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In a blow to President Obama’s health care law, Aetna, one of the nation’s major insurers, said Monday that it would sharply reduce its participation in the law’s public marketplaces next year. Aetna said it would no longer offer individual insurance products on the exchanges in about two-thirds of the 778 counties where it now provides such coverage. The company will maintain a presence on exchanges in Delaware, Iowa, Nebraska and Virginia, it said. (Pear, 8/16)

Aetna Inc, the No. 3 U.S. health insurer, on Monday said that due to persistent financial losses on Obamacare plans, it will sell individual insurance on the government-run online marketplaces in only four states next year, down from the current 15 states. Aetna's decision follows similar moves from UnitedHealth Group Inc. and Humana Inc., which have cited similar concerns about financial losses on these exchanges created under President Barack Obama's national healthcare reform law. (Humer, 8/15)

Aetna cited unsustainable losses as the primary reason for trimming its Obamacare participation. The number of counties where it sells exchange plans will drop from 778 to 242. “Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool,” Aetna CEO Mark Bertolini said in a statement. “Fifty-five percent of our individual on-exchange membership is new in 2016, and in the second quarter we saw individuals in need of high-cost care represent an even larger share of our on-exchange population.” (Demko, 8/15)

Aetna’s move will sharpen concerns about competitive options in the exchanges—and it puts at least one county, Pinal in Arizona, at risk of having no insurers offering exchange plans in 2017, a circumstance that would present a major challenge to the basic mechanics of the ACA. ... Stephen Briggs, a spokesman for Arizona’s state insurance regulator, said the state currently has no insurers that have filed to offer exchange plans in Pinal, a county in the Phoenix area.“It’s a concern for us,” he said, but the regulator doesn’t “have any legal leverage to compel anyone to offer a plan.” (Wilde Mathews, 8/15)

Next year will be the law’s fourth of providing coverage under the new markets. Aetna’s decision doesn’t affect people covered by the company this year, but when they look for 2017 coverage, they’ll need to pick a new insurer. The decision raises the prospect that some consumers will only have one insurer to choose from when they buy 2017 coverage. (Tracer, 8/15)

Aetna, which had 838,000 exchange customers at the end of June, said its policyholders are turning out to be sicker and costlier than expected. The company, along with its peers, has criticized the federal program designed to mitigate those risks. (Luhby, 8/15)

The Obama administration argued the move is not a sign that the ObamaCare marketplaces are in trouble. “Aetna’s decision to alter its Marketplace participation does not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that,” said the administration’s ObamaCare marketplace CEO, Kevin Counihan. (Sullivan, 8/15)

Aetna's announcement comes as the insurer is locked in a battle with the U.S. Department of Justice over its effort to acquire Humana for $37 billion. The department sued to block the deal and a trial is scheduled to begin Dec. 5. (Singer, 8/15)

On sabbatical from the University of Arizona, [Dr. Paul Gordon] set off in the spring on a cross-country bicycling trip and “listening tour” from Washington, D.C., to Seattle, talking along the way to Americans about the controversial health law that President Obama signed six years ago. Much of what Gordon uncovered was as unsettling as the current presidential campaign. Americans raged at the government, at the healthcare system, at fellow citizens who’d gained coverage through Obamacare. The outpouring of resentment and apparent lack of empathy disturbed Gordon at first. “Not a lot of generosity of spirit,” he noted glumly over the phone early in his trip. (Levey, 8/16)

CareFirst BlueCross BlueShield says it needs huge rate hikes next year to make up for nearly $300 million in losses in the individual market during its first three years of competing on Maryland’s Obamacare exchange. CareFirst CEO Chet Burrell made the case for increasing rates on his company's PPO plans by 36.6 percent and its HMO plans by 27.8 percent during a public hearing today before the Maryland Insurance Administration. (Demko, 8/15)

Under the new rules, Covered California enrollees who receive tax credits — currently about 90 percent of them — will be able to select different plans for different members of the family in the online health insurance application. Tax credits will be distributed proportionally among the different plans.Previously, the online application only allowed those who were not eligible for tax credits to choose multiple plans within a family. (Bazar, 8/15)

Debate over how a divided Congress should respond to the Zika virus moved from Washington to the campaign trail in the first half of the summer recess, ranging from the presidential campaign to House contests. While it's not clear yet that fear of the mosquito-borne virus will prove to be a major issue that moves votes, Zika certainly has emerged as a flash point in Florida, the ground zero for infections in the continental U.S. (Shutt, 8/15)

Democratic U.S. Senator Jeanne Shaheen called on Congress today to provide money for research on the Zika virus. She spoke to state and town officials in Salem, where mosquitos with both West Nile and EEE have been successfully controlled in years past. (Corwin, 8/15)

Health officials say a Texas resident who recently traveled to an area of Miami where local Zika transmission occurred has tested positive for the virus. The Texas Department of State Health Services said Monday that it’s the first Texas case to be linked to travel within the continental U.S. Health officials linked the case to Miami travel after investigating factors such as travel dates and when symptoms appeared. (8/15)

Zika's now spreading from state to state in the U.S.. Health officials in Texas said Monday a resident there caught Zika in Florida and brought it home. It doesn't mean Zika's an epidemic just yet, but it does show just how easily the virus can spread once enough people in an area are infected. "This is the first Texas case to be linked to travel within the continental United States. The case will be classified as 'travel-associated' and is being investigated for more details," the Texas health department said in a statement. (Fox, 8/15)

Texas Health and Human Services had announced recently that women on Medicaid could see their physician and get a prescription for two free cans of mosquito repellent monthly at their pharmacy. Today, the process has been streamlined. Now pregnant women of any age and all women between 10 and 45 on Medicaid can go directly to the pharmacy to pick up the spray. No doctor’s visit is required. (Rigby, 8/15)

Anthony Fauci has spent his career hunting ways to treat and prevent infectious diseases, from tuberculosis to severe acute respiratory syndrome, or SARS. He did pioneering work on deciphering how HIV/AIDS attacks the human immune system, and during more than three decades as director of the National Institute of Allergy and Infectious Diseases has continued the quest to end the HIV/AIDS epidemic across the world. In recent years, Fauci and other researchers at NIH, working alongside the pharmaceutical industry, also have found themselves scrambling to develop vaccines and treatments for emerging diseases such as Ebola and Zika. (Dennis, 8/15)

Hillary Clinton endorsed the Obama administration’s cancer moonshot initiative on Monday and pledged to continue its work if she is elected president. The announcement preceded a campaign event that Clinton is holding with Vice President Joe Biden, who has led the effort after the death of his son Beau of brain cancer in 2015. (Scott, 8/15)

Hillary Clinton pledged to continue Vice President Joe Biden’s cancer moonshot initiative if elected president and called on Congress to pass funding for the effort. ... President Obama announced the cancer moonshot earlier during his State of the Union address in January. He put Biden in charge of it, following the death of the vice president’s son, Beau. The effort has since focused on creating a large research cohort and enhancing researcher’s coordination. (Owens, 8/15)

Hillary Clinton’s doctor certified that she “is in excellent physical condition.” Donald Trump’s physician declared he would be the healthiest president — ever. Testaments like these have become a ritual of American politics. But in the absence of detailed medical records, nobody seems to take them seriously. The result has been a political vacuum in this year’s presidential campaign, one filled by speculation over what the nominees, two of the oldest in US history, might be hiding. (Scott, 8/15)

Republican presidential candidate Donald Trump on Thursday named former New York Lt. Gov. Betsy McCaughey, known for sparking the debunked claim that the Affordable Care Act would create “death panels,” to his economic team. McCaughey also helped defeat Hillary Clinton's healthcare proposal when Clinton was first lady in the 1990s by saying it would ban patients from paying doctors for services outside of their coverage. Her claims are frequently rated as untrue by fact-checking organizations and by journalists. (Muchmore, 8/12)

When the Los Angeles hairstylist Chaz Dean pitched his almond mint and lavender-scented hair care products — endorsed by celebrities like Brooke Shields and Alyssa Milano — he sold millions. But his formula got an unexpected result: itching, rashes, even hair loss in large clumps, in both adults and children. More than 21,000 complaints have been lodged against his Wen Hair Care, and Mr. Dean, the blue-eyed, golden-haired stylist to the stars, has found himself at the center of a fierce debate over the government’s power to ensure the safety of a cosmetics industry with about $50 billion in annual sales. (Lipton and Abrams, 8/15)

Yet the legal challenge is not over for Medtronic. The company, one of the world’s largest medical device manufacturers, now faces a whistleblower lawsuit that claims it sought Food and Drug Administration approval for its devices under false pretenses — and that the devices have been regularly used for a purpose that was never intended by regulators. “They were labeled, ‘not for cervical spine use,’ and yet in everything about them, including emails from their marketing folks, it makes clear that they were meant to be and were used in the cervical spine,” said Dr. Vikas Saini, president of the Lown Institute, a Boston health care think tank, who has followed the case. (Kaplan, 8/15)

The law that bans federal funding for Medicaid coverage of most abortions is now in the spotlight some 40 years after it was passed by Congress, emerging as an election issue in the national debate over the procedure. First approved in 1976, and renewed annually ever since as part of the congressional appropriations process, the Hyde Amendment makes exceptions in cases of rape or incest, or when a pregnancy endangers a women's life. For most of its existence, the amendment had broad bipartisan support in Congress, but that's now changed. (Crary, 8 /16)

The chairman of the Texas Legislature's Women's Health Caucus urged the state auditor's office to investigate the awarding of a $1.6 million state grant to an anti-abortion group Monday. Rep. Jessica Farrar, D-Houston, said the Health and Human Services Commission's decision last week to award the Healthy Texas Women program's grant to the Round Rock-based Heidi Group funnels tax dollars to an unlicensed medical provider with a an anti-abortion agenda.  (Zelinski, 8/15)

Acetaminophen, long the mainstay of a pregnant woman’s pain-relief arsenal, has been linked to behavioral problems in children born to mothers who used it during pregnancy. Research published Monday by the journal JAMA Pediatrics found that a woman’s use of acetaminophen at 18 and 32 weeks of pregnancy was associated with greater odds that when the resulting child was 7 years old, his or her mother would report a range of problematic behaviors. (Healy, 8/15)

There's no question the study addresses an important topic. About half of all pregnant women take acetaminophen during pregnancy because it's considered safer than other painkillers. And hyperactivity and other behavioral problems in childhood are common and potentially disruptive. The study reports that these behavioral problems were about 20 to 45 percent more common among the children of women who took acetaminophen during pregnancy. So it sounds like a pretty important finding, right? Well, it's not quite so simple. (Harris, 8/15)

Despite the increased risk for women taking the drug, the total risk of developing behavioral issues overall remained small, with 5 percent of children studied being affected by these behavioral issues. “This does not mean it is not safe during pregnancy," Stergiakouli said. (Ghodadra and Mohney, 8/15)

The researchers did try to address some of the questions doubters had. They asked the women, for instance, about symptoms that may have caused them to take pain medication. Infections such as influenza can affect brain development — for instance, they are linked to autism. It's one of the many reasons pregnant women are urged to get flu shots. But the surveys didn't ask one key question, which is how often or at what doses the women took the pills. If the risk of behavior problems went up the more often women took the pills, that would be more of a smoking gun. (Fox, 8/15)

Staci Gruber vividly remembers her first hit of marijuana, back when she was in college. ... Today, she runs the 2-year-old Marijuana Investigations for Neuroscientific Discovery, or MIND, project at McLean Hospital in this suburb of Boston. With cognitive testing and neuroimaging, MIND is conducting a longitudinal study of medical marijuana. (Samuel, 8/15)

Thirty businesses have won approval to grow and process medical marijuana in Maryland, regulators announced Monday, putting life into the industry more than three years after lawmakers legalized the drug for medical use. Several of the winning applicants have political ties — with major donors or high-ranking officials on their teams — including a company that hired the Maryland lawmaker who was the driving force behind the tightly regulated program. (Gregg and Nirappil, 8/15)

The state has awarded preliminary licenses to more than 20 companies to grow and process marijuana in Maryland, a major step forward in the effort to make medical cannabis available to patients in Maryland. Licenses were awarded Monday to companies across the state, from Washington County in Western Maryland to Worcester County on the Eastern Shore.  They plan to grow marijuana plants and turn them into pills, oils, extracts and other products for patients suffering from a range of illnesses. (Wood, 8/15)

“The trouble is: You think you have time.” That Buddhist-sounding quote from a fortune cookie rattled around the back of my head for decades, seemingly for no reason. Now that I find myself living with my 94-year-old mother in a Florida city where preacher Billy Graham got his start and being a never-wed 60-something has made me a tourist attraction of sorts, I finally understand why I thought the repercussions of growing old without a child or two would not apply to me: I was just plain delusional. (Zubrod, 8/15)

Today's 65-year-olds can expect to spend an average of $130,000 on health care during their retirement, from premiums to co-payments to eyeglasses, according to new estimates. The average single 65-year-old woman can expect to need $135,000 to spend on health care in retirement, while a man will spend $125,000, according to estimates from Fidelity Investments. (Steverman, 8/16)

Despite a growing body of research that shows staying in bed can be harmful to seniors, many hospitals still don’t put a high priority on making them walk. At [the University of Alabama at Birmingham (UAB) Hospital-Highlands] 26-bed geriatric unit, known as the Acute Care for Elders unit, or ACE, patients are encouraged to start moving as soon as they arrive. The unit is one of a few hundred around the U.S. that is attempting to provide better and more tailored care to geriatric patients. The hospital opened the unit in 2008 with the recognition that the elderly population was growing and that many older patients didn’t fare well in the hospital. (Gorman, 8/16)

Ms. Marsh took Brody, now 6, to an occupational therapist who determined he had a sensory-processing disorder, or SPD, a condition in which the body and brain have difficulty processing and responding to sensory stimuli in the environment. Some people with SPD are hypersensitive to loud noises or different textured foods, for instance; others may be agitated by the touch of a clothing tag. Still other children with SPD may show hardly any response to external stimuli. SPD is believed to affect 5% to 16% of children in the U.S., various studies have found. Not all doctors accept the existence of SPD, which isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders. (Reddy, 8/15)

It came as a surprise this June when the Centers for Disease Control and Prevention recommended against using the nasal flu vaccine for the 2016-2017 flu season, citing a lack of evidence that it works. Now, findings from a Canadian study appear at first blush to contradict the research that led the Advisory Committee on Immunization Practices to recommend against that live attenuated vaccine.But things aren't so simple. (Haelle, 8/15)

Racial inequity and violence rank higher than ever on the list of top child health concerns among black adults, according to a new poll from C.S. Mott Children's Hospital. More than 60 percent of black adults say racial inequities are a "big problem" for children, while 45 percent of Hispanic adults and only 17 percent of white adults said the same. Specifically, racial inequities and school violence ranked numbers two and three on the list of child health concerns among black Americans. Gun violence -- which did not appear on any other's group's top 10 --- ranked seventh. (Welch, 8/15)

Roughly one-third of the globe can no longer see the Milky Way thanks to artificial light at night. The impact of light pollution has long been obvious, but scientists are now exploring the role of constant exposure to light on health, and a study in the journal Current Biology adds both good and bad news. Researchers in Holland say the absence of natural light-and-dark rhythms can lead "to severe disruption of a wide variety of health parameters"—including a loss of bone density. (Moore, 8/15)

Despite decades of warnings from the "Back to Sleep" campaign, many parents are still putting their babies to sleep in ways that raise the risk of sudden infant death syndrome (SIDS), a new study finds. Each year in the United States, about 3,500 infants die suddenly, from no obvious cause, according to the U.S. Centers for Disease Control and Prevention. A majority of those deaths are labeled as SIDS -- a phenomenon that researchers still don't completely understand. (Norton, /15)

Last August, my sister Betsy asked if I knew anything about using bitcoin, a form of virtual currency. It took me a while to realize why she was asking: She wanted to buy a lethal amount of drugs and she didn’t want the purchase to be traceable. Betsy was diagnosed with amyotrophic lateral sclerosis in July 2013. It’s a cruel disease that slowly robs a person of the ability to move, speak, eat and, eventually, breathe. There is no treatment, let alone a cure, and there probably won’t be for several years. (Davis, 8/15)

Colorado voters this fall will decide whether terminally ill people should be allowed to receive prescriptions for drugs to end their own lives. The "Medical Aid in Dying" measure was certified Monday as having enough petition signatures to make ballots this fall. Five other states have some law allowing the terminally ill to end their lives. (Wyatt, 8/16)

Colorado voters will decide in November whether a terminally ill adult should be allowed to take a prescribed drug to cause his or her death. If voters pass Initiative 145, Colorado would become the sixth state to authorize some type of end-of-life option for the terminally ill. ... The initiative requires anyone exercising the option to be at least 18 years old, have a terminal illness with less than six months to live and be able to self-administer the drugs that cause death. (Bunch, 8/15)

According to a new report, Florida and 42 other states fail to give the public easy access to health care pricing. The study, co-published by two nonprofits - Catalyst for Payment Reform and Health Care Incentives Improvement Institute - assessed how readily consumers were able to find health care prices in each state. Suzanne Delbanko , the executive director of Catalyst for Payment Reform, said Florida is not alone when it comes to getting an ‘F’ grade. (Miller, 8/15)

Union nurses at five Twin Cities hospitals will vote Thursday on whether to authorize another strike at five Allina hospitals. Negotiators for the Minnesota Nurses Association are urging their members to authorize an open-ended walkout. They hope the prospect of an indefinite strike will put more pressure on the health system to settle a contract.In June, 4,800 nurses struck Allina for one week. in a dispute that still centers on health benefits. (Benson, 8/15)

Bay Area companies say Sutter Health is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future. Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, the letter says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices. (Dembosky, 8/15)

As Sacramento area school districts step up efforts to ensure that kindergartners and seventh graders get vaccinated so they can attend class, a federal judge in San Diego is weighing whether to temporarily block the law that eliminated parents’ ability to exempt their children from shots by citing personal beliefs. Rebecca Estepp, spokeswoman for the nonprofit Education 4 All Foundation, said U.S. District Judge Dana Sabraw announced he expects to decide the week of Aug. 22 whether to temporarily halt Senate Bill 277 while a lawsuit goes forward. The foundation is one of 21 plaintiffs in the suit. (Kalb, 8/15)

Texas health regulators are starting from scratch in designing a system to store massive amounts of data — after spending millions of dollars trying to roll out a version that’s now been scrapped. Charles Smith, executive commissioner of the Texas Health and Human Services Commission, said Monday that his agency had recently nixed a $121 million contract to create an Enterprise Data Warehouse, an enormous database that would store a wide range of information about the many programs the agency administers. First funded in 2007, the project was expected to be up and running a few years after. (Malewitz and Walters, 8/15)

A group of local and national advocates are calling on the federal government to investigate whether it’s unjust for people with a mental illness, who haven't been convicted of a crime, to be treated in a prison. New Hampshire is one of only a few states that transfers individuals with a violent mental illness to the Department of Corrections, and it’s been doing so for more than three decades. (Sutherland, 8/15)

Officials from Mercy, other Iowa hospitals and the state’s long-term care ombudsman agree: Iowa is grappling with a long-term care crisis. Many predict the problem will intensify as Iowa’s population ages. “Especially in states with an older population, which Iowa is, we’re going to be facing situations where people with cognitive disorders and dementia will be in hospitals. That challenge will just increasingly worsen,” said Francis Sanchez, a mental health medical director for Great River Health Systems in West Burlington. (Clayworth, 8/15)

Nine Kansas medical practices and collaborative groups will participate in an experiment to find out if doctors could do a better job preventing heart attacks and strokes. The project is part of the Million Hearts federal initiative, which is trying to prevent 1 million heart attacks, strokes and heart disease deaths by 2017. Some of the participating practices will use a risk calculator adopted by the American Heart Association to try to pinpoint their patients’ risk of cardiovascular disease. (Hart, 8/15)

Judges have issued competing rulings over the validity of lawsuits filed by patients who fear they may have been infected by a former surgical technologist at Swedish Medical Center who stole painkiller syringes while he was HIV positive. Denver District Court Judge Jay Grant on Thursday dismissed one of the lawsuits because free blood tests offered by Swedish had not found infections among those suing. (Osher, 8/15)

Tianqiao Chen, a Chinese billionaire who made his initial fortune in online gambling, has purchased a 9.9% stake in troubled hospital giant Community Health Systems, according to a regulatory filing Monday. Chen, through affiliate Shanda Media Limited, reported on Aug. 3 that he had accumulated 11.3 million shares of Franklin, Tenn.-based CHS, the filing said. (Dave Barkholz, 8/15)

The small, six-member staff at Asian Pacific Community in Action in Phoenix has a big enemy: the infectious liver disease hepatitis B. It's a prevalent and now preventable virus that disproportionately affects Asians and Pacific Islanders, a growing population in Arizona. According to the U.S. Centers for Disease Control and Prevention, the Asian and Pacific Islander community makes up less than 5 percent of the United States population but accounts for more than half of those living with hepatitis B. (Quijada, 8/15)

Hillary Clinton supports adding a public option to the Affordable Care Act -- that is, a government-run insurance program to compete with private health insurance. ... This position makes a lot of practical sense, as the New Republic’s Brian Beutler has been pointing out. The Congressional Budget Office has scored a public option as deficit-reducing, which means Democrats wouldn’t have to raise taxes or cut spending to pay for it. ... But it’s one thing for Democrats to support a policy. It’s quite another for it to be the kind of high priority they would fight for. (Jonathan Bernstein, 8/15)

There are a lot of people in the U.S. who dream of single-payer health care. And what a dream it is! Government as the only entity paying for care, able to drive down costs while ensuring universal coverage. There are not a lot such dreamers who think that the transition to such a system is imminent here. Republicans don’t even like Obamacare, a comparatively moderate program. There seems little hope that they will vote for single payer anytime soon … and even if Democrats somehow manage to get control of White House, the House of Representatives and 60 votes in the Senate, swing-state senators with a nervous eye on their next election are unlikely to support such an ambitious shift to the left. What do to, then, if you’re an advocate for single payer? Well, take your campaign to the state level. (Megan McArdle, 8/15)

When I started out as a doctor in 1999, the Institute of Medicine published a blockbuster report that declared that up to 98,000 people were dying in United States hospitals each year as a result of preventable medical errors. Just a few months ago, a study in the BMJ declared that number has now risen to more than 250,000, making preventable medical errors in hospitals the third-largest cause of death in the country in 2013. ... Although medical errors should concern us all, these statistics are more controversial than you might think. (Aaron E. Carroll, 8/15)

In a vacation season when many of us want a break from alarming news, the world seems not to be cooperating. And that includes the health care industry. (A shame, that: "Health" and "care" could be such soothing words.) We hear that we should be alarmed about proposed rate hikes in the subsidized Health Insurance Marketplace created by the Affordable Care Act ("ObamaCare"). But before we freak out, let's take a deep collective breath and remember a couple of things. (Ken Janda, 8/15)

Denis Robinson wasn’t bothered in the least that he was billed nearly $100,000 by Providence Tarzana Medical Center for the recent removal of his gallbladder.“What do I care?” he said. “I have Medicare Plan F, the Cadillac of Medicare plans. They covered every dime.” Actually, Robinson, 69, should care a great deal. Medicare is a taxpayer-funded system, so any claim submitted by a doctor or hospital affects the financial integrity of the entire program. The fact that Medicare paid less than $4,000 for a $97,000 claim — we’ll get back to that in a moment. (David Lazarus, 8/16)

Companion diagnostics is gaining currency as novel drugs are being paired up with tests that determine which patients will have a higher chance of responding to that drug. But 15 years after the human genome project has been completed, the progress of precision medicine appears to be woefully slow, at least according to Nicholas Dracopoli, vice president and head of Oncology Biomarkers at Janssen Research & Development, part of Johnson & Johnson. Others believe precision medicine and companion diagnostics have a chicken and egg problem. (Arundhati Parmar, 8/15)

Have you ever seen a baby born with microcephaly? If you have, you know it is impossible to not weep at the tiny, misshapen head. To hold such a baby is heartbreaking; chances he or she will grow up are slim. If you have not seen such a condition, I hope you never will. Clearly, few members of Congress know what this is all about. Otherwise, how could they have possibly gone on vacation without appropriating the funds begged for by those at the Centers for Disease Control? (Ann McFeatters, 8/15)

As part of a research project, I'm in Brazil this summer hearing the experiences of women and health care providers about their perceptions of the risk of Zika infection and potential changes in reproductive behavior. Our findings suggest that, while incredibly concerned about Zika, wealthier women ... feel in control of preventing the virus by using repellent, netting their homes and postponing pregnancy. Poorer women have a more fatalistic attitude about getting infected with Zika and even about getting pregnant. Poorer women also feel that they can't protect themselves as well as wealthy women can because they lack the means to do so (money to buy repellents and mosquito nets), and they recognize their living conditions make them more vulnerable to mosquito bites (particularly through exposure to open sewage and stagnant water.) (Leticia J. Marteleto, 8/15)

In my experience, physicians who expect medical students and other trainees to do a good job involve us in patient care and make us a valuable part of the team. As a result, we feel useful, push ourselves to excel, and learn more in the process. Those who expect shoddy work limit our role and then conclude we had little to contribute. These encounters have far less educational value. (Akhilesh Pathipati, 8/15)