The so-called "mass" clinics are the nation's first partnership between federal and state health agencies.

"This is important because we are getting a large number of people who are at high risk for the complications of H1N1 vaccinated in a short period of time," said Dr. Kevin Yeskey of the U.S. Department of Health and Human Services.

About 1,000 vaccinations were given Friday at Delaware Technical and Community College-Terry Campus in Dover. Other clinics are scheduled for the Delaware Tech-Stanton Campus in New Castle on Saturday and Delaware Tech-Owens in Georgetown on Sunday.

Those considered to be at the highest risk for H1N1 are infants and children six months to 4 years of age; pregnant women; and those aged five to 64 with chronic conditions.

So far, of the 1,791 H1N1 cases reported in Delaware, there have been five deaths and 13 hospitalizations, according to the Delaware Division of Public Health.

And though the number of cases seems to be stabilizing, officials say the public should not get a false sense of security.

"In the last three weeks we've actually seen the numbers going down," said Rita Landgraf, Secretary of the Delaware Department of Health and Social Services. "But this is not traditionally the flu season. So we are still reinforcing good hygiene practices as well as prevention through vaccination."

State-wide more than 87,000 vaccinations have been administered.

Despite some concerns about the H1N1 vaccination, Dr. Yeskey says it is safe.

"Yes, this is a safe, effective vaccine and it prevents the disease."

THIS WEEK'S TOPIC: Families and aging
Gathering around the Thanksgiving table families often find themselves discussing tough issues around aging. Maybe the family's elders suddenly appear to be more frail, and in need of assistance. Or the aging parents feel like their kids are overbearing and trying to run their lives. How can families navigate issues such as independence, assistance, or sharing the care responsibilities among relatives? How do older adults envision their lives as they age, how do they stay connected, and what's important to them?

Join our conversation – tell us what has worked for you, your family, or what you are struggling with.

When: 12:00 noon Tues, November 24th.

Where: Right here. Click the blue button in the right sidebar to join the chat.

Moderator: Maiken Scott

This weeks guests:

Brian M. Duke, Brian M. Duke is Director of the Bucks County Area Agency on Aging. He has worked in the field of aging for many years, and also has personal experience as a caregiver; he cared for his mother during the last years of her life.

Dr. Dan Gottlieb is a therapist and psychologist, and the host of WHYY's weekly radio program "Voices in the Family".

Dr. Adam Davey Dr. Adam Davey is a Developmental Psychologist with a Research Interest in Aging. He is an Associate Professor in the Department of Public Health at Temple University.
 

Listen:

The U.S. Nuclear Regulatory Commission says the Philadelphia V.A. failed to keep track of the radiation doses given to patients. It also says the staff was not trained to spot and report medical errors. Commission spokeswoman Viktoria Mitlyng says the V.A. will have a chance to dispute, or explain, the allegations during a meeting December 17th.

Mitlyng: We are asking them to come and , you know, tell us what went wrong. What do they need to do to make sure that such errors do not occur again.

Mitlyng says regulators began to question whether the V.A.'s reports to the commission were accurate, so inspectors recently went back to the hospital to cull through its records.

In brachytherapy small radioactive seeds are implanted in the prostate to kill cancer. The V.A. reported 98 possible medical errors associated with its Philadelphia program.

Mitlyng says keeping an accurate accounting of a patient's radiation exposure is critical for good care.

Mitlyng: How can you assess? You have to be able to say: The patient received this much radiation and maybe he'll need another treatment, or we don't want to give him another treatment.

V.A. spokesman Dale Warman declined to comment on the individual allegations but says the hospital is working closely with federal regulators.

Warman: It was our staff, here at the Philadelphia V.A. who discovered the situation. Once it was discovered, the program was immediately shut down. We convened initially our own investigation. We hosted the NRC out here several times. So there have been numerous internal and external reviews of the brachytherapy program.

Listen:

For some theater-goers, the play's deeply emotional plot comes as a surprise.

"I thought it was about rabbits"

Instead, Rabbit Hole is about a family coping with grief in the months after a 4 year old boy gets killed in a car accident. Playwright David Lindsay-Abaire received rave reviews from critics for his sensitive, quiet, and realistic portrayal of people torn apart by sadness.

The subject matter makes the play a challenge for both audiences and cast. For some, it stirs up hard memories. Here's the Arden theater's artistic director, Terry Nolan:

Nolan: I had a sister who died about 25 years ago, so she was younger, so when I read the play, I recognized it. I understood immediately what the family was grappling with.

For others, it's a topic that seems unbearable. Brian Russell plays the father in Rabbit Hole. While he fell in love with the play, his wife, who usually practices his roles with him couldn't stand it:

(l-r): Grace Gonglewski as Becca and Brian Russell as Howie in Arden Theatre Company's production of Rabbit Hole. Photo by Mark Garvin.

So – the play has been a bit of a tough sell for the Arden says Terry Nolan:

Nolan: As we have been marketing it, it's been a constant challenge to figure out how we are honest about the subject matter of the play, while letting the audience know that it's also a play that is filled with laughter and love.

After the performance on a Sunday afternoon – the feedback is positive:

Audience Member: it was beautifully done, and it was very engaging.

And theater goers are in conversation about grief:

(l-r): Julianna Zinkel as Izzy, Janis Dardaris as Nat, and Grace Gonglewski as Becca in Arden Theatre Company's production of Rabbit Hole. Photo by Mark Garvin.

That's what a play like this can do, says Philadelphia therapist Linda Welsh. It can start a conversation on a difficult topic, provide an outlet to deal with emotions, and teach important lessons along the way:

Welsh: What you can learn is how not to force your own way of dealing with loss and grief on someone, even someone who you think you know very well, and is very close to you, that everybody has to work these things out as their style allows.

Actress Grace Gonglewski who plays the mother in Rabbit Hole hopes for a simple take-away message – to be kind to one another:

Gonglewski: When my mother died I would be driving in the car, and I would lose myself in the grief, and I would not go right away when the green light changed. And I wanted to say to the person behind me, yo buddy just chill out, I'm grieving. But there is no way to have that in your life. So I hope that this play will remind people to just treat each other with a little tenderness, because there is a lot of grief.

Rabbit Hole is at The Arden Theater in Philadelphia through December 20th.

All 994 appointments in New Castle County have already been taken, but slots are still available in Kent and Sussex County.  82 spots are available in Kent County, while more than 534 appointments are still open in Sussex.

Director of the Delaware Division of Public Health Dr. Karyl Rattay says the clinics are the most efficient and convenient way to get those who are at risk vaccinated.  "We want to avoid people who are already at high risk for the flu having to stand in long lines in the cold and rain."  Getting those at risk, especially those with other medical problems,  has been a priority for Division of Public Health.  That's because all five Delawareans who've died from H1N1 complications have had underlying health conditions that made their sickness fatal.

Kriedeman: Really those public health clinics are for those in the recommended groups – including children – who don't have access to private providers such as a school.

Kriedeman says the vaccine will be free, but participants have to schedule an appointment. The clinics begin Friday, Nov 20th and will be held at six locations across the state.

For more information on how to register — and who qualifies go to Pennsylvania’s health department Web site

Experts say it is clear that the drugs lower so-called bad cholesterol. But a new study suggests that a common form of vitamin B works better to reduce artery plaque and prevent heart attack and stroke. Drug maker Merck & Co. called the study “flawed.”

Find more coverage from National Public Radio:

Cardiologist Weighs In on Negative Vytorin Study

Listen:

Slightly more than 60 percent of the 1,100 students at Germantown Academy have been immunized against the H1N1 flu. While other schools across the region are waiting for their supplies, the academy got its shipment a month ago. James Connor is Head of School.

Connor: We're not sure why we got it so early, our school nurse was out there really early last summer, exploring all of this, so may be we were, sort of, first in line.

A Pennsylvania Department of Health spokeswoman says the distribution process is generally first come, first served. Germantown's school nurse says her team was diligent about filling out the required paperwork to qualify as a distribution site.

At-risk adults at Germantown also got the vaccine, and the academy shared doses with its sister school in North Philadelphia.

Lori Andress is the school nurse at Germantown Academy.

Andress: So we registered to say we were interested. Then the next step was to register how many students were enrolled, how many faculty were enrolled in the school and then the third step was the actual order of the shipment.

Germantown got its shipment in mid-October. The academy also shared vaccine with a local doctor who has some high-risk patients.

Listen:

Many Medicare enrollees choose an Advantage plan to enjoy expanded benefits and low out-of-pocket costs. But seniors are complaining that the new options are limited and pricey.

Christine McBennett directs the insurance-advice program for Philadelphia's Commission on Services to the Aging. She says co-payment prices are rising.

McBennett: It seems to be going up between five and 15 dollars per visit, depending on whether you are going to see your primary care physician or a specialist. And some of the monthly premiums have gone up anywhere between 10 and 100 dollars per month. Nothing is getting less expensive next year.

Medicare administrators are urging seniors to choose a new plan to ensure that they'll get a prescription drug plan that covers the medicines they need. Seniors who don't actively select a plan could be left without drug coverage.

So, McBennett says: choose carefully.

McBennett: Different plans cover different drugs at different costs and different monthly premiums, so it's in the individuals best interest to proactively chose a plan by researching which plans they would be best suited for.

Nancy O'Connor is a Medicare administrator.

O'Connor: If you are in a Medicare Advantage plan and you opt to do nothing, you will go back into the original Medicare plan for your health coverage. However, if you had drug coverage, you need to pick up a stand alone prescription drug plan.

December 31st is the deadline to select a new Medicare plan.

The Medicare Web site has a drug-plan finder to guide seniors.

More info:


The Mayor’s Commission on Services to the Aging
: 215-686-8462


Albert Einstein Medical Center's Premier Years Program: 215-456-7600

Last year the van traveled all around Delaware to make it easier for more than 1,200 women to get mammograms.

Now, women in their 40's who've been told for years the importance of breast self exam and mammograms are getting a new message from a government task force: wait until you're 50 unless you have high risk factors.

Vicky Cooke is a breast cancer survivor who received her diagnosis at age 44 after discovering a lump during a self exam.

She's also the executive director at the Delaware Breast Cancer Coalition in Wilmington.

"We're in the position where we understand the science of this and understand how the statistics are put together," Vicky Cooke, executive director of the Delaware Breast Cancer Coalition, said. "However without an alternative to mammography we're in a bit of dilemma ourselves on how to address this ourselves."

The fact that the Delaware Breast Cancer Coalition is a member of the National Breast Cancer Coalition which supports the new guidelines issued by the U.S. Preventative Services Task Force, puts the Delaware chapter in a tough spot.  Cooke says she's been getting calls all day from survivors who question the new guidelines.  Many of them believe the former ones saved their lives.

"What we do as an agency is try to provide women with all the information.  So, this is information, it's out there so it's going to be up to the women to decide what guidelines they want to follow. And I think that's important for women to be empowered with all knowledge and all information so they can make the best decision for themselves."

One thing that hasn't changed is the statistic that one in eight women will get breast cancer.