December 2010 | Health Autism

Friday, December 31, 2010

“Autism coverage, energy audits, take effect Jan. 1 - CNBC” plus 1 more

Autism coverage, energy audits, take effect Jan. 1 - CNBC

Posted: 31 Dec 2010 10:24 AM PST

US News

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Autism coverage, energy audits, take effect Jan. 1

The Associated Press | December 31, 2010 | 01:28 PM EST

Access to treatment for children with autism, making information on the energy efficiency of homes available to home buyers, and tighter safety training for construction workers are among new Nevada laws that take effect Saturday.

The autism bill, AB162, was approved by the 2009 Legislature and signed by Gov. Jim Gibbons. Its passage came after testimony from parents, medical experts and children with autism about the benefits of early intervention and treatment — and the high costs that make it unaffordable for many families.

"Learning about the daily challenges that these families face in obtaining and financing necessary medical treatment was both enlightening and heartbreaking," the bill's sponsor, Assemblyman James Ohrenschall, D-Las Vegas, said after its passage.

At least 35 states have laws related to autism and insurance coverage.

Autism affects about 5,000 children in Nevada — more than AIDS, childhood cancer and diabetes combined. With early treatment, about 50 percent of children exhibit no signs of the disorder.

"Intervention makes a big difference," said state Sen. Sheila Leslie. "Without treatment, it's almost like giving up on their potential."

The law requires both public and private health insurance companies to screen and provide treatment for autism spectrum disorders up to a cap of $36,000 a year, until the child is 18 unless still in high school.

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What are your picks for top health stories of the year? - Weblogs.baltimoresun.com

Posted: 31 Dec 2010 03:51 AM PST

It's the time of year when we like to look back before we look forward.

So here's my list of the Top 10 health stories of the year that touched us locally. Please tell me if you disagree with my picks and if I missed any big stories.

10. The beloved state dessert, the Smith Island Cake, is declared one of the nation's least healthy foods by Health magazine.

9. Baltimore hires a food czar, Holly Freishtat, to help the city figure out how to better feed itself and cut down on obesity-related illnesses.

8. Four Loko, the caffeinated alcohol drink, is pulled off national and local store shelves.

7. Everyone is told to get a flu shot by the U.S. Centers for Disease Control and Prevention for the first time.

6. A 12-year-old article in prestigious British medical journal that scared parents everywhere by making a link between autism and the mercury in childhood immunizations is retracted.

5. Haiti's earthquake devastates a city and mobilizes many people to offer their time, skills and money to help the needy.

4. A federal judge blocks funding for embryonic stem cell research, and scientists fear potentially life-saving discoveries are jeopardized.

3. A doctor at Johns Hopkins Hospital is shot by the distraught son of a patient, who later killed himself and his mother.

2. St. Joseph Medical Center tells heart patients their stents may not have been necessary.

1. The health care reform law passes and begins to offer protections for consumers and the promise of coverage to the uninsured.

I got pretty close to this year-in-review list, compiled by the health editor here at The Sun. She also included bed bugs, doctor shortages, Mercy Medical Center's new hospital buidling and a record grant to the University of Maryland for celiac research, among other stories.

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Thursday, December 30, 2010

“Start year with mental health screening - United Press International” plus 1 more

Start year with mental health screening - United Press International

Posted: 29 Dec 2010 09:47 PM PST

Published: Dec. 30, 2010 at 12:53 AM

BOSTON, Dec. 30 (UPI) -- The start of a new year is a perfect time to take stock of your emotions and address mental health issues, a U.S. psychiatrist advises.

Dr. Douglas G. Jacobs, associate clinical professor of psychiatry at Harvard Medical School and the founder of Screening for Mental Health Inc., suggests this New Year's, gauge your emotional well-being by taking a free, anonymous mental health self-assessment at www.HelpYourselfHelpOthers.org.

The Web site, sponsored by the non-profit Screening for Mental Health, offers brief questionnaires for depression, alcohol problems and other mood and anxiety disorders.

The questions are designed to assess whether an individual may be at risk for a disorder. For those who score positive, referrals to local treatment resources are provided.

"Everyone struggles with stress or the blues from time to time," Jacobs says in a statement. "It's a normal part of life. But if you have been feeling sad, anxious or irritable for more than two weeks, it could be a sign of a more serious health issue."

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Adults with autism face many struggles - KABC

Posted: 29 Dec 2010 05:22 PM PST

LOS ANGELES (KABC) -- One-point-five million people in the U.S. have autism. About 80 percent are under 22, and research shows most do note end up living independent lives.

Some call the number of kids who will become adults with autism over the next five years an autism tsunami. That's because most state and federal assistance programs for autism stop at age 22, leaving these young adults with no place to go.

Paul Voss, 35, has Asperger's syndrome -- a form of autism. Through his job as a maintenance man, he earns money, independence and self esteem -- things many adults with autism are missing.

"When you have Asperger's syndrome it's a struggle," said Voss.

He got his job through the Daniel Jordan Fiddle Foundation, one of the few groups devoted to adults with autism.

"It's very frustrating, you see that beautiful little child on Time Magazine but you don't realize they're going to be 24 and 37 and whatever," said Mary Meyer, a mother of an autistic adult.

Her 36-year-old daughter Susan also found work and a creative outlet through the foundation.

"You usually don't have to worry about housing for children, jobs for children. Once you get to be an adult it's a lot more complex," said Susan Meyer.

Linda Walder Fiddle started the group in memory of her son Danny, an autistic boy who suddenly died from a seizure at the age of 9.

"So that really was the inspiration, Danny's life and the fact that I realized there were few, if any, programs for adults and we need to create a different world than what existed for adults," said Walder Fiddle.

Only three percent of autistic adults live independently. Just six percent hold paid, full-time jobs. The Daniel Jordan Fiddle Foundation helps people with all aspects of adult life including finding an apartment, staying active and job training.

"We're very loyal, we're very trustworthy, we're very responsible," said Susan Meyer.

For Voss, the foundation provides purpose.

"Never give up on the belief that there is a place out there for you," said Voss.

The Daniel Jordan Fiddle Foundation is based in New Jersey, but leaders are developing program models and blueprints so communities around the U.S. can launch similar programs.

Get more Health & Food »

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health, health & food, denise dador

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Wednesday, December 29, 2010

“Top 9 Health Stories of 2010 - ABC News” plus 1 more

Haiti Earthquake

The immediate damage to infrastructure and the death toll seemed apparent across the poorest country in the Western Hemisphere. Although more than a billion aid dollars funnelled in to repair Haiti, many experts braced for a public-health aftershock.

And they were right.

Nearly 10 months after the January earthquake, cholera spread to many rural areas and quickly creeped into the capital city, Port-au-Prince. In just a few months, nearly a thousand Haitians died from the waterborne disease.

"What we are seeing now may be the tip of the iceberg," Dr. Georges Dubuche, adviser to Haiti's Ministry of Health, said in a news conference early October.

Many experts did not know then the extent of the epidemic.

Indeed, Cholera spread faster than many public health experts anticipated. Relief workers continue to ramp up efforts to manage the outbreak amid the more than 2,000 people who have now died from the disease.

Health Care Overhaul

Affordable health care for all became the buzz phrase for the Obama Administration. Indeed, with the Affordable Care Act signed into law in March, the Obama Administration may have its way.

The $938 billion health care bill will expand coverage to 32 million Americans, but many of the provisions -- with the exception of prescription drug coverage for older Americans and children who have been denied insurance because of pre-existing conditions -- are not expected to go into effect until 2014.

Omnibus Ruling on Vaccines and Autism

The U.S. Court of Federal Claims concluded in March that thimerosal -- a preservative found in some vaccines -- does not cause autism. The courts reviewed previous scientific studies and found no correlation between vaccination rates, mercury levels and the incidence of autism in children.

This so-called landmark decision followed many rulings in previous years that cited no association between vaccines and autism. Previous rulings by the court also dismissed the autism-vaccine connection. Still, it's likely there may be more cases because many parents of children with autism are unconvinced.

Indeed, the 2008 settlement for Hannah Polling became the staple case for many families of children with autism. The Polling family received compensation for Hannah's "vaccine injury" when the court settled, because, according to settlement documents, the vaccinations she received, "significantly aggravated an underlying mitochondrial disorder [...] and manifested as a regressive encephalopathy with features of autism spectrum disorder."

Many people say that regardless of the 2010 omnibus rulings, there will be more cases such as Polling's to come.

FDA Oversight on Food Safety

An estimated 87 million Americans are sickened by contaminated food, and 5,700 die from food-related disease each year, according to the Centers for Disease Control and Prevention. But supporters of the Food Safety Modernization Act, which has already passed in both the U.S. Senate and House of Representatives, hope greater food industry oversight by the U.S. Food and Drug Administration will change that.

Among the provisions of the bill, the FDA would have authority to order mandatory recall of tainted foods and set safety standards for raw produce, such as fresh fruit and vegetables. The agency would also increase inspections of domestic and foreign food facilities.

But many food industry companies are particularly concerned with the Tester Amendment, a part of the bill that would exempt smaller food producers and those that distribute locally.

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Minimize Winter Health Hazards -- Some Unlikely - CBS News

Posted: 28 Dec 2010 08:26 AM PST

(CBS) From shoveling snow to taking down decorations, the holidays and months that follow can be filled with health hazards.

Those are obvious - but there are many that aren't as apparent.

For instance - did you know getting kissed on New Year's Eve could be a problem?!

Special Section: Dr. Jennifer Ashton
Dr. Jennifer Ashton's Twitter page

On "The Early Show" Tuesday, CBS News Medical Correspondent Dr. Jennifer Ashton shed light on the activities to beware of:

Shoveling snow

For the rest of us, before going out, warm up with some stretching. The best way to clear the snow is to push it to the side -- instead of lifting it. If you do have to lift it, use your legs, not your back muscles -- squat with your legs apart, knees bent, and back straight. Lift by straightening your legs, without bending at the waist. Then walk to where you want to dump the snow, holding the shovelful of snow close to your body. Holding it with outstretched arms puts too much weight on your spine. Also, don't throw snow over your shoulder -- it may strain your back muscles.

Don't forget to pace and hydrate yourself -- it's easier to get dehydrated in the cold. Drink plenty of water or other warm beverages -- not alcohol, because it will make you feel colder once the "warm glow" wears off.

Taking down holiday decorations requires care. I know the holidays can be tiring, but just as we practiced safety going into the season, we need to be safe cleaning and packing up. Every year, about 12,500 people are treated for falls, cuts, shocks, and burns due to incidents with holiday decorations.

When you're removing outdoor lights, never pull or tug on them -- they could unravel and inadvertently wrap around a power line. It's a good time check on your lights for any damage -- like frayed wires or cracked lights - and throw out damaged sets.

Christmas trees are generally dried out by this time, so either continue watering yours or get it recycled ASAP -- the longer a tree stays up, the greater a fire hazard it can be. Never burn your Christmas tree in the fireplace -- the trees can have a lot of sap, which is highly flammable and can explode.

Another word of advice: Plan ahead for a designated driver. It's a festive time of year -- and you need to plan ahead before you party. If you will be drinking, plan to have a designated driver -- someone who won't be drinking and can safely transport you back home. One-in-three fatal car accidents involve alcohol or drugs. Remember, after just one drink, your decision-making abilities can become impaired. After two drinks, reasoning and memory are affected. It's important to remember alcohol takes time to metabolize out of your system -- coffee won't help sober you up.

If you're tired, rest up before you hit the road -- sleepy driving can be just as dangerous.

Also: Be careful about that New Year's kiss! If you or your date is sick -- that midnight smooch may be hazardous to your health or his or hers! You could be jumpstarting your 2011 with a cold or flu. If you show signs of a flu-like illness, then the Centers for Disease Control recommends staying home for at least 24 hours AFTER your fever is gone. It might not be as festive or romantic, but if you are sick, close contact with people is not advised. There's also a lot of socializing, so don't forget to wash your hands and avoid touching your eyes, nose and mouth too much.

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Monday, December 27, 2010

“Hormone Replacement Therapy: Clearing Up the Facts About Women's Health - Huffingtonpost.com”

Hormone Replacement Therapy: Clearing Up the Facts About Women's Health - Huffingtonpost.com

Posted: 22 Dec 2010 04:58 AM PST

As a gynecologist, practicing for over 25 years and having treated thousands of women of all ages and stages of their lives, I am certain of the following: Unless and until we have all our facts -- regarding all aspects of our health and health care -- we cannot make informed decisions. Many women live paralyzed by fear, hearing misinformation regarding medical studies. Misrepresentation of the absolute risk of various choices has created mass confusion and and in some cases, the reactive discontinuation of potentially helpful medications. These fear-induced reactions create a dangerous schism between women and their care providers. When I'm not engaged in individualized patient care I'm advocating for women to get the facts that may save them unnecessary misery, lower their quality of life and increase their risks for many diseases of aging. With a steady stream of intelligent, clear, organized and useful evidence-based good information, a sense of a working knowledge of their basic biology and body science, women can understand their options -- something the sensationalized style of medical reporting and conventional medicine keeps us from having.

We live in a paradoxical time with regard to women's health care consciousness. How the generation of Baby Boomer feminists, the burners of the bra, the women who took control of their fertility with the pill, who fought for equality in their professions, could retreat so far into submission in fear is certainly puzzling. Case in point: the debate about hormone replacement therapy. It is clear that misrepresentation of the facts by journalists is frightening women from something that may benefit their health and certainly enhance their quality of life.

The single largest barrier to women taking estrogen/hormone therapy and allowing themselves to feel better after menopause is the fear of breast cancer. A powerful recent example is the New York Times, October 20th headline which read "Prempro Hormone Therapy Amplifies Breast Cancer Risks, Study Finds."

The study released on October 20th regarding hormone replacement therapy (HRT) and breast cancer (from Women's Health Initiative group Chlebowski et., al JAMA,) was met with fearful reactions by the news media, but aside from getting terrified by the reports, what can we actually learn from this study? For one thing, this study has absolutely no impact on women who are not taking Prempro, and for those who are, the absolute risk is exactly what we already knew. There is a .008 percent increase risk for a breast cancer diagnosis with an increase risk of death from breast cancer of .012 percent. These are very tiny individual risks of an increase of 8 cases per 10,000 women years of use. The reader was led to believe that there was a 29 percent increase in deaths from Prempro, with an absolute difference of 1.2 women in 10,000 years of use! Placing such data in perspective is a great service to aid women in placing risk in a meaningful context. Why are we not told this? What is to be gained from frightening us? Why can't we know the truth? Women are competent to know these facts and figures as adults making long term self care choices.

The new information from the study published on October 20th in JAMA actually is in the details of breast cancer cell types associated with the particular progestin found in Prempro, and the incidence of higher death rates. The increase in the risk of death from breast cancer while taking Prempro compared to a placebo, in the new report, was one woman per 10,000 woman-years of use -- a level described by the FDA as "extremely rare" -- while the estrogen alone trial of the WHI study showed a 23 percent decreased risk of being diagnosed with breast cancer.

The detail of which hormones a woman takes is very important. We must help make women aware of news about different products that do not relate to their risk status. For example, we even have very reassuring data about estradiol and natural progesterone not statistically increasing risk for breast cancer (Breast Cancer Res Treat. 2008 Jan;107(1):103-11. Epub 2007 Feb 27) and also showing much better survival if one does get a breast cancer diagnosis if the woman is on estradiol at the time of diagnosis. Improved breast cancer survival among hormone replacement therapy users is durable after 5 years of additional followup, Christante D). (These are identical hormones to naturally produced estrogen and progesterone, also called Bioidentical hormones by some with FDA approved products available all across the U.S.)

The bottom line is there are many better options than Premarin or PremPro. Simply look at the estrogens delivered through the skin, all biologically identical to that which we naturally make in our bodies and for which nature selected over millions of "randomized blinded trial years" (the process of natural selection at its finest in my opinion). In all sorts of research, at cellular levels, as well as gene regulation and gene suppression/expression studies, estradiol is very positive in its effects on cell differentiation; in essence, keeping healthy breast cells healthy. That is the goal of ideal hormone support for every tissue we study: The enhancement of balanced, regulated cell growth and positive antioxidant effects of estradiol.

The truth is that after all the hullabaloo over the past nine years since the initial termination of the HT arm of the WHI, estrogen turns out to be quite safe, the MPA has a cloud of suspicion, and the future recommendation is for careful assessment on an individual basis for every women transiting menopause to determine health status, future risk for disease, and a decision based on a clear indication whether hormones are truly needed and recommended in her situation. If a woman chooses hormone support then current knowledge should be used to determine what dose, type and route of administration is best for her.

The WHI has succeeded in adding valuable information showing that postmenopausal hormone therapy has clear rewards and very small risks when started in newly menopausal women. It remains a woman's right to choose, not just a legal abortion, but to engage in a process of education and transparent explanation of the facts. Each of us can check these facts in a clear and unbiased way at the North American Menopause Society's website.

Let's think about why these studies are misinterpreted, over-inflated and misreported, an important question and one I will address in future posts.

Statements made in this blog are the personal opinions of Dr. Ricki Pollycove, a board-certified specialist in women's health care, specializing in healthy aging throughout all stages of women's lives. She has been in active clinical gynecology practice since 1981, and author of the "Pocket Guide to Bioidentical Hormones." Information provided here is not intended to substitute for individualized medical choices which should be made with the supervision of the treating clinician. Always consult your care provider before making any medical decisions or changes in your health practices based upon the information provided in this blog.

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Sunday, December 26, 2010

“Autism program is a true holiday gift - St. Louis Post-Dispatch”

Autism program is a true holiday gift - St. Louis Post-Dispatch

Posted: 25 Dec 2010 10:13 PM PST

BY CYNTHIA BILLHARTZ GREGORIAN • cbillhartz@post-dispatch.com > 314-340-8114 www.STLtoday.com | | Posted: Saturday, December 25, 2010 12:15 am

OVERLAND • Tommy Ney put an ornament or two on the Christmas tree in his family's living room last Monday. But he wasn't really feeling the moment.

The sky was gray and Tommy, who's 22, tall and husky, was more interested in checking on the weather.

A few years back, a storm knocked out the power at his family's home for several days. Now, when it's cloudy, he worries incessantly, opening and closing the sliding patio door several times an hour to get a closer look at the sky.

Christy Ney was pleased that her son put ornaments on the tree at all.

It was a first — one of many since he joined the Midwest Adult Autism Project three months ago.

Tommy has also started — on occasion — cleaning up after himself, following instructions, and keeping his hands to himself in public.

He isn't as "bangy" as he once was either, Christy Ney said, referring to how he'll suddenly pound his hands on his chair and yelp loudly.

"He's using personal pronouns, too," added his sister, Amy Ney, 20. She's noticed this since returning home a few days ago from Truman State University in Kirksville, Mo., where she's studying speech therapy.

Trimming the tree with Tommy, Amy and their younger son, Andy, 14, is bittersweet for Tom and Christy Ney.

Twenty years ago, Christy Ney had finished the same yuletide ritual when she noticed something odd: Tommy was unfazed by the sparkly spectacle.

What's wrong with him, she wondered. A 2 1/2 year old should be looking at the lights and playing with the ornaments. They scheduled a doctor's appointment and a few weeks later, they had their answer: Their son was diagnosed as autistic.

Earlier this year, he aged out of the Special School District of St. Louis County, and the Neys had no idea where to go from there.

What do you do, day in and day out, with a 6-foot, 230-pound severely autistic man who's too volatile for sheltered workshops and most day programs? Quit your job and stay home with him? Institutionalize him?

Tommy receives $30,000 a year in disability payments from the Missouri Department of Mental Health. But Christy Ney said that doesn't cover the day program at TouchPoint Autism Services (formerly Judevine Center for Autism) in south St. Louis. And the few other options available locally can't provide the one-on-one attention he needs.

The Neys were searching for answers when they learned about another autistic man, Josh Gay, 23, who was taking part in programs at the Center for Head Injury Services in Maryland Heights.

Brain injuries and autism share a lot of functional similarities. So when the Neys asked about enrolling Tommy, the center decided it was time to create a separate program.

MORE KIDS DIAGNOSED

Tom Ney notes how 20 years ago, only one in 5,000 children were diagnosed with autism. Today, that figure is closer to 1 in 110. About 2,000 autistic children are enrolled in the Special School District, which means there's a growing need for adult programs.

Enter Rick Goolsby, coordinator of the project, and Melissa Weber, a behavioral therapist and owner of Best Behavior Consulting.

The two had worked together at TouchPoint and took what they learned there, added to it and developed the day program called the Midwest Adult Autism Project. The day program is based at the Center for Head Injury Services.

It officially started in September with Tommy its first client. Josh, who has Asperger's syndrome, a milder version of autism, transitioned in about a month ago from the center's other programs, and three other students soon followed. Goolsby hopes to grow to 24 clients in three years.

Clients are evaluated over the first 30 days so Goolsby and Weber can determine goals for each one and create a plan to reach them. They get one-on-one attention the first 90 days and two-on-one attention for the next 90 days.

The project's philosophy stems from the notion that even adults with severe autism have something to learn.

Ed Calvin and Annalise Evans, project technicians, help carry out the individual plans.

Days are filled with activities ranging from playing games and watching movies, to working on math puzzles and reading assignments. Calvin and Evans keep activities short and mix them up.

Autistic people like routine, but the only thing constant in life is change, Goolsby said.

They exercise in the center's gym, where Josh, who's even bigger than Tommy, lost 7 pounds in three weeks.

A dry-erase board in the activity room contains conversation topics and four basic rules for Tommy. He's to talk in a quiet voice, keep his hands to himself, stay with the group and follow directions.

'LIKE A TORNADO'

In a room next door, Calvin and Evans teach basic living skills.

Recently, they worked on Tommy's table manners by breaking down the process of eating: Sit up. Take small bites. Chew. If you spill food, adjust your plate or chair.They videotape the lessons and send the DVD home with instructions so family members can repeat them.

"With autism spectrum, they won't take something from here out into the world in general," Goolsby said. It must be retaught in each setting.

They're also teaching Tommy and Josh to clean up after themselves.

"He's like a tornado," Christy Ney said. "I go to bed at night with a clean kitchen and wake up with every cabinet open, food on the table, the milk is out."

Lately, there's been less mess, and Tommy helps clean up. If he refuses, she tells him she's going to call Ed Calvin. It usually works.

"Before, he'd bang his head on the table and scream," she said

A SAFE ROOM

When Tommy and Josh get upset or overly excited, they're steered toward the project's padded room. Goolsby and Weber say it's a place to stretch, relax and practice coping strategies.

"I don't want anyone to think this is where they go when they're in trouble," Goolsby said. "It's not a kiddie prison or a timeout room."

They've put Tommy in the room twice on a nonvoluntary basis. He accidentally gave Goolsby a fat lip during one of those incidents.

Most of the time he's in there because he wants to be, lying on the floor, listening to music and watching a wave machine.

The room is also equipped with a video camera so Goolsby and Weber can figure out what works best at calming their clients down.

All interventions and lessons are data driven, Weber said. She flips through charts that show how Tommy and Josh behave in almost any given situation.

"A lot of times they need prerequisite skills," she said. "For instance maybe they can't verbalize that they need a break."

Part-time speech and occupational therapists help with that.

Josh has earned his GED and has a rich vocabulary, but he has behavioral issues, too.

Goolsby and Weber timed how long he could go between episodes of challenging behavior. It was about three hours. That gave them a baseline to work on as well as an idea of when to give him breaks.

Recently, when Goolsby told Josh that it was Tommy's turn to pick a game, he looked at Goolsby and said: "I'm very disappointed."

His mother Susan Gay was surprised to hear this. It was a breakthrough.

"He can still get physical and throw things and do a little yelling," she said. "It used to last hours and hours. Now, we're down to minutes."

The Gays hope Josh eventually can live independently.

That won't be possible for Tommy.

On the afternoon of the tree trimming, he'd plopped himself in a recliner next to the patio door and was leaning his large frame back as far as the chair would allow. He was trying to reach the door, so he could open it and see the sky.

Amy and Andy continued trimming the tree, but Tommy was done with that.

Christy Ney tried to get him to sit up. He resisted. They began giggling. For a moment, there was a connection between mother and son.

He sat up, and she handed him an ornament, a brass horse with his name engraved on it. It was from his first Christmas — before anyone knew what lay ahead.

Christy Ney chuckles when she rattles off Tommy's wish list this Christmas: popcorn, Lay's potato chips and Disney's "Beauty and the Beast" movie.

Sometimes she feels sad that he doesn't ask for the things that other 22-year-olds ask for. But she also treasures his innocence.

He measures his years by holidays, so after today, the family will start counting down to New Year's, then Valentine's Day, St. Patty's and so on.

"And Tommy thinks he should get presents for every holiday," said Christy Ney. "So if we have to wrap up a bag of chips, I guess that'll be fine."

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Saturday, December 25, 2010

“Autism program is a true holiday gift - St. Louis Post-Dispatch” plus 1 more

Autism program is a true holiday gift - St. Louis Post-Dispatch

Posted: 25 Dec 2010 11:07 AM PST