.

Pour beef mixture into a 2 quart casserole dish and top with Cheddar cheese.

Spread mashed potato on top.

Bake in the preheated oven until the pie is hot, and the mashed potatoes are golden brown, about 30 minutes.

Ask the Doctor: Biking

DEAR DR. DONOHUE: Please answer this as soon as you can.
I am told that biking causes impotence.
I bike long distances every day and have been doing so for many years.
I don’t have this problem, and I don’t want to get it.
The source of this information was reliable.
I will stop biking if this is true. Is it? - W.W.

ANSWER: It’s possible.
Sitting for long times on a hard bicycle seat compresses nerves and blood vessels needed for an erection.
If this process is in its early stages, the biker gets a warning with numbness of the genitals.
The numbness leaves soon after finishing a biking session.
Even if full-blown erectile dysfunction occurs, taking a rest from biking restores potency.
However, the biker also needs to change the bike seat.

Thursday, December 08, 2011

AAA: West Virginia Gasoline Prices Drop 3.6 Cents More

In West Virginia gasoline prices fell 3.6 cents a gallon this week, bringing the current average price for a gallon of regular, unleaded gasoline to $3.324.

According to AAA’s Fuel Gauge, crude oil prices moved slightly higher to close at $100.99 per barrel for West Texas Intermediate (WTI) crude at close of Monday’s formal trading on the NYMEX.

Equities markets continued to surge on positive signs for the U.S. economy and renewed optimism that Europe may address its debt crisis.

These same factors, along with weakness in the U.S. dollar and geopolitical concerns with Iran, put upward pressure on oil prices as well.

Last week, global central banks unexpectedly announced a coordinated move to inject liquidity into the financial system and address what has been growing concern surrounding the debt crisis in Europe.

This news helped stock indices surge, with the Dow Jones Industrial Average posting its largest one-day gain in more than a year, and oil prices move higher as well.

The European Union and U.S. also announced they would tighten sanctions against Iran over that country’s suspect nuclear program.

The EU imported 450,000 barrels per day of crude oil from Iran last year and any news that escalates the situation beyond posturing could have a significant impact on crude prices.

Optimism that the U.S. economy is recovering was boosted by data on Friday showing a much better than expected jobs report.

A recovering U.S. economy would be expected to demand more crude oil and put upward pressure on crude prices.

This week’s average prices: West Virginia Average =  $3.324

Average price during the week of November 29, 2011 =  $3.360

Average price during the week of December 07, 2010 =  $3.026

Area Gasoline Prices on 12.07.11:

Arnoldsburg = $3.42

Buckhannon = $3.47

Burnsville = $3.47

Clarksburg = $3.29

Glenville = $3.49

Grantsville =  $3.39

Gassaway =  $3.47

Harrisville = $3.35

Jane Lew = $3.49

Parkersburg = $3.26

Pennsboro =  $3.35

Sutton =  $3.47

Weston =  $3.46

West Union =  $3.39

2011 Report Lists Best to Worst Run States in America

1. Wyoming (Best)

State debt per capita: $2,452 (18th lowest) percent without health insurance: 14.9% (21st highest) percent below poverty line: 10.3% (7th lowest) Unemployment: 5.8% (6th lowest).

Wyoming comes in first place in 24/7 Wall St.’s Best Run States for the second year in a row. The state has high marks in many categories including high school graduation rate. A whopping 92.3% of states residents age 25 or older have at least a high school diploma the highest rate in the country. The state also has the fourth lowest rate of violent crimes and the sixth lowest unemployment rate. Wyoming has the smallest population of any state in the country.

2. Nebraska

State debt per capita: $1,407 (4th lowest) percent without health insurance: 11.5% (14th lowest) percent below poverty line: 11.9% (tied for 14th lowest) Unemployment: 4.2% (2nd lowest).

The state of Nebraska had the 21st lowest revenue per capita in the country in 2009 yet managed to spend more per capita that year than all but seven states. The state has the fourth lowest debt per capita, and it is one of 13 states with a perfect AAA credit rating. Besides being financially sound, Nebraska also has an unemployment rate of 4.2%, the second lowest rate in the country. The state also has relatively low poverty, high graduation rates and the seventh lowest rate of foreclosures last month.

3. North Dakota

State debt per capita: $2,721 (20th lowest) percent without health insurance: 9.8% (9th lowest) percent below poverty line: 12.3% (17th lowest) Unemployment: 3.5% (the lowest).

One of the best measures of North Dakota’s success is its unemployment rate of 3.5%, the lowest in the country and one that has not been above 5% in over 20 years. While the state has relied on a stable agriculture sector to keep unemployment low, the booming oil industry has created a $1 billion surplus in the past three years. From 2009 to 2011 Montana was the only other state to report a surplus, according to the Center on Budget and Policy Priorities.

4. Minnesota

State debt per capita: $1,790 (8th lowest) percent without health insurance: 9.1% (4th lowest) percent below poverty line: 11.0% (10th lowest) Unemployment: 6.9% (14th lowest).

Minnesota moved up in the ranking from fifth to fourth due to its improvement in several categories, including violent crime rate and health insurance coverage. In 2010, just 9.1% of state residents were without health insurance coverage, the fourth best rate in the country. The state also continues to excel in the areas it did last year. Some 91.5% of the state’s adult population has graduated high school which makes it the second highest percentage in the country. The state also has the eighth lowest debt per capita.

5. Iowa

State debt per capita: $2,117 (13th lowest) percent without health insurance: 9.3% (6th lowest) percent below poverty line: 11.9% (tied for 14th lowest) Unemployment: 6% (8th lowest).

Iowa’s greatest assets are its rates of educated and insured residents. Some 90.6% of residents 25 years and older have at least a high school diploma and only 9.3% of residents do not have health insurance. These are among the best rates in the country. Iowa also has an exceptionally low unemployment rate and the highest credit rating available, demonstrating its healthy economy.

6. Utah

State debt per capita: $2,274 (15th lowest) percent without health insurance: 15.3% (20th highest) percent below poverty line: 11.5% (12th lowest) Unemployment: 7.4% (17th lowest).

Utah kept the same rank it had in the last survey. The state has the fifth-lowest violent crime rate in the country, as well as the seventh-highest graduation rate in the country. However, Utah had one of the higher foreclosure rates in the country in October, and 15.3% of the population (an above-average rate) is without health insurance.

7. Vermont

State debt per capita: $5,514 (9th highest) percent without health insurance: 8% (3rd lowest) percent below poverty line: 11.7% (13th lowest) Unemployment: 5.8% (5th lowest).

Vermont does extremely well in a number of areas considered for this list. Residents are highly educated, and Vermont has the second lowest rate of violent crime in the country. It also has the third lowest percentage of uninsured residents in the country. However, the state has saddled its citizens with debt; Vermont’s debt per capita is more than $5,500, which is the ninth highest in the country.

8. Virginia

State debt per capita: $3,100 (22nd lowest) percent without health insurance: 13.1% (20th lowest) percent below poverty line: 10.7% (8th lowest) Unemployment: 6.5% (10th lowest).

Virginia is the highest-ranked state in the southern U.S., largely because it does not suffer from many of the problems that plague the rest of the South. The state has a median income of $60,674, the eighth-highest in the country, as well as a poverty rate of 10.7%, which is the eighth lowest. The state also has the sixth-lowest violent crime rate in the country, with just 213 incidents taking place in 2010 for every 100,000 people.

9. Kansas

State debt per capita: $2,086 (10th lowest) percent without health insurance: 13.9% (24th lowest) percent below poverty line: 12.8% (tied for 21st lowest) Unemployment: 6.7% (12th lowest).

Kansas has the 10th-lowest state debt per capita in the country. However, the state’s ranking may change as its debt grows. According to The Hutchinson News, borrowing by school districts has increased over 800% since 1990. Kansas has a relatively low unemployment rate of 6.7% compared to the national rate of 9.1%.

10. South Dakota

State debt per capita: $4,485 (12th highest) percent without health insurance: 12.4% (18th lowest) percent below poverty line: 13.8% (25th highest) Unemployment: 4.6% (3rd lowest).

South Dakota rounds out the list of the 10 best-run states in the country. While the state is slightly below average in median income and poverty, otherwise things are going quite well in the state. South Dakota has the third-lowest unemployment rate in the country. It is also one of the few states to truly avoid the worst parts of the housing crisis. Just one in 4,352 homes was foreclosed in October — the fourth lowest rate in the country.

11. Maryland

State debt per capita: $4,133 (14th highest) percent without health insurance: 11.3% (13th lowest) percent below poverty line: 9.1% (tied for 2nd lowest) Unemployment: 7.4% (16th lowest).

Despite its relatively high state debt of $4,133 per person, Maryland has a credit rating of AAA, the highest available. The state also has a particularly low poverty rate. Only 9.1% of people are living below the poverty line which is the third lowest in the country. But, the number of Maryland residents in poverty increased by nearly 80,000 from 2009 to 2010, the paper notes.

12. Hawaii

State debt per capita: $5,328 (10th highest) percent without health insurance: 7.9% (2nd lowest) percent below poverty line: 10.0% (6th lowest) Unemployment: 6.4% (9th lowest).

Hawaii dropped two slots (from 10th to 12th) on our list because of the decline in median household income and an unchanged unemployment rate. However, the state’s overall picture is a positive one. Just 7.9% of state residents are without health insurance, the second-lowest rate in the country. Hawaii also ranks in the highest 10 for median household income, and among the lowest 10 in poverty and unemployment.

13. New Hampshire

State debt per capita: $6,357 (7th highest) percent without health insurance: 11.1% (12th lowest) percent below poverty line: 8.1% (the lowest) Unemployment: 5.4% (4th lowest).

New Hampshire has a poverty rate of only 8.1% the lowest in the country and down from 8.5% last year. The state also has the third lowest rate of violent crime and the fourth lowest unemployment rate. The state’s finances are not perfect, however. It has the seventh highest debt per capita and a credit rating of AA, which is two grades below the best. The state government is trying to address this problem.

On March 30, 2011, the New Hampshire House approved a bill that would make deep cuts to social and health programs and limit collective bargaining rights aimed at restricting how unions impact these programs.

14. Maine

State debt per capita: $4,092 (15th highest) percent without health insurance: 10.1% (10th lowest) percent below poverty line: 12.6% (20th lowest) Unemployment: 7.5% (18th lowest).

Maine has moved up three spots from last year’s ranking, partially because of improvements in health insurance coverage and unemployment. For the second year in a row, Maine sports the lowest violent crime rate in the country, at 122 incidents per 100,000 people. Fiscally, the state is not as sound as others. The state only has an AA credit rating. In the fiscal year 2009, the state had a debt of $4,092 per person, the 15th highest in the country.

15. Pennsylvania

State debt per capita: $3,331 (25th highest) percent without health insurance: 10.2% (11th lowest) percent below poverty line: 12.8% (tied for 21st lowest) Unemployment: 8.3% (24th highest).

Only 10.2% of Pennsylvania residents go without health insurance. This includes residents covered under “Adult Basic,” a state-funded health plan for low-income adults. This program was canceled early this year due to financial restrictions. In 2009, the state collected revenues of just over $3,000 per person. At the same time, it spent over $6,100 per person.

16. Wisconsin

State debt per capita: $3,707 (19th highest) percent without health insurance: 9.4% (7th lowest) percent below poverty line: 12.1% (16th lowest) Unemployment: 7.8% (21st lowest).

Wisconsin would perform much better on our list if it were not for its fiscal scores. The state only has an AA credit rating, and its $3,707 of state debt per capita is the 19th worst in the country. However, the state performs better than average in median household income, poverty rate and unemployment. Also, just 9.4% of the state’s population is without health insurance, a better rate than all but six states.

17. Washington

State debt per capita: $3,719 (18th highest) percent without health insurance: 14.2% (25th lowest) percent below poverty line: 12.5% (tied for 18th lowest) Unemployment: 9.1% (16th highest).

Washington State has moved down one slot from last year’s rank, partially due to an increase in unemployment and an increase in poverty rate. On the whole, the state performs better than average in most categories, including household income, violent crime rate and high school graduation. And while the state does not make it to the top 10 in any single category, it also avoids the bottom 10 in each.

18. Alaska

State debt per capita: $9,505 (2nd highest) percent without health insurance: 19.9% (4th highest) percent below poverty line: 9.1% (tied for 2nd lowest) Unemployment: 7.6% (19th lowest).

Alaska performs exceptionally well in a number of categories. It has the second lowest percentage of people below the poverty line and the fifth highest percentage of adults with high school diplomas. However, the state has the second highest debt per capita. It also has the second highest rate of violent crime.

19. North Carolina

State debt per capita: $2,138 (14th highest) percent without health insurance: 16.8% (17th highest) percent below poverty line: 16.2% (14th highest) Unemployment: 10.5% (8th highest).

North Carolina has jumped five spots compared to last year’s ranking, largely because of the substantial reduction in violent crime over the past year. The rate dropped from 467 violent crimes for every 100,000 residents in 2009, to 363 per 100,000 people in 2010. Despite a healthy budget, including a AAA credit rating and low debt per capita, North Carolina still performs worse than average in a number of categories, including high school graduation rate, unemployment, health insurance coverage and poverty.

20. Missouri

State debt per capita: $3,218 (24th highest) percent without health insurance: 13.2% (21st highest) percent below poverty line: 14.5% (tied for 21st highest) Unemployment: 8.7% (22nd highest).

Missouri has moved up five spots from last year’s rank of 24 partly because its unemployment rate has decreased from 9.3% to 8.7%. The state also boasts a AAA credit rating from S&P thanks to state efforts to fund its debts.

21. Delaware

State debt per capita: $6,796 (5th highest) percent without health insurance: 9.7% (8th lowest) percent below poverty line: 11.3% (11th lowest) Unemployment: 8.1% (23rd lowest).

Delaware has fallen 10 spots since last year’s ranking. It has the third highest rate of violent crime in the country, worse than it was last year. The state also has the fifth largest debt per capita. On the other hand, it has one of the lowest rates of residents without health insurance and a relatively small percentage of people living below the poverty line.

22. Connecticut

State debt per capita: $8,088 (4th highest) percent without health insurance: 9.1% (4th lowest) percent below poverty line: 9.7% (5th lowest) Unemployment: 8.9% (tied for 20th highest).

Connecticut is a relatively wealthy state with the fourth greatest median household income in the country. This is reflected in the tax and spending habits of its government. In 2009, the state collected the sixth largest amount in revenue per capita and spent the eighth largest amount. The state has the fourth lowest percentage of residents without health insurance, thanks in part to state programs such as Charter Oaks Health Plan and Husky Healthcare. However, the state ranks fourth worst when it comes to state debt, owing $8,088 per person.

23. Indiana

State debt per capita: $3,702 (20th highest) percent without health insurance: 14.8% (22nd highest) percent below poverty line: 14.2% (24th highest) Unemployment: 8.9% (tied for 20th highest).

Indiana ranks only 23rd on the list of best-run states, but that is a marked improvement from last year’s 29th spot. The state’s scores improved this year in unemployment, violent crime and the percentage of the state’s adult population with a high school diploma. The state still has a great deal of room for improvement, as it ranks in the bottom two-thirds for every single category except for credit rating.

24. Ohio

State debt per capita: $2,423 (17th lowest) percent without health insurance: 12.3% (17th lowest) percent below poverty line: 14.8% (17th highest) Unemployment: 9.1% (17th highest).

Ohio’s state revenue in the fiscal year of 2009 was the fourth-lowest in the country. In the same time period, the state spent $71 billion, nearly three times that amount per resident. Despite that fact, Ohio still has an AA+ credit rating and a below-average debt per capita. Ohio scores worse than average on unemployment, median income, foreclosures and poverty. The state does slightly better on graduation rates. Ohio also spends a higher portion of its budget on education than most states.

25. Texas

State debt per capita: $1,240 (2nd lowest) percent without health insurance: 23.7% (the highest) percent below poverty line: 17.0% (9th lowest) Unemployment: 8.5% (23rd highest).

Texas managed to spend the third least per capita in 2009, and as a partial consequence has the second lowest debt per capita, a mere $1,240 per person. Austere spending comes at a price. Nearly a quarter of the state’s residents are without health insurance. Also, only 80.9% of Texans 25 years or older graduated from high school. While this is an improvement from its 2003 rate of 77%, it is tied with California for worst among all states.

26. Idaho

State debt per capita: $2,284 (16th lowest) percent without health insurance: 17.7% (11th highest) percent below poverty line: 14.3% (23rd highest) Unemployment: 9% (19th highest).

Idaho has the seventh-lowest violent crime rate in the country, a manageable debt per capita and a AA+ credit rating. Otherwise, the state leaves much to be desired. It has the 11th highest rate of residents without health insurance coverage. It also had one of the highest foreclosure rates in the country last month. On a state and local level combined, Idaho spends less per capita than any state in the country on its population.

27. Montana

State debt per capita: $4,903 (11th highest) percent without health insurance: 17.3% (13th highest) percent below poverty line: 14.6% (tied for 19th highest) Unemployment: 7.7% (20th lowest).

Montana’s neighbor, Wyoming, has a debt per capita of $2,452 and an AAA rating. Montana state debt per resident is almost exactly double that and the state has an AA rating to show for it. Despite the fact that the state’s debt is higher, it actually spends significantly less per person in most key areas than Wyoming. The state has a high percentage of high school graduates among its adult population and a healthy housing market, but otherwise does relatively poorly. The state is worse than average in health insurance coverage and poverty. It also has the 11th lowest median household income in the U.S.

28. Oklahoma

State debt per capita: $2,689 (19th lowest) percent without health insurance: 18.9% (7th highest) percent below poverty line: 16.3% (tied for 13th highest) Unemployment: 5.9% (7th lowest).

Oklahoma has improved since last year’s ranking, moving up from 32nd place to 27th. One significant change has been the state’s improved unemployment rate, which fell from 7% last year to 5.9%. Many of these new job gains fall within the professional and business services category, a field which can be spurred or hindered by state taxes. Home prices in Oklahoma have increased just fewer than 18% since 2006. However, the state also has a fairly high percentage of residents without health insurance.

29. Tennessee

State debt per capita: $773 (the lowest) percent without health insurance: 14.4% (25th highest) percent below poverty line: 16.9% (10th highest) Unemployment: 9.8% (11th highest).

Tennessee has less debt per capita than any state in the country, a mere $773 per person. In contrast, Massachusetts’ debt per resident is $11,357. Because of its low debt, the state has earned a credit rating of AA+ by Standard & Poor’s. The state spends the second-least per capita each year, which is helpful in keeping its debt low, but it also means many programs go underfunded. For example, it spends less per capita than any state in the country on education. It also happens to have the 11th lowest percentage of adults with a high school diploma.

30. Massachusetts

State debt per capita: $11,357 (the highest) percent without health insurance: 4.4% (the lowest) percent below poverty line: 10.8% (9th lowest) Unemployment: 7.3% (15th lowest).

Massachusetts provides many benefits to its residents. For instance, as a result of its widely-talked about health insurance system, only 4.4% of people are uninsured — the lowest rate in the country. The state also spends a large amount on cash assistance for needy families and on pension benefits for retired state employees. To provide this much, however, the state must spend a lot. As a result, Massachusetts has the highest state debt per capita in the country.

31. Oregon

State debt per capita: $3,284 (15th lowest) percent without health insurance: 17.1% (15th highest) percent below poverty line: 14.6% (tied for 19th highest) Unemployment: 9.6% (14th highest).

In 2009, Oregon had the second-lowest revenue per capita and spent the 20th most per capita in the state budget. Oregon has a higher-than-average rate of adults with a high school education, as well as the 12th-lowest violent crime rate in the country. But the state otherwise performs quite poorly. Oregon has worse-than-average poverty rate, health insurance coverage and unemployment. Meanwhile, the state had the ninth-highest foreclosure rate in the country in October — one in every 455 homes.

32. Georgia

State debt per capita: $1,378 (3rd lowest) percent without health insurance: 19.7% (5th highest) percent below poverty line: 16.5% (11th highest) Unemployment: 10.3% (9th highest).

In the fiscal year 2009, Georgia’s revenue amounted to $3,419 per person, the 17th lowest revenue in the country. However, the state spent $4,217 per capita that year, the second-lowest expenditure per capita across all programs. The state spent just $984 per person that year on public welfare, the third-lowest amount in the country. This lack of spending contributed to the state’s poverty rate of 16.5%, the 11th highest in the country — and the nearly 20% without health insurance, the fifth highest percentage in the country.

33. Colorado

State debt per capita: $3,454 (23rd highest) percent without health insurance: 15.9% (18th highest) percent below poverty line: 12.5% (tied for 18th lowest) Unemployment: 8.3% (25th highest).

Colorado has dropped from 25th place last year to 33rd this year. The state is hurt in part by its housing market. One in every 458 housing units were foreclosed in October 2011. Still, the has a rate of education that is relatively higher than most other states with just under 90% of residents 25 and older finishing a high school education.

34. New York

State debt per capita: $6,288 (8th highest) percent without health insurance: 11.9% (15th lowest) percent below poverty line: 14.4% (22nd highest) Unemployment: 8% (22nd lowest).

New York State received the seventh greatest revenues per capita in the country and actually spent the sixth most per capita that same year. At $3,553, the state spends the fifth most per person on education. It also spends the most in the country on public welfare at $2,276 per person. However, this high spending has led to continuous fiscal problems in the state. New York has the eighth-highest debt per capita in the country as well as an S&P AA credit rating. Even with the high level of spending, New York falls short in many measurements.

It is worse than average in violent crime, high school graduation, poverty and decline in home value since 2006.

35. Arkansas

State debt per capita: $1,436 (5th lowest) percent without health insurance: 17.5% (13th highest) percent below poverty line: 18.4% (3rd highest) Unemployment: 8.2% (25th lowest).

Arkansas has the third highest rate of poverty in the country, which in turn hurts its ranking in other categories. It has the third lowest median household income. The state also has a low%age of residents with high school diploma compared to the other states, as well as a high rate of violent crimes. However, the state has the fifth lowest state debt per capita.

36. Alabama

State debt per capita: $1,738 (7th lowest) percent without health insurance: 14.6% (tied for 24th highest) percent below poverty line: 17.4% (7th highest) Unemployment: 9.8% (12th highest).

Alabama only has a AA credit rating, but it maintains one of the lowest debts per capita in the country, at just $1,738 per person. Also, foreclosures are near the average. Otherwise, the state performs among the worst in the country in nearly every considered metric. The state has the fifth-lowest median household income in the country, as well as a poverty rate of 17.4% — the seventh-highest in the country.

37. New Jersey

State debt per capita: $6,551 (6th highest) percent without health insurance: 13.2% (21st lowest) percent below poverty line: 9.5% (4th lowest) Unemployment: 9.2% (15th highest)

Despite having the second highest median household in the country, New Jersey performs poorly in a number of areas. Most notably, the state has the sixth highest state debt per capita. Its credit rating was also downgraded from AA to AA- in February 2011 due to concerns over its massive retirement obligations.

38. Mississippi

State debt per capita: $2,107 (12th lowest) percent without health insurance: 18.2% (9th highest) percent below poverty line: 21.8% (the highest) Unemployment: 10.6% (tied for 5th highest).

Mississippi has improved six slots from last year and is now out of the bottom 10. The state spends the 11th most in the country on public welfare, yet it remains the poorest in the country. Residents’ median income was just over $36,000 in 2010, with more than one in five living below the poverty line. Both of these statistics are the worst in the U.S. On the other hand, foreclosures in October were the fifth lowest in the country. Also, violent crime has dropped significantly in the state over the past year, from 304.6 incidents per capita in 2009 to 269.7 in 2010.

39. West Virginia

State debt per capita: $3,578 (22nd highest) percent without health insurance: 14.6% (tied for 24th highest) percent below poverty line: 17.6% (6th highest) Unemployment: 8.2% (24th highest).

West Virginia has the sixth highest percentage of people living below the poverty line in the country. It also has the eighth lowest percentage of adults with a high school diploma and the second lowest median household income of $38,218. The state also collects far more in revenue compared to other states, while it spends about an average amount.

40. Florida

State debt per capita: $2,104 (11th lowest) percent without health insurance: 21.3% (3rd highest) percent below poverty line: 15.0% (16th highest) Unemployment: 10.6% (tied for 5th highest).

Florida was hit hard by the housing crisis. Home values declined the third most-in the country between 2006 and 2010. In October, one in every 423 homes was foreclosed upon. The state spends very little relative to its budget, and so it maintains a low debt per capita and a AAA credit rating. However, its lack of expenditure on public welfare has not helped the state’s poor, unemployed and uninsured citizens.

The state had the sixth highest unemployment rate in the country in September. Also, 21.3% of Florida’s population in 2010 was without health insurance, the third-highest rate in the country.

41. New Mexico

State debt per capita: $4,004 (16th highest) percent without health insurance: 19.6% (6th highest) percent below poverty line: 18.7% (12th highest) Unemployment: 6.6% (11th lowest).

New Mexico has a relatively low unemployment rate of 6.6% compared with the national average of 9.1%. This is down from 8.6% one year ago. Other statistics are not as promising. At 18.7%, the state has the second highest poverty rate in the country. Worst still, almost 20% of New Mexicans do not have health insurance. The state also has the highest rate of violent crime in the country.

42. Louisiana

State debt per capita: $3,914 (17th highest) percent without health insurance: 17.8% (10th highest) percent below poverty line: 17.8% (5th highest) Unemployment: 6.9% (13th lowest).

Louisiana remains in our bottom 10 again this year, although it has improved since last year, primarily because of decreases in unemployment and violent crime rate. In all, however, the state ranks poorly in most of the metrics we considered. Louisiana has the fifth-highest poverty rate in the country, the 10th-highest percentage of residents without health insurance coverage and the fifth lowest percentage of adults with a high school diploma.

43. Rhode Island

State debt per capita: $8,716 (3rd highest) percent without health insurance: 12.2% (16th lowest) percent below poverty line: 12.8% (tied for 21st lowest) Unemployment: 10.5% (7th highest).

Rhode Island has many positive attributes, including low violent crime rate and a relatively low poverty rate. However, the state’s spending is exceptionally high, and it has accumulated $8,716 in debt per capita. Nearly 20% of expenditures are for public education, yet compared with other states it has the 10th lowest percentage of adults who have graduated from high school.

44. Kentucky

State debt per capita: $3,107 (23rd lowest) percent without health insurance: 15.3% (20th highest) percent below poverty line: 18.2% (4th highest) Unemployment: 9.7% (13th highest).

Last year, 24/7 Wall St. named Kentucky the worst-run state in the country. The state saw slight improvements in the percentage of its population with high school diplomas and poverty rate. Violent crime dropped significantly (now the 10th-lowest rate in the country) compared to the 17th-lowest last year. Despite these improvements, Kentucky remains one of the poorest states in the country, ranking among the five worst for median income and poverty rate. It is also one of just four states to be awarded an unfavorable AA- credit rating, the third worst score awarded to any state.

45. South Carolina

State debt per capita: $3,379 (24th highest) percent without health insurance: 17.5% (13th highest) percent below poverty line: 17.1% (8th highest) Unemployment: 11% (4th highest).

Fiscally speaking, South Carolina is relatively sound. It takes in the 27th most in revenue per capita and spends the 24th most in total expenditures per capita. Its state debt per capita is slightly below average. However, the state has the eighth highest poverty rate and the fourth highest unemployment rate. It also has the fifth highest rate of violent crime, with 597.7 crime committed per 100,000 people. This is actually an improvement from last year when the state’s violent crime rate was 731 per 100,000 — the worst in the country.

46. Nevada

State debt per capita: $1,690 (6th lowest) percent without health insurance: 22.6% (2nd highest) percent below poverty line: 13.0% (24th lowest) Unemployment: 13.4% (the highest).

Nevada has dropped five places in rankings. This drop is due primarily to its credit downgrade this year from AA+ to AA. Surprisingly, the state has one of the lowest debts per capita in the country, at just $1,690 per person. However, it has other financial woes that make it a long-term risk. Nevada properties declined 44.5% in value between 2006 and 2010, the worst decline in the country. In October alone, one in every 180 homes was foreclosed upon, easily the worst rate in the country. The state also has the second lowest percentage of residents covered by health insurance and the highest unemployment rate in the country.

47. Arizona

State debt per capita: $1,882 (9th lowest) percent without health insurance: 16.9% (16th highest) percent below poverty line: 16.3% (tied for 13th highest) Unemployment: 9.1% (18th highest).

Arizona’s housing market was one of the worst hit in the country during the housing crisis. Home values have dropped 28.6% since 2006, the fourth worst rate in the country. In October 2011, one in every 259 housing units were foreclosed upon, which was the third worst rate that month in the U.S. Arizona also has one of the lowest credit scores in the country after its downgrade to AA- in 2009.

48. Michigan

State debt per capita: $2,963 (21st lowest) percent without health insurance: 12.4% (18th lowest) percent below poverty line: 15.7% (15th highest) Unemployment: 11.1% (3rd highest).
Michigan has arguably suffered more than any state in post-industrial America. The state is one of just four with a credit rating of AA-, although its debt per capita is actually below average. The state ranks among the worst in the country for violent crime, unemployment, foreclosures and home price decline.

49. Illinois

State debt per capita: $4,424 (13th highest) percent without health insurance: 13.8% (23rd lowest) percent below poverty line: 13.1% (25th lowest) Unemployment: 10% (10th highest).

Illinois has fallen from 43rd last year to the overall second-worst run state in the country. The state performs poorly in most categories, but is worst when it comes to its credit rating. Illinois has a credit rating of A+, the second worst given to any state, behind only California. The state has been on credit watch since 2008 because of budget shortfalls and legal challenges against then-governor Rod Blagojevich.

50. California (Worst)

State debt per capita: $3,660 (21st highest) percent without health insurance: 18.5% (8th highest) percent below poverty line: 14.5% (tied for 21st highest) Unemployment: 11.9% (2nd highest).

California has moved down one slot on from last year to earn the title of the worst-run state in the country. In the fiscal year 2009, the state spent $430 billion, roughly 14% of all the money spent by states in that year. Compared to its revenue, the state spent too much.

California had the 10th lowest revenue per person, and spent the 15th most per person. California is the only state in the country to be rated A-, the lowest rating ever given to a state by S&P. Despite the huge amount the state spends each year, conditions remain poor. California has the second-lowest percentage of adults with a high school diploma in the country, the second-highest foreclosure rate and is tied for the second highest unemployment rate in the U.S.

A Proposal in MonPower Rate Case

West Virginia Public Service Commission is considering a proposed settlement in a rate case filed by FirstEnergy, the parent company of MonPower.

The agreement will increase rates for customers by 3.5%.

West Virginia Consumer Advocate Byron Harris says the company was seeking a 4.5% increase.

Harris agreed with the settlement amount.

“In any settlement you never get everything you hope you could get, but I think it’s a reasonable settlement and probably about where the Commission would come out on the case,“ Harris said.

The case has to do with the increased cost for MonPower when it comes to the purchase of coal and buying additional power off the electric grid.

MonPower’s average residential customer would see their monthly bill go up $3.46 to $99.34.

Harris says there are several other things he likes about the case including long-term phase-in implications that will help keep rates down lower in the future.

“All in all I think it’s a reasonable outcome,“ he said.

Harris says this type of cases is difficult for his office to defend because it’s based on what the company has already spent.

“Trying to recreate what could have happened is a relatively high hurdle for the advocates representing customers,“ he said.

The state PSC hasn’t yet approved the settlement.

The company would like to have the rate increase go into effect January 01, 2012.

MonPower serves nearly 390,000 customers in West Virginia.

Bon Appétit: Old Fashioned Coconut Pie

Ingredients:

  3 cups half-and-half
  2 eggs
  3/4 cup white sugar
  1/2 cup all-purpose flour
  1/4 teaspoon salt
  1 cup flaked coconut, toasted
  1 teaspoon vanilla extract
  1 (9 inch) pie shell, baked
  1 cup frozen whipped topping, thawed

Directions:

In a medium saucepan, combine half-and-half, eggs, sugar, flour and salt.

Bring to a boil over low heat, stirring constantly.

Remove from heat, and stir in 3/4 cup of the coconut and the vanilla extract.

Pour into pie shell and chill 2 to 4 hours, or until firm.

Top with whipped topping, and with remaining 1/4 cup of coconut.

Note: To toast coconut, spread it in an ungreased pan and bake in a 350 degree F (175 degrees C) oven for 5 to 7 minutes, or until golden brown, stirring occasionally.

Ask the Doctor: Elevated Triglycerides

DEAR DR. DONOHUE: My triglycerides are elevated.
They are in the range of 193 (2.18).
Are my high triglycerides being caused by my medicines?
I weigh 200 pounds and am 5 feet 9 inches. - G.B.

ANSWER: Triglycerides are fats.
They work in concert with cholesterol to clog arteries, but the main focus of attention still remains on LDL cholesterol, bad cholesterol.
The ideal triglyceride reading is less than 150 mg/dL (1.69 mmol/L).
Your reading is in a range called borderline high, not an eyebrow-raising number.
Of your five medicines, the only one that might raise triglycerides is hydrochlorothiazide, a water pill.
However, your dose is so small that I don’t believe it’s contributing to your triglyceride elevation.
Rather than adding any new medicine to your list, make some life changes.
Greatly reduce sugar intake and go easy on alcohol.
If you lose 5% to 10% of your body weight, your triglycerides will drop.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Wednesday, December 07, 2011

Bon Appétit: Cranberry Streusel Pie

Ingredients:

  1 pound fresh cranberries
  3/4 cup white sugar
  1/4 cup all-purpose flour
  1/2 cup packed brown sugar
  1/2 cup walnuts
  1/4 cup all-purpose flour
  1 teaspoon shortening
  1 recipe pastry for a 9 inch single crust pie

Directions:

Smash berries.

Stir in sugar and 1/4 cup flour.

Pour filling into pie crust.

Smash walnuts into small pieces.

Stir in brown sugar, 1/4 cup flour, and shortening with a pastry blender.

The mixture should be crumbly.

Sprinkle over pie.

Bake at 350 degrees F (175 degrees C) for 45 minutes, or until done.

Ask the Doctor: Pounding Heart

DEAR DR. DONOHUE: For several years my wife had unpredictable, short episodes of a “pounding heart.“
She had EKGs, but never during an episode.
They were normal.
Her heart doctor ordered a LifeWatch monitor that records heart action for three weeks.
It showed that my wife had attacks of atrial fibrillation.
She had to have a pacemaker and is now feeling better than she has in several years. - E.F.

ANSWER: Long-term cardiac monitoring has been a godsend for people who have transient attacks of heart symptoms, like your wife did.
Your wife’s experience informs many people of a device that could be diagnostically lifesaving for them.

Tuesday, December 06, 2011

Bon Appétit: Brussels Sprouts with Mustard

Ingredients:

  2 tablespoons cornstarch
  1/4 cup water
  1 (14.5 ounce) can chicken broth
  1 pound Brussels sprouts
  2 teaspoons prepared Dijon-style mustard
  2 teaspoons lemon juice

Directions:

Dissolve cornstarch in 1/4 cup water, and set aside.

In a medium saucepan over medium heat, bring chicken broth to a boil.

Add Brussels sprouts, and cook until tender.

Strain, reserving chicken broth, and place Brussels sprouts in a warm serving dish.

Return chicken broth to stove, stir in mustard and lemon juice, and return to boil.

Add cornstarch mixture.

Cook and stir until thickened.

Pour over Brussels sprouts to serve.

Ask the Doctor: Prolotherapy

DEAR DR. DONOHUE: What is your opinion of prolotherapy?
I have quite severe osteoarthritis in both thumbs and have been receiving cortisone injections for it.
I was told that prolotherapy would be more effective than cortisone and that the relief would be longer-lasting. - B.N.

ANSWER: Prolotherapy involves the injection of various substances around damaged ligaments and tendon attachments.
It triggers inflammation.
The inflammation, in turn, promotes healing by stimulating collagen formation.
Often the material injected is dextrose (sugar) mixed with lidocaine (an anesthetic).
Some reports say that it is quite successful in things like tennis and golf elbow, where the pain comes from ligament tears.
Other reports question its efficacy. It won’t hurt you.
I find it hard to believe it is more effective than cortisone for the inflammation of arthritis.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Monday, December 05, 2011

Manchin’s Message from the Hill to the Mountains: PROTECTING SOCIAL SECURITY FOR FUTURE GENERATIONS

Last week, the debate in Washington was over whether or not we should extend and expand a payroll tax cut that would have cost more than $240 billion in a year.

But the debate ignored one simple fact: Americans pay for one thing with our payroll tax.

One.

Social Security.

Social Security isn’t just another government program. It was established in 1935 to provide economic security for our nation’s seniors who worked hard and earned their retirement benefits. They worked their whole lives to create a better and greater America.

Right now, Social Security is in trouble. By 2037, according to the trustees, if we don’t do anything, benefits for everyone will have to be cut by 22%.

And yet we’re talking about digging a deeper hole by destabilizing its funding.

All in return for what? A temporary measure that has already cost nearly $120 billion and has – at best – created few, if any, jobs.

In the real world, when policy doesn’t work, you stop and try something else. Apparently, in Washington, you double down.

That doesn’t make any sense to me and it doesn’t make sense to the good people of West Virginia.

If the payroll tax cut were to be extended as it stands now, the average family in West Virginia would pay $14 less per week. For a lot of people, that’s a lot of money.

But the few West Virginians who even realize that they’re getting that help say that they would gladly give it up in return for a reliable Social Security safety net – or for meaningful tax reform that cuts rates across the board and ensures that every American, especially the wealthy, will start paying their fair share.

Let me be clear. As a country, we can’t expect that Social Security will remain secure if we keep telling Americans that we don’t have to pay for it – and that is exactly the conclusion people will reach if we keep reducing their contributions.

We tried this payroll tax cut last year, and I supported it. But I will not double down on a failed policy – especially one that jeopardizes the future of Social Security.

As for taxes, don’t get me wrong. I don’t want to see Americans paying higher tax rates.

I simply want a commonsense tax system that ensures that everyone pays their fair share, especially the wealthy, who have benefited the most from our failed tax system.

I want tax reform that lowers rates for everyone as we close the loopholes, credits and offsets that allow some corporations and some Americans to avoid paying their fair share.

At this critical moment in our history we must get our financial house in order, and letting Americans believe that we don’t have to pay for Social Security is wrong.
So, I did not vote for either the Democratic or the Republican proposal to extend the payroll tax cuts.

Looking forward, for the sake our nation, I hope that we will begin to work on a proposal that makes the hard decisions, while also protecting the programs and commitments we value as a nation. The best path forward, I believe, is based on the bipartisan framework and recommendations outlined in the Bowles-Simpson proposal, which strives to cut our deficits in responsible and balanced manner.

It is not perfect. No plan is. I do not agree with everything it proposes, but no plan can be everything to everyone.

But I will continue to urge our President and the leadership of both Chambers to support any and all efforts to enact these recommendations.

I don’t want to be part of the first generation that leaves this great nation in worse shape for the next generation. And I don’t think that any Member of Congress or our President wants to fail the next generation, either.

I ask that we all remember the great opportunity we have before us to do what is right.

Bon Appétit: No Bake Pumpkin Pie

Ingredients:

  1 (9 inch) prepared graham cracker crust
  1 (.25 ounce) package unflavored gelatin
  1 teaspoon ground cinnamon
  1/2 teaspoon ground ginger
  1/2 teaspoon ground nutmeg
  1/2 teaspoon salt
  1 (14 ounce) can sweetened condensed milk
  2 eggs, beaten
  1 (15 ounce) can pumpkin puree

Directions:

In a heavy saucepan combine gelatin, cinnamon, ginger, nutmeg, and salt.

Stir in condensed milk and beaten eggs, mixing well.

Let stand one minute, then place on burner over low heat, stirring constantly for about 10 minutes, or until gelatin dissolves and mixture thickens.

Remove from heat.

Stir in pumpkin, mixing thoroughly, and pour mixture into graham cracker crust.

Chill for at least 3 hours before serving.

Ask the Doctor: Infertility Increases with Age

DEAR DR. DONOHUE: I’m having my first child at the age of 35.
Will you comment on the risks involved at this age?
I am healthy and exercise and I’m at a good weight. - B.T.

ANSWER: I’ll start by quoting a respected gynecologist: “The decade between 25 and 35 is the ideal time to have a child.“
Infertility increases with age.
You are not suffering from that.
Ectopic pregnancies, pregnancies that result in fetal development outside the uterus, as in the ovarian tubes, increase with age.
Miscarriages are more common at older ages.
The possibility of chromosomal abnormalities also increases with aging.
However, 35 is not old age.
Women older than 45 usually have good outcomes from their pregnancies.
If you’re worried that age 35 presents a problem during the delivery of a child, it doesn’t.
Furthermore, you are in excellent shape, so you ought not to have any trouble at all.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Sunday, December 04, 2011

Payroll Tax Cut To Help Families, Create Jobs

Senator Jay Rockefeller voted in favor of a bill that would cut payroll taxes for more than 900,000 West Virginia families next year.  The plan failed tonight in the Senate.

“I support this provision for a simple reason: it puts money into the paychecks of ordinary, working families, will assist small businesses, and can spark job creation across the country,” said Rockefeller.

“My overriding goal, as this year comes to a close, has been helping struggling West Virginians and finding ways to create jobs and new opportunities.  The payroll tax cut is a sensible way to do that and I am proud to vote for it.  Economists estimate this provision would create more than 1 million new jobs – and potentially save many more.  Moreover, my support for this provision is based on my confidence that the Social Security Trust Funds are fully protected.  Despite what critics say, the legislation specifically requires that the Social Security Trust Funds not be affected by the payroll cut.

“It’s unfortunate that we were unable to reach consensus on a bill that helps each American who is struggling financially.  I will continue to fight to prevent this tax hike from taking place.  My hope is that we can regroup and reach a deal on extending the payroll tax holiday – along with an extension of unemployment benefits – by the end of this year.”

The current two-percent payroll tax break is scheduled to expire at the end of this month.  The new bill would continue the payroll tax cut for employees into next year, and boost it to a 3.1 percent break.  The bill would also cut in half the employer-side Social Security payroll taxes. The average taxpayer would see an extra $1,500 in their paycheck next year.  For example, Dan, a married father of two from Milton, told Rockefeller’s office that he wants to see this tax cut extended because it would help him provide for his children and pay for the specialized speech care his son needs.

Without this bill, Dan will have to pay at least $1,000 more in taxes instead of using that money for his family.  Not only would this bill prevent a tax hike, but it would also increase the amount that families like Dan’s take home by $500, putting a total of about $1,500 back in families’ pockets so that they can pay their bills, put food on the table, and afford medical expenses.

The bill is fully paid for by closing tax breaks and loopholes for millionaires and billionaires.

Key Provisions Of The Middle Class Tax Cut Act Of 2011:

• The legislation is fully paid for and protects Social Security.   That means that the Social Security Trust Funds will not lose one nickel because of this tax cut for working families.  The Social Security Trust Funds are U.S. Treasury bonds, among the safest investments in the world.  The Social Security Trust Funds are secure until 2036 according to the Trustees Report.

• Provides Tax Cut to 160 Million Workers.   The bill cuts in half (from 6.2% to 3.1%) the Social Security payroll tax paid by employees and the self-employed on their wages and salaries for 2012.  Approximately 160 million workers throughout the country and 900,000 West Virginians will benefit from this tax cut, with the average family seeing nearly $1,500 in additional take-home pay.

• Cuts the Payroll Tax in Half for 98% of U..S. Businesses.   The bill cuts in half (from 6.2% to 3.1%) the Social Security payroll tax paid by employers on the first $5 million of taxable payroll for 2012.  This will benefit all businesses, but 98% of businesses will see their portion of the Social Security payroll tax cut in half.

• Gives an Added Incentive for Businesses to Hire New Workers. The bill completely eliminates (from 6.2% to 0%) the Social Security payroll tax paid by employers on the first $12.5 million of an employer’s increased taxable payroll for the 4th quarter of 2011 and $50 million in increased payroll for 2012.

• Closes Tax Breaks and Loopholes for Millionaires Without Adding a Dime to the Deficit.   In order to create or save hundreds of thousands of jobs and prevent a tax hike that would impact 160 million American workers, the bill imposes a 3.25% surtax on incomes over $1 million.  The surtax is effective for taxable years beginning after December 31, 2012.

Recalls - 12.02.11

HALLOWEEN FLASHLIGHTS

Nygala Corp. is recalling Halloween Projection Flashlights sold from August 2010 to October 2011.

The flashlights can overheat, blister and melt, posing fire and burn hazards.

The black and orange plastic flashlight is 6 ½ inches long and has pumpkins, bats, witches, haunted houses and cats on the handle.

The flashlights come with six different plastic lenses that attach to the flashlight to project various images, including a pumpkin, bat, witch, haunted house and cat. “Flomo,” “HW189” and UPC 677916518266 are printed on the packaging.

Consumers should return the flashlights to the store where purchased for a full refund.

Consumers can also contact Nygala Corp. at 800.445.5936 between 9:00 AM and 5:00 PM ET Monday through Friday or visit www.flomousa.com.

BATTERY CASES FOR IPHONE

Best Buy is recalling Rocketfish™ Model RF-KL12 Mobile Battery Cases for iPhone 3G and 3GS sold nationwide and in Canada from April 2010 to September 2011.

The battery case can overheat while charging, posing a fire hazard.

This recall includes the Rocketfish™ Model RF-KL12 Mobile Battery Case.

The model number “RF-KL12” appears on the front of the product’s packaging, on the packaging barcode, and in white print on the curved inner surface of the product.

Consumers should contact Best Buy at 800.917.5737 between 8:00 AM and 8:00 PM any day, or visit www.bestbuy.com (US) or www.bestbuy.ca or www.futureshop.ca (Canada) for instructions on returning the product and receiving a Best Buy gift card.

EXTERNAL BATTERY CASES

Mophie LLC is recalling iPod Touch Rechargeable External Battery Cases sold nationwide since April 2011.

The battery case’s integrated circuit switch can overheat, posing a burn hazard.

The recalled product is a Mophie Juice Pack Air rechargeable external battery which consists of a lithium polymer battery built into a plastic case designed to snap onto the back of an iPod Touch 4G music player.

Only battery cases with serial numbers that have the first five alphanumeric characters of TR113 through TR120 are subject to this recall.

The serial number can be found inside the housing of the product.

Consumers should contact Mophie at 877.308.4581 between 9:00 AM and 5:00 PM ET Monday through Friday or visit www.mophie.com/exchange for instructions on receiving a replacement product.

Bon Appétit: Chicken Broth in a Slow Cooker

Ingredients:

  2 1/2 pounds bone-in chicken pieces
  6 cups water
  2 stalks celery, chopped
  2 carrots, chopped
  1 onion, quartered
  1 tablespoon dried basil

Directions:

Place the chicken pieces, water, celery, carrots, onion, and basil in a slow cooker.

Cook on Low setting for 8 to 10 hours.

Strain before using, and discard vegetables.

Chicken may be removed from the bones, and used in soup.

Ask the Doctor: Earache on an Airplane

DEAR DR. DONOHUE: A while back, you had information in your column about ear trouble while on a plane. Last spring, we went on an airplane for my grandson’s graduation.
On the flight back, my granddaughter got a terrible earache.
I had the same trouble a year previously.
She was crying, and we didn’t know what to do.
What causes this, and what can be done for it? - B.L.

ANSWER: The earache comes from an imbalance of pressure on the outside and inside of the eardrum.
It happens on ascent and descent, but it’s more common on descent.
The pressure imbalance pushes the eardrum inward.
That is painful.
Hundreds of readers wrote to me about EarPlanes Ear Plugs, found in many drugstores.
These earplugs lessen pressure on the eardrum.
I’m convinced they work well.
Other tricks to equalize pressure include repeated yawning, gum-chewing and plugging the nose between thumb and index finger while forcing air out of the nose.
Get the EarPlanes.
I believe they’ll solve your trouble.

Saturday, December 03, 2011

Gilmer County Farmers’ Market Holiday Market - This Saturday - 12.03.11

The Holiday Farmers’ Market will feature fresh wreaths, trees, and garland again this year.

There will be Crafts, Baked Goods, and Fresh Fruit.

Apples are available by the bushel ranging in price from $22-$26 per bushel depending on the variety. Of course they are also available by the pound.

We will have Holiday Grapes, Grapefruit, Oranges and Tangerines.

Don’t forget to get your Jams and Jellies for the Holiday at the Market.

Be sure to check your Honey supply and come on out and purchase for the winter.

The Baptist Church Cancer Fund ladies will also with us this year again.  They will have soup and sandwiches, as well as baked goods.  Also they will have soups by the quart again this year.

Come join us for the festivities.

Thanks to all our vendors this year for providing us the opportunity to “Buy Fresh Buy Local”.

Greater thanks go out to the dedicated customers who come to purchase and enjoy the socialization.

Again thanks to everyone.

Bon Appétit: Turkey a la King

Ingredients:

  2 tablespoons butter
  3 fresh mushrooms, sliced
  1 tablespoon all-purpose flour
  1 cup chicken broth
  1/2 cup heavy cream
  1 cup chopped cooked turkey
  1/3 cup frozen peas, thawed
  salt and pepper to taste

Directions:

In a large skillet over medium low heat, cook butter until golden brown.

Saute mushrooms until tender.

Stir in flour until smooth.

Slowly whisk in chicken broth, and cook until slightly thickened.

Stir in cream, turkey and peas.

Reduce heat to low, and cook until thickened.

Season with salt and pepper.

Ask the Doctor: Walking

DEAR DR. DONOHUE:
My husband and I have started walking every evening.
It’s our way of staying in shape. I like it.
My husband actually listens to what I have to say when we walk.
There is one thorn in my side.
My husband insists that I don’t walk correctly, and he is constantly giving me ways to change my walking style.
It’s extremely irritating. I have been walking the way I walk since I was an infant.
Is there really a special way to do so? - R.C.

ANSWER: Most people develop a walk natural for them, and there’s nothing wrong with that.
Some general pointers about the proper walking style are worth incorporating into your walking pattern.
Keep your head erect with eyes focused about 20 feet in front of you.
Your arms should be bent at the elbow.
When the right foot hits the ground, the left arm should be in front of your body, and vice versa when your left foot hits the ground.
The heel of the foot should strike the ground first, and the liftoff should come from the toes.
Older people tend to shorten their walking stride in an attempt to keep both feet always on the ground.
This gives them more balance and stability.
They should try to take a little longer stride and use their arms for balance and stability as I described above.

Friday, December 02, 2011

West Virginia Suspends Enrollment in In-Home Care Program

Elderly and disabled West Virginia residents who apply for a state in-home care program will be put on a waiting list because of funding concerns.

The state Bureau of Medical Services has notified care providers that applications for the Aged and Disabled Wavier program won’t be accepted after December 05, 2011, media outlets reported Thursday.

The program provides in-home care to seniors and the disabled who might otherwise go to nursing homes.

Enrollment will be capped at 8,130 participants statewide because of a reduction in federal Medicaid matching funds and rising costs, said John Law, spokesman for the Department of Health and Human Resources.

“We cannot expand optional Medicaid services when the state’s federal match is decreasing, the entire Medicaid funding structure is being debated on the national level and Medicaid is scheduled to add 140,000 members beginning in 2014,“ Law said.

Federal matching Medicaid funds fell from 83.05% in 2010, which included a one-time infusion of stimulus money, to 76.62% this year.

The federal match will decline again in October 2012 to 72.04%.

The reduction of federal matching funds comes as the program’s cost sand demand for services increase.

Since 2007, the per-person, per-year costs of providing in-home care has risen by more than $2,000. Enrollment has increased from 4,700 to more than 8,000.

“There are so many things in Medicaid you can’t do, we can take a step without cutting anybody from the waiver,“ Law said. “We’re not reducing any services, we’re not freezing any rates — all three of those things are happening in states around the country. We are merely stopping the expansion.“

Governor Earl Ray Tomblin wants to preserve services for those already enrolled in the program, spokeswoman Jacqueline Proctor said.

Delegate Don Perdue, D-Wayne, said capping enrollment in the program is “penny wise and pound foolish.“

“Because what happens with those folks is if they can’t get alternative services, their only alternative is to go to the nursing home,“ Perdue said.

Law said state officials do not know how many people would go into a nursing home without the program.

The state last capped enrollment in 2009 but resumed accepting applications following an outcry by participants, advocates and lawmakers.

Bon Appétit: Leftover Turkey Pot Pie

Ingredients:

  2 cups frozen peas and carrots
  2 cups frozen green beans
  1 cup sliced celery
  2/3 cup butter
  2/3 cup chopped onion
  2/3 cup all-purpose flour
  1 teaspoon salt
  1 teaspoon ground black pepper
  1/2 teaspoon celery seed
  1/2 teaspoon onion powder
  1/2 teaspoon Italian seasoning
  1 3/4 cups chicken broth
  1 1/3 cups milk
  4 cups cubed cooked turkey meat - light and dark meat mixed
  4 (9 inch) unbaked pie crusts

Directions:

Preheat an oven to 425 degrees F (220 degrees C).

Place the peas and carrots, green beans, and celery into a saucepan; cover with water, bring to a boil, and simmer over medium-low heat until the celery is tender, about 8 minutes.

Drain the vegetables in a colander set in the sink, and set aside.

Melt the butter in a saucepan over medium heat, and cook the onion until translucent, about 5 minutes.

Stir in 2/3 cup of flour, salt, black pepper, celery seed, onion powder, and Italian seasoning; slowly whisk in the chicken broth and milk until the mixture comes to a simmer and thickens.

Remove from heat; stir the cooked vegetables and turkey meat into the filling until well combined.

Fit 2 pie crusts into the bottom of 2 9-inch pie dishes.

Spoon half the filling into each pie crust, then top each pie with another crust.

Pinch and roll the top and bottom crusts together at the edge of each pie to seal, and cut several small slits into the top of the pies with a sharp knife to release steam.

Bake in the preheated oven until the crusts are golden brown and the filling is bubbly, 30 to 35 minutes.

If the crusts are browning too quickly, cover the pies with aluminum foil after about 15 minutes.

Cool for 10 minutes before serving.

Ask the Doctor: Fingers with Paronychia

DEAR DR. DONOHUE: I have had two fingers with paronychia for more than a year.
A dermatologist has prescribed Prevex HC and it has helped somewhat, but there is still swelling and redness around the cuticle of those fingers.
I wear rubber gloves for household chores.
What causes paronychia, and is there a more effective treatment? - L.T.

ANSWER: You have chronic paronychia (PEAR-oh-NICK-ee-uh).
It’s an infection of the skin border that frames the fingernail and toenail.
Housewives, cooks, bartenders and people who have their hands constantly in water are the ones who develop this problem.
Cotton gloves worn under your rubber gloves afford greater protection.
In chronic paronychia, yeasts and bacteria are the culprits.
Econazole and clotrimazole creams along with your Prevex HC might turn the tide in your favor.
Prevex HC contains hydrocortisone. This product isn’t available in the U.S.

Dr. Donohue regrets that he is unable to answer individual letters. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475.

Thursday, December 01, 2011

AAA: Gasoline Prices Drop More 5 Cents in WV, But Not Locally

The current average price for a gallon of regular, unleaded gasoline in West Virginia is $3.360, down 5.3 cents per gallon from a week ago.

According to AAA’s Fuel Gauge, crude oil prices were up 96 cents Monday at the close of formal trading on the NYMEX finishing at $97.73, erasing the brief drop in prices that occurred last week.

The increase followed positive retail sales news indicating consumers spent more than $52 billion over the weekend, a nine percent increase from last year.

In addition to the holiday retail sales, crude prices followed an overall climb in the stock market in the wake of better economic news from Europe.

Analysts pointed to reports that European countries are participating in discussions to fortify the tenuous sovereign debt situation in the euro zone as a reason for optimism that, rather than split apart, the European Union (EU) may be moving to strengthen ties.

In particular, France and Germany, the two largest and most financially secure nations of the EU, are pushing towards a financial accord in advance of a December 09, 2011 summit which may have significant consequences for the euro zone.

The euro strengthened against the dollar today providing added impetus for crude prices.

Crude oil futures are priced in U.S. dollars.

Prices were also pressured higher in response to a number of developments in the Middle East.

Several reports indicate that the EU may consider banning all oil imports from Iran in the wake of a recent United Nation’s report that Iran might be developing a nuclear weapons system.

According to the Energy Information Administration (EIA), Iran is the second-largest oil producer in the Organization of Petroleum Exporting Countries (OPEC) and the EU is only second to China in terms of consuming Iranian oil.

EU Ministers are scheduled to meet later this week to determine what course of action is to be taken.

The current national retail average price for a gallon of self-serve regular gasoline is $3.295, which is 4.5 cents less than last week, 15.1 cents less than a month ago, but 43.8 cents more than the price one year ago.

This week’s average prices: West Virginia Average =  $3.360

Average price during the week of November 22, 2011 =  $3.413

Average price during the week of November 30, 2010 =  $2.921

Area Gasoline Prices on 11.30.11:

Arnoldsburg = $3.42

Burnsville = $3.49

Glenville = $3.49

Grantsville =  $3.39

Gassaway =  $3.49

Harrisville = $3.39

Jane Lew = $3.49

Linn = $3.49

Pennsboro =  $3.39

Sutton =  $3.49

Weston =  $3.49

West Union =  $3.39

West Virginia Affordable Health Care Promotes U.S. Health Care Law’s Savings

The federal health care overhaul has saved more than 25,000 West Virginians more than $13 million so far this year.

West Virginians for Affordable Health Care cited those figures and others Wednesday, hoping to increase support for the federal law.

The overhaul’s many provisions include several that improve Medicare coverage of prescription drugs.

One is gradually closing a coverage gap known as the doughnut hole.

West Virginia has the second-highest percentage of Medicare recipients among the states.

Group officials said the $13 million reflects the reduced cost of nearly 193,000 drug prescriptions.

The group says most of the savings reflects discounts by brand-name drug makers.

The federal overhaul remains a subject of debate in West Virginia.

Critics want the state to join ongoing efforts to repeal or overturn it.

Bon Appétit: Pumpkin, Spinach, and Feta Frittata

Ingredients:

  4 cups cubed fresh pumpkin
  1 (10 ounce) potato, peeled and coarsely chopped
  4 1/2 ounces fresh spinach, chopped
  7 ounces crumbled feta cheese
  3/4 cup shredded Cheddar cheese
  8 eggs, lightly beaten
  1 small red onion, thinly sliced

Directions:

Preheat oven to 400 degrees F (200 degrees C).

Lightly grease a 10-inch square baking dish and line it with parchment paper.

Place the pumpkin in a microwave-safe bowl; cover and cook in microwave on full power, stirring halfway through cooking time, until tender, about 5 minutes.

Place the potato in a microwave-safe bowl; cover and cook in microwave on full power until tender enough to pierce with a fork, about 4 minutes.

Combine the pumpkin and potato in a large bowl.

Add the spinach, feta cheese, Cheddar cheese, and eggs; stir.

Transfer mixture to prepared dish; top with sliced onion.

Bake in preheated oven until firm, about 25 minutes.

Allow to rest 5 minutes before serving.

Ask the Doctor: Consider Cochlear Implants

DEAR DR. DONOHUE: I wear hearing aids in both ears.
My right ear is almost totally deaf.
I have a hard time understanding people unless they are very close up.
What do you think of cochlear implants?
Would they be helpful? - V.S.

ANSWER: The cochlea is the part of the inner ear that transmits sound to the hearing nerve, which, in turn, takes it to the part of the brain that makes us aware of the sound.
Without a functioning cochlea, hearing is impaired to the point it might be totally lost.
A cochlear implant is a device that transforms sound into electrical signals and sends those signals through the cochlea to the hearing nerve.
It’s a two-part device.
The external part consists of a microphone and a speech processor that passes sound to the internal part of the device.
That internal part is connected to the hearing nerve through wires passing into the cochlea.
Candidates for a cochlear implant are people with severe hearing loss that isn’t benefited by hearing aids.
I think these devices are amazing.
The sound heard by a person with such a device is different from normal sound.
In weeks to months, the person grows accustomed to it, and its sound becomes more natural to that person.
It improves a deaf person’s ability to understand the spoken word.
Make an appointment with an ear, nose and throat doctor and an audiologist who can assess your need of and adaptability to this device.

Wednesday, November 30, 2011

Bon Appétit: Bananas Foster over Puff Pastry

Ingredients:

  1 sheet Pepperidge Farm® Puff Pastry
  6 medium bananas, peeled
  1/2 cup packed brown sugar
  1/4 cup rum
  2 tablespoons butter or margarine
  1 tablespoon lemon juice
  1/2 teaspoon ground cinnamon
  1 cup sour cream
  1 tablespoon packed brown sugar

Directions:

Thaw pastry sheet at room temperature 30 minutes.

Preheat oven to 425 degrees F.

Unfold pastry sheet on lightly floured surface.

Trim pastry to make 9-inch circle.

Place on baking sheet.

Bake 10 min. or until golden.

Remove from baking sheet and cool on wire rack.

Cut bananas in half lengthwise and then crosswise into slices.

Mix 1/2 cup brown sugar, rum, butter, lemon juice and cinnamon in skillet.

Heat to a boil.

Cook and stir until mixture thickens, about 2 min.

Add bananas and toss to coat.

Mix sour cream and remaining brown sugar.

Spoon banana mixture over pastry.

Top with sour cream mixture.

Cut into wedges.

Ask the Doctor: Medical Marijuana vs. Regular Marijuana

DEAR DR. DONOHUE: What is the difference between medical marijuana and regular marijuana?
How long does it stay in a person?
Some say marijuana has no side effects.
Is that so? - D.P.

ANSWER: The two are exactly the same.
“Medical” marijuana is used to treat medical conditions - pain, nausea, the side effects of cancer medicines, glaucoma and epilepsy.
Marijuana is detectable in the urine of heavy users for up to four weeks.
Smoking a single marijuana cigarette is detectable for four days.
Marijuana does have some unpleasant side effects, but they are not common in casual users.
It can cause gum disease, lung problems, memory deficits and learning difficulties.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Tuesday, November 29, 2011

Bon Appétit: Turkey Burritos

Ingredients:

  1 pound ground turkey
  2 (7 ounce) cans hot tomato sauce
  1 (15.25 ounce) can whole kernel corn, drained
  1/2 small onion, diced
  1 (16 ounce) can fat-free refried beans
  1 (16 ounce) container fat free sour cream
  3/4 cup shredded reduced-fat Cheddar cheese
  6 (10 inch) flour tortillas

Directions:

In a large skillet over medium high heat, brown ground turkey.

Stir in tomato sauce, corn and onion.

Reduce heat to medium and let simmer, stirring occasionally, until liquids reduce (about 20 minutes).

In a separate medium skillet, heat beans over medium-low heat.

Prepare sour cream and cheese for sprinkling into burritos.

One by one, heat tortillas over stove burner for 1 to 2 minutes, flipping a few times.

Top with beans, then meat mixture, then sour cream and cheese.

Fold over and serve while still warm.

Ask the Doctor: Hip Resurfacing

DEAR DR. DONOHUE: I am 59 and have been active all my life.
I am 5 feet 6 inches tall and weigh about 135 pounds.
I participated in the 1972 U.S. Olympic trials for the 10,000-meter run.
My right hip has bothered me for many years.
X-rays show that bone is rubbing against bone.
I have quit running.
I researched a procedure called hip resurfacing, and believe this route would be better than hip replacement for me.
I would appreciate your opinion. - D.A.

ANSWER: Hip resurfacing isn’t new. It was introduced more than 40 years ago, but interest in it waned because less-than-satisfactory results were obtained.
Now, with new materials and different techniques, interest has resumed.
It’s an attractive alternative for many people with hip problems.
Patients are carefully selected.
They must have strong bones.
Imagine the hip joint by making a fist with your right hand and covering the fist with your left.
The fist represents the top of the femur (the thigh bone), a ball affair that fits into a socket (the covering left hand) on the pelvis.
The two comprise the hip joint.
In hip resurfacing, the surfaces of each are shaved in order to smooth them.
The ball of the femur is covered with a metallic cap and a metallic cup is placed in the pelvic socket.
This is less surgery than a standard hip replacement, but it is difficult surgery.
In six weeks postoperatively, people are walking, biking and swimming.
In a year, they can do just about anything they want, including running.
I can see why this procedure would suit you.

Monday, November 28, 2011

Gilmer County PSD: Boil Water Advisory for Normantown Area

The Gilmer County Public Service District has issued a boil water advisory for customers from the top of Normantown Hill, through Normantown, Stumptown, Gassaway Road and Rosedale Road until further notice.

Medicare’s Drug Coverage Gap Shrinks

Medicare’s prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs.

The “doughnut hole,” an anxiety-inducing catch in an otherwise popular benefit, will shrink about 40% for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press.

The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions.

But thanks to discounts and other provisions in President Barack Obama’s health care overhaul law that cost fell to $901, according to Medicare’s Office of the Actuary, which handles economic estimates.

A 50% discount that the law secured from pharmaceutical companies on brand name drugs yielded an average savings of $581.

Medicare also picked up more of the cost of generic drugs, saving an additional $22.

The estimates are averages, so some Medicare recipients may do worse and others better. Also, it’s still unclear if the discounts will start to overcome seniors’ deep unease about the law.

Concern over cutting Medicare to expand coverage for the uninsured helped push older voters toward Republicans in the 2010 congressional elections. Obama and the Democrats have been trying to woo them back ever since.

“For people with high drug expenditures, the 50% discount offers real savings,” said Tricia Neuman, director of Medicare policy for the nonpartisan Kaiser Family Foundation. “It’s certainly more helpful than no coverage at all, which is what they had previously.”

More than 2 million beneficiaries already have gotten some help, discounts that have gone largely to middle-class seniors, because the poor are covered in the gap at taxpayer expense.

For retired elementary school teacher Carolyn Friedman, it meant she didn’t need a loan to pay for drugs that keep her epilepsy under control.

“What a change for the better,” said Friedman, 71, of Sunrise, FL. “This year it was easier to pay my bills, whereas last year I had to borrow money to pay for my medications when I was in the doughnut hole.”

One of her brand-name anti-seizure drugs cost about $370 in the gap last year, and the other about $270. This year Friedman paid about $150 and $130, respectively, for a month’s supply.

Medicare covers about 47 million older and disabled people, and about 9 in 10 have some kind of prescription plan. Most rely on the drug benefit, also known as Part D, which is delivered through private insurance plans.

Beneficiaries have until December 07, 2011 to change their drug plans for 2012.

Consumer advocates recommend that seniors check their coverage during open enrollment to see if their current choice remains the best for next year.

Many families start the process around the Thanksgiving holiday.

The coverage gap, a money-saving idea from a previous Congress, never has been popular.

It starts after an individual beneficiary and his or her drug plan have spent a total of $2,840 on medications for the year. Seniors are then on their own for the next $3,600.

Once total spending reaches about $6,440, Medicare’s catastrophic coverage kicks in and beneficiaries pay only a token amount. Most people do not spend enough in the doughnut hole to qualify for catastrophic coverage.

Although few private insurance plans still cap the amount they spend on medications, Medicare’s hole-in-the-middle approach is highly unusual.

The Republican-led Congress that passed the drug benefit under President George W. Bush was trying to balance coverage and costs, as many conservatives fretted about creating a new unfunded entitlement.

Supporters wanted all beneficiaries to get some initial benefit from the program, and they wanted to protect those with overwhelmingly high costs.

The resulting compromise led to the doughnut hole.

Under Obama’s health care law, the gap will be gradually phased down by 2020.

This year, the law provides a 50% discount on brand name drugs and 7% break on generics. Next year the discount on generics rises to 14%. When the changes are fully phased in, beneficiaries will still be responsible for their annual deductible and 25% of the cost of their medications until they reach catastrophic coverage.

If Republicans succeed in repealing what they dismiss as “Obamacare,” the discounts would be wiped out as well.

Joan Gibbs thought her pharmacy had made a mistake. Her total cost for a brand-name painkiller in the doughnut hole came out lower than her co-payment earlier in the year, at a time her plan was picking up most of the tab.

“I reluctantly called the insurance company,” said Gibbs, 54, who lives near Cleveland. “If they had made a mistake, I knew they would catch it sooner or later. I was very surprised that it turned out to be such a good discount.”

Gibbs is on Medicare because of an auto-immune disorder and other medical problems that left her unable to work.

Other beneficiaries say it’s still a struggle, even with the discounts.

John Robinson of Bel Air, Md., has diabetes and heart problems. A retired director of patient accounts for a hospital, Robinson said he runs up his credit card balance to pay for insulin, other medications and diabetic supplies in the doughnut hole.

“Thank God for credit cards,” said Robinson, 71. “I thought it was better this year, but it still cost me more money than I had.”

Bon Appétit: Slow Cooker Cranberry Pork

Ingredients:

  1 (16 ounce) can cranberry sauce
  1/3 cup French salad dressing
  1 onion, sliced
  1 (3 pound) boneless pork loin roast

Directions:

In a medium bowl, stir together the cranberry sauce, salad dressing, and onion.

Place pork in a slow cooker, and cover with the sauce mixture.

Cover, and cook on High for 4 hours, or on Low for 8 hours.

Pork is done when the internal temperature has reached 160 degrees F (70 degrees C).

Ask the Doctor: Replacing Testosterone Not Difficult

DEAR DR. DONOHUE: Recently I found out through lab reports that I am almost completely out of the hormone testosterone.
Nobody ever talks about this problem.
Will you write something about it?
What causes it?
I am 54.
Now I am taking a testosterone drug. -M.P.

ANSWER: The testes make the male hormone testosterone.
It’s responsible for the development of male characteristics - facial hair, deep voice, muscle and bone growth, and the maturation of sex organs.
A surge of testosterone takes place at puberty, and production continues throughout life.
Aging is the principal cause of a diminution in its production.
An 80-year-old produces only half the amount that a 20-year-old produces.
Fifty-four is far too young to have no testosterone.
Infections of the testes, like mumps, can turn off production.
So can excessive drinking of alcohol.
An autoimmune attack on the testes, starvation, hemochromatosis (an illness in which iron infiltrates the testes), prolonged use of cortisone, kidney failure and a number of inherited conditions are other reasons for a decline in testosterone.
I think I understand you to be saying you have none of these.
Then that puts you in the category of idiopathic low production.
“Idiopathic” is a word often used in medicine. It means “I don’t know.“
Signs of having too little testosterone include a loss of interest in sex, a diminution of energy and a shrinkage of muscles.
Testosterone blood levels are measurable.
Normally, the height of daily production occurs in the morning.
The best time to have blood drawn for testosterone assay is around 8 AM.
Replacement isn’t an onerous task.
There are many effective testosterone preparations.