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Health briefs 3-19-18


n Registered Nurses Invited to MVH Career Fair/Open house, 11:30 a.m. to 4:30 p.m. March 22 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital.

n Better Breathers Club, 2-3 p.m. March 20 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital. Information and registration: 724-258-1226.

n Colorectal Screening, 1 p.m. March 21 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital. Information and registration: 724-258-1333.

n Kick Butts Day information table, 9 a.m. to 2 p.m. March 21 in the lobby of the Fayette County Health Center. Free cessation classes are offered.

n Multiphasic Blood Analysis, 7-10 a.m. March 24 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital. Information and registration: 724-258-1282.

n Smoke Free for Life program, 1-3 p.m. April 2, 9, 16 and 23 in Monongahela Valley HealthPlex suite 270. The program will also be held in the same location: 5:30-7:30 p.m. June 5, 12, 19 and 26; 10 a.m. to noon Sept. 6, 13, 20 and 27; 5:30-7:30 p.m. Nov. 6, 13, 20 and 27. Information: 724-258-1226.

n Hernia Screening and Seminar, 10 a.m. to noon, April 28 in Conference rooms 1 and 2 on the fourth floor of Excela Square at Frick in Mount Pleasant. Information: 1-877-771-1234.

n Exercise classes, Tuesdays and Thursdays, Center in the Woods, 130 Woodland Court, Brownsville. Classes include chair dancing at 9:30 a.m. followed by healthy steps at 11 a.m. Information: 724-938-3554

Support groups

n Suicide Bereavement Support Group, 1-2:30 p.m., March 26 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital. Information and registration: 724-678-3601.

n Grief Support Group, 2-3:30 p.m. through March 20 at Weatherwood Manor in Greensburg. It is a six-week group. A second six-week group meets 2-3:30 p.m. from March 19 through April 30 at Latrobe United Methodist Church.

n Stroke Support Group, 6-8 p.m. March 20 in Community Room 2 in the main lobby of Uniontown Hospital. Information: 724-430-5341.

n Stroke Support Group, 6-7 p.m. March 27 in Conference Room A on the first floor of Excela Westmoreland Hospital. Information: 1-877-771-1234.

n Osteoporosis Support Group, 5:30 p.m. April 12 at the Health Center on New Salem Road in Uniontown. Registration: 724-626-8780.

n Caregiver Support Group, 6:30-8:30 p.m., the fourth Wednesday of the month at Lafayette Manor. Classes meet in the new Physical Therapy Department. Light refreshments are provided.

n Stepping Stones Bereavement Support Program, beginning at 7 p.m. March 5 and running for 10 weeks at the Fayette County Health Center on New Salem Road. Anyone who is grieving the loss of a loved one is welcome. Information and registrations: 724-438-9373 or 724-439-1683.

n Cancer Grief Group, 2:30-4 p.m. every Thursday at Our Clubhouse on Route 30 East in Greensburg.

n Grief support group, 6-8 p.m., first Tuesday of every month, at the St. John the Evangelist Church on West Crawford Avenue in Connellsville. The group is a collaborative effort for those facing grief due to the loss of a loved one from addiction. Information: 724-628-6840.

n Al-Anon Family Groups, 8 p.m., Wednesdays, Trinity Church basement, Fayette and Morgantown streets, Uniontown, and 7:30 p.m., Fridays, Christian Church, Pittsburgh Street, Connellsville. These meetings are for anyone who has been affected by or is having problems from someone else’s drinking. Information: or

n Survivors of Incest Anonymous group, 6:30-8 p.m., the first and third Mondays of the month, excluding holidays. This 12-step recovery program is meant for men and women aged 18 or older who were sexually abused by a trusted person as a child. The group meets at the Mount Macrina Retreat Center. A similar group, Healing Friends, is from 6:30-7:30 p.m., East Liberty Presbyterian Church in Pittsburgh, on the second and fourth Tuesdays of the month. Information:, or

n Missing Piece of My Heart Support Group, the last Thursday of each month, 6-8 p.m., at the Crime Victim’s Center conference room in the Oliver Square Plaza. The group is for families who have lost a child to a violent crime. Information: 724-438-1470.

n Silver Generation Support Program, 10 a.m. to noon, Wednesdays, East End United Community Center, Uniontown. The program is for ages 55 and older. Information: 724-437-1660.


n Childbirth and Labor Preparation Courses, March 20 7-9 p.m. in Community Room 1 of the main lobby at Uniontown Hospital. Information and registration: 724-430-4646.

n Managing Your Diabetes, 6-9 p.m. March 20-22 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital. Information and registration: 724-258-1483.

n Living With Diabetes, Looking Forward, 1-3 p.m. March 19 at Excela Frick Hospital.

n Childbirth and Beyond, 6:30 to 9 p.m. March 21 at the Memorial Conference Center on the ground floor of Westmoreland Hospital.

n Insulin Pump course, 9 a.m. to noon March 22 in Conference Room 1 on the first floor of Excela Latrobe Hospital.

n Breastfeeding Success, 9-11:30 a.m. March 24 on the First Floor Conference Rooms at Westmoreland Hospital.

n Living Well Series: Orthopedics “Back Pain and Disc Degeneration,” 6 p.m. March 26 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital, featuring Eric Jabors, M.D. and his discussion of advanced treatments.

n Is Weight Loss Surgery Right For You? 6 p.m. March 26 at the Anthony M. Lombardi Education Conference Center at Monongahela Valley Hospital. Information and registration: 724-258-1333.

n Yoga class, 5:15 p.m., Mondays, Conference Room D at the Excela Health Westmoreland Hospital, and Thursdays, Auditorium A/B/ in the Excela Health Latrobe Hospital.

n Chair Fit mixed cardiovascular training, 10:30-11:30 a.m., Mondays, Conference Room D in Excela Health Westmoreland Hospital.

n Interval Training class, 4:30-5:30 p.m., Mondays, at the Memorial Conference Center at Excela Health Westmoreland Hospital.

n Body Sculpting and Core Conditioning, 4:30 p.m., Wednesdays, in the Memorial Conference Center in Excela Health Westmoreland Hospital. Information: 724-830-8568.

Article source:

4-H virtual 5K promotes a healthy lifestyle among families



There’s more than one way to complete a 5K, and Florida youth and their families are planning to try them all during the month of March as part of a statewide effort to promote a healthy lifestyle.

To get involved in the Florida 4-H Virtual 5K, participants can run, walk, bike, dance, swim — anything that gets them to 6,500 steps, the equivalent of 5 kilometers or 3.1 miles, said Vanessa Spero-Swingle, a regional specialized 4-H agent. 

4-H is the youth development program of the University of Florida Institute of Food and Agricultural Sciences Extension, and serves about 200,000 youth in the state. 
Registration fees for the Virtual 5K will support 4-H Healthy Living programs in Florida. United Healthcare, a sponsor of the 5K, is offering scholarships to help more youth and families participate.

Those who sign up online and finish the challenge will receive a medal of recognition for their commitment to an active lifestyle, Spero-Swingle said.

“Healthy living is one of the three main components of 4-H, which also focuses on the sciences and leadership. 4-H members understand that a healthy body and mind are essential to learning and leading, and we hope the Virtual 5K will help more people experience those benefits,” Spero-Swingle said.

Unlike most 5K events, which take place in a central location, this 5K is virtual because people throughout the state can participate by themselves or in groups at their own pace, Spero-Swingle explained.

Andrea Lazzari, a 4-H agent with UF/IFAS Extension Brevard County, said about 50 youth and adults participated in a planned day of activities March 3.

“Most of our members were running or walking, but there were also some biking, roller blading, and scootering their way to the finish line,” Lazzari said. “Healthy living activities like this one get our youth and their families excited about living a healthy lifestyle. When these kids and their families get together to participate, that’s even better because they can work to motivate each other. Youth who partake in healthy lifestyle choices now are more likely to be happy, healthy adults.”

The Brevard County event also included a make-your-own healthy trail mix station and a “smoothie bike,” a stationary bike that powers a blender filled with healthy smoothie ingredients.

Both 4-H members and non-members can sign up for the Virtual 5K online. Visit

Article source:

Healthy Living: Learn to manage your chronic pain | Local …

Karen Douglas is health education coordinator at Samaritan Health Services. To learn more ways to help manage your chronic pain, Samaritan Health Services offers a free, six-week series called PainWise First Steps. For more information or register for a class, call the Samaritan Health Services Health Education Department at 541-768-6811.

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What’s good for the body is good for the brain: Tips for better brain health

When it comes to our hearts, even the nonmedical types among us pretty much know what we need to be doing. In a nutshell: exercising and eating right.

But when it comes to our brains, guidelines tend to be foggier. Besides, we figure, since we’re probably as smart as we’ll ever be, what can we possibly do?

Plenty, but let’s start with this reminder: Just because right this second you can’t remember the name of your first-grade teacher, that doesn’t mean your smarts are on the wane. Not by a long shot.

“Science is showing for the first time in 30 years that our brain is the most modifiable part of our body and easiest to strengthen, more than our heart or teeth,” says Sandra Bond Chapman, founder and chief director of the Center for BrainHealth at the University of Texas, Dallas. The center opened a new facility in October: The Brain Performance Institute, which offers scientifically based programs to enhance brain performance and health.

Although Alzheimer’s now tops heart disease and cancer when it comes to our fear factor about diseases, Chapman says, strengthening your brain is more than decreasing the chance of developing dementia. Instead, it’s about increasing brain health.

Here are tips from Chapman and other experts:

Exercise. This isn’t completely surprising. What, after all, isn’t made better by exercise? Fitness has been linked to a healthier brain in a study by UT Southwestern’s O’Donnell Brain Institute and the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Dallas.

“We think if you have a good cardiovascular fitness level, your heart is stronger and blood supply healthier, and you have a better chance to get enough blood supply for the brain,” says Dr. Kan Ding, a neurologist with the Brain Institute and lead author of the study. “That’s very important for brain health, because the brain is a very unique organ. All the energy it needs is from blood from the rest of the body, so blood supply is very important for the brain.”

The study examined the fitness levels of people who had a high risk for developing dementia by having them walk on a treadmill. Then they underwent a special MRI sequence called diffusion tensor imaging, “which is able to show us all the white matter in your brain,” she says, “and how the neurons connect to each other.”

The result: “The higher your fitness level, the better the highway system in your brain. Those with the better highway system did better on our cognitive performance test, on brain games to test how fast you respond to a question, or how many words you can remember.”

This study “shows exercise is a promising way to prevent or slow cognitive decline in that population.”

It’s the first study, she says, to show that exercise does more than make you feel good; it shows the structural impact of exercise.

Aim for 30 minutes most days, which is what Ding says is now her goal.

Take five. In this 24/7 world, there is always something with which to clog or entertain our brain. But, Chapman says, “our brain loves to be reset. Five-by-five is what we call it. Take five minutes five times a day to let your brain stop. It could be a walk around where you are inside, or go outside. Let your engine reset.”

Stop multi-tasking. Ah, how tempting it is to be talking on the phone while surfing online while cooking dinner. But that is making our brain networks “more frayed,” Chapman says. “Brain efficiency breaks down. We’re making an older brain out of a younger brain.”

The paradox, she says, is that people tend to think, “I’m doing three things at once, so I must be more efficient.” However, she says, “When you try to do three things at once, there are more errors, they take longer to do and they’re more shallow.”

So instead of taking pride in pushing yourself to do two or three things at once — which stresses out the brain and can lead to depression, she says — focus on single-tasking. “Doing one thing for a concerted period of time will strengthen the brain and increase energy tremendously.”

Up your fruit and vegetable intake. “The way we eat affects our energy; it affects our glucose,” Chapman says. “Our brain is a greedy animal. If we’re eating foods that require a lot of digestive juices, that takes away from our brain. What’s good for your heart is good for your brain.”

Sarah Lock, executive director of AARP’s Global Council on Brain Health, recommends five types of food we all need to be eating on a regular basis to keep our brains in tiptop shape:

• Berries (whole, not juice)

• Fresh vegetables (bring on the greens)

• Healthy fats (think olive oil)

• Nuts (they’re high-calorie, too, so limit your intake)

• Fish and seafood

Practice innovative thinking. “Our brain is wired to see things in new ways and to be figuring out things,” Chapman says. So while memorization is fine, “the brain gets jaded the more things we do on rote. Innovative thinking in our world that’s always changing helps keep mental independence. Our brain is built to do this until the day we die.”

A few tips: Thank someone using different words. Think of a different way to formulate a subject line or the contents of an email. “What’s a way to reframe a conversation with a family member,” she asks, “to see things from a broader perspective?”

Take a technology timeout. “Take a respite. You’ll see a quick rebound and guess what? You haven’t missed that much,” Chapman says. “If we were to take away technology from meetings, we could end them in 20 minutes. People say, ‘You don’t understand. Clients expect me to respond right away.’ I say, ‘No. They’re paying for your brain.’ ”

Believe in your brain. Our brain system starts slowing down as early as our 40s, Chapman says, “but only because we let it.” True, some people will develop Alzheimer’s, especially because the population is aging. But, she adds, “on average, 87 percent of people won’t.” And if we’re genetically prone to Alzheimer’s but have taken care of our brains, we’ll have reserve to maybe push back the symptoms by, perhaps three to five years, she says.

“Healthy lifestyle factors can mitigate the onset, but we don’t necessarily know exactly how long,” she says. Even without that knowledge though, “Why wouldn’t we build brain reserve? We save for investment retirement.”

Article source:

Lauren’s List: Healthy Eating Tips You May Want To Ignore

Thinking Of Starting A Family? Read These Health Tips First

Maintain a healthy weight 

For women, being underweight, overweight and even over-exercising may lead to infertility, according to the American College of Obstetricians and Gynecologists. For men, obesity is also associated with infertility due to lowered sperm count and motility, according to the National Infertility Association. Therefore, couples should maintain an optimal body weight to increase the chance of getting pregnant.

Diets favouring whole grains, fruits, vegetables, poultry, and seafood are associated with better fertility in women and better semen quality in men, according to a review published in the American Journal of Obstetrics and Gynecology in 2017.

Avoid going on fad diets, as those who take on restrictive diets for short periods of time often get fed up quickly, start over-eating, make poor food choices and regain the weight they lost. Fad diets can also deplete your body of the nutrients it needs for a healthy pregnancy. Consult a dietitian who can help you lose weight in a way that suits your lifestyle.

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The Health 202: Trump will propose executing drug dealers. But only in some already legal cases.


President Trump has admired Philippine President Rodrigo Duterte as a model for cracking down on drug crimes. (AP Photo/Bullit Marquez, File)

President Trump today will emphasize that the death penalty can be extended to drug dealers. But compared to his tough talk about executing a class of people he seems to view as street thugs, the president’s proposal aimed at curbing the opioid epidemic is a little less than it seems.

On a visit to New Hampshire, one of the states hardest-hit by opioid addiction and overdose, Trump will officially propose that his Justice Department pursue stiffer penalties — including capital punishment — for traffickers when appropriate under the law.

That last part is important as the administration had been considering making trafficking in even small doses of fentanyl — a deadly synthetic opioid — a capital offense. But instead, Trump is urging more aggressive prosecution of drug dealers, and only seeking the death penalty when it’s already available.

U.S. law allows for the death penalty to be applied in four types of drug-related cases, according to the Death Penalty Information Center: murder committed during a drug-related drive-by shooting, murder committed with the use of a firearm during a drug-trafficking crime, murder related to drug trafficking and murder of a law-enforcement officer that relates to drugs.

The measures are part of a three-pronged approach to fighting opioid abuse and overdose the White House rolled out last night. It’s aimed at reducing the demand for opioids by slowing overprescribing, cutting off the supply of illicit drugs and helping those who are addicted, my colleague Katie Zezima reports.

“The opioid crisis is viewed by us at the White House as a nonpartisan problem searching for a bipartisan solution,” White House counselor Kellyanne Conway told reporters.

For weeks, whenever the president mentioned opioid abuse, he has praised the leaders of countries where people are executed for drug crimes, or even shot in cold blood. Exhibit A: Philippines President Rodrigo Duterte, whose brutal campaign to crack down on illicit drug has resulted in the deaths of more than 12,000 people without due process, as police and hired guns have slaughtered suspected users and distributors on the streets and in their homes.

Trump applauded Duterte last spring for doing an “unbelievable job” in combating the illegal drug trade, and after meeting with Duterte in November he said the two have a “great relationship.” Last month, Axios’s Jonathan Swan reported that Trump often compares drug dealers to serial killers and advocates they get the death sentence, as in the Philippines and a handful of other countries mostly in Asia and the Middle East.

And a week ago, at a political rally in Pennsylvania, the president again suggested the United States should join the handful of other countries in allowing capital punishment for drug crimes.

“You kill 5,000 people with drugs because you’re smuggling them in, and you are making a lot of money and people are dying,” Trump said, prompting cheers from the gathered crowd. “And they don’t even put you in jail. That’s why we have a problem, folks. I don’t think we should play games.”

Trump’s “tough guy” stance stood in stark contrast to the more measured approach preferred by some of his top administrators, such as Health and Human Services Secretary Alex Azar. Azar has gone out of his way to stress better treatment as key to quashing the epidemic.

The United States is one of 32 countries with death penalty laws for drug offenses, but only seven nations actually conduct executions routinely, according to a March report from Harm Reduction International. They include Iran, Saudi Arabia, Vietnam and Malaysia, as well as China and Singapore, two countries Trump also referred to as examples of ways he thinks the United States should approach the issue.

(The Philippines doesn’t actually allow the death penalty for drug crimes, but executions are being carried out ad hoc under Duterte as noted above.)

Ashok Kumar, Singapore’s U.S. ambassador, argued in a recent letter to The Washington Post that his country is one of the few that have kept drug abuse under control through its “clearheaded approach,” which includes education, rehab programs — and stiff penalties.

But experts in drug law say there’s no evidence that capital punishment on its own reduces dealing or drug use – and it could even worsen the behavior. The most likely scenario is that lower-level operators, such as drug runners, would be caught and executed while organized criminal leaders remained free to carry on their activities, Georgetown Law professor Larry Gostin told me.

“In the case of trafficking, the economic rewards are so lucrative and the supply networks so sophisticated that, in my view, it would provide no deterrent to organized crime,” Gostin said.

Iran, for example, has one of the highest addiction rates in the world. According to the United Nations Office of Drugs and Crime, 2.2 million people — nearly 3 percent of the population — are hooked on drugs. Yet Iran also carries out more executions per capita for drug offenses than any other country, with 242 people executed last year, according to HRI.

Columbia University law professor Jeffrey Fagan also said he sees no scientific evidence that executing drug dealers deters dealing or drug use. “It’s not a smart policy, even if it has some emotional appeal,” Fagan told me.

But it’s well known that Trump acts — and speaks — from his gut, not necessarily because he believes there’s evidence to support his views. From his own blunt rhetoric, he has made clear he admires the same trait in other world leaders, even leaders such as Duterte who show a blatant disregard for human rights.

Duterte announced Wednesday that he’s withdrawing the Philippines from the Rome Statute, the treaty that established the International Criminal Court, which is looking into his violent campaign to determine whether it justifies an official investigation into charges of crimes against humanity. Duterte said the decision to withdraw was because of “baseless, unprecedented and outrageous attacks” by U.N. officials and an attempt by the ICC prosecutor to seek jurisdiction “in violation of due process and presumption of innocence.”

And last year, Duterte said this: “Hitler massacred 3 million Jews. There are 3 million drug addicts. I’d be happy to slaughter them … You destroy my country, I kill you. It’s a legitimate thing. If you destroy our young children, I will kill you.” (AP Photo/Andrew Harnik, File)

AHH: Many Obamacare insurers turned a profit for the first time last year after three years of pretty heavy losses. Politico’s Paul Demko writes premium spikes led to the profitable year, citing analysis of financial filings of 29 regional Blue Cross Blue Shield plans. Steven Udvarhelyi, CEO of Blue Cross and Blue Shield of Louisiana, told Paul that 2017 “was the first year we got our head above water in the individual market since the ACA passed.”

“The healthier balance sheets are a welcome development for insurers after three years of major Obamacare losses, estimated at more than $15 billion by McKinsey,” Paul writes. “That led many national insurers, including UnitedHealth Group and Aetna, to flee the law’s marketplaces, in some cases leaving Blue Cross Blue Shield plans as the only option for customers.”

But one profitable year doesn’t totally rescue insurers from potential instability moving ahead. The Trump administration is expected to finalize a rule making it easier to buy cheaper plans that are exempt from parts of the health-care law, following Congress’s repeal of the law’s individual mandate. These big changes to the law are weighing on insurers as they decide what to do for 2019.

This file photo shows a Centers for Disease Control and Prevention logo at the agency’s federal headquarters in Atlanta. (AP Photo/David Goldman, File)

OOF: The leading candidate to head the Centers for Disease Control and Prevention is Robert Redfield, a longtime AIDS researcher who is well-respected for his work but once expressed a controversial position on HIV testing, our colleague Lena H. Sun reports.

Redfield was previously floated as a candidate for the top post at the CDC as well as at the National Institutes of Health under other GOP admnistrations, Lena writes. He would fill the role left vacant by Brenda Fitzgerald, who stepped down in January amid reports that she had investments in tobacco, drug and food stocks while heading the CDC.

Redfield is a former Army physician, and currently the director of clinical care and research at the Institute of Human Virology at the University of Maryland School of Medicine. He oversees a major clinical program providing HIV care and treatment to more than 6,000 patients in the Baltimore-Washington region and a care program that is part of the President’s Emergency Plan for AIDS Relief, known as PEPFAR. He has also served as a member of the Presidential Advisory Council on HIV/AIDS.

In the early 1990s, while he was an AIDS researcher in the Army, Redfield stirred controversy over an experimental AIDS vaccine that ultimately failed. “He had been known as a strong supporter of mandatory patient testing for HIV during the 1980s, at a time before effective treatments were available and intense stigma surrounded people infected with the virus,” Lena writes. Some felt the policies he advocated weren’t embracing sound public health approaches to the AIDS epidemic and were stigmatizing of those who were infected.

Trump speaks during an opioids event at the White House in October. (AP Photo/Evan Vucci, File)

OUCH: Watch out, opioid epidemic. Six months after Trump declared opioid abuse a public health emergency, his administration has a detailed plan for how it plans to counter the abuse and overdose crisis. We wrote extensively above about the penalties it’s proposing, but the plan officials released yesterday also calls for a slew of other policies to limit access to opioids and improve education. Here are some of the White House’s goals and strategies, per Katie:

  • Sharply reduce the number of painkillers that are prescribed nationwide, aiming to slash opioid prescriptions by one-third over three years.
  • Tighten the number of opioid prescriptions that can be reimbursed by Medicaid as a way to curb overprescribing.
  • Create a national prescription-drug monitoring system so suspicious prescriptions can be flagged. Right now, each state operates its own, and a few states have data-sharing agreements.
  • Test all federal inmates for opioid addiction and provide options for treatment when inmates complete their sentences and reenter society.

  • Put more naloxone, a drug that can reverse opioid overdoses, in the hands of more first responders. 

The Supreme Court is set to hear a major free-speech case on Tuesday related to information about abortion services. (AP Photo/J. Scott Applewhite, File)

— Tomorrow, the Supreme Court is set to hear oral arguments in a major case on free-speech rights for antiabortion “crisis” pregnancy centers, a hearing The Health 202 wrote about in November. The Post’s Robert Barnes reports from Gilroy, Calif., about clinics that are challenging a new state law requiring them to publicly post a notice informing clients about the availability of free or low-cost access to family-planning services, including abortion.

These centers say they’re being forced to deliver a message antithetical to their mission: encouraging women to carry out their pregnancies rather than end them. But California cites Supreme Court precedent upholding those abortion language requirements in contending it is requiring the clinic to deliver only a neutral and factual message, Bob reports. The message “doesn’t move in one direction or another on the political spectrum,” either in encouraging abortion or discouraging it, California Attorney General Xavier Becerra told Bob.

“We were trying to figure out the way to best get information to people about their health-care options and their rights,” Becerra said. “And this is a pretty straightforward way — neutral way — of getting that information to women.”

Abortion-rights advocates could ironically benefit in other ways, even if they lose this particular case. “If the court rules broadly against the government’s ability to have centers deliver its message, some abortion rights supporters wonder whether the same reasoning could work in their favor in other cases,” Robert writes. “They might challenge dozens of state laws that require doctors and others to deliver certain information to women about the alleged dangers that accompany abortion.”

Abortion rights supporters and opponents rally in the Texas state capitol. (AP Photo/Tamir Kalifa)

— On Friday, the National Academy of Sciences released the first in-depth report in more than 40 years about the state of science on abortion safety and quality in the United States. The work — conducted with support from six private foundations — found that abortions done in a clinic or with drugs appear to be safe in the vast majority of cases, The Post’s Ariana Eunjung Cha reports. Among the study’s interesting takeaways:

  • Legal abortions in the United States, whether by medication or the three major surgical methods, “are safe and effective.”
  • The quality of abortion care depends on where a woman lives.
  • Ninety-five percent of abortions are at clinics or other office-based settings.
  • Despite much speculation about abortion’s impact on future childbearing, the science shows that the procedure does not appear to increase the risk of secondary infertility, pregnancy-related hypertensive disorders, abnormal placentation, preterm birth or breast cancer.
  • Having an abortion does not appear to be linked to such mental-health consequences as depression, anxiety, and/or post-traumatic stress disorder.

House Speaker Paul Ryan (R-Wis.). (Andrew Harrer/Bloomberg)

—Four former FDA commissioners say the “Right to Try” legislation the GOP-led House is teeing up for another vote would put vulnerable patients in danger, our colleague Laurie McGinley reports. Robert Califf and Margaret Hamburg, who led the FDA under the Obama administration, and Mark McClellan and Andrew von Eschenbach, who served under George W. Bush, sent a statement to lawmakers provided to The Post. “There is no evidence that either bill would meaningfully improve access for patients, but both would remove the FDA from the process and create a dangerous precedent that would erode protections for vulnerable patients,” they warned.

“Right to Try” would allow seriously ill patients to bypass the FDA in order to get access to experimental drugs. A Senate version of the bill passed over the summer. The House version failed to pass last week 259-140, seven votes short of the two-thirds threshold needed to pass a bill under suspension of the rules, a procedure typically reserved only for non-controversial legislation. Afterwards, House Majority Leader Kevin McCarthy (R-Calif.) said lawmakers would try again to pass the legislation with only a majority vote.

–A few more good reads from The Post and beyond:

Coming Up

  • The House Energy and Commerce Subcommittee on Oversight and Investigations holds a hearing on the DEA’s role in combating the opioid crisis on Tuesday.
  • The Senate Finance Committee holds a hearing on the nominations of “John J. Bartrum, of Indiana, to be an Assistant Secretary of Health and Human Services and Lynn A. Johnson, of Colorado, to be Assistant Secretary for Family Support, Department of Health and Human Services” on Tuesday.
  • The House Ways and Means Subcommittee on Health holds a hearing on “Implementation of MACRA’s Physician Payment Policies” on Wednesday.
  • The Atlantic holds an event on “The State of Care” on Wednesday.
  • Politico holds an event on “How to Improve Health Care in Nursing Homes and Bend the Cost Curve” on Wednesday.
  • The House Energy and Commerce Subcommittee on Health holds a hearing on the opioid crisis on Wednesday.
  • The Alliance for Health Policy, the Association of Health Care Journalists and the National Institute for Health Care Management hold a webinar on Thursday.

On Saturday Night Live, Anderson Cooper interviews members of a White House in turmoil: 

And on Weekend Update, SNL interviews Kate McKinnon as Education Secretary Betsy Devos: 

Watch the moment a family was reunited with a German shepherd that United Airlines mistakenly shipped to Japan:

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Why The World Needs Health Care Innovation Now


The health care industry can be difficult for innovation. There are a whole host of challenges that make it difficult to drive change — and many who try quickly get discouraged. Some of these challenges result from necessary features of the industry, such as regulation, research and ethical standards. Others — like policy debates, outdated systems and an overwhelming amount of red tape — are problems that need to be solved as soon as possible.

While some of these issues are difficult to resolve quickly, innovators in all corners of the health care industry are working to try and make improvements for patients, practitioners and companies alike. And since health care spending increased by $3.3 trillion in 2016, the opportunities for growth are replete. The following are some of the top reasons that we need health care innovation now.

Faster Development Of Treatments

It takes far too long for new drugs to make it to market. Data from research firm PhRMA identified that it takes 10 years, on average, for a new drug to be available for use. About 60-70% of that time is taken up in clinical trials, but frequently, the remainder is due to outdated regulatory systems. 

Fortunately, through the use of technology, we can significantly speed up that process. Sophisticated AI can increase the effectiveness of researchers, helping them find useful compounds or relevant data that might have been too difficult to find without contextual search features. Pharmaceutical companies are beginning to appreciate the powerful ways in which AI can augment drug research and development. For example, Genentech and GNS Healthcare announced a partnership last year aimed at using AI technology to analyze massive amounts of cancer patient data in order to identify novel cancer therapies. 

Additionally, cloud platforms can help digitize many of the regulatory processes that are still on paper. Some people have even argued that the development process itself should be more customizable and that current FDA regulations are too one-size-fits-all for certain treatments.

Increased Access To Care

Health care systems are different all around the world, and unfortunately, in many regions, it can be difficult to connect people with care. Access is frequently tied to economic status. A CDC report detailed that in the U.S., over 23% of near-poor adults ages 18-64 don’t have access to health insurance, and that number rises to 26% within the poor category. This isn’t just a challenge in the U.S., either — even in countries with universal insurance, access to care can be limited by geography. Smaller communities may not be able to find the services they need locally.

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Why Process Is US Health Care’s Biggest Problem

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A lot of money has been spent on information technology in health care with little to show for it. To understand why we must pay a visit to the hospital.

It only takes 10 minutes of direct observation of a nurse in a hospital to understand care-delivery processes are not standardized and are dependent on individuals, not systems. This lack of reproducibility leads to errors. Since every caregiver does it his or her own way, it’s difficult to improve anything. Stable systems that are reproducible are required to deliver consistently high quality. Industrial companies figured this out 50 years ago. The writings of manufacturing gurus Imai and Shingo provide insight into how quality is built into processes. A process must first be stabilized then standardized before being improved. Because few standardized processes exist in care delivery there are many possibilities for error. That’s why simply making a poor process electronic by implementing an electronic health record (EHR) doesn’t lead to better quality or cost.

When it comes to change, the technology is the easiest part. Most health systems in America have or are implementing the EHR. And the vendor processes for implementation have become very good. The hard part is to get the doctors, nurses, and administrators to agree on what is the best way to deliver the care. Since the doctors control most care decisions, the rest of the provider team follows the doctors’ lead. If the doctor wants to do things a certain way, that’s what is done. The problem is the next doctor wants it his way and so on. Eventually, we end up with a hopeless mess in which no one knows how anything should be done on any given day. And good luck to a new nurse or technician coming into the system who must learn a multitude of work processes and remember the doctor-dependent differences.

Health care technology is very effective when it is used to support a well-designed care process. The design of new standard care processes need to be owned and driven by the people doing the work, not by some outside consulting firm that brings a 100-page playbook as the answer. As the frontline workers create new designs, they need certain systems that can help them deliver the improved care. Examples of these systems include electronic alerts for medication interactions and reminders to ensure all steps in the care process for the pneumonia patient are followed.

Insight Center

There are two types of improvement systems needed to create a well-designed care process. One is a improvement approach that brings members of an existing clinical team members together to improve an existing care process. They use proven improvement methods such as the principles, systems, and tools of the Toyota Production System (TPS). The second is an innovation process aimed at radically redesigning care. It’s associated with TPS and employs design thinking.

In both cases, the initial effort where rapid experimentation occurs might be an ambulatory clinic or an ER. It becomes a place for others in the organization to learn. It is an inch-wide, mile-deep change in practice that incorporates new processes not only for care delivery but also management. It should result in the systems necessary for sustaining improvement over time. As the model line achieves 50% to 80% improvement over baseline performance, the learning should be spread to other parts of the organization. This new way becomes the new best-known way to deliver care.

One example of a radical innovation is the attempt of HealthEast (now part of Fairview Health Services), which serves the Minneapolis-Saint Paul area, to create the clinic of the future. The leaders brought the vendors in their extended supply chain to the table to help in the design process. This included Epic, an EHR company; Herman Miller, an office furniture company; Boldt, a construction company; and HGA, an architectural firm. Together, the team began redesigning the care-delivery model. Each vendor had the opportunity to deeply understand the needs of the HealthEast providers. By the end of the design phase a new process supported by electronic records, architecture, furniture, and building was integrated to create a unique patient experience.

Before HealthEast formed the model clinic, a group of 11 clinicians had over 11 preferred ways for “their” clinic assistant to do just about everything. One key process, screening the patient for health risks such as cancer and hypertension, resulted in over seven places in the EMR for the provider to look for relevant information. Not only is that time-consuming (contributing to physician burnout), but it also greatly increases the chances of missing important information.

The multi-disciplinary team created a single screening process. Now, clinicians have just two places to look in the EMR for information on whether patients have had screens like mammograms and colonoscopies for cancer, staff can remind patients about what screening tests they need, and leaders are able to support the development of standardized clinical processes. The leader’s standard work is to audit the process and monitor the data. If the process stops being followed or the data shows deteriorating results, leaders will know that immediately.

In the first three months after its introduction, the redesigned process reduced provider search time per patient by 23 minutes. The overall screening rate went from 60% compliance to 72% compliance, meaning over 500 more individuals were appropriately screened over baseline. Perhaps more telling are the changes in patient comments. They went from comments such as “I do not feel my medication list was reviewed,” to “My doctor and medical assistant are always timely, thorough, and reassuring.” These results would not have happened unless all parties were working to build a better process.

Technology now exists to support disruptive innovation in health care. It is an important enabler, but the process must precede the technology. For example, Hospital at Home is an innovation that may well cut the cost of care significantly by reducing the need for inpatient beds. It couldn’t happen without the technology, which allows 24-hour monitoring of patients, real-time electronic communication between providers, and complex equipment to be rapidly set up in the patient home. But it still requires a nurse and a doctor.

What that nurse and doctor do and how they do it are still what will determine successful outcomes of care. Building the care process through careful understanding of what each process step delivers is critical. The medical team can then leverage the technology for data and communication and other needs that support the steps in the process.

Again, this requires standardized work. Every nurse and doctor does not get to do it his or her own way. Standards are established about how the work is performed, and those standards are followed by all until a better way is determined collectively by the team. New innovative care models such as Hospital at Home are based on clear and reproducible standards and will obsolete the old ways of the non-standardized care delivered in most hospitals.


It takes more design time to create a care model that builds in quality and efficiency, but without that work upfront, the technology doesn’t matter and, in fact, only increases costs. This thinking is not new. Many industries from aviation to automotive to nuclear power have been applying this concept of “process before technology” for a long time. The safety and quality results in those industries is second to none. It’s about time health care catches up. Our lives may depend on it.

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More evidence essential oils ‘make male breasts develop’

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A suspected link between abnormal breast growth in young boys and the use of lavender and tea tree oils has been given new weight, after a study found eight chemicals contained in the oils interfere with hormones.

Gynaecomastia is rare, and there is often no obvious cause.

But there have been a number of cases linked to use of these essential oils.

The American study found that key chemicals in the oils boost oestrogen and inhibit testosterone.

Not everyone will have the same reaction to an essential oil.

The plant-derived oils are found in a number of products such as soaps, lotions, shampoos and hair-styling products. They’re also popular as alternative cleaning products and medical treatments.

Lead researcher J. Tyler Ramsey from the National Institute of Environmental Health Sciences (NIEHS), in North Carolina, suggested caution when using the oils.

“Our society deems essential oils as safe. However, they possess a diverse amount of chemicals and should be used with caution because some of these chemicals are potential endocrine disruptors.”

A growing number of reported cases of male gynaecomastia have coincided with topical exposure to the oils.

After they stopped using the products, the symptoms subsided.

A previous study by Dr Kenneth Korach – who was also co-investigator for this study – found that lavender and tea tree oil had properties that competed with or hindered the hormones that control male characteristics, which could affect puberty and growth.

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The new study looked at eight key chemicals from the hundreds that make up the oils. Four of the tested chemicals appear in both oils and the others were in either oil.

They were tested on human cancer cells in the laboratory to measure the changes.

The researchers found all eight demonstrated varying degrees of promoting oestrogen and/or inhibiting testosterone properties.

“Lavender oil and tea tree oil pose potential environmental health concerns and should be investigated further,” said Mr Ramsey.

Many of the chemicals tested appear in at least 65 other essential oils, which is of concern, he added.

Essential oil guidelines

  • Precautions should be observed when using essential oils since they are highly concentrated
  • Do not apply undiluted essential oils directly to the skin
  • Never use undiluted oils on children under the age of three
  • If you are pregnant you should seek the advice of your doctor, midwife before using essential oils
  • When used appropriately, essential oils and aromatherapy products are safe for all the entire family
  • Source: Aromatherapy Trade Council

Prof Ieuan Hughes, emeritus professor of paediatrics at the University of Cambridge said the findings “have confirmed why an individual using such oils containing these chemicals may develop breast tissue”.

“The anti-male hormone effects are rather unexpected and it is not possible to comment further without the data.

“Of course, not everyone exposing themselves to such oils has adverse effects, so it is possible there are particular individuals who may be more sensitive to the effects of the chemicals, or perhaps are using the products in excess.

He said attention should be given to better regulation of these products.

Prof Hughes added: “Clearly, the longer-term effects of such exposure are unknown.”

Dr Rod Mitchell, honorary consultant paediatric endocrinologist at the Queens Medical Research Institute in Edinburgh said the study “is important in establishing a possible mechanism for the suggested link between gynaecomastia and exposure to lavender and tea tree oils”.

“However, there are important factors that must be taken into account when interpreting these results. The tests are conducted in cancer cells, which may not represent the situation in normal breast tissue.

“The concentration (dose) to which the cells are exposed may not be equivalent to exposure in humans. There is a complex relationship between oestrogen, testosterone and other hormones in the body, that cannot be replicated in these experiments.”

He called for further larger studies.

“At present, there is insufficient evidence to support the concept that exposure to lavender and tea tree oil containing products cause gynaecomastia in children, and further epidemiological and experimental studies are required.”

The study results will be presented on 19 March at the Endocrine Society’s annual meeting in Chicago.

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