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Monday, Sep 12 2016

麻豆女优 Health News Original Stories 4

  • Better Training, Tourniquets And Techniques Since 9/11 Are Saving Lives
  • Report: Hungry Teens Often Feel Responsibility To Help Feed The Family
  • Colorado Gun Shops Work Together To Prevent Suicides
  • Tossing Unused Surgical Supplies Wastes Millions Of Dollars, Study Finds

Health Law 1

  • Facing Financial Losses, Dartmouth Withdraws From Health Law's ACO Program

Campaign 2016 1

  • Clinton Diagnosed With Pneumonia

Capitol Watch 1

  • Republicans Likely To Drop Planned Parenthood Provision For Zika Funding

Marketplace 1

  • Many Health Care Providers, Suppliers Not Ready For Disaster Readiness Rule

Public Health 4

  • 15 Years Later, 9/11 Responders Face Daunting Health Problems
  • 'The Streets Are Awash With Adderall': Misuse Of ADHD Drugs Skyrocketing
  • The History Of Antibiotic Resistance: It Was An Arms Race They Thought They Could Win
  • Concussion Concerns Cast Shadow Over NFL Opening Weekend

Quality 1

  • Project Aims To Empower Primary Doctors To Cut Down On Specialist Referrals

Health IT 1

  • Mapping Program Guides Doctors Navigating Cancer Treatments

State Watch 1

  • State Highlights: Mass. Budget Cuts Leading To Long Waiting List For Home Care; N.H. Hospitals Band Together For Financial Health

Editorials And Opinions 1

  • Viewpoints: New Health, Poverty Data Deserve Attention; Switching Tactics On Zika

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Better Training, Tourniquets And Techniques Since 9/11 Are Saving Lives

U.S. trauma care experts are increasingly focusing on ways to help civilian victims of violence 鈥 whether the incidents were mass shootings or bad car accidents 鈥 avoid bleeding to death at the scene. ( Rachel Bluth , 9/10 )

Report: Hungry Teens Often Feel Responsibility To Help Feed The Family

After interviewing scores of teenagers, researchers report that many who face hunger are not aware of assistance programs or think they don鈥檛 qualify. ( Carmen Heredia Rodriguez , 9/12 )

Colorado Gun Shops Work Together To Prevent Suicides

Gun shop owners and public health workers in Colorado are finding common ground amid rancor over guns and politics. They are collaborating to reduce suicides involving firearms. ( John Daley, Colorado Public Radio , 9/12 )

Tossing Unused Surgical Supplies Wastes Millions Of Dollars, Study Finds

Researchers at the University of California, San Francisco estimate that hospitals could lose nearly $1,000 per surgery by throwing away opened but unused supplies, such as gloves and sponges. ( Ana B. Ibarra , 9/12 )

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Summaries Of The News:

Health Law

Facing Financial Losses, Dartmouth Withdraws From Health Law's ACO Program

The accountable care organization model was devised by Dartmouth researchers, and Dartmouth's health system did save money, but not enough to avoid penalties. 鈥淲e would have loved to stay in the federal program, but it was just not sustainable," said Dr. Robert A. Greene, a vice president with the Dartmouth-Hitchcock Health System. Other news reports pick up on how the hospital's financial issues are playing out in New Hampshire.

In its quest to remake the nation鈥檚 health care system, the Obama administration has urged doctors and hospitals to band together to improve care and cut costs, using a model devised by researchers at Dartmouth College. But Dartmouth itself, facing mounting financial losses in the federal program, has dropped out, raising questions about the future of the new entities known as accountable care organizations, created under the Affordable Care Act. (Pear, 9/10)

Dartmouth-Hitchcock plans to lay off hundreds of employees after a poor financial performance last fiscal year. In an email sent to Dartmouth-Hitchcock employees, CEO James Weinstein said the company needs to shave $100 million ... in annual expenses to achieve financial stability. The company finished last fiscal year with a $12 million ... deficit. (Moon, 9/9)

Republican candidates for governor are calling for inquiries into how the new contract between the New Hampshire Hospital with Dartmouth-Hitchcock was handled 鈥 with some pushing for the outright cancellation of the deal. Up to 460 layoffs were announced Friday, just two days after Dartmouth-Hitchcock was awarded a controversial, $37 million state contract by members of the Executive Council. (Feely, 9/11)

In other health law news 鈥

New York's Department of Financial Services has issued an emergency regulation intended to help the state's health insurers deal with a federal requirement that puts some under sharp financial stress.聽The federally mandated program for adjusting financial risk under the Affordable Care Act transfers pooled funds to plans showing higher-risk clients. (9/11)

Steve Banke employs 40 people at 3-Points, a small IT outsourcing company he founded almost 15 years ago. And he wants those workers and their families to have strong health insurance options. Employees at the firm, based in Oak Brook, Ill., can choose between two types of Blue Cross and Blue Shield of Illinois plans: a PPO with a broader network of hospitals and doctors or a cheaper HMO network. Banke's company covers a percentage of the premiums, and those costs have risen rapidly over the past several years, often more than 12% annually, he said. (Herman, 9/10)

It has been a tumultuous year for Connecticut鈥檚 state health insurance exchange, but the latest 鈥 and most significant 鈥 blow could come Monday if its largest insurer decides not to offer plans next year. The insurer, ConnectiCare Benefits, is facing a Monday deadline to decide whether to leave the exchange in 2017 after a Superior Court judge in New Britain blocked a motion Friday afternoon that would have given the Farmington-based company more time. Whether ConnectiCare will remain on the exchange has not been determined, and potentially could be decided based on how the state Insurance Department rules on a last-minute appeal submitted by the insurer Friday evening. (Constable, 9/12)

Campaign 2016

Clinton Diagnosed With Pneumonia

Both Hillary Clinton and Donald Trump have come under pressure for not releasing their complete medical records.

Democratic presidential nominee Hillary Clinton fell ill during a memorial service marking the 15th anniversary of the Sept. 11, 2001, terrorist attacks, leaving abruptly and inserting new speculation about her health into a presidential campaign in which Republican Donald Trump has called her weak and unfit. Video of Clinton鈥檚 hurried departure from the Ground Zero memorial showed her buckling and stumbling as she got into her van. Clinton鈥檚 campaign issued a statement from her doctor later Sunday revealing that she had been diagnosed with pneumonia two days earlier. (Phillip and Gearan, 9/11)

Hillary Clinton鈥檚 campaign said Sunday she had been diagnosed with pneumonia and would cancel a planned two-day swing through California, hours after the Democratic presidential nominee abruptly left a 9/11 memorial ceremony in New York for what her aides described as her feeling 鈥渙verheated.鈥 The diagnosis, coupled with a remark by Mrs. Clinton late Friday criticizing some Trump supporters as a 鈥渂asket of deplorables,鈥 is an unwelcome distraction for a campaign facing a tightening of polls in recent weeks. (Nicholas and Hook, 9/12)

Hillary Clinton has been ill with pneumonia, her doctor revealed in a Sunday evening statement that may shake up the presidential race.聽Clinton鈥檚 health had been the subject of much speculation, fueled most recently by a coughing fit she had at the start of a campaign event in Cleveland, Ohio, last Monday.聽But now it seems that the symptoms she blamed on seasonal allergies may have been a sign of the pneumonia that was diagnosed on Friday. (Hellman, 9/11)

Embattled ex-pharmaceutical CEO Martin Shkreli showed up outside of Chelsea Clinton's New York City apartment Sunday to taunt Hillary Clinton about her health. The Democratic presidential nominee left a 9/11 memorial ceremony early Sunday after becoming "overheated," aides said. After resting at her daughter's apartment, she emerged, telling reporters she felt great. Shkreli stood outside yelling and telling her to drop out of the presidential race.聽"Do you need pharma bro's help?" Shkreli yelled at Clinton, according to a video he posted on YouTube. (Hellmann, 9/11)

Investors nursing wounds after the worst selloff in three months for equity and debt markets got another stress to ponder after concerns over Hillary Clinton鈥檚 health flared anew. The 68-year-old Democratic presidential nominee, whose polling edge over Donald Trump has soothed traders who fear ruptures to U.S. policy and see virtue in political gridlock, is suffering from pneumonia and became overheated and dehydrated during a Sept. 11 commemoration Sunday, forcing her to leave abruptly, her doctor said. (Renick and Ciolli, 9/11)

Hillary Clinton, the Democratic presidential nominee, has pneumonia, her doctor said in a statement on Sunday. Here are some facts about the illness: what it is, what it does and how people recover. (Chokshi, 9/11)

Democratic presidential candidate Hillary Clinton's diagnosis with pneumonia brings national attention to a common but deadly infection and one of the most frequent causes of hospital visits in the United States. ... For U.S. seniors, hospitalization for pneumonia has a greater risk of death compared to any of the other top 10 reasons for hospitalization, according to the American Thoracic Society, a physician's organization that advocates for improving care for lung diseases. (Gallagher, 9/12)

Hillary Clinton has pneumonia, her doctor said Sunday, hours after the Democratic nominee stumbled and exited a 9/11 commemoration ceremony early. The incident seems certain to prompt further scrutiny of Clinton's health and her campaign's transparency -- though Republican rival Donald Trump was uncharacteristically silent throughout a solemn day marking the 15th anniversary of the September 11 attacks. (Bradner, Prokupecz and Merica, 9/12)

In lieu of releasing his medical records, Donald Trump is turning to a familiar space 鈥 a TV doctor show 鈥 to allay voters鈥 concerns about his health. That鈥檚 the game plan next week when the 70-year-old reality TV star-turned-politician plans to appear on Dr. Mehmet Oz鈥檚 highly rated 鈥 and highly criticized 鈥 daytime talk show to discuss his 鈥減ersonal health regimen,鈥 as the show promoted it, amid demands that he and Hillary Clinton both disclose their medical records. (Cook, 9/9)

Meanwhile, Clinton's camp responds to criticism of her drug plan聽鈥

U.S. Presidential candidate Hillary Clinton's spokeswoman said on Friday Clinton's plan to curb drug spending was not the blow to medical innovation that Pfizer Inc Chief Executive Ian Read described it as being on Thursday. "Throughout this campaign, Hillary Clinton has called for expanding investments in innovation for healthcare, from a cure for Alzheimer's to聽building on Vice President Biden's Cancer Moonshot initiative," campaign spokeswoman Julie Wood said in an emailed statement. (Humer and Pierson, 9/9)

Capitol Watch

Republicans Likely To Drop Planned Parenthood Provision For Zika Funding

Lawmakers are expected to vote on a stripped down version of the $1.1 billion package in combination with the spending bill. In other news, officials in Puerto Rico are warning that there aren't enough resources to fund the fight against the virus, spraying in Miami beach has commenced and more stories on Zika.

Lawmakers are edging closer to breaking a monthslong impasse over funds to combat the Zika virus, as Republican lawmakers and aides said they expected to drop a contentious provision that would effectively block funding to clinics in Puerto Rico that work with Planned Parenthood. Lawmakers and aides from both parties said Friday they anticipated that this month Congress would pass a package combining Zika funding with a spending bill that would keep the government running until early December. The government鈥檚 current funding is scheduled to expire at midnight on Sept. 30. (Peterson, 9/9)

Florida Gov. Rick Scott will go to Washington, D.C., this week to urge Congress to fund the fight against the mosquito-borne Zika virus as the disease continues to be detected in Miami-Dade County. ... President Barack Obama requested Congress allocate $1.9 billion for the Zika fight in February. But Congress has been unable to agree on a funding plan. (9/11)

After about two months in recess, Congress is back in Washington D.C., and people are hopeful there will be some agreement on what can be done to combat the Zika virus鈥攚hich has already plagued more than 750 Floridians. That comes as the Senate failed to pass another Zika funding bill again this week and there may be even more issues surrounding the mosquito-borne disease on the table. (Cordner, 9/9)

Doctors in Puerto Rico are warning that the U.S. territory does not have the resources to handle the fallout of a Zika epidemic as officials report an uptick in the number of fetuses with malformations that were carried by women infected with the virus. The cases are among the first of what health officials believe could reach a couple hundred next year, sparking concerns about the lack of funds and specialists needed to care for children with severe birth defects on an island mired in a deep economic crisis. (9/9)

Zika is working its way around the United States. ... But while mosquitoes are a key menace when it comes to Zika, the media and public officials are too focused on them. They also need to pay attention to sex: If we are going to stop the spread of this disease, we are going to need better access to Zika testing for anyone who is sexually active in a Zika zone. (Folkers, Caplan and Igel, 9/11)

Miami Beach authorities started spraying for Zika-carrying mosquitoes Friday, and spraying's expected to continue for weeks.Authorities in other states are also cracking down on mosquitoes as the Zika threat worsens. It is the peak of mosquito season in the U.S., and the insects can be expected to continue biting until October in warmer states. ... Here are some of the weapons available to fight disease-carrying mosquitoes. (Fox, 9/9)

The first round of aerial insecticide spraying in South Beach was completed at 5:32 a.m. Friday. ... Just after 5 a.m., a plane flew over the ocean just offshore and released the spray. According to county officials, on-board meteorological equipment was used to measure weather conditions and calculate a flight path that would allow the aircraft to spray the insecticide and let the wind waft over the island. (Flechas, 9/11)

Small aircraft started predawn spraying of insecticide to kill Zika-carrying mosquitoes in Miami Beach Friday morning. The spraying had been delayed a day after worried and angry residents complained to city officials and organized a small protest outside City Hall. Hours after spraying ended, the mayor's office announced that a fresh pool of mosquitoes had tested positive for the virus. (Fox, 9/9)

An Orlando nonprofit is recruiting volunteers to process data for researchers studying the Zika virus. ...The World Community Grid developed from an IBM Corporate Citizenship project. To run massive computer simulations, the grid breaks down data to process in the background on personal devices without accessing private information. (9/11)

The virus, transmitted mainly through bites from infected mosquitoes, has spread across parts of Latin America, the Caribbean and most recently Miami.聽While nearly all of the more than 170 cases reported in Texas were contracted by people traveling outside the country, health officials said South Texas is especially vulnerable to an outbreak.聽The Aedes aegypti mosquito, which can carry the Zika virus, dengue and chikungunya, is endemic to the Texas-Mexico border. Air conditioning and window screens help prevent transmission, but impoverished neighborhoods, known as colonias, often lack these amenities. (Nelsen, 9/11)

Marketplace

Many Health Care Providers, Suppliers Not Ready For Disaster Readiness Rule

The New York Times reports that the rule, which is designed to protect against severe gaps in patient care after major disasters such as Hurricane Katrina and Hurricane Sandy, gives the health industry just over a year to prepare. Meanwhile, KQED examines the impact of physicians opting for subscription models instead of insurance and Hawaii's largest insurer is moving forward with a plan to change the way primary care physicians are paid.

An estimated 72,315 American health care providers and suppliers 鈥 from hospitals and nursing homes to dialysis facilities and care homes for those with intellectual disabilities 鈥 will have a little over a year to meet federal disaster preparedness requirements completed this week by the Centers for Medicare and Medicaid Services. The new rule is aimed at preventing the severe breakdown in patient care that followed disasters including Hurricane Katrina and Hurricane Sandy, while also strengthening the ability to provide services during other types of emergencies, such as pandemics and terrorist attacks. (Fink, 9/9)

[Dr. Lorraine Page is]聽one of a growing number of doctors who have cut loose from what she calls the 鈥渁ssembly-line, volume approach鈥 that most of her colleagues聽have experienced. These breakaway docs are now using a health care delivery model called direct primary care. Page has cut back on the number of patients she sees,聽and spends more time with the ones she does. She doesn鈥檛 take insurance and deals mostly in cash. Page charges each time she sees a patient,聽but most聽direct primary care doctors bill聽a monthly fee for unlimited visits. (Gorn, 9/11)

Hawaii鈥檚 largest health insurer is plowing ahead with an ambitious plan to dramatically overhaul the way primary care doctors are paid 鈥 by giving them a monthly per patient fee. The Hawaii Medical Service Association, which covers more than half of the state鈥檚 1.4 million residents, in January will start paying physicians a standard monthly rate per patient. It's part of health care industry鈥檚 effort 鈥 with encouragement from the Obama administration 鈥 to move away from a fee-for-service system that payers say encourages overtreatment and overspending. (Ehley, 9/9)

Public Health

15 Years Later, 9/11 Responders Face Daunting Health Problems

For those who rushed in to try to save people after the Sept. 11, 2001 terrorist attacks, the toll has been steep. Some are dying, their bodies riddled with cancer, and others haven't even connected their symptoms to the work they did 15 years ago. And the mental toll on survivors and first responders continues to be high.

Making the decision to help 15 years ago might end Garrett Goodwin's life early. Goodwin, 39, was one of tens of thousands of people at ground zero right after the Sept. 11, 2001, attacks.聽A trained medic, he traveled from Tampa, Fla., to New York to volunteer. But now, his lungs are failing him, and doctors say that will lead to his death. Goodwin is one of many volunteers who spent long hours toiling in the World Trade Center ruins, where toxic fumes have left many sick or dead. (Bowen, 9/9)

In the years after the 9/11 attacks, health experts have learned more about how the debris, smoke and wreckage affected the health of first responders and other survivors of the attacks. Those who stayed in the area and breathed in the dust and smoke have been found to be more at risk for a host of health problems, including cancer, asthma, mental health disorders and gastrointestinal diseases. ... The FDNY reports that in addition to the 343 FDNY members killed on 9/11, another 127 firefighters have died of illnesses related to working at Ground Zero in the past 15 years. (Mohney, 9/11)

Fifteen years have passed since the worst international terrorist attack in history claimed the lives of nearly 3,000 people, more than 400 of whom were first responders. Since then, tens of thousands have developed illnesses stemming from exposure to toxins at Ground Zero. ... Under the 2005 World Trade Center Disability Law,聽public employees and retirees who became disabled as a result of September 11-related operations are entitled to a 75-percent disability pension. But in order to qualify, EMTs and rescue paramedics had to have submitted a sworn statement聽to the New York City Employee Retirement System (NYCERS) indicating the dates and locations of their participation at Ground Zero. (Margolin, 9/10)

This week, just days before the 15th anniversary of the September 11th terrorist attacks, [Helaina] Hovitz released a memoir entitled聽鈥淎fter聽9/11:聽One Girl鈥檚 Journey Through Darkness to a New Beginning.鈥澛營n the book, she recounts the all-too familiar events of the day as seen through a child鈥檚 eyes. She also聽details her struggle through聽more than a decade of misdiagnosed post-traumatic stress disorder (PTSD)聽and 聽the聽alcoholism that came with it,聽and she聽writes about what finally helped her cope. (Welch, 9/9)

In a study of聽813 first responders, 12.8 percent had cognitive impairment. Responders like [Anthony] Flammia, with a diagnosis of PTSD with flashbacks, were three times as likely to have impairment. The average age of the group was just 53. (Lapook, 9/9)

Strange. Beautiful. Disconcerting.聽For Liz and Steve Alderman, those were their first reactions when they walked into the 9/11 Memorial just days before the somber 15-year mark since the terror attack here. ... They founded The Peter C. Alderman Foundation (PCAF) in 2002 with the mission of helping "one of the world's most vulnerable populations recover from the emotional wounds of war," with a focus on mental health rehabilitation for victims of terror and the trauma of war. Liz and Steve have built the foundation into a $1.5 million-a-year organization operating in Cambodia, Uganda, Kenya and Burundi, and also working in refugee camps. (Harlow, 9/9)

Meanwhile, strides have been made in the area of trauma care聽鈥

Kaiser Health News staff writer Rachel Bluth reports: "War abroad and carnage at home since 9/11 have taught Americans much about saving lives after violent tragedies. Whether they were hurt in mass shootings or gruesome car accidents, it鈥檚 not uncommon for victims to bleed to death on the scene because trained assistance didn鈥檛 arrive in time to help them. But one of the most powerful initiatives in trauma care in the past 15 years might make a difference." (Bluth, 9/12)

'The Streets Are Awash With Adderall': Misuse Of ADHD Drugs Skyrocketing

In Florida, a bellwether state for drug abuse problems, overdose deaths involving amphetamines increased more than 450 percent between 2008 and 2014.

Public health officials have focused on the national plague of narcotic painkillers. But another scourge is looming largely unnoticed: The drugs used to treat attention deficit hyperactivity disorder in adults.聽Since 2013, there have been more than 19,000 reports of complications from ADHD drugs, most of which are stimulants like Adderall, made to the U.S. Food and Drug Administration, according to a Milwaukee Journal Sentinel/MedPage Today analysis.聽Of those, adults were far more likely than children to suffer severe complications, such as death and hospitalization.聽(Wynn and Fiore, 9/10)

Meanwhile, in news from the opioid crisis聽鈥

A safety director in a city that released photos of a 4-year-old boy in a vehicle with two adults slumped over after overdosing on heroin and fentanyl said Friday he and others wanted to send a message to addicts they should find safe places for their children when using debilitating drugs. The photos were taken Wednesday in East Liverpool, a city of about 11,000 residents along the Ohio River, and were posted to the police department鈥檚 Facebook page Thursday. (Gillispie, 9/9)

The聽campaign against marijuana legalization in Arizona received a major infusion of cash last week聽from a聽synthetic cannabis聽drugmaker that has been investigated for alleged improper聽marketing of聽a聽highly addictive聽prescription painkiller, according to campaign finance reports. The $500,000 donation from聽Insys Therapeutics, based in聽Chandler, Ariz., amounts to more than聽one-third of all money raised by Arizonans for Responsible Drug Policy, the group opposing legalization. It's one of the largest single contributions to any anti-legalization campaign ever, according to campaign finance records聽maintained by ballotpedia.com. (Ingraham, 9/9)

Patients鈥 addiction problems hit home for Fishman and for thousands of other physicians who have recovered from their own drug dependence.聽Substance abuse among health professionals is not something the public likes to think about. But it鈥檚 very real. In 2014, a USA Today review of state and federal records identified hundreds of cases in recent years in which physicians and other health care practitioners were disciplined or prosecuted for drug diversion or other medical misconduct related to substance abuse. (Kanne, 9/11)

One of the harshest critics of how the state has handled the opioid addiction crisis is about to take her seat on the Governor's Commission on Drug and Alcohol Abuse, the steering committee for efforts to stop the soaring death toll. Melissa Crews, whose criticism of Democratic Gov. Maggie Hassan in a political ad led to her resignation from the board of Hope for New Hampshire Recovery, was recently named to the commission by Republican Senate President Chuck Morse. (Solomon, 9/10)

The History Of Antibiotic Resistance: It Was An Arms Race They Thought They Could Win

As more cases are diagnosed, Stat looks back at scientists' warnings over the past 60 years about superbugs. They were ignored.

Bacteria that have evolved to withstand antibiotics kill 700,000 people each year, and ever more powerful strains are spreading around the world. Researchers are worried that we will enter a post-antibiotic age, in which we are infected by bacteria that can defeat every drug medicine has to offer. Next week, the United Nations will convene a high-level meeting to coordinate the global fight against these invisible enemies. (Zimmer, 9/12)

Medical detectives said Friday they are still baffled about how much-feared drug-resistant superbugs infected two people in the U.S. this year, but they have good news: both patients recovered and don't seem to have infected anyone else. ... Scientists fear an E. coli bacteria with the mcr-1 gene could pass it to another superbug with other mutations -- creating a true superbug that resists all known antibiotics. (Fox, 9/9)

This summer, a Pennsylvania woman was found to carry a superbug that is resistant to the antibiotic of last resort,聽causing alarm about the potential of聽dangerous drug resistance spreading聽across the United States. Ever since, health researchers have been looking for where else such germs might be lurking. On Friday, the Centers for Disease Control and Prevention said the superbug popped up in a 2-year-old girl in Connecticut. She got sick in June and was found to have a strain of E. coli bacteria with the antibiotic-resistance gene known as mcr-1, making her the fourth human case in the United States identified so far. (Sun, 9/9)

Concussion Concerns Cast Shadow Over NFL Opening Weekend

Quarterback Cam Newton took a brutal hit, prompting a review of the medical team's response to his injury. The incident adds fodder to the intense scrutiny facing football and concussion protocol. In other public health news, experts say abstinence-only sex ed just doesn't work, some push to start screening children for mental health issues as early as 6 months, super-lice are winning the battle against over-the-counter products and more.

The NFL kicked off its opening weekend for the 2016 season, and while the league's revenues continue to climb, a hit against a star quarterback in the season opener on Thursday has renewed controversy over brain injuries in America's most popular spectator sport.The NFL and the NFL Players' Association announced today that they are both addressing circumstances surrounding decisions made by medical personnel during Thursday's game between the Carolina Panthers and Denver Broncos when the Panthers' star quarterback Cam Newton took what appeared to be a brutal hit by Broncos safety Darian Stewart. (Hayden, 9/11)

Although refraining from having sexual intercourse is a sure-fire way to prevent pregnancies and sexually transmitted infections, a recent report published in the journal Pediatrics concluded that abstinence-only programs are ineffective in delaying the initiation of sex. The federal government has invested more than $100 million into abstinence-only sexuality education since an eight-point definition of abstinence education was enacted in 1996 under the Social Security Act. (Armstrong, 9/9)

Briggs works at the Healthy Steps program at the Montefiore Comprehensive Health Care Center in the South Bronx, screening children as young as 6 months for mental health issues. That may sound young, too young maybe, but that's when some experts believe it's important to catch the first signs that something may be wrong. Many say waiting until kindergarten is too late. So Briggs sees a lot of babies at the Healthy Steps program, but the crying doesn't seem to faze her at all. Visiting with baby and parent, she watches the way they interact. (Cardoza, 9/9)

A new report warns that over-the-counter products have lost much of their effectiveness against the so-called super聽lice. Prescription products, though, can still get rid of the creepy critters. Parents should turn to physicians first instead of trying to treat their children themselves with over-the-counter products, said report lead author Dr. Ellen Koch. She鈥檚 a dermatologist with the University of Pittsburgh Medical Center. (Dotinga, 9/9)

The American Academy of Pediatrics (AAP) states that there鈥檚 no medical evidence that starting solids in any particular order has any advantages. ...In fact, studies show babies鈥 food preferences actually start in utero. Babies whose mothers drank carrot juice during pregnancy and while breastfeeding had fewer negative expressions when they started to eat carrots than infants who had not been exposed to the flavor, a study in the journal Pediatrics found. (Revelant, 9/11)

For anyone with asthma, preventing attacks of wheezing, coughing, chest tightness and shortness of breath is a top priority. Might vitamin D help? (Searing, 9/10)

Quality

Project Aims To Empower Primary Doctors To Cut Down On Specialist Referrals

Project ECHO is trying to train doctors to handle complex issues instead of sending the patient to a specialist.

Medical subspecialities began proliferating in the US in the 1970s, with the rise of more technologically advanced care. But with that trend came another novelty: Primary care doctors began referring their patients elsewhere for care. In the last 15 years, that practice has skyrocketed. Between 2000 and 2010 alone, referrals jumped from 41 million to 105 million annually. (Tedeschi and Fritz, 9/12)

Health IT

Mapping Program Guides Doctors Navigating Cancer Treatments

PiCnIc produces maps of cancer progression, using the smallest pieces of data to predict the likeliest paths.

What if doctors could call up a computerized map that would show them how a case of cancer is likely to progress? Tumor cells can mutate in unexpected ways. And cancers can suddenly grow. For doctors, anticipating cancer's next moves can help guide timely, effective patient treatment. A mapping program, called PiCnIc for short, aims to help physicians in staying a step ahead of cancer and preparing long-term treatment plans with fewer elements of surprise. (Kim, 9/9)

In other health technology news聽鈥

A new wave of robotically assisted tools for knee and hip replacements is moving into specialty centers and hospitals around Minnesota, and the number of procedures appears poised to spike in 2017. The surgical robots carry big price tags, but people who use them say the cost is made up in quicker recovery times and more predictable results, especially in complex cases. (Snowbeck, 9/9)

State Watch

State Highlights: Mass. Budget Cuts Leading To Long Waiting List For Home Care; N.H. Hospitals Band Together For Financial Health

Outlets report on health news from Massachusetts, New Hampshire, Minnesota, Ohio, California, Colorado, Florida, Washington, Iowa and Illinois.

For thousands of frail, older Massachusetts residents, home care visits offer a lifeline 鈥 and a way to remain in their houses even amid illness and disability. But that lifeline could be jeopardized by state budget cuts, according to elder advocates who say that as many as 200 residents a month could be added to waiting lists for services from Sept. 1 through June. They are urging legislators to act quickly, saying the state received federal money for elder home care and that money is just sitting in a trust fund. (Lazar, 9/10)

When Catholic Medical Center was looking to partner with Huggins Hospital, CMC executives held separate secret talks with executives from another hospital simultaneously, unbeknownst to the other.聽What emerged was a three-hospital affiliation agreement announced this summer aimed at sharing services and saving the patients and hospitals money. (Cousineau, 9/10)

Bleary-eyed from 22 hours of contract talks, leaders for Allina Health and its union hospital nurses appeared to be just one big issue away from agreement when they halted negotiations at 6 a.m. on Sept. 3. Forty-eight hours later the nurses hit the picket lines. Now, as the strike enters its second week, the question is: Will they still be that close when they return to bargaining after having slept, restrategized and traded bitter accusations for days? (Olson, 9/12)

Rep. Warren Davidson wants members of Congress to get their health care from Veterans Affairs鈥 facilities, and he plans to introduce legislation this week that would force lawmakers and their staff to make that switch. Davidson, who represents Butler County, said the bill would motivate members of Congress to improve care at the VA鈥檚 vast network of clinics and hospitals 鈥 quickly and dramatically. (Shesgreen, 9/10)

With the nation鈥檚 senior population expected to double in the next 20 years, there鈥檚 a growing need for senior services. One niche: the millions of LGBT baby boomers who came from an era when equal rights were only a dream. A new community in Palm Springs is a sign of the changing times. (Napoli, 9/12)

This week, officials in Riverside Country (which is near Los Angeles) said they are investigating the suspected cases of leprosy, now usually called Hansen's disease, at an elementary school in the area. Nursing staff at the school first notified officials about the possible infections on Sept. 2, but it will take several weeks to confirm them, according to the Los Angeles Times. Cases of Hansen's disease in the United States are rare, but they do occur, with about 100 to 200 cases typically reported each year, according to the Centers for Disease Control and Prevention. (Rettner, 9/12)

It鈥檚 ladies night at the Centennial Gun Club in a suburb of Denver. More than 80 women are here for safety instruction and target practice. Tonight the club is offering more than shooting, though. The women rotate through the firing range, and in another large room, they hear a sobering presentation from emergency room doctor Emmy Betz. She鈥檚 part of a collaboration between gun shops and public health leaders in the state to help prevent suicide. (Daley, 9/12)

Orlando Health has rebranded its five outpatient Boston Diagnostic Imaging centers to Orlando Health Imaging Centers. The health system and Medical Center Radiology Group created a company and purchased the five outpatient centers in December 2014. The centers are in Ocoee, Altamonte Springs, downtown Orlando and Sanford. The downtown clinic temporarily lost its certification in August 2015, after federal officials raised questions about the quality of their mammograms. (Miller, 9/10)

State health officials have confirmed five cases of Legionnaires' disease in people who live or work in Hopkins and are investigating the source of the outbreak. Of those who became ill between Aug. 4 and Sept. 1, three are currently hospitalized, and two others were hospitalized and have recovered, the Minnesota Department of Health said Friday. The patients are all over the age of 50. Legionnaires' disease is a severe form of pneumonia usually caused by infection, according to the federal Centers for Disease Control and Prevention. (9/9)

The procedure marks the first adult intestine transplant performed at UWMC, and one of just eight ever in the Northwest region that includes Washington, Oregon, Idaho, Montana and Alaska, federal data show. But it also demonstrates the maturation of the UW鈥檚 intestinal rehabilitation program, started by Reyes four years ago to treat patients like Oberts whose guts were failing. (Aleccia, 9/10)

More than a year after two of Iowa鈥檚 four mental health institutes were shut down, the institute in Cherokee is operating similarly to how it had been in recent years. Apprehension had run through Cherokee in 2009, when state officials explored closing one or more of the state鈥檚 four mental health institutes. The loss of the northwest Iowa campus would have delivered a $24 million hit to the local economy. (Hayworth, 9/11)

The聽Lake County Health Department reported Friday that the county's first confirmed human case of West Nile virus affected an Ingleside resident late last month. In a news released issued Friday morning, health department officials said the patient was hospitalized in late August and discharged in early September. (9/9)

It's been a month since Sebastian DeLeon, an adventurous camp counselor in South Florida, went from being a regular teen to the boy who miraculously survived a deadly brain-eating amoeba. The 16-year-old is doing well and eager to get on with his life, he said on Friday from his South Florida home during a video call that was broadcast at the second annual Amoeba Summit at Florida Hospital. (Miller, 9/10)

Editorials And Opinions

Viewpoints: New Health, Poverty Data Deserve Attention; Switching Tactics On Zika

A selection of opinions on health care from around the country.

Like the man said, important numbers are coming out tomorrow. But, I can hear you thinking, if they鈥檙e out tomorrow, why do we have to talk about them today? Fair question.聽It鈥檚 because these data tend, IMHO, to not get enough attention. That鈥檚 because they鈥檙e for last year (2015) and, thus, don鈥檛 move markets. Also, this Census Bureau report is not like the monthly jobs report we all know and love, where you can聽look at the unemployment rate and the payroll jobs number and call it a day (not that I鈥檇 ever do so!). These data provide tons of results 鈥 e.g., the three variables listed in the title by age, race, gender, region, and much more 鈥 so the report can be a bit overwhelming. There are also some tricky methodological issues to consider. (Jared Bernstein, 9/12)

On Nov 8, the residents of a suburb of Key West will vote on whether to allow scientists to release genetically-modified mosquitoes into their backyards. Inserted into the mosquito's genetic makeup would be an artificial stretch of DNA that renders them unable to reproduce. As the 鈥渢ransgenic鈥 mosquitoes mate with wild ones, the plan goes, their offspring would die, bringing the local population of skeeters down significantly 鈥 by as much as 90 percent, according to Oxitec, the for-profit firm that wants to release the modified mosquitoes. That would potentially reduce the risk to local residents of catching mosquito-borne diseases such as dengue and Zika. ... The controversy Oxitec鈥檚 mosquito project has caused in Florida is a microcosm of a broader debate over the new biotechnology. (Fred Guterl, 9/12)

But while mosquitoes are a key menace when it comes to Zika, the media and public officials are too focused on them. They also need to pay attention to sex: If we are going to stop the spread of this disease, we are going to need better access to Zika testing for anyone who is sexually active in a Zika zone. (Kelly McBride Folkers, Arthur L. Caplan and Lee Igel, 9/11)

Twenty million people have health insurance today thanks to the ACA, and the uninsured rate in this country is the lowest on record. Plus, more than 10 million Americans now have coverage through the ACA's Marketplace. These consumers report that they're pleased with their coverage and can now access and afford the care they need. But we do expect 2017 to be a transition year for the Marketplace. (Sylvia Burwell, 9/9)

Come November, the grim trudge across the increasingly barren Obamacare landscape begins anew. Illinois consumers likely face staggering price hikes for individual insurance policies. Some types of plans could cost an average of 43 percent to 55 percent more. Ditto across the country: A first tranche of states approved 2017 rates with similarly cardiac-arrest-inducing premium increases. ... We can deny the current system's failings, or we can parlay our evolving knowledge into something much better. Put another way: The next president and Congress either reckon with Obamacare's failures or ... wait for the thud. (9/9)

No matter what the outcome of the election or its impact on the Affordable Care Act, there's one thing neither party disputes. The national imperative to promote systematic change of the healthcare delivery system, the focus of half that legislation, will remain intact. That means the shift from volume to value will not only endure, it will accelerate. The great transformation in how the U.S. pays for and delivers healthcare has become a permanent feature of the industry's landscape. (Merrill Goozner, 9/10)

Eight years ago, I wrote a medical report on the health of then-presidential candidate Barack Obama, whose personal physician I had been for 22 years. That report was 276 words and described Obama鈥檚 health as excellent. I was derided for issuing such a brief report, but there was nothing of significance in the medical history of this healthy, 47-year-old male. Meanwhile, Republican John McCain 鈥 a 71-year-old with a history of skin cancer 鈥 made nearly 1,200 pages of records available for a group of reporters to review. (Dr. David L. Scheiner, 9/9)

Earlier this year, the Food and Drug Administration approved a new weight-loss procedure in which a thin tube, implanted in the stomach, ejects food from the body before all the calories can be absorbed. Some have called it 鈥渕edically sanctioned bulimia,鈥 and it is the latest in a desperate search for new ways to stem the rising tides of obesity and Type 2 diabetes. Roughly one-third of adult Americans are now obese; two-thirds are overweight; and diabetes afflicts some 29 million. Another 86 million Americans have a condition called pre-diabetes. None of the proposed solutions have made a dent in these epidemics. (Sarah Hallberg and Osama Hamdy, 9/10)

I don鈥檛 know what is going on at Theranos. I never had a clue. I may be one of the few willing to admit it. This is a problem in both the technology and investment communities -- the simple inability to say 鈥淚 don鈥檛 know.鈥 There is plenty of evidence that many folks who claimed to understand the company and its founder -- putting lots of money at risk while giving the company a multibillion-dollar valuation -- didn鈥檛 have a clue either. The venture capitalists who funded this unicorn were unable to admit this. That blind spot is the focus of our attention today. (Barry Ritholtz, 9/9)

Although more than half of states have passed right-to-try laws, some have resisted the trend, saying they make false claims, conflict with existing federal regulations, and have the potential to exploit patients. Gov. Jerry Brown (D) of California vetoed a right-to-try bill last October, disappointing many who had hoped for less-regulated access to unapproved therapies for the dying. Why are these kinds of laws so controversial and so politically charged? (Carolyn Long Engelhard, 9/9)

The appeal of Amendment 69 for so many Coloradans is painfully obvious. The initiative for a single-payer health care system makes sense to anyone who has needed an EpiPen or a prescription for Hepatitis C, who has watched his take-home pay shrink while his insurance premiums and deductibles continue to soar, anyone whose blood boils when she hears about the outrageous salaries paid to CEOs of聽 hospital corporations and health insurance companies, and everyone who watched the support explode for an obscure Democratic socialist presidential hopeful from Vermont who campaigned for a 鈥淢edicare-for-all single-payer鈥 health care system. (Diane Carman, 9/10)

We can鈥檛 make a good decision in the state about what to do about exploding insurance premium rates for individuals if it鈥檚 MNsure that gets the blame. That鈥檚 because MNsure is nothing more than a government-run electronic marketplace and administrator that doesn鈥檛 insure anybody. Blaming it for escalating rates is a little like blaming your toaster for being overweight. (Lee Schafer, 9/10)

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